>Magister Scientiae - MSc / Background: Malnutrition is a risk factor for the development of pulmonary tuberculosis (TB) and may be responsible for the premature deaths of patients with active disease. An adequate nutritional status may therefore be protective in delaying the onset from latent infection to active disease. In South Africa, very little data is available on the nutritional status of adults who present with tuberculosis. This study therefore aims to compare the nutritional status of newly diagnosed pulmonary tuberculosis patients with TB-free controls.Study population & Design: This is a community based case-control study. Forty-three newly diagnosed pulmonary tuberculosis patients were recruited as cases and matched according to age,gender and race to 43 TB-free close contacts. HIV positive subjects were excluded from the study.Methods: Each participant was interviewed and completed a structured questionnaire to obtain demographic information. Weight was measured to the nearest 0.1kg and height to the nearest 1mm. A 24-hr dietary recall method was used to obtain dietary information. Biochemical analysis was carried out to measure concentrations of transferrin, albumin, CRP, ferritin, zinc,copper, vitamin A and E.Results: The median Body Mass Index (BMI) for cases was 18.80kg/m² (IQR 14.35, 32.11) and TB-free contacts 21.17 kg/m² (IQR 16.75, 34.98) with a significant difference between the groups of p=0.001. There was significant difference in weight (p=0.002) and MUAC (p=0.000)between groups. No significant difference in dietary intake of energy (KJ) (p=0.695), protein(p=0.804), CHO (p=0.801) and fat ( p=0.796) was found between groups. There was a statistically significant increase in ferritin (p=0.000) and C-reactive protein (CRP) (p=0.000) in TB patients, while albumin (p=0.000), serum zinc (p=0.000) and serum vitamin A (p=0.000) were statistically significantly lower among cases. Conclusion: There was no significant difference in the macronutrient intake of TB cases and TB-free contacts, although a significant difference was seen in BMI, MUAC and weight between groups, with all these parameters being lower in TB patients. Ferritin and CRP levels were markedly increased in TB cases while serum zinc, vitamin A and albumin are all significantly lower in TB patients than TB free contacts.

Orientador: Helena Zerlotti Wolf Grotto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T15:00:17Z (GMT). No. of bitstreams: 1 Anjos_BarbaraLimados_M.pdf: 1374406 bytes, checksum: ec94e23babc71511d9a13089be02f29c (MD5) Previous issue date: 2009 / Resumo: Introdução: A resposta de fase aguda é composta de uma complexa rede de eventos envolvendo diversas células e mediadores pró e anti-inflamatórios. O diagnóstico clínico dessa condição nem sempre é facilmente obtido. O desempenho de diversos marcadores da resposta aguda é constantemente avaliado em variados grupos de doença, com o objetivo de otimizar o diagnóstico, proporcionando ao médico e ao paciente uma definição terapêutica precisa e em curto espaço de tempo. Além de parâmetros como os relacionados aos leucócitos e velocidade de hemossedimentação, a determinação de proteínas como a proteína C reativa (PC-R) e a amilóde sérico A (SAA) são propostas como úteis na detecção da presença do processo inflamatório/infeccioso. O objetivo do presente estudo foi a avaliação de alguns marcadores da resposta inflamatória, comparando a eficiência entre eles na identificação de crianças atendidas num Serviço de Urgência com suspeita de apresentarem inflamação ou infecção, além disso, nas crianças com quadro suspeito de dengue avaliar tais parâmetros. Materiais e métodos: Foram estudadas 90 crianças com idade entre 1 mês e 10 anos atendidas na Unidade de Emergência Referenciada do Hospital das Clínicas da UNICAMP. De acordo com os dados clínicos, consulta dos prontuários e exames subsidiários, essas crianças foram divididas em grupo inflamatório (n= 17) e infeccioso (n= 66) e dentro do infeccioso em sugestivo de infecção bacteriana, viral e dengue. Foram avaliados os seguintes parâmetros: contagem de leucócitos e presença de granulócitos imaturos por equipamentos hematológicos automatizados e por observação microscópica do esfregaço de sangue; dosagem de PC-R por 2 sistemas, determinação dos níveis de SAA e IL-6 por kits comerciais. Resultados: O melhor marcador do processo inflamatório/infeccioso foi a PC-R (> 80% de positividade pelos 2 sistemas), seguido da SAA (73,3%) e da VHS (72,1%). A contagem de leucócitos e a detecção de granulócitos imaturos revelaram desempenho inferior ao recomendado, não sendo úteis para o diagnóstico. Não houve diferença nos valores de leucócitos, VHS, PC-R, SAA e IL-6 entre os grupos inflamatório e infeccioso, mas apresentaram níveis superiores no grupo bacteriano quando comparado ao viral a contagem de leucócitos, níveis de PC-R e SAA. Nos pacientes com suspeita clínica de dengue apresentaram níveis inferiores de leucócitos e plaquetas e quanto aos marcadores séricos a VHS apresentou valores significativamente diminuídos. Conclusões: A PC-R foi o biomarcador com melhor desempenho no grupo de crianças estudado, enquanto as informações fornecidas pelo hemograma identificaram o menor número de pacientes. Os resultados da SAA foram semelhantes aos da PC-R sendo, portanto, discutível a sua utilização na rotina diagnóstica. De acordo com os nossos dados, deve ser encorajada a associação da interpretação de mais de um parâmetro na detecção do processo inflamatório/infeccioso. / Abstract: Introduction: the acute-phase response consists of a complex network of events involving various cells and pro anti-inflammatory mediators. The clinical diagnosis of this condition is not always easily obtained. The performance of several markers of the acute response is constantly evaluated in different groups of diseases, aiming to optimize the diagnosis and in order to establish a precise therapeutic in a short time. In addition to parameters such as those related to leukocyte and erythrocyte sedimentation rate (ESR), the determination of levels of proteins such as C-reactive protein (CR-P) and serum amyloid A (SAA) are proposed as useful in detecting the presence of the inflammatory/infection process. The objective of this study was the assessment of some markers of inflammatory response, comparing the efficiency among them in identifying children from the emergency room with infection or inflammation suspicious. Materials and methods: a total of 90 children aged between 1 month and 10 years with a clinical suspicious to have inflammation or infection diseases attended in the Emergency Unit of Clinical Hospital of the UNICAMP were enrolled. According to clinical data, medical records and subsidiary exams, these children were divided into inflammatory (n = 17) and infectious groups (n = 66). Infectious group was subdivided into bacterial or viral infection. The following parameters were evaluated: white blood cell count and presence of immature granulocytes by automated hematology equipment and microscopic observation of blood smears, determination of PC-R by 2 systems, and measurement of SAA and IL-6 levels by commercial kits. Results: the best marker of the inflammatory/infection process was the CR-P (> 80% positivity from both systems), followed by SAA (73.3%) and ESR (72.1%). The leukocyte count and the detection of immature granulocytes showed performance below the recommended and, consequently not useful for diagnosis. There was no difference in the values of leukocytes, ESR, CR-P, SAA and IL-6 between inflammatory and infectious groups, but higher leukocyte counting, PC-R and SAA levels were observed in the bacterial group when compared to the viral one. Conclusions: The CR-P was the biomarker with better performance in the group of children studied, while information supplied by the blood cells analysis identified the smallest number of patients. The results of SAA was similar to PC-R; therefore is questionable the SAA measurement utility in routine diagnosis. According to our data, the association of more than one parameter in the detection of the inflammatory/ infection response should be encouraged. / Mestrado / Ciencias Biomedicas / Mestre em Ciências Médicas

A manheimiose pneumônica bovina (MPB) gera significativa lesividade quando predomina no Complexo Doença Respiratória Bovina. Visto isso, considera-se importante o estudo do diagnóstico precoce para melhor estadiamento e tratamento da doença. As concentrações plasmáticas e séricas das proteínas de fase aguda (PFA) têm sido adotadas na medicina veterinária como marcadores precoces de doenças inflamatórias e algumas vezes, relacionadas ao bem-estar animal. O presente estudo objetivou revisar o painel inflamatório da MPB; investigar a contribuição que o emprego da flunixina meglumina no tratamento de bovinos manifestando MPB; e investigar marcadores inflamatórios para o diagnóstico precoce da doença e evolução do tratamento, empregando referências de bem estar animal. Para isto foram utilizados 12 bezerros da raça holandesa com seis meses de idade, hígidos e divididos em dois grupos experimentais, o primeiro tratado com antimicrobiano e o segundo com antimicrobiano e anti-inflamatório. Os animais foram submetidos à inoculação intratraqueal de M. haemolytica e tiveram suas amostras de lavado broncoalveolar e de sangue colhidas em quatro momentos, onde foram realizados exame clínico, coleta de sangue e lavado broncoalveolar para realização de hemograma, determinação das proteínas de fase aguda, análise de cortisol e cortisona. A análise estatística foi realizada utilizando programa SAS 9.3 para Windows. Os dados foram testados quanto à normalidade pelo teste de Shapiko Wilk, considerando significância de 5%. Foi efetuada a análise de variância simples com comparação entre médias por meio do teste de LSD, sendo considerado significante p<0.05. O resultados mostraram que a MPB é uma doença de grande importância no cenário mundial; não foram encontradas diferenças estatísticas entre os marcadores precoces entre os grupos com ou sem anti-inflamatório, porém o uso concomitante com o antimicrobiano promoveu incremento do bem estar. / The bovine pneumonic mannheimiosis (MPB) generates significant lesivity when it predominates in the Complex Bovine Respiratory Disease. Thus being important the study of the previous diagnosis for better understanding and treatment of the disease. As plasma and serum concentrations of acute phase proteins (PFA) have been adopted in veterinary medicine as early markers of inflammatory diseases and sometimes related to animal welfare. The aim of the study was review the inflammatory panel of MPB; to investigate a contribution that the use of flunixin meglumina without treatment of bovines manifesting MPB; and to investigate inflammatory markers for the previous diagnosis of the disease and treatment evolution, using references of animal welfare. Twelve six-month-old, healthy and divided into two experimental groups, the first treated with antimicrobial and the second with antimicrobial and anti-inflammatory were used in this study. The animals were submitted to intratracheal inoculation of M. haemolytica and had their bronchoalveolar lavage and blood samples collected at four moments, where clinical examination, blood collection and bronchoalveolar lavage were carried out to perform hemogram, determination of the acute phase proteins, analysis of cortisol and cortisone. Statistical analysis was performed using SAS 9.3 software for Windows. The data were tested for normality by the Shapiko Wilk test, considering a significance of 5%. The analysis of simple variance was performed with a comparison of means by means of the LSD test, being considered significant p <0.05. The results showed that MPB is a disease of great importance in the world scenario; no statistical differences were found between the early markers between the groups with or without anti-inflammatory, but the concomitant use with the antimicrobial promoted an increase in animal welfare.

Orientador: Luiz Cláudio Nogueira Mendes / Coorientador: Juliana Regina Peiró / Banca: Valéria Marçal Félix de Lima / Banca: José Paes de Oliveira Filho / Resumo: Objetivando-se avaliar as concentrações séricas de Interleucina 6 (IL-6) e proteinograma de ovinos submetidos à endotoxemia experimental. Dez ovinos (4 anos) foram divididos em dois grupos, Grupo Controle (GC, n=4) inoculados com NaCl 0,9 %, IV e Grupo Tratado (GT, n= 6) inoculados com 400 ng/Kg de LPS de Escheria coli. O exame físico foi realizado, imediatamente antes da inoculação (M0), bem como a coleta de sangue para perfil hematológico e bioquímico, dosagem de IL-6 e proteinograma. As amostras foram coletadas em M0 e após 2, 4, 6, 12, 24, 36, 48 e 60 horas, de realizada a inoculação. A dosagem de IL-6 foi feita pelo método de ELISA e o proteinograma pelo método de eletroforese em poliacrilamida com dodecil sulfato de sódio (SDS-PAGE), para o perfil hematológico utilizou-se contador de células automático (BCVet- 2800), o perfil bioquímico foi realizado utilizando-se kits comerciais (Labtest®) e por fim, a concentração de glicose foi mensurada por meio de um monitor de glicemia (Breeze 2, Bayer®). Constatou-se um aumento na concentração de IL-6 60 horas pós-inoculação de LPS. O pico febril ocorreu quatro horas pós-indução endotoxêmica. Constatou- se leucopenia com neutropenia e redução na concentração da proteína total, albumina e glicoproteína ácida duas horas após a administração de LPS, acompanhados por uma elevação inicial na concentração de glicose, seguida de redução, seis horas pós-inoculação. Concluiu-se que a dosagem de Interleucina 6 e o proteinograma sérico são métodos de diagnósticos eficientes para detectar e monitorar a progressão e gravidade de processos inflamatórios provenientes de uma endotoxemia induzida experimentalmente em ovinos / Abstract: Aiming to evaluate serum concentrations of interleukin 6 (IL-6) and proteinogram of sheep undergoing experimental endotoxemia. Ten animals (4 years old) were divided into two groups, Control Group (CG, n= 4) inoculated with NaCl 0,9%, IV and Treated Group (TG, n= 6) inoculated with 400 ng/Kg of LPS from Escheria coli. The physical examination was performed immediately before inoculation (M0), as well as blood collection for hematological and biochemical profiles, dosage of IL-6 and proteinogram. Samples were collected at M0 and after 2, 4, 6, 12, 24, 36, 48 and 60 hours after of inoculation. The dosage of IL-6 was done by ELISA and the proteinogram by method of eletrophoresis in polyacrylamide sodium dodecyl sulphate (SDS-PAGE), for hematological profile was used automatic cell counter (BC-2800Vet), the biochemical profile was performed using commercial kits (Labtest®) and the glucose concentrations was measured using glucose monitor (Breeze2, Bayer®). It was found an increase in the dosage of IL-6 60 hours after LPS injection. The fever peak occurred four hours after induction of endotoxemia. There was leukopenia, with neutropenia and reduction in concentration of total protein, albumin and acid glycoprotein two hours after LPS administration, accompanied by an initial increase in glucose concentrations followed by a reduction six hours post-inoculation. It was conclude that the dosage of IL-6 and the proteinogram are effective diagnostic methods to detect and monitor the progression and severity of inflammatory processes from an experimentallay induced endotoxemia in sheep / Mestre

Orientador: Marco Antonio de Andrade Belo / Resumo: O presente estudo investigou os efeitos da ciclofosfamida (CYP) na modulação de proteínas de fase aguda (APPs) e acúmulo celular em exsudatos presentes na bexiga natatória de tilápias (modelo de peixe de aerocistite) e o recrutamento de leucócitos na lamínula de vidro implantadas no tecido subcutâneo. Foram utilizadas 140 tilápias (Oreochromis niloticus) (± 150 g) distribuídas em 14 aquários com capacidade para 250 L de água (n = 10). Os animais foram distribuídos em dois ensaios: Experimento I: foram utilizados 80 animais distribuídos em quatro tratamentos: T1 - controle NAIVE; T2 - controle negativo + solução salina injetada NaCl; T3- controle positivo + injetado com Aeromonas hydrophila; T4- ciclofosfamida, Isopac ® Sigma (200 mg / kg, dose única, por via intraperitoneal) + injetado com A. hydrophila. As amostras de exsudato e sangue foram coletadas 6 e 24 horas após a infecção (HPI) para a contagem de células e determinação do fracionamento eletroforético das APPs por SDS-PAGE, digestão de proteínas em gel e identificação por espectrometria de massa. Experimento II: os peixes foram alocados (n=60) em 3 grupos experimentais: G1 - controle NAIVE; G2 – controle positivo + implante de lamínula; G3 - ciclofosfamida, Isopac ® Sigma (200 mg / kg, dose única, por via intraperitoneal) + implante de lamínula. Após serem anestesiados, foram submetidos ao implante da lamínula de vidro de 10mm de diâmetro no tecido subcutâneo. As amostras de sangue foram coletadas e as lamínulas foram... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The present study investigated the effects of cyclophosphamide (CYP) on the modulation of acute phase proteins (APPs) and cellular accumulation in exudates present in the swim bladder of tilapia (aerocystitis fish model) and the recruitment of leukocytes on a glass cover slip implanted in the subcutaneous tissue. One hundred forty tilapia (Oreochromis niloticus) (± 150 g) were distributed in 14 aquariums with capacity of 250 L (n = 10), for two trials. Experiment I: For this purpose, 80 fish were distributed in four treatments: T1 – naïve control; T2 - negative control + injected with NaCl solution; T3- positive control + injected with A. hydrophila; and T4- cyclophosphamide (200 mg/kg) + injected with A. hydrophila. Samples of exudate and blood were collected 6 and 24 hours post-inoculation (HPI) for cell counts and determination of the APP electrophoretic fractionation by SDS-PAGE, in-gel protein digestion and mass spectrometric identification. Experiment II: Fish were allocated (n = 60) in 3 experimental groups: G1 – naive control; G2 - positive control + coverlet implant; and G3 - cyclophosphamide (200 mg/kg, single dose intraperitoneally) + cover slip implant. The glass coverslips (10 mm diameter) were implanted after anesthetization in the subcutaneous tissue. Blood samples were collected and the coverslips were carefully removed and washed with 0.9% saline 74 and 144 hours implantation. Then they were fixed in Bouin's solution and stained with hematoxylineosin. The tot... (Complete abstract click electronic access below) / Doutor

The hepatic acute phase response (APR), stimulated by injury or inflammation, is characterized by significant changes in circulating acute phase protein (APP) concentrations. While individual functions of liver-derived APPs are known, the net consequence of APP changes is unclear. Pneumonia and sepsis elicit systemic inflammation and induce a robust APR. Although APR activation is regarded as a hallmark of infection, direct contributions of liver activation to pulmonary defense during pneumonia and sepsis-induced pneumonia remain unclear. Pneumonia causes a pulmonary inflammatory response coordinated largely by alveolar macrophages, and is typified by cytokine production, leukocyte recruitment and plasma extravasation, the latter of can enable delivery of hepatocyte-derived APPs to the infection site. To determine the functional significance of the hepatic APR during pneumonia, we challenged APR-null mice lacking hepatocyte signal transducer and activator of transcription-3 (STAT3) and RelA with 106 colony-forming units (CFU) Escherichia coli intratracheally. HepSTAT3/RelA-/- mice displayed ablated APP induction, significantly increased mortality, tumor necrosis factor-dependent hepatotoxicity, and pulmonary bacterial burdens. Following a lower (4x105 CFU) E. coli inoculum, hepSTAT3/RelA-/- mice had decreased APP concentrations with reduced pulmonary inflammation and diminished airspace macrophage activation. Similar results were obtained in the context of endotoxemia and pneumonia. We employed an endotoxemia/pneumonia model, whereby 18 hours of intraperitoneal E. coli lipopolysaccharide (5 mg/kg) was followed by intratracheal E. coli (106 CFU) in mice lacking hepatocyte STAT3 (hepSTAT3-/-) or control hepSTAT3+/+ mice. Following endotoxemia and pneumonia, hepSTAT3-/- mice, with significantly reduced levels of circulating and airspace APPs, exhibited significantly elevated lung and blood bacterial burdens and mortality. While neither recruited airspace neutrophils nor lung injury were altered in endotoxemic hepSTAT3-/- mice, in vivo production of reactive oxygen species in alveolar macrophage was significantly decreased. Additionally, bronchoalveolar lavage fluid from this group of hepSTAT3-/- mice allowed greater bacterial growth ex vivo. These results identify a lung-liver axis, whereby the liver response enhances macrophage activation and pulmonary host defense during pneumonia and sepsis-induced pneumonia. Taken together, induction of liver acute phase gene expression programs contributes to countering the deleterious consequences of pneumonia, whether it is alone or in the context of sepsis-induced infection.

C-reactive protein (CRP), a component of the innate immune system, is an antipneumococcal plasma protein. Human CRP has been shown to protect mice against infection with lethal doses of Streptococcus pneumoniae by decreasing bacteremia. in vitro, CRP binds to phosphocholine-containing substances, such as pneumococcal C-polysaccharide, in a Ca2+-dependent manner. Phosphocholine-complexed human CRP activates the complement system in both human and murine sera. The mechanism of antipneumococcal action of CRP in vivo, however, has not been defined yet. In this study, we tested a decades-old hypothesis that the complement-activating property of phosphocholine-complexed CRP contributes to protection of mice against pneumococcal infection. Our approach was to investigate a CRP mutant, incapable of activating murine complement, in mouse protection experiments. We employed site-directed mutagenesis of CRP, guided by its three-dimensional structure, and identified a mutant H38R which, unlike wild-type CRP, did not activate complement in murine serum. Substitution of His38 with Arg in CRP did not affect the pentameric structure of CRP, did not affect the binding of CRP to pneumococci, and did not decrease the stability of CRP in mouse circulation. Employing a murine model of pneumococcal infection, we found that passively administered H38R CRP failed to protect mice against infection. Infected mice injected with H38R CRP showed no reduction in bacteremia and did not survive longer, as opposed to infected mice treated with wild-type CRP. Thus, the hypothesis that complement activation by phosphocholine-complexed CRP is an antipneumococcal effector function was supported. We can conclude now that complement activation by phosphocholine-complexed CRP is indeed essential for CRP-mediated protection of mice against pneumococcal infection.

No description available.

Neste trabalho foram estudados os perfis renal, hepático, energético, hormonal e de proteínas de fase aguda (proteinograma) para avaliar possíveis interações com o desempenho reprodutivo em bovinos. Para isso, foram delineados três experimentos. No experimento 1 o objetivo foi verificar se a inseminação artificial (IA) causa alterações nos perfis renal, hepático, energético, hormonal e de proteínas de fase aguda e estudar as relações entre esses perfis e a hemodinâmica uterina. Foram utilizadas amostras de sangue de vacas Nelore que foram inseminadas (GIA, n=9) ou não (GC, n=9). As amostras foram coletadas 30 horas antes da IA, 4, 24, 48 e 168 horas após a IA. No experimento 2 o objetivo foi estudar os efeitos da qualidade do sêmen sobre o perfil hepático e proteinograma, e estudar a relação dos perfis renal, hepático, energético, hormonal e proteinograma sobre a vascularização uterina. Foram utilizadas amostras sanguíneas de 362 vacas, que foram divididas em três grupos experimentais de acordo com a qualidade do sêmen: Boa (n=121), Média (n=121) e Regular (n=120). As amostras foram coletadas 30 horas antes da IA, 4 e 24 horas após a IA. Por fim, o experimento 3 é um estudo retrospectivo, realizado com o objetivo de comparar os perfis renal, hepático, energético, hormonal, e proteínas de fase aguda entre animais prenhes e vazios após a IA, e verificar se há relação entre a hemodinâmica uterina e a fertilidade. Neste experimento, os animais foram divididos em dois grupos experimentais de acordo com o resultado da IA (prenhe, n=76 X vazia, n=45). Em todos os experimentos, nos mesmos momentos da coleta de sangue, foram realizadas avaliações ultrassonográficas do útero no modo color Doppler e espectral. As amostras dos experimentos 1, 2 e 3 foram submetidas à quantificação das proteínas de fase aguda e dos componentes metabólicos utilizando analisador bioquímico automático (RX Daytona) e à dosagem hormonal, pela técnica de radioimunoensaio. Os dados foram analisados pelo PROC MIXED (SAS, versão 9.2, 2010). Foram consideradas diferenças estatísticas quando P<0,05. No experimento 1, os grupos não diferiram quanto aos perfis renal, hepático, energético, hormonal e proteinograma, no entanto, o RI apresentou correlações positivas com AST e BHB e correlação negativa com estradiol. O estradiol também foi correlacionado com EV, entretanto essa correlação foi positiva. No experimento 2, os animais inseminados com sêmen B, M ou R apresentaram concentrações semelhantes das variáveis do perfil hepático e proteínograma. O RI foi correlacionado positivamente com colesterol, HDL, LDL, e progesterona, e negativamente com glicose, estradiol, albumina e proteína total. Já o EV apresentou correlações negativas com ureia, GGT e cortisol. No experimento 3, os grupos Vazio e Prenhe foram semelhantes quanto aos perfis renal, hepático, energético, hormonal, proteiograma e hemodinâmica uterina. Sendo assim, conclui-se que o processo da IA e a qualidade do sêmen utilizado não causam alterações sistêmicas, bem como a fertilidade não pode ser explicada por estas alterações. Adicionalmente, a hemodinâmica uterina é correlacionada com diversos parâmetros, no entanto, o padrão vascular do útero não mostrou relação com a fertilidade / In this study, were evaluated kidney, liver, energy, hormonal and acute phase proteins profiles to evaluate the possible interactions with the reproductive performance in cattle. For this, three experiments were designed. In experiment 1 the objective was to verify if artificial insemination (AI) causes changes in renal, liver, energetic, hormonal and acute phase proteins profiles and to study the relationship between these profiles and uterine hemodynamics. Blood samples from inseminated (GIA, n = 9) or non inseminated Nellore cows (CG, n = 9) were used. Samples were collected 30 hours before AI, 4, 24, 48 and 168 hours after AI. In experiment 2 the objective was to study the effects of semen quality on liver and protein profiles and study the relationship of renal, liver, energetic, hormonal and protein profiles on uterine vascularization. Blood samples of 362 cows were used, which were divided into three groups according to semen quality: Good (n = 121), medium (n = 121) and Regular (n = 1200. Samples were collected 30 hours before AI, 4 and 24 hours after AI. Finally, experiment 3 is a retrospective study, carried out in order to compare the renal, liver, energetic, hormonal, and acute phase proteins profiles between pregnant and non pregnant animals after AI, and check for relationship between uterine hemodynamics and fertility. In this experiment, animals were divided into two groups according to the result of AI (pregnant, n = 76 and non pregnant, n = 45). In all experiments, at the same time of blood sampling were performed sonographic evaluations of the uterus in color Doppler and spectral mode. The samples of experiments 1, 2 and 3 were subjected to quantification of acute phase proteins and metabolic components using automatic biochemical analyzer (RX Daytona) and to hormone dosage, by radioimmunoassay. Data were analyzed using PROC MIXED (SAS, version 9.2, 2010). Statistics differences were considered when P<0,05. In experiment 1, the groups did not differ about kidney, liver, energetic, hormonal and protein profiles, however, the RI showed positive correlations with AST and BHB and negative correlation with estradiol. Estradiol was also correlated with EV, however this correlation was positive. In experiment 2, the animals inseminated with semen B, M or R showed similar concentrations of the variables of liver and proteinogram profiles. The RI was positively correlated with cholesterol, HDL, LDL, and progesterone, and negatively with glucose, estradiol, albumin and total protein. EV showed negative correlations with urea, GGT and cortisol. In Experiment 3, the non pregnant and pregnant groups were similar about kidney, liver, energetic, hormonal, proteiogram profiles and uterine hemodynamics. Thus, in this study were not observed systemic changes caused by AI process and by quality of semen, and systemic differences did not notice is between non pregnant and pregnant animals. Additionally, uterine hemodynamic is correlated with various parameters, however, the vascular pattern of the uterus was not correlated with fertility

Die Arbeit untersucht die Akute Phase Reaktion nach erfolgreicher kardiopulmonaler Reanimation. Untersuchungsgegenstand war der Verlauf unterschiedlicher Akute Phase Proteine und Procalcitonin in Abhängigkeit von verschiedenen klinischen Parametern. Ebenso wurde das Verhalten der Akute Phase Proteine bei gesunden Probanden unter kontrollierter systemischer Hypoxie untersucht, da die Hypoxie als Auslöser der Akute Phase Reaktion diskutiert wird. Außerdem wurde betrachtet, welche Parameter sich für die Diagnose einer nach der Reanimation auftretenden Ventilator-assoziierten Pneumonie eignen. In die Untersuchung wurden 33 reanimierte Patienten eingeschlossen sowie 7 Probanden, die sich freiwillig einer hypobaren Hypoxie ausgesetzt hatten. Die wesentlichen Resultate sind: 1) Die untersuchten Akute Phase Proteine verhalten sich nach kardiopulmonaler Reanimation wie dies in der Literatur für andere Genesen beschrieben ist. Das Procalcitonin zeigt gewisse Charakteristika eines Akute Phase Proteins, wobei die Daten eine abschließende Beurteilung nicht ermöglichen. 2) Die Konzentrationsänderungen der Akute Phase Proteine treten bei allen Patienten unabhängig von ihrem Krankheitsverlauf auf. Schlussfolgerung ist, dass nach kardiopulmonaler Reanimation unabhängig von der Ursache regelmäßig eine Akute Phase Reaktion auftritt. 3) Die Probanden zeigten unter hypobarer Hypoxie keine Akute Phase Reaktion, obwohl ein Anstieg der Erythropoetin-Konzentration eine Aktivierung der sauerstoffabhängigen Genexpression anzeigte. Der Sauerstoffmangel reicht deshalb zur Erklärung der Akute Phase Reaktion als alleinige Ursache nicht aus. 4) Der Verlauf der untersuchten Akute Phase Parameter bleibt von einer Ventilator-assoziierten Pneumonie als Komplikation unbeeinflusst. Das Procalcitonin zeigte hingegen bereits frühzeitig im Verlauf deutliche Unterschiede zwischen Patienten mit und ohne Ventilator-assoziierte Pneumonie. / The thesis paper studies the acute phase reaction after successful cardiopulmonary resuscitation. Focus were different acute phase proteins as well as procalcitonin in relation to different clinical parameters. Also the course of these acute phase proteins during hypobaric hypoxia in volunteers was studied, because hyoxia is being discussed as a potential cause of the acute phase reaction. Additionally it was determined, which parameters are suitable to diagnose a ventilator-associated pneumonia after resuscitation. The study included 33 resuscitated patients as well as 7 volunteers undergoing a hypobaric hypoxia. The main results are: 1) The acute phase proteins studied behave after cardiopulmonary resuscitation as described in the literature for other causes. Procalcitonin show certain aspects of an acute phase protein, however, the data do not permit a final judgment. 2) The changes in concentration of the acute phase proteins take place in all patients regardless of the case history. It can be concluded that after cardiopulmonary resuscitation always an acute phase reaction occurs. 3) The volunteers undergoing hypobaric hypoxia showed no acute phase reaction, even though a rise in erythropoetin concentration indicated an oxygen-dependent gene expression. The hypoxia alone therefore is not a sufficient explanation for the development of the acute phase reaction. 4) The course of the acute phase proteins studied is not influenced by a ventilator-associated pneumonia as complication. The course of procalcitonin, however, shows early significant differences between patients with and without ventilator-associated pneumonia.