RESUMO
NLRP3 inflammasome has a key role in chronic low-grade metabolic inflammation, and its excessive activation may contribute to the beginning and progression of several diseases, including hepatic insulin resistance (hIR). Thus, this review aims to highlight the role of NLRP3 inflammasome and oxidative stress in the development of hIR and evidence related to phytochemical intervention in this context. In this review, we will address the hIR pathogenesis related to reactive oxygen species (ROS) production mechanisms, involving oxidized mitochondrial DNA (ox-mtDNA) and thioredoxin interacting protein (TXNIP) induction in the NLRP3 inflammasome activation. Moreover, we discuss the inhibitory effect of bioactive compounds on the insulin signaling pathway, and the role of microRNAs (miRNAs) in the phytochemical target mechanism in ameliorating hIR. Although most of the research in the field has been focused on evaluating the inhibitory effect of phytochemicals on the NLRP3 inflammasome pathway, further investigation and clinical studies are required to provide insights into the mechanisms of action, and, thus, encourage the use of these bioactive compounds as an additional therapeutic strategy to improve hIR and correlated conditions.
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Objetivo: Descrever a atuação da Câmara Técnica de Atenção à Saúde do Conselho Federal de Enfermagem, na elaboração de normas e atualização do conhecimento técnico-científico da profissão. Métodos: Trata-se de um estudo teórico-reflexivo, desenvolvido a partir do conhecimento e das experiências, acadêmicas e profissionais dos autores sobre atuação e contribuição da Câmara Técnica de Atenção à Saúde, na assessoria aos questionamentos dos profissionais de enfermagem, desenvolvendo estudos que possam inferir na mudança comportamental ou evolução das técnicas desenvolvidas pelos profissionais. Resultados: Aponta a atuação da Câmara Técnica de Atenção à Saúde como espaço de discussão, de construção formal e de atualização da ciência enfermagem, frente às realidades vivenciadas pelos profissionais no campo da prática, sobre o seu cenário de exercício profissional de novas condutas, bem como a reflexão sobre possíveis posicionamentos técnicos da profissão. Conclusão: A Câmara Técnica de Atenção à Saúde atua de forma democrática, ética, técnico-científica e legal, apoiando todos os Conselhos Regionais de Enfermagem e profissionais de enfermagem que tenham suas demandas voltadas para a atenção à saúde, oferecendo resultados com qualidade e garantindo provimentos, instruções, elaboração e execução de normativas que tratam de inovação e uniformidade de procedimentos para o exercício da Enfermagem no Brasil. (AU)
Objective: To describe the work of the Federal Nursing Council's Technical Chamber for Health Care in drawing up standards and updating the profession's technical and scientific knowledge. Methods: This is a theoretical-reflective study, based on the authors' academic and professional knowledge and experience of the work and contribution of the Technical Board of Health Care in advising nursing professionals on their questions, developing studies that could lead to behavioral changes or the evolution of techniques developed by professionals. Results: It points to the work of the Technical Chamber for Health Care as a space for discussion, formal construction and updating of nursing science, in the face of the realities experienced by professionals in the field of practice, about their professional practice scenario of new behaviors, as well as reflection on possible technical positions of the profession. Conclusion: The Technical Chamber for Health Care acts in a democratic, ethical, technical-scientific and legal manner, supporting all the Regional Nursing Councils and nursing professionals whose demands are focused on health care, offering quality results and guaranteeing provisions, instructions, preparation and implementation of regulations that deal with innovation and uniformity of procedures for the practice of nursing in Brazil. (AU)
Objetivo: Describir el trabajo de la Cámara Técnica de Cuidados de Salud del Consejo Federal de Enfermería en la elaboración de normas y actualización de los conocimientos técnico-científicos de la profesión. Métodos: Se trata de un estudio teórico-reflexivo, basado en el conocimiento y la experiencia académica y profesional de los autores sobre el trabajo y la contribución de la Cámara Técnica de Cuidados de Salud, en el asesoramiento a los profesionales de enfermería en sus cuestiones, en el desarrollo de estudios que puedan conducir a cambios de comportamiento o en la evolución de las técnicas desarrolladas por los profesionales. Resultados: Se señala el trabajo de la Cámara Técnica para el Cuidado de la Salud como un espacio de discusión, construcción formal y actualización de la ciencia de la enfermería, frente a las realidades vividas por los profesionales en el campo de la práctica, sobre su práctica profesional escenario de nuevos comportamientos, así como la reflexión sobre posibles posiciones técnicas de la profesión. Conclusión: La Cámara Técnica de Atención a la Salud actúa de forma democrática, ética, técnico-científica y jurídica, apoyando a todos los Consejos Regionales de Enfermería y a los profesionales de enfermería cuyas demandas se centran en la atención a la salud, ofreciendo resultados de calidad y garantizando disposiciones, instrucciones, redacción e implementación de reglamentos que se ocupan de la innovación y la uniformidad de los procedimientos para la práctica de la enfermería en Brasil. (AU)
Assuntos
Prática Profissional , Enfermagem , Atenção à SaúdeRESUMO
CONTEXT: The role of silymarin in hepatic lipid dysfunction and its possible mechanisms of action were investigated. OBJECTIVE: To evaluate the effects of silymarin on hepatic and metabolic profiles in mice fed with 30% fructose for 8 weeks. METHODS: We evaluated the antioxidant profile of silymarin; mice consumed 30% fructose and were treated with silymarin (120 mg/kg/day or 240 mg/kg/day). We performed biochemical, redox status, and histopathological assays. RT-qPCR was performed to detect ACC-1, ACC-2, FAS, and CS expression, and western blotting to detect PGC-1α levels. RESULTS: Silymarin contains high levels of phenolic compounds and flavonoids and exhibited significant antioxidant capacity in vitro. In vivo, the fructose-fed groups showed increased levels of AST, ALT, SOD/CAT, TBARS, hepatic TG, and cholesterol, as well as hypertriglyceridaemia, hypercholesterolaemia, and increased ACC-1 and FAS. Silymarin treatment reduced these parameters and increased mRNA levels and activity of hepatic citrate synthase. CONCLUSIONS: These results suggest that silymarin reduces worsening of NAFLD.
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Calcitonin Gene-Related Peptide (CGRP) is a potent vasodilator peptide widely distributed in the central nervous system and various peripheral tissues, including cardiac muscle. However, its role in heart protein metabolism remains unknown. We examined the acute effects of CGRP on autophagy and the related signaling pathways in the heart mice and cultured neonatal cardiomyocytes. CGRP (100 µg kg-1; s.c.) or 0.9 % saline was injected in awake male C57B16 mice, and the metabolic profile was determined up to 60 min. In fed mice, CGRP drastically increased glycemia and reduced insulinemia, an effect that was accompanied by reduced cardiac phosphorylation levels of Akt at Ser473 without affecting FoxO. Despite these catabolic effects, CGRP acutely inhibited autophagy as estimated by the decrease in LC3II:LC3I and autophagic flux. In addition, the fasting-induced autophagic flux in mice hearts was entirely abrogated by one single injection of CGRP. In parallel, CGRP stimulated PKA/CREB and mTORC1 signaling and increased the phosphorylation of Unc51-like kinase-1 (ULK1), an essential protein in autophagy initiation. Similar effects were observed in cardiomyocytes, in which CGRP also inhibited autophagic flux and stimulated Akt and FoxO phosphorylation. These ï¬ndings suggest that CGRP in vivo acutely suppresses autophagy in the heart of fed and fasted mice, most likely through the activation of PKA/mTORC1 signaling but independent of Akt.
Assuntos
Autofagia/efeitos dos fármacos , Peptídeo Relacionado com Gene de Calcitonina/fisiologia , Coração/efeitos dos fármacos , Animais , AMP Cíclico/metabolismo , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Camundongos , Miócitos Cardíacos/efeitos dos fármacos , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacosRESUMO
AIM: There is growing evidence about the ability of cyclic adenosine monophosphate (cAMP) signaling and nonselective phosphodiesterase (PDE) inhibitors on mitigate muscle atrophy. PDE4 accounts for the major cAMP hydrolyzing activity in skeletal muscles, therefore advances are necessary about the consequences of treatment with PDE4 inhibitors on protein breakdown in atrophied muscles. We postulated that rolipram (selective PDE4 inhibitor) may activate cAMP downstream effectors, inhibiting proteolytic systems in skeletal muscles of diabetic rats. MAIN METHODS: Streptozotocin-induced diabetic rats were treated with 2 mg/kg rolipram for 3 days. Changes in the levels of components belonging to the proteolytic machineries in soleus and extensor digitorum longus (EDL) muscles were investigated, as well as cAMP effectors. KEY FINDINGS: Treatment of diabetic rats with rolipram decreased the levels of atrogin-1 and MuRF-1 in soleus and EDL, and reduced the activities of calpains and caspase-3; these findings partially explains the low ubiquitin conjugates levels and the decreased proteasome activity. The inhibition of muscle proteolysis may be occurring due to phosphorylation and inhibition of forkhead box O (FoxO) factors, probably as a consequence of the increased cAMP levels, followed by the activation of PKA and Akt effectors. Akt activation may be associated with the increased levels of exchange protein directly activated by cAMP (EPAC). As a result, rolipram treatment spared muscle mass in diabetic rats. SIGNIFICANCE: The antiproteolytic responses associated with PDE4 inhibition may be helpful to motivate future investigations about the repositioning of PDE4 inhibitors for the treatment of muscle wasting conditions.
Assuntos
3',5'-AMP Cíclico Fosfodiesterases/antagonistas & inibidores , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Diabetes Mellitus Experimental/metabolismo , Músculo Esquelético/metabolismo , Proteínas do Tecido Nervoso/antagonistas & inibidores , Inibidores da Fosfodiesterase 4/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Animais , Calpaína/metabolismo , Caspase 3/metabolismo , AMP Cíclico/metabolismo , Masculino , Atrofia Muscular/metabolismo , Fosforilação , Complexo de Endopeptidases do Proteassoma/metabolismo , Ratos , Ratos Wistar , Rolipram/farmacologia , Transdução de Sinais/efeitos dos fármacosRESUMO
Objetivo: Compreender as potencialidades e as situações de vulnerabilidades que envolvem os adolescentes quanto às questões de saúde e cidadania. Métodos: Trata-se de um estudo de abordagem qualitativa do tipo pesquisa-ação desenvolvido em uma escola pública da rede estadual de ensino. Participaram 21 adolescentes escolares do primeiro ano do ensino médio, sendo a amostra não probabilística do tipo intencional. Os dados foram coletados mediante a realização de círculos de cultura e analisados por meio da análise de conteúdo. Resultados: O conhecimento foi visto como uma potencialidade para execução de atitudes e práticas adequadas pelos adolescentes, e referenciado como fator positivo para o enfrentamento de situações de vulnerabilidades. Conclusão: Os adolescentes possuem potencialidades que podem ser fortalecidas com a educação em saúde, e as situações de vulnerabilidades existentes em seu cotidiano podem ser enfrentadas com a estimulação do protagonismo desse grupo populacional
Objective: To understand the potentialities and the situations of vulnerabilities that wrap the adolescents as for the questions of health and citizenship. Methods: Inquiry-action is treated as a study of qualitative approach of the type developed in a public school of the state net of teaching. They announced 21 school adolescents of the first year of the secondary education, being the sample not probabilística of the intentional type. The data were collected by means of the realization of circles of culture and analysed through the content analysis. Results: The knowledge was seen as a potentiality for execution of attitudes and practices adapted by the adolescents, and referenciado like positive factor for the enfrentamento of situations of vulnerabilities. Conclusion: The adolescents have potentialities that can be strengthened with the education in health, and the situations of existent vulnerabilities in his daily life can be faced with the stimulation of the protagonismo of this population group
Objetivo: Entender las potencialidades y las situaciones de vulnerabilidades que envuelven a los adolescentes en cuanto a las preguntas de salud y ciudadanía. Método: La acción de la pregunta es tratada como un estudio del enfoque cualitativo del tipo desarrollado en una escuela pública de la red estatal de la enseñanza. Anunciaron a 21 adolescentes escolares del primer año de la educación secundaria, siendo la muestra no probabilística del tipo intencional. Los datos fueron coleccionados por medio de la realización de círculos de la cultura y analizados a través de la análisis de contenido. Resultados: El conocimiento fue visto como una potencialidad para ejecución de actitudes y prácticas adaptadas por los adolescentes y referenciado como el factor positivo para el enfrentamento de situaciones de vulnerabilidades. Conclusión: Los adolescentes tienen potencialidades que pueden ser reforzadas con la educación en la salud, y las situaciones de vulnerabilidades existentes en su vida cotidiana pueden ser enfrentantes con el estímulo del protagonismo de este grupo demográfico
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Humanos , Masculino , Feminino , Adolescente , Educação em Saúde , Adolescente , Participação da ComunidadeRESUMO
Although we have shown that catecholamines suppress the activity of the Ubiquitin-Proteasome System (UPS) and atrophy-related genes expression through a cAMP-dependent manner in skeletal muscle from rodents, the underlying mechanisms remain unclear. Here, we report that a single injection of norepinephrine (NE; 1 mg kg-1 ; s.c) attenuated the fasting-induced up-regulation of FoxO-target genes in tibialis anterior (TA) muscles by the stimulation of PKA/CREB and Akt/FoxO1 signaling pathways. In addition, muscle-specific activation of PKA by the overexpression of PKA catalytic subunit (PKAcat) suppressed FoxO reporter activity induced by (1) a wild-type; (2) a non-phosphorylatable; (3) a non-phosphorylatable and non-acetylatable forms of FoxO1 and FoxO3; (4) downregulation of FoxO protein content, and probably by (5) PGC-1α up-regulation. Consistently, the overexpression of the PKAcat inhibitor (PKI) up-regulated FoxO activity and the content of Atrogin-1 and MuRF1, as well as induced muscle fiber atrophy, the latter effect being prevented by the overexpression of a dominant negative (d. n.) form of FoxO (d.n.FoxO). The sustained overexpression of PKAcat induced fiber-type transition toward a smaller, slower, and more oxidative phenotype and improved muscle resistance to fatigue. Taken together, our data provide the first evidence that endogenous PKA activity is required to restrain the basal activity of FoxO and physiologically important to maintain skeletal muscle mass.
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Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Proteína Forkhead Box O1/metabolismo , Músculo Esquelético/enzimologia , Atrofia Muscular/metabolismo , Animais , Linhagem Celular , Proteína Forkhead Box O3/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Músculo Esquelético/patologia , Mioblastos Esqueléticos/enzimologia , Transdução de SinaisRESUMO
The sympathetic nervous system (SNS) activates cAMP signaling and promotes trophic effects on brown adipose tissue (BAT) through poorly understood mechanisms. Because norepinephrine has been found to induce antiproteolytic effects on muscle and heart, we hypothesized that the SNS could inhibit autophagy in interscapular BAT (IBAT). Here, we describe that selective sympathetic denervation of rat IBAT kept at 25°C induced atrophy, and in parallel dephosphorylated forkhead box class O (FoxO), and increased cathepsin activity, autophagic flux, autophagosome formation, and expression of autophagy-related genes. Conversely, cold stimulus (4°C) for up to 72 h induced thermogenesis and IBAT hypertrophy, an anabolic effect that was associated with inhibition of cathepsin activity, autophagic flux, and autophagosome formation. These effects were abrogated by sympathetic denervation, which also upregulated Gabarapl1 mRNA. In addition, the cold-driven sympathetic activation stimulated the mechanistic target of rapamycin (mTOR) pathway, leading to the enhancement of protein synthesis, evaluated in vivo by puromycin incorporation, and to the inhibitory phosphorylation of Unc51-like kinase-1, a key protein in the initiation of autophagy. This coincided with a higher content of exchange protein-1 directly activated by cAMP (Epac1), a cAMP effector, and phosphorylation of Akt at Thr308, all these effects being abolished by denervation. Systemic treatment with norepinephrine for 72 h mimicked most of the cold effects on IBAT. These data suggest that the noradrenergic sympathetic inputs to IBAT restrain basal autophagy via suppression of FoxO and, in the setting of cold, stimulate protein synthesis via the Epac/Akt/mTOR-dependent pathway and suppress the autophagosome formation, probably through posttranscriptional mechanisms.NEW & NOTEWORTHY The underlying mechanisms related to the anabolic role of sympathetic innervation on brown adipose tissue (BAT) are unclear. We show that sympathetic denervation activates autophagic-lysosomal degradation, leading to a loss of mitochondrial proteins and BAT atrophy. Conversely, cold-driven sympathetic activation suppresses autophagy and stimulates protein synthesis, leading to BAT hypertrophy. Given its high-potential capacity for heat production, understanding the mechanisms that contribute to BAT mass is important to optimize chances of survival for endotherms in cold ambients.
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Tecido Adiposo Marrom , Termogênese , Animais , Autofagia , Temperatura Baixa , Lisossomos , Ratos , Sistema Nervoso SimpáticoRESUMO
OBJETIVO: Reconhecer no processo de trabalho dos profissionais da atenção básica, junto a Estratégia Saúde da Família, os domínios de competências em promoção da saúde diante das ações praticadas com base no referencial das Competências em Promoção da Saúde (CompHP). MÉTODOS: Trata-se de estudo descritivo e exploratório de natureza qualitativa, realizado no município de Acopiara, Ceará, Brasil. Participaram do estudo, desenvolvido no período de março a junho de 2016, nove profissionais com atuação definida na Estratégia Saúde da Família. Os dados foram coletados através de entrevista semiestruturada e organizados a partir da técnica da análise temática das falas dos participantes. RESULTADOS: Os profissionais desconhecem o referencial do CompHP, bem como os seus domínios e as competências propostas. Entretanto, evidencia-se que os domínios: de diagnóstico, comunicação, liderança, possibilidade de mudanças e advocacia em saúde são manifestados nas falas dos participantes. Deste modo, os saberes e práticas dos profissionais articulam-se aos domínios de competências do CompHP supracitados. Os domínios não manifestados pelos profissionais foram: parceria, planejamento, implementação e avaliação em saúde. CONCLUSÃO: Observou-se o desconhecimento dos profissionais quanto à existência e proposta no referencial do CompHP, o que revela a necessidade de incluí-los nos momentos formativos, em todo e qualquer nível de formação. (AU)
OBJECTIVE: To recognize in the work process of Primary Health Care professionals, along with the Family Health Strategy, the domains of health promotion competencies in the face of actions carried out on the basis of the Health Promotion Competencies (CompHP) framework. METHODS: This is a qualitative descriptive and exploratory study carried out in the municipality of Acopiara, Ceará, Brazil. The study was carried out from March to June 2016 with nine professionals with a defined role in the Family Health Strategy. The data were collected using a structured interview and organized based on the Thematic Analysis of the participants' statements. RESULTS: The professionals are not aware of the CompHP framework and its domains and proposed competencies. However, it is evident that the needs assessment, communication, leadership, possibility of changes and advocacy for health domains are manifested in the participants' statements. Thus, the professionals' knowledge and practices are linked to the aforementioned domains of CompHP competencies. The domains not manifested by professionals were: partnership, planning, implementation and evaluation in health. CONCLUSION: Professionals are unaware of the existence and purpose of the CompHP framework, which reveals the need to include them in training moments at any and all levels of training. (AU)
OBJETIVO: Reconocer el proceso de trabajo de los profesionales de la atención básica en la Estrategia Salud de la Familia y los dominios de las competencias para la promoción de la salud ante las acciones practicadas basadas en el referencial de las Competencias para la Promoción de la Salud (CompHP). MÉTODOS: Se trata de estudio descriptivo, exploratorio y cualitativo realizado en el municipio de Acopiara, Ceará, Brasil. El estudio ha sido desarrollado en el período entre marzo y junio de 2016 en el cual participaron nueve profesionales con actuación definida en la Estrategia Salud de la Familia. Se recogieron los datos a través de una entrevista semiestructurada y les organizaron a través de la técnica del análisis temático de las hablas de los participantes. RESULTADOS: Los profesionales desconocen el referencial del CompHP así como sus dominios y las competencias propuestas. Sin embargo, se evidencia que los dominios de diagnóstico, comunicación, liderazgo, posibilidades de cambios y abogacía en salud se manifiestan en las hablas de los participantes. Así, los saberes y las prácticas de los profesionales se articulan con los dominios de competencias del CompHP mencionados antes. Los dominios no manifestados por los profesionales fueron la compañía, el planeamiento, la implementación y la evaluación en salud. CONCLUSIÓN: Se observó el desconocimiento de los profesionales respecto la existencia y propuesta en el referencial del CompHP lo que revela la necesidad de incluirlos en los momentos de formación en todo y cualquier nivel de formación. (AU)
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Atenção Primária à Saúde , Educação Baseada em Competências , Promoção da SaúdeRESUMO
Advances in the knowledge of the mechanisms controlling protein breakdown in skeletal muscles have allowed the exploration of new options for treating muscle-wasting conditions. Pentoxifylline (PTX), a nonselective phosphodiesterase (PDE) inhibitor, attenuates the loss of muscle mass during catabolic conditions, mainly via inhibiting protein breakdown. The aim of this study was to explore the mechanisms by which PTX inhibits proteolysis in the soleus and extensor digitorum longus (EDL) muscles of streptozotocin-induced diabetic rats. The levels of atrogin-1 and muscle RING finger-1 were decreased, as were the activities of caspase-3 (EDL) and calpains (soleus and EDL), in diabetic rats treated with PTX, which at least partly explains the drop in the ubiquitin conjugate (EDL) levels and in proteasome activity (soleus and EDL). Treatment with PTX decreased PDE activity and increased cAMP content in muscles of diabetic rats; moreover, it also increased both the protein levels of exchange protein directly activated by cAMP (EPAC, a cAMP effector) and the phosphorylation of Akt. The loss of muscle mass was practically prevented in diabetic rats treated with PTX. These findings advance our understanding of the mechanisms underlying the antiproteolytic effects of PTX and suggest the use of PDE inhibitors as a strategy to activate cAMP signaling, which is emerging as a promising target for treating muscle mass loss during atrophic conditions. NEW & NOTEWORTHY cAMP signaling has been explored as a strategy to attenuate skeletal muscle atrophies. Therefore, in addition to ß2AR agonists, phosphodiesterase inhibitors such as pentoxifylline (PTX) can be an interesting option. This study advances the understanding of the mechanisms related to the antiproteolytic effects of PTX on skeletal muscles of diabetic rats, which involve the activation of both exchange protein directly activated by cAMP and Akt effectors, inhibiting the expression of atrogenes and calpain/caspase-3-proteolytic machinery.
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Diabetes Mellitus Experimental/complicações , Músculo Esquelético/efeitos dos fármacos , Atrofia Muscular/prevenção & controle , Pentoxifilina/uso terapêutico , Inibidores de Fosfodiesterase/uso terapêutico , Proteólise/efeitos dos fármacos , Animais , Glicemia/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , AMP Cíclico/metabolismo , Avaliação Pré-Clínica de Medicamentos , Fatores de Troca do Nucleotídeo Guanina/metabolismo , Masculino , Músculo Esquelético/metabolismo , Atrofia Muscular/etiologia , Atrofia Muscular/metabolismo , Pentoxifilina/farmacologia , Inibidores de Fosfodiesterase/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos Wistar , Transdução de Sinais/efeitos dos fármacos , Fator de Necrose Tumoral alfa/sangueRESUMO
Graft-versus-host disease (GVHD) is an immunological reaction and a frequent complication following allogeneic hematopoietic stem cell transplantation. It is associated with high mortality rates and may have a significant negative impact on the patient's quality of life, particularly in the chronic-stage setting. Many different organs can be involved, which leads to a wide range of clinical manifestations. In this context, dermatologists play a key role by diagnosing and treating GVHD from the outset since cutaneous features are not just the most common but are also usually the presenting sign. Several skin-direct therapies are available and may be indicated as monotherapy or adjuvant treatment in order to allow faster tapering and withdrawal of systemic immunosuppression. Treatment of steroid-refractory patients remains a challenge and, to date, no consensus has been reached for one single agent in second-line therapy. This article aims to review skin involvement as well as provide and update discussion on therapeutic options for both acute and chronic cutaneous GVHD.
Assuntos
Fármacos Dermatológicos/uso terapêutico , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Terapia de Imunossupressão/métodos , Dermatopatias/terapia , Doença Aguda/terapia , Administração Cutânea , Administração Intravenosa , Administração Oral , Biomarcadores/análise , Doença Crônica/terapia , Glucocorticoides/uso terapêutico , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/imunologia , Doença Enxerto-Hospedeiro/mortalidade , Humanos , Qualidade de Vida , Pele/imunologia , Dermatopatias/diagnóstico , Dermatopatias/imunologia , Dermatopatias/mortalidadeRESUMO
Objetivo: avaliar os indicadores de parto e nascimento das parturientes soropositivas para vírus da imunodeficiência humana. Métodos: estudo documental realizado com 92 prontuários e fichas de investigação de mulheres soropositivas para vírus da imunodeficiência humana, com análise das variáveis sociodemográficas, obstétricas e neonatais. Utilizou-se o teste qui-quadrado para verificar associação entre as variáveis preditoras e desfecho. Resultados: as parturientes receberam profilaxias perinatais (77,2%) e no parto (91,3%); 52,2% realizaram sete consultas pré-natais. Quanto aos recém-nascidos, 8,7% nasceram prematuros, 18,5% com baixo peso e 92,4% receberam profilaxia com antirretroviral nas primeiras 24h do nascimento. Conclusão: a vulnerabilidade e o maior risco de adoecer ocorrem em adultos jovens, com escolaridade e nível socioeconômico baixos. O indicador de cobertura de gestantes necessita melhorar seus índices, uma vez que pouco mais da metade das mulheres realizou sete consultas pré-natais, impactando negativamente na evolução da gravidez com percentual de profilaxias na gestação abaixo do desejado. (AU)
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Humanos , Feminino , Gravidez , Nível de Saúde , HIV , Gravidez de Alto Risco , Gestantes , Indicadores (Estatística)RESUMO
PURPOSE: Investigate the glycerol-3-phosphate generation pathways in epididymal (EPI) and retroperitoneal (RETRO) adipose tissues from dexamethasone-treated rats. METHODS: Rats were treated with dexamethasone for 7 days. Glycerol-3-phosphate generation pathways via glycolysis, glyceroneogenesis and direct phosphorylation of glycerol were evaluated, respectively, by 2-deoxyglucose uptake, phosphoenolpyruvate carboxykinase (PEPCK-C) activity and pyruvate incorporation into triacylglycerol (TAG)-glycerol, and glycerokinase activity and glycerol incorporation into TAG-glycerol. RESULTS: Dexamethasone treatment markedly decreased the body weight, but increased the weight and lipid content of EPI and RETRO and plasma insulin, glucose, non-esterified fatty acid and TAG levels. EPI and RETRO from dexamethasone-treated rats showed increased rates of de novo fatty acid synthesis (80 and 100%) and basal lipolysis (20%). In EPI, dexamethasone decreased the 2-deoxyglucose uptake (50%), as well as glyceroneogenesis, evidenced by a decrease of PEPCK-C activity (39%) and TAG-glycerol synthesis from pyruvate (66%), but increased the glycerokinase activity (50%) and TAG-glycerol synthesis from glycerol (72%) in this tissue. In spite of a similar reduction in 2-deoxyglucose uptake in RETRO, dexamethasone treatment increased glyceroneogenesis, evidenced by PEPCK activity (96%), and TAG-glycerol synthesis from pyruvate (110%), accompanied by a decrease in glycerokinase activity (50%) and TAG-glycerol synthesis from glycerol (50%). Dexamethasone effects on RETRO were accompanied by a decrease in p-Akt content and by lower insulin effects on the rates of glycerol release in the presence of isoproterenol and on the rates of glucose uptake in isolated adipocytes. CONCLUSION: Our data demonstrated differential regulation of glyceroneogenesis and direct phosphorylation of glycerol by glucocorticoids in EPI and RETRO from rats.
Assuntos
Tecido Adiposo Branco/metabolismo , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Dexametasona/farmacologia , Epididimo/metabolismo , Glucocorticoides/farmacologia , Glicerol/metabolismo , Gordura Intra-Abdominal/efeitos dos fármacos , Gordura Intra-Abdominal/metabolismo , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Tecido Adiposo Branco/efeitos dos fármacos , Adiposidade/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Epididimo/efeitos dos fármacos , Glicerol Quinase/biossíntese , Peptídeos e Proteínas de Sinalização Intracelular/biossíntese , Peptídeos e Proteínas de Sinalização Intracelular/genética , Lipólise/efeitos dos fármacos , Masculino , Tamanho do Órgão/efeitos dos fármacos , Fosfoenolpiruvato Carboxiquinase (GTP)/biossíntese , Fosfoenolpiruvato Carboxiquinase (GTP)/genética , Ratos , Ratos Wistar , Espaço Retroperitoneal , Triglicerídeos/biossínteseRESUMO
PURPOSE: To investigate the longitudinal change of central corneal thickness (CCT) in patients with systemic sclerosis (SSc) and to elucidate whether it contributes to misinterpretation of intraocular pressure (IOP) in this group of patients. METHODS: Twenty patients with SSc and 20 sex- and age-matched controls were examined at 2 visits 5 years apart. Age, sex, race, subtype of SSc, disease duration, autoantibody profile, use of disease-modifying antirheumatic drugs (DMARDs), best-corrected visual acuity, spherical equivalent refraction, IOP, and CCT were recorded. IOP was assessed by applanation tonometry and CCT by ultrasonic pachymetry. RESULTS: CCT decreased by 7.2 µm [95% confidence interval (CI), -2.1 to -12.2 µm] between the first and second measurements (P = 0.008) in patients with SSc and by 2.4 µm (P = 0.39, 95% CI, -8.0 to 3.3 µm) in the control group. Considering patients with SSc, CCT decreased by a mean of 11.6 µm [95% CI, -4.3 to -19.0 µm (P = 0.007)] among those taking DMARDs at the second visit and by 4.2 µm [95% CI, -3.0 to -11.5 µm (P = 0.2)] in patients not taking any DMARDs. There was no statistically significant change in IOP between the 2 visits for either the SSc group (P = 0.84) or the control group (P = 0.29). Mean change in CCT was not associated with either IOP at first visit or with change in IOP in SSc patients. CONCLUSIONS: CCT decreased with time in SSc. However, the slight rates of thinning observed are unlikely to considerably influence applanation tonometry or clinical decision-making over the short to intermediate term.
Assuntos
Córnea/patologia , Doenças da Córnea/etiologia , Escleroderma Sistêmico/complicações , Adulto , Idoso , Antirreumáticos/uso terapêutico , Doenças da Córnea/diagnóstico , Paquimetria Corneana , Feminino , Humanos , Pressão Intraocular/fisiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/tratamento farmacológico , Tonometria OcularRESUMO
Compared with the extensor digitorum longus (EDL) muscle of control rats (C), the EDL muscle of rats fed a low-protein, high-carbohydrate diet (LPHC) showed a 36% reduction in mass. Muscle mass is determined by the balance between protein synthesis and proteolysis; thus, the aim of this work was to evaluate the components involved in these processes. Compared with the muscle from C rats, the EDL muscle from LPHC diet-fed rats showed a reduction (34%) in the in vitro basal protein synthesis and a 22% reduction in the in vitro basal proteolysis suggesting that the reduction in the mass can be associated with a change in the rate of the two processes. Soon after euthanasia, in the EDL muscles of the rats fed the LPHC diet for 15days, the activity of caspase-3 and that of components of the ubiquitin-proteasome system (atrogin-1 content and chymotrypsin-like activity) were decreased. The phosphorylation of p70(S6K) and 4E-BP1, proteins involved in protein synthesis, was also decreased. We observed an increase in the insulin-stimulated protein content of p-Akt. Thus, the higher insulin sensitivity in the EDL muscle of LPHC rats seemed to contribute to the lower proteolysis in LPHC rats. However, even with the higher insulin sensitivity, the reduction in p-E4-BP1 and p70(S6K) indicates a reduction in protein synthesis, showing that factors other than insulin can have a greater effect on the control of protein synthesis.
Assuntos
Caspase 3/metabolismo , Dieta da Carga de Carboidratos/efeitos adversos , Dieta com Restrição de Proteínas/efeitos adversos , Regulação para Baixo , Resistência à Insulina , Músculo Esquelético/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Animais , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Pé , Peptídeos e Proteínas de Sinalização Intracelular , Masculino , Desenvolvimento Muscular , Músculo Esquelético/enzimologia , Fosfoproteínas/genética , Fosfoproteínas/metabolismo , Fosforilação , Biossíntese de Proteínas , Processamento de Proteína Pós-Traducional , Proteínas Tirosina Fosfatases/genética , Proteínas Tirosina Fosfatases/metabolismo , Proteólise , Distribuição Aleatória , Ratos Wistar , Proteínas Quinases S6 Ribossômicas 70-kDa/genética , Proteínas Quinases S6 Ribossômicas 70-kDa/metabolismo , UbiquitinaçãoRESUMO
This study measures the curcumin concentration in rat plasma by liquid chromatography and investigates the changes in the glucose tolerance and insulin sensitivity of streptozotocin-diabetic rats treated with curcumin-enriched yoghurt. The analytical method for curcumin detection was linear from 10 to 500 ng/mL. The C maxâ¡ and the time to reach C maxâ¡ (t maxâ¡) of curcumin in plasma were 3.14 ± 0.9 µg/mL and 5 minutes (10 mg/kg, i.v.) and 0.06 ± 0.01 µg/mL and 14 minutes (500 mg/kg, p.o.). The elimination half-time was 8.64 ± 2.31 (i.v.) and 32.70 ± 12.92 (p.o.) minutes. The oral bioavailability was about 0.47%. Changes in the glucose tolerance and insulin sensitivity were investigated in four groups: normal and diabetic rats treated with yoghurt (NYOG and DYOG, resp.) and treated with 90 mg/kg/day curcumin incorporated in yoghurt (NC90 and DC90, resp.). After 15 days of treatment, the glucose tolerance and the insulin sensitivity were significantly improved in DC90 rats in comparison with DYOG, which can be associated with an increase in the AKT phosphorylation levels and GLUT4 translocation in skeletal muscles. These findings can explain, at least in part, the benefits of curcumin-enriched yoghurt to diabetes and substantiate evidences for the curcumin metabolite(s) as being responsible for the antidiabetic activity.
RESUMO
The aim of this study was to investigate the changes in the rates of both protein synthesis and breakdown, and the activation of intracellular effectors that control these processes in soleus muscles from growing rats fed a low-protein, high-carbohydrate (LPHC) diet for 15 days. The mass and the protein content, as well as the rate of protein synthesis, were decreased in the soleus from LPHC-fed rats. The availability of amino acids was diminished, since the levels of various essential amino acids were decreased in the plasma of LPHC-fed rats. Overall rate of proteolysis was also decreased, explained by reductions in the mRNA levels of atrogin-1 and MuRF-1, ubiquitin conjugates, proteasome activity, and in the activity of caspase-3. Soleus muscles from LPHC-fed rats showed increased insulin sensitivity, with increased levels of insulin receptor and phosphorylation levels of AKT, which probably explains the inhibition of both the caspase-3 activity and the ubiquitin-proteasome system. The fall of muscle proteolysis seems to represent an adaptive response that contributes to spare proteins in a condition of diminished availability of dietary amino acids. Furthermore, the decreased rate of protein synthesis may be the driving factor to the lower muscle mass gain in growing rats fed the LPHC diet.
Assuntos
Caspase 3/metabolismo , Dieta com Restrição de Proteínas , Carboidratos da Dieta/farmacologia , Músculo Esquelético/efeitos dos fármacos , Complexo de Endopeptidases do Proteassoma/metabolismo , Biossíntese de Proteínas/efeitos dos fármacos , Proteólise/efeitos dos fármacos , Ubiquitina/metabolismo , Aminoácidos/sangue , Animais , Catepsina B/metabolismo , Proteínas Alimentares/administração & dosagem , Proteínas Alimentares/farmacologia , Resistência à Insulina , Masculino , Proteínas Musculares/biossíntese , Músculo Esquelético/enzimologia , Músculo Esquelético/metabolismo , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Receptor de Insulina/metabolismo , Proteínas Ligases SKP Culina F-Box/biossíntese , Proteínas com Motivo Tripartido , Ubiquitina-Proteína Ligases/biossínteseRESUMO
OBJECTIVE: to evaluate the participation of adolescents in the Family Health Strategy, from the theoretical-methodological structure of an enabler to participation. METHOD: a quantitative study, conducted from December of 2010 to March of 2011, with 213 professionals in the FHS in the region of Cariri-Ceará-Brazil. Data were collected through a questionnaire and organized in SPSS 18.0. RESULTS: the level of normative participation becomes manifest beginning with the adolescent search for health services, motivated by disease (77.9%). Normative participation + independence appear when they seek prenatal care and family planning. Emancipatory participation was identified by the frequency of adolescents in group activities, in the schools, and a move in the direction of the level of transformative participation was observed. CONCLUSION: in this context, it is understood that there exists a need to stimulate the participatory process of the adolescents for a change in health promotion in this group. .
OBJETIVO: avaliar a participação de adolescentes na Estratégia Saúde da Família, a partir da Estrutura Teórico-Metodológica de uma Participação Habilitadora. MÉTODO: estudo quantitativo, realizado de dezembro de 2010 a março de 2011, com 213 profissionais da Estratégia Saúde da Família, na região do Cariri, Ceará, Brasil. Os dados foram coletados através de questionário e organizados no Statistical Package for the Social Sciences, versão 18.0. RESULTADOS: o nível de Participação Normativa torna-se manifesto a partir da busca do adolescente pelo serviço de saúde, motivada pela doença (77,9%). A Participação Normativa + Independência aparece quando os mesmos buscam o pré-natal e o planejamento familiar. A Participação Emancipatória foi identificada através da frequência dos adolescentes em atividades de grupo, nas escolas, sendo observado um movimento em direção ao nível de Participação Transformadora. CONCLUSÃO: nesse contexto, entende-se que existe necessidade de estimular o processo participativo dos adolescentes para a mudança na promoção da saúde desse grupo. .
OBJETIVO: evaluar la participación de los adolescentes en la Estrategia de Salud de la Familia, de la estructura teórico-metodológica de un facilitador a la participación. MÉTODO: un estudio cuantitativo, realizado a partir de diciembre de 2010 a marzo de 2011, con 213 profesionales de la ESF en la región de Cariri-Ceará-Brasil. Los datos fueron recolectados a través de un cuestionario y se organizaron en SPSS 18.0. RESULTADOS: el nivel de participación normativo se pone de manifiesto comenzando la busqueda de servicios de salud por los adolescentes, motivados por enfermedad (77,9%). Aparecen la participación normativa + independencia cuando buscan atención prenatal y planificación familiar. Se idenificó la participación emancipadora por la frecuencia de adolescentes en actividades de grupo, en las escuelas, y se observó un movimiento en la dirección del nivel de participación transformadora. CONCLUSIÓN: en este contexto, se entiende que existe una necesidad de estimular el proceso de participación de los adolescentes para un cambio en la promoción de la salud en este grupo. .
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Saúde da Família , Comportamento do Adolescente , Participação da Comunidade , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: to evaluate the participation of adolescents in the Family Health Strategy, from the theoretical-methodological structure of an enabler to participation. METHOD: a quantitative study, conducted from December of 2010 to March of 2011, with 213 professionals in the FHS in the region of Cariri-Ceará-Brazil. Data were collected through a questionnaire and organized in SPSS 18.0. RESULTS: the level of normative participation becomes manifest beginning with the adolescent search for health services, motivated by disease (77.9%). Normative participation + independence appear when they seek prenatal care and family planning. Emancipatory participation was identified by the frequency of adolescents in group activities, in the schools, and a move in the direction of the level of transformative participation was observed. CONCLUSION: in this context, it is understood that there exists a need to stimulate the participatory process of the adolescents for a change in health promotion in this group.