RESUMO
This study evaluated the association between anorexia of aging and nutrients intake. It was a cross-sectional study with 130 individuals aged 60 years or older, undergoing outpatient care in the city of Campinas, São Paulo. Anorexia of Aging (AA) was assessed using the Simplified Nutrition Appetite Questionnaire (SNAQ), and food consumption was evaluated using the 24-hour recall (24HR). The prevalence of AA was 27.7%, in which 66.7% were women and 38.9% were older than 80 years. Elderly with AA presented lower intake of calories (1172.6 kcal vs 1477.9 kcal; p = 0.003), carbohydrates (158.5 g vs 194.1 g; p = 0.015), proteins (49.9 g vs 68.5 g; p = 0.004) and lipids (34.6 g vs 46.1 g; p = 0.006). They also had lower intake of fibers (12.6 g vs 19.4 g; p < 0.001), iron (6.4 mg vs 8.9 mg; p < 0.001) and zinc (6.0 mg vs 8.5 mg; p = 0.004). Our results show that intake of most nutrients is significantly lower in AA elderly, except carbohydrates, which may point to worse-quality diets. The diagnosis of AA, as well as the evaluation of elderly food intake, are essential to prevent undernutrition, vulnerabilities, and increased morbidity and mortality.
Assuntos
Anorexia/diagnóstico , Dieta , Ingestão de Energia/fisiologia , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Apetite , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nutrientes/análise , Inquéritos e QuestionáriosRESUMO
PURPOSE OF REVIEW: Resistant hypertension (RHTN) is a condition in which besides the antihypertensive therapy using at least three different drugs (including a diuretics), brachial blood pressure does not reach the target (e.g., 140/90 mmHg). RECENT FINDINGS: Despite the diversity of clinical presentations, we divide RHTN in two major groups according to blood pressure and number of drugs taken: controlled (C-RHTN) and uncontrolled (UC-RHTN) resistant hypertension, with refractory hypertension (RfHTN) included in the latter subgroup. Both C-RHTN and UC-RHTN are heterogenic and complex syndromes. To better approach this matter, the some pathophysiological mechanisms (increased volemia, hyperactivity, plasma cortisol, adipocitokines, and other pro-inflammatory factors), have a pivotal clinical role. Some features (African ethnic, obesity, age > 60, LV hypertrophy, and vascular stiffness) increase the risk of refractoriness as well as worst prognosis. Based on increased target organ damage, cardiovascular risk and events will be addressed in this review. Our conclusion is that although both C-RHTN and UC-RHTN are extreme phenotypes of hard-to-control BP, some mechanisms of the disease and clinical expressions are distinct. According to these differences, "UC-RHTN and C-RHTN are not in the same bag."
Assuntos
Hipertensão/fisiopatologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Humanos , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológicoRESUMO
Frailty is a clinical condition associated with pathological aging and biological vulnerability. In the spectrum of events related to frailty, aging of the cardiocirculatory system and abnormalities in arterial blood pressure (BP) partly explain the changes in tissue perfusion and, potentially, the decrease in physiological reserves. This study investigated the relationship between BP levels, systemic arterial hypertension (SAH) and the frailty phenotype by analyzing frailty criteria in a cross-sectional model into the FIBRA network, a populational sample of community-dwelling elders in Southeastern Brazil. Study participants with ≥65 years were selected by probabilistic sampling of residents in the urban area of the municipality of Campinas (n=900). Considering frailty as a whole and the difference between genders, there was a greater proportion of frail or pre-frail individuals among women than men. Analysis of individual frailty criteria showed that weight loss and fatigue were more common among women (18.3% vs. 12.5%, p=0.034 and 22.5% vs. 11.9%, p<0.001, respectively). Comparison of individuals with or without SAH failed to reveal any differences related to frailty criteria. Nevertheless, averages of diastolic blood pressure (DBP) and mean arterial blood pressure values were lower among elderly individuals with reduced grip strength, physical activity and the frailty classification as a whole (OR 0.986, IC 0.975-0.997) (for every 1 mmHg reduction in MBP values, the likelihood of being frail increased 1.4%). Our findings corroborate the relationship between BP values and frailty in the elderly and contribute to an understanding of the pathophysiological mechanisms of the syndrome.
Assuntos
Pressão Sanguínea/fisiologia , Idoso Fragilizado , Avaliação Geriátrica/métodos , Hipertensão/fisiopatologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Fenótipo , Prevalência , Estudos RetrospectivosRESUMO
Apoptotic protease activating factor 1 (APAF-1) has a critical role in the regulation of apoptosis. In the present study, the mRNA expression analysis of different APAF-1 transcripts (APAF-1S, APAF-1LC, APAF-1LN, and APAF-1XL) was analyzed in bone marrow samples from 37 patients with acute myeloid leukemia (newly diagnosed, with no previous treatment). APAF-1XL and APAF-1LN transcripts (with and without an extra WD-40 repeat region, respectively) were detected in all samples, although the major form expressed was APAF-1XL in 65% of the samples (group 1), while 35% of the samples expressed primarily APAF-1LN (group 2). Only 46% of the patients presented complete remission in response to remission induction therapy (represented by less than 5% marrow blasts and hematological recovery), all but 2 cases being from group 1, 21.6% did not attain complete remission (only 1 case from group 1), and 32.4% of the patients died early. Lower expression of APAF-1XL (APAF-1XL/APAF-1LN ratio <1.2) was associated with a poor response to therapy (P = 0.0005, Fisher exact test). Both groups showed similar characteristics regarding white blood cell counts, cytogenetic data or presence of gene rearrangements associated with good prognosis as AML1-ETO, CBFB-MYH11 and PML/RARA. Since it has been shown that only the isoforms with the extra WD-40 repeat region activate procaspase-9, we suggest that low procaspase-9 activation may also be involved in the deregulation of apoptosis and chemotherapy resistance in acute myeloid leukemia.
Assuntos
Fator Apoptótico 1 Ativador de Proteases/genética , Leucemia Mieloide Aguda/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Células da Medula Óssea/química , Estudos de Casos e Controles , DNA Complementar/genética , Densitometria , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Transcrição , Transcrição Gênica/genética , Falha de Tratamento , Adulto JovemRESUMO
Apoptotic protease activating factor 1 (APAF-1) has a critical role in the regulation of apoptosis. In the present study, the mRNA expression analysis of different APAF-1 transcripts (APAF-1S, APAF-1LC, APAF-1LN, and APAF-1XL) was analyzed in bone marrow samples from 37 patients with acute myeloid leukemia (newly diagnosed, with no previous treatment). APAF-1XL and APAF-1LN transcripts (with and without an extra WD-40 repeat region, respectively) were detected in all samples, although the major form expressed was APAF-1XL in 65 percent of the samples (group 1), while 35 percent of the samples expressed primarily APAF-1LN (group 2). Only 46 percent of the patients presented complete remission in response to remission induction therapy (represented by less than 5 percent marrow blasts and hematological recovery), all but 2 cases being from group 1, 21.6 percent did not attain complete remission (only 1 case from group 1), and 32.4 percent of the patients died early. Lower expression of APAF-1XL (APAF-1XL/APAF-1LN ratio <1.2) was associated with a poor response to therapy (P = 0.0005, Fisher exact test). Both groups showed similar characteristics regarding white blood cell counts, cytogenetic data or presence of gene rearrangements associated with good prognosis as AML1-ETO, CBFB-MYH11 and PML/RARA. Since it has been shown that only the isoforms with the extra WD-40 repeat region activate procaspase-9, we suggest that low procaspase-9 activation may also be involved in the deregulation of apoptosis and chemotherapy resistance in acute myeloid leukemia.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fator Apoptótico 1 Ativador de Proteases/genética , Leucemia Mieloide Aguda/genética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Células da Medula Óssea/química , Estudos de Casos e Controles , Densitometria , DNA Complementar/genética , Regulação Neoplásica da Expressão Gênica , Leucemia Mieloide Aguda/tratamento farmacológico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , RNA Mensageiro/genética , Fatores de Transcrição , Falha de Tratamento , Transcrição Gênica/genética , Biomarcadores Tumorais/genética , Adulto JovemRESUMO
1. The major effect associated with hydroxyurea (HU) treatment of sickle cell anaemia (SCA) patients is an increase in fetal haemoglobin (HbF) synthesis, which inhibits the polymerization of haemoglobin S. 2. Hydroxyurea improves clinical symptoms by reducing the frequency of pain and vaso-occlusive crises, acute chest syndrome, transfusion requirements and hospitalization. 3. The molecular mechanisms responsible for HU-mediated induction of fetal globin transcription are not completely understood. Therefore, the aim of the present study was to identify differentially expressed genes participating in these mechanisms. 4. We established two suppression subtractive hybridization (SSH) libraries from reticulocytes obtained from SCA patients either not on or on HU treatment. The gene expression of some of the genes identified was subsequently evaluated by real-time polymerase chain reaction (PCR). 5. Genes identified with altered expression included SUDS3, FZD5 and PHC3, which may be associated with the regulation of globin expression. 6. This is the first demonstration of an association between HU treatment and the expression of genes identified in erythroid cells.
Assuntos
Perfilação da Expressão Gênica , Hidroxiureia/farmacologia , Reticulócitos/efeitos dos fármacos , Reticulócitos/metabolismo , Traço Falciforme/metabolismo , Adulto , Feminino , Regulação da Expressão Gênica , Biblioteca Gênica , Humanos , MasculinoRESUMO
Hemoglobin (Hb) Indianapolis [beta112 (G14) Cys-->Arg] is a rare and slightly unstable beta-globin variant. All carriers described to date were clinically normal with only mild reticulocytosis. We report here a case of a Brazilian patient in whom hemolytic anemia and acute renal failure were probably caused by the presence of this variant.
Assuntos
Anemia Hemolítica/metabolismo , Anemia Hemolítica/patologia , Cisteína/genética , Hemoglobinas Anormais/genética , Hemoglobinas Anormais/metabolismo , Rim/metabolismo , Rim/patologia , Adulto , Anemia Hemolítica/genética , Arginina/genética , Arginina/metabolismo , Sequência de Bases , Brasil , Criança , Pré-Escolar , Cisteína/metabolismo , Feminino , Humanos , Masculino , Dados de Sequência MolecularRESUMO
This study relates regional and seasonal UV index (UVI) variations, number of skin cancer cases and population skin-color distribution in Brazil. UVI calculations were performed using the UV Global Atmospheric Model (UVGAME), whose characteristics and validations are provided in thiis article. Health and racial data sets are based on the health and census data collected by Brazilian governmental agencies in the past. The discussion covers cultural customs and details of health and educational campaigns in Brazil. Despite lower UV levels in the South and Southeast regions, the results show a number of nonmelanoma skin cancer (NMSC) cases regions, where the white population is predominant. In general, in the southern regions about 50 new NMSC cases per 100000 inhabitants have been diagnosed each year. These rates decrease almost 40% in the Central-North regions and more than 80% in Northeast region, where miscegenation is common. In addition, the UVI evaluation is extended to other South American sites with singular characteristics, e.g. populous cities located in high altitudes or those affected by the Antarctic ozone hole in the extreme south of the continent.
Assuntos
Neoplasias Cutâneas/epidemiologia , Raios Ultravioleta , Brasil/epidemiologia , Humanos , Ozônio/análise , Neoplasias Cutâneas/etnologia , Pigmentação da Pele , América do SulRESUMO
We describe the clinical and molecular characteristics of two unrelated Brazilian families with an association of the Sicilian form of (deltabeta) degrees -thalassemia with hemoglobin S and beta-thalassemia. Direct sequencing of the beta-globin gene showed only the hemoglobin S mutation in patient 1 and the beta-thalassemia IVS1-110 in patient 2. The other allele was deleted in both patients and PCR of DNA samples of the breakpoint region of both patients showed a band of approximately 1,150 bp, expected to be observed in the DNA of carriers of Sicilian (deltabeta) degrees -thalassemia. The nucleotide sequence of this fragment confirmed the Sicilian deletion. There are few reports concerning the Hb S/(deltabeta) degrees -thalassemia association and patient 2 is the first reported case of Sicilian type of (deltabeta) degrees -thalassemia in association with beta-thalassemia documented at the molecular level.
Assuntos
Hemoglobina Falciforme/genética , Mutação/genética , Talassemia beta/genética , Adulto , Sequência de Aminoácidos , Brasil , Análise Mutacional de DNA , Feminino , Humanos , Masculino , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Talassemia beta/diagnósticoRESUMO
We describe the clinical and molecular characteristics of two unrelated Brazilian families with an association of the Sicilian form of (deltaß)º-thalassemia with hemoglobin S and ß-thalassemia. Direct sequencing of the ß-globin gene showed only the hemoglobin S mutation in patient 1 and the ß-thalassemia IVS1-110 in patient 2. The other allele was deleted in both patients and PCR of DNA samples of the breakpoint region of both patients showed a band of approximately 1,150 bp, expected to be observed in the DNA of carriers of Sicilian (deltaß)º-thalassemia. The nucleotide sequence of this fragment confirmed the Sicilian deletion. There are few reports concerning the Hb S/(deltaß)º-thalassemia association and patient 2 is the first reported case of Sicilian type of (deltaß)º-thalassemia in association with ß-thalassemia documented at the molecular level
Assuntos
Humanos , Masculino , Feminino , Adulto , Talassemia beta , Hemoglobina Falciforme , Talassemia beta , Brasil , DNA , Reação em Cadeia da PolimeraseRESUMO
The histologic changes observed in the remnant kidney model include progressive mesangial expansion with collapse of capillary lumina, interstitial fibrosis and mononuclear cellular infiltration. Transforming growth factor-beta (TGF-beta 1) is an important regulator of extracellular matrix formation. The purpose of this study was to investigate the production and distribution of TGF-beta 1 in the kidney during the development of glomerulosclerosis and renal fibrosis in rats with subtotal renal ablation. Eighty-two female Wistar rats weighing 180-220 g were divided into two groups: 49 rats were subjected to 5/6 renal ablation and 33 to sham operation. Urinary albumin excretion, blood pressure and glomerular filtration rate (GFR) were evaluated after the surgical procedure. We also performed histology and immunohistochemistry and determined mRNA for TGF-beta 1 in the kidneys of these rats 8, 15, 30 and 90 days after operation. The results showed progressively higher immunohistochemical TGF-beta 1 staining in rats with subtotal renal ablation. Cortical renal content of TGF-beta 1 mRNA was also higher in these animals and peaked at day 15. The existence of a temporal association between glomerulosclerosis, interstitial fibrosis and intense mononuclear cellular infiltration on the one hand and higher immunohistochemical TGF-beta 1 staining in the renal cortex on the other show that this polypeptide may contribute to the development of renal fibrosis in this model.