RESUMO
O presente trabalho pretende descrever o perfil do paciente portador de DORT atendido pelo Sistema Unico de Saude(SUS) em Belo Horizonte. Conhece-lo e de fundamental importancia, pois essas patologias sao responsaveis por cerca de (85 por cento) dos afastamentos do trabalho alem, de causarem grandes impactos psicologicos e socioeconomicos. Realizou-se o levantamento de 145 prontuarios de pacientes do Centro de Referencia de Saude ddo Trabalhador (CERSAT), no periodo de 1998 a 2001. Dados como sexo, faixa etaria, escolaridade, profissao, situacao de trabalho e diagnosticos foram analisados. Os resultados apontam que as DORT acometem mais as mulheres entre 21 e 50 anos de idade com baixo grau de escolaridade. Dados importantes foram observados no item ``diagnosticos``, pois estes tem-se mostrado inconclusivos, impedindo intervencao fisioterapica adequada. Constatou-se, contudo, que as tendinites continuam sendo as mais frequentes (49 por cento) e que as tenossinovites, as epicondilites e a fibromialgia tem aumentado nos ultimos anos, sendo que, na maioria dos casos, os pacientes chegam ao tratamento em fases avancadas. Essa situacao e um problema de saude publicae tem trazido prejuizos aos trabalhadores, tornando evidente a importancia de conhecer as necessidades dos pacientes e de oferecer-lhes tratamento mais adequado
Assuntos
Epidemiologia , Especialidade de Fisioterapia , Saúde OcupacionalRESUMO
In the retina of newborn rats there is evidence for two mechanisms of programmed cell death. Apoptosis of ganglion cells (RGCs) following axotomy depends on protein synthesis. In contrast, inhibition of protein synthesis leads to apoptosis in the neuroblastic layer (NBL). The induction of apoptosis following translational arrest suggests that post-translational modifications of apoptosis-associated proteins may be crucial to the cell death programs in the developing retina. We investigated the possible role of protein kinases upon apoptosis in retinal explants in vitro. An increase in the intracellular concentration of cAMP produced either by the adenylyl-cyclase activator forskolin (10 microM) or by 8-Br-cAMP (1 mM), prevented apoptosis induced in the NBL by inhibition of protein synthesis, but had no statistically significant effect upon RGC death. In contrast, neither 8-Br-cGMP (1 mM) nor the specific cGMP-phosphodiesterase inhibitor zaprinast (10-100 microM) had significant effects on apoptosis in the retina. The cAMP-phosphodiesterase inhibitors isobutylmethylxantine (IBMX, 0.1-1 mM) and Ro-201724 (50-200 microM) also prevented apoptosis in the NBL. The isoquinolinesulfonamide H89 (20 microM), a specific cAMP-dependent protein kinase inhibitor, partially reverted the protective effect of either forskolin or IBMX within the NBL. Neither 12-O-tetradecanoyl phorbol-13-acetate (TPA, 10 nM) nor bisindolylmaleimide (0.2-0.5 microM), respectively an activator and an inhibitor of protein kinase C had significant effects upon the retinal explants. The protein kinase inhibitor 2-aminopurine (2-AP, 10 mM) prevented apoptosis of axotomized ganglion cells and induced apoptosis in the NBL. Forskolin prevented the apoptosis induced by 2-AP in the NBL, whereas TPA had no effect. The effects of 2-AP were, however, not dependent on inhibition of protein synthesis. The data indicate that modulation of the activity of both cAMP-dependent protein kinase and several protein kinases sensitive to 2-aminopurine selectively affect apoptosis in distinct cell layers of the developing retina.
Assuntos
Envelhecimento/fisiologia , Apoptose/fisiologia , Proteínas Quinases/fisiologia , Retina/fisiologia , 2-Aminopurina/farmacologia , Animais , Animais Recém-Nascidos/fisiologia , Antimetabólitos/farmacologia , AMP Cíclico/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/fisiologia , Embrião de Mamíferos/fisiologia , Inibidores Enzimáticos/farmacologia , Técnicas In Vitro , Inibidores de Fosfodiesterase/farmacologia , Inibidores de Proteínas Quinases , Ratos , Retina/citologiaRESUMO
Studies of programmed cell death in the developing retina in vitro are currently reviewed. The results of inhibiting protein synthesis in retinal explants indicate two mechanisms of apoptosis. One mechanism depends on the synthesis of positive modulators ('killer proteins'), while a distinct, latent mechanism appears to be continuously blocked by negative modulators. Extracellular modulators of apoptosis include the neurotrophic factors NT-4 and BDNF, while glutamate may have either a positive or a negative modulatory action on apoptosis. Several protein kinases selectively modulate apoptosis in distinct retinal layers. Calcium and nitric oxide were also shown to affect apoptosis in the developing retinal tissue. The protein c-Jun was found associated with apoptosis in various circumstances, while p53 seems to be selectively expressed in some instances of apoptosis. The results indicate that the sensitivity of each retinal cell to apoptosis is controlled by multiple, interactive, cell type- and context-specific mechanisms. Apoptosis in the retina depends on a critical interplay of extracellular signals delivered through neurotrophic factors, neurotransmitters and neuromodulators, several signal transduction pathways, and the expression of a variety of genes.
Assuntos
Apoptose/fisiologia , Fator Neurotrófico Derivado do Encéfalo/fisiologia , Técnicas de Cultura , Degeneração Retiniana/metabolismo , Transdução de Sinais/fisiologia , Animais , Camundongos , RatosRESUMO
Studies of programmed cell death in the developing retina in vitro are currently reviewed. The results of inhibiting protein synthesis in retinal explants indicate two mechanisms of apoptosis. One mechanism depends on the synthesis of positive modulators ('killer proteins'), while a distinct, latent mechanism appears to be continuously blocked by negative modulators. Extracellular modulators of apoptosis include the neurotrophic factors NT-4 and BDNF, while glutamate may have either a positive or a negative modulatory action on apoptosis. Several protein kinases selectively modulate apoptosis in distinct retinal layers. Calcium and nitric oxide were also shown to affect apoptosis in the developing retianl tissue. The protein c-Jun was found associated with apoptosis in various circumstances, while p53 seems to be selectively expressed in some instances of apoptosis. The results indicate that the sensitivity of each retinal cell to apoptosis is controlled by multiple, interactive, cell type- and context-specific mechanisms. Apoptosis in the retina depends on a critical interplay of extracellular signals delivered through neurotrophic factors, neurotransmitters and neuromodulators, several signal transduction pathways, and the expression of a variety of genes.