RESUMO
Breast milk is considered the gold standard nutritional resource for very low birth weight (VLBW) infants in terms of nutrients and protective factors. If mother's milk is not available, the second choice is donated and fortified human milk (HM) from the Human Milk Bank (HMB). This study hypothesized that HM could be lyophilized and used as an additive to increase the levels of macronutrients and micronutrients available to VLBW infants. This study aimed to constitute a lyophilized HM concentrate and determine the osmolality and the concentration of macronutrients and micronutrients in HM samples at "baseline" and in "HM concentrates", analyzed immediately (HMCI), and after 3 (HMC3m) and 6 (HMC6m) months of freezing. Osmolality was verified using the freezing point osmometric method. Macronutrient quantification was performed using the MIRIS Human Milk Analyzer. Micronutrients were determined by Flame Atomic Absorption Spectrophotometry and by the automated colorimetric method. Bayesian linear mixed effect models were adjusted using OpenBUGS to estimate mean differences and 95% credibility intervals (CrI) of osmolality and of macro- and micronutrients between the types of HM samples. A comparison of dosage values showed a significant increase between HM baseline and HMCI, HMC3m, and HMC6m. Comparing HM baseline and HMCI highlighted the increase in energy content and the concentration of carbohydrates and total lipids. The Ca and P contents increased and the levels of energy, total lipids, and Cu were reduced in HMC3m compared to HMCI. Ca, Mg, K, Zn, and P increased and the levels of energy, total lipids, and Cu were reduced in HMC6m, compared to HMCI. The present study confirms the possibility of formulation and utilization of the immediate concentrate. Partial stability of HM concentrates generated from freeze-drying of donated milk do not recommend storage.
Assuntos
Análise de Alimentos , Alimentos Infantis/análise , Recém-Nascido de muito Baixo Peso , Leite Humano/química , Carboidratos da Dieta/análise , Feminino , Liofilização , Humanos , Recém-Nascido , Lipídeos/análise , Masculino , Metais/análiseRESUMO
Ethanol alters motricity, learning, cognition, and cellular metabolism in the cerebellum. The combination of ethanol with caffeine by consuming "energy drinks" is becoming increasingly popular among young people. We analyzed the use of ethanol and caffeine on apoptosis in the cerebellum of UChB rats. The adult rats were divided into three groups (n = 14/group): UChB group: rats fed with 1:10 (v/v) ethanol ad libitum (free choice for water or ethanol) drinking from >1.9 mL of ethanol/kg body weight/day, Control group and UChB/caffeine group (free choice for water or ethanol + caffeine 300 mg/L). The treatments occurred from Day 100 till Day 150, totalizing 50 days of ethanol/caffeine ingestion. Cerebellar sections were subjected to immunohistochemistry and gene expression for Real Time-PCR (RT-PCR) for Caspase-3, XIAP, and insulin-like growth factor 1-receptor (IGF-1R). The results showed a significant increase in the gene expression of Caspase-3 and XIAP in UChB group. On the other hand, the animals of the UChB/caffeine group showed similar results to the Controls. Regarding IGFR-1, there was greater expression in the UChB groups with strong labeling in Purkinje cells. Ethanol produces neuronal and glial neurodegeneration on the cerebellum of UChB rats. The simultaneous ingestion of ethanol and caffeine reversed the ethanol damages acting caffeine with a neuroprotective effect.
Assuntos
Apoptose/efeitos dos fármacos , Cafeína/farmacologia , Cerebelo/patologia , Etanol/farmacologia , Animais , Caspase 3/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , Ratos Wistar , Receptor IGF Tipo 1/metabolismo , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/metabolismoRESUMO
BACKGROUND: Human milk, with essential nutrients and long chain polyunsaturated fatty acids (LC-PUFAs) such as the omega 3 and 6 fatty acids is important for development of the central nervous system and the retina in very low birth weight infants (<1,500 g). However, breast milk may not be sufficient to meet these needs. The possibility of supplementing breast milk with a lyophilisate of human milk was explored in this study. The objectives of this study were to determine the total lipid content and the lipid profile of the Human Milk on Baseline (HMB) and that of the Concentrates with the Human Milk + lyophilisate (with lyophilisate of milk in the immediate period (HMCI), at 3 months (HMC3m), and at 6 months (HMC6m) of storage). METHODS: Fifty donors from the Human Milk Bank of Children's Hospital provided consent, and donated milk samples. Macronutrient (including total lipids) quantification was performed using the MIRIS® Human Milk Analyzer, and the fatty acid profile was determined by gas chromatography (CG-FID, SHIMADZU®). RESULTS: There was a higher lipid concentration in HMCI relative to HMB. The concentrations of the main fatty acids (% of total) were as follows: palmitic acid (C16:0) HMB, 22.30%; HMCI, 21.46%; HMC3m, 21.54%; and HMC6m, 21.95% (p<0.01); oleic acid (C18:1n-9) HMB, 30.41%; HMCI, 30.47%; HMC3m, 30.55%; and HMC6m, 29.79% (p = 0.46); linoleic acid (C18:2n-6) HMB, 19.62%; HMCI, 19.88%; HMC3m, 19.49%; and HMC6m, 19.45% (p = 0.58); arachidonic acid (C20:4n-6) HMB, 0.35%; HMCI, 0.16%; HMC3m, 0.13%; and HMC6m, 0.15% (p<0.01); α-linolenic acid (C18:3n-3) HMB,1.32%; HMCI, 1.37%; HMC3m, 1.34%; and 1.34% HMC6m (p = 0.14); docosahexaenoic acid (C22:6n-3) HMB, 0.10%; HMCI, 0.06%; HMC3m, 0.05%; and HMC6m, 0.06% (p<0.01). There were no significant changes in the lipid profile when stored. There was no evidence of peroxidation during storage. CONCLUSIONS: Freeze-dried human milk fortified with a human milk concentrate brings potential benefits to newborns, mainly by preserving the essential nutrients present only in breast milk; however, further clinical studies are required to evaluate the safety and efficacy of the concentrate as a standard nutritional food option for very low birth weight infants.
Assuntos
Ácidos Graxos/análise , Fórmulas Infantis/química , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Leite Humano/química , Adolescente , Adulto , Cromatografia Gasosa , Feminino , Liofilização , Humanos , Alimentos Infantis , Recém-Nascido , Recém-Nascido Prematuro , Lipídeos/análise , Adulto JovemRESUMO
Testosterone is often recommended in the treatment of several aging-related conditions. However, there are still questions about the consequences of this therapy in terms of hormonal and inflammatory parameters that are crucial for prostate homeostasis. Thus, we investigate if the testosterone therapy (TT) modulates the hormone receptors and inflammatory cytokines in the ventral prostate of adult rats. Wistar rats aging 150 days were divided into two experimental groups (n = 10/group): T: received subcutaneous injections of testosterone cypionate (5 mg/kg body weight) diluted in corn oil every other day for 4 weeks; and C: received corn oil as vehicle. Animals were euthanized at 180 days old by decapitation. Blood was collected to obtain hormone and cytokines concentrations. The ventral prostate was dissected and processed for light microscope and molecular analyses. Relative ventral prostate weight and epithelial compartment were increased after TT. The number of intact and degranulated mast cells was reduced in the T group. Plasma testosterone, DHT and intraprostatic testosterone concentrations were higher in the T group. TT leads to an increase in cell proliferation and up-regulation of AR, ERß, PAR-4, and NRF2. Importantly, plasma concentration and tissue expression of IL-10 and TNF-α were higher after TT. In summary, these results indicate that TT can regulate inflammatory response, with impacts in cytokines and mast cell population, and modulates steroids receptors, important parameters for prostatic homeostasis.
Assuntos
Próstata/efeitos dos fármacos , Testosterona/análogos & derivados , Animais , Proteínas Reguladoras de Apoptose/análise , Proteínas Reguladoras de Apoptose/sangue , Proliferação de Células/efeitos dos fármacos , Citocinas/análise , Citocinas/sangue , Receptor beta de Estrogênio/análise , Receptor beta de Estrogênio/sangue , Inflamação/metabolismo , Masculino , Fator 2 Relacionado a NF-E2/análise , Fator 2 Relacionado a NF-E2/sangue , Próstata/metabolismo , Ratos , Ratos Wistar , Receptores Androgênicos/metabolismo , Testosterona/metabolismo , Testosterona/farmacologiaRESUMO
OBJECTIVE: Feeding intolerance, manifesting as increased gastric residual, is a common finding in preterm neonates. Little is known about the regulation of gastric emptying early in life and the extent to which this plays a role in the preterm infants' feeding tolerance. The goal of this study was to evaluate clinically stable 28- to 32-week gestation neonates during the first 4 weeks of life and noninvasively determine their gastric emptying rate. STUDY DESIGN: Ultrasound measurements of gastric milk content volume were obtained from 25 neonates immediately after, 30 and/or 60 minutes following routine gavage feeds. The content emptying rate was calculated from the gastric volume data. RESULTS: Gastric emptying rate was not postnatal age-dependent, was significantly higher at 30 minutes, whenever compared with 60-minute postfeed and directly proportional to the feed volume. At any postnatal age, the gastric emptying rate was at least 6-fold greater, when comparing the lowest and highest average stomach content volumes. CONCLUSIONS: The gastric emptying rate of preterm infants is content volume-dependent and unrelated to the postnatal age. Given the present findings, further investigation on the gastric residual of preterm infants receiving larger than currently administered feed volumes at the initiation of enteral nutrition, is warranted.
Assuntos
Esvaziamento Gástrico/fisiologia , Conteúdo Gastrointestinal/diagnóstico por imagem , Recém-Nascido Prematuro , Ultrassonografia/métodos , Feminino , Humanos , Recém-Nascido , Masculino , Estudos ProspectivosRESUMO
UNLABELLED: Background and rationale for the study. We designed to test whether there is interaction of maternal separation (MS) on the ethanol-preferring rats liver structure. The UCh rat pups were separated daily from their mothers during the stress hyporesponsive period (SHRP), between four and 14 days-old, always at the same time for four hours in a cage containing eight subdivisions, one for each pup. Subsequently, rats that presented the highest (UChB) and the lowest (UChA) ethanol (EtOH) consumption were selected to the study. Both UChB and UChA rats received 10% (v/v) EtOH and distilled water ad libitum until the end of the experiment (120 days-old). The liver was collected to histological routine for morphometric and stereological analyses, and immunohistochemistry. RESULTS: There was an interaction of MS and EtOH on the liver: increased liver mass, peritubular vessels, stellate cell numbers, steatosis and cell death, decreased necrosis, sinusoidal capillary diameters and cell proliferation. While there was a decrease in FSH, testosterone and 5α-di-hidrotestosterone, and increasing corticosterone and cholesterol. CONCLUSIONS: There is interaction of MS and EtOH on the liver structure, dependent on the amount of EtOH intake. Furthermore, the interaction of stress and drugs can increase or decrease their effects on the liver or indirectly via hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Ansiedade de Separação/patologia , Etanol/toxicidade , Hepatopatias Alcoólicas/etiologia , Fígado/efeitos dos fármacos , Fatores Etários , Consumo de Bebidas Alcoólicas/patologia , Animais , Animais Recém-Nascidos , Ansiedade de Separação/sangue , Ansiedade de Separação/psicologia , Biomarcadores/sangue , Morte Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Etanol/administração & dosagem , Fígado Gorduroso Alcoólico/etiologia , Fígado Gorduroso Alcoólico/patologia , Feminino , Células Estreladas do Fígado/efeitos dos fármacos , Células Estreladas do Fígado/patologia , Hepatomegalia/induzido quimicamente , Hepatomegalia/patologia , Fígado/patologia , Hepatopatias Alcoólicas/patologia , Hepatopatias Alcoólicas/psicologia , Masculino , Fatores de TempoRESUMO
AIMS: Chronic ethanol consumption leads to reproductive damages, since it can act directly in the tissues or indirectly, causing a hormonal imbalance. Prostate is a hormone-dependent gland and, consequently, susceptible to ethanol. The potential of testosterone therapy in the ethanol-related disorders was investigated in the prostate microenvironment. MAIN METHODS: UChB rats aged 90 days were divided into 2 experimental groups (n=20): C: drinking water only and EtOH: drinking 10% (v/v) ethanol at >2 g/kg body weight/day+water. At 150 days old, 10 rats from each group received subcutaneous injections of testosterone cypionate (5 mg/kg body weight) diluted in corn oil every other day for 4 weeks, constituting T and EtOH+T, while the remaining animals received corn oil as vehicle. Animals were euthanized at 180 days old, by decapitation. Blood was collected to obtain hormone concentrations and ventral prostate was dissected and processed for light microscope and molecular analyses. KEY FINDINGS: Ventral prostate weight, plasma testosterone and DHT and intraprostatic testosterone concentrations were increased after testosterone treatment. Plasma estradiol level was reduced in the EtOH+T. Inflammatory foci, metaplasia and epithelial atrophy were constantly found in the prostate of EtOH and were not observed after hormonal therapy. No differences were found in the expression of AR, ERß and DACH-1. Additionally, testosterone treatment down-regulated ERα and increased the e-cadherin and α-actinin immunoreactivities. SIGNIFICANCE: Testosterone was able to reverse damages caused by ethanol consumption in the prostate microenvironment and becomes a possible target to be investigated to ethanol-related disorders.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Androgênios/uso terapêutico , Próstata/efeitos dos fármacos , Próstata/patologia , Testosterona/uso terapêutico , Actinina/metabolismo , Alcoolismo/terapia , Animais , Atrofia , Peso Corporal , Caderinas/metabolismo , Proliferação de Células , Etanol , Inflamação , Masculino , Tamanho do Órgão/efeitos dos fármacos , RatosRESUMO
OBJECTIVE: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. METHODS: This was a multicentric cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. Outcomes: death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Statistics: Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. RESULTS: 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 - 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) ...
OBJETIVO: Analisar os efeitos da terapêutica adotada para o canal arterial (CA) em recém-nascidos (RN) < 1.000gadmitidos em unidades neonatais (UN) da Rede Brasileira de Pesquisas Neonatais (RBPN), sobre os desfechos: óbito, displasia broncopulmonar (DBP), hemorragia intraventricular grave (HIVIII/IV), retinopatia da prematuridade cirúrgica (ROPcir), enterocolite necrosante cirúrgica (ECNcir) e o desfecho combinado óbito e DBP. MÉTODOS: Estudo multicêntrico, de coorte, coleta de dados retrospectiva, incluindo RN de 16 UN da RBPN de 01/01/2010 a 31/12/2011, PN < 1.000 g, idade gestacional (IG) < 33 semanas e diagnóstico ecocardiográfico de PCA. Excluídos: óbitos ou transferências até o terceiro dia de vida, infecções congênitas ou malformações. Grupos:G1 - conservadora (sem intervenção medicamentosa ou cirúrgica), G2 - farmacológica (indometacina ou ibuprofeno) e G3 - cirúrgico (com ou sem tratamento farmacológico anterior). Analisou-se: uso de esteroide antenatal, parto cesárea, PN, IG, Apgar5' < 4, sexo masculino, SNAPPE II, síndrome do dDesconforto respiratório (SDR), sepse tardia, ventilação mecânica (VM), surfactante < 2 horas de vida, tempo de VM e os desfechos: óbito, dependência de oxigênio com 36 semanas (DBP36s), HIV III/IV, ROPcir, ECNcir e óbito/DBP36s. Estatística: Teste t-Student, Qui-Quadrado ou teste Exato de Fisher. Testes de Regressão Binária Logística e Regressão Múltipla Stepwise Backward. MedCalc (Medical Calculator) software, versão 12.1.4.0.p < 0,05. RESULTADOS: Foram selecionados 1.097 RN e 494 foram incluídos: G1-187 (37,8%), G2-205 (41,5%) e G3-102 (20,6%). Verificou-se: maior mortalidade (51,3%) no G1 e menor no G3(14,7%); maior frequência DBP36s (70,6%) e ROPcir (23,5%) ...
Assuntos
Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Permeabilidade do Canal Arterial/terapia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Índice de Apgar , Brasil/epidemiologia , Displasia Broncopulmonar/mortalidade , Displasia Broncopulmonar/terapia , Estudos de Coortes , Permeabilidade do Canal Arterial/mortalidade , Idade Gestacional , Ligadura/métodos , Respiração Artificial , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
OBJECTIVE: To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. METHODS: This was a multicentric, cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. OUTCOMES: death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. STATISTICS: Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. RESULTS: 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 - 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) and ROPsur were observed in G3 (23.5%). The lowest occurrence of death/BPD36wks occurred in G2 (58.0%). Pharmacological (OR 0.29; 95% CI: 0.14-0.62) and conservative (OR 0.34; 95% CI: 0.14-0.79) treatments were protective for the outcome death/BPD36wks. CONCLUSION: The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.
Assuntos
Permeabilidade do Canal Arterial/terapia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso/crescimento & desenvolvimento , Índice de Apgar , Brasil/epidemiologia , Displasia Broncopulmonar/mortalidade , Displasia Broncopulmonar/terapia , Estudos de Coortes , Permeabilidade do Canal Arterial/mortalidade , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Ligadura/métodos , Masculino , Gravidez , Respiração Artificial , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
The present study characterized the opinions of health professionals about strategies for assessing and managing pediatric pain in a public teaching hospital. The sample consisted of 92 health professionals who worked in pediatric wards, pediatric intensive care, and neonatal intensive care. The sample included 45 doctors, 18 nurses, 16 psychologists, eight physiotherapists, and five occupational therapists. Data were collected through a self-administered questionnaire that included 22 open questions on the following topics: pain assessment, pharmacological management, and non-pharmacological interventions. Each area was analyzed with regard to actions, resources, gaps, and needs. The questionnaire was developed based on the principles of Strategic Planning. Two trained researchers analyzed the thematic content of all of the responses. With regard to actions and resources, 33% of the respondents mentioned the use of instruments for pain assessment, 73% reported that they prescribed pharmacological treatments for symptoms of pain, and 26% reported the use of non-pharmacological interventions for the relief of pain. The professionals predominantly reported a lack of training for pain assessment and management, standardized protocols, and human and material resources. Consequently, 96% of the professionals reported the necessity for educational training and standardized implementation guidelines for pain assessment services. These findings provide a baseline of the health professional's opinions of pain issues, which are essential for implementing and increasing pain assessment and management policies institutionally.
Assuntos
Humanos , Masculino , Feminino , Medição da Dor , Pediatria , Pessoal de Saúde , Inquéritos e QuestionáriosRESUMO
The present study characterized the opinions of health professionals about strategies for assessing and managing pediatric pain in a public teaching hospital. The sample consisted of 92 health professionals who worked in pediatric wards, pediatric intensive care, and neonatal intensive care. The sample included 45 doctors, 18 nurses, 16 psychologists, eight physiotherapists, and five occupational therapists. Data were collected through a self-administered questionnaire that included 22 open questions on the following topics: pain assessment, pharmacological management, and non-pharmacological interventions. Each area was analyzed with regard to actions, resources, gaps, and needs. The questionnaire was developed based on the principles of Strategic Planning. Two trained researchers analyzed the thematic content of all of the responses. With regard to actions and resources, 33% of the respondents mentioned the use of instruments for pain assessment, 73% reported that they prescribed pharmacological treatments for symptoms of pain, and 26% reported the use of non-pharmacological interventions for the relief of pain. The professionals predominantly reported a lack of training for pain assessment and management, standardized protocols, and human and material resources. Consequently, 96% of the professionals reported the necessity for educational training and standardized implementation guidelines for pain assessment services. These findings provide a baseline of the health professional's opinions of pain issues, which are essential for implementing and increasing pain assessment and management policies institutionally.(AU)
Assuntos
Humanos , Masculino , Feminino , Medição da Dor , Pediatria , Inquéritos e Questionários , Pessoal de SaúdeRESUMO
AIM: To evaluate the effect of body position on the cardiorespiratory indicators of preterm newborns receiving nasal continuous positive airway pressure (CPAP). METHODS: Analytical, observational, prospective, cross-sectional, randomised crossover study was carried out on sixteen newborns that received nasal CPAP. The infants had a mean gestational age of 29.7 ± 2 weeks and birthweight of 1353 ± 280 g. Cardiorespiratory indicators (respiratory rate, heart rate and oxygen saturation) were evaluated in each infant in the supine, prone and right and left lateral decubitus positions at intervals of 10 min over a period of 60 min. RESULTS: The cardiorespiratory indicators were similar and within the normal range in the four decubitus positions. There was no difference in respiratory or heart rate between body positions. Although they showed desirable values, oxygen saturation was significantly lower in left lateral decubitus (96.6 ± 1.7%) when compared to the supine (97.1 ± 1.3%) and prone positions (97.4 ± 1.1%) (p = 0.00) and was also significantly lower in right lateral decubitus (96.9 ± 1.4%) when compared to the prone position (p = 0.00). CONCLUSION: We found no preferential decubitus position for preterm newborns receiving nasal CPAP, the supine position may be a choice, but the left and right lateral positions were less advantageous in terms of oxygen saturation.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Recém-Nascido Prematuro , Postura , Estudos Cross-Over , Estudos Transversais , Feminino , Frequência Cardíaca , Humanos , Recém-Nascido , Terapia Intensiva Neonatal/métodos , Masculino , Estudos Prospectivos , Taxa RespiratóriaRESUMO
BACKGROUND: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. OBJECTIVE: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. METHOD: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. RESULTS: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255 g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. CONCLUSION: The use of an elastic chest band improves respiratory indicators such as oxygen saturation.
Assuntos
Doenças do Prematuro/terapia , Oxigênio/metabolismo , Posicionamento do Paciente , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/metabolismo , Doenças do Prematuro/fisiopatologia , Masculino , Estudos Prospectivos , Mecânica Respiratória , Terapia Respiratória/instrumentação , CostelasRESUMO
BACKGROUND: Preterm newborns have higher thoracic compliance, providing less stability to the different forces of distortion imposed on the rib cage, leading to instability of the chest. Adequate body position may reduce this instability and facilitate respiratory work. OBJECTIVE: To assess the oxygen saturation response of preterm newborns receiving rib cage stabilization with an elastic band in two body positions. METHOD: A clinical, prospective, randomized crossover study was conducted, including sixteen newborns with a gestational age of 31 to 35 weeks (mean 32.8 weeks) at a tertiary care facility, who did not receive supplemental oxygen. The infants were placed in a sequence of prone and supine positions with and without chest stabilization with an elastic band. Respiratory rate, heart rate, and oxygen saturation were measured at 10-minute intervals, corresponding to 7 samplings of 60 minutes. Data collection was interrupted when oxygen saturation was less than 90%. RESULTS: The mean gestational age of the infants was 32.8±1.5 weeks and the mean birth weight was 1,789±255g. Better values for the variables studied were observed in the supine position with an elastic chest band compared to the supine position without the band. The positions using an elastic band resulted in lower mean respiratory rate and heart rate and higher oxygen saturation. CONCLUSION: The use of an elastic chest band improves respiratory indicators such as oxygen saturation. .
CONTEXTUALIZAÇÃO: Os recém-nascidos pré-termos possuem maior complacência torácica, oferecendo menor estabilidade às diferentes forças de distorção impostas à parede torácica, o que leva à instabilidade da caixa torácica. A posição corporal adequada pode diminuir essa instabilidade, facilitando o trabalho respiratório. OBJETIVO: Verificar a resposta da saturação de oxigênio em recém-nascido pré-termo com estabilização do gradil costal com faixa elástica em dois posicionamentos corporais. MÉTODO: Estudo com delineamento de ensaio clínico prospectivo, randomizado e tipo crossover. Foram avaliados 16 recém-nascidos com idade gestacional de 31 a 35 semanas (média 32,8 semanas) e sem oxigênio suplementar, em instituição de nível terciário. O grupo foi submetido à sequência de decúbitos posturais ventral e dorsal, alterando-os com e sem estabilização do tórax por meio da faixa elástica. Os indicadores biológicos colhidos foram frequência respiratória, frequência cardíaca e saturação de oxigênio. Os dados foram coletados de 10 em 10 minutos, totalizando 60 minutos com sete coletas. O critério de interrupção da coleta se deu pela saturação menor que 90%. RESULTADOS: O grupo estudado apresentou média de idade gestacional de 32,8±1,5 semanas e peso ao nascimento de 1.789±255g. Encontramos melhores valores das variáveis na supinação com faixa quando comparada com supinação sem faixa. Os valores médios menores da frequência respiratória e da frequência cardíaca foram alcançados no decúbito com faixa, já a saturação ...
Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Doenças do Prematuro/terapia , Oxigênio/metabolismo , Posicionamento do Paciente , Recém-Nascido Prematuro , Doenças do Prematuro/metabolismo , Doenças do Prematuro/fisiopatologia , Estudos Prospectivos , Mecânica Respiratória , Costelas , Terapia Respiratória/instrumentaçãoRESUMO
BACKGROUND: Ethanol (EtOH) alters the all-trans-retinoic acid (ATRA) levels in some tissues. Retinol and ATRA are essential for cell proliferation, differentiation, and maintenance of prostate homeostasis. It has been suggested that disturbances in retinol/ATRA concentration as well as in the expression of retinoic acid receptors (RARs) contribute to benign prostate hyperplasia and prostate cancer. This study aimed to evaluate whether EtOH consumption is able to alter retinol and ATRA levels in the plasma and prostate tissue as well as the expression of RARs, cell proliferation, and apoptosis index. METHODS: All animals were divided into 4 groups (n = 10/group). UChA: rats fed 10% (v/v) EtOH ad libitum; UChACo: EtOH-naïve rats without access to EtOH; UChB: rats fed 10% (v/v) EtOH ad libitum; UChBCo: EtOH-naïve rats without access to EtOH. Animals were euthanized by decapitation after 60 days of EtOH consumption for high-performance liquid chromatography and light microscopy analysis. RESULTS: EtOH reduced plasma retinol concentration in both UChA and UChB groups, while the retinol concentration was not significantly different in prostate tissue. Conversely, plasma and prostate ATRA levels increased in UChB group compared with controls, beyond the up-regulation of RARß and -γ in dorsal prostate lobe. Additionally, no alteration was found in cell proliferation and apoptosis index involving dorsal and lateral prostate lobe. CONCLUSIONS: We conclude that EtOH alters the plasma retinol concentrations proportionally to the amount of EtOH consumed. Moreover, high EtOH consumption increases the concentration of ATRA in plasma/prostate tissue and especially induces the RARß and RARγ in the dorsal prostate lobe. EtOH consumption and increased ATRA levels were not associated with cell proliferation and apoptosis in the prostate.
Assuntos
Consumo de Bebidas Alcoólicas/sangue , Etanol/farmacologia , Próstata/efeitos dos fármacos , Próstata/patologia , Receptores do Ácido Retinoico/metabolismo , Tretinoína/sangue , Animais , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Depressores do Sistema Nervoso Central/farmacologia , Masculino , Próstata/metabolismo , Ratos , Ratos WistarRESUMO
PURPOSE: We aimed to test the convergent validity of the COMFORT scale and the Cardiac Analgesic Assessment Scale (CAAS) and to evaluate changes in physiological parameters over time in response to a painful procedure in neonates and infants following cardiac surgery. METHODS: From October 2006 to May 2008, 16 children were prospectively evaluated over 1-3 days after cardiac surgery while they remained on mechanical ventilation and received infusions of sedatives and analgesics. Pain was assessed by the COMFORT scale and CAAS before and during endotracheal tube suctioning. Heart rate, systemic systolic blood pressure, pulmonary artery pressure, oxygen saturation and pupil size were recorded at the same times. RESULTS: During endotracheal suctioning on the first day, there was a significant increase in COMFORT and CAAS scores, systemic systolic blood pressure tended to decrease, pulmonary artery pressure significantly increased and there was a significant reduction in oxygen saturation. Heart rate and pupil size did not change significantly during the painful procedure throughout the study. COMFORT scores significantly correlated with CAAS scores on all days. Nevertheless, agreement for the detection of pain between both scales was weak (κ<0.5). The COMFORT scale detected more patients with pain. CONCLUSIONS: There was poor agreement between the COMFORT scale and CAAS for detection of pain in neonates and infants who had undergone cardiac surgery. A reduction in systemic systolic blood pressure and a rise in pulmonary artery pressure were observed during painful stimulation on the first post-operative day. For this population, a pain scale scoring physiological parameters according to their variation to higher and lower values should be developed.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiopatias Congênitas/cirurgia , Medição da Dor/métodos , Dor Pós-Operatória/diagnóstico , Brasil , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Período Pós-OperatórioRESUMO
Aquaporins (AQPs), notably AQP-1 and AQP-9, may contribute to reabsorption of fluid and solute across the epididymis. Ethanol is related to be a toxicant affecting directly or indirectly the epididymis and the sperm motility. This study examined the expression of AQP-1 and AQP-9 in adult epididymis of the UChA and UChB 10% (v/v) ethanol-preferring rats, focusing the ethanol-induced hormonal disturbances upon the regulation of these AQPs. Chronic ethanol intake significantly decreased body weight, while UChA and UChB rats displayed a marked loss of epididymal weights. Both ethanol-consuming animals had a severe reduction of testosterone levels, whereas LH and 17ß-estradiol were unchanged. Throughout the epididymis, a strong reaction to AQP-1 was observed in myoid and endothelial cells of the UChB ethanol-preferring rats, differently from a moderate intensity in the initial segment of the UChA rats. In addition, AQP-9 showed a strong immunoreaction in the apical membrane of principal cells at initial segment. In cauda epididymis, the level of AQP-9 was reduced along the microvillus projections in both UChA and UChB rats compared to controls. We conclude that chronic ethanol consumption modulates the androgen levels, thereby modifying the expression pattern of AQP-1 and 9 in the epididymis.
Assuntos
Aquaporina 1/metabolismo , Aquaporinas/metabolismo , Epididimo/metabolismo , Etanol/farmacologia , Animais , Epididimo/citologia , Epididimo/efeitos dos fármacos , Imuno-Histoquímica , Masculino , Ratos , Ratos Wistar , Testosterona/sangueRESUMO
BACKGROUND: Variations in maternal care are associated with neonatal stress, hormonal disturbances and reproductive injuries during adulthood. However, the effects of these variations on sex hormones and steroid receptors during ovary development remain undetermined. This study aimed to investigate whether variations in maternal care are able to influence the hormonal profile, follicular dynamics and expression of AR, ER-alpha and ER-beta in the ovaries of UCh rat offspring. METHODS: Twenty-four adult UCh rats, aged 120 days, were randomly divided into two groups (UChA and UChB) and mated. Maternal care was assessed from birth (day 0) to the 10th postnatal day (PND). In adulthood, twenty adult female rats (UChA and UChB offspring; n = 10/group), aged 120 days, were euthanized by decapitation during the morning estrus. RESULTS: UChA females (providing high maternal care) more frequently displayed the behaviors of carrying pups, as well as licking/grooming and arched back nursing cares. Also, mothers providing high care had elevated corticosterone levels. Additionally, offspring receiving low maternal care showed the highest estrous cycle duration, increased corticosterone and 17beta-estradiol levels, overexpression of receptors ER-alpha and ER-beta, increased numbers of primordial, antral and mature follicles and accentuated granulosa cell proliferation. CONCLUSIONS: Our study suggests that low maternal care alters corticosterone and 17beta-estradiol levels, disrupting the estrous cycle and folliculogenesis and differentially regulating the expression of ER-alpha and ER-beta in the ovaries of adult rats.
Assuntos
Ciclo Estral/fisiologia , Hormônios/sangue , Comportamento Materno/fisiologia , Folículo Ovariano/crescimento & desenvolvimento , Ovário/metabolismo , Receptores de Estrogênio/metabolismo , Animais , Animais Recém-Nascidos , Western Blotting , Corticosterona/sangue , Estradiol/sangue , Receptor alfa de Estrogênio/metabolismo , Receptor beta de Estrogênio/metabolismo , Feminino , Imuno-Histoquímica , Antígeno Ki-67/metabolismo , Masculino , Folículo Ovariano/citologia , Ratos , Ratos Endogâmicos , Fatores de TempoRESUMO
BACKGROUND: Melatonin is associated with direct or indirect actions upon female reproductive function. However, its effects on sex hormones and steroid receptors during ovulation are not clearly defined. This study aimed to verify whether exposure to long-term melatonin is able to cause reproductive hormonal disturbances as well as their role on sex steroid receptors in the rat ovary, oviduct and uterus during ovulation. METHODS: Twenty-four adult Wistar rats, 60 days old (+/-250 g) were randomly divided into two groups. Control group (Co): received 0.9% NaCl 0.3 mL+95% ethanol 0.04 mL as vehicle; Melatonin-treated group (MEL): received vehicle+melatonin [100 µg/100 g BW/day] both intraperitoneally during 60 days. All animals were euthanized by decapitation during the morning estrus at 4 a.m. RESULTS: Melatonin significantly reduced the plasma levels of LH and 17 beta-estradiol, while urinary 6-sulfatoximelatonin (STM) was increased at the morning estrus. In addition, melatonin promoted differential regulation of the estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR) and melatonin receptor (MTR) along the reproductive tissues. In ovary, melatonin induced a down-regulation of ER-alpha and PRB levels. Conversely, it was observed that PRA and MT1R were up-regulated. In oviduct, AR and ER-alpha levels were down-regulated, in contrast to high expression of both PRA and PRB. Finally, the ER-beta and PRB levels were down-regulated in uterus tissue and only MT1R was up-regulated. CONCLUSIONS: We suggest that melatonin partially suppress the hypothalamus-pituitary-ovarian axis, in addition, it induces differential regulation of sex steroid receptors in the ovary, oviduct and uterus during ovulation.
Assuntos
Estradiol/sangue , Tubas Uterinas/metabolismo , Hormônio Luteinizante/sangue , Melatonina/farmacologia , Ovário/metabolismo , Receptores de Esteroides/metabolismo , Útero/metabolismo , Animais , Tubas Uterinas/efeitos dos fármacos , Feminino , Ovário/efeitos dos fármacos , Ovulação , Ratos , Ratos Wistar , Receptor MT1 de Melatonina/efeitos dos fármacos , Reprodução/efeitos dos fármacos , Útero/efeitos dos fármacosRESUMO
BACKGROUND: Chronic ethanol intake leads to reproductive damage including reactive oxygen species formation, which accelerates the oxidative process. Melatonin is known to regulate the reproductive cycle, food/liquid intake, and it may also act as a potent antioxidant indoleamine. The aim of this study was to verify the effects of alcoholism and melatonin treatment on overall feed efficiency and to analyze its protective role against the oxidative stress in the ovarian tissue of UChB rats (submitted to 10% [v/v] voluntary ethanol consumption). METHODS: Forty adult female rats (n = 10/group) were finally selected for this study: UChB Co: drinking water only; and UChB EtOH: drinking ethanol at 2 to 6 ml/100 g/d + water, both receiving 0.9% NaCl + 95% ethanol 0.04 ml as vehicle. Concomitantly, UChB Co + M and UChB EtOH + M groups were infused with vehicle + melatonin (100 µg/100 g body weight/d) intraperitoneally over 60 days. All animals were euthanized by decapitation during the morning estrus (4 am). RESULTS: Body weight gain was reduced with ethanol plus melatonin after 40 days of treatment. In both melatonin-treated groups, it was observed a reduction in food-derived calories and liquid intake toward the end of treatment. The amount of consumed ethanol dropped during the treatment. Estrous cycle was longer in rats that received both ethanol and melatonin, with prolonged diestrus. Following to oxidative status, lipid hydroperoxide levels were higher in the ovaries of ethanol-preferring rats and decreased after melatonin treatment. Additionally, antioxidant activities of superoxide dismutase, glutathione peroxidase activity, and glutathione reductase activity were increased in melatonin-treated groups. CONCLUSIONS: We suggest that melatonin is able to affect feed efficiency and, conversely, it protects the ovaries against the oxidative stress arising from ethanol consumption.