RESUMO
BACKGROUND: Exposure to toxins during pregnancy is the main modifiable behavior that affects the placenta and, consequently, the fetus. In particular, smoking is a recognized risk factor for negative outcomes. Our study pretended to examine gross and microscopic placental features in women who reported exposure to tobacco, alcohol, or other psychoactive substances. METHODS: In this observational case-control study, we collected 706 placentas to assess precise substance exposure histological-interaction features of in the placenta. We examined gross and microscopic placental features, and then recorded maternal and newborn clinical conditions. RESULTS: We found that 4.8% of mothers admitted to consumption of some type of (harmful) substance. The most common pre-existing maternal condition was obesity (20.3%); predominant complications included amniotic infection (32.3%), urinary tract infection (14.5%) and hypertensive disorders of pregnancy (14.5%). In newborns, we discovered positive associations as respiratory distress syndrome. Macroscopically, exposed mothers had heavier placentas, more true knots, and single umbilical artery; microscopically, they were more likely to exhibit fetal vascular malperfusion (FVM). CONCLUSIONS: Until our present study, no research linked umbilical cord defects to toxic substance exposure; our study results do confirm association with adverse outcomes in neonates and alterations in the neuro-cardio-placental circuit through FVM. IMPLICATIONS: The results are confirming the importance of this modifiable risk factor and how its presence may potentially affect the course of pregnancy, as well as the health of both mother and child.
Assuntos
Placenta , Complicações na Gravidez , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Gravidez , Placenta/patologia , Recém-Nascido , Estudos de Casos e Controles , Adulto , Complicações na Gravidez/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores de RiscoRESUMO
OBJECTIVE: The purpose of this study is to assess the clinical and functional results of patients with acute middle third of Achilles tendon rupture treated conservatively by orthopedic boot and early weight-bearing. MATERIAL AND METHODS: This is a prospective observational study with 19 patients with acute Achilles tendon rupture treated by conservative treatment. Demographic variables, ATRS score, function using heel-rise test, calf circumference and Achilles tendon resting angle were analyzed. The clinical and functional registration was performed at six weeks, three, six and 12 months of injury. A statistical analysis was performed. RESULTS: At one year follow-up, the 94% of patients were capable of standing single heel rise, the mean of twin atrophy was 1.03 cm ± 0.51 compared to uninjured side and the difference of Achilles tendon resting angle was 5.63 degrees ± 4.17 compared to contralateral limb. The 83.24% of patients returned to play and the mean of ATRS score was 87.41 points ± 17.78. Two partial re-rupture (11%) were occurred at three months of follow-up, which continued with orthopedic treatment. CONCLUSIONS: Based on the results, functional orthopedic treatment using orthopedic boot and early weight-bearing presents good clinical and functional outcomes, considering it a valid treatment for acute Achilles tendon ruptures.
OBJETIVO: Analizar los resultados clínicos y funcionales de los pacientes con rotura aguda del cuerpo del tendón de Aquiles tratados de forma conservadora mediante bota ortopédica y carga precoz. MATERIAL Y MÉTODOS: Estudio observacional prospectivo con 19 pacientes con rotura aguda de tendón de Aquiles tratados de forma ortopédica. Se analizaron las variables demográficas, la escala ATRS (Achilles tendon Total Rupture Score), la función mediante el test de puntillas, masa muscular gemelar y el equino en reposo residual. Los registros clínicos y funcionales se realizaron a las seis semanas, tres, seis y 12 meses. Se realizó un análisis estadístico mediante Stata 14. RESULTADOS: A los 12 meses, 94% de los pacientes realizaban puntillas monopodales, la media de la atrofia gemelar fue de 1.03 cm ± 0.51 respecto a extremidad contralateral y la diferencia de equino residual respecto el lado sano era de 5.63 grados ± 4.17, 83.24% de los pacientes realizaban su práctica deportiva habitual previa a la rotura. La media de ATRS de la muestra era de 87.41 puntos ± 17.78. Se registraron dos rerroturas parciales (11%) a los tres meses de seguimiento que continuaron con tratamiento ortopédico. CONCLUSIONES: El tratamiento ortopédico funcional mediante bota ortopédica y carga precoz presenta buenos resultados clínicos y funcionales, considerándolo un tratamiento válido para las roturas agudas del tendón de Aquiles.
Assuntos
Tendão do Calcâneo , Traumatismos dos Tendões , Tendão do Calcâneo/lesões , Humanos , Ruptura/terapia , Traumatismos dos Tendões/terapia , Resultado do Tratamento , Suporte de CargaRESUMO
AIMS: To evaluate and compare the association of four potential insulin resistance (IR) biomarkers (pigment-epithelium-derived factor [PEDF], retinol-binding-protein-4 [RBP-4], chitinase-3-like protein 1 [YKL-40] and brain-derived neurotrophic factor [BDNF]) with objective measures of IR. METHODS: We studied 81 subjects with different metabolic profiles. All participants underwent a 5-point OGTT with calculation of multiple IR indexes. A subgroup of 21 participants additionally underwent a hyperinsulinemic-euglycemic clamp. IR was defined as belonging to the highest quartile of incremental area under the insulin curve (iAUCins), or to the lowest quartile of the insulin sensitivity index (ISI). RESULTS: PEDF was associated with adiposity variables. PEDF and RBP4 increased linearly across quartiles of iAUCins (for PEDF p-trend=0.029; for RBP-4 p-trend=0.053). YKL-40 and BDNF were not associated with any adiposity or IR variable. PEDF and RBP-4 levels identified individuals with IR by the iAUCins definition: A PEDF cutoff of 11.9ng/mL had 60% sensitivity and 68% specificity, while a RBP-4 cutoff of 71.6ng/mL had 70% sensitivity and 57% specificity. In multiple regression analyses simultaneously including clinical variables and the studied biomarkers, only BMI, PEDF and RBP-4 remained significant predictors of IR. CONCLUSIONS: Plasma PEDF and RBP4 identified IR in subjects with no prior diagnosis of diabetes.
Assuntos
Biomarcadores/sangue , Fator Neurotrófico Derivado do Encéfalo/sangue , Proteína 1 Semelhante à Quitinase-3/sangue , Técnicas de Diagnóstico Endócrino , Proteínas do Olho/sangue , Resistência à Insulina , Fatores de Crescimento Neural/sangue , Proteínas Plasmáticas de Ligação ao Retinol/análise , Serpinas/sangue , Adulto , Idoso , Feminino , Técnica Clamp de Glucose , Intolerância à Glucose/sangue , Intolerância à Glucose/complicações , Intolerância à Glucose/diagnóstico , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/metabolismo , Estado Pré-Diabético/sangue , Estado Pré-Diabético/complicações , Estado Pré-Diabético/diagnóstico , Proteínas Plasmáticas de Ligação ao Retinol/metabolismoRESUMO
Diabetic polyneuropathy (DPN) encompasses multiple syndromes with a common pathogenesis. Glycemic control shows a limited correlation with DPN, arguing in favor of major involvement of other factors, one of which is alterations of lipid and lipoprotein metabolism. Consistent associations have been found between plasma triglycerides/remnant lipoproteins and the risk of DPN. Studies in cultured nerve tissue or in murine models of diabetes have unveiled mechanisms linking lipid metabolism to DPN. Deficient insulin action increases fatty acids flux to nerve cells, inducing mitochondrial dysfunction, anomalous protein kinase C signaling, and perturbations in the physicochemical properties of the plasma membrane. Oxidized low-density lipoproteins bind to cellular receptors and promote generation of reactive oxygen species, worsening mitochondrial function and altering the electrical properties of neurons. Supplementation with specific fatty acids has led to prevention or reversal of different modalities of DPN in animal models. Post hoc and secondary analyses of clinical trials have found benefits of cholesterol reducing (statins and ezetimibe), triglyceride-reducing (fibrates), or lipid antioxidant (thioctic acid) therapies over the progression and severity of DPN. However, these findings are mostly hypothesis-generating. Randomized trials are warranted in which the impact of intensive plasma lipids normalization on DPN outcomes is specifically evaluated.
Assuntos
Neuropatias Diabéticas/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipídeos/sangue , Animais , Neuropatias Diabéticas/metabolismo , Humanos , Hipolipemiantes/farmacologiaRESUMO
The aim of the present study was to evaluate the influence of Helicobacter pylori on MLH1 and MGMT mRNA levels in patients with chronic gastritis and gastric cancer. The study included 217 patients, of which 26 were uninfected, 127 had chronic gastritis and were H. pylori-positive, and 64 had gastric cancer. Bacterial genotypes were evaluated by polymerase chain reaction (PCR), and the expression levels of MLH1 and MGMT were determined by quantitative real-time PCR and immunohistochemistry. There was an association between infection with cagA, vacA s1m1 strains and gastric cancer development. When the gastric epithelium and associated inflammation were examined for expression of MLH1 and MGMT, an overall increase in expression was observed. On the other hand, these levels decrease significantly among gastric cancer patients. The loss of MLH1 and MGMT expression in gastric cancer patients suggests that it is not an early event in H. pylori-associated gastric carcinogenesis.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/biossíntese , Metilases de Modificação do DNA/biossíntese , Enzimas Reparadoras do DNA/biossíntese , Gastrite/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori/isolamento & purificação , Proteínas Nucleares/biossíntese , Neoplasias Gástricas/patologia , Proteínas Supressoras de Tumor/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Perfilação da Expressão Gênica , Infecções por Helicobacter/microbiologia , Humanos , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Proteína 1 Homóloga a MutL , Neoplasias Gástricas/microbiologia , Adulto JovemRESUMO
A case of a 16-year-old female with a disseminated tumor was reported six years after surgical treatment. In October 1993 the diagnosis of a bronchial carcinoid tumor was made and a left pneumonectomy was performed. No adjuvant treatment was indicated. In May 1999 a relapse was confirmed by cytology, and a treatment with rec-hIFNalpha (10 MU intramuscular, thrice/week) was indicated. Her clinical condition improved, (ECOG 2 to 0), after three months of stable disease at evaluation, up to March 2002 when she developed a progressive disease as documented by abdominal CT scan. The histological block of the primary tumor was sent to the Centre of Molecular Immunology in order to evaluate the recognition of the ganglioside molecule on the tumor by immunohistochemistry, which was informed as positive. In April 2002 we decided to begin a compassionate treatment with the vaccine NGcGM3/VSSP Montanide ISA 51 in combination with rec-hIFNalpha. Since then up to now (56 months after progression with rec-hIFNalpha alone) the patient still has stable disease. In summary, we observed very encouraging results that could support further studies in this type of patients.
Assuntos
Neoplasias Brônquicas/terapia , Vacinas Anticâncer/uso terapêutico , Tumor Carcinoide/terapia , Gangliosídeo G(M3)/análogos & derivados , Interferon-alfa/uso terapêutico , Interferons/uso terapêutico , Adolescente , Progressão da Doença , Intervalo Livre de Doença , Feminino , Gangliosídeo G(M3)/imunologia , Gangliosídeo G(M3)/uso terapêutico , Humanos , Imuno-Histoquímica/métodos , Recidiva , Indução de Remissão , Tomografia Computadorizada por Raios XRESUMO
Chicken embryonic adipofibroblasts (CEA) accumulate intracytoplasmic lipids when cultured in medium containing chicken serum (CS), but not in medium with fetal bovine serum (FBS). To characterize this process of lipid accumulation, we evaluated the expression of the enzyme glycerol-3-phosphate dehydrogenase (E.C.1.1.1.8) (GPDH), first in chicken tissues and then in CEA cultured under diverse conditions. GPDH activity in adipose depots from 4-wk-old broiler chickens was similar or higher than that shown by liver, the main organ for fatty acid synthesis in chickens, while skeletal muscle had the lowest levels of GPDH. In vitro, GPDH activity increased in CEA cultured in the presence of CS but not in medium with FBS, paralleling the lipid accumulation by these cells. Both lipid accumulation and GPDH activity were further increased in CEA cultured in the presence of embryonic CS. Our results show that GPDH is highly expressed in avian tissues related to lipid metabolism and therefore can be a reliable marker for avian adipogenesis, and suggest that ECS is an optimum source for the purification of avian adipogenic factors.
Assuntos
Tecido Adiposo/enzimologia , Galinhas/metabolismo , Glicerolfosfato Desidrogenase/metabolismo , Metabolismo dos Lipídeos , Tecido Adiposo/citologia , Tecido Adiposo/embriologia , Animais , Sangue , Células Cultivadas , Embrião de Galinha , Meios de Cultura , Ácidos Graxos/biossíntese , Fibroblastos/enzimologia , Regulação Enzimológica da Expressão Gênica , Fígado/citologia , Fígado/enzimologia , Masculino , Músculo Esquelético/citologia , Músculo Esquelético/enzimologiaRESUMO
Cell number is usually evaluated during in vitro studies to estimate metabolic or pharmacological effects of specific compounds. However, estimation of in vitro cell density by direct cell counting is a laborious and time-consuming task, whereas indirect methods for cell quantitation have serious disadvantages such as environmental costs or inaccuracies derived from non-specific interferences. We developed a new method for in vitro cell density quantitation which employs carmine, a natural dye widely used for chromosome staining in cytological studies. Normal or transformed murine fibroblasts, avian normal fibroblasts, human epithelial HeLa cells, and insect cells, inoculated at a range of cell densities, were fixed with 4% formaldehyde/PBS and stained with 0.4% alcoholic-HCl carmine. The stain retained in cell monolayers was extracted with 0.01 M NaOH and spectrophotometrically measured at 531 nm. Invariably, high correlation coefficients between cell number and absorbance were obtained for each cell type, within a range of 5 x 10(3) to 5 x 10(5) cells. Moreover, identical cell growth curves were obtained when cell number was estimated over several days of culture by both direct cell counting and carmine staining methods. Our results show that the carmine staining method represents an easy, precise and reliable alternative for in vitro cell quantitation, avoiding interferences caused by cell components modulable by culture treatments, and over a wide range of cell types and cell densities.
Assuntos
Carmim , Contagem de Células/métodos , Colorimetria/métodos , Corantes , Coloração e Rotulagem/métodos , Células 3T3 , Animais , Técnicas de Cultura de Células/métodos , Linhagem Celular Transformada , Embrião de Galinha , Células HeLa , Humanos , Insetos , Camundongos , Reprodutibilidade dos Testes , Espectrofotometria/métodosRESUMO
Aiming to know the factors that influenced the use of erythropoietin (EPO) in chronic hemodialysis patients, we retrospectively studied 82 patients (41 male), of whom 15 received EPO. No differences, between patients receiving or not receiving EPO, were found in age (46.9 +/- 25 and 57 +/- 13 years respectively), male/female ratio (9/6 and 32/35 respectively), time on dialysis (36.4 +/- 25.6 and 36.8 +/- 31.8 months respectively), dialysis hours (3.19 +/- 0.6 and 3.33 +/- 0.39 h respectively) and proportion of diabetics (6.6 and 20.8% respectively). Prior to EPO use and compared to untreated patients, treated patients were transfused with a higher frequency (60 vs 22%) and with more units/patients/years (0.12 vs 0.08). Hemoglobin levels at the start of the treatment was similar in treated and untreated patients (8.4 +/- 1.46 vs 8.78 +/- 1.97 g/dl). EPO was indicated in 11 patients due to general symptomatology associated to anemia and in 4 due to cardiac failure or angina. We conclude that EPO treatment is indicated in approximately 18% of patients in dialysis. An adequate dialytic treatment may achieve optimal hemoglobin levels with minimal transfusion requirements and without need of EPO, thus reducing costs.
Assuntos
Anemia/tratamento farmacológico , Eritropoetina/administração & dosagem , Falência Renal Crônica/complicações , Diálise Renal , Adulto , Idoso , Análise de Variância , Anemia/sangue , Anemia/etiologia , Transfusão de Sangue , Eritropoetina/uso terapêutico , Feminino , Hemoglobinas/análise , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Las carencias nutricionales por micronutrientes, principalmente vitamina A, Hierro y Yodo afectan a grandes poblaciones en todo el mundo, particularmente a los niños menores de cinco años, mujeres en edad reproductiva, embarazadas y lactantes. Estudios realizados en Ecuador han registrado una prevalencia de anemia por deficiencia de hierro en el 60 por ciento de las mujeres embarazadas. En el país la prevalencia de deficiencia de vitamina A es de 18 por ciento en menores de 5 años en las provincias de pobreza crítica. No se han publicado estudios sobre prevalencia de anemia y de hipovitaminosis A en mujeres lactantes. Estudios de suplementación realizados en mujeres embarazadas anémicas han demostrado incrementos significativos en la hemoglobina cuando la vitamina A fua adicionada a la suplementación con hierro y una megadosis de vitamina A, sobre el estado del hierro en mujeres lactantes la morbilidad de sus lactantes. El diseño del estudio fue de tipo clínico experimental, randomizado y ciego, controlado con grupo placebo. Se estudiaron 123 mujeres que asistieron al Patronato Municipal San José de la Ciudad de Quito para la atención del parto. Las lactantes seleccionadas se dividieron en cuatro grupos de tratamiento: un grupo recibió hierro en dosis bisemanales con una megadosis de vitamina A; un segundo grupo recibió únicamente hierro; un tercer grupo recibió únicamente vitamina A. La valoración del estado nutricional del hierro fué realizada al inicio y al término de ocho semanas de suplementación...
Assuntos
Humanos , Alimentos Fortificados , Comportamento do Lactente , Ferro , Vitamina A , MulheresRESUMO
Se estudiaron 85 pacientes de cáncer de mama a las que se les realizó 18 pruebas de laboratorio antes y a 3 meses del tratamiento; no se encontró asociación alguna con el pronóstico a 3 años de evolución. Simultáneamente se estudiaron 71 pacientes de linfoma a los que se les realizó los mismos análisis y se encontró una asociación con el pronóstico y las zonas de albúmina, alfa 1 y gamma de la electroforesis de proteínas, hierro, eritrosedimentación, PCR y fosfatasa alcalina en el linfoma de Hodgkin, mientras que en el linfoma no Hodgkin tuvieron valor pronóstico la zona alfa 2, la haptoglobina, la ceruloplasmina y la eritrosedimentación. Estas conservaron su valor pronóstico aun dentro de un mismo estadio, en el linfoma no Hodgkin, mientras que en el linfoma de Hodgkin se asocian al estadio
Assuntos
Humanos , Feminino , Neoplasias da Mama , Linfoma , Biomarcadores/análise , PrognósticoRESUMO
The respiratory function of 51 insulin-dependent diabetic patients (31 with and 20 without LJM) was studied. The variables age, diabetes duration, height, and metabolic control were similar for both groups. Vital capacity (VC), forced expiratory volume (FEV), mean maximum expiratory flow (MMEF), and FEV/VC ratio were determined before and after the administration of a bronchodilator. VC, FEV, and MMEF showed significantly lower values (p less than 0.02) in patients without LJM as compared to those with LJM. It is suggested that these alterations may be due to abnormalities of collagen fibers and elasticity in the lung and are not related to reversible bronchial obstruction. We believe that LJM is an extrinsic manifestation of a systemic process, aggravating the prognosis of diabetes mellitus.