RESUMO
In the murine model, it was demonstrated that pro-inflammatory cytokines and chemokines are essential to the formation and modulation of Schistosoma-induced granulomatous inflammation. However, the relationship of these immune mediators and disease severity is hard to be established in naturally infected individuals. The current study evaluates the association between plasma concentrations of MIF, sTNF-R1, CCL3, CCL7 and CCL24 and schistosomiasis morbidity in Schistosoma mansoni-infected patients with a low parasite burden. For this propose, 97 S. mansoni-infected individuals were subjected to abdominal ultrasound analysis and clinical examination. Among them, 88 had plasma concentration of immune mediators estimated by ELISA assay. Multivariate linear regression models were used to evaluate the relationship between the plasma concentration of immune mediators and the variables investigated. Although most individuals presented low parasite burden, over 30% of them showed signs of fibrosis defined by ultrasound measurements and 2 patients had a severe form of schistosomiasis. No association between parasite burden and the plasma levels of chemokine/cytokines or disease severity was observed. There was a positive association between plasma concentration of CCL4, sTNF-R1, CCL3 and MIF with gall bladder thickness and/or with portal vein thickness that are liver fibrosis markers. In contrast, no association was found between CCL7 plasma concentrations with any of the schistosomiasis morbidity parameters evaluated. The data showed that CCL24, sTNFR1, MIF and CCL3 can be detected in plasma of S. mansoni-infected individuals and their concentration would be used as prognostic makers of Schistosoma-induced liver fibrosis, even in individuals with low parasite burden.
Assuntos
Quimiocina CCL24/sangue , Quimiocina CCL3/sangue , Quimiocina CCL7/sangue , Oxirredutases Intramoleculares/sangue , Cirrose Hepática/imunologia , Fatores Inibidores da Migração de Macrófagos/sangue , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Schistosoma mansoni/imunologia , Esquistossomose mansoni/imunologia , Adolescente , Adulto , Idoso , Animais , Humanos , Fígado/irrigação sanguínea , Fígado/parasitologia , Fígado/patologia , Cirrose Hepática/parasitologia , Pessoa de Meia-Idade , Veia Porta/patologia , Esquistossomose mansoni/parasitologia , Adulto JovemRESUMO
Mineralocorticoid receptors (MRs), which are activated by mineralocorticoids and glucocorticoids, actively participate in mechanisms that affect the structure and function of blood vessels. Although experimental and clinical evidence shows that vascular damage in diabetes is associated with structural alterations in large and small arteries, the role of MR in this process needs further studies. Thus, we tested the hypothesis that MR, through redox-sensitive mechanisms, plays a role in diabetes-associated vascular remodelling. Male, 12-14-weeks-old db/db mice, a model of type 2 diabetes and their non-diabetic counterpart controls (db/+) were treated with spironolactone (MR antagonist, 50 mg/kg/day) or vehicle for 6 weeks. Spironolactone treatment did not affect blood pressure, fasting glucose levels or weight gain, but increased serum potassium and total cholesterol in both, diabetic and control mice. In addition, spironolactone significantly reduced serum insulin levels, but not aldosterone levels in diabetic mice. Insulin sensitivity, evaluated by the HOMA (homoeostatic model assessment)-index, was improved in spironolactone-treated diabetic mice. Mesenteric resistance arteries from vehicle-treated db/db mice exhibited inward hypertrophic remodelling, increased number of smooth muscle cells and increased vascular stiffness. These structural changes, determined by morphometric analysis and with a myography for pressurized arteries, were prevented by spironolactone treatment. Arteries from vehicle-treated db/db mice also exhibited augmented collagen content, determined by Picrosirius Red staining and Western blotting, increased reactive oxygen species (ROS) generation, determined by dihydroethidium (DHE) fluorescence, as well as increased expression of NAD(P)H oxidases 1 and 4 and increased activity of mitogen-activated protein kinases (MAPKs). Spironolactone treatment prevented all these changes, indicating that MR importantly contributes to diabetes-associated vascular dysfunction by inducing oxidative stress and by increasing the activity of redox-sensitive proteins.
Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Antagonistas de Receptores de Mineralocorticoides/química , Receptores de Mineralocorticoides/fisiologia , Aldosterona/sangue , Animais , Glicemia/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Colesterol/sangue , Colágeno/química , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Tipo 2/sangue , Etídio/análogos & derivados , Etídio/química , Glucocorticoides/metabolismo , Insulina/sangue , Masculino , Camundongos , Mineralocorticoides/metabolismo , Potássio/sangue , Espécies Reativas de Oxigênio/química , Espironolactona/uso terapêuticoRESUMO
The outcomes of HIV-infected patients requiring critical care have improved. However, in developing countries, information about HIV-infected patients admitted to intensive care units (ICUs) is scarce. We describe the prognosis of HIV-infected patients admitted to a Brazilian ICU and the factors predictive of short- and long-term survival. A historical cohort study, including HIV-infected patients admitted to a Brazilian ICU at an HIV/AIDS reference hospital, was conducted. Survivors were followed up for 24 months after ICU discharge. Demographic, clinical and laboratory data, disease severity scores and mortality were evaluated. Data were analysed using survival and regression models. One hundred and twenty-five patients were studied. In-ICU and in-hospital mortality rates were 46.4% and 68.0%, respectively. Multivariate analysis showed that the in-ICU mortality was significantly associated with APACHE (Acute Physiology and Chronic Health Evaluation) II scores (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.03-1.11), mechanical ventilation (OR, 6.39; 95% CI, 1.29-31.76), tuberculosis treatment (OR, 2.62; 95% CI, 1.03-6.71), use of antiretroviral therapy (OR, 0.19; 95% CI, 0.05-0.77) and septic shock (OR, 4.38; 95% CI, 1.78-10.76). Septic shock was also associated with long-term survival (hazard ratio, 3.0; 95% CI, 1.31-6.90). In-hospital and in-ICU mortality were higher than those reported for developed countries. ICU admission mostly due to AIDS-related diseases may explain these differences.
Assuntos
Infecções por HIV/mortalidade , Adulto , Análise de Variância , Brasil/epidemiologia , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Razão de Chances , Análise de Regressão , Choque Séptico/mortalidade , Choque Séptico/virologia , Resultado do TratamentoRESUMO
The potential of populations of Bemisia tabaci (Genn.) to become resistant to insecticides has stimulated research into alternative tactics of integrated pest management such as the induction of host-plant resistance. Recent data have shown that silicon can increase the degree of resistance of host plants to insect pests. Therefore the aim of our work was to study the effects of silicon application on the vegetative development of soybean plants and on the induction of resistance to the silverleaf whitefly, B. tabaci biotype B. We performed choice and no-choice tests of oviposition preference on two soybean cultivars, IAC-19 (moderately resistant to B. tabaci biotype B) and MONSOY-8001 (susceptible), with and without application of silicon. Silicon did not affect silverleaf whitefly oviposition preferences, but caused significant mortality in nymphs. Thus, silicon increased the degree of resistance to silverleaf whitefly. Silicon decreased the production of phenolic compounds, but did not affect lignin production. However, when applied to cultivar IAC-19, it increased the production of non-protein organic nitrogen. Silicon had no effect on the vegetative development of soybean plants, but it increased the degree of resistance to the silverleaf whitefly. We conclude that silicon applications combined with cultivar IAC-19 can significantly decrease silverleaf whitefly populations, having a positive impact both on the soybean plant and on the environment.
Assuntos
Resistência à Doença/efeitos dos fármacos , Glycine max/efeitos dos fármacos , Glycine max/fisiologia , Hemípteros , Silício/farmacologia , AnimaisRESUMO
BACKGROUND AND PURPOSE: It is well known that adenine-based purines exert multiple effects on pain transmission. However, less attention has been given to the potential effects of guanine-based purines on pain transmission. The aim of this study was to investigate the effects of intraperitoneal (i.p.) and oral (p.o.) administration of guanosine on mice pain models. Additionally, investigation into the mechanisms of action of guanosine, its potential toxicity and cerebrospinal fluid (CSF) purine levels were also assessed. EXPERIMENTAL APPROACH: Mice received an i.p. or p.o. administration of vehicle (0.1 mM NaOH) or guanosine (up to 240 mg x kg(-1)) and were evaluated in several pain models. KEY RESULTS: Guanosine produced dose-dependent antinociceptive effects in the hot-plate, glutamate, capsaicin, formalin and acetic acid models, but it was ineffective in the tail-flick test. Additionally, guanosine produced a significant inhibition of biting behaviour induced by i.t. injection of glutamate, AMPA, kainate and trans-ACPD, but not against NMDA, substance P or capsaicin. The antinociceptive effects of guanosine were prevented by selective and non-selective adenosine receptor antagonists. Systemic administration of guanosine (120 mg x kg(-1)) induced an approximately sevenfold increase on CSF guanosine levels. Guanosine prevented the increase on spinal cord glutamate uptake induced by intraplantar capsaicin. CONCLUSIONS AND IMPLICATIONS: This study provides new evidence on the mechanism of action of the antinociceptive effects after systemic administration of guanosine. These effects seem to be related to the modulation of adenosine A(1) and A(2A) receptors and non-NMDA glutamate receptors.
Assuntos
Analgésicos/uso terapêutico , Guanosina/uso terapêutico , Dor/tratamento farmacológico , Administração Oral , Analgésicos/administração & dosagem , Analgésicos/líquido cefalorraquidiano , Analgésicos/farmacologia , Analgésicos/toxicidade , Animais , Comportamento Animal/efeitos dos fármacos , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Cromatografia Líquida de Alta Pressão , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Edema/tratamento farmacológico , Guanosina/administração & dosagem , Guanosina/líquido cefalorraquidiano , Guanosina/farmacologia , Guanosina/toxicidade , Injeções Intraperitoneais , Dose Letal Mediana , Masculino , Camundongos , Atividade Motora/efeitos dos fármacos , Dor/líquido cefalorraquidiano , Dor/fisiopatologia , Limiar da Dor/efeitos dos fármacos , Medula Espinal/efeitos dos fármacos , Medula Espinal/metabolismoRESUMO
BACKGROUND AND PURPOSE: Allopurinol is a potent inhibitor of the enzyme xanthine oxidase, used primarily in the treatment of hyperuricemia and gout. It is well known that purines exert multiple effects on pain transmission. We hypothesized that the inhibition of xanthine oxidase by allopurinol, thereby reducing purine degradation, could be a valid strategy to enhance purinergic activity. The aim of this study was to investigate the anti-nociceptive profile of allopurinol on chemical and thermal pain models in mice. EXPERIMENTAL APPROACH: Mice received an intraperitoneal (i.p.) injection of vehicle (Tween 10%) or allopurinol (10-400 mg kg(-1)). Anti-nociceptive effects were measured with intraplantar capsaicin, intraplantar glutamate, tail-flick or hot-plate tests. KEY RESULTS: Allopurinol presented dose-dependent anti-nociceptive effects in all models. The opioid antagonist naloxone did not affect these anti-nociceptive effects. The non-selective adenosine-receptor antagonist caffeine and the selective A(1) adenosine-receptor antagonist, DPCPX, but not the selective A(2A) adenosine-receptor antagonist, SCH58261, completely prevented allopurinol-induced anti-nociception. No obvious motor deficits were produced by allopurinol, at doses up to 200 mg kg(-1). Allopurinol also caused an increase in cerebrospinal fluid levels of purines, including the nucleosides adenosine and guanosine, and decreased cerebrospinal fluid concentration of uric acid. CONCLUSIONS AND IMPLICATIONS: Allopurinol-induced anti-nociception may be related to adenosine accumulation. Allopurinol is an old and extensively used compound and seems to be well tolerated with no obvious central nervous system toxic effects at high doses. This drug may be useful to treat pain syndromes in humans.
Assuntos
Agonistas do Receptor A1 de Adenosina , Alopurinol/farmacologia , Analgésicos/farmacologia , Xantina Oxidase/antagonistas & inibidores , Adenosina/líquido cefalorraquidiano , Antagonistas do Receptor A1 de Adenosina , Antagonistas do Receptor A2 de Adenosina , Alopurinol/uso terapêutico , Analgésicos/uso terapêutico , Animais , Capsaicina , Relação Dose-Resposta a Droga , Ácido Glutâmico , Temperatura Alta , Injeções Intraperitoneais , Masculino , Camundongos , Naloxona/farmacologia , Antagonistas de Entorpecentes/farmacologia , Dor/tratamento farmacológico , Dor/etiologia , Medição da Dor , Pirimidinas/farmacologia , Triazóis/farmacologia , Ácido Úrico/líquido cefalorraquidiano , Xantinas/farmacologiaRESUMO
Schistosomal myeloradiculopathy (SMR) is the most common neurological form of Schistosoma mansoni infection. In this study we investigated the expression of chemokines and Th2 cytokines in serum and cerebral spinal fluid (CSF) of SMR patients. SMR patients presented increased serum levels of CCL11/eotaxin and CCL24/eotaxin-2 when compared to controls. SMR patients also had higher levels of IL-13 in CSF. Thus, SMR patients present enhancement of both IL-13 and CCR3 acting chemokines, both of which may facilitate the expression of a Th2 response and Th2-dependent damage to the spinal cord. As this cytokine is responsible for promoting Th2 responses, this finding is in accordance to the view that Th2 cells are important in the immunological process against the S. mansoni.
Assuntos
Quimiocinas/sangue , Quimiocinas/líquido cefalorraquidiano , Citocinas/sangue , Citocinas/líquido cefalorraquidiano , Neuroesquistossomose/imunologia , Schistosoma mansoni/imunologia , Células Th2/imunologia , Adolescente , Adulto , Animais , Feminino , Humanos , Masculino , Neuroesquistossomose/sangue , Neuroesquistossomose/líquido cefalorraquidianoRESUMO
Trata-se de um estudo de caso com uma criança internada em Unidade de Terapia Intensiva Pediátrica, cujo objetivo é descrever os fatores que interferem na preservação de seu sono e repouso. Utilizou-se como método, para a coleta de dados, observação direta, a partir dos procedimentos realizados e da maneira de cuidar da criança pela equipe multiprofissional. Os resultados denotam que o sono e o repouso foram interrompidos em intervalos de 25 minutos, evidenciando a necessidade e a privatização do sono e repouso nestas circunstâncias. Conclui-se que a assistência à criança que necessita de cuidados intensivos deve estar voltada para atender suas necessidades individuais, utilizando para tal uma abordagem humanística que implica na formação de conjuntos, na interdisciplinaridade dos profissionais, buscando a integralidade, a unicidade e a interdependência.
Assuntos
Humanos , Criança , Cuidados Críticos , Enfermagem Pediátrica , Equipe de Assistência ao Paciente , Repouso em Cama , Sono , Unidades de Terapia Intensiva PediátricaRESUMO
O estudo analisou os principais fatores que interferem na dinâmica do sono/repouso, com vista à reflexão do processo de cuidar da criança internada em Unidade de Terapia Intensiva. Objetiva-se analisar o processo do sono, tendo como apoio a revisão da literatura publicada nas duas últimas décadas do século XX. Percorreram-se as estações da neurofisiologia do sono e de seus estágios; o ritmo circadiano; a necessidade do sono dos lactentes; o sono do lactente; a privação do sono até chegar às drogas que nele interferem. As evidências disponíveis indicam que no conteúdo de cada estação neurofisiológica a necessidade do sono/repouso está presente. Sua manutenção é benéfica, contribuindo para que o organismo responda melhor às estratégias terapêuticas aplicadas. Entende-se que os cuidados de enfermagem, sob essa ótica, implicam ver além da doença, considerando-se o cliente e o contexto em que se insere como um todo.
Assuntos
Humanos , Recém-Nascido , Lactente , Sono , Terapia Intensiva Neonatal , Cuidado do Lactente , Cuidados de Enfermagem , DescansoRESUMO
Enquanto recorte da dissertação da autora, busca chegar à essência do entendimento do Centro de Atenção Psicossocial (CAPS) por 34 usuários residentes em Ubá - MG. Através dos depoimentos, houve representação de suas realidades, dos elementos afetivos, mentais e sociais. Após análise de todas as entrevistas, emergiu, dentre outras, a categoria: "o espaço social do CAPS como possibilitador de mudanças na vida". Assim, foi verificado que este serviço não representa um espaço físico qualquer, mas um lugar onde eles reconhecem como referência e lugar de tratamento. Representa, também, a possibilidade de mudanças, a possibilidade de æretornar à realidadeÆ, de ærealizar um sonhoÆ, de fazer pensar que ele é capaz. Conclui-se que o processo de reabilitação já vem causando efeito nas vidas dos usuários, a partir do momento em que o CAPS está viabilizando autonomia nos seus afazeres cotidianos, nas suas relações, na sua vida afetiva, social e econômica...
Being an excerpt from the authorÆs dissertation, this is an attempt at understanding the essence of what the Psychosocial Care Center means to 34 of its users, residents of the city of Ubá in the State of Minas Gerais. By means of the reports their realities were represented concerning the emotional, mental and social elements. From analyzing all the interviews, there has emerged one category, among thers: "the social space of CAPS as an enabler for producing changes in life". Thus it became evident that the service is not considered as being just some kind of a material space, but that it is recognized both as a reference point and where to get treatment. It also means the possibility for change the possibility to "come back to reality", to "make a dream come true", to make a person feel that he/she is capable of achievement. As a result, the rehabilitation process is already affecting the lives of the users, their autonomy being stimulated by CAPS concerning their everyday chores, their relations, and their emotional, social and economic life...
El presente estudio es una síntesis de la disertación de la autora, procura llegar a la esencia de la comprensión del Centro de Atención Psicosocial mediante 34 usuários residentes en Ubá - MG. Por medio de los testimonios, hubo una representación de sus realidades, de los elementos afectivos, mentales y sociales. Después del análisis de todas las entrevistas, emergió, entre otras, la categoría: "el espacio social del CAPS como posibilitador de cambios en la vida del usuario". Así, se verificó que este servicio no representa un espacio físico cualquiera, pero sí un lugar que ellos reconocen como referencia y lugar de tratamiento. Representa, también, la posibilidad de cambios, la posibilidad de 'regresar a la realidad", de "realizar un sueño', de hacer pensar que él es capaz. Se concluye que el proceso de rehabilitación ya está causando efecto en las vidas de los usuários, a partir del momento en que el CAPS está haciendo posible la autonomía en sus quehaceres cotidianos, en sus relaciones, en su vida afectiva, social y económica...