Vascular trauma: a five year review

O presente trabalho pretende avaliar a casuística dos traumatismos vasculares agudos admitidos no Serviço de Cirurgia Vascular dos Hospitais da Universidade de Coimbra (HUC) durante o período de 5 anos, compreendido entre Julho de 2004 e Junho de 2009. Foram avaliados 97 doentes, sendo a principal causa de traumatismo as lesões iatrogénicas, seguida dos acidentes de viação. No grupo de doentes não relacionados com procedimentos coronários percutâneos verificou-se que no membro superior as artérias umeral e radial foram as mais afectadas, enquanto no membro inferior foram as artérias femoral superficial e poplítea. A isquémia aguda foi a principal forma de apresentação. Relativamente ao tratamento deste grupo de doentes, a RATT (ressecção e anastomose topo-topo) e o enxerto foram os mais utlizados no membro superior, enquanto a trombectomia e o bypass foram as técnicas mais aplicadas a nível do membro inferior. Não houve mortalidade mas a morbilidade foi elevada, predominando as lesões neurológicas nos traumatismos do membro superior, e a amputação nos do membro inferior. Os resultados deste trabalho foram concordantes com o que está publicado na literatura em que se demonstra um aumento progressivo dos traumatismos de origem iatrogénica

Twenty-four weeks of β-alanine supplementation on carnosine content, related genes, and exercise

Introduction: Skeletal muscle carnosine content can be increased through [beta]-alanine supplementation, but the maximum increase achievable with supplementation is unknown. No study has investigated the effects of prolonged supplementation on carnosine-related genes or exercise capacity. Purpose: To investigate the effects of 24-weeks of [beta]-alanine supplementation on muscle carnosine content, gene expression and high-intensity cycling capacity (CCT110%). Methods: Twenty-five active males were supplemented with 6.4 g[middle dot]day-1 of sustained release [beta]-alanine (BA) or placebo (PL) over a 24-week period. Every 4 weeks participants provided a muscle biopsy and performed the CCT110%. Biopsies were analysed for muscle carnosine content and gene expression (CARNS, TauT, ABAT, CNDP2, PHT1, PEPT2 and PAT1). Results: Carnosine content was increased from baseline at every time point in BA (all P<0.0001; Week 4: +11.37+/-7.03 mmol[middle dot]kg-1dm, Week 8: +13.88+/-7.84 mmol[middle dot]kg-1dm, Week 12: +16.95+/-8.54 mmol[middle dot]kg-1dm, Week 16: +17.63+/-8.42 mmol[middle dot]kg-1dm, Week 20: +21.20+/-7.86 mmol[middle dot]kg-1dm, Week 24: +20.15+/-7.63 mmol[middle dot]kg-1dm), but not PL (all P=1.00). Maximal changes were +25.66+/-7.63 mmol[middle dot]kg-1dm (range: +17.13 to +41.32 mmol[middle dot]kg-1dm), and absolute maximal content was 48.03+/-8.97 mmol[middle dot]kg-1dm (range: 31.79 to 63.92 mmol[middle dot]kg-1dm). There was an effect of supplement (P=0.002) on TauT; no further differences in gene expression were shown. Exercise capacity was improved in BA (P=0.05) with possible to almost certain improvements across all weeks. Conclusions: Twenty-four weeks of [beta]-alanine supplementation increased muscle carnosine content and improved high-intensity cycling capacity. Downregulation of TauT suggests it plays an important role in muscle carnosine accumulation with [beta]-alanine supplementation, while the variability in changes in muscle carnosine content between individuals suggests that other determinants other than the availability of [beta]-alanine may also bear a major influence on muscle carnosine content

Dispelling the myth that habitual caffeine consumption influences the performance response to acute caffeine supplementation

Objective: To investigate the influence of habitual caffeine intake on aerobic exercise performance responses to acute caffeine supplementation. Methods: A double-blind, crossover, counterbalanced study was performed. Forty male endurance-trained cyclists were allocated into tertiles according to their daily caffeine intake: low (58 ± 29 mg.d-1), moderate (143 ± 25 mg.d-1), and high consumers (351 ± 139 mg.d-1). Participants completed three trials in which they performed simulated cycling time-trials in the fastest time possible following ingestion of: caffeine (CAF: 6 mg.kg-1 BM), placebo (PLA), and no supplement (CON). Results: Mixed-model analysis revealed time-trial performance was significantly improved in CAF compared to PLA and CON (29.92±2.18 min vs 30.81±2.67 and 31.14±2.71 min; P = 0.05). Blood lactate and ratings of perceived exertion were not different between trials and tertiles (P>0.05). Conclusion: Performance effects of acute caffeine supplementation during a ~30 min cycling TT performance were not influenced by the level of habitual caffeine consumption

The Liver Plays a Major Role in Clearance and Destruction of Blood Trypomastigotes in Trypanosoma cruzi Chronically Infected Mice

Intravenous challenge with Trypanosoma cruzi can be used to investigate the process and consequences of blood parasite clearance in experimental Chagas disease. One hour after intravenous challenge of chronically infected mice with 5×106 trypomastigotes, the liver constituted a major site of parasite accumulation, as revealed by PCR. Intact parasites and/or parasite remnants were visualized at this time point scattered in the liver parenchyma. Moreover, at this time, many of liver-cleared parasites were viable, as estimated by the frequency of positive cultures, which considerably diminished after 48 h. Following clearance, the number of infiltrating cells in the hepatic tissue notably increased: initially (at 24 h) as diffuse infiltrates affecting the whole parenchyma, and at 48 h, in the form of large focal infiltrates in both the parenchyma and perivascular spaces. Phenotypic characterization of liver-infiltrating cells 24 h after challenge revealed an increase in Mac1+, CD8+ and CD4+ cells, followed by natural killer (NK) cells. As evidence that liver-infiltrating CD4+ and CD8+ cells were activated, increased frequencies of CD69+CD8+, CD69+CD4+ and CD25+CD122+CD4+ cells were observed at 24 and 48 h after challenge, and of CD25−CD122+CD4+ cells at 48 h. The major role of CD4+ cells in liver protection was suggested by data showing a very high frequency of interferon (IFN)-γ-producing CD4+ cells 24 h after challenge. In contrast, liver CD8+ cells produced little IFN-γ, even though they showed an enhanced potential for secreting this cytokine, as revealed by in vitro T cell receptor (TCR) stimulation. Confirming the effectiveness of the liver immune response in blood parasite control during the chronic phase of infection, no live parasites were detected in this organ 7 days after challenge