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Avaliação eletrocardiográfica ambulatorial de cães com ehrliquiose monocítica crônicaFilippi, Mauricio Gianfrancesco. January 2016 (has links)
Orientador: Maria Lucia Gomes Lourenço / Resumo: Ambulatorial electrocardiographic monitoring, or Holter method, has been shown to be an effective tool in veterinary medicine to detect early heart lesions, not only to monitor the electrical activity of the heart, but also to control the autonomic nervous system of this organ. It is also known that the main infectious diseases of dogs, such as canine distemper and canine monocytic ehrlichiosis (CME) cause considerable lesions in the heart, proven by histopathological examination. It has already been proven the occurrence of myocarditis in the CME, leading to frequent presence of changes in the generation and conduction of the cardiac electrical impulse. The present study analyzed the electrical activity of the heart during 24 hours, focusing on the prevalence of arrhythmias, heart rate variability study and the biomarkers concentration of dogs with chronic CME (sick group) compared to healthy animals (control group). Forty-five percent of the animals in the diseased group had a high frequency of arrhythmias during the study. The mean concentration of cardiac troponin I and creatinokinase MB (CK-MB) was significant (0.24 ng / mL ± 0.5; 229 ± 205 IU / mL) compared to the control group (0.042 ± 0.07 ng / ML, 126 ± 46.12 IU / mL). The standard deviation of the mean of all NN (SDNN) intervals and the percentage of adjacent RR intervals with a duration difference greater than 50 milliseconds (pnn50%) were also extremely significant (83 ± 65 and 14.56 ± 20) when compared to Healthy... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre
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ESTUDO DE RISCO CARDIOVASCULAR: UMA PROPOSTA DE USO DA MIELOPEROXIDASE SÉRICA E AVALIAÇÃO DE PRESSÃO INTRACRANIANASilva, Anderson José de Melo e 06 October 2017 (has links)
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Previous issue date: 2017-10-06 / The Acute Coronary Syndrome (ACS) defines a range of clinical changes that are compatible with myocardial ischemia, resulting in the death of myocardial cells due functional deficit of blood flow, characterizing the acute myocardial infarction (AMI). The AMI is evidenced through clinical data that are reinforced by electrocardiogram (ECG), imaging and even the biochemical markers (biomarkers) evaluation, such as serum creatine phosphokinase (CK), its isoenzyme MB fraction (CK-MB), troponin and new biomarkers not yet included in routine laboratory tests, such as myeloperoxidase (MPO). In addition to new laboratory markers, science allows the development of new technologies for clinical assessment of patients, providing new information and less risk, such as non-invasive evaluation of intracranial pressure (ICP). This study is justified by the need to predict earlier the complications in patients with suspected AMI, as well as evaluate them as to the diagnosis and prognosis of the event in question. Thus, we sought to study patients with suspected ACS/AMI about the cardiovascular risk and possible PIC change through traditional biomarkers, most current markers ( "gold standard") and new biomarkers and new ICP monitoring technology. Therefore, from a population of 20 patients, randomly selected according to gender and age, separated into two groups: CK-MB≥25 IU (n = 6) and CK-MB<25 IU (n = 14), which were submitted to measurement of PIC and PAS, as well as biochemical and hematological measurements, and specific cardiac biomarkers. As a result, there was correlation of clinical significance between the values of creatine kinase MB fraction (CK-MB) and glycated hemoglobin (HGBA1C). From these data, it started to study two cases that were selected two patients. It was observed that even with changes of CK-MB, troponin and myeloperoxidase (compared to laboratory practice reference values for traditional markers and "gold standard" and MPO value considered normal in the literature), it was found not manifestations that have allowed to observe reduction of cerebral compliance, where the waves P2 are larger than P1, and therefore, there were no PIC changes identified for patients under the conditions studied. Thus, it was concluded that, even without demonstration of PIC change in this work, it is not possible to exclude the value of its inclusion in the clinical evaluation, considering that biases, like the sample universe and the time of collection of PIC or the use of medication at the admission time on hospital, may have contributed to the non-registration of changes in ICP, even in cases where patients had an unfavorable evolution of the clinical picture. / A Síndrome Coronariana Aguda (SCA) define uma gama de alterações clinicas que são compatíveis com um quadro de isquemia miocárdica, acarretando na morte de células do tecido miocárdico devido ao déficit funcional do fluxo sanguíneo, caracterizando o Infarto Agudo do Miocárdio (IAM). O IAM pode se revelar através de dados clínicos que são reforçados pelo eletrocardiograma (ECG), exames de imagem e ainda a pesquisa de marcadores bioquímicos (biomarcadores), tais como Creatinafosfoquinase (CK), sua isoenzima fração MB (CK-MB), troponina e novos biomarcadores ainda não inclusos na rotina laboratorial, tais como mieloperoxidase (MPO). Além de novos marcadores laboratoriais a ciência permite o desenvolvimento de novas tecnologias para avaliação clínica dos pacientes, proporcionando novas informações e menor risco, tais como a avaliação não invasiva da pressão intracraniana (PIC). O presente trabalho justifica-se pela necessidade de se prever intercorrências com maior antecedência em pacientes com suspeita de IAM, assim como em avaliá-los quanto ao diagnóstico e prognóstico do evento em questão. Desta forma, buscou-se estudar pacientes com suspeita de SCA/IAM quanto ao risco cardiovascular e possível alteração de PIC por meio biomarcadores tradicionais, marcadores mais atuais ("padrão ouro") e novos biomarcadores e nova tecnologia de acompanhamento da PIC. Para tanto, de uma população de 20 pacientes, escolhidos aleatoriamente quanto ao gênero e idade, separou-se em dois grupos: CK-MB≥25 UI (n=6) e CK-MB˂ 25 UI (n=14), os quais foram submetidos à aferição de PIC e PAS, além de dosagens bioquímicas e hematológicas, bem como biomarcadores cardíacos. Como resultado, observou-se correlação de significância clinica entre os valores de creatinofosfoquinase fração MB (CK-MB) e hemoglobina glicada (HgbA1C). A partir destes dados, passou-se ao estudo de dois casos clínicos em que foram selecionados dois pacientes. Foi observado que, mesmo com alterações de CK-MB, troponinas e Mieloperoxidase (comparando-se a valores de referencia da prática laboratorial para os marcadores tradicionais e "padrão ouro" e valor de MPO considerado normal em literatura especializada), constatou-se não haver manifestações que permitissem observar redução da complacência cerebral, quando as ondas P2 se dão maiores que ondas P1 e, portanto, não foram identificadas alterações de PIC para os pacientes nas condições estudadas. Com isso, concluiu-se que, mesmo não havendo demonstração de alteração de PIC neste trabalho, não se pode excluir o valor de sua inclusão na avaliação clínica, dado que vieses como universo amostral, bem como o momento da coleta da PIC e ou uso de medicação no momento da admissão hospitalar, podem ter contribuído para o não-registro de alterações da PIC, mesmo em casos que os pacientes tiveram uma evolução desfavorável do quadro clínico.
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Avaliação eletrocardiográfica ambulatorial de cães com ehrliquiose monocítica crônica / Ambulatory electrocardiographic evaluation of dogs with chronic monocytic ehrlichiosisFilippi, Maurício Gianfrancesco [UNESP] 12 December 2016 (has links)
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Previous issue date: 2016-12-12 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A monitorização eletrocardiográfica ambulatorial, ou método Holter, vem se mostrando como uma ferramenta eficaz na Medicina Veterinária para detectar lesões cardíacas precoces, não só por monitorar a atividade elétrica do coração, como também o controle do sistema nervoso autônomo desse órgão. Sabe-se também que as principais enfermidades infecciosas de cães, como a cinomose e a erliquiose monocítica canina (EMC) provocam lesões consideráveis no coração, comprovadas por exame histopatológico. Já está comprovada a ocorrência de miocardite na EMC, levando a frequente presença de alterações na geração e condução do impulso elétrico cardíaco. O presente estudo analisou a atividade elétrica do coração durante 24 horas, com enfoque na prevalência de arritmias, estudo da variabilidade da frequência cardíaca e na concentração de biomarcadores de cães com EMC crônica (grupo doente) em comparação à animais saudáveis (grupo controle). Quarenta e cinco por cento dos animais do grupo doente possuíram alta frequência de arritmias durante o estudo. A média da concentração de troponina cardíaca I e de creatinokinase MB (CK-MB) foi significativa (0,24 ng/mL ± 0,5; 229 ± 205 UI/mL) em comparação ao grupo controle (0,042 ± 0,07 ng/mL; 126 ± 46,12 UI/mL). O desvio padrão da média de todos os intervalos NN (SDNN) e a porcentagem de intervalos RR adjacentes com diferença de duração superior a 50 milissegundos (pnn50%) também foram extremamente singificativos (83 ± 65 e 14,56 ± 20) quando comparado aos animais saudáveis (268 ± 74,6 e 55,87 ± 12,8), respectivamente. Podemos concluir que a EMC crônica possui caráter arritmôgenico, onde há persistente lesão miocárdica e intensa estimulação do sistema nervoso autônomo simpático no coração. / Ambulatorial electrocardiographic monitoring, or Holter method, has been shown to be an effective tool in veterinary medicine to detect early heart lesions, not only to monitor the electrical activity of the heart, but also to control the autonomic nervous system of this organ. It is also known that the main infectious diseases of dogs, such as canine distemper and canine monocytic ehrlichiosis (CME) cause considerable lesions in the heart, proven by histopathological examination. It has already been proven the occurrence of myocarditis in the CME, leading to frequent presence of changes in the generation and conduction of the cardiac electrical impulse. The present study analyzed the electrical activity of the heart during 24 hours, focusing on the prevalence of arrhythmias, heart rate variability study and the biomarkers concentration of dogs with chronic CME (sick group) compared to healthy animals (control group). Forty-five percent of the animals in the diseased group had a high frequency of arrhythmias during the study. The mean concentration of cardiac troponin I and creatinokinase MB (CK-MB) was significant (0.24 ng / mL ± 0.5; 229 ± 205 IU / mL) compared to the control group (0.042 ± 0.07 ng / ML, 126 ± 46.12 IU / mL). The standard deviation of the mean of all NN (SDNN) intervals and the percentage of adjacent RR intervals with a duration difference greater than 50 milliseconds (pnn50%) were also extremely significant (83 ± 65 and 14.56 ± 20) when compared to Healthy animals (268 ± 74.6, 55.87 ± 12.8), respectively. It can be concluded that chronic CME has an arrhythmogenic character, where there is persistent myocardial injury and intense stimulation of the sympathetic autonomic nervous system of the heart. / FAPESP: 2014/11219-6
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New Risk Markers in Atrial FibrillationHijazi, Ziad January 2013 (has links)
Atrial fibrillation (AF) confers an independent increased risk of stroke and death. The stroke risk is very heterogeneous and current risk stratification models based on clinical variables, such as the CHADS2 and CHA2DS2VASc score, only offer a modest discriminating value. The aims of this thesis were to study cardiac biomarkers, cardiac troponin and natriuretic peptides e.g. N-terminal prohormone-B-type natriuretic peptide (NT-proBNP), and describe levels in AF patients, investigate the association with stroke or systemic embolism, cardiovascular event, major bleeding and mortality, and to assess how levels of cardiac biomarkers change over time. Cardiac troponin was analyzed with contemporary assays and high sensitivity assays. The study populations consisted of patients with atrial fibrillation and one risk factor for stroke included in the RE-LY (n=6189) and the ARISTOTLE (n=14892) biomarker substudies. Median follow-up time was 2.2 years and 1.9 years, respectively. In a subset of participants (n=2514) data from repeated measurements was available at three months. Cardiac troponin was detectable in 57.0% with the contemporary assay and 99.4% with the high sensitivity assay. NT-proBNP was elevated in approximately three quarters of the participants. In Cox models adjusted for established risk factors the cardiac biomarkers levels was independently associated with stroke or systemic embolism, cardiovascular events, and mortality. Only cardiac troponin was associated with major bleeding. In ROC analyses the prediction of stroke or systemic embolism, cardiovascular events, and mortality increased significantly by addition of cardiac troponin or NT-proBNP to the models. Persistent detectable cardiac troponin (contemporary assay) and elevated NT-proBNP levels were found in a large number of participants. Persistent detectable or elevated levels conferred significantly higher risk for stroke or systemic embolism, cardiovascular events, and mortality. By using both cardiac biomarkers simultaneously the risk stratification improved even further for all outcomes. In conclusion the analyses for the first time display that elevation of troponin I and NT-proBNP are common in patients with AF and independently related to increased risks of stroke, cardiovascular events and mortality. Persistent elevation of troponin and NT-proBNP indicate a worse prognosis than transient elevations or no elevations of either marker. The cardiac biomarkers added substantial improvements to existing risk stratification models.
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Development of a Surface Enhanced Raman Spectroscopy Platform Technology to Detect Cardiac Biomarkers of Myocardial InfarctionBenford, Melodie Elane 03 October 2013 (has links)
The clinical evaluation of people with possible myocardial infarction (MI) is often limited by atypical symptoms and inconclusive initial electrocardiograms. A recent consensus from the American College of Cardiology has redefined acute MI to include cardiac markers as central to diagnosis. To address this clinical need, a sensitive microfluidic surface-enhanced Raman spectroscopy (SERS) nanochannel-based optical device is being developed for ultimate use as a point-of-care device for the simultaneous measurement of MI blood biomarkers. The device can provide enhancements of the Raman signal of the analyte measured of up to 1013 using a mechanical aggregation technique at the interface of nanofluidic structures enabling repeatable SERS measurements. Specifically in this research iterations of a sensitive, low volume SERS platform technology were designed that provided quantitative information across a specific range. With the SERS platforms studied, not only were SERS enhancements of up to 1013 achieved but also imprecision values of less than 10% across the 10-50 pM range using a ratiometric approach and qualitative detection down to 100 aM was achieved. Beyond assessment of SERS substrates, assay designs were investigated and characterized including, label-free techniques and competitive immunoassay formats. Lastly, detecting the SERS signal of multiplexed reporter molecules was investigated. By identifying the analyte and assay constraints the design and optimization of future assays will be aided using this SERS platform technology.
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Troponina 1 cardíaca em cães submetidos a tratamento periontalMazioli, Grasiele Bonadiman Cypriano 31 July 2013 (has links)
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Dissertacao Grasiele Bonadiman.pdf: 3637833 bytes, checksum: 9c919dca44b71050b2c6cbe78d9a59a6 (MD5) / Possíveis associações entre doença periodontal (DP) e alterações cardiovasculares em cães, como a endocardite infecciosa (EI), são relatadas na literatura, apesar de ainda não comprovadas. Fármacos anestésicos, utilizados para a tratamento periodontal (TP), podem levar à hipotensão, redução do fluxo sanguíneo coronariano e isquemia miocárdica. A determinação de biomarcadores, especialmente a
troponina I cardíaca (TnIc), pode ser utilizada para a detecção de lesão miocárdica tanto em casos de EI, quanto por efeitos de fármacos anestésicos. Objetivou-se avaliar os níveis séricos de TnIc em cães com DP, como um indicador de EI, anestesiados para TP, com e sem o uso de antibióticos. Utilizou-se 24 cães com DP, sem evidências de outras doenças sistêmicas, selecionados por meio de avaliação física, laboratorial e cardiovascular. Formou-se três grupos de 8 cães cada: grupo I (controle) – cães anestesiados; grupo II - cães anestesiados submetidos a TP, não tratados com antibióticos; grupo III - cães anestesiados submetidos a TP, tratados com antibióticos. Os cães foram sedados com meperidina e acepromazina, induzidos com propofol e mantidos com isoflurano em oxigênio. Dosagens de TnIc
foram realizadas imediatamente antes e 24 horas após o TP, com kit comercial pelo método de ELISA. A análise estatística foi realizada por meio do teste de "D'Agostino & Pearson", teste t para comparação de duas médias e teste post hoc de comparação múltipla de Tukey, após a análise de variância. Não houve diferença significativa nas dosagens de TnIc entre os grupos, nem entre os momentos avaliados (p>0,05). Conclui-se que não há aumento de TnIc em cães com DP após o TP, submetidos ou não a antibioticoterapia, podendo sugerir que não houve o desenvolvimento de EI; e não há aumento de TnIc em cães saudáveis submetidos ao protocolo anestésico estipulado. / Associations between periodontal disease (PD) and cardiovascular changes in dogs, such as infeccious endocarditis (IE), are reported by literature, although no evidences between them are verified. Anesthetic drugs, used for periodontal treatment (PT), can lead to hypotension, reduction of coronary blood flow and
myocardial ischemia. Determination of biomarkers, especially cardiac troponin I (cTnI) can be used for the detection of myocardial injury in both cases: endocarditis and the effects of anesthetic drugs. This study aimed to evaluate canine cTnI in dogs with PD, as an indicator of IE, after PT, with and without using antibiotics. It was used 24 dogs with PD, with no evidence of any other systemic diseases. They were
selected by physical examination, laboratory and cardiovascular evaluation and were divided into three groups: group I (n=8; control) - anesthetized dogs, group II (n=8) - anesthetized dogs submited to PT, not treated with antibiotics, group III (n=8) - anesthetized dogs submited to PT, treated with antibiotics. The dogs were sedated with acepromazine and meperidine, induced with propofol and maintained with isoflurane in oxygen. Canine cTnI dosages were taken immediately before and 24 hours after PT, using commercial kit (ELISA). Statistical analysis were performed by using "D'Agostino & Pearson" normality test, unpaired t test to compare two samples and Tukey´s post hoc test for multiple comparisons. All tests were performed at a
level of significance of 0.05 No significant differences were found between groups or in different moments (p>0.05). It was concluded that there is no increased cTnI in dogs with PD after PT, treated or not with antibiotics, suggesting that there was no development of IE, and there is no increase in canine cTnI in healthy dogs anesthetized using this protocol.
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Galectina-3 como biomarcador na insuficiência cardíaca secundária à degeneração valvar crônica de mitral em cães / Galectin-3 as biomarker in heart failure secondary to chronic mitral valve degeneration in dogsCastro, Jacqueline Ribeiro de 04 May 2016 (has links)
A degeneração valvar crônica mitral (DVCM) é uma cardiopatia de alta prevalência na clínica médica de pequenos animais e acomete principalmente cães idosos de raças de pequeno porte. A fim de se acompanhar a evolução da insuficiência cardíaca (IC), a galectina-3 (Gal-3) vem sendo utilizada como um biomarcador na identificação de doenças cardíacas pré-clínicas, progressão e descompensação em pacientes humanos. O objetivo deste estudo clínico foi estabelecer intervalos de referência da Gal-3 na população canina estudada e determinar a utilidade desse novo biomarcador sérico, isoladamente ou em associação com o pró-peptídeo natriurético tipo B (NT-proBNP) e a troponina cardíaca I (cTnI), para estimativa de prognóstico em curto prazo em cães com IC decorrente de DVCM. O delineamento fundamentou-se em um estudo clínico observacional transversal prospectivo com braço longitudinal. A amostra foi composta por 139 cães distribuídos em cinco grupos criteriosamente selecionados de acordo com o estadiamento da DVCM (Grupo controle: estágio A- composto por 60 cães hígidos de raças de pequeno porte com predisposição à DVCM, 28 cães em estágio B1, 20 cães em B2, 20 cães em estágio C e 11 cães em estágio D), advindos da rotina do Serviço de Cardiologia do VCM, Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Os grupos B1, B2, C e D foram avaliados em um segundo momento, aos 60 dias. Foram dosados Gal-3 humana e canina, NTproBNP e cTnI. Os valores de referência mensurados no grupo A para Gal-3 humana foram de 7,548 ng/mL (P25%-75%=8,933-10,960). A recuperação da concentração de Gal-3 em cães clinicamente saudáveis, obtida com kit canino, foi significativamente mais baixa, com baixa repetibilidade e reprodutibilidade, em comparação com o kit humano, sugerindo assim menor sensibilidade do kit canino utilizado. Ainda, a magnitude e a variação nas concentrações de Gal-3 humana e canina não permitiram a detecção de diferenças entre os estágios da DVCM e também não foram capazes de identificar pacientes em IC. Conclui-se, portanto, que diferentemente dos demais marcadores avaliados, NT-proBNP e cTnI, já consagrados na IC para a espécie canina, a Gal-3 não se constitui em um biomarcador adequado para avaliar a IC secundária à DVCM em cães / Chronic mitral valve degeneration (CMVD) is a highly prevalent heart disease in small animal internal medicine seen mainly in older small breed dogs. In order to follow the progression of heart failure (HF), galectin-3 (Gal-3) has been applied as a biomarker to identify pre-clinical cardiac diseases, progression and decompensation in human patients. This study aimed to establish reference intervals for Gal-3 in a canine population, and to determine the utility of this new biomarker, isolated or in association with Type B natriuretic pro-peptide (NT-proBNP) and cardiac troponin I to estimate short term prognosis in dogs with HF caused by CMVD. It was designed as an observational prospective cross-sectional clinical study with a longitudinal arm. One hundred thirty nine dogs were distributed among five groups with rigorous selection criteria, according to ACVIM CMVD staging (Control group: stage A- 60 healthy small breed dogs, predisposed to CMVD; 28 dogs in stage B1, 20 dogs in stage B2, 20 dogs in stage C and 11 dogs in stage D), recruited from the Cardiology Service from the Veterinary Teaching Hospital, School of Veterinary Medicine, University of São Paulo. Groups B1, B2, C and D had a second blood sampling at day 60. Measurements were obtained for human and canine Gal-3, NT-proBNP and cTnI. Reference values obtained for group A for human Gal-3 were 7.548 ng/mL (P25%-75%=8.933-10.960). Gal-3 concentration recovery for healthy dogs obtained with canine kit was significantly lower, with low repeatability and reproducibility, compared to the human kit, suggesting lower sensitivity of the canine Gal-3 kit used. We concluded that the magnitude and variation observed in human and canine Gal-3 did not allow for detection of differences between stages of CMVD nor were capable of identifying patients in HF, compared to the other measured biomarkers, NT-proBNP and cTnI, already established for canine HF evaluation
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Physiology of Adventure Racing : with emphasis on circulatory response and cardiac fatigueMattsson, C. Mikael January 2011 (has links)
The overall aims of this thesis were to elucidate the circulatory responses to ultra-endurance exercise (Adventure Racing), and furthermore, to contribute to the clarification of the so called “exercise-induced cardiac fatigue” in relation to said exercise. An Adventure race (AR) varies in duration from six hours to over six days, in which the participants have to navigate through a number of check-points over a pre-set course, using a combination of three or more endurance/outdoor sports, e.g., cycling, running, and kayaking. This thesis is based on the results from four different protocols; 12- and 24-h (n = 8 and 9, respectively) in a controlled setting with fixed exercise intensity, and 53-h and 5-7-day (n = 15 in each) in field setting under race conditions. The subjects in all protocols were experienced adventure racing athletes, competitive at elite level. Study I and II address the circulatory responses and cardiovascular drift, using methods for monitoring heart rate (HR), oxygen uptake (VO2), cardiac output (non-invasive re-breathing) and blood pressure, during ergometer cycling at fixed steady state work rate at periods before, during and after the ultra-endurance exercise. In Study III and IV we examined the possible presence of exercise-induced cardiac fatigue after a 5-7-day AR, from two different perspectives. In Study III analyses were performed with biochemical methods to determine circulating levels of cardiac specific biomarkers (i.e., creatine kinase isoenzyme MB (CK-MB), troponin I, B-type natriuretic peptide (BNP) and N-terminal prohormonal B-type natriuretic peptide (NT-proBNP)). We also made an attempt to relate increases in biomarkers to rated relative performance. In Study IV we used tissue velocity imaging (TVI) (VIVID I, GE VingMed Ultrasound, Norway) to determine whether the high workload (extreme duration) would induce signs of functional cardiac fatigue similar to those that occur in skeletal muscle, i.e., decreased peak systolic velocities. Using conventional echocardiography we also evaluated whether the hearts of experienced ultra-endurance athletes are larger than the normal upper limit. The central circulation changed in several steps in response to ultra-endurance exercise. Compared to initial levels, VO2 was increased at every time-point measured. The increase was attributed to peripheral adaptations, confirmed by a close correlation between change in VO2 and change in arteriovenous oxygen difference. The first step of the circulatory response was typical of normal (early) cardiovascular drift, with increased HR and concomitantly decreased stroke volume (SV) and oxygen pulse (VO2/HR), occurring over the first 4-6 h. The second step, which continued until approximately 12h, included reversed HR-drift, with normalisation of SV and VO2/HR. When exercise continued for 50 h a late cardiovascular drift was noted, characterised by increased VO2/HR, (indicating more efficient energy distribution), decreased peripheral resistance, increased SV, and decreased work of the heart. Since cardiac output was maintained at all-time points we interpret the changes as physiologically appropriate adaptations. Our findings in Study III point towards a distinction between the clinical/pathological and the physiological/exercise-induced release of cardiac biomarkers. The results imply that troponin and CKMB lack relevance in the (healthy) exercise setting, but that BNP, or NT-proBNP adjusted for exercise duration, might be a relevant indicator for impairment of exercise performance. High levels of NTproBNP, up to 2500 ng · l -1 , can be present after ultra-endurance exercise in healthy athletes without any subjective signs or clinical symptoms of heart failure. However, these high levels of NT-proBNP seemed to be associated with decreased relative exercise performance, and might be an indicator of the cardiac fatigue that has previously been described after endurance exercise. Study IV revealed that the sizes of the hearts (left ventricle) of all of our ultra-endurance athletes were within normal limits. The measurements of peak systolic velocities showed (for group average) no signs of cardiac fatigue even after 6 days of continuous exercise. This discrepancy between ours and other studies, involving e.g., marathon or triathlon, might reflect the fact that this type of exercise is performed at relatively low average intensity, suggesting that the intensity, rather than the duration, of exercise is the primary determinant of cardiac fatigue. / Physiology of Adventure Racing
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Alterações hematológicas, hemostáticas e bioquímicas de cães tratados com anti-inflamatórios não esteroidais / Hematological, hemostatic and biochemical effects on nonsteroidal anti-inflammatory therapy in dogsMarini Filho, Rivaldo 26 September 2011 (has links)
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Previous issue date: 2011-09-26 / This study aimed to evaluate the heart and liver biomarkers, hematology and hemostasis in healthy dogs, submitted to therapy with nonsteroidal anti-inflammatory non-selective (NSAID), COX-2 preferential and COX-2 selective drugs. Were used 30 mongrel dogs, adults, males and females, clinically healthy, randomly divided into 5 groups (G) of 6 animals, that received the follow therapies: ketoprofen, nimesulide, meloxican, etodolac and celecoxib. The blood count, hemostatic profile (clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), platelets and fibrinogen), cardiac biomarkers (CK, CKMB) and liver function (ALT, AST and albumin) were evaluate before, at 5 and 10 days (T0, T5, T10) of treatment in all treatment groups, and at 20 days (T20) treatment in celecoxib. The CT scan showed significant increase in the ketoprofen group at T5, while in the nimesulide group significantly increased at T10, in both groups when compared to T0. In TP, the etodolac group showed significant reduction in the T5 compared to T0, while the platelet count increased at T10 compared to T0 and T5 in the ketoprofen group. The red blood cells and Ht decreased in T10 compared to T0 in the ketoprofen group, while the reduction in the celecoxib group T20 compared to T0. The celecoxib group revealed decreased values of total leukocytes, neutrophils and lymphocytes in the T20. Significant increase in CKMB, LDH, and ALT were observed in the celecoxib group. Reduction of serum albumin occurred in the nimesulide and ketoprofen groups in T5 and T10 and T10, respectively. In conclusion, meloxican was the safest drug to NSAID therapy in dogs. The NSAIDs ketoprofen, nimesulide and etodolac should be used judiciously in patients with dysfunction of coagulation profile, once that promote increase in coagulation parameters. Celecoxib appears to be safe in relation to the coagulation, even under prolonged therapy. Celecoxib and ketoprofen therapy requires attention for use in anemic dogs because they are able to reduce the red series. Ketoprofen is contraindicated in patients with hypoalbuminemia. Long term celecoxib therapy should be used cautiously in dogs with immunosuppressive processes, since it was able to reduce the white blood cell counts. / O presente estudo teve como objetivo avaliar as alterações bioquímicas cardíacas e hepáticas, hematologia e hemostasia de cães saudáveis, submetidos à terapia com anti-inflamatórios não-esteroidais não seletivos (AINEs), COX-2 preferenciais e COX-2 seletivos. Foram utilizados 30 cães, sem raça definida, adultos, machos e fêmeas, clinicamente sadios, divididos aleatoriamente em 5 grupos (G) de 6 animais, que receberam as seguintes terapias: cetoprofeno, nimesulida, meloxican, etodolaco e celecoxibe. O hemograma, perfil hemostático (tempo de coagulação (TC), tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA), plaquetas e fibrinogênio), biomarcadores cardíacos (creatinofosfoquinase (CK) e sua fração MB- CKMB) e função hepática (alanina aminotransferase (ALT), aspartato aminotransferase (AST) e albumina) foram avaliados antes, aos 5, 10 dias (T0, T5 e T10) de tratamento em todos os grupos, e também aos 20 dias (T20) de tratamento no celecoxibe. O TC revelou aumento significativo no T5 no grupo cetoprofeno, enquanto no grupo nimesulida houve aumento significativo no T10, em ambos os grupos em relação ao T0. No TP, o grupo etodolaco revelou redução significativa no T5 em relação ao T0, enquanto a contagem de plaquetas aumentou no T10 em relação ao T0 e T5 no cetoprofeno. As hemáceas e o Ht diminuiram no T10 em relação ao T0 no cetoprofeno, enquanto no grupo celecoxibe houve redução no T20 em relação ao T0. O celecoxibe revelou diminuição dos valores de Leucócitos totais, neutrófilos e linfócitos no T20. No grupo celecoxibe houve aumento significativo de CKMB, CK, e ALT. Redução da albumina sérica ocorreu nos grupos cetoprofeno e nimesulida no T10 e T5 e T10, respectivamente. Em conclusão, o meloxican foi o fármaco que se revelou mais seguro para uso em cães, em relação aos aspectos avaliados. Os AINEs cetoprofeno, nimesulida e etodolaco devem ser usados criteriosamente em pacientes portadores de disfunções do perfil de coagulação, uma vez que promovem prolongamento do mesmo, enquanto o celecoxibe revela-se seguro neste aspecto, mesmo sob terapia prolongada. Celecoxibe e cetoprofeno exigem atenção para uso em cães anêmicos, pois são capazes de reduzir a série vermelha. O uso de cetoprofeno em pacientes com hipoalbuminemia é contra-indicado Celecoxibe em terapia prolongada deve ser usado cautelosamente em portadores de processos imunossupressores, uma vez que foi capaz de reduzir a leucometria.
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Alterações hematológicas, hemostáticas e bioquímicas de cães tratados com anti-inflamatórios não esteroidais / Hematological, hemostatic and biochemical effects on nonsteroidal anti-inflammatory therapy in dogsMarini Filho, Rivaldo 26 September 2011 (has links)
Made available in DSpace on 2016-07-18T17:53:09Z (GMT). No. of bitstreams: 1
Rivaldo.pdf: 292230 bytes, checksum: a2cbda0e4eeea6a416fde16f3f375530 (MD5)
Previous issue date: 2011-09-26 / This study aimed to evaluate the heart and liver biomarkers, hematology and hemostasis in healthy dogs, submitted to therapy with nonsteroidal anti-inflammatory non-selective (NSAID), COX-2 preferential and COX-2 selective drugs. Were used 30 mongrel dogs, adults, males and females, clinically healthy, randomly divided into 5 groups (G) of 6 animals, that received the follow therapies: ketoprofen, nimesulide, meloxican, etodolac and celecoxib. The blood count, hemostatic profile (clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), platelets and fibrinogen), cardiac biomarkers (CK, CKMB) and liver function (ALT, AST and albumin) were evaluate before, at 5 and 10 days (T0, T5, T10) of treatment in all treatment groups, and at 20 days (T20) treatment in celecoxib. The CT scan showed significant increase in the ketoprofen group at T5, while in the nimesulide group significantly increased at T10, in both groups when compared to T0. In TP, the etodolac group showed significant reduction in the T5 compared to T0, while the platelet count increased at T10 compared to T0 and T5 in the ketoprofen group. The red blood cells and Ht decreased in T10 compared to T0 in the ketoprofen group, while the reduction in the celecoxib group T20 compared to T0. The celecoxib group revealed decreased values of total leukocytes, neutrophils and lymphocytes in the T20. Significant increase in CKMB, LDH, and ALT were observed in the celecoxib group. Reduction of serum albumin occurred in the nimesulide and ketoprofen groups in T5 and T10 and T10, respectively. In conclusion, meloxican was the safest drug to NSAID therapy in dogs. The NSAIDs ketoprofen, nimesulide and etodolac should be used judiciously in patients with dysfunction of coagulation profile, once that promote increase in coagulation parameters. Celecoxib appears to be safe in relation to the coagulation, even under prolonged therapy. Celecoxib and ketoprofen therapy requires attention for use in anemic dogs because they are able to reduce the red series. Ketoprofen is contraindicated in patients with hypoalbuminemia. Long term celecoxib therapy should be used cautiously in dogs with immunosuppressive processes, since it was able to reduce the white blood cell counts. / O presente estudo teve como objetivo avaliar as alterações bioquímicas cardíacas e hepáticas, hematologia e hemostasia de cães saudáveis, submetidos à terapia com anti-inflamatórios não-esteroidais não seletivos (AINEs), COX-2 preferenciais e COX-2 seletivos. Foram utilizados 30 cães, sem raça definida, adultos, machos e fêmeas, clinicamente sadios, divididos aleatoriamente em 5 grupos (G) de 6 animais, que receberam as seguintes terapias: cetoprofeno, nimesulida, meloxican, etodolaco e celecoxibe. O hemograma, perfil hemostático (tempo de coagulação (TC), tempo de protrombina (TP), tempo de tromboplastina parcial ativada (TTPA), plaquetas e fibrinogênio), biomarcadores cardíacos (creatinofosfoquinase (CK) e sua fração MB- CKMB) e função hepática (alanina aminotransferase (ALT), aspartato aminotransferase (AST) e albumina) foram avaliados antes, aos 5, 10 dias (T0, T5 e T10) de tratamento em todos os grupos, e também aos 20 dias (T20) de tratamento no celecoxibe. O TC revelou aumento significativo no T5 no grupo cetoprofeno, enquanto no grupo nimesulida houve aumento significativo no T10, em ambos os grupos em relação ao T0. No TP, o grupo etodolaco revelou redução significativa no T5 em relação ao T0, enquanto a contagem de plaquetas aumentou no T10 em relação ao T0 e T5 no cetoprofeno. As hemáceas e o Ht diminuiram no T10 em relação ao T0 no cetoprofeno, enquanto no grupo celecoxibe houve redução no T20 em relação ao T0. O celecoxibe revelou diminuição dos valores de Leucócitos totais, neutrófilos e linfócitos no T20. No grupo celecoxibe houve aumento significativo de CKMB, CK, e ALT. Redução da albumina sérica ocorreu nos grupos cetoprofeno e nimesulida no T10 e T5 e T10, respectivamente. Em conclusão, o meloxican foi o fármaco que se revelou mais seguro para uso em cães, em relação aos aspectos avaliados. Os AINEs cetoprofeno, nimesulida e etodolaco devem ser usados criteriosamente em pacientes portadores de disfunções do perfil de coagulação, uma vez que promovem prolongamento do mesmo, enquanto o celecoxibe revela-se seguro neste aspecto, mesmo sob terapia prolongada. Celecoxibe e cetoprofeno exigem atenção para uso em cães anêmicos, pois são capazes de reduzir a série vermelha. O uso de cetoprofeno em pacientes com hipoalbuminemia é contra-indicado Celecoxibe em terapia prolongada deve ser usado cautelosamente em portadores de processos imunossupressores, uma vez que foi capaz de reduzir a leucometria.
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