Tesis Vidal Patricia - para biblioteca
Cushing's disease (CD) is characterized by chronic hypercortisolism, which cause metabolic and systemic alterations. It is associated to a lot of comorbidities,\nhypertension is one of them, which leads along with hypercortisolism, to kidney\ndisease, and both have an impact on coagulation para...
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| Autor principal: | |
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| Otros Autores: | |
| Formato: | Tesis doctoral acceptedVersion |
| Lenguaje: | Español |
| Publicado: |
Universidad de Buenos Aires. Facultad de Ciencias Veterinarias
2019
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| Materias: | |
| Acceso en línea: | http://repositoriouba.sisbi.uba.ar/gsdl/cgi-bin/library.cgi?a=d&c=avaposgra&cl=CL1&d=HWA_3135 https://repositoriouba.sisbi.uba.ar/gsdl/collect/avaposgra/index/assoc/HWA_3135.dir/3135.PDF |
| Aporte de: |
| id |
I28-R145-HWA_3135 |
|---|---|
| record_format |
dspace |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-145 |
| collection |
Repositorio Digital de la Universidad de Buenos Aires (UBA) |
| language |
Español |
| orig_language_str_mv |
spa |
| topic |
Enfermedad de Cushing Nefropatía Hipertensión Hipercoagulabilidad Caninos Síndrome de Cushing Nefropatías Variables Enfermedades renales Endocrinología |
| spellingShingle |
Enfermedad de Cushing Nefropatía Hipertensión Hipercoagulabilidad Caninos Síndrome de Cushing Nefropatías Variables Enfermedades renales Endocrinología Vidal, Patricia Noemí Tesis Vidal Patricia - para biblioteca |
| topic_facet |
Enfermedad de Cushing Nefropatía Hipertensión Hipercoagulabilidad Caninos Síndrome de Cushing Nefropatías Variables Enfermedades renales Endocrinología |
| description |
Cushing's disease (CD) is characterized by chronic hypercortisolism, which cause metabolic and systemic alterations. It is associated to a lot of comorbidities,\nhypertension is one of them, which leads along with hypercortisolism, to kidney\ndisease, and both have an impact on coagulation parameters which develops in an hypercoagulability state with thrombosis risk.\nTaken all this to account, CD?s dogs were studied. The results showed an important\ndecrease in nitric oxide (NO) correlated with the increase in cortisol (r = -0.67, P\n<0.0001), and both were associated with an increase in blood pressure [(PS and\ncortisol (r = 0.46, P = 0.008) PS and NO (r = - 0.87; P <0.0001)], specially with\ndiastolic pressure (PD). PD correlated with cortisol (r = 0.63, P <0.0001) positively and with NO (r = -0.81; P <0.0001). All this has an impact in renal parameters affecting the glomerular filtration rate (GFR) (r = - 0.58, P = 0.007) and increasing proteinuria,\nevidenced by the increase in protein/creatinine ratio in urine (UPC) (r = 0.8, P <0.001), which is an indicator of early glomerular damage. Using Resistance Index (IR) related\nto the UPC and blood pressure have a high prognostic value of renal affection. To decided what treatment is the most effective renoprotective and hypotensive therapy, a\ncomparison was made between 2 groups of CD?s dogs according to the UPC value, they were also subdivided according to arterial pressure. enalapril vs doxazosina were\ncompared. The comparison was made between all the gropus. Dozaxosine was the\nmost effective in reducing UPC (*P-valueBvsE= 0,01) and blood pressure (PS: PvalueBvsE = 0,01 and P-valueBvsD= 0,029; PD P-valueBvsE = 0,002).\nThe hypercoagulability state in CD?s dogs was confirmed, a comparison between a\ncontrol group (healthy dogs) and cushing?s dogs was made, it was found in cushing?s dogs a high concentrations of von-Willebrand Factor (FvW) and plasminogen activator\ninhibitor-1 (PAI-1) (P-value = 0.003 and P-value = 0.002 respectively), and a decreased in activity of Antithrombin III (ATIII), which was associated with an increase of UPC (r =\n-0.75, P-value <0.001 ) and presence of D-Dimer + (DD) (r = -0.5, P-value = 0.008),\nhaving a correlation in both cases. Those results have a great utility as early indicators of thrombosis risk or pulmonary thromboembolism (TEP). Indicators associated with\nclinical symptoms and a possitive lung thrombosis image are needed to confirm the TEP. To explain one of the mechanisms involved in the development of hypertension, the\nconcentrations of aldosterone and angiotensin II (Ang II) in CD?s dogs were compared\nwith a group of healthy dogs. The results showed that aldosterone would not be\ninvolved, becuase the concentration was the same in healthy controls as CD?s dogs (P-valor= 0,8), but Ang II was found increased in cushing?s dogs (P-valor< 0,0001), which means that it has a rol in cushing's hypertension. The resaults of this research thesis has a great relevance to expand the knowledge in\nthe pathophysiology of this disease. It will help to improve the early diagnosis of these comorbidities and to implement appropriate preventive therapies in the daily clinic which will improve the quality life and survival of the patient. |
| author2 |
Castillo, Víctor Alejandro |
| author_facet |
Castillo, Víctor Alejandro Vidal, Patricia Noemí |
| format |
Tesis doctoral Tesis doctoral acceptedVersion |
| author |
Vidal, Patricia Noemí |
| author_sort |
Vidal, Patricia Noemí |
| title |
Tesis Vidal Patricia - para biblioteca |
| title_short |
Tesis Vidal Patricia - para biblioteca |
| title_full |
Tesis Vidal Patricia - para biblioteca |
| title_fullStr |
Tesis Vidal Patricia - para biblioteca |
| title_full_unstemmed |
Tesis Vidal Patricia - para biblioteca |
| title_sort |
tesis vidal patricia - para biblioteca |
| publisher |
Universidad de Buenos Aires. Facultad de Ciencias Veterinarias |
| publishDate |
2019 |
| url |
http://repositoriouba.sisbi.uba.ar/gsdl/cgi-bin/library.cgi?a=d&c=avaposgra&cl=CL1&d=HWA_3135 https://repositoriouba.sisbi.uba.ar/gsdl/collect/avaposgra/index/assoc/HWA_3135.dir/3135.PDF |
| work_keys_str_mv |
AT vidalpatricianoemi tesisvidalpatriciaparabiblioteca AT vidalpatricianoemi nefropatiaasociadaalaenfermedaddecushingenelcaninoestudiodevariablesdevalorpredictivodedanorenal |
| _version_ |
1824356447620694016 |
| spelling |
I28-R145-HWA_31352024-10-23 Tesis Vidal Patricia - para biblioteca Cushing's disease (CD) is characterized by chronic hypercortisolism, which cause metabolic and systemic alterations. It is associated to a lot of comorbidities,\nhypertension is one of them, which leads along with hypercortisolism, to kidney\ndisease, and both have an impact on coagulation parameters which develops in an hypercoagulability state with thrombosis risk.\nTaken all this to account, CD?s dogs were studied. The results showed an important\ndecrease in nitric oxide (NO) correlated with the increase in cortisol (r = -0.67, P\n<0.0001), and both were associated with an increase in blood pressure [(PS and\ncortisol (r = 0.46, P = 0.008) PS and NO (r = - 0.87; P <0.0001)], specially with\ndiastolic pressure (PD). PD correlated with cortisol (r = 0.63, P <0.0001) positively and with NO (r = -0.81; P <0.0001). All this has an impact in renal parameters affecting the glomerular filtration rate (GFR) (r = - 0.58, P = 0.007) and increasing proteinuria,\nevidenced by the increase in protein/creatinine ratio in urine (UPC) (r = 0.8, P <0.001), which is an indicator of early glomerular damage. Using Resistance Index (IR) related\nto the UPC and blood pressure have a high prognostic value of renal affection. To decided what treatment is the most effective renoprotective and hypotensive therapy, a\ncomparison was made between 2 groups of CD?s dogs according to the UPC value, they were also subdivided according to arterial pressure. enalapril vs doxazosina were\ncompared. The comparison was made between all the gropus. Dozaxosine was the\nmost effective in reducing UPC (*P-valueBvsE= 0,01) and blood pressure (PS: PvalueBvsE = 0,01 and P-valueBvsD= 0,029; PD P-valueBvsE = 0,002).\nThe hypercoagulability state in CD?s dogs was confirmed, a comparison between a\ncontrol group (healthy dogs) and cushing?s dogs was made, it was found in cushing?s dogs a high concentrations of von-Willebrand Factor (FvW) and plasminogen activator\ninhibitor-1 (PAI-1) (P-value = 0.003 and P-value = 0.002 respectively), and a decreased in activity of Antithrombin III (ATIII), which was associated with an increase of UPC (r =\n-0.75, P-value <0.001 ) and presence of D-Dimer + (DD) (r = -0.5, P-value = 0.008),\nhaving a correlation in both cases. Those results have a great utility as early indicators of thrombosis risk or pulmonary thromboembolism (TEP). Indicators associated with\nclinical symptoms and a possitive lung thrombosis image are needed to confirm the TEP. To explain one of the mechanisms involved in the development of hypertension, the\nconcentrations of aldosterone and angiotensin II (Ang II) in CD?s dogs were compared\nwith a group of healthy dogs. The results showed that aldosterone would not be\ninvolved, becuase the concentration was the same in healthy controls as CD?s dogs (P-valor= 0,8), but Ang II was found increased in cushing?s dogs (P-valor< 0,0001), which means that it has a rol in cushing's hypertension. The resaults of this research thesis has a great relevance to expand the knowledge in\nthe pathophysiology of this disease. It will help to improve the early diagnosis of these comorbidities and to implement appropriate preventive therapies in the daily clinic which will improve the quality life and survival of the patient. Fil: Vidal, Patricia Noemí. Universidad de Buenos Aires. Facultad de Ciencias Veterinarias. Buenos Aires, Argentina Castillo, Víctor Alejandro Vidal, Patricia Noemí 2019-03-22 La Enfermedad de Cushing (EC) se caracteriza por un estado de hipercortisolismo\ncrónico, que provoca alteraciones metabólicas y sistémicas. Está asociada a gran cantidad de comorbilidades entre ellas la hipertensión arterial, de alta prevalencia, que conduce, junto con el hipercortisolismo, a la enfermedad renal, y ambas tienen repercusión en parámetros de coagulación, induciendo un estado de\nhipercoagulabilidad con riesgo de trombosis.\nPara el estudio de estas comorbilidades se evaluaron perros con EC, evidenciándose\ndisminución del oxido nítrico (NO) correlacionado con el aumento del cortisol (r= -0.67; P<0.0001), asociados al aumento de presión arterial [PS y cortisol (r=0.46; P=0.008)\nPS y NO (r= - 0.87; P<0.0001)], con predominio de la presión diastólica (PD). PD correlacionó con cortisol (r=0.63; P<0.0001) de forma positiva y con el NO (r= -0.81; P<0.0001) de forma inversa. Repercutiendo la PD, en parámetros renales afectándose la tasa de filtrado glomerular (GFR) (r= - 0.58; P=0.007) y aumentando la proteinuria,\nevidenciada por el aumento en la relación proteína/creatinina en orina (UPC) (r= 0.8;\nP<0.001). UPC es un indicador de daño glomerular temprano. La utilización del Índice\nde resistencia (IR), relacionado al UPC y la presión arterial, posee gran valor pronostico de afección renal. Para el posterior empleo de la terapia renoprotectora e\nhipotensora más efectiva, se realizó la comparación entre 2 grandes grupos de perros\ncon EC según valor de UPC, a su vez subdivididos según presión arterial. Se comparó\nenalapril vs doxazosina entre los distintos grupo, siendo más efectiva la Dozaxosina en reducir UPC (*P-valorBvsE= 0,01) y presión arterial (PS: P-valorBvsE = 0,01 y P-valorBvsD= 0,029; PD P-valorBvsE = 0,002).\nSe pudo comprobar el estado de hipercoagulabilidad en perros con EC, a través de su comparación con un grupo control (perros sanos), encontrándose las concentraciones\nde Factor de von-Willebrand (FvW) y el Inhibidor del Activador de Plasminogeno-1 (PAI-1) elevadas (P-valor=0,003 y P-valor=0,002 respectivamente), y disminuida la actividad de Antitrombina III (ATIII), la cual se asoció al aumento de UPC (r=-0,75; Pvalor <0,001) y presencia de Dímero-D + (DD) (r=-0,5; P-valor=0,008), habiendo\ncorrelación en ambos casos. Resultados de gran utilidad para su posterior utilización\ncomo indicadores tempranos de riesgo de trombosis o Tromboembolismo pulmonar\n(TEP), asociados a sintomatología clínica e imágenes confirmatorias, para posterior terapia profiláctica. Se evaluaron las concentraciones de aldosterona y angiotensina II (Ang II) en perros\ncon EC comparándola con perros sanos, para explicar parte de los mecanismos\ninvolucrados en el desarrollo de hipertensión. Los resultados arrojaron que la\naldosterona no estaría involucrada, ya que su concentración fue la misma en controles sanos que perros con EC (P-valor= 0,8), no así la Ang II que se la encontró aumentada en los perros Cushing (P-valor< 0,0001). Los datos aportados en esta tesis son de gran relevancia para ampliar el conocimiento\nen la fisiopatología de esta enfermedad y mejorar el diagnóstico precoz de estas\ncomorbilidades e implementar terapias preventivas adecuadas en la clínica diaria que\nmejorarán la calidad y sobrevida del paciente.\nPalabras clave: Enfermedad de Cushing application/pdf Enfermedad de Cushing Nefropatía Hipertensión Hipercoagulabilidad spa Universidad de Buenos Aires. Facultad de Ciencias Veterinarias info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-ncnd/2.5/ar/ Caninos Síndrome de Cushing Nefropatías Variables Enfermedades renales Endocrinología Ciencias Veterinarias Doctora de la Universidad de Buenos Aires Nefropatía asociada a la enfermedad de Cushing en el canino : estudio de variables de valor predictivo de daño renal info:eu-repo/semantics/doctoralThesis info:ar-repo/semantics/tesis doctoral info:eu-repo/semantics/acceptedVersion http://repositoriouba.sisbi.uba.ar/gsdl/cgi-bin/library.cgi?a=d&c=avaposgra&cl=CL1&d=HWA_3135 https://repositoriouba.sisbi.uba.ar/gsdl/collect/avaposgra/index/assoc/HWA_3135.dir/3135.PDF |