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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Der Einfluss von Noradrenalin auf Gap Junction Kanäle

Glawe, Inken 24 October 2011 (has links) (PDF)
Gap Junction Kanäle sind wesentlich für die interzelluläre Kommunikation im Herzen. Die wichtigsten kardialen Gap Junction Proteine sind Connexin 43, Connexin 40 und in frühen Entwicklungsstadien Connexin 45. Da Katecholamine eine wichtige Rolle in der kardialen Physiologie bzw. Pathophysiologie spielen, sollte geklärt werden, ob Katecholamine die Expression von Connexin 40 und Connexin 43 beeinflussen. Es wurden neonatale Rattenkardiomyozyten in Zellkultur 24 Stunden mit aufsteigenden Noradrenalinkonzentrationen (1-10000 nM) (physiologischer Agonist für α-und β-Adrenozeptoren) inkubiert. Hier zeigte sich ein signifikanter Anstieg der Connexin 43 Expression, während die Connexin 40 Expression nicht beeinflußt wurde. Um zu zeigen über welchen Adrenozeptor (α oder β) die Hochregulation von Cx 43 durch Noradrenalin erfolgt, wurden die Zellkulturen in zwei weiteren Versuchsreihen zusätzlich mit einem β-Blocker (Propranolol 100µM) bzw. einem α- Blocker (Prazosin 10 µM) über 24 Std. inkubiert. Hier zeigte sich eine deutliche Inhibierung des Noradrenalineffektes durch die Blockade der α-Rezeptoren durch Prazosin. Eine Blockade der β-Rezeptoren hatte keinen inhibitorischen Effekt auf die Hochregulation der Expression von Cx 43 durch Noradrenalin. Es kam hier sogar zu einer verstärkten Expression verglichen mit der Cx 43 Expression unter Noradrenalin ohne Rezeptorblockade. Desweiteren wurde überprüft, ob es auch unter der Behandlung von Sprague– Dawley-Ratten mit einem β-Mimetikum (Isoprenalin) bzw. einem α-Mimetikum (Phenylephrin) zu einer Veränderung der Connexinexpression kommt. Die Western Blot Analysen ergaben hierbei wieder einen α-Rezeptoren vermittelten Effekt, indem es zu einem wesentlichen Konzentrationsanstieg von Connexin 43 unter der Behandlung mit Phenylephrin kam.
2

Ultrassonografia pulmonar na identificação da dispneia aguda cardiogênica em pacientes hospitalizados / Lung ultrasonography identifying acute cardiogenic dyspnea in hospitalized patients

Araujo, Caroline de Souza Costa 29 March 2016 (has links)
Acute dyspnea (AD) is a common complaint in a hospital unit and frequently, differential diagnosis is a challenge despite acquirement of diverse methodologies. Lung ultrasonography (LU) has shown useful identifying AD of cardiogenic origin. However, there is a shortage of national studies confirming such quality. Objectives: Evaluate LU’s contribution on identification of cardiogenic origin AD. Methodology: This is a prospective, longitudinal cohort of patients in emergency room and admitted into hospital unit, with AD complaint. They were evaluated by Framingham risk score (FRS) for cardiac insufficiency (CI) and subjected to the following additional tests: electrocardiogram (ECG), chest radiography (CR), transthoracic ecodoppler cardiogram (TTE) and LU. Excluded pulmonary fibrosis and lung neoplasm patients. Calculated: sensitivity, specificity, positive and negative predictive value, as well as ROC curve of LU for AD diagnosis. Interobserver agreement among methods was estimated by kappa statistic. Results: From February to October of 2015, 118 patients (9 excluded) were classified according to presence or absence of CI by FRS. Of 109 cases, 60 (55%) had CI. These were elder (average age 76±16.7, p=0.01), men (60%, p=0.004), hypertensive (83%, p=0.01), diabetic (50.8%, p=0.03), with chronic renal insufficiency (CRI) (32.2%, p=0.03) and with higher adapted Killip classification (p=0.00) and functional class (p=0.003). Presented more pulmonary interstitial edema(IPE) on LU, CI to CR criteria (p=0.009) and, on TTE, higher E/e’ ratio (p=0.002) and left ventricle diastolic dysfunction (p=0.04), besides lower ejection fraction (p=0.00). Importants predictors on IPE detection by US in these patients were male gender, diabetics and with ejection fraction of reduced(p=0.01; 0.02 and 0.03, respectively). There was modest kappa agreement (k) between LU with FRS (k=0.25) and CR (k=0.22) for CI and moderate between LU (k=0,48) and CR and interobserver CR (kappa=0,44) LU sensibility for IEP in patients with CI was 90.91%, 65% specificity, 85.1% positive predictive value and 76.4% negative. Conclusion: therefore, concludes that LU proved to be a useful tool and with reproducibility when identifying AD of cardiogenic. / A dispneia aguda (DA) é uma queixa frequente em unidade hospitalar e o diagnóstico diferencial torna-se desafiador a despeito da aquisição de diferentes metodologias aplicadas. A ultrassonografia pulmonar (UP) tem-se demonstrado útil na identificação de DA de origem cardiogênica. Todavia, há poucos estudos nacionais ratificando esse benefício. Objetivos: Avaliar a contribuição da UP na identificação de DA de origem cardiogênica. Metodologia: Trata-se de uma coorte, prospectiva, longitudinal, de pacientes em pronto-socorro e internos em unidade hospitalar, com queixa principal de DA. Foram avaliados pelo escore de Framingham (EF) para insuficiência cardíaca(IC) e submetidos aos seguintes exames complementares: eletrocardiograma(ECG), radiografia de tórax (RT), ecodopplercardiograma transtorácico(ETT) e UP. Excluídos os portadores de fibrose ou neoplasia pulmonar. Foram calculados os parâmetros de sensibilidade, especificidade, valor preditivo positivo e negativo, assim como a curva ROC da UP para o diagnóstico de DA. Concordância inter-observador entre métodos foi estimada pelo método kappa. Resultados: De fevereiro a outubro/2015, 118 pacientes (9 excluídos) foram classificados quanto a presença ou não de IC pelo EF. Dos 109 casos, 60(55%) tinham IC. Esses eram mais idosos (idade média 76±16.7, p=0.01), homens (60%, p=0.004), hipertensos (83%, p=0.01), diabéticos (50.8%, p=0.03), com insuficiência renal crônica (IRC)(32.2%, p=0.03), maior graduação de Killip adaptada(p=0.00) e classe funcional(p=0.003). Apresentaram mais edema intersticial pulmonar(EIP) à UP (p=0.00), critérios de IC à RT (p=0.009) e, ao ETT, maiores relação E/e’(p=0.002) e disfunção diastólica do ventrículo esquerdo(p=0.04), além de menor fração de ejeção(p=0.00). Os preditores independentes na detecção de EIP pela US nesses pacientes foram o sexo masculino, diabéticos e com fração de ejeção reduzida(p=0.01; 0.02 e 0.03, respectivamente). Houve razoável concordância kappa (k) entre UP com EF(k=0.25) e RT(k=0.22) para IC e moderada da UP(k: 0.48) e RT(k:0.44) inter-observador. A sensibilidade da UP para EIP em pacientes com IC foi 90.91%, especificidade 65%, valor preditivo positivo 85.1% e preditivo negativo de 76.4%. Conclusão: Conclui-se que a UP demonstrou ser ferramenta útil e com reprodutibilidade na identificação de DA de origem cardiogênica.
3

Uso do strain do átrio esquerdo na identificação da disfunção diastólica indeterminada em pacientes com doença renal crônica em tratamento conservador

Sousa Netto, Jaime Afonso 31 July 2018 (has links)
Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-09-20T11:23:05Z No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-10-01T19:27:18Z (GMT) No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) / Made available in DSpace on 2018-10-01T19:27:18Z (GMT). No. of bitstreams: 1 jaimeafonsosousanetto.pdf: 1492332 bytes, checksum: b3474331db3578ab3863a9ab3071334f (MD5) Previous issue date: 2018-07-31 / Introdução: Metade dos pacientes com insuficiência cardíaca (IC) apresentam disfunção diastólica (DD) e fração de ejeção preservada do ventrículo esquerdo (FEpVE). A hipertrofia ventricular esquerda (HVE) é a anormalidade cardíaca em pacientes com doença renal crônica (DRC). O diagnóstico por imagem da DD é tradicionalmente realizado com a ecocardiografia transtorácica (ETT), sendo o volume do átrio esquerdo indexado (IVAE) um dos principais componentes no algoritmo da avaliação da DD. A metodologia do speckle tracking através do strain longitudinal global do ventrículo esquerdo (SLGVE) e o strain atrial esquerdo (SAE), possibilitam quantificar a contratilidade miocárdica e a avaliação instantânea da função do átrio esquerdo, respectivamente. Objetivo: Avaliar, em pacientes com DRC estágios 3B a 5 (em tratamento conservador) e FEpVE, o uso do SAE na identificação da disfunção diastólica indeterminada pelo IVAE. Métodos: Estudo de caso controle que avaliou pacientes com DRC estágios 3B a 5, em tratamento conservador, e que apresentavam fração de ejeção normal através da ecocardiografia transtorácico (ETT). Os pacientes foram divididos em dois grupos, com e sem HVE. A disfunção diastólica (DD), baseado em recomendações recentes da ASE, 2016, foi avaliada inicialmente pela ETT e, posteriormente, através do SAE (valor normal de referência >23%) pelo método speckle tracking. Adicionalmente, também se avaliou o strain longitudinal global do ventrículo esquerdo (SLGVE). O diagnóstico da DRC seguiu os critérios do KDIGO de 2012. Resultados: No total, foram avaliados 114 pacientes (57 em cada grupo), com idade média de 66,3±8,65, sendo 52,7% do sexo feminino, 94% hipertensos e 46% diabéticos. A média da taxa de filtração glomerular (em mL/min/1,73 m2) nos pacientes com e sem HVE foi de 32,6±11,9 e 40,4±13,9, respectivamente. A presença da DD no grupo com HVE (24,6%) foi maior do que no grupo sem HVE. Entre os 29 pacientes com HVE e DD indeterminada pelo IVAE, o SAE reduzido foi observado em 10 casos, aumentando o percentual de DD para 42%. No grupo sem HVE e DD indeterminada (18 casos), o SEA reduzido foi observado em quatro pacientes, aumentando para 21% o DD. A relação E/e´ no ânulo mitral lateral não apresentou alteração significativa entre os grupos (10,75±3,3; 10,14±3,8; p>0,05 Conclusão: Em pacientes com DRC não dialítica, o uso do SAE potencialmente aumenta a identificação de casos indeterminados de DD. / Introduction: Half of patients with heart failure (HF) have diastolic dysfunction (DD) and preserved left ventricular ejection fraction (LVEF). Left ventricular hypertrophy (LVH) is the cardiac abnormality in patients with chronic kidney disease (CKD). DD imaging has traditionally been performed with transthoracic echocardiography (TTE), with indexed left atrium volume (VTE) being one of the main components in the DD assessment algorithm. The methodology of speckle tracking through left ventricular global longitudinal strain (SLGVE) and left atrial strain (SAE), allows quantification of myocardial contractility and the instantaneous evaluation of left atrial function, respectively. Objective: To evaluate the use of SAE in the identification of undetermined diastolic dysfunction by VTE in patients with CKD stages 3B to 5 (in conservative treatment) and FEpVE. Methods: A control case study that evaluated patients with CKD stages 3B to 5, in conservative treatment, and who presented normal ejection fraction through transthoracic echocardiography (ETT). Patients were divided into two groups, with and without LVH. Diastolic dysfunction (DD), based on recent ASE recommendations, 2016, was initially evaluated by ETT and, later, by the SAE (reference normal value> 23%) by the speckle tracking method. In addition, the overall longitudinal strain of the left ventricle (SLGLE) was also evaluated. Results: A total of 114 patients (57 in each group) were evaluated, with a mean age of 66.3 ± 8.65, of which 52.7% were female, 94 % hypertensive and 46% diabetic. The mean glomerular filtration rate (in mL / min / 1.73 m2) in patients with and without LVH was 32.6 ± 11.9 and 40.4 ± 13.9, respectively. The presence of DD in the group with LVH (24.6%) was higher than in the group without LVH. Among the 29 patients with LVH and DD undetermined by IVAE, reduced SAE was observed in 10 cases, increasing the percentage of DD to 42%. In the group without undetermined LVH and DD (18 cases), the reduced SEA was observed in four patients, increasing the DD to 21%. Conclusion: In patients with non-dialytic CKD, the use of E / e 'in the lateral mitral annulus did not present significant alteration between the groups (10.75 ± 3.3; 10.14 ± 3.8; p> 0.05 of SAE potentially increases the identification of indeterminate cases of DD.
4

Der Einfluss von Noradrenalin auf Gap Junction Kanäle

Glawe, Inken 27 September 2011 (has links)
Gap Junction Kanäle sind wesentlich für die interzelluläre Kommunikation im Herzen. Die wichtigsten kardialen Gap Junction Proteine sind Connexin 43, Connexin 40 und in frühen Entwicklungsstadien Connexin 45. Da Katecholamine eine wichtige Rolle in der kardialen Physiologie bzw. Pathophysiologie spielen, sollte geklärt werden, ob Katecholamine die Expression von Connexin 40 und Connexin 43 beeinflussen. Es wurden neonatale Rattenkardiomyozyten in Zellkultur 24 Stunden mit aufsteigenden Noradrenalinkonzentrationen (1-10000 nM) (physiologischer Agonist für α-und β-Adrenozeptoren) inkubiert. Hier zeigte sich ein signifikanter Anstieg der Connexin 43 Expression, während die Connexin 40 Expression nicht beeinflußt wurde. Um zu zeigen über welchen Adrenozeptor (α oder β) die Hochregulation von Cx 43 durch Noradrenalin erfolgt, wurden die Zellkulturen in zwei weiteren Versuchsreihen zusätzlich mit einem β-Blocker (Propranolol 100µM) bzw. einem α- Blocker (Prazosin 10 µM) über 24 Std. inkubiert. Hier zeigte sich eine deutliche Inhibierung des Noradrenalineffektes durch die Blockade der α-Rezeptoren durch Prazosin. Eine Blockade der β-Rezeptoren hatte keinen inhibitorischen Effekt auf die Hochregulation der Expression von Cx 43 durch Noradrenalin. Es kam hier sogar zu einer verstärkten Expression verglichen mit der Cx 43 Expression unter Noradrenalin ohne Rezeptorblockade. Desweiteren wurde überprüft, ob es auch unter der Behandlung von Sprague– Dawley-Ratten mit einem β-Mimetikum (Isoprenalin) bzw. einem α-Mimetikum (Phenylephrin) zu einer Veränderung der Connexinexpression kommt. Die Western Blot Analysen ergaben hierbei wieder einen α-Rezeptoren vermittelten Effekt, indem es zu einem wesentlichen Konzentrationsanstieg von Connexin 43 unter der Behandlung mit Phenylephrin kam.
5

LPS-bindendes Protein an humanem Myokard unter Berücksichtigung der parodontalen Gesundheit und des IL-1-Polymorphismus / Eine klinisch-experimentelle Untersuchung bei Patienten mit kardialer Insuffizienz / LPS-binding protein in the human myocardium taking the periodontal health and the IL-1-polymorphism into account / A clinical-experimental examination in patients with cardiac insufficiency

Semper-Pinnecke, Elske 20 August 2013 (has links)
No description available.

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