Troponinas : marcadores de lesión miocárdica en perros

Cada vez son más los trabajos científicos en los que se determinan distinas sustancias que pueden se útiles como marcadores de lesión miocárdica. Dentro de estos marcadores, las troponinas, y en concreto la troponina I, exclusiva de los miocitos y la troponina C, se describen como marcadores esenciales para el diagnóstico de infarto de miocardio en medicina humana, así como para establecer actuaciones terapéuticas propias en estos casos. En medicina veterinaria existen algunos trabajos en los que se determina la concentración de estas troponinas. El objetivo del presente artículo es hacer una revisión de los trabajos encontrados en la bibliografía sobre la determinación de troponinas para esablecer su posible utilidad en la clínica diaria.

Utilidad clínica del electrocardiograma : valor práctico, usos y limitaciones. ¿El electrocardiógrafo puede ser una herramienta útil y necesaria o solo un juguete para algunos especialistas?

En este artículo, los autores pretenden disipar nuestras dudas acerca del coste de los equipos de electrocardiografía, si son o no rentables y qué modelos son los más adecuados.In this article the authors try to help us about the cost of an electrocardiographic equipment, íf it is or it is not profitabe and what models are the best

Medetomidina/Atipamezol, su papel en la anestesia de animales de compañía en la clínica privada : primeras experiencias clínicas

En el presente trabajo, los autores revisan sus primeras experiencias clínicas sobre la utilización de una combinación de un agonista alfa-2 central: medetomidina y un agente selectivo de reversión: atipamezol, en la sedación, contención farmacológica, premedicación y anestesia de perros y gatos en la clínica diaria. Se aportan los datos de los pacientes incluidos en el estudio, los procedimientos clínicos a los que fueron sometidos, los efectos secundarios encontrados con el uso de tales medicamentos y la forma de evitarlos en la medida de lo posible o enfrentarse a ellos cuando se presentan.In this paper the authors review their first clinical experiences with a combination of an alpha-2 adrenergic central agonist: medetomidine and its reversal agent: atipamezole, in the sedation, premedication and anaesthesia of dogs and cats in clinical practice. The authors summarize data obtained from patients, the clinical procedures done, the undesirable side effects found with their use and which is their actual approach in arder to prevent them or how they manage those secondary effects when they re already present

Sitagliptin improved glucose assimilation in detriment of fatty-acid utilization in experimental type-II diabetes: Role of GLP-1 isoforms in Glut4 receptor trafficking

Background: The distribution of glucose and fatty-acid transporters in the heart is crucial for energy consecution and myocardial function. In this sense, the glucagon-like peptide-1 (GLP-1) enhancer, sitagliptin, improves glucose homeostasis but it could also trigger direct cardioprotective actions, including regulation of energy substrate utilization. Methods: Type-II diabetic GK (Goto-Kakizaki), sitagliptin-treated GK (10 mg/kg/day) and wistar rats (n = 10, each) underwent echocardiographic evaluation, and positron emission tomography scanning for [ 18 F]-2-fluoro-2-deoxy-d-glucose ( 18 FDG). Hearts and plasma were isolated for biochemical approaches. Cultured cardiomyocytes were examined for receptor distribution after incretin stimulation in high fatty acid or high glucose media. Results: Untreated GK rats exhibited hyperglycemia, hyperlipidemia, insulin resistance, and plasma GLP-1 reduction. Moreover, GK myocardium decreased 18 FDG assimilation and diastolic dysfunction. However, sitagliptin improved hyperglycemia, insulin resistance, and GLP-1 levels, and additionally, enhanced 18 FDG uptake and diastolic function. Sitagliptin also stimulated the sarcolemmal translocation of the glucose transporter-4 (Glut4), in detriment of the fatty acyl translocase (FAT)/CD36. In fact, Glut4 mRNA expression and sarcolemmal translocation were also increased after GLP-1 stimulation in high-fatty acid incubated cardiomyocytes. PI3K/Akt and AMPKα were involved in this response. Intriguingly, the GLP-1 degradation metabolite, GLP-1(9-36), showed similar effects. Conclusions: Besides of its anti-hyperglycemic effect, sitagliptin-enhanced GLP-1 may ameliorate diastolic dysfunction in type-II diabetes by shifting fatty acid to glucose utilization in the cardiomyocyte, and thus, improving cardiac efficiency and reducing lipolysisThis work was supported by national grants from Ministerio de Educación y Ciencia (SAF2009-08367), Comunidad de Madrid (CCG10-UAM/BIO-5289), and PIE13/00051 and PI14/00386 (IS. Carlos III). Merck Sharp and Dohme (Darmstadt, Germany) provided sitagliptin and partial financial support to the conduct of the stud

Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

Anaesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

The anaesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anaesthesiologist’s main concern are to ensure oxygen delivery and tissue perfusion. Since anaesthetic procedures in such patients are rare, there is no previous report about the anaesthetic management. A 5.5 year old, 32 kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anaesthetized for an ovariohysterectomy to remove an ovarian tumour that was producing high volume ascites. Methadone (0.3 mg kg-1) was administered intramuscularly (IM) for pre-anaesthetic medication, etomidate (1.3 mg kg-1) and midazolam (0.2 mg kg-1) were used for induction of anaesthesia and after endotracheal intubation, anaesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5-10 μg kg-1 h-1) and paracetamol (15 mg kg-1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem and pimobendan) and continued during the anaesthetic procedure. Dobutamine (1.5-5 µg kg-1 min-1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg-1) and incisional bupivacaine (2 mg kg-1) were administered at the end of surgery to provide postoperative analgesia. Anaesthesia was otherwise uneventful, and recovery was considered excellent