No description available.

The present study evaluated the frequency of major risk factors for atherothrombosis in patients with Chronic Obstructive Pulmonary Disease (COPD) in oxygen in both gender. The sample consisted of 62 individuals, 28 men and 34 women, mean age 71.8 ± 8.7 years, all members of the Home Care Program, Hospital de Clinicas, Universidade Federal de Uberlândia. COPD was diagnosed when there were clinical signs and symptoms with changes in spirometry [(Forced Expiratory Volume in one second by forced vital capacity (FEV1/FVC) &#8804; 0.7 boncodilatador post (BD)]. All subjects received regular treatment with inhaled corticosteroids, Tiotropium and ß-2 agonist with long duration. We evaluated the following risk factors for atherothrombosis: body composition [(body weight, body mass index (BMI) and waist to hip index (WHI)], fasting plasma glucose, plasma lipid profile [(Total Cholesterol (TC), HDL-cholesterol (HDL-C) and triglycerides (TG)], smoking and tobacco intake, sedentary lifestyle, blood pressure at rest, C-reactive protein highly sensitive (hsCRP), forced expiratory volume in first second (FEV1), heart rate (HR), hypoxemia and calculation of Framingham risk score (FRS). The statistical analysis used SPSS 13.0 for Windows and BioEstat 5.0. Mean comparisons were made using T test and U test of Mann-Whitney, adopting, as significant, p values <0.05. At final evaluation, it was observed that all subjects were sedentary, the rate of type 2 diabetes mellitus (T2DM) was 11.3%, the rate of hypertension (HBP) was 41.9% and 19.4% of the subjects smoked actively. The mean HR was 82.8 ± 13.9 bpm; partial pressure of oxygen in the blood (PO2) found the average was 48.4 ± 8.8 mmHg, the mean FEV1 was 35 ± 15%, median hsCRP was found to be 6.5 ± 13.6 mg / l. The average weight (kg) was 59, 3 ± 15.3, BMI 24.4 ± 5.5 and ICQ 1.0 ± 0.1. The ERF was below average in this population, probably by correcting hypoxemia and oxygen provided by the appropriate treatment of COPD . The elevated serum levels of TG, TC, LDL-C and fasting glucose, and presence of high levels of blood pressure and smoking were equally distributed in both gender. Serum HDL-C were significantly lower in men. Variables such as hsCRP, FC, and PO2 were also equally distributed between men and women, except for the FEV1, lower in men. Men had higher ERF (higher risk for MI or death in 10 years) and low HDL-C in men contributed decisively to this finding. FEV1 reduced CRP levels and hypoxemia characteristics were found across the sample, and these items are included in the risk factors for atherothrombosis. / O presente estudo investigou a frequência dos principais fatores de risco para aterotrombose em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) em oxigenoterapia em ambos os sexos. A amostra foi constituída por 62 indivíduos, 28 homens e 34 mulheres, com idade média de 71,8 ± 8,7 anos, todos integrantes do Programa de Assistência Domiciliar do Hospital de Clínicas da Universidade Federal de Uberlândia. A DPOC foi diagnosticada quando havia sinais e sintomas clínicos com alteração na espirometria [(Volume Expiratório Forçado no primeiro segundo pela Capacidade Vital Forçada (VEF1/CVF) &#8804; 0.7 pós broncodilatador (BD)]. Todos os indivíduos recebiam tratamento regular com corticóide inalatório, Tiotrópio e ß-2 agonista de longa duração. Foram avaliados os seguintes fatores de risco para aterotrombose: composição corporal [(peso corporal, Índice de Massa Corpórea (IMC) e Índice Cintura Quadril (ICQ)], glicemia de jejum, perfil lipídico plasmático [(Colesterol Total (CT), HDL-Colesterol (HDL-C) e triglicérides (TG)], tabagismo e carga tabágica, sedentarismo, pressão arterial sistêmica de repouso, Proteína C reativa ultra-sensível (PCRus), volume expiratório forçado no primeiro segundo (VEF1), frequência cardíaca de repouso (FC), hipoxemia e cálculo do Escore de Risco de Framingham (ERF). Para análise estatística foram utilizados os programas SPSS 13.0 for Windows e BioEstat 5.0. Foram feitas comparações de médias utilizando-se o teste T e o teste U de Mann-Whitney, adotando-se, como significantes, valores de p < 0,05. Ao final da avaliação foi observado que todos os indivíduos eram sedentários, a taxa de diabete melito tipo 2 (DM2) foi 11,3%, a taxa de Hipertensão Arterial Sistêmica (HAS) foi 41,9% e 19,4% dos indivíduos fumavam ativamente. A FC média foi 82,8 ± 13,9 bpm; a pressão parcial de oxigênio no sangue (PO2) média encontrada era 48,4 ± 8,8 mmHg; o VEF1 médio foi 35 ± 15%; a mediana do PCRus encontrada foi 6,5 ± 13,6 mg/l. A média de peso (kg) foi 59,3 ± 15,3 com IMC de 24,4 ± 5,5 e ICQ de 1,0 ± 0,1. O ERF em média foi baixo na população estudada, provavelmente por correção da hipoxemia proporcionada pela oxigenoterapia e pelo adequado tratamento da DPOC. Os valores séricos elevados de TG, CT, LDL-C e glicose de jejum, e presença de níveis altos da pressão arterial sistêmica e tabagismo estavam igualmente distribuídos em ambos os sexos. Níveis séricos de HDL-C foram significantemente mais baixos no homem. As variáveis como PCRus, FC e PO2 também estavam igualmente distribuídas entre homens e mulheres, exceto quanto ao VEF1, mais baixo nos homens. Os homens apresentaram ERF mais elevado (maior risco para IAM ou morte em 10 anos) e a redução do HDL-C em homens contribuiu de forma determinante para este achado. O VEF1 reduzido, PCR aumentada e hipoxemia foram características encontradas em toda a amostra estudada e estes itens estão incluídos nos fatores de risco para aterotrombose. / Mestre em Ciências da Saúde

Sur l’île de La Réunion, la prévalence du diabète de type 2 est 3,5 fois plus élevée que celle de la France hexagonale. Parmi les diverses complications qu’engendre le diabète, les AVC qui en résultent sont responsables d’une forte mortalité faisant des maladies cardiovasculaires un problème de santé publique majeur sur l’île. Les AVC ischémiques proviennent de l’occlusion d’une artère cérébrale par un thrombus généré localement ou qui s’est détaché d’une plaque d’athérothrombose généralement localisée au niveau des bifurcations carotidiennes. Les plaques compliquées sont souvent caractérisées par des hémorragies intraplaques, responsables de l’extravasation des cellules sanguines. Différents marqueurs moléculaires, protéiques et physiques peuvent refléter ces processus et renseigner le médecin sur l’instabilité de la plaque du patient. Il est donc important d’étudier ces marqueurs de risque de rupture de plaques carotidiennes chez les patients diabétiques, afin d’en prévenir les complications et la mortalité associée. L’hémorragie intraplaque, notamment pourvoyeuse d’érythrocytes et de neutrophiles libérant leurs contenus cytoplasmiques, participe activement à la déstabilisation de la plaque d’athérothrombose chez le diabétique. Cette thèse a permis l’étude de l’influence de ces marqueurs à travers une étude clinique et de proposer un nouveau concept de phagocytose des érythrocytes glyqués par les cellules endothéliales in vitro. Ainsi, les résultats préliminaires de l’étude clinique nous permettent de supposer que la clairance des globules rouges des patients diabétiques est altérée, ce qui leurs permettraient de résider sur une période plus longue dans les plaques de ces patients. De cette manière, les globules rouges pourraient y être pris en charge par d’autres types cellulaires comme les cellules endothéliales. Nous avons tout d’abord mis au point un modèle de glycation des érythrocytes in vitro reflétant un diabète mal équilibré. Nous avons ensuite mis en évidence que les globules rouges glyqués pouvaient être phagocytés par les cellules endothéliales humaines, conduisant à une prolifération limitée et à la surexpression de l’HO-1. Ces données suggèrent qu’une ingestion des érythrocytes glyqués par les cellules endothéliales pourrait amplifier la déstabilisation des plaques d’athérothrombose carotidiennes des diabétiques. / Type 2 diabetes prevalence in Reunion Island, a French overseas department, is 3.5 higher than in France mainland. Among the various diseases caused by diabetes, stroke induces high mortality making cardiovascular diseases a major public health problem on the island. Ischemic stroke results from a cerebral artery occlusion by a thrombus that is locally produced or has detached from an atherothrombotic plaque usually located at the carotid bifurcations. Complicated plaques can are often characterized by intraplaque hemorrhages, responsible for blood cell extravasation. Several molecular and physical markers can reflect these processes and inform the physician about the instability of the patient's plaque. It is therefore of major importance to study the markers of carotid plaque rupture in diabetic patients in order to prevent complications and associated mortality. Intraplaque hemorrhage, providing erythrocytes and neutrophils releasing their cytoplasmic contents, plays an active role in destabilizing atherothrombotic plaque in diabetic subjects. The objectives of the present thesis were to study these markers in a clinical study and to suggest a new concept of red blood cell phagocytosis by endothelial cells in vitro. According to the first results of the clinical study, we can suggest that in diabetic patients, the clearance of red blood cells is impaired. This prolonged residence of red blood cells in atherosclerotic plaques from diabetic patients. In this way, red blood cells could be phagocytosed by othercell types such as endothelial cells. In this work, we have also set up an in vitro model of erythrocyte glycation that reflects a clinical situation of poorly controlled diabetes. We have demonstrated that glycated red blood cell phagocytosed by human endothelial cells, leading to their limited proliferation and to HO-1 overexpression. These data suggest an ingestion of glycated erythrocytes by endothelial cells may amplify the destabilization of carotid atherothrombotic plaques in diabetics.

OBJETIVO: Estudiar el efecto del tratamiento con 2-metoxiestradiol en el remodelado vascular miocárdico inducido por la hipertensión y tras una lesión vascular por denudación endotelial en arteria femoral.MATERIAL Y MÉTODOS: modelo de hipertensión: se han utilizado 5 grupos experimentales de ratas SHR de 10 semanas de vida: rata hembra intacta, rata hembra ovarioectomizada, rata hembra ovarioectomizada y tratada con 2-metoxiestradiol, rata macho y rata macho tratada con 2-metoxiestradiol. Se les midió la presión por pletismografía una vez por semana hasta la semana 18. En la semana 18 se les extrae en corazón y los vasos del lecho mesentérico para realizar los protocolos de análisis de la estructura vascular miocárdica y de producción de anión superóxido y expresión de proteínas relacionadas con la proliferación celular. Modelo de lesión vascular: se han utilizado 5 grupos experimentales de ratas SD: rata hembra intacta, rata hembra ovarioectomizada, rata hembra ovar ioectomizada y tratada con 2-metoxiestradiol, rata macho y rata macho tratada con 2-metoxiestradiol. A la semana de establecer los grupos, se les realiza la cirugía de lesión endotelial por denudación y a las dos semanas se extrae la muestra y se cuantifica la formación de neoíntima.RESULTADOS: Modelo de Hipertensión: Existen diferencias entre sexos en las ratas SHR, tanto en la evolución de la Hipertensión como en el remodelado vascular miocárdico, en la actividad de la NADPH oxidasa vascular de lecho mesentérico y en los factores protéicos de proliferación celular. El tratamiento con 2-metoxiestradiol atenuó el aumento de la presión arterial sistólica provocada por la ovarioectomía así como en el remodelado vascular miocárdico. En la expresión de proteínas y en la actividad de la enzima NADPH oxidasa disminuyó pero no de forma significativa. En las ratas macho, el tratamiento con 2-metoxiestradiol atenuó la evolución de la hipertensión, el remodelado vascular miocárdico, e l incremento de la actividad de la enzima NADPH oxidasa y los factores de proliferación celular. Modelo de Lesión Vascular: No hemos observado diferencias entre sexos en la formación de neoíntima. La ovarioectomía provocó un incremento en la formación de neoíntima y el tratamiento con 2-metoxiestradiol atenuó dicho incremento. En ratas macho, este metabolito no mostró efecto ninguno.