objective: It has been implied that neointimal proliferation and remodeling are the major causes of restenosis. The objective of this study is to assess the effect of orally administered L-arginine on these two factors in hypercholesterolemic rabbits that had suffered an injury to their iliac arteries caused by a catheter balloon. Methods:The study included nineteen rabbits that were divided in two groups: control (CG) and arginine (AG). There were 19 arteries studied from the control group and 17 in the arginine group. The animals were placed on a 2% hypercholesterolemic diet for 15 days and then submitted to a balloon angioplasty in order to produce a lesion in their iliac arteries. Next, the AG animals were given a 1g/kg/day oral dose of a L-arginine solution. The animals were sacrificed 15 days after the angioplasty procedure and histological artery sections were prepared, stained and fixed. The ratio between the neointimal area (in mm 2 ) and the media layer (in mm 2 ) was used to represent lesion development. In order to determine remodeling, the ratio between the total area of the medial portion of the vessel (greater balloon contact) and the total area of the reference segment of the vessel (less balloon contact) was used.results: Mean neointimal thickness (NI/M) was 0.8151±0.2201 in CG and 0.3296±0.1133 in AG. Remodeling patterns for the two groups studied were similar. conclusion: In the experimental model used, L-arginine was able to reduce intimal tissue thickness in hypercholesterolemic rabbits but did not act on artery remodeling.
RESUMOIntrodução: embora o exame neurológico permaneça como o principal parâmetro de avaliação do comprometimento cerebral em muitas UTIs pediátricas do Brasil, o EEG é um exame de fácil realização, baixo custo e que não oferece riscos significativos ao paciente. Nosso objetivo foi avaliar as alterações específicas e inespecíficas, particularmente a presença de paroxismos epileptogênicos, no EEG de crianças em estado de coma e relacionar esses achados com o risco de morte. Métodos: estudo de delineamento retrospectivo. Resultados: foram analisados 36 EEGs de 18 crianças, 10 do sexo masculino (55,6%), com idade entre dois meses e 15,5 anos (mediana: 3,2±4,7 anos). As etiologias do coma foram diversas. Todos os EEGs foram anormais, sendo o alentecimento e a depressão de voltagem as alterações mais observadas. Somente em um exame foi registrada assimetria entre os hemisférios cerebrais. Em 30,6% dos exames foram observados paroxismos epileptogênicos focais, multifocais ou generalizados. A taxa de mortalidade foi 38,9%. Dos 19 EEGs obtidos nas sete crianças que morreram durante o internamento na UTI, 21,1% apresentavam paroxismos epileptogênicos. Conclusão: embora nossa casuística seja relativamente pequena, inferimos que a presença de paroxismos epileptogênicos no EEG de crianças não epilépticas em estado de coma é relativamente frequente, embora não tenhamos observado uma associação consistente desse achado com maior risco de morte.Palavras-chave: eletrencefalograma, estado de coma, infância. ABSTRACT Electroencephalografic abnormalities as prognostic factor in acute coma in non-epileptic childrenIntroduction: Although the neurological examination remains the main parameter for assessment of the brain impairment in many pediatric ICU in Brazil, the EEG is an easy exam to perform, with low costs and offers no significant risk to the patient. Our aim was to evaluate the presence of specific and non specific abnormalities and epileptogenic paroxysms in the EEGs of children in coma and to relate these findings with the risk of death. Methods: retrospective study. Results: 36 EEGs were performed in 18 children. 10 were male (55.6%), aged between two months and 15.5 years (median: 3.2±4.7 years). Different causes for the coma state were described. All EEGs were abnormal and the slowing and voltage depression patterns were the most common abnormalities observed. Only one test showed asymmetry between the cerebral hemispheres. 30.6% of the patients had focal, multifocal or generalized epileptogenic paroxysms on the EEGs. The mortality rate was 38.9%. Analyzing the 19 EEGs obtained from seven children who died during the ICU stay, 21.1% had epileptogenic paroxysms. Conclusion: In spite of the fact that our sample is relatively small, we infer that epileptogenic paroxysms in the EEGs of non-epileptic children in coma is relatively common, even not observing a consistent association of this finding with high risk of death.
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