Resumo: O objetivo deste trabalho foi identificar os metabólitos séricos e o escore de condição corporal (BCS) de vacas Holandesas associados à ocorrência de doenças periparturientes, quando sob estresse térmico. Amostras de sangue foram coletadas de 181 vacas uma semana após o parto, e o BCS foi determinado no parto. Vacas com concentração de β-hidroxibutirato (BHBA) ≥ 0,8 mmol L-1 tinham 2,2 vezes mais chances de desenvolver metrite e 4,4 vezes mais chances de desenvolver endometrite clínica (EC). Vacas com níveis séricos de creatinina ≥ 2,0 mg dL-1 apresentaram 2,2 e 4,5 vezes maior risco (p ≤ 0,05) de sofrer de metrite e EC, respectivamente, na lactação atual. As chances de metrite e EC foram 2,7 e 4,6 vezes maiores (p < 0,01) em vacas com proteína total sérica (TP) ≥ 5,0 mg dL-1. Vacas com níveis séricos de glicose ≤ 70 mg dL-1 e ácidos graxos não esterificados (NEFAs) ≥ 0,5 tiveram 9,4 e 8,8 vezes mais chances de desenvolver cetose clínica, respectivamente, que vacas com níveis mais baixos de glicose e NEFAs no sangue. O uso estratégico de testes metabólicos para monitorar vacas Holandesas em transição, para prevenir algumas doenças pós-parto devido ao estresse térmico, deve se concentrar em BHBA, NEFAs, glicose, creatinina e TP no sangue. Além disso, o BCS ≤ 3,2 deve ser evitado para prevenir a endometrite.

Abstract: The objective of this work was to identify the serum metabolites and the body condition score (BCS) of Holstein cows associated with the occurrence of periparturient diseases, when under heat stress. Blood samples were collected from 181 cows one week after calving, and the BCS was recorded at calving. Cows with β-hydroxybutyrate (BHBA) concentration ≥ 0.8 mmol L-1 were 2.2 times more likely to develop metritis and 4.4 times more likely to develop clinical endometritis (CE). Cows with serum creatinine levels ≥ 2.0 mg dL-1 showed 2.2 and 4.5 greater risk (p ≤ 0.05) of suffering from metritis and CE, respectively, during the current lactation. The odds of metritis and CE occurrence were 2.7 and 4.6 times greater (p < 0.01) in cows with serum total protein (TP) ≥ 5.0 mg dL-1. Cows with serum glucose levels ≤ 70 mg dL-1 and non-esterified fatty acids (NEFAs) ≥ 0.5 had 9.4 and 8.8 times greater odds of developing clinical ketosis, respectively, than cows with lower glucose and NEFA blood levels. The strategic use of metabolic tests to monitor transition Holstein cows, aiming to prevent some postpartum diseases due to heat stress, should focus on blood BHBA, NEFAs, glucose, creatinine, and TP. Additionally, the BCS ≤ 3.2 should be avoided to prevent endometritis.

Abstract: Background: Primary percutaneous coronary intervention (PPCI) is the treatment of choice for acute ST-elevation myocardial infarction (STEMI). The delays associated with PPCI reduce the benefits of this therapy. To minimize these delays, the pharmacoinvasive strategy (PS) was developed, consisting of applying thrombolytic therapy followed by coronary angioplasty 2 to 24 hours after. Objective: To compare the safety and efficiency of PPCI vs PS in STEMI. Methods: We included patients with STEMI who had emergency PCI. The primary endpoint was combined major adverse cardiac events (MACE), death, reinfarction, stroke, target vessel revascularization (TVR) during hospitalization. The secondary endpoints were the individual components of MACE, and major bleeding (Bleeding Academic Research Consortium: BARC ≥ 3). Results: A total of 400 patients, 263 (65.8%) for PPCI group, 114 (28.5%) for PS group and 23 (5.75%) for diagnostic group. The PS group, 79 (69.3%) were then categorized as systematic angioplasty having had a successful thrombolysis, and 35 (30.7%) were rescue angioplasty because they had a failed thrombolysis. There were no differences in MACE: 13 (9.5%) patients in PS and 27 (10.3%) patients in the PPCI (p = 0.806), there were no differences in the individual components of MACE. The rate of major bleeding was the same, 5 (3.6%) and 4 (1.5%) respectively (p = 0.173). The multivariate analysis did not show a relationship between MACE and the reperfusion strategy. Conclusions: The pharmacoinvasive strategy when compared to PPCI has a similar rate of primary and secondary endpoints. There is no increase in major bleeding therefore, it is an important strategy that offers a reperfusion therapy for patients with STEMI in a non-PCI capable hospital.

Resumen: Antecedentes: La intervención coronaria percutánea primaria (ICPP) es el tratamiento de elección en infarto agudo al miocardio con elevación del ST (IAMCEST). El retraso relacionado con ICPP disminuye el beneficio. Buscando una reperfusión oportuna se implementa la estrategia farmacoinvasiva (EFI), que consiste en realizar trombólisis seguido de ICP entre 2 a 24 horas después. Objetivo: Comparar la seguridad y eficacia en pacientes sometidos a ICPP contra EFI en IAMCEST. Métodos: Se incluyeron pacientes con IAMCEST sometidos a ICP emergente. El punto final primario son eventos cardiacos adversos mayores (ECAM), muerte, reinfarto, evento vascular cerebral y revascularización del vaso tratado, durante la hospitalización. Los puntos finales secundarios son la presencia de los componentes individuales del ECAM, y el sangrado mayor (BARC ≥ 3). Resultados: Se estudiaron 400 pacientes, 263 (65.8%) de ICPP, 114 (28.5%) a EFI y 23 (5.75%) angiografía diagnóstica. Del grupo EFI, 79 (69.3%) fueron angioplastia sistemática por trombólisis exitosa y 35 (30.7%) por angioplastia de rescate por trombólisis fallida. No se observó diferencia en la frecuencia de ECAM: EFI 13 (9.5%) contra ICPP 27 (10.3%) respectivamente (p = 0.806), tampoco hubo diferencia en los componentes individuales. No se observó diferencia en sangrado mayor, 5 (3.6%) vs 4 (1.5%), (p = 0.173). El análisis multivariado no relacionó la estrategia de reperfusión con los ECAM. Conclusiones: La EFI comparada con ICPP demuestra una tasa similar de ECAM, así como de sus componentes individuales. No se asocia con aumento de hemorragia mayor, concluyendo que ofrece el beneficio de una reperfusión oportuna sin aumento del riesgo en los hospitales que no tienen la capacidad para realizar ICPP.

Abstract Bioresorbable linear poly(ether-ester-urethane)s with different hydrophilic characteristics were synthesized from triblock copolymers of poly(ε-caprolactone)-poly(ethylene oxide)-poly(ε-caprolactone) (PCL-PEO) as macrodiols, and L-lysine diisocyanate (LDI) or hexamethylenediisocyanate (HDI) were used as the required diisocyanates. Macrodiols were obtained by ring-opening polymerization (ROP) of ε-caprolactone (CL). Polyurethanes were synthesized by the reaction of the triblock copolymers with LDI or HDI in solution using stannous 2-ethylhexanoate as catalyst. Polyurethane tablets were fabricated and investigated as prospective drug delivery systems. The effect of the PEO content on the polymers' performance as drug carriers was evaluated. It was found that water provoked more swelling and erosion of polymers with higher contents of PEO. The hydrocortisone release profiles were analyzed using the Ritger-Peppas approximation. An anomalous release behaviour (values of n higher than 0.5) was found for most of the analyzed samples.