Effects of ischemic preconditioning and cilostazol on muscle ischemia-reperfusion injury in rats

PURPOSE: To evaluate effects of ischemic preconditioning and Cilostazol on muscle ischemia-reperfusion injury.METHODS: Male Wistar rats were submitted to muscle ischemic and reperfusion injury (4h of the left common iliac artery occlusion followed by 1h of reperfusion). Five experimental groups were constituted: Control group (n=4); Ischemia-Reperfusion (IR, n=5); Ischemic preconditioning group (IP, n=6); Ischemia-Reperfusion group treated with cilostazol (IRCi, n=6) and Ischemic preconditioning group treated with cilostazol (IPCi, n=6). At the end, left gracile muscle was removed and embedded in paraffin. Histopathology, neutrophil infiltration, myocyte necrosis and edema were analyzed.RESULTS: When compared with the control group, IR group showed increased neutrophil infiltration, severe necrosis and edema. There was significant difference between myocytes necrosis of IR group and IP group. There was no difference between the histopathological changes between IP, IRCi and IPCi groups.CONCLUSIONS: the model of IR caused severe muscle injury in the rat hind limb and ischemic preconditioning has a protective effect, reducing myocyte necrosis, however, treatment with cilostazol and also the association between cilostazol and preconditioning has no protective effect on the skeletal muscle subjected to ischemia and reperfusion injury.Universidade Federal de São Paulo, Dept Surg, Surg Tech Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, Surg Tech Lab, São Paulo, BrazilWeb of Scienc

Remote ischemic preconditioning and tacrolimus in the fetal small bowel transplant in mice

PURPOSE: To evaluate the effect of remote ischemic preconditioning (IPC-R) in the fetal small bowel transplantation model. METHODS: Two groups were constituted: The Isogenic transplant (ISO, C57BL/6 mice, n=24) and the allogenic transplant (ALO, BALB/c mice, n=24). In each group, the animals were distributed with and without IPC-R. It was obtained the following subgroups: Tx, IPC-R, Fk, IPC-Fk, in both strains. Intestinal grafts were stained with hematoxylin and eosin and immunohistochemically. RESULTS: The graft development evaluation in ISO group showed that IPC-R reduced the development compared with ISO-Tx (5.2+/-0.4 vs 9.0+/-0.8) and IPC-R-Fk increased the graft development compared with IPC-R (11.2+/-0.7 and 10.2+/-0.8). In ALO group, IPC-Fk increased the development compared with ALO-Tx and ALO with IPC-R (6.0+/-0.8, 9.0+/-1.2, 0.0+/-0.0, 0.5+/-0.3). The PCNA expression was increased in ISO group treated with Fk and IPC-R compared to other groups (12.2+/-0.8 vs Tx: 8.8+/-0.9, IPC-R: 8.0+/-0.4 and Fk: 9.0+/-0.6). The graft rejection was lower in groups treated with IPC-R (-18%), Fk (-68%) or both (-61%) compared with ALO-Tx. CONCLUSION: Remote ischemic preconditioning showed benefic effect even associate with Tacrolimus on the development and acute rejection of the fetal small bowel graft in the Isogenic and Allogenic transplants.Univ Fed Sao Paulo UNIFESP, Sch Med, Operat Tech & Expt Surg Div, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Lab Emergency Med LIM 51, Sao Paulo, BrazilUniv Fed Vale Sao Francisco UNIVASF, Sch Med, Petrolina, PE, BrazilFMUSP, Surg Physiopathol Lab LIM 62, Sao Paulo, SP, BrazilOperative Technique and Experimental Surgery Division, Medical School, Universidade Federal de São Paulo (UNIFESP), BrazilWeb of Scienc

Effect of hyperbaric oxygen therapy combined with autologous platelet concentrate applied in rabbit fibula fraction healing

OBJECTIVES: The purpose is to study the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing the fibula bone of rabbits after induced fractures. METHODS: A total of 128 male New Zealand albino rabbits, between 6-8 months old, were subjected to a total osteotomy of the proximal portion of the right fibula. After surgery, the animals were divided into four groups (n = 32 each): control group, in which animals were subjected to osteotomy; autologous platelet concentrate group, in which animals were subjected to osteotomy and autologous platelet concentrate applied at the fracture site; hyperbaric oxygen group, in which animals were subjected to osteotomy and 9 consecutive daily hyperbaric oxygen therapy sessions; and autologous platelet concentrate and hyperbaric oxygen group, in which animals were subjected to osteotomy, autologous platelet concentrate applied at the fracture site, and 9 consecutive daily hyperbaric oxygen therapy sessions. Each group was divided into 4 subgroups according to a pre-determined euthanasia time points: 2, 4, 6, and 8 weeks postoperative. After euthanasia at a specific time point, the fibula containing the osseous callus was prepared histologically and stained with hematoxylin and eosin or picrosirius red. RESULTS: Autologous platelet concentrates and hyperbaric oxygen therapy, applied together or separately, increased the rate of bone healing compared with the control group. CONCLUSION: Hyperbaric oxygen therapy and autologous platelet concentrate combined increased the rate of bone healing in this experimental model.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Universidade Federal do Vale do Sao Francisco Colegiado de MedicinaUniversidade Federal de São Paulo (UNIFESP) Departamento de CirurgiaUniversidade Federal do Vale do Sao Francisco Colegiado de Medicina VeterinariaSociedade Brasileira de Traumatologia Esportiva e ArtroscopiaUNIFESP, Depto. de Cirurgia104698SciEL

Effect of hyperbaric oxygen therapy combined with autologous platelet concentrate applied in rabbit fibula fraction healing

OBJECTIVES: The purpose is to study the effects of hyperbaric oxygen therapy and autologous platelet concentrates in healing the fibula bone of rabbits after induced fractures. METHODS: A total of 128 male New Zealand albino rabbits, between 6-8 months old, were subjected to a total osteotomy of the proximal portion of the right fibula. After surgery, the animals were divided into four groups (n = 32 each): control group, in which animals were subjected to osteotomy; autologous platelet concentrate group, in which animals were subjected to osteotomy and autologous platelet concentrate applied at the fracture site; hyperbaric oxygen group, in which animals were subjected to osteotomy and 9 consecutive daily hyperbaric oxygen therapy sessions; and autologous platelet concentrate and hyperbaric oxygen group, in which animals were subjected to osteotomy, autologous platelet concentrate applied at the fracture site, and 9 consecutive daily hyperbaric oxygen therapy sessions. Each group was divided into 4 subgroups according to a pre-determined euthanasia time points: 2, 4, 6, and 8 weeks postoperative. After euthanasia at a specific time point, the fibula containing the osseous callus was prepared histologically and stained with hematoxylin and eosin or picrosirius red. RESULTS: Autologous platelet concentrates and hyperbaric oxygen therapy, applied together or separately, increased the rate of bone healing compared with the control group. CONCLUSION: Hyperbaric oxygen therapy and autologous platelet concentrate combined increased the rate of bone healing in this experimental model

Carotid stenosis: what is the high-risk population?

OBJECTIVE: Prevention is the best treatment for cerebrovascular disease, which is why early diagnosis and the immediate treatment of carotid stenosis contribute significantly to reducing the incidence of stroke. Given its silent nature, 80% of stroke cases occur in asymptomatic individuals, emphasizing the importance of screening individuals with carotid stenosis and identifying high-risk groups for the disease. The aim of this study was to determine the prevalence and the most frequent risk factors for carotid stenosis. METHODS: A transversal study was conducted in the form of a stroke prevention campaign held on three nonconsecutive Saturdays. During the sessions, carotid stenosis diagnostic procedures were performed for 500 individuals aged 60 years or older who had systemic arterial hypertension and/or diabetes mellitus and/or coronary heart disease and/or a family history of stroke. RESULTS: The prevalence of carotid stenosis in the population studied was 7.4%, and the most frequent risk factors identified were mean age of 70 years, carotid bruit, peripheral obstructive arterial disease, coronary insufficiency and smoking. Independent predictive factors of carotid stenosis include the presence of carotid bruit or peripheral obstructive heart disease and/or coronary insufficiency. CONCLUSIONS: The population with peripheral obstructive heart disease and carotid bruit should undergo routine screening for carotid stenosis

Acidificante urinário em dieta com elevado excesso de bases para gatos adultos

Maintaining the pH of urine in the ideal range (6.2 - 6.4) is of great importance for health promotion in the lower urinary tract of cats. In the economic and standard feed sector this is a major concern, given that the animal urine tends to be alkaline after food consumption of those commercial segments, which predispose to the formation of struvite urolith. Therefore, this study aimed to study the effects of increasing levels of urinary acidifiers (0.0%, 0.3%, 0.6% and 0.9%, on a dry matter base) in feed with high excess base over the acid-basic balance in the organism, apparent digestibility coefficients of nutrients, urinary pH, hydro-electrolyte balance in cats, as well as the adequacy of equations proposed in the literature to estimate the urinary pH. Twenty-four adult cats, males and females were distributed in a completely randomized design, consisting of six animals per treatment. The dry matter content of urine presented a quadratic behavior (p<0,05; y = 9.5863 + 3.2299x + 0.7871x2 R2 = 99,91%), HCO3-, total CO2 and excess blood base during the period in which the animals were fed were high when including 0.9% acidifier compared to 0.6% (p<0.05). In contrast, the use of the additive did not change the urinary pH, blood electrolyte concentration, nutrient digestibility, fecal score, food and water intake (p>0.05). The equations proposed in the literature, which use excess of base in feed to estimate urinary pH, overestimated the pH values found in this study.A manutenção do pH da urina na faixa ideal (6,2 - 6,4) é de grande importância para a promoção da saúde do trato urinário inferior de felinos. Em alimentos do segmento econômico e standard essa é uma grande preocupação, já que a urina dos animais tende a ser alcalina, após o consumo de alimentos desses segmentos comerciais, predispondo à formação de urólito de estruvita. Nesse sentido, neste trabalho, objetivou-se estudar os efeitos de níveis crescentes de acidificante urinário (0,0%; 0,3%; 0,6%; e 0,9%, em base de matéria seca) em alimento com elevado excesso de bases sobre o balanço ácido-básico do organismo, coeficientes de digestibilidade aparente dos nutrientes, pH urinário, equilíbrio hidro-eletrolítico de gatos, bem como a adequação de equações propostas na literatura para estimar o pH urinário. Foram utilizados vinte e quatro gatos adultos, machos e fêmeas, distribuídos em delineamento inteiramente casualizado, constituído de seis animais por tratamento. A matéria seca da urina apresentou comportamento quadrático (p<0,05; y = 9.5863 + 3.2299x + 0.7871x2 R2 = 99,91%), o HCO3 -, CO2 total e excesso de bases sanguíneos, no período em que os animais estavam alimentados, apresentaram-se elevados, na inclusão de 0,9% de acidificante em comparação a 0,6% (p<0,05). Em contrapartida, a utilização do aditivo não alterou o pH urinário, a concentração de eletrólitos sanguíneos, digestibilidade dos nutrientes, escore fecal, consumo de alimento e de água (p>0,05). As equações propostas na literatura, que utilizam o excesso de bases do alimento para estimar o pH urinário, superestimaram os valores de pH encontrados no presente estudo

Profile of paediatric rheumatology specialists and services in the state of São Paulo

INTRODUCTION: Paediatric rheumatology (PR) is an emerging specialty, practised by a limited number of specialists. Currently, there is neither a record of the profile of rheumatology patients being treated in Brazil nor data on the training of qualified rheumatology professionals in the country. OBJECTIVE: To investigate the profile of PR specialists and services, as well as the characteristics of paediatric patients with rheumatic diseases, for estimating the current state of rheumatology in the state of São Paulo. PATIENTS AND METHODS: In 2010, the scientific department of PR of the Paediatric Society of São Paulo administered a questionnaire that was answered by 24/31 accredited specialists in PR practising in state of São Paulo and by 8/21 institutions that provide PR care. RESULTS: Most (91%) of the surveyed professionals practise in public institutions. Private clinics (28.6%) and public institutions (37.5%) reported not having access to nailfold capillaroscopy, and 50% of the private clinics reported not having access to acupuncture. The average duration of professional practise in PR was 9.4 years, and 67% of the physicians had attended postgraduate programmes. Seven (87.5%) public institutions perform teaching activities, in which new paediatric rheumatologists are trained, and five (62.5%) offer postgraduate programmes. Two-thirds of the surveyed specialists use immunosuppressants and biological agents classified as restricted use by the Health Secretariat. The disease most frequently reported was juvenile idiopathic arthritis (29.1-34.5%), followed by juvenile systemic lupus erythematosus (JSLE) (11.6-12.3%) and rheumatic fever (9.1-15.9%). The incidence of vasculitis (including Henoch-Schönlein purpura, Wegener's granulomatosis, and Takayasu's arteritis) and autoinflammatory syndromes was higher in public institutions compared to other institutions (P = 0.03, P = 0.04, P = 0.002, and P < 0.0001, respectively). Patients with JSLE had the highest mortality rate (68% of deaths), mainly due to infection. CONCLUSION: The field of PR in the state of São Paulo has a significant number of specialists with postgraduate degrees who mostly practise at teaching institutions with infrastructures appropriate for the care of high-complexity patients.INTRODUÇÃO: A reumatologia pediátrica (RP) é uma especialidade emergente, com número restrito de especialistas, e ainda não conta com uma casuística brasileira sobre o perfil dos pacientes atendidos e as informações sobre a formação de profissionais capacitados. OBJETIVO: Estudar o perfil dos especialistas e dos serviços em RP e as características dos pacientes com doenças reumáticas nessa faixa etária a fim de estimar a situação atual no estado de São Paulo (ESP). PACIENTES E MÉTODOS: No ano de 2010 o departamento científico de RP da Sociedade de Pediatria de São Paulo encaminhou um questionário respondido por 24/31 especialistas com título de especialização em RP que atuam no ESP e por 8/12 instituições com atendimento nesta especialidade. RESULTADOS: A maioria (91%) dos profissionais exerce suas atividades em instituições públicas. Clínicas privadas (28,6%) e instituições (37,5%) relataram não ter acesso ao exame de capilaroscopia e 50% das clínicas privadas não tem acesso à acupuntura. A média de tempo de prática profissional na especialidade foi de 9,4 anos, sendo 67% deles pós-graduados. Sete (87,5%) instituições públicas atuam na área de ensino, formando novos reumatologistas pediátricos. Cinco (62,5%) delas têm pós-graduação. Dois terços dos especialistas utilizam imunossupressores e agentes biológicos de uso restrito pela Secretaria da Saúde. A doença mais atendida foi artrite idiopática juvenil (29,1%-34,5%), seguida de lúpus eritematoso sistêmico juvenil (LESJ) (11,6%-12,3%) e febre reumática (9,1%-15,9%). Vasculites (púrpura de Henoch Schönlein, Wegener, Takayasu) e síndromes autoinflamatórias foram mais incidentes nas instituições públicas (P = 0,03; P = 0,04; P = 0,002 e P < 0,0001, respectivamente). O LESJ foi a doença com maior mortalidade (68% dos óbitos), principalmente por infecção. CONCLUSÃO: A RP no ESP conta com um número expressivo de especialistas pós-graduados, que atuam especialmente em instituições de ensino, com infraestrutura adequada ao atendimento de pacientes de alta complexidade.Universidade Federal de São Paulo (UNIFESP) Departamento de Pediatria Setor de Reumatologia PediátricaUniversidade de São Paulo Faculdade de Medicina Hospital das ClínicasSanta Casa de Misericórdia de São Paulo Departamento de Pediatria Setor de ReumatologiaUniversidade Estadual de Campinas Unidade de Reumatologia PediátricaUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Puericultura e PediatriaSanta Casa de Misericórdia de Santos Setor de Reumatologia PediátricaFaculdade de Medicina de Botucatu Hospital Estadual de Bauru Serviço de Reumatologia PediátricaFaculdade de Medicina de BotucatuUNIFESP, Depto. de Pediatria Setor de Reumatologia PediátricaSciEL