Navegando por Palavras-chave "Pancreatite necrosante aguda"

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    Efeitos do etil-piruvato no tratamento da resposta inflamatória da lesão pulmonar na pancreatite aguda necrosante induzida em ratos
    (Universidade Federal de São Paulo (UNIFESP), 2011-11-24) Matone, Jacques [UNIFESP]; Goldenberg, Alberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    INTRODUCTION: Severe acute pancreatitis (AP) is characterized by hemodynamic alterations and systemic inflammatory response leading to a high mortality rate. In AP the inappropriate activation of pancreatic enzymes plays an important role in pancreas autodigestion and in the inflammatory mechanisms responsible for the systemic response of the disease. Ethyl-pyruvate, a novel antiinflammatory agent, simple derivative of endogenous metabolite, has been shown to improve survival and/or ameliorate organ dysfunction in a wide variety of preclinical models of critical illnesses, such as severe sepsis, acute respiratory distress syndrome and stroke. It was hypothesized that the EP could diminish the systemic response and acute lung injury associated to necrotizing acute pancreatitis. PURPOSE: The aim of the present study was to evaluate if the ethylpyruvate solution could reduce mortality in AP and/or diminish the acute lung injury. METHODS: 40 male rats, weighing between 270 to 330 grams were operated. An experimental model of severe AP by injection of 0,1ml/100g of 2.5% sodium taurocholate into the bilio-pancreatic duct was utilized. The rats were divided into 2 groups of 10 animals each: CT - control (treatment with 50ml/kg of Ringer’s solution, intraperitoneal) and EP (treatment with 50ml/kg of Ringer ethylpyruvate solution, intra-peritoneal), 3 hours following AP induction. After 6 hours, a new infusion of the treatment solution was performed in each group. Two hours later, the animals were killed and the pulmonary parenchyma was resected for biomolecular analysis, consisting of: interleukin, myeloperoxidase, MDA, nitric oxide, metalloproteinases and heat shock protein. In the second part of the experiment, another, 20 rats were randomly divided into EP and CT groups, in order to evaluate a survival comparison between the two groups. RESULTS: There were no significant differences in IL-1B,IL-10, MMP-9, HSP70, nitric oxide, MPO, MDA (lipidic peroxidation) concerning both groups. The levels of IL-6 were significantly diminished in the EP group. Furthermore, the MMP-2 levels were also reduced in the EP group. (p<0,05). The animals from the EP treatment groups had improved survival, when compared to control group. (p<0.05). CONCLUSIONS: The ethyl-pyruvate diminishes acute lung injury inflammatory response in acute pancreatitis and ameliorates survival when compared to control group, in the experimental model of necrotizing acute pancreatitis.
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    Resultados do tratamento da pancreatite aguda grave
    (Colégio Brasileiro de Cirurgiões, 2012-10-01) Apodaca-Torrez, Franz Robert [UNIFESP]; Lobo, Edson Jose [UNIFESP]; Monteiro, Lilah Maria Carvas [UNIFESP]; Melo, Geraldine Ragot de [UNIFESP]; Goldenberg, Alberto [UNIFESP]; Herani Filho, Benedito [UNIFESP]; Triviño, Tarcisio [UNIFESP]; Lopes Filho, Gaspar de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the results of the Protocol for treatment of patients with severe acute pancreatitis. METHODS: We consecutively analyzed age, gender, etiology, length of hospital stay, type of treatment and mortality of 37 patients with severe acute pancreatitis from January 2002. RESULTS: The patients' ages ranged from 20 to 88 years (average 50 years), 27% were female and 73% male. Mean overall hospital stay was 47 days. Thirteen patients were treated surgically, the average operations per patient was two. There were six deaths among patients undergoing surgical treatment (46%) and two deaths in the group submitted to medical treatment alone (8.3%). The overall mortality was 21%. CONCLUSION: After modification in the form of management of patients with severe acute pancreatitis, there was a decrease in mortality and a trend for conservative management.
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    Valor da difusão (dwi) na quantificação da severidade da pancreatite aguda
    (Universidade Federal de São Paulo (UNIFESP), 2016-03-03) Tertulino, Franklin de Freitas [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Ardengh, José Celso; Schraibman, Vladimir; http://lattes.cnpq.br/7156173153438406; http://lattes.cnpq.br/0773701784699419; http://lattes.cnpq.br/4903816455277036; http://lattes.cnpq.br/9824666157123983; Universidade Federal de São Paulo (UNIFESP)
    Objective: To test the use of Magnetic Resonance Diffusion Imaging (dRM) To differentiate different levels of severity from acute pancreatitis (AP). Method: Thirty-six patients submitted to dRM and cholangiopancreatography by Magnetic resonance imaging were divided into patients with mild PA (PAL, n = 13),Necrotizing PA (PAN, n = 8), and normal pancreas (PN, n = 15, controls). The pancreas Was divided into head, body and tail, and each segment was classified as According to the characteristics of the images: standard 1, normal; Pattern 2, inflammation Light; And standard 3, necrosis. The apparent diffusion coefficients (apparent Diffusion coefficients, ADCs) were measured in each of the segments and Correlated with clinical diagnoses. Results: 108 segments (three segments per patient) were evaluated. The Segments classified as standard 1 in the PN and PAL groups presented Similar ADC values ??(P = 0.29). The calculated ADC values ??for the Pancreatic segments grouped according to different imaging patterns (1-3) were significantly different (P = 0.001). Comparisons revealed Significant differences in signal strength across all three (P <0.05). Conclusions: dRM was a compatible and safe option to differentiate the In patients with PAL, PAN and PN, especially in patients with With contraindication to contrast MR or computed tomography (which Is traditionally necessary to determine the presence of necrosis). The measurement Of ADCs allowed the precise differentiation between standards 1, 2 and 3.