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1.
Artigo em Inglês | MEDLINE | ID: mdl-36089787

RESUMO

BACKGROUND: Credentials of molecular diagnostic approaches are an important goal. Since protein-protein interaction (PPI) network analysis is an apposite method for molecular valuation, a PPI grid related to Intrinsically Disordered Proteins (IDPs) of RA was targeted in the present research. AIM: The aim of the study is to analyse the role of highly disordered proteins and their functional parameters in causing Rheumatoid Arthritis (RA). METHODS: Cytoscape software helped in identifying molecular interaction networks. Intrinsically disordered proteins lack higher order structure and have functional advantages, but their dysregulation can cause several diseases. All the significant proteins responsible for RA were identified. On the basis of the data obtained, highly disordered proteins were selected. Further, MSA was done to find the similarity among the highly disordered proteins and their functional partners. To determine the most relevant functional partner( s)/interacting protein(s) out of large network, three filters were introduced in the methodology. RESULTS: The two filtered proteins, IBSP and FGF2, have common functions and also play a vital role in the pathways of RA. Thus, gives an in-depth knowledge of molecular mechanisms involved in Rheumatoid Arthritis and targeted therapeutics. CONCLUSION: The network analysis of these proteins has been explored using Cytoscape, and the proteins with favourable values of graph centrality parameters such as IBSP and FGF2 are identified. Interesting functional cross talk such as bio mineralization, boneremodelling, angiogenesis, cell differentiation, etc., of SPP1 with IBSP and FGF2 is found, which throws light into the fact that these two proteins play a vital role in the pathways of RA.


Assuntos
Artrite Reumatoide , Proteínas Intrinsicamente Desordenadas , Humanos , Proteínas Intrinsicamente Desordenadas/química , Osteopontina/metabolismo , Fator 2 de Crescimento de Fibroblastos/metabolismo , Mapas de Interação de Proteínas , Artrite Reumatoide/diagnóstico
2.
Head Neck ; 44(11): 2473-2480, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35920377

RESUMO

INTRODUCTION: Lip reconstruction aims at maintaining the function and aesthetics of the facial subunits. Sensation in the reconstructed lip helps in bolus formation, tactile discrimination, and thermal sensation. In this study, we aim to describe random pattern nasolabial flap for lip reconstruction using various functional parameters. METHODOLOGY: This is a retrospective study of 22 patients with carcinoma lip who underwent surgical resection and reconstruction with sensate nasolabial flap. Several clinicopathological parameters were studied. Outcome parameters like oral competence, tactile sensation, thermal sensitivity of reconstructed lip and speech outcomes were evaluated. RESULT: A functional outcome with 2-4 mm of two-point discrimination was obtained in 19 patients. All patients had intelligible speech. A mean sulcus depth of 19.59 mm was achieved. One patient had partial flap loss owing to wound infection. CONCLUSION: Random pattern senate nasolabial flap offers a good functional outcome by maintaining the tactile and thermal sensitivity.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Labiais , Procedimentos de Cirurgia Plástica , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Lábio/patologia , Lábio/cirurgia , Neoplasias Labiais/cirurgia , Estudos Retrospectivos , Retalhos Cirúrgicos/patologia , Resultado do Tratamento
3.
Genes (Basel) ; 13(5)2022 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-35627186

RESUMO

Although metabolic acidosis is associated with numerous pathophysiological conditions and its vasorelaxation effects have been well described in different animal and culture models, the molecular mechanisms of acidosis-induced vasorelaxation are not fully understood. Mesenteric artery models have been used extensively to examine the vascular response to various pathophysiological conditions. Our previous studies and several other reports have suggested the vascular responses of goat mesenteric arteries and human arteries to various stimuli, including acidic stress, are highly similar. In this study, to further identify the signaling molecules responsible for altered vasoreactivity in response to acidic pH, we examined the proteomic profile of acid stress-induced vasorelaxation using a goat mesenteric artery model. The vascular proteomes under acidic pH were compared using 2D-GE with 7 cm IPG strips and mini gels, LC-MS/MS, and MALDI TOF MS. The unique proteins identified by mass spectroscopy were actin, transgelin, WD repeat-containing protein 1, desmin, tropomyosin, ATP synthase ß, Hsp27, aldehyde dehydrogenase, pyruvate kinase, and vitamin K epoxide reductase complex subunit 1-like protein. Out of five protein spots identified as actin, three were upregulated > 2-fold. ATP synthase ß was also upregulated (2.14-fold) under acid stress. Other actin-associated proteins upregulated were transgelin, desmin, and WD repeat-containing protein 1. Isometric contraction studies revealed that both receptor-mediated (histamine) and non-receptor-mediated (KCl) vasocontraction were attenuated, whereas acetylcholine-induced vasorelaxation was augmented under acidosis. Overall, the altered vasoreactivity under acidosis observed in the functional studies could possibly be attributed to the increase in expression of actin and ATP synthase ß.


Assuntos
Acidose , Vasodilatação , Acidose/metabolismo , Actinas/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Cromatografia Líquida , Desmina/metabolismo , Artérias Mesentéricas/metabolismo , Óxido Nítrico Sintase , Proteômica , Espectrometria de Massas em Tandem
4.
Expert Rev Neurother ; 21(12): 1455-1472, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34756134

RESUMO

INTRODUCTION: Dementia is a progressive neurodegenerative disorder impairing memory and cognition. Alzheimer's Disease, followed by vascular dementia - the most typical form. Risk factors for vascular dementia include diabetes, cardiovascular disease, hyperlipidemia. Lipids' levels are significantly associated with vascular changes in the brain. AREAS COVERED: The present article reviews the cholesterol metabolism in the brain, which includes: the synthesis, transport, storage, and elimination process. Additionally, it reviews the role of cholesterol in the pathogenesis of dementia and statin as a therapeutic intervention in dementia. In addition to the above, it further reviews evidence in support of as well as against statin therapy in dementia, recent updates of statin pharmacology, and demerits of use of statin pharmacotherapy. EXPERT OPINION: Amyloid-ß peptides and intraneuronal neurofibrillary tangles are markers of Alzheimer's disease. Evidence shows cholesterol modulates the functioning of enzymes associated with Amyloid-ß peptide processing and synthesis. Lowering cholesterol using statin may help prevent or delay the progression of dementia. This paper reviews the role of statin in dementia and recommends extensive future studies, including genetic research, to obtain a precise medication approach for patients with dementia.


Assuntos
Doença de Alzheimer , Inibidores de Hidroximetilglutaril-CoA Redutases , Doença de Alzheimer/tratamento farmacológico , Peptídeos beta-Amiloides/metabolismo , Encéfalo/metabolismo , Colesterol , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
5.
Sci Rep ; 10(1): 8074, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32415277

RESUMO

Interactions between proteins and ligands, which are fundamental to many biochemical processes essential to life, are mostly studied at dilute buffer conditions. The effects of the highly crowded nature of biological cells and the effects of liquid-liquid phase separation inducing biomolecular droplet formation as a means of membrane-less compartmentalization have been largely neglected in protein binding studies. We investigated the binding of a small ligand (ANS) to one of the most multifunctional proteins, bovine serum albumin (BSA) in an aqueous two-phase system (ATPS) composed of PEG and Dextran. Also, aiming to shed more light on differences in binding mode compared to the neat buffer data, we examined the effect of high hydrostatic pressure (HHP) on the binding process. We observe a marked effect of the ATPS on the binding characteristics of BSA. Not only the binding constants change in the ATPS system, but also the integrity of binding sites is partially lost, which is most likely due to soft enthalpic interactions of the BSA with components in the dense droplet phase of the ATPS. Using pressure modulation, differences in binding sites could be unravelled by their different volumetric and hydration properties. Regarding the vital biological relevance of the study, we notice that extreme biological environments, such as HHP, can markedly affect the binding characteristics of proteins. Hence, organisms experiencing high-pressure stress in the deep sea need to finely adjust the volume changes of their biochemical reactions in cellulo.


Assuntos
Naftalenossulfonato de Anilina/química , Soroalbumina Bovina/química , Soroalbumina Bovina/metabolismo , Estresse Mecânico , Água/química , Animais , Bovinos , Interações Hidrofóbicas e Hidrofílicas , Pressão , Ligação Proteica , Conformação Proteica
6.
Chem Commun (Camb) ; 56(3): 395-398, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31820766

RESUMO

We studied the combined effects of an aqueous two-phase system (ATPS) invoking liquid-liquid phase separation and pressure on an enzymatic hydrolysis reaction. We show that simple steric crowding effects are not able to explain the kinetic constants and their pressure dependence in the ATPS. Additional contributions, such as changes in water activity and non-specific weak interactions with ATPS components have to be invoked to explain the results obtained. The findings are relevant for understanding cellular processes of piezophiles and might have significant bearings on biotechnological applications using liquid-liquid phase separation and pressure in concert for modulating enzymatic reactions.

7.
Catheter Cardiovasc Interv ; 91(2): 175-179, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29193753

RESUMO

OBJECTIVES: The aim of the Hybrid Video Registry (HVR) is to assess the acute safety and efficacy of the Hybrid Approach in comparison to other contemporary methods of CTO-PCI. BACKGROUND: Recently, multiple techniques in Percutaneous Coronary Intervention (PCI) for coronary Chronic Total Occlusions (CTO) have been synthesized into a method referred to as the "Hybrid Approach". METHODS: About 194 video-taped timed live cases from CTO-PCI training workshops were analyzed by independent data abstractors and compared to three contemporary CTO-PCI registries stratified by case complexity based on the J-CTO score. RESULTS: Overall procedural success was 95% of all cases attempted with an excellent safety profile. In the most complex lesion subset, which made up 45% of all HVR cases, success was 92.8%, which was significantly higher than either the Royal Bromptom (78.9%), or Japanese-CTO (73.3%) registries, P = 0.04 Hybrid vs. Royal Brompton, P = 0.006 Hybrid vs. Japanese-CTO). The Hybrid Approach was also associated with shorter procedure times and lower contrast utilization. CONCLUSIONS: In a real world angiographic registry of complex CTOs, the Hybrid Approach to CTO-PCI is safe, and may be superior to other contemporary approaches to CTO intervention with respect to procedural success and efficiency among a diverse group of operators and lesion complexity. © 2017 Wiley Periodicals, Inc.


Assuntos
Oclusão Coronária/cirurgia , Intervenção Coronária Percutânea/métodos , Gravação em Vídeo , Angiografia Coronária , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/fisiopatologia , Humanos , Japão , Duração da Cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Complicações Pós-Operatórias/etiologia , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Reino Unido , Estados Unidos
8.
J Hazard Mater ; 336: 71-80, 2017 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-28475914

RESUMO

Arsenic (As) is a toxic environmental contaminant and potential human carcinogen. Chronic intake of arsenic-contaminated water and food leads to arsenicosis, a major public health problem in many parts of the world. Early detection of arsenic toxicity would greatly benefit patients; however, the detection of arsenicosis needs to be done early before onset of severe symptoms in which case the tools used for detection have to be both sensitive and reliable. In this context, the present study investigated plasma proteome changes in arsenic-exposed Labeo rohita, with the aim of identifying biomarkers for arsenicosis. Changes in the plasma proteome were investigated using gel-based proteomics technology. Using quantitative image analysis of the 2D proteome profiles, 14 unique spots were identified by MALDI-TOF/TOF MS and/or LC-MS/MS which included Apolipoprotein-A1 (Apo-A1) (6 spots), α-2 macroglobulin-like protein (A2ML) (2 spots), transferrin (TF) (3 spots) and warm-temperature acclimation related 65kDa protein (Wap65). The proteome data are available via ProteomeXchange with identifier PXD003404. Highly abundant protein spots identified in plasma from arsenic-exposed fish i.e. Apo-A1 (>10-fold), A2ML (7-fold) and Wap65 (>2-fold) indicate liver damage. It is proposed that a combination of these proteins could serve as useful biomarkers of hepatotoxicity and chronic liver disease due to arsenic exposure.


Assuntos
alfa-Globulinas/metabolismo , Intoxicação por Arsênico/diagnóstico , Arsênio/toxicidade , Carpas/sangue , Doença Hepática Crônica Induzida por Substâncias e Drogas/diagnóstico , Fígado/efeitos dos fármacos , Proteômica , Poluentes Químicos da Água/toxicidade , Animais , Apolipoproteína A-I/sangue , Biomarcadores/sangue , Doença Hepática Crônica Induzida por Substâncias e Drogas/sangue , Cromatografia Líquida , Modelos Animais de Doenças , Diagnóstico Precoce , Eletroforese em Gel Bidimensional , Proteínas de Peixes/sangue , Humanos , Limite de Detecção , Reprodutibilidade dos Testes , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Espectrometria de Massas em Tandem , Transferrina/metabolismo
9.
Res Vet Sci ; 108: 76-84, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27663374

RESUMO

The study explored antagonistic activity of the cellular components of potential probiotic bacteria from mrigal (Cirrhinus mrigala) against fish pathogens with a basic insight of the chemical nature of the antagonistic compound. Totally 208 autochthonous gut bacteria were isolated, of which 22 strains revealed antagonism towards ≥2 of the six common fish pathogens. Zones of inhibition (halo diameter) were presented as score and the four most promising strains were selected as putative probiotics based on the cumulative score assigned. Further, evaluation of different cellular components exhibited bactericidal activity against the fish pathogens. Verification of other probiotic properties revealed that each of the selected strains produced diverse extra-cellular enzymes. The selected strains grew better in intestinal mucus than skin mucus, were resistant to diluted bile juice (2-20%) and safe for the target fish. The extracellular product used as crude bacteriocin revealed thermostability (up to 90°C) and activity over wide pH range (4-9). Partial loss of activity through treatment with proteinase-K and trypsin indicated proteinaceous nature of the antibacterial compound produced by the probiotic strains. 16S rRNA partial gene sequencing revealed that the four strains CM1FG7, CM1HG5, CM3FG19 and CM3HG10 were similar to Bacillus stratosphericus (KM277362), Bacillus aerophilus (KM277363), Bacillus licheniformis (KM277364) and Solibacillus silvestris (KM277365), respectively.


Assuntos
Antibacterianos/farmacologia , Bactérias/química , Bactérias/efeitos dos fármacos , Bacteriocinas/farmacologia , Carpas/microbiologia , Probióticos/farmacologia , Animais , Bactérias/genética , Microbioma Gastrointestinal , RNA Ribossômico 16S/genética , RNA Ribossômico 16S/metabolismo , Análise de Sequência de DNA/veterinária
10.
Electrophoresis ; 37(12): 1704-17, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27058960

RESUMO

The present study was undertaken to investigate the proteomic changes in the liver of murrel Channa striatus exposed to high temperature stress. Fishes were exposed to 36°C for 4 days and liver proteome changes were analyzed using gel- based proteomics, i.e. 2DE, MALDI-TOF/TOF-MS, and validation by transcript analysis. The study showed, besides others, increased abundance of two sets of proteins, the antioxidative enzymes superoxide dismutase (SOD), ferritin, cellular retinol binding protein (CRBP), glutathione-S-transferase (GST), and the chaperones HSP60 and protein disulfide isomerase; this was validated by transcript analysis. The proteome data are available via ProteomeXchange with identifier PXD002608. Further, gene expression analysis was also carried out in the fishes exposed to thermal stress for longer durations (30 days experimental exposure in laboratory and for 30 days beyond, taking Channa collected from a hot spring runoff at 36-38°C); sod, gst, crbp, and hsp60 were found to continue to remain upregulated at eight-, 2.5-, 2.4-, and 2.45-fold, respectively, in the hot spring runoff fish. Pathway analysis showed that the upregulations of the antioxidant enzymes as well as molecular chaperones are induced by the transcription factor Nrf2 (nuclear factor erythroid 2-related factor 2). Thus, while short-term heat stress tolerance involves the antioxidative enzymes SOD, ferritin, CRBP, GST, and chaperones HSP60 and protein disulfide isomerase, adaptation under chronic heat stress is associated with SOD, CRBP, GST, and HSP60.


Assuntos
Peixes/anatomia & histologia , Resposta ao Choque Térmico/genética , Fígado/metabolismo , Proteômica/métodos , Animais , Chaperonina 60/genética , Perfilação da Expressão Gênica , Glutationa Transferase/genética , Temperatura Alta , Proteínas Celulares de Ligação ao Retinol/genética , Superóxido Dismutase/genética , Regulação para Cima
11.
Fish Physiol Biochem ; 41(3): 789-802, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25810140

RESUMO

Muscle tissues contribute 34-48 % of the total body mass in fish. Proteomic analysis enables better understanding of the skeletal muscle physiology and metabolism. A proteome map reflects the general fingerprinting of the fish species and has the potential to identify novel proteins which could serve as biomarkers for many aspects of aquaculture including fish physiology and growth, flesh quality, food safety and aquatic environmental monitoring. The freshwater catfish Rita rita of the family Bagridae inhabiting the tropical rivers and estuaries is an important food fish with high nutritive value and is also considered a species of choice in riverine pollution monitoring. Omics information that could enhance utility of this species in molecular research is meager. Therefore, in the present study, proteomic analysis of Rita rita muscle has been carried out and functional genomics data have been generated. A reference muscle proteome has been developed, and 23 protein spots, representing 18 proteins, have been identified by MALDI-TOF/TOF-MS and LC-MS/MS. Besides, transcript information on a battery of heat shock proteins (Hsps) has been generated. The functional genomics information generated could act as the baseline data for further molecular research on this species.


Assuntos
Peixes-Gato/genética , Peixes-Gato/metabolismo , Fibras Musculares de Contração Rápida/metabolismo , Filogenia , Proteoma/metabolismo , Animais , Sequência de Bases , Cromatografia Líquida , Análise por Conglomerados , DNA Complementar/genética , Eletroforese em Gel de Poliacrilamida , Índia , Dados de Sequência Molecular , Proteoma/genética , Proteômica/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , Homologia de Sequência , Espectrometria de Massas em Tandem
12.
Fish Shellfish Immunol ; 44(1): 43-9, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25652292

RESUMO

Immune system is fundamental for survival of an organism against invading pathogens and other harmful agents. Cytokines, the signaling proteins that are produced transiently after cell activation and exert pleiotropic effects on cells of the immune system, are important mediators of cell mediated immune response. When expressed in a dysregulated fashion cytokines can underlie either immunodeficient or immunopathologic states. Heat shock proteins (stress proteins, HSPs) are also key proteins, which play important role in immunomodulation, apoptosis and influence the immune responses. Arsenic is a major toxic environmental contaminant and a human carcinogen. Prolonged drinking of arsenic-contaminated water leads to chronic arsenic toxicity (arsenicosis). Arsenic is also immunotoxic and renders the host immunocompromised. Arsenic exposure has been reported to result in growth retardation, gross pathology including skin and eye lesions, ulcerations, cataract development etc. in different fish species. The present study was undertaken to investigate the effect of arsenic exposure on the expression of immune genes IFN-γ, IL-4, IL-10, IL-12, complement C3a and HSP genes HSP47, HSP60, HSP70, HSC71, HSP78, and HSP90 in Labeo rohita, an important aquacultured species, as such information is not available on this major carp. Cytokine and HSP gene expression analyses were carried out in kidney and liver tissues, respectively, in arsenic-exposed fishes by RT-PCR and HSPs were analyzed by immunoblotting. It was observed that arsenic has a generalized immune-suppressive effect leading to down regulation of both Th1 and Th2 cytokines; besides, it led to up regulation of the HSP genes indicating arsenic-induced cellular stress. Thus arsenic exposure makes L. rohita immunocompromised and could increase its susceptibility to pathogen attacks.


Assuntos
Arsênio/toxicidade , Cyprinidae/genética , Citocinas/genética , Proteínas de Peixes/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas de Choque Térmico/genética , Poluentes Químicos da Água/toxicidade , Animais , Cyprinidae/imunologia , Cyprinidae/metabolismo , Citocinas/metabolismo , Proteínas de Peixes/metabolismo , Proteínas de Choque Térmico/metabolismo , Imunomodulação , Dados de Sequência Molecular , Análise de Sequência de DNA/veterinária
13.
J Amino Acids ; 2014: 269797, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25379285

RESUMO

Proteins and amino acids are important biomolecules which regulate key metabolic pathways and serve as precursors for synthesis of biologically important substances; moreover, amino acids are building blocks of proteins. Fish is an important dietary source of quality animal proteins and amino acids and play important role in human nutrition. In the present investigation, crude protein content and amino acid compositions of important food fishes from different habitats have been studied. Crude protein content was determined by Kjeldahl method and amino acid composition was analyzed by high performance liquid chromatography and information on 27 food fishes was generated. The analysis showed that the cold water species are rich in lysine and aspartic acid, marine fishes in leucine, small indigenous fishes in histidine, and the carps and catfishes in glutamic acid and glycine. The enriched nutrition knowledge base would enhance the utility of fish as a source of quality animal proteins and amino acids and aid in their inclusion in dietary counseling and patient guidance for specific nutritional needs.

14.
Appl Biochem Biotechnol ; 171(4): 1011-21, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23925556

RESUMO

Detection of species-specific sarcoplasmic peptides can be used as proteomic markers for fish food authentication and identification of species of origin in processed products. In the present study, proteomics technology was employed for differential characterization of sarcoplasmic peptides of two closely related fish species, Sperata seenghala and Sperata aor. Species-specific peptides were searched in white muscle extracts of the two species for identification of unique peptides that might aid in differentiation of the species, under two-dimensional gel electrophoresis platform. A total of 19 proteins were identified by combined matrix-assisted laser desorption ionization time-of-flight mass spectrometry and liquid chromatography-tandem mass spectrometry, of which nine and two proteins were found to be unique to S. seenghala and S. aor, respectively. One of the proteins, triosephosphate isomerase (TPI) was found to have three isoforms, out of which two were specific to S. aor, and one was specific to S. seenghala. All the three isoforms of TPI were present in the mixed samples of raw protein extracts of S. seenghala and S. aor, an observation that can be exploited to differentiate between the species and detection of deceptive practices of fraudulent substitution of commercially valuable fish species with inferior ones and differential characterization between closely related fish species.


Assuntos
Peixes/classificação , Peixes/metabolismo , Animais , Eletroforese em Gel Bidimensional , Proteômica , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Espectrometria de Massas em Tandem
15.
Am J Cardiol ; 109(7): 960-5, 2012 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-22296739

RESUMO

Percutaneous coronary intervention (PCI) of bifurcation lesions remains challenging with a higher risk of adverse outcomes. Whether adjunctive intravascular ultrasound (IVUS) imaging improves outcomes of PCI of bifurcation lesions remains unclear. This study sought to determine the long-term clinical outcomes associated with using IVUS for percutaneous treatment of coronary bifurcation lesions. From April 2003 through August 2010, 449 patients with 471 bifurcation lesions underwent PCI with (n = 247) and without (n = 202) the use of IVUS. Clinical outcomes (death, myocardial infarction [MI], periprocedural MI, stent thrombosis, target vessel revascularization [TVR], and target lesion revascularization [TLR]) were compared between patients undergoing PCI with and without IVUS using univariate and propensity score-adjusted analyses. Most patients (61%) presented with acute coronary syndrome and 89% of bifurcations lesions were Medina class 1,1,1. After propensity score adjustment, use of IVUS was associated with significantly lower rates of death or MI (odds ratio 0.38, 95% confidence interval 0.20 to 0.74, p = 0.005), death (odds ratio 0.40, 95% confidence interval 0.18 to 0.88, p = 0.02), MI (odds ratio 0.37, 95% confidence interval 0.14 to 0.98, p = 0.04), periprocedural MI (odds ratio 0.45, 95% confidence interval 0.20 to 0.97, p = 0.04), TVR (odds ratio 0.28, 95% confidence interval 0.14 to 0.53, p <0.0001), and TLR (odds ratio 0.27, 95% confidence interval 0.14 to 0.53, p = 0.0003) compared to no IVUS. In conclusion, IVUS-guided treatment of complex bifurcation lesions was associated with significantly lower rates of adverse cardiac events at late follow-up. Further study is warranted to evaluate the role of IVUS guidance in improving long-term outcomes after PCI of bifurcation lesions.


Assuntos
Angioplastia Coronária com Balão , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/terapia , Ultrassonografia de Intervenção , Idoso , Algoritmos , Intervalos de Confiança , Estenose Coronária/mortalidade , Vasos Coronários , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento
16.
Am J Cardiol ; 99(7): 930-3, 2007 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-17398186

RESUMO

Complementary and alternative medicine (CAM) use is common in patients with cardiovascular disease. Although numerous efforts have sought to understand CAM types and the prevalence of CAM, whether patients preferentially use CAM instead of evidence-based therapies is unknown. Self-reported use of CAM and evidence-based therapies in a prospective registry of hospitalized patients with acute coronary syndrome from March 1, 2001 to October 31, 2002 were examined. Poisson regression models were used to assess whether CAM use was independently associated with lower rates of aspirin, beta-blocker, and statin use in 596 patients with established coronary artery disease (CAD). Overall, CAM use was 19% in patients with CAD. Higher proportions of patients who used CAM were non-Caucasian (31% vs 12%), uninsured (12% vs 7%), economically burdened (58% vs 29%), and had depression (13% vs 6%, p<0.05 for all). Patients who used CAM were more likely to use beta blockers (64% vs 46%, p=0.008) and as likely to use aspirin (73% vs 74%, p=0.90) and statins (71% vs 68%, p=0.76) as non-CAM users. Adjusting for demographic and clinical factors did not change results (CAM users: RR 1.27, 95% confidence interval [CI] 1.01 to 1.60 for using beta blockers, RR 0.97, 95% CI 0.85 to 1.11 for using aspirin, and RR 1.05, 95% CI 0.87 to 1.28 for using statins). In conclusion, although CAM users with established CAD have worse socioeconomic status than nonusers, we found no evidence that they were less compliant with evidence-based therapies.


Assuntos
Terapias Complementares/estatística & dados numéricos , Doença da Artéria Coronariana/terapia , Autorrevelação , Antagonistas Adrenérgicos beta/uso terapêutico , Idoso , Análise de Variância , Angina Instável/terapia , Aspirina/uso terapêutico , Doença da Artéria Coronariana/epidemiologia , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Pessoa de Meia-Idade , Missouri/epidemiologia , Infarto do Miocárdio/terapia , Distribuição de Poisson , Estudos Prospectivos , Sistema de Registros , Análise de Regressão , Projetos de Pesquisa , Fatores Socioeconômicos , Síndrome
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