Quattro diversi esperimenti sono stati eseguiti per investigare i fattori che influenzano la fermentazione ruminale delle diete altamente fermentescibili e per sviluppare un modello per studiare la permeabilità gastro-intestinale nei ruminanti. Nello studio 1, quattro ibridi di mais sono stati valutati per la digeribilità ruminale delle loro frazioni. I risultati suggeriscono che i genotipi e le fasi di maturità influenzano fortemente la digeribilità della sostanza secca e dell’amido nel rumine. Nello studio 2, i risultati della fermentazione in vitro di diversi zuccheri ha rivelato che il lattulosio può essere uno zucchero indicatore per studiare la permeabilità intestinale nei ruminanti, grazie alla sua bassa fermentescibilità ruminale. Nello studio 3, per la prima volta un modello di enteropatia indotta da indometacina è stato utilizzato per valutare nei ruminanti la permeabilità dell’intestino tenue attraverso il test del lattulosio. I risultati mostrano che il lattulosio è passato dall'intestino al sangue modificando alcuni parametri metabolici e dell'infiammazione. Nello studio 4, una acidosi acuta è stata indotta in pecore per testare la permeabilità gastro-intestinale con il test del lattulosio. I risultati hanno dimostrato che l'acidosi acuta compromette il funzionamento della barriera gastro-intestinale consentendo l'assorbimento e la traslocazione di LPS e altre sostanze nocive e incrementa l'infiammazione. / Four different experiments were performed for the better understanding of the factors that affect rumen fermentation of highly fermentable diets and to develop a model to study GI permeability in ruminants. In study 1, four corn hybrids recommended for corn silage were evaluated for ruminal starch digestibility of their grain fractions. Results suggest that the genotypes and maturity stages greatly influenced the DM and starch digestibility in rumen. In study 2, the results of the in vitro rumen fermentation of different naturally occurring and synthetic sugars revealed that lactulose can be a good probe sugar to study GI tract permeability in ruminants due to its low and slow fermentation rate in rumen. In study 3, for the first time an indomethacin-induced enteropathy model was used in ruminants to assess small intestinal permeability by the lactulose test. The results established that lactulose passed from the intestine to blood with perturbation of some metabolic parameters and inflammation. In study 4, acute acidosis was induced in sheep to test GI permeability during acidosis condition by lactulose test. The results demonstrated that acute acidosis impair the GI barrier function which allow absorption and translocation of LPS and other harmful substances and increase inflammation.

Traumatic brain injury (TBI) is a severe condition and a major cause of death and disability. There is no pharmacological treatment available in clinical practice today and knowledge of brain injury mechanisms is of importance for development of neuroprotective drugs. The aims of the thesis were to get a better understanding of astrocyte reactions and immune responses, as well as behavioral changes after focal unilateral cortical contusion injury and diffuse bilateral central fluid percussion injury in rats and mice. In the focal injury models, the astrocyte reactions were generally restricted to the ipsilateral hemisphere. After diffuse TBI, vimentin and glial fibrillary acidic protein (GFAP) positive reactive astrocytes were bilaterally expressed in brain regions even distant from the injury site, including regions where axonal injury was seen. Early after diffuse TBI, there was a robust immune response, including activation of macrophages/microglia (Mac-2+) and infiltration of neutrophils (GR-1+) and T-cells (CD3+). In order to measure functional outcome, the recently established Multivariate Concentric Square Field™ (MCSF) test for complex behaviors, including risk taking and explorative strategies was used. The Morris water maze (MWM) was applied for testing learning and memory. The MCSF test revealed alterations in risk taking, risk assessment and exploratory behavior, in the mice subjected to focal injury whereas mice subjected to the diffuse injury showed a deviant stereotyped behavior. After focal injury mice showed a decreased ability to adapt to the arena in the second trial, when tested repeatedly in the MCSF test. Mice subjected to diffuse injury had an impaired memory but not learning, in the MWM test. Post-injury treatment with the anti-inflammatory anti-interleukin-1β (IgG2 a/k) antibody showed a positive effect on functional outcome in the diffuse injury model. Altogether, the results demonstrate that focal and diffuse TBI models produce differences in cellular reactions and behavioral outcome and that the immune response plays a key role in the pathology after brain injury.

Improved perinatal care during the last few years has led to higher survival rates for preterm infants. However, with higher survival rates, the number of children demonstrating long-term health disorders that result in a poorer quality of life is increasing. The most common complications in those preterm children include motion disorders, vision and hearing impairment, mental disorders, and chronic lung disease. Intrauterine infection may cause foetal infection and inflammation thus inducing the inflammatory response in foetus, defined by foetal inflammatory response syndrome (FIRS). FIRS may cause a heavy damage in foetus and newborns as well as later disorders in the infant organism, such as cerebral palsy and chronic lung disease. Speaking about researches proving relation of the perinatal inflammatory response and psychomotor development in a preterm newborn, these are few. The foetal inflammatory response syndrome is a problem that has not been examined yet in Lithuania. Researches of cytokines in umbilical cord blood to make prognoses on the health and psychomotor development in a premature infant has not been performed either. Hopefully, the study results will allow a more detail explanation of the reasons for preterm delivery, better understanding of health disorders in premature infants and prognosis of the process of a child development. The aim of the study was to evaluate the importance of FIRS for the early and later adaptation of premature infants and for... [to full text] / Dėl pagerėjusios perinatalinės priežiūros per pastaruosius metus neišnešiotų naujagimių išgyvenamumas labai pagerėjo. Tačiau, kai neišnešiotų naujagimių išgyvena vis daugiau, daugėja ir vaikų, kuriems augant, išryškėja ilgalaikiai sveikatos sutrikimai, pabloginantys jų gyvenimo kokybę. Nurodoma, kad dažniausia neišnešioto naujagimio gimimo priežastis yra intrauterinė infekcija, kuri progresuodama gali inicijuoti vaisiaus uždegiminio atsako sindromą, kurio metu vaisiuje suintensyvėja uždegiminių citokinų IL-1, IL-6, IL-8, TNF-α, augimo veiksnių gamyba. Šio sindromo pasekmė - sunkūs vaisiaus ir naujagimio pažeidimai bei vėlesni liekamieji kūdikio sveikatos sutrikimai, tokie kaip cerebrinis paralyžius ir lėtinė plaučių liga. Tyrimų, kurie rodytų perinatalinio uždegimo ir neišnešioto naujagimio psichomotorinės raidos sąsajas nėra daug. Ryšys tarp vaisiaus uždegimo ir neišnešiotų naujagimių retinopatijos atrastas neseniai, tad tyrimų šia kryptimi atlikta taip pat nedaug. Ryšys tarp perinatalinio uždegimo ir grėsmingų naujagimystės komplikacijų leidžia daryti prielaidą, kad neišnešioto naujagimio ankstyvas sveikatos vertinimas ir gyvenimo kokybės prognozė yra labai svarbūs, norint kuo anksčiau pradėti tikslinį gydymą bei ankstyvą vaiko raidos korekciją. Šio darbo tikslas buvo įvertinti vaisiaus uždegiminio atsako sindromo įtaką neišnešioto naujagimio sveikatai ir psichomotorinei raidai iki 1 metų koreguoto amžiaus. Tyrimo objektą sudarė virkštelės kraujo citokinų IL-6, bTNF-α... [toliau žr. visą tekstą]

Dėl pagerėjusios perinatalinės priežiūros per pastaruosius metus neišnešiotų naujagimių išgyvenamumas labai pagerėjo. Tačiau, kai neišnešiotų naujagimių išgyvena vis daugiau, daugėja ir vaikų, kuriems augant, išryškėja ilgalaikiai sveikatos sutrikimai, pabloginantys jų gyvenimo kokybę. Nurodoma, kad dažniausia neišnešioto naujagimio gimimo priežastis yra intrauterinė infekcija, kuri progresuodama gali inicijuoti vaisiaus uždegiminio atsako sindromą, kurio metu vaisiuje suintensyvėja uždegiminių citokinų IL-1, IL-6, IL-8, TNF-α, augimo veiksnių gamyba. Šio sindromo pasekmė - sunkūs vaisiaus ir naujagimio pažeidimai bei vėlesni liekamieji kūdikio sveikatos sutrikimai, tokie kaip cerebrinis paralyžius ir lėtinė plaučių liga. Tyrimų, kurie rodytų perinatalinio uždegimo ir neišnešioto naujagimio psichomotorinės raidos sąsajas nėra daug. Ryšys tarp vaisiaus uždegimo ir neišnešiotų naujagimių retinopatijos atrastas neseniai, tad tyrimų šia kryptimi atlikta taip pat nedaug. Ryšys tarp perinatalinio uždegimo ir grėsmingų naujagimystės komplikacijų leidžia daryti prielaidą, kad neišnešioto naujagimio ankstyvas sveikatos vertinimas ir gyvenimo kokybės prognozė yra labai svarbūs, norint kuo anksčiau pradėti tikslinį gydymą bei ankstyvą vaiko raidos korekciją. Šio darbo tikslas buvo įvertinti vaisiaus uždegiminio atsako sindromo įtaką neišnešioto naujagimio sveikatai ir psichomotorinei raidai iki 1 metų koreguoto amžiaus. Tyrimo objektą sudarė virkštelės kraujo citokinų IL-6, bTNF-α... [toliau žr. visą tekstą] / Improved perinatal care during the last few years has led to higher survival rates for preterm infants. However, with higher survival rates, the number of children demonstrating long-term health disorders that result in a poorer quality of life is increasing. The most common complications in those preterm children include motion disorders, vision and hearing impairment, mental disorders, and chronic lung disease. Intrauterine infection may cause foetal infection and inflammation thus inducing the inflammatory response in foetus, defined by foetal inflammatory response syndrome (FIRS). FIRS may cause a heavy damage in foetus and newborns as well as later disorders in the infant organism, such as cerebral palsy and chronic lung disease. Speaking about researches proving relation of the perinatal inflammatory response and psychomotor development in a preterm newborn, these are few. The foetal inflammatory response syndrome is a problem that has not been examined yet in Lithuania. Researches of cytokines in umbilical cord blood to make prognoses on the health and psychomotor development in a premature infant has not been performed either. Hopefully, the study results will allow a more detail explanation of the reasons for preterm delivery, better understanding of health disorders in premature infants and prognosis of the process of a child development. The aim of the study was to evaluate the importance of FIRS for the early and later adaptation of premature infants and for... [to full text]

Parmi les manifestations cliniques du paludisme où P. falciparum est le principal responsable des formes graves, les manifestations pulmonaires sont souvent sous-estimées. Malgré de nombreuses études tentant de mieux comprendre les mécanismes inflammatoires mis en jeu dans l'aggravation de la maladie, des zones d'ombres persistent. Pour étudier les interactions hôte-parasite et identifier des biomarqueurs de classification et d'évolutivité de l'accès palustre, nous avons effectué une étude de cohorte longitudinale prospective à l'Hôpital Monkole de Kinshasa, par une approche combinée immunologique et transcriptomique sur 30 jours. L'étude devant porter initialement sur les atteintes pulmonaires a été recentrée sur l'étude de la sévérité de l'accès palustre devant le peu de patients présentant des atteintes pulmonaires.A travers l'approche immunologique, une réponse pro-inflammatoire de type Th1 modérée est activée à l'admission des patients impaludés. L'approche transcriptomique a permis de le relier à une activation modérée des monocytes/macrophages médiée par la voie de signalisation de l'IL-12, toutefois plus importante chez les accès graves. L'infection palustre, et plus particulièrement l'accès grave paraissent être fortement sous dépendance de la réponse Th17 et plus particulièrement à l'activité des neutrophiles. La mise en place d'une réponse Th2 est également observée chez les patients impaludés. A J7, la réponse Th2 est majoritaire, associée à une importante activité hématopoïétique. A J30, les patients sont guéris et présentent globalement un profil similaire aux témoins.Ces résultats sont à confirmer et à approfondir par une augmentation de notre cohorte. / Among complications of the malaria access, mostly due to P. falciparum, the pulmonary injuries are often underestimated. Despite numerous studies trying to better understand the inflammatory mechanisms involved in disease worsening, they are still poorly understood. In view to study the host-parasite interactions and identify biomarkers according to severity of malaria, a prospective longitudinal cohort study was carried out in Monkole Hospital (Kinshasa) through a combined immunological and transcriptomic approach, with a follow up on 30 days. Initially, the study concerned the pulmonary injuries, but was focused on the the severity of malaria because of a weak patients number with lung damages.The immunological approach highlighted a moderate Th1 pro-inflammatory response at admission. The transcriptomic approach allowed to connect it with a moderate activation of monocytes/macrophages, mediated by IL-12 signaling pathway, higher in severe malaria. Malaria infection, particularly severe malaria, appears to be strongly dependent on Th17 response, especially to neutrophil activity. The establishment of a Th2 response is also observed in malaria patients. On day 7, Th2 response is predominant, associated with significant hematopoietic activity. On day 30, patients are cured and present a similar profile to healthy controls.These results have to be confirmed with an increased cohort.

O estudo consistiu de dois experimentos com o objetivo de avaliar os efeitos da acidose ruminal e restrição nutricional na ocorrência de processos inflamatórios nos animais e relacionar com as alterações na produção e composição do leite. Foram utilizadas doze vacas Holandês e Mestiças Holandês Jersey. Experimento 1: Na fase de adaptação, os animais receberam uma dieta formulada para atender 100% das necessidades nutricionais de energia e proteína. Na indução foi administrada uma dieta com restrição de 50% das necessidades em energia e proteína. Na recuperação os animais receberam uma das três dietas experimentais, para recuperar a estabilidade do leite: (1) suprimento somente de energia; (2) suprimento somente de proteína; (3) suprimento de energia e proteína. A restrição nutricional em energia e/ou proteína afeta negativamente a produção de leite, o peso vivo e o escore de condição corporal. Além de reduzir a eficiência de utilização de proteína da dieta e provocar uma maior instabilidade do leite ao teste do álcool. Entretanto, não altera o perfil sanguíneo e metabólico. Experimento 2: Os animais foram divididos em dois grupos (1) controle e (2) acidose. O delineamento experimental foi reversível simples com dois tratamentos e dois períodos experimentais. Foram analisados parâmetros referente às características físico-quimica, saúde da glândula mamária, medidas fisiológica, perfil metabólico e parâmetros sanguíneos. A indução da acidose ruminal subaguda (SARA) causou redução da produção e estabilidade do leite ao teste do álcool, pH urinário, pH fecal, pH ruminal. Entretanto, a indução a SARA não alterou os parâmetros sanguíneos avaliados. A SARA altera as características físico-químicas do leite, sem influenciar nas concentrações proteínas de fase aguda, caracterizando uma resposta inflamatória. A SARA pode acometer os animais sem apresentar mudanças no perfil sanguíneo dos mesmos. / The study consisted of two experiments with the aim of evaluating the effects of ruminal acidosis and nutritional restriction on the occurrence of inflammatory processes in animals and correlate with changes in milk production and composition. Twelve Holstein and cross bred Holstein and Jersey cows were used. In the first study, in the adaptation phase, the animals received a diet formulated to supply 100% of the nutritional needs of energy and protein. In the induction, a diet composed by 50% restriction of energy and protein requirements was administered. In the recuperation, the animals received one of the three experimental diets to recover milk stability: (1) only energy supply; (2) supply only of protein; (3) supply of energy and protein. The nutritional restriction in energy and / or protein can affects negatively milk production, weight and condition score body. In addition to reduce the efficiency of protein utilization of the diet and cause greater instability of the milk to the alcohol test. However, it does not changed the blood and metabolic profile. In second study, the animals were divided into two groups (1) control and (2) acidosis. The experimental design was simple reversible with two treatments and two experimental periods. Physiochemical characteristics, health of the mammary gland, physiological measures, metabolic profile and blood parameters were analyzed. Losses in milk production, reduction of alcohol stability test, urinary pH, fecal pH, ruminal pH were caused by Subacute ruminal acidosis (SARA) induction. However, induction of SARA did not changed the blood parameters evaluated. SARA changes the physical-chemical characteristics of the milk, without influencing the acute phase proteins concentrations, characterizing an inflammatory response. SARA can affect the animals without demostrate changes in the blood profile of the animals.

A lesão de isquemia e reperfusão pulmonar (LIRI) é a principal causa de disfunção precoce do enxerto após o transplante pulmonar. Diferentes substâncias têm sido utilizadas na tentativa de proteger o pulmão na fase inicial pós-transplante e melhorar o desempenho do enxerto com pouco resultado tanto a curto quanto em longo prazo. O peptídeo liberador gastrina (GRP) está envolvido na indução de respostas imunes inatas adaptativas por induzir a quimiotaxia de mastócitos, migração de macrófagos e proliferação de células T e fibroblastos. Este agente foi capaz de proteger o dano tecidual em outros modelos experimentais de inflamação, incluindo sepsis pós-isquemia e perfuração de ceco, artrite e colite induzidos por drogas. O efeito protetor foi atribuído ao bloqueio na liberação de citocinas pró-inflamatórias, como da interleucina -1 beta (IL-1G) e TNF- alfa (TNF-H), e inibição de migração de mononucleares. Nesta tese o efeito protetor do antagonista do receptor de peptídeo liberador de gastrina (GRPR), o RC-3095 (RC) endovenosamente administrado antes e depois da reperfusão foi estudado em modelo animal de LIRI. Vinte ratos Wistar foram randomizados em quatro grupos: (SHAM), Isquemia-reperfusão (IR), administração de RC Pré-IR (RC-Pré) e RC Pós-IR (RC-Pós). Após a reperfusão, os animais foram observados por 120 minutos. Foi realizada a análise histológica, com verificação de escala de lesão pulmonar, e imunohistoquímica para Caspase clivada - 9 e oxido nítrico sintetase endotelial (eNOS). Expressão de IL-1G e TNF-H foram quantificadas por Enzime-Linked Immunosorbent Assay (ELISA). Uma redução significativa na pressão arterial média foi observada nos grupos IR e RC - Pré quando comparado com seus valores antes da reperfusão (p < 0.001). No final do experimento o grupo RC-Pós apresentou uma redução significativa na pressão arterial de oxigênio em relação ao início (p=0.005). Observou-se maior expressão de Caspase - 9 clivada no grupo RC-Pós (p>0.013), quando comparado aos demais grupos. Não houve diferença significativa na captação da eNOS entre os grupos (p=0.206). Os grupos RC - Pré e Pós mostraram discreta redução, não atingindo significância estatística, da IL-1G (p=0.159) e TNF- H (p= 0.260), quando comparado com o grupo IR. Não houve diferença estatística entre as médias dos escores histológicos entre os diferentes grupos. e SHAM. Notavelmente, quando administrado após reperfusão parece potencializar dano celular estimulando a apoptose. Concluindo, a utilização do antagonista do peptídeo liberador de gastrina, RC-3095, não produziu efeito protetor significativo na resposta inflamatória em pulmões de ratos. Estudos adicionais devem ser implementados para confirmar estes achados. / Lung ischemia reperfusion injury (LIRI) is the main cause of early graft dysfunction and death after lung transplantation. Several methods and substances have been used as an attempt to protect the lung during the early phase after transplantation and improve graft performance at short and long term with limited results. The selective gastrin-releasing peptide receptor (GRPR) antagonist RC-3095 (RC) was shown to protect from damage in various models of inflammation, including sepsis due to cecal ischemia and perforation, drug-induced arthritis and colitis, probably due to the inhibition in the release of proinflammatory cytokines, such as interleukin-1-beta and TNFalpha, as well as interference with mononuclear migration. In this thesis, the protective effect of the selective gastrin-releasing peptide receptor (GRPR) antagonist RC-3095, administrated intravenous before and after reperfusion was studied in an animal model of LIRI. A total of 20 Wistar rats were randomized in four groups: (SHAM), Ischemia-reperfusion (IR), RC Pre-IR (RCPre) and the RC Post-IR (RC-Post) .The IR groups were submitted to a model of ischemia/reperfusion by clamping of the left pulmonary hilum for 45 minutes followed by reperfusion for 120 minutes. We recorded the hemodynamic parameters, blood gas analysis and histology. We analyzed Cleaved Caspase- 9 and endothelial nitric oxide synthase (eNOS) by immunohistochemistry. Expression of IL-1G and TNF-H was evaluated by Enzyme-Linked Immunosorbent Assay (ELISA). We observed that the final mean arterial pressure significantly decreased in IR and RC Pre-IR compared to their values before reperfusion (p < 0.001).The RC-Post group showed significant decrease of partial pressure of arterial oxygen at the end of the observation compared to baseline (p=0.005). Caspase-9 activity was significantly higher in the RC-Post- IR as compared to the other groups (p < 0.013). No significant differences were observed of eNOS activity among the groups. The groups RC Pre-IR e RC Post-IR did not show a significant decrease of IL-1G (p=0.159) and TNF-H (p= 0.260), as compared to IR. The histological score showed no significant differences among the groups. Notably, its use after reperfusion seems to potentiate cell damage, stimulating apoptosis In conclusion, RC3095, a selective GRPR antagonist failed to demonstrate a significant protective effect in our LIRI model in male Wistar rats. Further studies to address this question are warranted.

Submitted by Valquíria Barbieri (kikibarbi@hotmail.com) on 2018-04-18T20:05:35Z No. of bitstreams: 1 DISS_2015_Aurélio Abdias Sampaio Ferreira.pdf: 588938 bytes, checksum: b0dd84c74c6dea32ca2dada05d4e04ea (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2018-04-27T17:28:39Z (GMT) No. of bitstreams: 1 DISS_2015_Aurélio Abdias Sampaio Ferreira.pdf: 588938 bytes, checksum: b0dd84c74c6dea32ca2dada05d4e04ea (MD5) / Made available in DSpace on 2018-04-27T17:28:39Z (GMT). No. of bitstreams: 1 DISS_2015_Aurélio Abdias Sampaio Ferreira.pdf: 588938 bytes, checksum: b0dd84c74c6dea32ca2dada05d4e04ea (MD5) Previous issue date: 2015-08-13 / Investigar a resposta metabólica e inflamatória de pacientes submetidos à intervenção cirúrgica por câncer de mama que receberam cuidados tradicionais ou um protocolo multimodalde cuidados perioperatórios (protocolo ACERTO). Métodos: Estudo prospectivo com 18 pacientes operadas por câncer de mama e randomizadas para dois tipos de cuidados perioperatórios: 1) bebida contendo maltodextrina 12,5%, 06 horas(400 ml) e 02 horas (200 ml) antes da anestesia, nenhuma hidratação venosa no pós-operatório (PO), realimentação em até 12h no PO (grupo ACERTO,n= 09) ou 2) jejum completo de 6-8 horas, hidratação venosa no PO imediato, realimentação no 1º dia de PO (grupo controle, n= 09). Foram coletadas amostras de sangue na indução, com 10h e 24h de PO para dosagem deglicose, insulina, albumina e proteína C-reativa (PCR). Avaliou-se a sensibilidade a insulina pela equação de Quicki e o índice inflamatório foi calculado pela razão PCR/albumina. Os dados foram comparados entre os grupos por ANOVA de medidas repetidas. Resultados: Houve aumento da glicemia (p< 0,001), da insulinemia (p=0,002), e redução da sensibilidade insulínica (p=0,007) nos 02 grupos, sem diferença entre eles. Na indução anestésica a dosagem de PCR (4.1±1.9 vs. 2.6±1.3 mg/L; p=0,049) e o índice inflamatório (p=0,046) foram menores no grupo ACERTO. Comparando a evolução em cada grupo houve queda significativa albumina sérica apenas no grupo controle (de 4.1±0.3para 3.7±0.3 g/dl; p<0.05). Na evolução pós-operatória, a dosagem de albumina no grupo controle foi significantemente menor em relação ao ACERTO (p=0,023). Conclusão: O uso do protocolo multimodal ACERTO não modifica a resposta metabólica, mas diminui a resposta inflamatória de fase aguda em cirurgia de câncer de mama. / To investigate the metabolic and inflammatory response in patients submitted to breast cancer surgery receiving either traditional or a multimodal protocol of perioperative care (Acerto protocol). Methods: A prospective study including 18 patients submitted to breast cancer surgical procedures and randomized to receive two types of perioperative care: 1) a drink containing 12% maltodextrine 6h (400 ml) and 2h (200 ml) before anesthesia, no postoperative intravenous hydration, refeeding up to 12h after surgery (Acerto group, n=9) or 2) 6-8h preoperative fasting, intravenous hydration during immediate postoperative period, and refeeding on PO day 1 (Control group, n=9). Blood samples were collected at anesthetic induction, and at 10h and 24h postoperatively for glucose, insulin, albumin, C-reactive protein (PCR) assays. The insulin sensitivity was assessed by Quicki equation and the inflammatory index by the PCR/albumin ratio. Data were compared by repeated measures ANOVA. Results: We found a significant increase of serum glucose (p<0.001), insulin ((p=0.002), and a reduction of insulin sensitivity (p=0.007) in the two groups without difference between them. At induction of anesthesia PCR levels (4.1±1.9 vs. 2.6±1.3 mg/L; p=0,049) and the inflammatory index (p=0,046) were significant lesser in the Acerto group. During evolution there was a significant fall of serum albumin only in control group (from 4.1±0.3 to 3.7±0.3 g/dl; p<0.05). Albumin values were significantly lesser in controls than in the Acerto patients (p=0.023) during the postoperative phase. Conclusion: The use of the Acerto multimodal protocol of perioperative care do not modify the metabolic response but reduces the acute phase inflammatory response in breast cancer surgery.

O estudo consistiu de dois experimentos com o objetivo de avaliar os efeitos da acidose ruminal e restrição nutricional na ocorrência de processos inflamatórios nos animais e relacionar com as alterações na produção e composição do leite. Foram utilizadas doze vacas Holandês e Mestiças Holandês Jersey. Experimento 1: Na fase de adaptação, os animais receberam uma dieta formulada para atender 100% das necessidades nutricionais de energia e proteína. Na indução foi administrada uma dieta com restrição de 50% das necessidades em energia e proteína. Na recuperação os animais receberam uma das três dietas experimentais, para recuperar a estabilidade do leite: (1) suprimento somente de energia; (2) suprimento somente de proteína; (3) suprimento de energia e proteína. A restrição nutricional em energia e/ou proteína afeta negativamente a produção de leite, o peso vivo e o escore de condição corporal. Além de reduzir a eficiência de utilização de proteína da dieta e provocar uma maior instabilidade do leite ao teste do álcool. Entretanto, não altera o perfil sanguíneo e metabólico. Experimento 2: Os animais foram divididos em dois grupos (1) controle e (2) acidose. O delineamento experimental foi reversível simples com dois tratamentos e dois períodos experimentais. Foram analisados parâmetros referente às características físico-quimica, saúde da glândula mamária, medidas fisiológica, perfil metabólico e parâmetros sanguíneos. A indução da acidose ruminal subaguda (SARA) causou redução da produção e estabilidade do leite ao teste do álcool, pH urinário, pH fecal, pH ruminal. Entretanto, a indução a SARA não alterou os parâmetros sanguíneos avaliados. A SARA altera as características físico-químicas do leite, sem influenciar nas concentrações proteínas de fase aguda, caracterizando uma resposta inflamatória. A SARA pode acometer os animais sem apresentar mudanças no perfil sanguíneo dos mesmos. / The study consisted of two experiments with the aim of evaluating the effects of ruminal acidosis and nutritional restriction on the occurrence of inflammatory processes in animals and correlate with changes in milk production and composition. Twelve Holstein and cross bred Holstein and Jersey cows were used. In the first study, in the adaptation phase, the animals received a diet formulated to supply 100% of the nutritional needs of energy and protein. In the induction, a diet composed by 50% restriction of energy and protein requirements was administered. In the recuperation, the animals received one of the three experimental diets to recover milk stability: (1) only energy supply; (2) supply only of protein; (3) supply of energy and protein. The nutritional restriction in energy and / or protein can affects negatively milk production, weight and condition score body. In addition to reduce the efficiency of protein utilization of the diet and cause greater instability of the milk to the alcohol test. However, it does not changed the blood and metabolic profile. In second study, the animals were divided into two groups (1) control and (2) acidosis. The experimental design was simple reversible with two treatments and two experimental periods. Physiochemical characteristics, health of the mammary gland, physiological measures, metabolic profile and blood parameters were analyzed. Losses in milk production, reduction of alcohol stability test, urinary pH, fecal pH, ruminal pH were caused by Subacute ruminal acidosis (SARA) induction. However, induction of SARA did not changed the blood parameters evaluated. SARA changes the physical-chemical characteristics of the milk, without influencing the acute phase proteins concentrations, characterizing an inflammatory response. SARA can affect the animals without demostrate changes in the blood profile of the animals.

Introduction: Hip fracture surgery is the particular problem of very old patinets (>75 years), with high risk of VTE (up to 80%). It is essential to provide VTE prophylaxis. Patients advanced age and their polymorbidity contribute to the thrombophilic status. Objectives and methods: The aim of the study was to determine the changes of coagulation within the 28 post-operative days in 41 patients over 75 years who underwent hip fracture surgery. Another object was to determine acute phase response and an endothelial activation. The third task was to determine how affected is a key component of hemostasis, FXa activity by its specific inhibitor fondaparinux and enoxaparin, which inhibits FXa and thrombin in a 4:1 ratio and if there is bleeding complication in such a risk group patiens after antithrombotics long-term administration. Patients were randomly divided into two anticoagulant groups: fondaparinux (n = 23) and enoxaparin (n = 18). Results: Thrombophilia is demonstrated by a reactive increase of the most of these parameters preoperatively and reveals the effect of the initial trauma. A surgery further aggravates this reaction. This inflammatory and secondary prothrombogenic condition persisted until postoperative day 28. Both antithrombotics effectively inhibit thrombin generation without...