RESUMO
INTRODUCTION: Hallux valgus is a high frequency disorder, affecting the first ray. Operative correction techniques have grown popularity lately. One of them is the Reverdin-Isham technique (first metatarsal medial incomplete osteotomy). Recently, a protection and osteotomy cutting guide has been developed: the BARU system. OBJECTIVE: To test the usefulness of the BARU system as a protective factor for soft structures adjacent to the surgical site and guidance for osteotomy. MATERIAL AND METHODS: Experimental cadaveric study. Six cadaveric feet (two fresh-frozen and four in formaldehyde solution), unapproached. Feet were numbered and intervened with RI technique, three of them with BARU system and three without it. Afterwards, dissection by two dissectors who did not know whether the BARU system had been used or not, establishing a single-blinded model. 13 structures were evaluated in each foot. Data was recovered into Microsoft Office Excel and processed with SPSS. 2 test (significative if p value < 0.05) and relative risk were calculated. RESULTS: Approach using BARU system was satisfactory, with usual-size operation-ports. BARU system colocation was simple and radiological control showed adequate spatial location. The device contributed as reference for cutting direction and depth. 65 out of the 78 searched structures were found (83.3%). Six injuries were found among the assessed structures: plantar medial nerve (one injury), plantar medial artery (one injury), flexor brevis muscle (three injuries), abductor muscle (one injury). Five of these injuries occurred in non-utilizing BARU system feet. CONCLUSION: Promising results in terms of protection of nearby structures, cutting guide, and ease of intervention. Avoids X-rays exposure. Not significant statistical calculations, the sample should be enlarged.
INTRODUCCIÓN: El hallux valgus es una patología con alta prevalencia en la población. Técnicas de corrección quirúrgica han crecido en popularidad últimamente. Una de ellas es la de Reverdin-Isham (RI: osteotomía incompleta medial en primer metatarsiano), se desarrolló un dispositivo de protección y guía de corte para dicho procedimiento: el sistema BARU. OBJETIVO: Probar la utilidad del sistema BARU como factor protector de estructuras blandas adyacentes al sitio de abordaje y guía para osteotomía. MATERIAL Y MÉTODOS: Estudio cadavérico; seis pies (dos frescos y cuatro formolados) sin abordajes previos. Tres con el sistema BARU y tres sin éste. Posteriormente disección por dos disectores con enmascaramiento simple ciego. Se evaluaron 13 estructuras en cada pie. Los datos fueron recabados con Microsoft Office Excel y procesados en SPSS. Se realizó test de 2 (valor p < 0.05 significativo) y se calculó el riesgo relativo. RESULTADOS: El sistema BARU fue satisfactorio. Su colocación fue sencilla y el control radiológico mostró adecuada ubicación espacial. Ayudó como referencia para la dirección y profundidad del corte. Se encontraron 65 de las 78 estructuras buscadas (83.3%). En las estructuras evaluadas hubo seis lesiones: nervio plantar medial (uno dañado), arteria plantar medial (uno dañado), músculo flexor corto (tres dañados), músculo abductor (uno dañado). Cinco de estas lesiones ocurrieron en pies donde no se utilizó el sistema BARU. CONCLUSIÓN: Resultados prometedores en cuanto a protección de estructuras cercanas, guía de corte y facilidad para la intervención. Cálculos estadísticos no significativos, la muestra debería ampliarse.
Assuntos
Hallux Valgus , Ossos do Metatarso , Cadáver , Hallux Valgus/cirurgia , Humanos , Osteotomia , Resultado do TratamentoRESUMO
Resumen: Introducción: El hallux valgus es una patología con alta prevalencia en la población. Técnicas de corrección quirúrgica han crecido en popularidad últimamente. Una de ellas es la de Reverdin-Isham (RI: osteotomía incompleta medial en primer metatarsiano), se desarrolló un dispositivo de protección y guía de corte para dicho procedimiento: el sistema BARU. Objetivo: Probar la utilidad del sistema BARU como factor protector de estructuras blandas adyacentes al sitio de abordaje y guía para osteotomía. Material y métodos: Estudio cadavérico; seis pies (dos frescos y cuatro formolados) sin abordajes previos. Tres con el sistema BARU y tres sin éste. Posteriormente disección por dos disectores con enmascaramiento simple ciego. Se evaluaron 13 estructuras en cada pie. Los datos fueron recabados con Microsoft Office Excel y procesados en SPSS. Se realizó test de χ2 (valor p < 0.05 significativo) y se calculó el riesgo relativo. Resultados: El sistema BARU fue satisfactorio. Su colocación fue sencilla y el control radiológico mostró adecuada ubicación espacial. Ayudó como referencia para la dirección y profundidad del corte. Se encontraron 65 de las 78 estructuras buscadas (83.3%). En las estructuras evaluadas hubo seis lesiones: nervio plantar medial (uno dañado), arteria plantar medial (uno dañado), músculo flexor corto (tres dañados), músculo abductor (uno dañado). Cinco de estas lesiones ocurrieron en pies donde no se utilizó el sistema BARU. Conclusión: Resultados prometedores en cuanto a protección de estructuras cercanas, guía de corte y facilidad para la intervención. Cálculos estadísticos no significativos, la muestra debería ampliarse.
Abstract: Introduction: Hallux valgus is a high frequency disorder, affecting the first ray. Operative correction techniques have grown popularity lately. One of them is the Reverdin-Isham technique (first metatarsal medial incomplete osteotomy). Recently, a protection and osteotomy cutting guide has been developed: the BARU system. Objective: To test the usefulness of the BARU system as a protective factor for soft structures adjacent to the surgical site and guidance for osteotomy. Material and methods: Experimental cadaveric study. Six cadaveric feet (two fresh-frozen and four in formaldehyde solution), unapproached. Feet were numbered and intervened with RI technique, three of them with BARU system and three without it. Afterwards, dissection by two dissectors who did not know whether the BARU system had been used or not, establishing a single-blinded model. 13 structures were evaluated in each foot. Data was recovered into Microsoft Office Excel and processed with SPSS. χ2 test (significative if p value < 0.05) and relative risk were calculated. Results: Approach using BARU system was satisfactory, with usual-size operation-ports. BARU system colocation was simple and radiological control showed adequate spatial location. The device contributed as reference for cutting direction and depth. 65 out of the 78 searched structures were found (83.3%). Six injuries were found among the assessed structures: plantar medial nerve (one injury), plantar medial artery (one injury), flexor brevis muscle (three injuries), abductor muscle (one injury). Five of these injuries occurred in non-utilizing BARU system feet. Conclusion: Promising results in terms of protection of nearby structures, cutting guide, and ease of intervention. Avoids X-rays exposure. Not significant statistical calculations, the sample should be enlarged.
RESUMO
OBJECTIVE: The aim of this study was to examine echocardiographic parameters of left ventricle (LV) mechanics in obese patients before and after sleeve gastrectomy (SG). DESIGN AND METHODS: Twenty-five obese individuals submitted to laparoscopic SG were enrolled in this study. Echocardiography was performed before and after the procedure, and left ventricle mechanics were evaluated by speckle tracking imaging. RESULTS: Before surgery, altered global longitudinal strain (GLS) values were present in 56% of the patients. In a mean follow-up of 3.6 ± 0.5 months after surgery, there was an increase in GLS values (from 17.4 ± 3.2 to 19.3 ± 2.7%, P = 0.01). There was an inverse correlation between the absolute values of GLS in the preoperative period and the variation in the GLS at follow-up (r = 0.577, P = 0.002). Measurements of global circumferential strain (GCS), global radial strain (GRS), and LV twist were normal preoperatively and did not change after surgery. CONCLUSIONS: Altered global longitudinal strain values were common in young obese patients. Sleeve gastrectomy increased global longitudinal strain even in the early postoperative phase without promoting changes in global radial strain, global circumferential strain, and left ventricle twist measurements.
Assuntos
Gastrectomia/efeitos adversos , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/cirurgia , Função Ventricular Esquerda/fisiologia , Adulto , Estudos Controlados Antes e Depois , Ecocardiografia/métodos , Feminino , Gastrectomia/métodos , Gastrectomia/reabilitação , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Contração Miocárdica/fisiologia , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/epidemiologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Período Pré-Operatório , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/epidemiologia , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
Resumen: La epifisiólisis esternoclavicular es una lesión rara, siendo la variante posterior aún menos frecuente. Su presentación clínica puede ser sutil o puede comprometer estructuras mediastinales, ya sea inicialmente o durante la evolución, lo que constituye un cuadro grave y potencialmente fatal. Este reporte de caso documenta una disociación esternoclavicular en un paciente con esqueleto inmaduro, dada por una lesión fisaria tipo Salter y Harris 1, la que se trató quirúrgicamente mediante reducción abierta y fijación interna con lazadas en ocho transóseas con sutura no reabsorbible. Con un seguimiento de 10 meses y resultados excelentes. Esta técnica parece ser una buena opción para el tratamiento de luxación esternoclavicular en el paciente esquemáticamente inmaduro, recuperando la función y evitando complicaciones.
Abstract: Sternoclavicular epiphysiolysis is a rare lesion, the posterior variant being even less common. Its clinical presentation may be subtle, or it may compromise mediastinal structures, either initially or during evolution, which is a serious and potentially fatal picture. This case report documents sternoclavicular dissociation in a patient with an immature skeleton, given by a Salter and Harris 1-type injury, which was surgically treated by open reduction and internal fixation with transosseous configuration with non-reabsorbable suture. With a 10-month follow-up and excellent results. This technique seems to be a good option for the treatment of sternoclavicular dislocation in the schematically immature patient, regaining function and avoiding complications.
Assuntos
Humanos , Luxações Articulares , Epifise Deslocada , Articulação Esternoclavicular , Clavícula , Fixação Interna de FraturasRESUMO
Sternoclavicular epiphysiolysis is a rare lesion, the posterior variant being even less common. Its clinical presentation may be subtle, or it may compromise mediastinal structures, either initially or during evolution, which is a serious and potentially fatal picture. This case report documents sternoclavicular dissociation in a patient with an immature skeleton, given by a Salter and Harris 1-type injury, which was surgically treated by open reduction and internal fixation with transosseous configuration with non-reabsorbable suture. With a 10-month follow-up and excellent results. This technique seems to be a good option for the treatment of sternoclavicular dislocation in the schematically immature patient, regaining function and avoiding complications.
La epifisiólisis esternoclavicular es una lesión rara, siendo la variante posterior aún menos frecuente. Su presentación clínica puede ser sutil o puede comprometer estructuras mediastinales, ya sea inicialmente o durante la evolución, lo que constituye un cuadro grave y potencialmente fatal. Este reporte de caso documenta una disociación esternoclavicular en un paciente con esqueleto inmaduro, dada por una lesión fisaria tipo Salter y Harris 1, la que se trató quirúrgicamente mediante reducción abierta y fijación interna con lazadas en ocho transóseas con sutura no reabsorbible. Con un seguimiento de 10 meses y resultados excelentes. Esta técnica parece ser una buena opción para el tratamiento de luxación esternoclavicular en el paciente esquemáticamente inmaduro, recuperando la función y evitando complicaciones.
Assuntos
Epifise Deslocada , Luxações Articulares , Articulação Esternoclavicular , Clavícula , Fixação Interna de Fraturas , HumanosRESUMO
Transepithelial sodium transport is a process that involves active Na(+) transport at the basolateral membrane of the epithelial cell. This process is mediated by the Na(+)/K(+) pump, which exchanges 3 internal Na(+) by 2 external K(+) inducing a net charge movement and the second Na(+) pump, which transports Na(+) accompanied by Cl(-) and water. It has been suggested that this pump could also be electrogenic. Herein, we evaluated, in MDCK cells, the short-circuit current (Isc) generated by these Na(+) pumps at the basolateral membrane of the epithelial cells, using amphotericin B as an apical permeabilizing agent. In Cl(-)-containing media, Isc induced by amphotericin B is totally inhibited by ouabain, indicating that only the electrogenic Na(+)/K(+) pump is detectable in the presence of Cl(-). Electrogenicity of the second Na(+) pump can be demonstrated in Cl(-)-free media. The existence of a furosemide-sensitive component of Isc, in addition to an ouabain-sensitive one, was identified in absence of chloride. Passive Cl(-) movement associated with the function of the second Na(+) pump seems to be regulated by the pump itself. These results demonstrate that the second Na(+) pump is an electroneutral mechanism result from the stoichiometric movement of Na(+) and Cl(-) across the basolateral plasma membrane of the epithelial cell.
Assuntos
Células Epiteliais/metabolismo , ATPase Trocadora de Sódio-Potássio/metabolismo , Animais , Cloretos/química , Cloretos/metabolismo , Cães , Células Epiteliais/química , Transporte de Íons/fisiologia , Células Madin Darby de Rim Canino , Potássio/química , Potássio/metabolismo , Sódio/química , Sódio/metabolismo , ATPase Trocadora de Sódio-Potássio/químicaRESUMO
Secretory antibodies of the immunoglobulin A (sIgA) class constitute the first line of antigen-specific immune protection against pathogens and other antigens at mucosal surfaces. Although initially perceived as potentially deleterious, catalytic antibodies have been proposed to participate in the removal of metabolic wastes and in protection against infection. Here we show that the presence of sIgA endowed with serine protease-like hydrolytic activity in milk strongly correlates with PAR-2 activation in human intestinal epithelial cells. F(ab')(2) fragments of sIgA activated the epithelial cells in culture to produce beta-defensin-2 (hBD2). Intracellular Ca(2+) mobilization was induced by treatment with (1) sIgA-F(ab')(2) fragments; (2) trypsin, a recognized PAR-2 agonist; or (3) a synthetic PAR-2 agonist peptide (SLIGKV). The co-treatment with a synthetic PAR-2 antagonist peptide (FSLLRY) and sIgA-F(ab')(2) fragments eliminates the latter's effect; nevertheless, cells were not refractory to subsequent stimulation with sIgA-F(ab')(2) fragments. Both the induction of hBD-2 expression in epithelial cells and the increase in intracellular [Ca(2+)] stimulated by sIgA-F(ab')(2) fragments were inhibited by treatment with serine protease inhibitors or pertussis toxin (PTX). These findings suggest that catalytic antibodies can activate intestinal epithelial cells through G-protein-coupled PAR-2, and could actively participate in the immune system of breastfed babies inducing the production of peptides related to innate defense, such as defensins.
Assuntos
Anticorpos Catalíticos/imunologia , Imunoglobulina A Secretora/imunologia , Mucosa Intestinal/imunologia , Leite Humano/imunologia , Peptídeo Hidrolases/imunologia , Receptor PAR-2/agonistas , beta-Defensinas/biossíntese , Adolescente , Adulto , Anticorpos Catalíticos/isolamento & purificação , Anticorpos Catalíticos/metabolismo , Linhagem Celular Tumoral , Feminino , Células HT29 , Humanos , Imunidade Inata , Imunoglobulina A Secretora/isolamento & purificação , Imunoglobulina A Secretora/metabolismo , Fragmentos Fab das Imunoglobulinas/imunologia , Fragmentos Fab das Imunoglobulinas/isolamento & purificação , Fragmentos Fab das Imunoglobulinas/metabolismo , Leite Humano/enzimologia , Peptídeo Hidrolases/isolamento & purificação , Peptídeo Hidrolases/metabolismo , Receptor PAR-2/biossíntese , Adulto JovemRESUMO
OBJECTIVE: To show that the ceramic produced at the Institute for Materials Research, National Autonomous University of Mexico, is an appropriate replacement of bone graft in patients with bone tumors, benign tumors, pseudoarthrosis and arthrodesis treated at "General Ignacio Zaragoza" Regional Hospital. MATERIAL AND METHODS: An experimental, longitudinal study using bovine ceramic xenoimplants in patients covered by the Security and Social Services Institute for Civil Servants (ISSSTE), regardless of age and gender, all of whom consented to receiving the ceramic xenoimplant. Patients who did not consent or who discontinued treatment were excluded. A total of 24 patients were enrolled from March 1st to August 31st, 2006; two patients were withdrawn due to treatment discontinuation. They underwent X-ray evaluation of bone healing using the Montoya classification. RESULTS: The sample is composed of 14 male and 8 female patients, with a mean age of 46.6 years, and a standard deviation (s=) of 13.8. The most frequent indication was arthrodesis in 10 patients (45.45%), pseudoarthrosis in 6 (27.27%), benign tumors in 3 (13.63%), and bone defects in 3 (13.63%). Type II to type IV bone healing was observed in the sample. DISCUSSION: The use of ceramic xenoimplants is appropriate as a replacement of bone graft in patients with arthrodesis and bone defects, thus avoiding the need for autologous bone graft. This results in a decreased patient morbidity.
Assuntos
Artrodese , Neoplasias Ósseas/cirurgia , Transplante Ósseo , Pseudoartrose/cirurgia , Transplante Heterólogo , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-IdadeRESUMO
K+ -conductive pathways were evaluated in isolated surface and crypt colonic cells, by measuring (86)Rb efflux. In crypt cells, basal K+ efflux (rate constant: 0.24 +/- 0.044 min(-1), span: 24 +/- 1.3%) was inhibited by 30 mM TEA and 5 mM Ba2+ in an additive way, suggesting the existence of two different conductive pathways. Basal efflux was insensitive to apamin, iberiotoxin, charybdotoxin and clotrimazole. Ionomycin (5 microM) stimulated K+ efflux, increasing the rate constant to 0.65 +/- 0.007 min(-1) and the span to 83 +/- 3.2%. Ionomycin-induced K+ efflux was inhibited by clotrimazole (IC(50) of 25 +/- 0.4 microM) and charybdotoxin (IC(50) of 65 +/- 5.0 nM) and was insensitive to TEA, Ba2+, apamin and iberiotoxin, suggesting that this conductive pathway is related to the Ca2+-activated intermediate-conductance K+ channels (IK(ca)). Absence of extracellular Ca2+ did neither affect basal nor ionomycin-induced K+ efflux. However, intracellular Ca2+ depletion totally inhibited the ionomycin-induced K+ efflux, indicating that the activation of these K+ channels mainly depends on intracellular calcium liberation. K+ efflux was stimulated by intracellular Ca(2+) with an EC(50) of 1.1 +/- 0.04 microM. In surface cells, K+ efflux (rate constant: 0.17 +/- 0.027 min(-1); span: 25 +/- 3.4%) was insensitive to TEA and Ba2+. However, ionomycin induced K+ efflux with characteristics identical to that observed in crypt cells. In conclusion, both surface and crypt cells present IK(Ca) channels but only crypt cells have TEA- and Ba2+-sensitive conductive pathways, which would determine their participation in colonic K+ secretion.
Assuntos
Cálcio/farmacologia , Colo/fisiologia , Canais de Potássio Cálcio-Ativados/metabolismo , Potássio/metabolismo , Animais , Cálcio/metabolismo , Células Cultivadas , Colo/citologia , Inibidores Enzimáticos/farmacologia , Cobaias , Transporte de Íons/efeitos dos fármacos , Transporte de Íons/fisiologia , MasculinoRESUMO
The mechanisms involved in D-glucose and amino acid transport in the intestine of birds are still not clear. In chickens, D-glucose and amino acid absorption occurs via carrier-mediated transport, but in wild birds a passive paracellular mechanism seems to be the predominant pathway. The purpose of this work was to determine the existence of carrier-mediated sodium cotransport of D-glucose and L-alanine in the small intestine of Japanese quail (Coturnix coturnix), a granivorous bird. Intestinal transport was determined by changes in the short-circuit current (Isc), proportional to ion transmembrane flux, in the middle segment of the intestine of Japanese quail with a Ussing chamber. D-Glucose produced an increase of the Isc, and this effect was reverted by phloridzin, indicating the presence of a D-glucose transport mediated by the sodium/glucose cotranspoter 1. Addition of L-alanine also produced an increase of the Isc. We concluded that there is carrier-mediated cotransport of D-glucose and L-alanine with sodium in the small intestine of the Japanese quail.
Assuntos
Alanina/metabolismo , Coturnix/metabolismo , Glucose/metabolismo , Animais , Transporte Biológico/efeitos dos fármacos , Condutividade Elétrica , Impedância Elétrica , Glucose/farmacologia , Absorção Intestinal/efeitos dos fármacos , Absorção Intestinal/fisiologia , Intestino Delgado/fisiologia , Masculino , Proteínas de Transporte de Monossacarídeos/efeitos dos fármacos , Proteínas de Transporte de Monossacarídeos/fisiologia , Florizina/farmacologiaRESUMO
This paper describes a rapid and sensitive method to determine inorganic phosphate, even in the presence of labile organic phosphate compounds and large quantities of proteins. The method eliminates the use of sodium arsenite, a highly toxic compound, substituting bismuth citrate for it to stabilize the phosphomolybdic acid complex formed during the interaction of inorganic phosphate and molybdate reduced by ascorbic acid. This method has also been adapted to microplates and has been used to determine the activities of Na/K ATPase and alkaline phosphatase of intestinal basolateral and luminal plasma membranes.
Assuntos
Membrana Celular/enzimologia , Enterócitos/enzimologia , Compostos Organometálicos/química , Fosfatos/análise , Monoéster Fosfórico Hidrolases/análise , Fosfatase Alcalina/análise , Animais , Arsenitos/química , Arsenitos/toxicidade , Ácido Ascórbico/química , Soluções Tampão , Mucosa Intestinal/enzimologia , Modelos Lineares , Molibdênio/química , Compostos Organofosforados/análise , Fosfatos/normas , Ácidos Fosfóricos/química , Compostos de Sódio/química , Compostos de Sódio/toxicidade , ATPase Trocadora de Sódio-Potássio/análise , EspectrofotometriaRESUMO
The aim of this study was to evaluate long-term clinical follow-up and echocardiographic data on pregnant patients with mitral stenosis who underwent percutaneous mitral valvuloplasty (PMV) in our center and the development of their infants. PMV has proven to be an effective alternative to treat pregnant patients with mitral stenosis. However, long-term outcome of these patients, as well as the potential harmful effects caused by radiation on their infants, still awaits to be determined. From January 1988 to February 1999, 30 pregnant women (mean gestational duration, 24.95 +/- 5.59 weeks) underwent PMV. Twenty-three (77%) were subsequently followed by a medical interview during 5.33 +/- 3.12 years. Clinical variables such as NYHA functional class (FC), the need of a repeat PMV or surgical procedure, the presence of embolic events, and mortality rate were evaluated during follow-up. Mitral valve area, mean transmitral gradient, and the presence of mitral regurgitation were also assessed by Doppler echocardiography. Clinical data on the development of the infants were obtained from the assistant pediatricians. All patients were in NYHA FC III or IV before the procedure. During follow-up, 91% of them were in FC I and II. Two patients (9%) who had remained in FC III underwent a repeat successful PMV; no further surgery was required. There were no embolic events or death related to the procedure. Echocardiography showed an initial increase in mitral valve area from 1.14 +/- 0.22 cm(2) to 2.01 +/- 0.21 cm+/- (P < 0.0001). During long-term follow-up, it decreased to a mean of 1.75 +/- 0.24 cm(2) (P < 0. 0001). Initial transmitral valve gradient decreased from 17.73 +/- 4. 56 mm Hg to 5.91 +/- 1.80 mm Hg (P = 0.0001) and 8.95 +/- 3.58 (P = 0.002) during long-term follow-up. Twenty one children (96%), aged 4. 91 +/- 2.8 years, showed normal growth and development, and no clinical abnormalities were observed. These favorable long-term results suggests PVM to be the procedure of choice to treat pregnant women with mitral stenosis who remain in FC III or IV despite adequate medical therapy. No harmful effects due to the use of radiation were observed in the children.
Assuntos
Cateterismo , Estenose da Valva Mitral/terapia , Complicações Cardiovasculares na Gravidez/terapia , Adolescente , Adulto , Ecocardiografia Doppler em Cores , Feminino , Seguimentos , Idade Gestacional , Hemodinâmica , Humanos , Recém-Nascido , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/fisiopatologia , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico por imagem , Complicações Cardiovasculares na Gravidez/fisiopatologia , Resultado da Gravidez , Estudos RetrospectivosRESUMO
Four serotypes of dengue viruses produce dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. They are the most important arbovirus infections of humans, in terms of both morbidity and mortality, constituting one of the most rapidly expanding and re-emerging infectious disease problems in Latin America. In less than 20 years, the region has transformed itself from hypoendemic to hyperendemic, while serotype circulation in most countries has gone from none or single to multiple. Changes in endemicity have coincided with the emergence and increasing incidence of the severer forms of dengue infection. This article reviews the clinical presentations of these diseases. Health care providers who see patients in or returning from areas of Latin America, the Caribbean, and other tropical areas must consider dengue in the differential diagnosis of patients presenting with compatible symptoms, and must be knowledgeable in the current management of this important disease.
Assuntos
Vírus da Dengue/fisiologia , Dengue , Dengue Grave , Aedes/virologia , Animais , Região do Caribe/epidemiologia , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/terapia , Dengue/virologia , Vírus da Dengue/imunologia , Humanos , Insetos Vetores , América Latina/epidemiologia , Controle de Mosquitos , Dengue Grave/diagnóstico , Dengue Grave/epidemiologia , Dengue Grave/terapia , Dengue Grave/virologia , Vacinas ViraisRESUMO
BACKGROUND: To evaluate the zinc organic concentration in the chronic obstructive pulmonary disease (COPD) in relation to a control group. Also, to analyze if the serum zinc levels are related with zinc concentration in erythrocyte, nail and hair. PATIENTS AND METHODS: Forty patients of COPD have been studied, all males, average age 62 +/- 7 years and body mass index (BMI) of 27 +/- 4. Forty patients were included in the control group, with average age 57 +/- 9 years and BMI of 24 +/- 5. The patients with concomitant disease or booth treatment that could increase the zinc excretion were excluded. In all patients clinical history and examination, hematology and biochemistry tests, hepatic and lipid parameters, and nail, plasma, hair and erythrocyte zinc levels by atomic absorption spectrophotometry were done. Variance analysis and Pearson test were done. RESULTS: Blood, intraerythrocyte and nail zinc were similar in healthy subjects and patients; however, the median concentration of zinc in hair was significantly lower in patients (156 +/- 46 micrograms/g versus control group (185 +/- 64 micrograms/g) (p < 0.05). No differences were found between smokers and no smokers, and drinkers and no drinkers in relation with body concentration of zinc. CONCLUSION: The zinc concentration in hair can be a good method to evaluate the chronic deficiency in the human body. The COPD patients could be susceptible to develop zinc deficiency; the situation increases the possibility of infection diseases.
Assuntos
Pneumopatias Obstrutivas/complicações , Zinco/deficiência , Consumo de Bebidas Alcoólicas/metabolismo , Eritrócitos/química , Cabelo/química , Humanos , Lipídeos/sangue , Pneumopatias Obstrutivas/metabolismo , Masculino , Pessoa de Meia-Idade , Unhas/química , Pele/química , Fumar/metabolismo , Zinco/análise , Zinco/metabolismoRESUMO
Epinephrine and beta-adrenergic agonists (beta1 and beta2 for isoproterenol, beta1 for dobutamine, beta2 for salbutamol) stimulated K+ (or 86Rb) influx mediated by the Na+-K+-2Cl- cotransporter and the Na+-K+ pump in isolated colonic crypt cells. Preincubation with bumetanide abolished the epinephrine effect on the Na+-K+ pump, suggesting that the primary effect is on the cotransporter. Maximal effect was obtained with 1 microM epinephrine with an EC50 of 91.6 +/- 9.98 nM. Epinephrine-induced K+ transport was blocked by propranolol with an IC50 of 134 +/- 28.2 nM. alpha-Adrenergic drugs did not modify K+ transport mechanisms. Neither Ba2+ nor tetraethylammonium nor DIDS modified the adrenergic enhancement on the cotransporter. In addition, epinephrine did not affect K+ efflux. Dibutyryl cAMP did not alter K+ transport. Reduction of extracellular Ca2+ to 30 nM did not influence the response to epinephrine. However, 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid-AM abolished epinephrine-induced K+ transport. Ionomycin increased Na+-K+-2Cl- cotransport activity. Moreover, epinephrine increased intracellular Ca2+ concentration in a process inhibited by propranolol. In conclusion, epinephrine stimulated the Na+-K+-2Cl- cotransporter in a process mediated by beta1- and beta2-receptors and modulated by intracellular Ca2+ liberation.
Assuntos
Agonistas Adrenérgicos beta/farmacologia , Cálcio/metabolismo , Proteínas de Transporte/metabolismo , Colo/metabolismo , Membranas Intracelulares/metabolismo , Adrenérgicos/farmacologia , Animais , Transporte Biológico/efeitos dos fármacos , Bumetanida/farmacologia , Colo/citologia , Epinefrina/farmacologia , Cobaias , Masculino , Potássio/metabolismo , Sistemas do Segundo Mensageiro/fisiologia , Simportadores de Cloreto de Sódio-PotássioAssuntos
Eletrofisiologia/história , Eletrofisiologia/instrumentação , Eletrocardiografia/história , Eletroencefalografia/história , Eletrofisiologia/métodos , Inglaterra , França , Alemanha , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Países Baixos , Transdutores/história , Estados UnidosRESUMO
OBJECTIVE: To know and compare the beliefs, attitudes and motivations of donors and non-donors in relation with blood donation. MATERIAL AND METHODS: Transversal study by questionnaires administered to 197 blood donors and 303 non-donors. The questionnaires gathered: sociodemographic data, beliefs and attitudes (using a Likert scale), and motivations and demotivations (using upon questions). The responses were analysed using different descriptive analyses and bivariant tests, and factorial analysis and discriminant analysis were performed as multivariant analyses. RESULTS: The donor group had a mean age of 37.8 years, were 58.4 female and 41.6% male, and had made 6.02 donations. The non-donor group had a mean age of 39.8 years and were 53.8% female and 46.2 male. Regarding attitudes and beliefs, the donor group showed more confidence in the good conditions in which donations are performed, had less fears about the possibility that donation can affect health, their attitudes were generally less egotistical, and they had less fears about possible commercialisation of the blood. Both groups believed that blood banks and society itself give inadequate compensation to donors, but this belief was significantly greater among non-donors. Regarding the motivations of donors, the highest proportion were related with a sense of solidarity or duty (26.4%), followed by issues related with information or pressure (23.4%), and the possible personal or family benefits that donation might bring (21.8%). The initial motivations of most donors (75.9%) had not varied with the passage of time, and the factors found to be most demotivating for donation had to do with problems of access and comfort (74.6%). We would highlight that most non-donors denied any worries about blood donation (70.9%) and did not agree that those who need blood should be those who pay for it (92.8%). For non-donors, lack of information (43.6%) and different fears (32.3%) were the principal factors discouraging them from donating. Finally, discriminant analysis selected 11 of the items as providing 75.6% of correct discrimination between the one population and the other. CONCLUSIONS: Donors and non-donors reveal very different beliefs, attitudes and motivations towards blood donation, and the questionnaire employed in this study permits a high degree of discrimination between the two groups. The attitudes of non-donors towards donation are generally less favourable, but allow us to think that a high percentage of these could be changed with the right conditions.