Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Wisconsin-Madison, 1988. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.D.)--University of Hong Kong, 1989. / Also available in print.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1983.

Orientador: Orlando Petrucci Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T16:20:22Z (GMT). No. of bitstreams: 1 Lima_FanySilva_M.pdf: 1729080 bytes, checksum: a3d4e3c77bc179cf859c845d5e3bac06 (MD5) Previous issue date: 2015 / Resumo: O infarto agudo do miocárdio (IAM) ainda permanece como umas das principais causas de morbimortalidade em indivíduos adultos, ocasionando lesões miocárdicas pela isquemia seguida da reperfusão. No presente trabalho estudamos a cardioproteção por meio de três diferentes estratégias: a utilização de um fármaco denominado - Piracar (Piracetam, L-carnitiva, glutamato e aspartato), a utilização de uma solução contendo eritropoietina, glicose, insulina e potássio (EG); e por meio da modulação humoral/neurológica denominada isquemia de pré-condicionamento remoto (IPCR). Para esta análise utilizou-se de modelo agudo de isquemia e reperfusão miocárdica em suínos onde foram avaliadas variáveis hemodinâmicas, quantificação da área de infarto, quantidade de troponina I liberada (TnI-C) e de adenosina trifosfato no músculo cardíaco (ATP). Também foram estudadas proteínas relacionadas a isquemia e reperfusão miocárdicas de duas vias conhecidas como a Survivor Activating Factor Enhancement (SAFE) e a Reperfusion Injury Salvage Kinase Pathway (RISK) utilizando Western Blotting. Foi observado maior ativação das proteínas ERK (p?0,05) e STAT (p?0,05) no grupo EG e IPCR comparados ao controle, quando comparados entre si o grupo que se apresentou melhor foi o EG, também com a quantidade de ATP significativamente maior. No grupo Piracar e IPCR a AKT (p?0,05) apresentou-se ativada comparada aos demais grupos. Não encontramos diferença nas análises hemodinâmicas e na porcentagem de área de infarto. Entretanto, a TnI-C apresentou-se elevada na fase de reperfusão nos grupo IPCR e EG; e reduzida no grupo Piracar. Dos tratamentos estudados, o grupo EG foi o que mais se destacou pelo aumento significativo das proteínas ERK e STAT, e aparente melhora na reserva metabólica pela quantidade elevada de ATP disponível, enquanto os demais grupos e nas demais formas de análises foram semelhantes ou com resultados inferiores / Abstract: Acute myocardial infarction (AMI) still the major cause of morbidity and mortality in adults, causing myocardial ischemia followed by lesions of reperfusion. In the present study, we studied cardioprotection by 3 different strategies: the use of a so-called drug - Piracar ( Piracetam, L- carnitiva, glutamate and aspartate) using a solution containing erythropoietin, glucose, insulin and potassium (EG); by humoral and/modulation neurological called remote ischemic preconditioning (IPCR) . For this analysis we used the model of acute myocardial ischemia and reperfusion in pigs where hemodynamic variables were evaluated, quantification of infarct area, amount of troponin I released (cTnI) and adenosine triphosphate in the heart muscle (ATP). Were also studied proteins related to myocardial ischemia and reperfusion two-way known as the Survivor Activating Factor Enhancement (SAFE) Reperfusion Injury and Salvage Kinase Pathway (RISK) using Western blotting. We found greater activation of ERK proteins (p= 0,05) and STAT (p= 0,05) in the EG group and IPCR compared to the control, when comparing between the group that performed best was the EG, also with the amount significantly higher ATP. In group Piracar AKT (p= 0,05) was significantly activated compared to the other groups. No differences in hemodynamic analysis and the percentage of infarcted area. However, cTnI showed up high in the reperfusion phase in IPCR and EG group; and reduced in Piracar group. Of the treatments, the EG group was the one that stood out the significant increase in ERK and STAT proteins, and apparent improvement in metabolic reserve by the high amount of ATP available, while the other groups and other forms of analysis were similar or results below / Mestrado / Fisiopatologia Cirúrgica / Mestra em Ciências

Asthma affects 5%-10% of adults in the United States. Older adults (< 65 years) with asthma have higher rates of fatal asthma than younger adults. The occurrence of a respiratory emergency, such as status asthmaticus, would seem likely to create a situation of cardiopulmonary dysfunction conducive to myocardial ischemia. However, multiple studies of fatal or near-fatal asthma have failed to incriminate myocardial infarction as a contributing factor. We report a patient without underlying coronary artery disease who sustained myocardial injury consistent with myocardial ischemia and infarction during status asthmaticus while receiving recommended treatment without intravenous sympathomimetics or theophylline.

Non-Q Myocardial Infarction (NQMI) is considered to be an unstable condition with increased risk of recurrent infarction. Thus aggressive approaches in management have been recommended. However, there is no firm evidence that this strategy influences the course of NQMI patients favourably. To determine the experience at Groote Schuur Hospital all patients admitted to CCU from 1990 to 1993 with NQMI were analysed retrospectively especially with regard to management and outcome. One-hundred and eighty-one patients were admitted with NQMI. Seventy-eight percent (141) remained cardiovascularly stable in the early period after the index event; 51% (93) underwent cardiac catheterisation during that hospital admission and revascularization was performed in 29% (52). There were 2 deaths during the initial hospital admission, both after surgical revascularisation. At one year the cardiac mortality was 7%. There were 23 cardiac deaths in all. Early readmission for symptomatic recurrence of ischaemia was identified as a risk factor (p=0.004). By one year 51% of patients had developed recurrence of symptomatic ischaemia, the majority (62%) in the first 3 months after the primary admission. There was a significantly reduced recurrence in those patients managed actively (i.e. cardiac catheterisation with/without revascularization) as compared to those treated conservatively (p=0.001).

No description available.

The purpose of this thesis investigation was to determine the responsiveness and validity of a previously developed evaluative instrument (QL-SP), purported to measure quality of life in spouses of patients who have suffered a myocardial infarction. The 26 questions of the index address emotional concerns, functional limitations, sleep disturbances, and lifestyle changes; they are categorized into the Emotional Function Dimension (EFD) , and the Physical and Social Function Dimension (PSFD). Subjects (n=39) completed the QL-SP and a battery of established questionnaires during home visitations, 1-2 weeks after the patient member of the pair had been discharged from the hospital, and 8 weeks later. Predicted associations were derived according to standardized consensus methods suggesting how changes in the QL-SP dimensions should correlate with changes in the other indexes. Scores on the QL-SP between admission to the study and the second visit were improved for both the emotional function (t = 5.56, p < 0.001), and physical and social function (t = 6.11, p < 0.001) dimensions. The agreement between predicted and observed relationships, as measured statistically by a Kappa with Cicchetti weights, was significant (Kw = 0.43, p = 0.0012). The QL-SP appears to be a responsive and valid measure of quality of life in spouses of MI patients related to their partner's illness. It may be useful in clinical practice as a routine periodic assessment throughout the post-MI convalescent period, and as an evaluation tool for intervention strategies. / Thesis / Master of Science (MS)