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Modeling the economics of prevention /Lindgren, Peter, January 2005 (has links)
Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 4 uppsatser.
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Determinants and clinical implications of bleeding related to coronary artery bypass surgeryMikkola, R. (Reija) 21 November 2017 (has links)
Abstract
Coronary artery bypass grafting (CABG) is the treatment of choice for patients with three-vessel disease or left main stenosis. However, it is associated with considerable risk of perioperative complications such as myocardial infarction, stroke, infections, and mortality to which excessive bleeding is a contributing factor. This thesis aims to determine the factors involved in and clinical implications of bleeding after CABG.
The 1st study evaluated the effects of preoperative ASA discontinuation on the patient’s outcome after CABG. The results showed that late or no discontinuation of low-dose ASA before CABG may decrease the risk of postoperative stroke without increasing the risk of postoperative bleeding.
In the 2nd study the use of warfarin was found to be a safe during CABG with no excess bleeding nor other major complications.
The 3rd study estimated the impact of surgeons´ performances on blood loss and need for re-exploration after CABG. With 2001 study patients, this study clearly demonstrated that an individual surgeon is a powerful determinant of postoperative bleeding and need for re-exploration after CABG.
Using systematic review and meta-analysis, we estimated the risk of complications related to re-exploration for bleeding after CABG. In literature search in 2011, 8 articles with 557 923 patients fulfilled the inclusion criteria. Re-exploration for bleeding after cardiac surgery carries a significantly increased risk of postoperative mortality and morbidity, and thus has a major impact on the patient’s immediate postoperative outcome.
We also studied the impact of blood transfusion on the development of post-operative stroke after CABG. Of the study population of 2 226 CABG patients, stroke occurred postoperatively in 53 patients (2.4%). The statistical analysis showed that transfusion of blood products after CABG has a strong, dose-dependent association with the risk of stroke. The use of Octaplas® and platelet transfusions seem to have an even larger impact on the development of stroke than red blood cell transfusions.
The 6th study investigated the impact of transfusion of blood products on intermediate outcome after CABG in 2001 patients. The findings indicated that transfusion of any blood product is associated with a significant risk of all-cause and cardiac mortality after CABG. / Tiivistelmä
Sepelvaltimotauti on yleisin kuolinsyy ja sepelvaltimoiden ohitusleikkaus hyvine pitkäaikaistuloksineen on todettu parhaaksi hoidoksi potilailla, joilla on monen suonen tai vasemman päärungon tauti. Ohitusleikkaukseen liittyy kuitenkin verenvuodon sekä näihin kytkeytyvien komplikaatioiden riski. Tämän väitöskirjan tavoitteena oli määrittää verenvuodon riskitekijöitä sekä verituotteiden siirtojen vaikutusta ohitusleikkauspotilaiden ennusteeseen.
Verenhyytymistä estävien lääkkeiden tiedetään lisäävän verenvuotoja. Ensimmäinen tutkimus osoitti, että ASA:n jatkaminen keskeytyksettä ohitusleikkauksissa vähentää aivoinfarktien riskiä lisäämättä silti verenvuodon riskiä.
Toisessa tutkimuksessa pitkäaikainen warfariinihoito osoittautui turvalliseksi ohitusleikkauksen aikana eikä sen käyttö lisännyt verenvuotoja eikä muita komplikaatioita.
Kolmas tutkimus osoitti kirurgin taidon merkityksen verenvuotojen ja uusintaleikkausten määrään 2001 potilaalla. Verenvuotojen vuoksi tehtävien uusintaleikkausten negatiivinen vaikutus postoperatiiviseen mortaliteettiin sekä morbiditeettiin on todettu yksiselitteisesti useissa tutkimuksissa.
Vuonna 2011 tehdyllä systemaattisella kirjallisuuskatsauksella ja meta-analyysillä selvitimme yhteensä 557 923 ohitusleikkauspotilaan aineistosta, että verenvuodon jälkeisiin uusintaleikkauksiin liittyy huomattava kuoleman ja komplikaatioiden riski.
Verenvuotoja hoidetaan yleisesti verensiirroilla, vaikkakin useat tutkimukset ovat osoittaneet verituotteiden annon lisäävän mortaliteettia sekä komplikaatioriskiä. Viides tutkimus selvitteli sepelvaltimoleikkauksissa potilaalle annettujen verituotteiden ja leikkauksen yhteydessä sairastettujen aivoinfarktien välistä yhteyttä. Osoittautui, että verituotteiden käyttöön liittyy annosriippuvaisesti lisääntynyt riski saada aivoinfarkti leikkauksen yhteydessä. Varsinkin verihiutale- ja jääplasmasiirtoihin on todettu liittyvän vielä suurempi aivoinfarktin riski kuin punasolusiirtoihin.
Kuudes tutkimus selvitteli sepelvaltimoleikkauksien yhteydessä annettujen verituotteiden vaikutusta 2001 potilaan keskipitkään ennusteeseen. Tutkimus osoitti, että minkä tahansa verituotteen antoon sepelvaltimoleikkauksissa liittyy lisääntynyt kuoleman ja sydänkuoleman riski.
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Profiling Precursor Lipids for Specialized Pro-Resolution Molecules in Platelet-Rich Plasma Following Fish Oil and Aspirin IntakeTurner, Lisa A 01 January 2017 (has links)
Background: Unfavorable outcomes following periodontal surgeries can be attributed to impaired resolution mechanisms likely due to decreased levels of specialized pro-resolution molecules (SPM). The current study investigates if SPM substrate pools in platelet-rich plasma preparations (PRP) can be increased by essential fatty acid (EFA) and / or aspirin supplementation. Methods: Nineteen healthy volunteers were randomly assigned to take i) aspirin; ii) EFA; iii) aspirin and EFA. Four hours after intake, the lipid precursor pools in PRP were quantified using combined Liquid Chromatography tandem mass spectrometry (LC-MS/MS) and the data statistically analyzed using ANCOVA. Results: Of the 77 metabolites screened, only FFA (18:3) showed a significant interaction effect (p=0.019). By itself, neither EFA (p>0.9) nor aspirin (p>0.4) showed any difference (P>0.4). Multiple comparisons could not identify the differences between groups. Conclusions: There is inadequate data to support oral supplementation of EFA and /or aspirin to increase SPM levels in PRP.
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Acute Pharmacological Treatment given to Older Adults with Acute Myocardial Infarction: A Nationwide Emergency Department Study, 1992-2010Alowayesh, Maryam S 23 April 2013 (has links)
OBJECTIVES: To determine the pattern and predictors of use of antiplatelet agents and beta-blockers given in the emergency department (ED) to older adults with acute myocardial infarction (AMI) and its effects on in-hospital mortality and length of hospital stay (LOS) and to determine the effect of computerized ED guideline reminders on their utilization. METHODS: A cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) ED data for years 1992 to 2010 was conducted. Patients were included if they had an admission diagnosis of AMI (ICD-9-CM code 410.xx) and were ≥55 years. Survey logistic regression was used to examine whether there was a trend in the use of antiplatelet agents and beta-blockers across the years and to explore the association between various predictor variables, including ED computerized guideline reminders, and their utilization rates. The chi-square test was used to see whether users of these drugs were different from non-users in their rates of in-hospital mortality. Survey linear regression was used to explore the effect of utilization of these drugs on LOS. All the visits were weighted to get national estimates. All of the analyses were carried out with SAS 9.3 statistical package. RESULTS: A total of 1,771 visits (weighted frequency = 6.1 million) were eligible for this study. Both antiplatelet agents and beta-blockers were shown to have a positive trend across the years. Age, sex, chest pain, triage, using an ambulance, and metropolitan region were all found to be significant predictors of either antiplatelet agent or beta-blocker utilization. Use of beta-blockers was associated with lower in-hospital mortality. Neither drug class had an effect on LOS. Finally, patients who were treated in EDs with computerized guideline reminders were twice as likely to get an antiplatelet agent, but this was not seen with beta-blockers. CONCLUSION: This study displayed a positive pattern across the years in the use of antiplatelet agents and beta-blockers given to older AMI patients. It also showed that age, sex, and other important variables were significant predictors of their utilization. The use of beta-blockers yielded lower in-hospital mortality. Finally, the use of ED reminders increased antiplatelet agent utilization.
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Estratégias de regulamentação da medicação: o caso da propaganda de aspirina / Regulatory strategies of medication: the case of aspirin advertisingMoura, Morgana Moreira 17 March 2014 (has links)
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Previous issue date: 2014-03-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In a scenario of self-medication, drug advertising has a significant role. Thus, in this research,
we seek to understand the strategies used to regulate OTC (out-the-counter) medications,
focusing more specifically to the regulations of advertisements addressed to the general
public. For that, it has as a case study the advertisements of aspirin, Bayer lab. By having
ontological, epistemological and methodological bases strands post-constructionism, the work
was developed at the confluence of psychosocial studies of constructionism orientation and
techno-scientific studies of Actor-Network Theory. Backed by the concept of medicalization
and pharmaceuticalization, as well as the performance of the advertising of medicines in these
processes, initially sought to situate the advertising of aspirin in Brazil. Then it was aimed to
understand, using analysis of the identified regulations, when and how drug advertising
became the object of regulation. In this stage, the different actors who are part of this process
and the different periods in the regulatory line were identified. From the description of these
phases, we identified the impact of such regulation on the aspirin print advertising by
selecting advertisements published after the legislation change of each phase. Finally, the
controversies between CONAR and Anvisa in the regulatory process were described, as well
as the articulations, the divergence points and the weaknesses of this debate. Thus, we
conclude that the regulation has significant effect on advertising, but it has significant gaps
that show the conflict of interests among the sanitary authority, the pharmaceutical industry
and the people who consume these drugs, thus questioning the notion of self-medication and
the way people relate themselves to the substances and to the information about it / No cenário da automedicação, a propaganda de medicamentos possui papel significativo.
Assim, nessa pesquisa, buscamos entender as estratégias de regulamentação dos
medicamentos de venda livre, voltando-se mais especificamente às regulações das
propagandas endereçadas ao público em geral. Para isso, tem como estudo de caso as
propagandas de aspirina, do laboratório Bayer. Tendo por bases ontológicas, epistemológicas
e metodológicas as vertentes pós-construcionistas, o trabalho foi desenvolvida na confluência
dos estudos psicossociais de orientação construcionista e dos estudos tecnocientíficos da
Teoria ator-rede. Respaldados pelo conceito de medicalização e farmaceuticalização, bem
como a atuação da publicidade de medicamentos nesses processos, buscamos inicialmente
situar a propaganda de aspirina no Brasil. Em seguida, objetivou-se entender, por meio de
análise da regulamentação identificada, quando e como a propaganda de medicamentos
tornou-se objeto de regulação. Nessa etapa, identificamos os diferentes atores que fazem parte
desse processo e os diferentes períodos na linha de regulamentação. A partir da descrição
dessas fases, pudemos identificar o impacto dessa regulamentação na propaganda impressa de
aspirina, escolhendo propagandas publicadas após a legislação referente a ruptura de cada
fase. Por fim, descrevemos as controvérsias entre CONAR e Anvisa nesse processo de
regulamentação, bem como as articulações, os pontos de divergência e as fragilidades desse
debate. Com isso, podemos concluir que a regulamentação tem efeitos significativos na
propaganda, mas possui expressivas lacunas, que evidenciam o conflito de interesses entre a
autoridade sanitária, a indústria farmacêutica e as pessoas que consomem o medicamento,
problematizando assim a noção de automedicação e a forma como as pessoas se relacionam
com as substâncias e como as informações sobre essas
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Estudo comparativo entre agregação plaquetária por turbidimetria e impedância elétrica em relação a pacientes sob terapia antiplaquetária a base de ácido acetilsalicílico / Comparative study between platelet aggregation by turbidimetric and impedance methods in patients under acetylsalicilic acyd antiplatelet therapySilva, Leonardo Lorenzo da 29 September 2010 (has links)
A adesão de plaquetas nas paredes dos vasos sanguíneos e subsequente agregação são eventos cruciais tanto na hemorragia e quanto na trombose. A hiperagregação (agregação excessiva) das plaquetas pode causar a formação de um trombo e a posterior oclusão dos vasos sanguíneos levando a um processo isquêmico. A terapia antiplaquetária com ácido acetilsalicílico reduz em até 25% o risco de infartos do miocárdio não-fatais, acidentes vasculares cerebrais isquêmicos ou mortes de causa vascular em pacientes de alto risco, independentemente do sexo ou idade. Para avaliar laboratorialmente a eficácia dessa terapêutica, o método mais utilizado é o teste de agregação plaquetária, que pode ser feito em duas metodologias, a turbidimétrica e a por impedância elétrica. Com esse cenário, o objetivo do estudo é comparar essas duas metodologias para a monitorização do tratamento. Para isso foram utilizadas amostras de sangue de 30 pacientes adultos (média de 42 anos) de ambos os sexos que fazem uso regular do fármaco e analisadas através das duas metodologias, tendo seus resultados analisados e comparados. Os resultados do estudo mostraram pouca diferença estatística significante (p<0,05) entre os dois métodos nos principais agentes estimulantes, indicando que o método de impedância elétrica pode ser utilizado em rotina laboratorial em substituição, ou em complementação, com a metodologia turbidimétrica para monitorar a terapia antiplaquetária a base de ácido acetilsalicílico / The adhesion of platelets in the blood vessel wall and subsequent aggregation are crucial events in both bleeding and thrombosis. The hyperaggregation (excessive aggregation) of platelets can cause the formation of a thrombus and subsequent occlusion of blood vessels leading to an ischemic process. Antiplatelet therapy with acetylsalicylic acyd reduces by 25% the risk of myocardial infarctions, non-fatal strokes or deaths from vascular causes in patients at high risk, regardless of sex or age. To laboratory evaluation of the effectiveness of this therapy, the method most used is the platelet aggregation test, which can be done in two methods, the turbidimetric and electrical impedance. With this scenario, the objective of the study is to compare these two methodologies for monitoring the treatment. For such purpose, blood samples from 30 adult patients (mean 42 years) of both sexes who make regular use of the drug was analyzed using the two methodologies, and their results was analyzed and compared. The studys results showed little difference statistically significant (p <0.05) between the two methods with the main stimulant agents, indicating that the method of electrical impedance can be used in routine laboratory instead or complementing the methodology of turbidimetric for monitor antiplatelet therapy by acetylsalicylic acyd
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Análise transcriptômica de miRNAs em pacientes sob dupla terapia de antiagregação / Transcriptomic analysis of miRNAs on patients in dual antiplatelet therapyGermano, Juliana de Freitas 24 February 2016 (has links)
A terapia antiagregante é comumente indicada na prevenção e tratamento de doenças cardiovasculares. A dupla antiagregação com clopidrogrel e ácido acetilsalicílico (AAS) tem sido frequentemente adotada em pacientes com Doença Arterial Coronariana (DAC), mas apresenta ineficácia em uma parcela significativa da população com genótipo de respondedores. Essa falha terapêutica nos leva a questionar se outros mecanismos moleculares podem estar influenciando na resposta a esses fármacos. Recentes estudos sugerem que pequenas sequências de RNA não codificantes denominadas microRNAs (miRNAs) podem estar fortemente relacionadas com resposta ao tratamento fármaco-terapêutico, controlando as proteínas envolvidas na farmacocinética e farmacodinâmica. Entretanto, os principais miRNAs que atuam na dinâmica da resposta medicamentosa ainda não foram bem definidos. O objetivo deste estudo foi avaliar o perfil de miRNAs no sangue total periférico, procurando melhor esclarecer os mecanismos envolvidos na resposta aos antiagregantes plaquetários AAS e clopidogrel. Para isso, selecionou-se pacientes com DAC, os quais apresentavam diferentes respostas à dupla terapia de antiagregação determinadas pelo teste de agregação plaquetária. Baseados nos fenótipos, os perfis de expressão de miRNAs foram comparados entre os valores da taxa de agregação categorizados em tercis (T) de resposta. O grupo T1 foi constituído de pacientes respondedores, o T2 de respondedores intermediários e o T3 de não respondedores. Os perfis de miRNAs foram obtidos após sequenciamento de última geração e os dados obtidos foram analisados pelo pacote Deseq2. Os resultados mostraram 18 miRNAs diferentemente expressos entre os dois tercis extremos. Dentre esses miRNAs, 10 deles apresentaram importantes alvos relacionados com vias de ativação e agregação plaquetária quando analisados pelo software Ingenuity®. Dos 10 miRNAs, 4 deles, os quais apresentaram-se menos expressos no sequenciamento, demonstraram os mesmos perfis de expressão quando analisados pela reação em cadeia pela polimerase quantitativa (qPCR): hsa-miR-423-3p, hsa-miR-744-5p, hsa-miR- 30a-5p e hsa-let-7g-5p. A partir das análises de predição de alvos, pôde-se observar que os quatro miRNAs, quando menos expressos simultaneamente, predizem ativação da agregação plaquetária. Além disso, os miRNAs hsa-miR- 423-5p, hsa-miR-744-5p e hsa-let-7g-5p mostraram correlação com o perfil lipídico dos pacientes que, por sua vez, apresentou influência nos valores de agregação compreendidos no T3 de resposta a ambos os medicamentos. Sendo assim, conclui-se que maiores taxas de agregação plaquetária podem estar indiretamente relacionadas com os padrões de expressão de hsa-miR- 423-3p, hsa-miR-744-5p e hsa-let-7g-5p. Sugere-se que a avaliação do perfil de expressão destes 3 miRNAs no sangue periférico de pacientes com DAC possa predizer resposta terapêutica inadequada ao AAS e ao clopidogrel / The antiplatelet therapy is often indicated for the prevention and treatment of cardiovascular diseases. Dual antiplatelet therapy with clopidogrel and acetylsalicylic acid (ASA) has often been adopted in patients with coronary artery disease (CAD), but it has been ineffective in a significant portion of the population with genotype of responders. This fact leads us to question whether other molecular mechanisms may be influencing the response to these drugs. Recent studies suggest that small non-coding RNA sequences known as microRNAs (miRNAs) may be closely related to response to drug-therapeutic treatment, controlling proteins involved in pharmacokinetics and pharmacodynamics. The aim of this study was to evaluate the profile of miRNAs in whole blood, looking to better clarify mechanisms involved in ASA and clopidogrel response. For this purpose, we selected CAD patients who showed different responses to dual antiplatelet therapy determined by aggregation test. Based on the phenotypes, the miRNA expression profiles were compared between the platelet aggregation values categorized into tertiles (T) of response. The T1 group consisted of responding patients, the T2 consisted of intermediate responders and the T3 consisted of non-responders. The miRNA profiles were obtained after next-generation sequencing and data were analyzed by Deseq2 package. Results showed that 18 miRNAs were differentially expressed between the two extreme tertiles. By Ingenuity® software prediction analysis, 10 miRNAs showed important targets related with activation and aggregation of blood platelets. Of the 10 miRNAs, 4 of them, which were down-expressed on sequencing, showed the same fold-regulation when expression profiles were analyzed by quantitative polymerase chain reaction (qPCR): hsa-miR-423-3p, hsa-miR-744-5p, hsa-miR-30a-5p and has-hsa- let-7g-5p. By target prediction analysis, it was observed that, when the four miRNAs are simultaneously down-expressed, they predict activation of platelet aggregation. Furthermore, hsa-miR-423-5p, hsa-miR-744-5p, and hsa-let-7g-5p showed correlation with the lipid profile of patients which, in turn, demonstrated influence in aggregation values reaching T3 of response to both drugs. Therefore, we concluded that increased platelet aggregation rates may be indirectly related to the expression profiles of hsa-miR-423-3p, hsa-miR-744-5p and hsa-let-7g-5p. It is suggested that the evaluation of the expression profile of these three miRNAs in the peripheral blood of patients with CAD may predict inadequate therapeutic response to aspirin and clopidogrel.
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Genotoxicity of haloacetic acids, aspirin and ibuprofen in human cells : genotoxic effects of water disinfectant by-products in human blood and sperm and bulk and nano forms of aspirin and ibuprofen in human blood of respiratory disease patientsAli, Aftab H. M. January 2014 (has links)
This project focuses on two important topics which may pose hazards to human health. Firstly, drinking water disinfection by-products (DBPs), which are generated by the chemical disinfection of water have been investigated. What has not been shown is the effect of DBPs in human germ cells as well as somatic cells and whether oxidative stress is involved in the mechanism of genotoxic action. Three different DBPs (halo acetic acids: HAAs), together with the antioxidants – catalase and butylated hydroxyanisole (BHA), were investigated in peripheral blood cells and sperm from healthy individuals using the Comet assay and lymphocytes only using the micronucleus assay. Secondly, nanoparticles of the non-steroidal anti-inflammatory drugs (NSAIDs), aspirin and ibuprofen, have been investigated in patients with respiratory diseases, in the micronucleus assay and the Comet repair assay. NSAIDs inhibit cyclooxygenase enzyme activity, which plays part in tumour progression. In the Comet assay, BHA and catalase were able to reduce DNA damage in both cell types compared to HAAs alone. Similarly, in the micronucleus assay, micronuclei were reduced with the antioxidants, suggesting oxygen radical involvement in both assays. With the NSAIDs, reductions were seen for DNA damage in the micronucleus assay with aspirin and ibuprofen nanoparticles compared to their bulk forms. Using the Comet repair assay, aspirin and ibuprofen nanoparticles aided repair of DNA to a greater extent than their bulk counterparts, which in turn showed better repair compared to samples repaired without NSAIDs. These observations show the importance of DBPs and NSAIDs in genotoxic public health issues.
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Genotoxic effects of NSAIDs and hydrocortisone on bulk and nano forms in lymphocytes from patients with haematological cancersNormington, Charmaine January 2017 (has links)
Chronic inflammation is intimately linked with cancer development and progression and therefore reducing or eliminating inflammation represents a logical treatment and prevention strategy. Studies have shown that anti-inflammatory agents have anti-tumour effects in cancers, with reduced metastases and mortality. Current use of anti-inflammatory agents in the treatment and prevention of cancer is limited by their toxicity and side effects. The emerging field of nanotechnology allows the fundamental properties of a drug to be altered, creating a product with improved reactivity and bioavailability, leading to more targeted treatments and reduced dosage. In the present study, the genotoxic effects of three commonly used anti-inflammatory drugs; aspirin, ibuprofen and hydrocortisone, in their bulk and nano forms were evaluated on peripheral blood lymphocytes of healthy donors using the comet assay and the micronucleus assay. In order to determine any anti-cancer effects, these agents were also tested in peripheral blood lymphocytes in patients with haematological cancers. The glucocorticoid hydrocortisone was also evaluated for anti-oxidant capacity. Our results demonstrate that the nano versions of each drug produced a different response than the bulk counterpart, indicating that a reduction in particle size had an impact on the reactivity of the drug. Our results also indicate that the nano versions of each drug were less genotoxic than the bulk formulation, further emphasising the potential of nanoparticles as an improvement to current treatment options. We also found an anti-oxidant effect with hydrocortisone, with a more profound effect seen with the nano formulation.
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Avaliação da aspirina e do ácido cafeico fenetil estersobre o reparo tecidual cutâneo / Evaluation of aspirin and caffeic acid phenethyl ester on cutaneous wond healingJeanine Salles dos Santos 23 July 2012 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Numerosos modelos in vitro e in vivo foram desenvolvidos para estudar o reparo de lesões e identificar os mecanismos chave deste processo. Visando avaliar o processo de cicatrização utilizamos um modelo de lesão excisional total e um modelo de queimadura promovida por escaldamento. No estudo utilizando o modelo de lesão excisional total, abordamos o uso da aspirina (um inibidor não seletivo da COX) e seu efeito diferenciado sobre os sexos na cicatrização cutânea de camundongos. Observamos que os grupos fêmea controle e tratado apresentaram contração atrasada comparado aos grupos macho controle e tratado, respectivamente. Entre os grupos fêmea e macho controles, as fêmeas apresentaram menor atividade da mieloperoxidase e menor quantidade de células MIF-positivas do que os machos controle. Já entre os grupos fêmea e macho tratados, foi observado que nas fêmeas tratadas, a atividade da mieloperoxidase e a quantidade de macrófagos F4/80-positivos estavam maiores do que no grupo macho tratado. Ainda entre os grupos tratados, as fêmeas apresentaram menores níveis de hidroxiprolina e maior expressão proteica de vWF e VEGF comparado aos machos. No estudo das lesões causadas por queimadura, avaliamos as propriedades anti- inflamatórias e antioxidantes do ácido cafeico fenetil ester (CAPE) no reparo destas lesões e observamos que em 7, 14, 21 e 70 dias após a queimadura, o grupo queimado+CAPE apresentou menor área lesada, além de menor atividade da mieloperoxidase e dos níveis de nitrito do que o grupo queimado. Também foi observado que no grupo queimado+CAPE a expressão proteica de CD68 e de PECAM-1 estava reduzida comparada ao grupo queimado. Analisando os parâmetros de dano oxidativo foi observado que os níveis de MDA e de proteínas carboniladas estavam menores no grupo queimado+CAPE do que no grupo queimado, tanto no plasma quanto na lesão. Em suma, nosso estudo avaliou o processo de cicatrização de dois modelos de lesão, em roedores de diferentes espécies e em abordagens distintas. No modelo de lesão excisional total em camundongos observamos que a administração da aspirina prejudicou o processo de cicatrização em camundongos Balb/c fêmeas, mas não afetou esse processo nos machos da mesma linhagem, o que pode ser explicado pela redução dos níveis de estrógenos nas fêmeas. A utilização do CAPE na cicatrização de queimaduras em ratas comprovou sua eficácia anti-inflamatória e antioxidante devido ao grupo queimado+CAPE ter apresentado maior taxa de cicatrização, redução da resposta inflamatória, além da redução do dano oxidativo em lipídeos e proteínas comparado ao grupo queimado. / Several in vitro and in vivo models have been developed to study wound healing and to identify key mechanisms of this process. The most of these studies use animals models to reproduce the human physiology and possible therapeutic treatments. In order to evaluate the wound healing process in different wound models, we use a full-thickness excisional wound model and a burn model promoted by scalding. In the full-thickness excisional wound study, we approach the aspirin use (COX non-selective inhibitor) and its distinct effect on the gender in cutaneous wound healing on mice. It was observed that both female control and treated groups presented smaller wound area than male control and treated groups, respectively. Between female and male control groups, the females presented smaller myeloperoxidase activity and MIF-positive cells than control males. Comparing female and male treated groups it was observed that in female treated group, the myeloperoxidase activity and the F4/80-positive macrophages amount were greater than male treated group. Also between the treated groups, the females presented smaller hydroxyproline levels and greater vWF and VEGF protein expression compared to the males. In study of the burns performed by scalding, it was evaluated the caffeic acid phenethyl ester (CAPE) anti-inflammatory and antioxidant properties on repair of these lesions. It was observed that at 7, 14, 21 and 70 days after burning, the burn+CAPE group presented smaller wound area, beyond smaller myeloperoxidase activity and nitrite levels than burn group. It was also observed that the burn+CAPE group presented smaller CD68 and PECAM-1 protein expression compared to burn group. Analyzing the oxidative damage parameters, it was observed that the MDA and carbonilated proteins levels were greater in the burn group compared to burn+CAPE group. In conclusion, our study evaluated the wound healing process in 2 wound models on distinct rodent species with distinct approaches. In mice full-thickness wound model, under gender and aspirin action influence, it was seen that the aspirin administration impaired the wound healing process on Balb/c female mice, but did not alter the wound repair on males of the same lineage, what can be explained by reduction of the estrogen levels in these females. The CAPE use on rat burning healing demonstrated its anti-inflammatory and antioxidant efficiency because the burn+CAPE group presented greater burning healing, smaller inflammatory response, beyond smaller oxidative damage at lipid and protein level compared to burn group
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