ResumoIntrodução: As estatinas causaram uma revolução na prevenção e no tratamento do colesterol alto, porém é contraindicada no primeiro trimestre da gravidez, pois podem causar má formação no feto, no sistema nervoso central e nos membros. Objetivo: Verificar os efeitos da Sinvastatina na formação do palato e no desenvolvimento dos germes dentários dos primeiros molares superiores e inferiores. Material e método: Para o acasalamento, foram utilizados 14 camundongos fêmeas e quatro machos; o dia 'zero' da gestação foi identificado pelo plug vaginal após acasalamento. As fêmeas prenhes foram divididas em Grupos I e III -receberam 10 mg/kg solução salina em três semanas antes do acasalamento e a partir do acasalamento até o 14.º dia de prenhez, respectivamente. Grupos II e IV receberam 10 mg/kg de Sinvastatina, no período de três semanas antes do acasalamento e a partir do acasalamento até o 14.º dia de prenhez, respectivamente. Resultado: A análise histológica dos fetos dos Grupos I, II, III e IV mostrou o palato fusionado na linha mediana do processo palatino. Os germes dentários dos primeiros molares dos Grupos II e IV apresentaram um desenvolvimento atrasado quando comparados aos Grupos I e III, porém, todos estavam nas etapas de capuz e campânula. Conclusão: As análises histológica e estatística mostraram que os fetos apresentaram palato fusionado na linha média de fusão do processo palatino e os germes dentários dos Grupos II e IV mostraram-se com formas indefinidas e contornos irregulares. Este estudo preliminar mostrou que a Sinvastatina pode ocasionar alterações morfológicas nos germes dentários.Descritores: Odontogênese; Sinvastatina; colesterol. AbstractIntroduction: The statins have been strongly used for the prevention and treatment of high cholesterol, but are contraindicated in the first trimester of pregnancy because they may cause fetal malformation, affecting the central nervous system and the limbs. Objective: To investigate the effects of simvastatin in palate formation and development of tooth germs of the first upper and lower molars. Material and method: Fourteen female and 4 male mice were used for breeding. The day "zero" of pregnancy was identified by vaginal plug after mating. The pregnant females were divided into four groups. Animals from Groups I and III received daily 10 mg / kg of saline three weeks before mating and from mating through day 14 of pregnancy, respectively. Animals from Groups II and IV received daily 10 mg/kg of simvastatin in the 3 weeks prior to mating and from mating through day 14 of pregnancy, respectively. Result: Histological evaluation of fetuses from Groups I to IV showed fused palate. The first molar tooth germs from Groups II and IV showed up with undefined forms and jagged edges suggesting a slower development compared to Groups I and III, although all the samples were at the bell or hood development stages. . Conclusion: This preliminary study showed that simvastatin does not affect palate fusion but can cause morphologic alterations in tooth germs of fet...
Background Prosthetic valve endocarditis (PVE) occurs in 1–6% of patients with valve prostheses. The most common agent of late PVE are S. aureus and Streptococci. Spondylodiscitis may precede the onset of endocarditis or may be the first clinical manifestation. Coronary embolization is a rare but possible complication of endocarditis. Case report: A 61 years–old man was admitted to the Emergency Department for low back pain, fever and chest pain. Four years before he underwent mitral valve bioprosthesis implantation and hybrid myocardial revascularization (percutaneous on right coronary artery). During observation cardiac arrest from ventricular fibrillation occurred, treated with single shock and evidence of anterolateral myocardial infarction at ECG. An urgent coronarography revealed chronic occlusion of CABG on LAD and acute occlusion, of possible embolic origin, involving LAD mid tract, first diagonal branch and intermediate branch. Thromboaspiration and subsequent PTCA was performed. For hemodynamic instability inotropic and vasopressor supports were started. A transthoracic echocardiogram showed severe left ventricular dysfunction (EF 25%) and 3.5x1mm endocardial vegetation on the mitral bioprosthesis without significant bioprosthesis dysfunction (confirmed by transesophageal echocardiogram). Blood cultures resulted positive for Streptococcus gordonii and antibiotic therapy based on the antibiogram was begun. Cardiac surgery was ruled out due to prohibitive surgical risk despite high probability of embolization. Because of the history of back pain spinal MRI was performed with evidence of cervial and lumbosacral spondylodiscitis. Neurosurgical indications were ruled out. Levosimendan infusion allowed weaning of vasopressor and inotropic therapy, however without improvement of left ventricular ejection fraction. Daily echocardiographic follow–up showed disappearance of the vegetation. Antibiotic targeted therapy was continued for 5 months, given the persistence of spondylodiscitis, in anticipation of intracardiac defibrillator (ICD) implantation in primary prevention. Conclusion PVE is a severe clinical condition associated with high morbidity and mortality. Antibiotic therapy is recommended for at least 6 weeks in PVE, in this case prolonged up to 5 months given the need to implant an ICD. Regarding the treatment of embolic infarction thromboaspiration is recommended as the initial strategy and, if successful, may be the only interventional option.
The aim of this study was to analyze the morphological aspects of the liver parenchyma components in three stages of age in Holtzman rats. The livers of 33 female rats (Rattus norvegicus albinus, Holtzman) aged 120 days (G1 -young), 180 days (G2 -adults) and 540 days (G3 -elderly), with natural aging were studied. The material was processed and submitted to picrosirius technique and polarized light for visualization of collagen fibers, Periodic Acid -Schiff Reactive (PAS) to evidence the glycogen and stained nuclei to search for glycogen and mucus substances. After obtaining the percentage of birefringent collagen, a two-way analysis of variance (TwoWay ANOVA) was performed followed by Tukey's post-test (p<0.05) and for collagen, the analysis of variance was the One-way ANOVA. Morphological analysis of the liver showed normal features of the lobular parenchyma of the liver (hepatocytes, sinusoid capillaries, collagen fibers and blood vessels), but with mild inflammatory infiltrate in the portal space in some animals. Morphometric analysis did not reveal differences between groups regarding the frequency of nuclei and sinusoid capillaries, although this occurred in the "others" parameter between G1 and G2. Glycogen was present in all three groups. G1 presented the smallest amounts of birefringent collagen fibers, followed by G2; G3 showed significantly higher values of birefringent collagen fibers. The results obtained allowed us to conclude that the most relevant alterations obtained during the process of senescence of the rats' liver referred to the more accentuated presence of collagen fibers.
Impairment of physiological mechanisms responsible for maternal cardiovascular adaptation during pregnancy may be associated to intrauterine growth restriction (IUGR). Purpose To compare maternal cardiac parameters between pregnancies with IUGR and with fetal growth appropriate for gestational age (AGA). Methods Twenty-one IUGR (median age 31 years) were compared with 18 AGA matched for age, body size and gestational age (p > 0.35 for all). LV volumes and ejection fraction (LVEF) were measured by 3D echocardiography, and LV mass (LVM) and outflow velocity time integral (VTI) by conventional echocardiography. LV longitudinal strain (GLS) was assessed by speckle-tracking. Results Compared to AGA, IUGR mothers had similar LV volumes and LVEF, but larger LV mass (76 vs 63 g/m2, p = 0.006), LV mass/volume (1.14 vs 1.0 g/ml, p = 0.036) and lower VTI (19.9 vs 21.5 cm, p = 0.046) and GLS (-20 vs -22%, p = 0.032). Maternal LV GLS correlated with fetal growth and utero-placental hemodynamics (Table). At ROC curve analysis, maternal GLS had a good ability to discriminate IUGR from AGA (Figure). Conclusions IUGR had larger LV mass/volume and lower GLS than AGA. GLS was more sensitive than LVEF to detect LV function changes in IUGR. This is the first study reporting that worse maternal LV GLS correlates with fetal growth restriction and suboptimal utero-placental hemodynamics. Rho Spearman p APGAR score 0.36 0.03 Birthweight percentile 0.38 0.02 Biparietal diameter 0.47 0.003 Cranial circumference 0.31 0.07 Abdominal circumference 0.30 0.07 Umbilical vein velocity 0.64 0.003 Uterine artery mean pulsatility index -0.36 0.028 LV length 0.36 0.034 LV mid diameter 0.32 0.05 LV end-systolic volume 0.34 0.046 MAPSE 0.45 0.006 TAPSE 0.41 0.004 Mitral E wave 0.50 0.002 Mitral A wave 0.38 0.02 Correlation of maternal GLS (considered as positive) and fetal parameters. Abstract P205 Figure. GLS ability to discriminate IUGR vs AGA
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