RESUMO
Neural respiratory drive (NRD) is measured using a non-invasive recording of respiratory electromyographic signal. The parasternal intercostal muscle can assess the imbalance between the load and capacity of respiratory muscles and presents a similar pattern to diaphragmatic activity. We aimed to analyze the neural respiratory drive in seventeen individuals with hypertension during quite breathing and maximal voluntary ventilation (MVV) (103.9 ± 5.89 vs. 122.6 ± 5 l/min) in comparison with seventeen healthy subjects (46.5 ± 2.5 vs. 46.4 ± 2.4 years), respectively. The study protocol was composed of quite breathing during five minutes, maximum inspiratory pressure followed by maximal ventilatory ventilation (MVV) was recorded once for 15 seconds. Anthropometric measurements were collected, weight, height, waist, hip, and calf circumferences, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), BMI, and conicity index (CI). Differences between groups were analyzed using the unpaired t-test or Mann-Whitney test to determine the difference between groups and moments. A significance level of 5% (p<0,05) was adopted for all statistical analyses. The group of individuals with hypertension presented higher values when compared to the healthy group for neural respiratory drive (EMGpara% 17.9±1.3 vs. 13.1±0.8, p = 0.0006) and neural respiratory drive index (NRDi (AU) 320±25 vs. 205.7±15,p = 0.0004) during quiet breathing and maximal ventilatory ventilation (EMGpara% 29.3±2.7 vs. 18.3±0.8, p = 0.000, NRDi (AU) 3140±259.4 vs. 1886±73.1,p<0.0001), respectively. In conclusion, individuals with hypertension presented higher NRD during quiet breathing and maximal ventilatory ventilation when compared to healthy individuals.
Assuntos
Hipertensão , Humanos , Pessoa de Meia-Idade , Hipertensão/fisiopatologia , Masculino , Feminino , Estudos de Casos e Controles , Adulto , Eletromiografia , Ventilação Voluntária Máxima/fisiologia , Respiração , Músculos Respiratórios/fisiopatologiaRESUMO
AIMS: Infection is a complication after stroke and outcomes vary by sex. Thus, we investigated if sepsis affects brain from ischemic stroke and sex involvement. MAIN METHODS: Male and female Wistar rats, were submitted to middle cerebral artery occlusion (MCAO) and after 7 days sepsis to cecal ligation and perforation (CLP). Infarct size, neuroinflammation, oxidative stress, and mitochondrial activity were quantified 24 h after CLP in the prefrontal cortex and hippocampus. Survival and neurological score were assessed up to 15 days after MCAO or 8 days after CLP (starting at 2 h after MCAO) and memory at the end. KEY FINDINGS: CLP decreased survival, increased neurological impairments in MCAO females. Early, in male sepsis following MCAO led to increased glial activation in the brain structures, and increased TNF-α and IL-1ß in the hippocampus. All groups had higher IL-6 in both tissues, but the hippocampus had lower IL-10. CLP potentiated myeloperoxidase (MPO) in the prefrontal cortex of MCAO male and female. In MCAO+CLP, only male increased MPO and nitrite/nitrate in hippocampus. Males in all groups had protein oxidation in the prefrontal cortex, but only MCAO+CLP in the hippocampus. Catalase decreased in the prefrontal cortex and hippocampus of all males and females, and MCAO+CLP only increased this activity in males. Female MCAO+CLP had higher prefrontal cortex complex activity than males. In MCAO+CLP-induced long-term memory impairment only in females. SIGNIFICANCE: The parameters evaluated for early sepsis after ischemic stroke show a worse outcome for males, while females are affected during long-term follow-up.
Assuntos
AVC Isquêmico , Ratos Wistar , Sepse , Caracteres Sexuais , Animais , Masculino , Feminino , Sepse/complicações , Sepse/metabolismo , Ratos , AVC Isquêmico/metabolismo , AVC Isquêmico/complicações , AVC Isquêmico/patologia , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/patologia , Infarto da Artéria Cerebral Média/metabolismo , Hipocampo/metabolismo , Hipocampo/patologia , Estresse Oxidativo , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/patologia , Recuperação de Função Fisiológica , Fatores Sexuais , Isquemia Encefálica/metabolismo , Isquemia Encefálica/complicações , Peroxidase/metabolismoRESUMO
BACKGROUND: In response to inflammation and other stressors, tryptophan is catalyzed by Tryptophan 2,3-Dioxygenase (TDO), which leads to activation of the kynurenine pathway. Sepsis is a serious condition in which the body responds improperly to an infection, and the brain is the inflammation target in this condition. OBJECTIVE: This study aimed to determine if the induction of TDO contributes to the permeability of the Blood-Brain Barrier (BBB), mortality, neuroinflammation, oxidative stress, and mitochondrial dysfunction, besides long-term behavioral alterations in a preclinical model of sepsis. METHODS: Male Wistar rats with two months of age were submitted to the sepsis model using Cecal Ligation and Perforation (CLP). The rats received allopurinol (Allo, 20 mg/kg, gavage), a TDO inhibitor, or a vehicle once a day for seven days. RESULTS: Sepsis induction increased BBB permeability, IL-6 level, neutrophil infiltrate, nitric oxide formation, and oxidative stress, resulting in energy impairment in 24h after CLP and Allo administration restored these parameters. Regarding memory, Allo restored short-term memory impairment and decreased depressive behavior. However, no change in survival rate was verified. CONCLUSION: In summary, TDO inhibition effectively prevented depressive behavior and memory impairment 10 days after CLP by reducing acute BBB permeability, neuroinflammation, oxidative stress, and mitochondrial alteration.
Assuntos
Alopurinol , Barreira Hematoencefálica , Depressão , Estresse Oxidativo , Sepse , Triptofano Oxigenase , Animais , Masculino , Ratos , Alopurinol/farmacologia , Alopurinol/uso terapêutico , Barreira Hematoencefálica/efeitos dos fármacos , Barreira Hematoencefálica/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Depressão/tratamento farmacológico , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Memória/efeitos dos fármacos , Transtornos da Memória/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Ratos Wistar , Sepse/tratamento farmacológico , Sepse/complicações , Sepse/metabolismo , Triptofano Oxigenase/metabolismo , Triptofano Oxigenase/antagonistas & inibidoresRESUMO
Tityus serrulatus scorpion is responsible for a significant number of envenomings in Brazil, ranging from mild to severe, and in some cases, leading to fatalities. While supportive care is the primary treatment modality, moderate and severe cases require antivenom administration despite potential limitations and adverse effects. The remarkable proliferation of T. serrulatus scorpions, attributed to their biology and asexual reproduction, contributes to a high incidence of envenomation. T. serrulatus scorpion venom predominantly consists of short proteins acting as neurotoxins (α and ß), that primarily target ion channels. Nevertheless, high molecular weight compounds, including metalloproteases, serine proteases, phospholipases, and hyaluronidases, are also present in the venom. These compounds play a crucial role in envenomation, influencing the severity of symptoms and the spread of venom. This review endeavors to comprehensively understand the T. serrulatus scorpion venom by elucidating the primary high molecular weight compounds and exploring their potential contributions to envenomation. Understanding these compounds' mechanisms of action can aid in developing more effective treatments and prevention strategies, ultimately mitigating the impact of scorpion envenomation on public health in Brazil.
RESUMO
Tityus serrulatus scorpion is responsible for a significant number of envenomings in Brazil, ranging from mild to severe, and in some cases, leading to fatalities. While supportive care is the primary treatment modality, moderate and severe cases require antivenom administration despite potential limitations and adverse effects. The remarkable proliferation of T. serrulatus scorpions, attributed to their biology and asexual reproduction, contributes to a high incidence of envenomation. T. serrulatus scorpion venom predominantly consists of short proteins acting as neurotoxins (α and ß), that primarily target ion channels. Nevertheless, high molecular weight compounds, including metalloproteases, serine proteases, phospholipases, and hyaluronidases, are also present in the venom. These compounds play a crucial role in envenomation, influencing the severity of symptoms and the spread of venom. This review endeavors to comprehensively understand the T. serrulatus scorpion venom by elucidating the primary high molecular weight compounds and exploring their potential contributions to envenomation. Understanding these compounds' mechanisms of action can aid in developing more effective treatments and prevention strategies, ultimately mitigating the impact of scorpion envenomation on public health in Brazil.
Assuntos
Animais , Venenos de Escorpião/análise , Venenos de Escorpião/química , Peptídeo Hidrolases , Fosfolipases , Glicoproteínas , HialuronoglucosaminidaseRESUMO
Maple Syrup Urine Disease (MSUD) is a metabolic disease characterized by the accumulation of branched-chain amino acids (BCAA) in different tissues due to a deficit in the branched-chain alpha-ketoacid dehydrogenase complex. The most common symptoms are poor feeding, psychomotor delay, and neurological damage. However, dietary therapy is not effective. Studies have demonstrated that memantine improves neurological damage in neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. Therefore, we hypothesize that memantine, an NMDA receptor antagonist can ameliorate the effects elicited by BCAA in an MSUD animal model. For this, we organized the rats into four groups: control group (1), MSUD group (2), memantine group (3), and MSUD + memantine group (4). Animals were exposed to the MSUD model by the administration of BCAA (15.8 µL/g) (groups 2 and 4) or saline solution (0.9%) (groups 1 and 3) and treated with water or memantine (5 mg/kg) (groups 3 and 4). Our results showed that BCAA administration induced memory alterations, and changes in the levels of acetylcholine in the cerebral cortex. Furthermore, induction of oxidative damage and alterations in antioxidant enzyme activities along with an increase in pro-inflammatory cytokines were verified in the cerebral cortex. Thus, memantine treatment prevented the alterations in memory, acetylcholinesterase activity, 2',7'-Dichlorofluorescein oxidation, thiobarbituric acid reactive substances levels, sulfhydryl content, and inflammation. These findings suggest that memantine can improve the pathomechanisms observed in the MSUD model, and may improve oxidative stress, inflammation, and behavior alterations.
Assuntos
Doença da Urina de Xarope de Bordo , Ratos , Animais , Doença da Urina de Xarope de Bordo/tratamento farmacológico , Doença da Urina de Xarope de Bordo/metabolismo , Memantina/farmacologia , Memantina/uso terapêutico , Acetilcolinesterase , Modelos Animais de Doenças , Aminoácidos de Cadeia Ramificada , Antioxidantes/farmacologia , InflamaçãoRESUMO
BACKGROUND: Physical activity has been shown to benefit patients undergoing adjuvant cancer therapy. Although exercise interventions may be applied in several settings, most trials have focused on specialized facilities for their interventions. While these approaches benefit the access for individuals living near exercise centers, it hampers the assessment of real-world effectiveness. Therefore, evaluating the feasibility and implementation of home-based models of exercise training, especially in low-to-middle-income settings, may inform future physical activity trials and programs. In this article, we present the protocol for the BENEFIT CA trial, which aims to assess the implementation of a remote exercise intervention for patients with breast cancer or prostate cancer, primarily quantifying adherence to an exercise program. METHODS: This is a 12-week study, utilizing a non-randomized, single-arm design to assess the feasibility of a home-based exercise training. The intervention is remotely guided, and participants also receive an educational component about cancer and exercise. The study aims to recruit 40 patients diagnosed with breast cancer and 40 patients diagnosed with prostate cancer, all of whom undergoing active hormonal treatment. The primary outcome is the level of adherence, indicated as the proportion of performed exercise episodes. Secondary outcomes include recruitment rates, fatigue, quality of life, and functional capacity. Adverse events will be monitored throughout the study. Because this is a feasibility trial, the statistical analysis plan is based on descriptive statistics, which encompasses an intention-to-treat analysis and a plan for handling missing data. DISCUSSION: This is a low-cost feasibility study to orient the design of a wide-range, pragmatic phase 3 trial based on remote exercise intervention. With this study, we aim to better understand the adherence and implementation strategies regarding home-based exercise for the proposed population and, in the near future, move forward to a randomized clinical trial. In addition, this trial may contribute to engage patients with cancer in exercise programs throughout their treatment and beyond. TRIAL REGISTRATION: This trial has been approved by the Hospital de Clínicas de Porto Alegre Ethics Committee/IRB (48,869,621.9.0000.5327), and it is registered at Clinicaltrials.gov (NCT05258526), registered on February 25, 2022, prior to the beginning of the study.
RESUMO
Maple syrup urine disease (MSUD) is an inherited metabolic disorder caused by a deficiency in branched-chain alpha-ketoacid dehydrogenase complex (BCKAC). The treatment is a standard therapy based on a protein-restricted diet with low branched-chain amino acids (BCAA) content to reduce plasma levels and, consequently, the effects of accumulating their metabolites, mainly in the central nervous system. Although the benefits of dietary therapy for MSUD are undeniable, natural protein restriction may increase the risk of nutritional deficiencies, resulting in a low total antioxidant status that can predispose and contribute to oxidative stress. As MSUD is related to redox and energy imbalance, melatonin can be an important adjuvant treatment. Melatonin directly scavenges the hydroxy radical, peroxyl radical, nitrite anion, and singlet oxygen and indirectly induces antioxidant enzyme production. Therefore, this study assesses the role of melatonin treatment on oxidative stress in brain tissue and behavior parameters of zebrafish (Danio rerio) exposed to two concentrations of leucine-induced MSUD: leucine 2 mM and 5mM; and treated with 100 nM of melatonin. Oxidative stress was assessed through oxidative damage (TBARS, DCF, and sulfhydryl content) and antioxidant enzyme activity (SOD and CAT). Melatonin treatment improved redox imbalance with reduced TBARS levels, increased SOD activity, and normalized CAT activity to baseline. Behavior was analyzed with novel object recognition test. Animals exposed to leucine improved object recognition due to melatonin treatment. With the above, we can suggest that melatonin supplementation can protect neurologic oxidative stress, protecting leucine-induced behavior alterations such as memory impairment.
Assuntos
Doença da Urina de Xarope de Bordo , Melatonina , Animais , Leucina/efeitos adversos , Leucina/metabolismo , Doença da Urina de Xarope de Bordo/metabolismo , Peixe-Zebra/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Melatonina/farmacologia , Melatonina/uso terapêutico , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Estresse Oxidativo , Aminoácidos de Cadeia Ramificada/metabolismo , Superóxido Dismutase/metabolismoRESUMO
Background: An estimated 9.6 million people died from cancer globally in 2018, which is a reflection of the quality of patients' end-of-life care and its costs. Aim: To estimate direct medical costs of the last 30 days of oncology patients admitted to an inpatient clinic and to evaluate factors associated with medical costs at the end of life. Design: Cost-of-illness study with data from a retrospective cohort. Setting/Participants: We included patients aged 18 and older who were diagnosed with incurable cancer and who were admitted to a tertiary hospital in Brazil between January 1, 2018 and December 31, 2019. Results: Our sample included 109 patients with an average age of 69 (61â76). The median overall survival was 4.3 (.9â12.9) months. The median cost per patient per day related to hospitalization was BRL 119 (73â181)/United States dollars [USD] 21 (13â33). The cost of medication was BRL 66 (40â105)/USD 12 (7â19), representing 55.46% of costs while that of materials and supplies was BRL 30 (18â49)/USD 5 (3â9). In the multivariate analysis, when the limitation of interventions was recorded in the medical record, the median cost is reduced by BRL 50 (USD 9) per patient per day. Conclusions: The median cost per patient per day was BRL 119 (73â181). The recording of limitations of therapeutic interventions in the medical record was a predictor variable that influenced the final medical cost of patients, suggesting that medical practice and decision-making in end-of-life care impact costs.
Assuntos
Neoplasias , Humanos , Idoso , Estudos Retrospectivos , Custos e Análise de Custo , Neoplasias/terapia , Hospitalização , Pacientes Internados , Custos de Cuidados de SaúdeRESUMO
ABSTRACT: The Ilex paraguariensis is a species native to Brazil, Paraguay and Argentine, valued by its positive effects on human health. Mate processing consists of the following stages: pre-drying (rapid drying at high temperature, known as sapeco operation), drying, and milling. In order to verify the current process and to propose future improvements to the mate processing, thermal and mass balance analysis were applied to industrial mate processing units. Results showed that the consumption of energy in sapeco and drying operations exceeds the calorific input necessary for these operations. These results verify the need for a change in the management of temperatures in the sapeco and drying stages of mate processing in order to optimize the consumption of energy, resulting in lower costs, with positive effects on the quality of the mate products.
RESUMO: A Ilex paraguariensis é uma espécie nativa do Brasil, Paraguai e Argentina, valorizada por seus efeitos positivos na saúde humana. O processamento do mate consiste nas seguintes etapas: pré-secagem (secagem rápida em alta temperatura, conhecida como operação de sapeco), secagem e moagem. A fim de verificar o atual processo e propor melhorias futuras no processamento de mate, foram aplicadas análises térmicas e de balanço de massa em unidades industriais de processamento de mate. Os resultados mostraram que o consumo de energia nas operações de sapeco e secagem supera o aporte calorífico necessário para essas operações. Esses resultados comprovam a necessidade de uma mudança no gerenciamento das temperaturas nas etapas de sapeco e secagem do processamento da erva-mate, a fim de otimizar o consumo de energia, resultando em menores custos, com efeitos positivos na qualidade dos produtos da erva-mate.
RESUMO
The Ilex paraguariensis is a species native to Brazil, Paraguay and Argentine, valued by its positive effects on human health. Mate processing consists of the following stages: pre-drying (rapid drying at high temperature, known as sapeco operation), drying, and milling. In order to verify the current process and to propose future improvements to the mate processing, thermal and mass balance analysis were applied to industrial mate processing units. Results showed that the consumption of energy in sapeco and drying operations exceeds the calorific input necessary for these operations. These results verify the need for a change in the management of temperatures in the sapeco and drying stages of mate processing in order to optimize the consumption of energy, resulting in lower costs, with positive effects on the quality of the mate products.
A Ilex paraguariensis é uma espécie nativa do Brasil, Paraguai e Argentina, valorizada por seus efeitos positivos na saúde humana. O processamento do mate consiste nas seguintes etapas: pré-secagem (secagem rápida em alta temperatura, conhecida como operação de sapeco), secagem e moagem. A fim de verificar o atual processo e propor melhorias futuras no processamento de mate, foram aplicadas análises térmicas e de balanço de massa em unidades industriais de processamento de mate. Os resultados mostraram que o consumo de energia nas operações de sapeco e secagem supera o aporte calorífico necessário para essas operações. Esses resultados comprovam a necessidade de uma mudança no gerenciamento das temperaturas nas etapas de sapeco e secagem do processamento da erva-mate, a fim de otimizar o consumo de energia, resultando em menores custos, com efeitos positivos na qualidade dos produtos da erva-mate.
Assuntos
Temperatura , Ilex paraguariensis , Conservação de AlimentosRESUMO
Mortality in cirrhosis is mostly associated with the development of clinical decompensation, characterized by ascites, hepatic encephalopathy, variceal bleeding, or jaundice. Therefore, it is important to prevent and manage such complications. Traditionally, the pathophysiology of decompensated cirrhosis was explained by the peripheral arterial vasodilation hypothesis, but it is currently understood that decompensation might also be driven by a systemic inflammatory state (the systemic inflammation hypothesis). Considering its oncotic and nononcotic properties, albumin has been thoroughly evaluated in the prevention and management of several of these decompensating events. There are formal evidence-based recommendations from international medical societies proposing that albumin be administered in individuals with cirrhosis undergoing large-volume paracentesis, patients with spontaneous bacterial peritonitis, those with acute kidney injury (even before the etiological diagnosis), and those with hepatorenal syndrome. Moreover, there are a few randomized controlled trials and meta-analyses suggesting a possible role for albumin infusion in patients with cirrhosis and ascites (long-term albumin administration), individuals with hepatic encephalopathy, and those with acute-on-chronic liver failure undergoing modest-volume paracentesis. Further studies are necessary to elucidate whether albumin administration also benefits patients with cirrhosis and other complications, such as individuals with extraperitoneal infections, those hospitalized with decompensated cirrhosis and hypoalbuminemia, and patients with hyponatremia.
Assuntos
Varizes Esofágicas e Gástricas , Encefalopatia Hepática , Síndrome Hepatorrenal , Peritonite , Albuminas/uso terapêutico , Ascite/tratamento farmacológico , Ascite/terapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia , Encefalopatia Hepática/tratamento farmacológico , Síndrome Hepatorrenal/etiologia , Humanos , Cirrose Hepática/tratamento farmacológico , Peritonite/microbiologiaRESUMO
BACKGROUND: Cannabinoid-based therapy has been shown to be promising and is emerging as crucial for the treatment of cognitive deficits, mental illnesses, and many diseases considered incurable. There is a need to find an appropriate therapy for Alzheimer's disease, and cannabinoid-based therapy appears to be a feasible possibility. CASE PRESENTATION: This report addresses the beneficial effect of cannabinoids in microdoses on improving memory and brain functions of a patient with mild-stage Alzheimer's disease. The patient is a 75-year-old white man presenting with main symptoms of memory deficit, spatial and temporal disorientation, and limited daily activity. The experimental therapeutic intervention was carried out for 22 months with microdoses of a cannabis extract containing cannabinoids. Clinical evaluations using Mini-Mental State Examination and Alzheimer's Disease Assessment Scale-Cognitive Subscale were performed. CONCLUSIONS: Here we provide original evidence that cannabinoid microdosing could be effective as an Alzheimer's disease treatment while preventing major side effects. This is an important step toward dissociating cannabinoids' health-improving effects from potential narcotic-related limitations.
Assuntos
Doença de Alzheimer , Canabinoides , Atividades Cotidianas , Idoso , Doença de Alzheimer/tratamento farmacológico , Canabinoides/uso terapêutico , Humanos , Masculino , Transtornos da Memória , Extratos Vegetais/uso terapêuticoRESUMO
BACKGROUND: The review of pharmacotherapy can be conceptualized as a service in which the drugs used by the patient are reviewed to control the risks as well as to improve the results of the drug therapy, detecting, solving, and preventing issues associated with the drug, readjusting the doses and times (schedule) so that the treatment is not incompatible or in duplicity. METHODS: The aim of the study was to validate an intelligent information system, which was developed to assist the scheduling activity in the pharmacotherapy review. The system used the concept of Genetic Algorithms. To validate the system, hypothetical cases were elaborated considering various aspects of pharmacotherapy such as underdose, overdose, drug interactions and contraindications. These cases were tested in the system and were also analyzed by pharmaceutical experts with clinical and research experience in the pharmacotherapy review process. The degree of agreement between the assessments of the appointments carried out by the pharmaceutical specialists and by the system were measured using the Kappa index with a 95% confidence interval. RESULTS: In detecting errors and make propositions, the system was able to identify 80% of errors, with pharmaceutical experts identifying between 20 and 70% of errors. In relation the results of kappa between the cases, the system had 87,3% of concordance, whereas the best pharmaceutical expert had 75,5% of concordance, considering the correct answer. CONCLUSION: It can be concluded that with the methodology used, the investigation met the objectives and confirmed the system is effective for pharmaceutical review process. There are indications that the system can help in the Pharmacotherapy review process, being able to find prescription errors as well as to establish times for the use of medications according to the patient's routine.
Assuntos
Sistemas de Apoio a Decisões Clínicas , Interações Medicamentosas , Tratamento Farmacológico , Tratamento Farmacológico/métodos , HumanosRESUMO
BACKGROUND: The current quality of evidence supporting dry cupping for individuals with chronic low back pain (CLBP) is low and suggests that nonspecific factors impact experiences reported by patients. Therefore, this study assessed the impacts of social and professional support on the experience of individuals with CLBP treated with dry cupping or sham. METHOD: This is an observational study with qualitative approach. Twenty-four individuals with CLBP who received dry cupping or sham in a previous clinical trial were invited. Data was collected using a semi-structured interview conducted by a trained researcher. Content analysis was used to analyze experiences, systematic procedures, and description of the content of messages. The dimensions of "pain", "general perceptions", and "perceived social and professional support" guided the analysis. RESULTS: Answers of both groups converged on similar perceptions, especially regarding pain. Physical condition was the most fragile aspect. We also observed an influence of perceived social and professional support on painful symptoms. Thus, the experience of individuals with CLBP treated with dry cupping or sham indicated that factors related to social and professional support impacted results. CONCLUSIONS: We observed that individuals with CLBP reported similar perceptions of the effects of dry cupping or sham treatment, indicating that contextual factors may influence the perception of these individuals regarding the treatment received.
Assuntos
Dor Crônica , Ventosaterapia , Dor Lombar , Dor Crônica/terapia , Humanos , Dor Lombar/terapia , Medição da Dor , Avaliação de Resultados da Assistência ao Paciente , Pesquisa QualitativaRESUMO
Maple Syrup Urine Disease (MSUD) is caused by the deficiency in the activity of the branched-chain α-ketoacid dehydrogenase complex (BCKDC), resulting in the accumulation of the branched-chain amino acids (BCAA) leucine, isoleucine, and valine, and their respective branched-chain α-keto acids. Patients with MSUD are at high risk of developing chronic neuropsychiatric disorders; however, the pathophysiology of brain damage in these patients remains unclear. We hypothesize that MSUD can cause depressive symptoms in patients. To test our hypothesis, Wistar rats were submitted to the BCAA and tianeptine (antidepressant) administration for 21 days, starting seven days postnatal. Depression-like symptoms were assessed by testing for anhedonia and forced swimming after treatments. After the last test, the brain structures were dissected for the evaluation of neutrophins. We demonstrate that chronic BCAA administration induced depressive-like behavior, increased BDNF levels, and decreased NGF levels, suggesting a relationship between BCAA toxicity and brain damage, as observed in patients with MSUD. However, the administration of tianeptine was effective in preventing behavioral changes and restoring neurotrophins levels.
Assuntos
Doença da Urina de Xarope de Bordo , Tiazepinas , Aminoácidos de Cadeia Ramificada/metabolismo , Animais , Doença da Urina de Xarope de Bordo/metabolismo , Fatores de Crescimento Neural/metabolismo , Ratos , Ratos Wistar , Tiazepinas/farmacologiaRESUMO
The fabrication of a flexible supercapacitor with state-of-the-art performance is described, based on a facile and low-cost fabrication method that encompasses aligned carbon nanotube arrays (ACNTA)-polyaniline/polydimethylsiloxane electrodes (ACNTA-PANI/PDMS). The ACNTA were partially embedded in PDMS to ensure excellent adhesion and integration whilst PANI was electrodeposited on its surface to improve energy storage properties. The supercapacitor structure and morphology were investigated by Raman spectroscopy and scanning electron microscopy (SEM), respectively. The energy storage properties of the electrodes were evaluated in two and three-electrode configurations. The maximum value of specific capacitance was 408 mF cm-2 (265 F g-1) at 1 mA cm-2, and a high energy density of 20 µW h cm-2 (25.5 W h kg-1) was achieved at a power density of 100 µW cm-2 (126.6 W kg-1) for a symmetric two-electrode device. The device showed a good capacitance retention of 76% after 5000 cycles and was able to maintain 80% of its electrochemical properties while being measured at different bending angles, demonstrating excellent mechanical agility performance under extreme conditions and some of the highest carbon-based energy storage properties.
RESUMO
ABSTRACT Introduction: Although the efficacy of hydroxyurea (HU) in inhibiting erythrocyte sickling has been well demonstrated, the action of this drug on human neutrophils and the mechanism by which it improves the manifestations of the disease have not been studied thoroughly. We aimed to investigate the cell viability, along with inflammatory and oxidative markers in the neutrophils of sickle cell anemia (SCA) patients and the effects of HU therapy on these cells, by evaluating the dose-responsiveness. Methods: In the present study, 101 patients (45 men and 56 women, aged 18-69 years) with SCA were divided into groups according to the use or not of HU: the SS group (without HU treatment, n = 47) and the SSHU group (under HU treatment, n = 54). The SSHU group was further stratified into subgroups according to the daily dose of the drug that patients already used: SSHU - 0.5 g (n = 19); SSHU - 1 g (n = 26) and SSHU - 1.5-2 g (n = 9). A control group (AA) comprised 50 healthy individuals. Neutrophils isolated from whole blood were analyzed using Trypan Blue, monoiodotyrosine (MTT) and lactate dehydrogenase (LDH) toxicity assays. Myeloperoxidase (MPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and concentrations of interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α) and malonaldehyde (MDA) were also measured. Results: Neutrophils from SCA patients showed membrane fragility and a significant decrease in cell viability when analyzed by Trypan Blue (p < 0.05), MTT (p < 0.001) and LDH (p = 0.011), compared to the AA group. Levels of inflammatory (MPO, TNF-α, and IL-10) and oxidative markers (SOD, GSH-Px, and MDA) were also altered (p < 0.05) in these cells, showing a significant difference in the SSHU-1g and SSHU - 1.5-2 g groups, compared to the SS group. Treatment with HU reverted the levels of all markers to concentrations similar to those in healthy individuals in a positive dose-effect relationship. Conclusion: The HU did not generate a cytotoxic effect on neutrophils in SCA patients, but it modulated their oxidative and inflammatory mechanisms, promoting cytoprotection with a positive dose-effect.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Hidroxiureia , Anemia Falciforme , Fator de Necrose Tumoral alfa , Estresse Oxidativo , Citotoxicidade Imunológica , Dosagem , Inflamação , Malondialdeído , NeutrófilosRESUMO
RESUMO Introdução: O climatério corresponde ao período de transição entre a etapa reprodutiva e a não reprodutiva, onde há a menopausa caracterizada pela ausência de menstruação por 12 meses consecutivos, resultante da perda da atividade folicular ovariana. A Terapia de Reposição Hormonal (TRH) pode ser uma opção de tratamento com o intuito de melhorar as condições de saúde da mulher. O objetivo, deste estudo, foi investigar o perfil de idosas e sintomas climatéricos, além da utilização da TRH por mulheres em uma cidade do Sul de Santa Catarina. Métodos: Estudo epidemiológico com delineamento transversal quantitativo utilizando-se questionário para coleta de dados que ocorreu entre julho a setembro de 2017 e analisados no EpiInfo®. Resultados: Foram entrevistadas 107 idosas, média de idade 69,7 (± 8,9) anos. Das entrevistadas, 52,3% relataram algum sintoma climatérico, sendo mais frequente o fogacho. Pequena parcela das entrevistadas fez uso de TRH (15,9%), obtendo-se benefícios com a utilização. Destas, maioria foi administração via oral (88,2%), sendo que 35,3% usaram por mais de cinco anos, 82,4% relataram alguma reação adversa, sendo citada a mastalgia e o ganho de peso, e 64,7% realizavam consulta médica semestral. Somente 8,4% fizeram uso de chás, sendo a Amora Branca (Morus alba L) a mais citada. Conclusões: O esquema de TRH prescrito mais frequente foi a associação de estrógenos e progestógenos para administração por via oral, com acompanhamento médico semestral e obtendo-se resultados favoráveis. Medidas não farmacológicas foram adotadas por minoria das mulheres, adotando-se essencialmente o uso de planta medicinal na forma de chá. PALAVRA-CHAVE: Climatério, menopausa, terapia de reposição hormonal, saúde da mulher
ABSTRACT Introduction: The climacteric corresponds to the transition period between the reproductive and non-reproductive stages, where there is the menopause, characterized by the absence of menstruation for 12 consecutive months, resulting from the loss of ovarian follicular activity. Hormone Replacement Therapy (HRT) can be a treatment option with the aim of improving women's health conditions. The aim of this study was to investigate the profile of elderly women and climacteric symptoms, as well as the use of HRT by women in a city in southern Santa Catarina. Methods: Epidemiological study with a quantitative cross-sectional design using a questionnaire for data collection that was answered between July and September 2017 and analyzed in EpiInfo®. Results: 107 elderly women were interviewed, mean age 69.7 (± 8.9) years. Of the interviewees, 52.3% reported some climacteric symptom, with hot flashes being more frequent. A small portion of the interviewees used HRT (15.9%), obtaining benefits from its use. Of these, most were administered orally (88.2%), and 35.3% used it for more than five years, 82.4% reported some adverse reaction, mentioning breast tenderness and weight gain, and 64.7% had medical consultations every six months. Only 8.4% made use of teas, with the white blackberry (Morus alba L) being the most mentioned. Conclusions: The most frequent prescribed HRT regimen was the combination of estrogens and progestins for oral administration, with medical follow-up every six months and obtaining favorable results. Non-pharmacological measures were adopted by a minority of women, essentially adopting the use of medicinal plants in the form of tea. KEYWORDS: Climacteric, menopause, hormone replacement therapy, women's health
Assuntos
Humanos , Feminino , Climatério , Menopausa , Saúde da Mulher , Terapia de Reposição HormonalRESUMO
QUESTION: What are the effects of dry cupping on pain intensity, physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms and medication use in individuals with chronic non-specific low back pain? DESIGN: Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinding of participants and assessors. PARTICIPANTS: Ninety participants with chronic non-specific low back pain. INTERVENTIONS: The experimental group (n = 45) received dry cupping therapy, with cups bilaterally positioned parallel to the L1 to L5 vertebrae. The control group (n = 45) received sham cupping therapy. The interventions were applied once a week for 8 weeks. OUTCOME MEASURES: Participants were assessed before and after the first treatment session, and after 4 and 8 weeks of intervention. The primary outcome was pain intensity, measured with the numerical pain scale at rest, during fast walking and during trunk flexion. Secondary outcomes were physical function, functional mobility, trunk range of motion, perceived overall effect, quality of life, psychological symptoms and medication use. RESULTS: On a 0-to-10 scale, the between-group difference in pain severity at rest was negligible: MD 0.0 (95% CI -0.9 to 1.0) immediately after the first treatment, 0.4 (95% CI -0.5 to 1.5) at 4 weeks and 0.6 (95% CI -0.4 to 1.6) at 8 weeks. Similar negligible effects were observed on pain severity during fast walking or trunk flexion. Negligible effects were also found on physical function, functional mobility and perceived overall effect, where mean estimates and their confidence intervals all excluded worthwhile effects. No worthwhile benefits could be confirmed for any of the remaining secondary outcomes. CONCLUSION: Dry cupping therapy was not superior to sham cupping for improving pain, physical function, mobility, quality of life, psychological symptoms or medication use in people with non-specific chronic low back pain. PROTOCOL REGISTRATION NUMBER: NCT03909672.