RESUMO
The metabolic syndrome (MS) has become the new epidemic of this century. Although its associated pathologies may vary, the most common are hypertension, central obesity, dyslipidemia, low High Density Lipoproteins (HDL), high Low Density Lipoproteins (LDL), and type-2 diabetes. Several others can be present, such as hypertriglyceridemia, cardiopathies, atherosclerosis, altered levels of sex hormones, hypogonadism in men and nephropathy. Several factors such as gender, age, race, lifestyle and diet may contribute to modify its prevalence: men develop cardiovascular diseases at an earlier age than pre-menopausal women, who seem to be protected by the antioxidant properties of estrogens. The present review offers information, mostly from 2008 to the present, as well as our own work on a rat model of MS, which was developed by the administration of sucrose in drinking water. Sex steroid hormones play an important role in the appearance and development of the MS and of cardiovascular diseases. Variations in the levels of sex hormones, whether normal or pathological, may have significant influence in the onset of several diseases, metabolic syndrome components included, as well as in the behavior of tissues and organs. These are just some of the non-reproductive actions of sex hormones.
Assuntos
Doenças Cardiovasculares/etiologia , Hormônios Esteroides Gonadais/metabolismo , Doenças Metabólicas/etiologia , Animais , Doenças Cardiovasculares/epidemiologia , Dieta , Modelos Animais de Doenças , Fatores Epidemiológicos , Feminino , Humanos , Estilo de Vida , Masculino , Doenças Metabólicas/epidemiologia , Ratos , Fatores de Risco , Caracteres SexuaisRESUMO
General surgery was the first specialty of medicine. Nowadays, it is fragmented a progressive number of specialties, and has lost many of its fields. What will be the future of general surgery? What will be its repercussion on teaching surgery? From the point of view of a professor of surgery, our specialty today has nothing like what it was in the middle of the past century. Every day, its field of action becomes more and more reduced. Probably in the future, training in surgery will be limited to 2 years of basic knowledge, before the resident goes into the specialty of his/her choice.
Assuntos
Cirurgia Geral/tendências , Previsões , Humanos , MéxicoRESUMO
Unnecessary operations represent between 20 and 25% of total surgical practice. This article analyses causes, history, enormous economic effects and their consequences as an iatrogenic harm. Looking for a solution to the problem of unnecessary operations is urgent because these surgeries have a direct effect on the field of ethics and morality in the practice of surgery.
Assuntos
Ética Médica , Procedimentos Cirúrgicos Operatórios , Procedimentos Desnecessários , Medicina Defensiva/economia , Humanos , Doença Iatrogênica , Encaminhamento e Consulta/economia , Procedimentos Cirúrgicos Operatórios/economia , Procedimentos Desnecessários/economiaAssuntos
Sistema Cardiovascular/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Alquil e Aril Transferases/antagonistas & inibidores , Animais , Sistema Cardiovascular/citologia , Divisão Celular/efeitos dos fármacos , Divisão Celular/fisiologia , Inibidores Enzimáticos/farmacologia , Farnesiltranstransferase , Humanos , Proteína Quinase C/antagonistas & inibidores , Proteína Quinase C/efeitos dos fármacos , Proteína Quinase C/fisiologia , Proteínas Tirosina Quinases/antagonistas & inibidores , Proteínas Tirosina Quinases/efeitos dos fármacos , Proteínas Tirosina Quinases/fisiologia , Transdução de Sinais/fisiologia , Proteínas ras/efeitos dos fármacos , Proteínas ras/fisiologiaRESUMO
Insulin-elicited endothelin release in hypertriglyceridemic, hypertensive, hyperinsulinemic (HTG) rats was shown. Weanling male Wistar rats were given 30% sucrose in their drinking water for 20-24 wk. In vitro contractions of aorta and femoral arteries were elicited with 40 mM KCl. Endothelin release induced with KCl plus 50 microU/ml insulin resulted in increases in contractile responses: 41 +/- 5.9 and 57 +/- 6% for control and 65.5 +/- 6 and 95 +/- 9% for HTG aortas and femoral arteries, respectively. The endothelin ET(B)-receptor blocker BQ-788 decreased responses to KCl + insulin by 39 +/- 8 and 53 +/- 5% in control and 48 +/- 13 and 79 +/- 3.5% in HTG aortas and femoral arteries, respectively. The ET(A)-receptor antagonist PD-151242 inhibited these responses by 12 +/- 10 and 1 +/- 9% in control and by 51.5 +/- 9 and 58.5 +/- 1% in HTG aortas and femoral arteries, respectively. These results suggest that endothelin may contribute to the hypertension in this model.
Assuntos
Endotelina-1/metabolismo , Hipertensão/fisiopatologia , Hipertrigliceridemia/fisiopatologia , Insulina/fisiologia , Animais , Animais Recém-Nascidos , Anti-Hipertensivos/farmacologia , Azepinas/farmacologia , Teste de Tolerância a Glucose , Hipertensão/metabolismo , Hipertrigliceridemia/metabolismo , Masculino , Contração Muscular/efeitos dos fármacos , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/fisiopatologia , Oligopeptídeos/farmacologia , Piperidinas/farmacologia , Cloreto de Potássio/farmacologia , Ratos , Ratos WistarRESUMO
There exists great confusion concerning the different techniques for the treatment of gastroesophageal reflux. For instance, we apply the term fundoplication to different operations that often have nothing to do with the original description, and there is a serious lack of knowledge of the historical origins of many of these operations. This analysis is the result of a large review of the operations, and of the original papers as they were published.
Assuntos
Fundoplicatura/história , Refluxo Gastroesofágico/cirurgia , Refluxo Gastroesofágico/história , História do Século XIX , História do Século XX , HumanosRESUMO
There exists, in our times, a great confusion concording the different techniques for the treatment of gastroesophageal reflux. Today, for instance, we use the name "fundoplication" for different operations that, in many occasions, have nothing to do with the original description of the technique. It can be said that there exists a great lack of knowledge of the historical origins and of the evolution of all of these operations. The authors of this article have done a large-scale review of the original publications, as they appeared, for the first time, in medical literature.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/história , Refluxo Gastroesofágico/história , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Refluxo Gastroesofágico/cirurgia , História do Século XX , HumanosRESUMO
A case of a 66-year-old woman with a giant fibrovascular polyp protruding from the mouth is presented. The polyp was successfully removed by a cervical esophagotomy.
Assuntos
Neoplasias Esofágicas/patologia , Boca/patologia , Pólipos/patologia , Idoso , Tecido Conjuntivo/patologia , Esôfago/patologia , Feminino , Humanos , Mucosa/patologiaRESUMO
The operative Model of Primary Health Care, was developed to offer health services to a population living under conditions of extreme poverty in the municipality of Chimalhuacán, State of México. This article describes the theorical framework, organization and operationalization of an innovative model, changing the current paradigm of clinical practice to include allied health personnel with and especial training. At the core of the model is the Basic Unit of Primary Care that includes one physician and five allied health technicians for each 15,000 habitants. This model offer an alternative to improve the utilization of available personnel and infrastructure. Finally this paper emphasizes the importance of the permanece, surveillance and evaluation of the model.