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1.
Clin Exp Dermatol ; 39(2): 135-41, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24330076

RESUMO

BACKGROUND: Systemic sclerosis (SSc) is characterized by target-organ fibrosis and microvascular dysfunction, which can be assessed using nailfold capillaroscopy. Dermoscopy is a useful and easily performed method for diagnosing skin lesions. AIM: To compare conventional capillaroscopy, using the gold-standard method (conventional stereomicroscope nailfold capillaroscopy; SNFC), with polarized light noncontact dermoscopy (PNCD) and nonpolarized light contact dermoscopy (NPCD), and to evaluate their accuracy in diagnosing characteristic SSc-related alterations. METHODS: The study enrolled 45 patients with SSc. Capillaroscopy images and photographs were taken with three devices, SNFC, NPCD and PNCD, and these images were randomly analysed by a blinded observer. RESULTS: The scleroderma pattern was found in 83% of patients. PNCD and NPCD were highly sensitive in identifying the presence of focal capillary loss (96.4% and 100%, respectively), haemorrhage (96.2% and 92%, respectively), and scleroderma (91.9%, 94.6%), and showed high specificity for haemorrhage and enlarged loops. The intra-observer kappa values for detection of the scleroderma pattern by SNFC images, NPCD and PNCD were moderate to good: (κ = 0.71 (95% CI 0.44-0.95), κ = 0.60 (95% CI 0.35-0.83) and κ = 0.60 (95% CI 0.32-0.86), respectively. Evaluation of haemorrhage presence gave high kappa values for all methods: κ = 0.77 (95% CI 0.57-0.95), κ = 0.90 (95% CI 0.76-1.00) and κ = 0.95 (95% CI 0.85-1.00), respectively. CONCLUSIONS: Both polarized and nonpolarized dermoscopy are reliable methods for valuation of nailfold capillaroscopy in patients with SSc. They are easy to perform, with good rates of accuracy and results that are comparable with traditional capillaroscopy.


Assuntos
Dermoscopia/métodos , Angioscopia Microscópica/métodos , Unhas/irrigação sanguínea , Escleroderma Sistêmico/complicações , Adulto , Idoso , Feminino , Hemorragia/diagnóstico , Humanos , Masculino , Microcirculação , Pessoa de Meia-Idade , Variações Dependentes do Observador , Escleroderma Sistêmico/patologia , Sensibilidade e Especificidade
2.
J Eur Acad Dermatol Venereol ; 22(8): 992-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18422535

RESUMO

INTRODUCTION: Atopic dermatitis places a large burden on patients and their families, with greater risk of emotional disorders and behavioural problems. Preliminary evidence suggests that support groups and educational programs are helpful in reducing stress, disease and pruritus severity and improves quality of life (QoL). OBJECTIVES: To evaluate the intensity of pruritus and the QoL in children with atopic dermatitis and their families after joining support groups. Material and methods Subjects were randomly assigned to intervention or control group and completed the Children's Dermatology Life Quality Index (CDLQI) and Family Dermatitis Impact (FDI). Pruritus was evaluated by the Yosipovitch's questionnaire for pruritus. Each patient/family unit was considered as one 'patient'. Participants were divided into two different groups: one with children under 16 years and the second with patients' relatives. Each unit was accompanied during 6 months. RESULTS: Thirty-two patients and their relatives completed the questionnaires satisfactorily. After intervention, pruritus intensity was similar (P = 0.42), but the pattern of pruritus improved in the intervention group. Overall QoL for CDLQI instruments improved significantly (P < 0.01) and, when specific domains were analysed, personal relationships (P = 0.02) and leisure (P = 0.04) showed marked enhancement. FDI scores failed to demonstrate differences in the QoL of patients' relatives after treatment. CONCLUSION: The improvement on pruritus and QoL showed that atopic dermatitis patients had benefits with the attendance to support groups. We consider that these non-pharmacological approaches can be a very effective accessory tools in the management of recalcitrant forms of the disease.


Assuntos
Dermatite Atópica/psicologia , Família/psicologia , Prurido/psicologia , Qualidade de Vida , Grupos de Autoajuda , Adolescente , Análise de Variância , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Inquéritos e Questionários
3.
Braz J Med Biol Res ; 39(10): 1281-90, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17053838

RESUMO

The main function of the cardiac adrenergic system is to regulate cardiac work both in physiologic and pathologic states. A better understanding of this system has permitted the elucidation of its role in the development and progression of heart failure. Regardless of the initial insult, depressed cardiac output results in sympathetic activation. Adrenergic receptors provide a limiting step to this activation and their sustained recruitment in chronic heart failure has proven to be deleterious to the failing heart. This concept has been confirmed by examining the effect of beta-blockers on the progression of heart failure. Studies of adrenergic receptor polymorphisms have recently focused on their impact on the adrenergic system regarding its adaptive mechanisms, susceptibilities and pharmacological responses. In this article, we review the function of the adrenergic system and its maladaptive responses in heart failure. Next, we discuss major adrenergic receptor polymorphisms and their consequences for heart failure risk, progression and prognosis. Finally, we discuss possible therapeutic implications resulting from the understanding of polymorphisms and the identification of individual genetic characteristics.


Assuntos
Baixo Débito Cardíaco/genética , Polimorfismo Genético/genética , Receptores Adrenérgicos alfa/genética , Receptores Adrenérgicos beta/genética , Baixo Débito Cardíaco/fisiopatologia , Progressão da Doença , Humanos , Prognóstico , Receptores Adrenérgicos alfa/fisiologia , Receptores Adrenérgicos beta/fisiologia
4.
Braz. j. med. biol. res ; 39(10): 1281-1290, Oct. 2006. ilus, tab, graf
Artigo em Inglês | LILACS | ID: lil-437816

RESUMO

The main function of the cardiac adrenergic system is to regulate cardiac work both in physiologic and pathologic states. A better understanding of this system has permitted the elucidation of its role in the development and progression of heart failure. Regardless of the initial insult, depressed cardiac output results in sympathetic activation. Adrenergic receptors provide a limiting step to this activation and their sustained recruitment in chronic heart failure has proven to be deleterious to the failing heart. This concept has been confirmed by examining the effect of ß-blockers on the progression of heart failure. Studies of adrenergic receptor polymorphisms have recently focused on their impact on the adrenergic system regarding its adaptive mechanisms, susceptibilities and pharmacological responses. In this article, we review the function of the adrenergic system and its maladaptive responses in heart failure. Next, we discuss major adrenergic receptor polymorphisms and their consequences for heart failure risk, progression and prognosis. Finally, we discuss possible therapeutic implications resulting from the understanding of polymorphisms and the identification of individual genetic characteristics.


Assuntos
Humanos , Baixo Débito Cardíaco/genética , Baixo Débito Cardíaco/fisiopatologia , Polimorfismo Genético/genética , Receptores Adrenérgicos alfa/genética , Receptores Adrenérgicos beta/genética , Progressão da Doença , Prognóstico , Receptores Adrenérgicos alfa/fisiologia , Receptores Adrenérgicos beta/fisiologia
5.
Braz J Med Biol Res ; 39(6): 767-72, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16751982

RESUMO

The present study was designed to evaluate the time course changes in peripheral markers of oxidative stress in a chronic HgCl2 intoxication model. Twenty male adult Wistar rats were treated subcutaneously daily for 30 days and divided into two groups of 10 animals each: Hg, which received HgCl2 (0.16 mg kg(-1) day(-1)), and control, receiving the same volume of saline solution. Blood was collected at the first, second and fourth weeks of Hg administration to evaluate lipid peroxidation (LPO), total radical trapping antioxidant potential (TRAP), and superoxide dismutase (Cu,Zn-SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), and catalase (CAT). HgCl2 administration induced a rise (by 26%) in LPO compared to control (143 +/- 10 cps/mg hemoglobin) in the second week and no difference was found at the end of the treatment. At that time, GST and GPx were higher (14 and 24%, respectively) in the Hg group, and Cu,Zn-SOD was lower (54%) compared to control. At the end of the treatment, Cu,Zn-SOD and CAT were higher (43 and 10%, respectively) in the Hg group compared to control (4.6 +/- 0.3 U/mg protein; 37 +/- 0.9 pmol/mg protein, respectively). TRAP was lower (69%) in the first week compared to control (43.8 +/- 1.9 mM Trolox). These data provide evidence that HgCl2 administration is accompanied by systemic oxidative damage in the initial phase of the process, which leads to adaptive changes in the antioxidant reserve, thus decreasing the oxidative injury at the end of 30 days of HgCl2 administration. These results suggest that a preventive treatment with antioxidants would help to avoid oxidative damage in subjects with chronic intoxication.


Assuntos
Antioxidantes/análise , Eritrócitos/enzimologia , Peroxidação de Lipídeos/efeitos dos fármacos , Cloreto de Mercúrio/intoxicação , Estresse Oxidativo/efeitos dos fármacos , Peroxidases/sangue , Animais , Antioxidantes/metabolismo , Biomarcadores/sangue , Doença Crônica , Modelos Animais de Doenças , Luminescência , Masculino , Peroxidases/metabolismo , Ratos , Ratos Wistar , Fatores de Tempo
6.
Braz. j. med. biol. res ; 39(6): 767-772, June 2006. ilus, tab
Artigo em Inglês | LILACS | ID: lil-428268

RESUMO

The present study was designed to evaluate the time course changes in peripheral markers of oxidative stress in a chronic HgCl2 intoxication model. Twenty male adult Wistar rats were treated subcutaneously daily for 30 days and divided into two groups of 10 animals each: Hg, which received HgCl2 (0.16 mg kg-1 day-1), and control, receiving the same volume of saline solution. Blood was collected at the first, second and fourth weeks of Hg administration to evaluate lipid peroxidation (LPO), total radical trapping antioxidant potential (TRAP), and superoxide dismutase (Cu,Zn-SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), and catalase (CAT). HgCl2 administration induced a rise (by 26 percent) in LPO compared to control (143 ± 10 cps/mg hemoglobin) in the second week and no difference was found at the end of the treatment. At that time, GST and GPx were higher (14 and 24 percent, respectively) in the Hg group, and Cu,Zn-SOD was lower (54 percent) compared to control. At the end of the treatment, Cu,Zn-SOD and CAT were higher (43 and 10 percent, respectively) in the Hg group compared to control (4.6 ± 0.3 U/mg protein; 37 ± 0.9 pmol/mg protein, respectively). TRAP was lower (69 percent) in the first week compared to control (43.8 ± 1.9 mM Trolox). These data provide evidence that HgCl2 administration is accompanied by systemic oxidative damage in the initial phase of the process, which leads to adaptive changes in the antioxidant reserve, thus decreasing the oxidative injury at the end of 30 days of HgCl2 administration. These results suggest that a preventive treatment with antioxidants would help to avoid oxidative damage in subjects with chronic intoxication.


Assuntos
Animais , Masculino , Ratos , Antioxidantes/análise , Eritrócitos/enzimologia , Peroxidação de Lipídeos/efeitos dos fármacos , Cloreto de Mercúrio/intoxicação , Estresse Oxidativo/efeitos dos fármacos , Peroxidases/sangue , Antioxidantes/metabolismo , Biomarcadores/sangue , Doença Crônica , Modelos Animais de Doenças , Luminescência , Peroxidases/metabolismo , Ratos Wistar , Fatores de Tempo
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