RESUMO
Paget's disease or osteitis deformans is a bone metabolic disease characterized by an increased bone resorption followed by an increased but irregular bone formation. This results in a weakened, deformed bone and an increase bone mass with collagen fibers forming an irregular and pathologic mosaic instead of the parallel symmetry that characterizes healthy bone. It is considered as a non-neoplastic disorder that mimics a bone tumor. Its origin is still uncertain; however, it has been postulated that genetic or environmental factors are involved in its etiology. It rarely occurs in young patients and its prevalence increases with age. It usually affects both genders with a slight predominance of males. It may be symptomatic or asymptomatic depending on the bones involved, with the most common clinical manifestation being pain of the affected bone. Lesion distribution varies from monostotic involvement (25%) to generalized disease (75%). The most frequent complication is a fracture in a pathological area, while the most serious one is sarcomatous degeneration (approximately 1%; higher in the generalized form). The diagnosis is usually radiologic, by means of plain X-rays and biochemical markers such as alkaline phosphatase, among others, which is elevated in 85% of patients. Treatment of this disease consists of bisphosphonates, which have a proven efficacy and high remission rates. They are indicated in patients with clinical manifestations and in asymptomatic patients with evidence of disease activity. We report the case of a patient with Paget's disease in an infrequent location as is the patella.
Assuntos
Osteíte Deformante , Patela , Adulto , Fatores Etários , Idoso de 80 Anos ou mais , Conservadores da Densidade Óssea/uso terapêutico , Difosfonatos/uso terapêutico , Feminino , Fraturas Ósseas/etiologia , Humanos , Traumatismos do Joelho/etiologia , Masculino , Pessoa de Meia-Idade , Osteíte Deformante/complicações , Osteíte Deformante/diagnóstico , Osteíte Deformante/diagnóstico por imagem , Osteíte Deformante/tratamento farmacológico , Osteíte Deformante/epidemiologia , Medição da Dor , Radiografia , Fatores SexuaisRESUMO
The present study was designed to understand how carbohydrate (CBH) and protein metabolism are related in the penaeid shrimp Litopenaeus vannamei. With this information, we obtained a comprehensive schedule of the protein-carbohydrate metabolism including enzymatic, energetic, and functional aspects. We used salinity to determine its role as a modulator of the protein-carbohydrate metabolism in shrimp. Two experiments were designed. The first experiment evaluated the effect of CBH-salinity combinations in growth and survival, and hemolymph glucose, protein, and ammonia levels, digestive gland glycogen, osmotic pressure, and glutamate dehydrogenase (GDH) of L. vannamei juveniles acclimated during 18 days at a salinity of 15 per thousand and 40 per thousand. The second experiment was done to evaluate the effect of dietary CBH level on pre- and postprandial oxygen consumption, ammonia excretion, and the oxygen-nitrogen ratio (O/N) of juvenile L. vannamei in shrimps acclimated at 40 per thousand salinity. We also evaluated the ability of shrimp to carbohydrate adaptation. We made phosphoenolpyruvate carboxykinase (PECPK) and hexokinase activity measurements after a change in dietary carbohydrate levels at different times during 10 days. The growth rate depended on the combination salinity-dietary CBH-protein level. The maximum growth rate was obtained in shrimps maintained at 15 per thousand salinity and with a diet containing low CBH and high protein. The protein in hemolymph is related to the dietary protein levels; high dietary protein levels produced a high protein concentration in hemolymph. This suggests hemolymph is able to store proteins after a salinity acclimation. Depending on the salinity, the hemolymph proteins could be used as a source of osmotic effectors or as metabolic energy. The O/N values obtained show that shrimp used proteins as a source of energy, mainly when shrimps were fed with low CBH. The role played by postprandial nitrogen excretion (PPNE) in apparent heat increase (AHI) (PPNE/AHI ratio) is lower in shrimps fed diets containing high CBH in comparison with shrimps fed diets containing low CBH levels. These results confirm that the metabolism of L. vannamei juveniles is controlled by dietary protein levels, affecting the processes involved in the mechanical and biochemical transformations of ingested food. A growth depression effect was observed in shrimps fed with low-CBH protein diets and maintained in 40 per thousand salinity. In these shrimps, the hemolymph ammonia concentration (HAC) was significantly higher than that observed in shrimps fed with low CBH and maintained in 15 per thousand salinity. That high HAC level coincided with lower growth rate, which suggests that this level might be toxic for juveniles of L. vannamei. Results obtained for GDH activity showed this enzyme regulated both HAC and hemolymph protein levels, with high values in shrimps fed with low CBH levels and maintained in 40 per thousand salinity, and lower in shrimps fed with high CBH and maintained in 15 per thousand salinity. These differences mean that shrimp with a high-gill GDH activity might waste more energy in oxidation of the excess proteins and amino acids, reducing the energy for growth. It was evident that L. vannamei can convert protein to glycogen by a gluconeogenic pathway, which permitted shrimp to maintain a minimum circulating glucose of 0.34 mg/ml in hemolymph. A high PECPK activity was observed in shrimps fed a diet containing low CBH level indicating that the gluconeogenic pathway is activated, as in vertebrates by low dietary CBH levels. After a change in diet, we observed a change in PEPCK; however, it was lower and seems to depend on the way of adaptation, because it occurred after 6 days when adapting to a high-CBH diet and with little change for the low-CBH diet.
RESUMO
El Plan de Educación a través de información clara y precisa tiende a disminuir la frecuencia de las exacerbaciones, consecuentemente la disminución de la sintomatología clínica, mayor cumplimiento del tratamiento, y mejorar la calidad de vida. Objetivos: Evaluar el nivel de información previa de los pacientes que pertenecen al programa y el nivel de captación de la información brindada, para determinar el grado de efectividad del proceso educativo. Material y Métodos: Se encuestaron 50 pacientes con asma de bajo nivel socieconómico que pertenecen al programa. Fue administrado un cuestionario elaborado por nosotros, compuesto de 10 preguntas, en dos momentos: uno previo a la reunión informativa a cargo del equipo interdisciplinario, y otro posterior a ella. Se analizaron los datos a través de técnicas de estadística descriptiva e inferencial; para esta última se aplicó el Test de Significación Normal. Resultados: Los porcentajes promedios de respuestas correctas antes y después de la información fueron respectivamente: 65,4 por ciento y 89,8 por ciento, determinando una diferencia estadísticamente significativa (p < 0,005). Conclusiones: El nivel de captación de la información fue muy bueno, en aquellas preguntas que el conocimiento previo era significativamente menor, superó la diferencia promedio de respuestas correctas, y ratifica nuestra experiencia clínica: el desconocimiento y/o la negación de los aspectos emocionales intervinientes en esta enfermedad
Assuntos
Humanos , Criança , Asma , Estudo de Avaliação , Educação de Pacientes como Assunto , Educação em Saúde/tendências , Avaliação Educacional/estatística & dados numéricos , Estudo de AvaliaçãoRESUMO
El Plan de Educación a través de información clara y precisa tiende a disminuir la frecuencia de las exacerbaciones, consecuentemente la disminución de la sintomatología clínica, mayor cumplimiento del tratamiento, y mejorar la calidad de vida. Objetivos: Evaluar el nivel de información previa de los pacientes que pertenecen al programa y el nivel de captación de la información brindada, para determinar el grado de efectividad del proceso educativo. Material y Métodos: Se encuestaron 50 pacientes con asma de bajo nivel socieconómico que pertenecen al programa. Fue administrado un cuestionario elaborado por nosotros, compuesto de 10 preguntas, en dos momentos: uno previo a la reunión informativa a cargo del equipo interdisciplinario, y otro posterior a ella. Se analizaron los datos a través de técnicas de estadística descriptiva e inferencial; para esta última se aplicó el Test de Significación Normal. Resultados: Los porcentajes promedios de respuestas correctas antes y después de la información fueron respectivamente: 65,4 por ciento y 89,8 por ciento, determinando una diferencia estadísticamente significativa (p < 0,005). Conclusiones: El nivel de captación de la información fue muy bueno, en aquellas preguntas que el conocimiento previo era significativamente menor, superó la diferencia promedio de respuestas correctas, y ratifica nuestra experiencia clínica: el desconocimiento y/o la negación de los aspectos emocionales intervinientes en esta enfermedad (AU)
Assuntos
Humanos , Criança , Asma , Estudo de Avaliação , Educação de Pacientes como Assunto , Educação em Saúde/tendências , Avaliação Educacional/estatística & dados numéricos , Estudo de AvaliaçãoRESUMO
The heme precursor 5-aminolevulinic acid (ALA), acting as a prooxidant, has been proposed to underlie the clinical manifestations of various porphyric disorders. Accordingly, ALA-generated oxyradicals where shown to cause oxidative lesions in biomolecules and isolated cell organelles and to release iron from ferritin. In rats, administered ALA triggered oxidative stress in liver, brain and red muscles. We now study the correlation between the plasma antioxidant capacity and tissue oxidative damage, after acute (one and two doses) and prolonged (eight doses) ALA treatment of rats (one dose of ALA = 40 mg/kg body weight). The in situ spontaneous chemiluminescence intensity increased 5-fold in brain, 50% in liver and 4-fold in soleus muscle upon two dose-treatment, indicating tissue response to oxidative injury by ALA. Chemiluminescence reached the highest intensity after one or two doses of ALA and decreased after eight doses in all tissues. The plasma trapping capacity, evaluated by the luminol/2-amidinopropane system, gave a parallel response: maximum values after two doses and decreased values after prolonged treatment. After eight doses, the ALA concentration was found to be 3-fold above the normal value in plasma, 48% higher in liver and 38% higher in total brain. These data indicate that the plasma antioxidant system responds to ALA treatment and is correlated with tissue chemiluminescence. In vitro studies showed that ALA does not interfere with the antioxidant plasma capacity, neither promoting oxidation of plasma elements nor binding to plasma proteins.
Assuntos
Ácido Aminolevulínico/farmacologia , Antioxidantes/metabolismo , Estresse Oxidativo , Amidinas/química , Amidinas/metabolismo , Ácido Aminolevulínico/análise , Ácido Aminolevulínico/sangue , Animais , Ácido Ascórbico/química , Ácido Ascórbico/metabolismo , Proteínas Sanguíneas/efeitos dos fármacos , Proteínas Sanguíneas/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Cromanos/química , Cromanos/metabolismo , Glutationa/química , Glutationa/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Medições Luminescentes , Luminol/química , Luminol/metabolismo , Masculino , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Oxirredução , Plasma/efeitos dos fármacos , Plasma/metabolismo , Ratos , Ratos Wistar , Compostos de Sulfidrila/análise , Compostos de Sulfidrila/química , Compostos de Sulfidrila/metabolismo , Ácido Úrico/química , Ácido Úrico/metabolismoRESUMO
The 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) radical cation can be generated by incubation of ABTS and 2,2'-azo-bis(2- amidinopropane) at 45 degrees C. The ABTS radical cation is stable for several minutes at room temperature and reacts quantitatively and instantaneously with several antioxidants, such as Trolox, ascorbic acid, uric acid, cysteine, glutathione and bilirubin. In contrast, the ABTS radical cation reacts slowly with albumin. When serum is added to a solution of the ABTS radical cation, the bleaching of the radical follows biphasic kinetics, with a fast decay followed by a slow decay that takes place within several minutes. The fast decay is primarily due to uric acid, while the slow decay is related to the protein content of the sample. We propose that this procedure can provide an independent and simultaneous evaluation of the low molecular weight and protein antioxidants present in biological samples such as serum.
Assuntos
Antioxidantes/farmacologia , Indicadores e Reagentes/metabolismo , Ácidos Sulfônicos/metabolismo , Ácido Ascórbico/sangue , Benzotiazóis , Bilirrubina/sangue , Cromanos/farmacologia , Cisteína/sangue , Glutationa/sangue , Temperatura , Fatores de Tempo , Ácido Úrico/sangueRESUMO
The 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) radical cation can be generated by incubation of ABTS and 2,2'-azo-bis(2-amidinopropane) at 45 degrees Celsius. The ABTS radical cation is stable for several minutes at room temperature and reacts quantitatively and instantaneously with several antioxidants, such as Trolox, ascorbic acid, uric acid, cysteine, glutathione and bilirubin. In contrast, the ABTS radical cation reacts slowly with albumin. When serum is added to a solution of the ABTS radical cation, the bleaching of the radical follows biphasic kinetics, with a fast decay followed by a slow decay that takes place within several minutes. The fast decay is primarily due to uric acid, while the slow decay is related to the protein content of the sample. We propose that this procedure can provide an independent and simultaneous evaluation of the low molecular weight and protein antioxidants present in biological samples such as serum.
Assuntos
Humanos , Masculino , Feminino , Ácidos Sulfônicos/metabolismo , Antioxidantes/farmacologia , Indicadores e Reagentes/metabolismo , Ácido Ascórbico/sangue , Ácido Úrico/sangue , Bilirrubina/sangue , Cromanos/farmacologia , Cisteína/sangue , Glutationa/sangue , Temperatura , Fatores de TempoRESUMO
The ethanolic extracts of two types of cuban propolis (R and P) showed a similar manner of scavenging action against different species of oxygen radicals which were generated by specific chemical reactions. Chemiluminescence produced by superoxide generated from the xanthine-xanthine oxidase reaction was 50% inhibited by approximately 5 micrograms/ml of propolis R and 9.5 micrograms/ml of propolis P and by catechin (0.15 micrograms/ml) and superoxide dismutase (72 ng/ml). Alkoxy radical scavenging effect was similar to that produced by 0.11 micrograms/ml of alpha-tocopherol: inhibition of chemiluminescence by 50% was caused by approximately 0.6 micrograms/ml of both propolis preparations. The results indicate that the antioxidative properties of both propolis could be attributed to their free radical scavenging activity against alkoxy radicals and to a lesser degree against superoxide.
Assuntos
Própole/farmacologia , Catequina/farmacologia , Interações Medicamentosas , Sequestradores de Radicais Livres , Medições Luminescentes , Própole/isolamento & purificação , Superóxido Dismutase/metabolismo , Xantina Oxidase/metabolismo , Xantinas/metabolismoRESUMO
Glutathione reductase activity from mice liver is significantly enhanced by lobenzarit disodium at concentrations between 0.3 and 1.5 mM. A maximum activation of almost 30% is achieved at a drug concentration of 0.9 mM. Similar results were observed with glutathione reductase from human leukocytes, but not with the enzyme from yeast. By preincubation with the enzyme from mice liver, lobenzarit also proved to prevent, at least partially, the immediate inhibition caused by the well-known thiol-reacting agents, thus indicating a protecting effect on the catalytically important thiol residue of the enzyme. The results here obtained explain in part the recently found hepatoprotective effect of lobenzarit disodium against acute liver toxicity induced by acetaminophen in mice.
Assuntos
Glutationa Redutase/metabolismo , Imunossupressores/farmacologia , Fígado/enzimologia , ortoaminobenzoatos/farmacologia , Animais , Ativação Enzimática/efeitos dos fármacos , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Leucócitos/efeitos dos fármacos , Leucócitos/enzimologia , Fígado/efeitos dos fármacos , CamundongosRESUMO
Fish constitute one of the most important groups of allergens in the induction of immediate (type I) food hypersensitivity. In our environment, fish allergy is present in 22% of all patients with a diagnosis of food hypersensitivity. We studied the allergenic significance of the fish species considered most representative because of their greater consumption in our environment (flatfishes: Pleuronectiformes such as sole, whiff, and witch; Gadiformes such as hake; and Scombriformes such as albacore) or because of the results of previous studies of Gadiformes such as cod. Through the use of isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting, we have observed that several allergens common to all these species are able to bind specific IgE from the sera of sensitized patients. This allergenic community has been confirmed by radioallergosorbent inhibition. Another group of species-specific allergens focuses in the regions at about pH 5 and with molecular weights less than 14 kilodaltons; these allergens correspond to sarcoplasmic parvoalbumins. From the results observed, which have been confirmed by various procedures and techniques, we conclude that hake is the fish with the capability to induce the strongest IgE response, followed by whiff; the witch seems to be the least allergenic of all flatfishes. Among all species studied, albacore was the least allergenic. These results may be considered when one introduces supplementary feeding with fish in infants, most particularly in infants at high risk for atopy.