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ABSTRACT Objective The incidence of thrombotic events and acute kidney injury is high in critically ill patients with COVID-19. We aimed to evaluate and compare the coagulation profiles of patients with COVID-19 developing acute kidney injury versus those who did not, during their intensive care unit stay. Methods Conventional coagulation and platelet function tests, fibrinolysis, endogenous inhibitors of coagulation tests, and rotational thromboelastometry were conducted on days 0, 1, 3, 7, and 14 following intensive care unit admission. Results Out of 30 patients included, 13 (43.4%) met the criteria for acute kidney injury. Comparing both groups, patients with acute kidney injury were older: 73 (60-84) versus 54 (47-64) years, p=0.027, and had a lower baseline glomerular filtration rate: 70 (51-81) versus 93 (83-106) mL/min/1.73m2, p=0.004. On day 1, D-dimer and fibrinogen levels were elevated but similar between groups: 1780 (1319-5517) versus 1794 (726-2324) ng/mL, p=0.145 and 608 (550-700) versus 642 (469-722) g/dL, p=0.95, respectively. Rotational thromboelastometry data were also similar between groups. However, antithrombin activity and protein C levels were lower in patients who developed acute kidney injury: 82 (75-92) versus 98 (90-116), p=0.028 and 70 (52-82) versus 88 (78-101) µ/mL, p=0.038, respectively. Mean protein C levels were lower in the group with acute kidney injury across multiple time points during their stay in the intensive care unit. Conclusion Critically ill patients experiencing acute kidney injury exhibited lower endogenous anticoagulant levels. Further studies are needed to understand the role of natural anticoagulants in the pathophysiology of acute kidney injury within this population.

https://doi.org/10.31744/einstein_journal/2023ao0119

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Abstract: En | Text: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

Skipping breakfast among preschoolers: associated factors and its dose-response relationship with overweight/obesity
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GUIMARÃES, Ana Carolina Vieira de Teixeira

; CARDOSO, Camila Kellen de Souza

; SOUZA, Luciana Bronzi de

; GUIMARÃES, Marília Mendonça

; PEIXOTO, Maria do Rosário Gondim

Revista de Nutrição

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2021, Volume 34 elocation e200276

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Investigar fatores associados à omissão do café da manhã em pré-escolares e avaliar a relação dose-dependente entre frequência de consumo desta refeição e prevalência de excesso de peso. Métodos Estudo transversal com 463 crianças (24-59 meses de idade) da área urbana de Goiânia, Goiás, Brasil. Coletou-se dados sociodemográficos, estado nutricional materno e da criança, hábito de vida e práticas alimentares infantis usando questionário padronizado e recordatório alimentar habitual em visitas domiciliares. A omissão do café da manhã foi definida como frequência de consumo “menor que sete dias por semana”. Com base no índice de massa corporal por idade, as crianças foram classificadas com excesso de peso se escore-z ≥ 2. Utilizou-se regressão logística múltipla para avaliar associação entre as variáveis pesquisadas e a omissão do café da manhã. A relação dose-dependente entre frequência do café da manhã e excesso de peso foi determinada pelo teste de tendência. Resultados A prevalência de omissão do café da manhã foi 8.42% (IC95%: 6.1-11.3). Houve associação entre o hábito de trocar o jantar por lanche (OR ajustado: 2.61 (IC95%:1.25-5.46); p=0.010) e o excesso de peso materno (OR ajustado: 2.63, IC95%:1.29-5.37; p=0.008) com a omissão do café da manhã. A prevalência de excesso de peso diminui quando a frequência do consumo do café da manhã aumenta (p=0.035). Conclusão Há associação dose-resposta entre excesso de peso e omissão do café da manhã. Crianças que trocam o jantar por lanche e têm mães com excesso de peso apresentam maior chance de omitirem o café da manhã.

ABSTRACT Objective To investigate factors associated with skipping breakfast in preschoolers and test a dose-dependent relationship between the frequency of breakfast consumption and the prevalence of overweight/obesity. Methods This is a cross-sectional study, carried out with 463 children (24 to 59 months of age) who live in the urban location of Goiânia, Goiás, Brazil. Sociodemographic data, maternal and child nutritional status, lifestyle, and dietary practices were collected using a standardized questionnaire and Habitual Food Recall during a home-based interview. Skipping breakfast was defined as a frequency of consumption “less than seven days a week”. Based on body mass index by age, children were classified as overweight/obese if Z-score ≥2. Multiple logistic regression was used to assess the association between the variables surveyed and skipping breakfast. The dose-dependent relationship between breakfast frequency and overweight/obesity was determined by the trend test. Results The prevalence of skipping breakfast was 8.42% (95%IC: 6.1-11.3). There was an association between the habit of substituting dinner for a sandwich/snack (adjusted OR: 2.61, 95%IC: 1.25-5.46; p=0.010) and the mother’s overweight (adjusted OR: 2.63; 95%CI: 1.29-5.37; p=0.008) with the habit of skipping breakfast. The trend test shows that the prevalence of overweight/obesity decreases as the frequency of breakfast consumption increases (p=0.035). Additionally, when assessing the quality of breakfast, frequent consumption of foods considered unhealthy was observed. Conclusion There is a dose-response association between overweight/obesity and skipping breakfast. Children who substitute traditional dinner for a sandwich/snack and whose mothers are overweight are more likely to skip breakfast.

https://doi.org/10.1590/1678-9865202134200276

Accidental falls in middle-aged women
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Stolt, Lígia Raquel Ortiz Gomes

; Kolish, Daniel Vieira

; Cardoso, Maria Regina Alves

; Tanaka, Clarice

; Vasconcelos, Erika Flauzino Silva

; Pereira, Elaine Cristina

; Dellú, Máyra Cecilia

; Pereira, Wendry Maria Paixão

; Aldrighi, José Mendes

; Schmitt, Ana Carolina Basso

Revista de Saúde Pública

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2020, Volume 54 elocation 141

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Estimar a prevalência de quedas acidentais em mulheres e identificar possíveis associações de variáveis sociodemográficas, clínicas e de hábitos de vida com as quedas, em 2007 e 2014. MÉTODOS Foram realizados dois estudos transversais, em 2007 e 2014, dentro do Projeto de Saúde de Pindamonhangaba (PROSAPIN), com mulheres com idades variando de 35 a 75 anos. As amostras probabilísticas foram selecionadas dentre as mulheres residentes no município e participantes da Estratégia Saúde da Família. A coleta de dados incluiu: entrevista face a face, exame antropométrico e exame sanguíneo. A variável de desfecho “Sofreu queda nos últimos seis meses?” foi levantada durante a entrevista. Foram estimadas as prevalências de quedas em 2007 e 2014 por ponto e intervalo de confiança de 95% (IC95%). Modelos de regressão logística múltipla foram construídos para identificar a associação das variáveis independentes e a ocorrência de quedas para cada ano a partir da odds ratio (OR). Utilizou-se o software Stata 14.0 para análise estatística. RESULTADOS As prevalências de quedas acidentais foram: 17,6% (IC95% 14,9–20,5) em 2007 e 17,2% (IC95% 14,8–19,8) em 2014. Em 2007 os fatores associados a quedas foram: idade de 50–64 anos (OR = 1,81; IC95% 1,17–2,80), ensino médio (OR = 1,76; IC95% 1,06–2,93), hiperuricemia (OR = 3,74; IC95% 2,17–6,44), depressão (OR = 2,07; IC95% 1,31–3,27), sono ruim (OR = 1,78; IC95% 1,12–2,82) e sonolência diurna (OR = 1,86; IC95% 1,16–2,99). Em 2014 permaneceram: idade de 50–64 anos (OR = 1,64; IC95% 1,04–2,58), hiperuricemia (OR = 1,91; IC95% 1,07–3,43) e depressão (OR = 1,56; IC95% 1,02–2,38), acrescidos da síndrome metabólica (OR = 1,60; IC95% 1,03–2,47) e da dor musculoesquelética (OR = 1,81; IC95% 1,03–3,18). CONCLUSÕES As quedas ocorrem de maneira importante em mulheres a partir dos 50 anos, indicando que não são restritas a idosos e que há necessidade de iniciar medidas preventivas mais precocemente. Os dois estudos mostraram magnitudes semelhantes de ocorrência de quedas acidentais e reforçaram sua multifatorialidade. Além disso, a hiperuricemia pode ser um potencial novo fator associado a quedas.

ABSTRACT OBJECTIVE To estimate the prevalence of accidental falls in women and to identify possible associations of sociodemographic, clinical and lifestyle variables with falls, in 2007 and 2014. METHODS Two cross-sectional studies were performed, in 2007 and 2014, within the Projeto de Saúde de Pindamonhangaba (PROSAPIN – Pindamonhangaba Health Project), with women aged between 35 to 75 years. Probabilistic samples were selected among women living in the municipality and participating in the Health Family Strategy. Data collection included: face-to-face interview, anthropometric examination and blood test. The outcome variable “have you fallen in the last six months?” was raised during the interview. The prevalence of falls in 2007 and 2014 were estimated by score with a 95% confidence interval (95%CI). Multiple logistic regression models were constructed to identify the association of independent variables with the occurrence of falls for each year based on the odds ratio (OR). We used the Stata 14.0 software for statistical analysis. RESULTS The prevalence of accidental falls were: 17.6% (95%CI 14.9–20.5) in 2007 and 17.2% (95%CI 14.8–19.8) in 2014. In 2007, factors associated with falls were: aged 50–64 years (OR = 1.81; 95%CI 1.17–2.80), high school (OR = 1.76; 95%CI 1.06–2.93), hyperuricemia (OR = 3.74; 95%CI 2.17–6.44), depression (OR = 2.07; 95%CI 1.31–3.27), poor sleep (OR = 1.78; 95%CI 1.12–2.82) and daytime sleepiness (OR = 1.86; 95%CI 1.16–2.99). In 2014, they were: aged 50–64 years (OR = 1.64; 95%CI 1.04–2.58), hyperuricemia (OR = 1.91; 95%CI 1.07–3.43) and depression (OR = 1.56; 95%CI 1.02–2.38), plus metabolic syndrome (OR = 1.60; 95%CI 1.03–2.47) and musculoskeletal pain (OR = 1.81; 95%CI 1.03–3.18). CONCLUSIONS Falls occur significantly in women aged 50 years or over, indicating that they are not restricted to older adults and that there is a need to initiate preventive measures earlier. Both studies showed similar magnitudes of occurrence of accidental falls and reinforced their multifactorial nature. In addition, hyperuricemia may be a potential new factor associated with falls.

https://doi.org/10.11606/s1518-8787.2020054002579 369 downloads

Accidental falls in middle-aged women
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Stolt, Lígia Raquel Ortiz Gomes

; Kolish, Daniel Vieira

; Cardoso, Maria Regina Alves

; Tanaka, Clarice

; Vasconcelos, Erika Flauzino Silva

; Pereira, Elaine Cristina

; Dellú, Máyra Cecilia

; Pereira, Wendry Maria Paixão

; Aldrighi, José Mendes

; Schmitt, Ana Carolina Basso

Revista de Saúde Pública

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2020, Volume 54 elocation 141

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2020054002579

Evaluating the psychometric properties of the iconographical falls efficacy scale (ICON-FES)
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Moreira, Ana Carolina Silva de Souza

; Mazo, Giovana Zarpellon

; Vieira, Mariluce Poerschke

; Machado, Deyse Borges

; Cardoso, Fernando Luiz

; Carvalho, Raquel Vieira Costa de

; Cruz, Roberto Moraes

Clinics

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2020, Volume 75 elocation e1427

Abstract: En | Text: En | PDF: En

OBJECTIVE: This study aims to analyze the construct and content validity of the Iconographical Falls Efficacy Scale (Icon-FES) in order to measure the fear of falling in community-dwelling older adults. METHODS: The Icon-FES was applied to 333 older adults. An exploratory factor analysis was performed to assess internal consistency. Item response theory (IRT) and confirmatory factor analysis (CFA) were used to evaluate the consistency of the questionnaire and whether it corresponded satisfactorily to the construct “concern about falling.” Concurrent validity with the Falls Efficacy Scale-International (FES-I) and convergent validity with the Senior Fitness Test (SFT) were also assessed. Receiving operator characteristic (ROC) curves were used to determine the sensitivity and specificity. RESULTS: The structural model of the 30-item and 10-item Icon-FES showed some theoretical fragility. The final model of the new short version of the Icon-FES consisted of 13 items, yielding a theoretically satisfactory structural model. Validity analyses indicated that the 13-item Icon-FES had a moderate relationship with the SFT, a strong relationship with the FES-I, and good sensitivity and specificity for a history of falls. CONCLUSION: The 13-item Icon-FES has excellent psychometric properties for measuring fear of falling in community-dwelling older adults. It can be recommended as a screening tool for fear of falling for both research and clinical purposes.

https://doi.org/10.6061/clinics/2020/e1427 771 downloads

Increase in fall-related hospitalization, mortality, and lethality among older adults in Brazil
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Stolt, Lígia Raquel Ortiz Gomes

; Kolisch, Daniel Vieira

; Tanaka, Clarice

; Cardoso, Maria Regina Alves

; Schmitt, Ana Carolina Basso

Revista de Saúde Pública

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2020, Volume 54 elocation 76

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Estimar as tendências de internação, mortalidade e letalidade por quedas em idosos no Brasil e regiões. MÉTODOS Estudo descritivo realizado a partir de dados do Sistema de Informações Hospitalares do Sistema Único de Saúde. Foram incluídos os registros de todos os idosos, a partir de 60 anos, internados por quedas acidentais entre janeiro de 1998 e novembro de 2015 em todas regiões do Brasil. Foram selecionados os códigos E885, E886, E880, E884, E888 e W01, W03, W10, W17, W18 da Classificação Internacional de Doenças (CID), 9ª e 10ª revisão respectivamente, e calculadas as taxas de internação e mortalidade por quedas por 100.000 habitantes, além da letalidade. Para cálculo de tendências, usou-se o procedimento de Prais-Winsten de autorregressão para análise de séries temporais. RESULTADOS Foram realizadas 1.192.829 internações por quedas no período, ocorreram 54.673 desfechos fatais, e a letalidade foi de 4,5%. As taxas de internação apresentaram tendências crescentes, com sazonalidade, no Brasil e nas regiões Nordeste, Centro-Oeste e Sul (taxas de crescimento de 11%, 44%, 13% e 14%, respectivamente). No Norte, a taxa de internação foi decrescente, e no Sudeste foi estacionária (taxas de crescimento: 48% e 3%). CONCLUSÕES Houve tendência crescente de internações, mortalidade e letalidade por quedas em idosos entre 1998 e 2015 no Brasil, com picos sazonais no segundo e terceiro trimestres. É necessário aprimorar tanto a assistência hospitalar quanto incentivar programas de prevenção de quedas em idosos, visto que estamos em plena transição demográfica.

ABSTRACT OBJECTIVE To estimate the trends of fall-related hospitalization, mortality, and lethality among older adults in Brazil and regions. METHODS This is a descriptive study based on data from the Hospital Information System of the Brazilian Unified Health System. We included records of every older adult, aged 60 years or older, hospitalized for accidental fall from January, 1998 to November, 2015 in all Brazilian regions. We selected the codes E885, E886, E880, E884, E884 from the International Classification of Diseases, 9th revision, and W01, W03, W10, W17, W18 from the 10th revision, and calculated fall-related hospitalization and mortality rates per 100,000 inhabitants, as well as lethality. To estimate trends, we applied the Prais-Winsten regression for time series analysis. RESULTS During the period, 1,192,829 fall-related hospitalizations occurred, among which 54,673 had a fatal outcome; lethality was 4.5%. Hospitalization rates showed upward trends, with seasonality, in Brazil (11%), and in the Northeast (44%), Midwest (13%), and South regions (14%). The North showed a decreasing hospitalization rate (48%), and the Southeast a stationary one (3%). CONCLUSIONS In Brazil, fall-related hospitalizations, mortality, and lethality among older adults showed an upward trend from 1998 to 2015, with seasonal peaks in the second and third quarters. Considering we are in plain demographic transition, to improve hospital healthcare and encourage falls prevention programs among older adults is essential.

https://doi.org/10.11606/s1518-8787.2020054001691

Increase in fall-related hospitalization, mortality, and lethality among older adults in Brazil
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Stolt, Lígia Raquel Ortiz Gomes

; Kolisch, Daniel Vieira

; Tanaka, Clarice

; Cardoso, Maria Regina Alves

; Schmitt, Ana Carolina Basso

Revista de Saúde Pública

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2020, Volume 54 elocation 76

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.11606/s1518-8787.2020054001691 934 downloads

Memory impairments and increased GFAP expression in hippocampal astrocytes following hypercaloric diet in rats
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Bondan, Eduardo Fernandes

; Cardoso, Carolina Vieira

; Martins, Maria de Fátima Monteiro

; Otton, Rosemari

Arquivos de Neuro-Psiquiatria

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sep 2019, Volume 77 N. 9 Pages 601 - 608

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: A inflamação hipotalâmica e a superexpressão da proteína glial fibrilar ácida (GFAP) em astrócitos são bem descritas em animais obesos, assim como déficits cognitivos e de memória. Como o hipocampo desempenha importante papel na consolidação de informações, esta investigação teve como objetivo observar a função da memória e a expressão astrocitária da GFAP no hipocampo de ratos que receberam dieta hipercalórica ou normocalórica. Métodos: Ratos Wistar machos adultos receberam dieta rica em gordura (cafeteria) ou dieta padrão por 60 dias. No 61º dia, os ratos foram submetidos ao teste de reconhecimento de objetos (NOR) 3 e 24 horas após o primeiro contato com os objetos, para avaliação da memória de curto e de longo prazo, respectivamente. Após, os ratos foram eutanasiados e os encéfalos coletados para pesquisa imuno-histoquímica da expressão astrocitária de GFAP no hipocampo (áreas CA1, CA2 e CA3) e no hipotálamo (núcleos periventricular e arqueado). A reatividade astrocitária foi avaliada por morfometria. Diferentes depósitos de tecido adiposo branco e marrom foram pesados para calcular o índice de adiposidade. Resultados: A dieta hipercalórica aumentou o ganho de peso corporal, o índice de adiposidade, o peso do tecido adiposo branco (epididimal, subcutâneo e retroperitoneal) e marrom. Ratos alimentados com dieta hipercalórica apresentaram prejuízos na memória de curto e longo prazo no teste NOR e aumento da expressão de GFAP em astrócitos de todas as áreas hipotalâmicas e hipocampais analisadas. Conclusão: Esta astrogliose sugere que a resposta neuroinflamatória também ocorre no hipocampo, podendo estar envolvida nas perdas de memória observadas em animais obesos/com sobrepeso.

ABSTRACT Objective: Hypothalamic inflammation and glial fibrillary acidic protein (GFAP) overexpression in astrocytes are well described in obese animals, as are some cognitive and memory deficits. As the hippocampus plays important roles in the consolidation of information, this investigation aimed to observe the memory function and the astrocyte expression of GFAP in the hippocampus of rats that received either a hypercaloric or a normocaloric diet. Methods: Adult male Wistar rats received a high-fat (cafeteria) or a standard diet for 60 days. On the 61st day, the rats were submitted to the novel object recognition (NOR) test at three and 24 hours after the first contact with objects, to assess short-term and long-term memory, respectively. Thereafter, the rats were euthanized and their brains were collected for GFAP immunohistochemical investigation in the hippocampus (CA1, CA2, CA3 areas) and hypothalamus (periventricular and arcuate nuclei). Astrocytic reactivity was assessed by morphometry. Different white adipose tissue depots and brown adipose tissue were weighed to calculate the adiposity index. Results: The hypercaloric diet increased body weight gain, adiposity index, white adipose tissue weight (epididymal, subcutaneous and retroperitoneal) and brown adipose tissue weight. Rats fed with the hypercaloric diet showed short-term and long-term memory impairments in the NOR test, as well as increased GFAP expression in astrocytes from all analyzed hypothalamic and hippocampal areas. Conclusion: This astrogliosis suggests that the neuroinflammatory response also occurs in the hippocampus and may be involved in the memory losses observed in obese/overweight animals.

https://doi.org/10.1590/0004-282x20190091 2518 downloads

10.

Propentofylline reduces glial scar development following gliotoxic damage in the rat brainstem
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Bondan, Eduardo Fernandes

; Martins, Maria de Fátima Monteiro

; Dossa, Pietro Domingues

; Viebig, Lígia Bocamino

; Cardoso, Carolina Vieira

; Martins Júnior, João Lopes

; Bernardi, Maria Martha

Arquivos de Neuro-Psiquiatria

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sep 2016, Volume 74 N. 9 Pages 730 - 736

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A propentofilina é uma xantina que deprime a ativação das células gliais, cujas respostas contribuem para o dano neural durante inflamação. A injeção de brometo de etídio no sistema nervoso central induz a perda oligodendroglial e astrocitária, resultando em desmielinização, neuroinflamação e ruptura da barreira hematoencefálica. Os astrócitos sobreviventes apresentam vigorosa reação ao redor da lesão com aumento da imunorreatividade à proteína glial fibrilar ácida (GFAP). Objetivo Este estudo objetivou avaliar o efeito da propentofilina sobre a resposta astrocitária após injúria gliotóxica. Método Ratos Wistar foram injetados com brometo de etídio na cisterna basal e tratados ou não com propentofilina (12.5mg/kg/dia, intraperitoneal). Amostras do tronco encefálico foram coletadas dos 15 aos 31 dias pós-injeção do gliotóxico e processadas para estudo ultraestrutural e imuno-histoquímico para GFAP. Resultados e Conclusão Os resultados demonstram que a propentofilina reduziu a ativação astrocitária até o 21o dia, sugerindo que essa droga pode atuar na redução da cicatriz glial após injúria.

ABSTRACT Propentofylline is a xanthine derivative that depresses activation of glial cells, whose responses contribute to neural tissue damage during inflammation. Ethidium bromide injection into the central nervous system induces local oligodendroglial and astrocytic loss, resulting in primary demyelination, neuroinflammation and blood-brain barrier disruption. Surviving astrocytes present a vigorous reaction around the injury site with increased immunoreactivity to glial fibrillary acidic protein (GFAP). Objective This study aimed to evaluate the effect of propentofylline administration on astrocytic response following gliotoxic injury. Method Wistar rats were injected with ethidium bromide into the cisterna pontis and treated or not with propentofylline (12.5mg/kg/day, intraperitoneal) during the experimental period. Brainstem sections were collected from 15 to 31 days after gliotoxic injection and processed for GFAP immunohistochemistry. Results and Conclusion Results demonstrate that propentofylline decreased astrocytic activation until the 21st day, suggesting that this drug may have a role in reducing glial scar development following injury.

https://doi.org/10.1590/0004-282X20160108 1382 downloads

11.

Low Prevalance of Major Events Adverse to Exercise Stress Echocardiography
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Andrade, Stephanie Macedo

; Telino, Caio José Coutinho Leal

; Sousa, Antônio Carlos Sobral

; Melo, Enaldo Vieira de

; Teixeira, Carla Carolina Cardoso

; Teixeira, Clarissa Karine Cardoso

; Santana, Jaquiele Santos

; Mota, Igor Larchert

; Matos, Carlos José Oliveira de

; Oliveira, Joselina Luzia Menezes

Arquivos Brasileiros de Cardiologia

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aug 2016, Volume 107 N. 2 Pages 116 - 123

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento: A ecocardiografia sob estresse constitui metodologia validada para diagnóstico e estratificação de risco da doença arterial coronária. A ecocardiografia sob estresse físico (EEF) tem se destacado como a mais fisiológica dentre as modalidades de estresse, todavia sua segurança não está bem estabelecida. Objetivo: Estudar as complicações relacionadas à EEF e as variáveis clínicas e ecocardiográficas preditoras dessas ocorrências. Método: Estudo transversal composto por 10250 pacientes submetidos à EEF por conveniência, de janeiro de 2000 a junho de 2014. As arritmias cardíacas (AC) foram as complicações mais frequentemente encontradas durante o exame. Os voluntários foramdivididos em dois grupos, de acordo com a ocorrência de AC à EEF: grupo G1 - composto por pacientes que apresentaram AC e grupo G2 - formado por indivíduos que não exibiram tal complicação. Resultados: O grupo G1 com 2843 (27,7%) pacientes, e grupo G2 formado por 7407 (72,3%). Não foram registrados óbitos, infarto agudo do miocárdio, assistolia ou fibrilação ventricular. As extrassístoles supraventriculares (13,7%) e as ventriculares (11,5%) foram as AC predominantes. O grupo G1 apresentou idade média mais elevada, maior frequência de hipertensão arterial sistêmica e tabagismo, maiores dimensões da raiz da aorta e do átrio esquerdo (AE) e menor fração de ejeção do ventrículo esquerdo que o G2. O grupo G1 exibiu também, mais alterações isquêmicas (p < 0,001). As variáveis preditoras foram idade (RR 1,04; [IC] 95% 1,038 - 1,049) e AE (RR 1,64; [IC] 95% 1,448 - 1,872). Conclusão: A presente investigação demonstrou que a EEF é uma modalidade segura, ocorrendo apenas complicações não-fatais. Idade avançada e aumento da dimensão do AE são preditores da presença de arritmias cardíacas.

Abstract Background: Stress echocardiography is well validated for diagnosis and risk stratification of coronary artery disease. Exercise stress echocardiography (ESE) has been shown to be the most physiological among the modalities of stress, but its safety is not well established. Objective: To study the complications related to ESE and clinical and echocardiographic variables most commonly associated with their occurrence. Methods: Cross-sectional study consisting of 10250 patients submitted to ESE for convenience, from January 2000 to June 2014. Cardiac Arrhythmias (CA) were the most frequent complications observed during the examination. The volunteers were divided into two groups according to the occurrence of CA during ESE: G1 group, composed of patients who have CA, and G2 formed by individuals who did not show such complication. Results: Group G1, consisting of 2843 patients (27.7%), and Group G2 consisting of 7407 patients (72.3%). There was no death, acute myocardial infarction, ventricular fibrillation or asystole. Predominant CAs were: supraventricular extrasystoles (13.7%), and ventricular extrasystoles (11.5%). G1 group had a higher mean age, higher frequency of hypertension and smoking, larger aortic roots and left atrium (LA) and lower ejection fraction than G2. G1 group also had more ischemic changes (p < 0.001). The predictor variables were age (RR 1.04; [CI] 95% from 1.038 to 1.049) and LA (RR 1.64; [CI] 95% from 1.448 to 1.872). Conclusion: ESE proved to be a safe modality of stress, with non-fatal complications only. Advanced age and enlargement of the left atrium are predictive of cardiac arrhythmias.

https://doi.org/10.5935/abc.20160096 1658 downloads

12.

Inflammatory response of endothelial cells to hepatitis C virus recombinant envelope glycoprotein 2 protein exposure
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Urbaczek, Ana Carolina

; Ribeiro, Lívia Carolina de Abreu

; Ximenes, Valdecir Farias

; Afonso, Ana

; Nogueira, Camila Tita

; Generoso, Wesley Cardoso

; Alberice, Juliana Vieira

; Rudnicki, Martina

; Ferrer, Renila

; Fonseca, Luiz Marcos da

; Costa, Paulo Inácio da

Memórias do Instituto Oswaldo Cruz

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sep 2014, Volume 109 N. 6 Pages 748 - 756

Abstract: En | Text: En | PDF: En

The hepatitis C virus (HCV) encodes approximately 10 different structural and non-structural proteins, including the envelope glycoprotein 2 (E2). HCV proteins, especially the envelope proteins, bind to cell receptors and can damage tissues. Endothelial inflammation is the most important determinant of fibrosis progression and, consequently, cirrhosis. The aim of this study was to evaluate and compare the inflammatory response of endothelial cells to two recombinant forms of the HCV E2 protein produced in different expression systems (Escherichia coli and Pichia pastoris). We observed the induction of cell death and the production of nitric oxide, hydrogen peroxide, interleukin-8 and vascular endothelial growth factor A in human umbilical vein endothelial cells (HUVECs) stimulated by the two recombinant E2 proteins. The E2-induced apoptosis of HUVECs was confirmed using the molecular marker PARP. The apoptosis rescue observed when the antioxidant N-acetylcysteine was used suggests that reactive oxygen species are involved in E2-induced apoptosis. We propose that these proteins are involved in the chronic inflammation caused by HCV.

https://doi.org/10.1590/0074-0276140090 1803 downloads

13.

Anestesia em paciente com saturnismo: relato de caso
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Lima, Luís Mauro Alvim de

; Resende, Flávio Castro

; Santos, Ana Carolina Janiques dos

; Terra, Patricia Pimentel Duarte Rodrigues

; Pantoja, Alberto Vieira

; Resende, Marco Antonio Cardoso de

Revista Brasileira de Anestesiologia

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dec 2012, Volume 62 N. 6 Pages 866 - 868

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

JUSTICATIVA E OBJETIVOS: O saturnismo decorre da intoxicação crônica pelo chumbo, comum após exposição ocupacional. Projéteis retidos no corpo podem resultar em elevados níveis plasmáticos de chumbo com inúmeras repercussões clínicas, principalmente neurológicas. Apresentamos um caso de paciente sintomático, sem diagnóstico, que foi detectado durante visita pré-anestésica. RELATO DO CASO: Paciente apresentado para retirada de projétil alojado em joelho esquerdo há 14 anos, com polineuropatia sem investigação. Durante visita pré-anestésica foi levantada a hipótese de saturnismo, confirmada pelos altos níveis plasmáticos de chumbo (129 µg.dL-1). A cirurgia foi realizada sob anestesia geral antes do início da quelação do chumbo. Durante indução anestésica, o paciente evoluiu com apneia, sem rigidez torácica após 50 µg de fentanil. CONCLUSÃO: A intoxicação por chumbo interfere com a função de diversos órgãos e sistemas, altera o metabolismo oxidativo e os mecanismos intracelulares de sinalização. O acometimento neurológico, com redução da condução neural merece especial atenção do anestesiologista.

BACKGROUND AND OBJECTIVES: Lead poisoning, also Saturnism, results from chronic lead poisoning, common after occupational exposure. Projectiles retained in the body may result in increased levels of plasma lead with numerous clinical implications, particularly neurological. We report a case of a symptomatic patient, undiagnosed, whose diagnosis was made during the preanesthesia evaluation. CASE REPORT: The patient was attended at our hospital to remove a bullet lodged in his left knee 14 years ago, presenting with polyneuropathy without investigation. During the preanesthetic visit, saturnism was hypothesized and confirmed by high plasma lead levels (129 µg.dL-1). Surgery was performed under general anesthesia before starting lead chelation. During anesthesia, the patient developed apnea, without chest-wall rigidity after administration of fentanyl (50 mg). CONCLUSION: Lead poisoning interferes with the function of various organs and systems, alters oxidative metabolism and intracellular signaling mechanisms. Neurological involvement, with reduced neural conduction, deserves special attention from anesthesiologists.

JUSTIFICATIVA Y OBJETIVOS: El saturnismo proviene de la intoxicación crónica por el plomo común después de la exposición ocupacional. Los proyectiles que el cuerpo retiene pueden traer como resultado elevados niveles plasmáticos de plomo con innumerables repercusiones clínicas, principalmente neurológicas. Presentamos aquí un caso de paciente sintomático, sin diagnóstico, y que fue detectado durante la visita preanestésica. RELATO DEL CASO: Paciente que se presentó para la retirada de una bala que se había alojado en la rodilla izquierda hacía 14 años, con polineuropatía sin investigación. Durante la visita preanestésica se pensó en saturnismo, lo que fue confirmado por los altos niveles plasmáticos de plomo (129 µg.dL-1). La cirugía fue realizada bajo anestesia general antes del inicio de la quelación del plomo. Durante la inducción anestésica, el paciente evolucionó con apnea sin rigidez torácica después de 50 µg de fentanilo. CONCLUSIONES: La intoxicación por plomo interfiere con la función de diversos órganos y sistemas, altera el metabolismo oxidativo y los mecanismos intracelulares de señalización. El compromiso neurológico, con la reducción de la conducción neural, merece una especial atención por parte del anestesiólogo.

9400 downloads

14.

Ozonized oils: a qualitative and quantitative analysis
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Guinesi, Adriana Simionatto

; Andolfatto, Carolina

; Bonetti Filho, Idomeo

; Cardoso, Arnaldo Alves

; Passaretti Filho, Juliano

; Farac, Roberta Vieira

Brazilian Dental Journal

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2011, Volume 22 N. 1 Pages 37 - 40

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A maioria dos problemas de origem endodôntica tem um agente etiológico bacteriano. Assim, existe um interesse permanente em se buscar substâncias químicas mais efetivas e que possam substituir o PMCC ou os antibióticos como curativos de demora. Dentre as possíveis substâncias, o ozônio apresenta algumas características biológicas interessantes: ação bactericida, efeito debridante, estímulo a angiogênese, além do efeito oxidante. O propósito do presente estudo foi avaliar quimicamente a presença de ozônio nos óleos de girassol, rícino, oliva e amêndoas, além do propilenoglicol, bem como subproputos da ozonização, como formaldeído. Essas substâncias foram ozonizadas, inseridas em tubetes anestésicos vazios e esterilizados, e analisadas por meio do teste da reação entre ozônio e índigo, para determinação da presença de ozônio; e teste do ácido cromotrópico, para determinação da presença de formaldeído. Foi observado ausência total de ozônio em todas as amostras testadas, além da presença de formaldeído. A ação bactericida e curativa dos óleos ozonizados poderia ser atribuída aos produtos formados pela ozonização de óleos minerais, como o formaldeído, e não ao ozônio propriamente dito.

Most of the problems of endodontic origin have a bacterial etiological agent. Thus, there is a continued interest in seeking more effective chemical substances that can replace the camphorated paramonochiorophenol or antibiotics as intracanal medicaments. Among the possible substances, ozone has some interesting biological characteristics: bactericidal action, debriding effect, angiogenesis stimulation capacity and high oxidizing power. The purpose of this study was to chemically evaluate the presence of ozone in sunflower, castor, olive and almond oil, as well as in propylene glycol and byproducts of ozonation, such as formaldehyde. These compounds were ozonized, inserted into empty and sterile vials, and analyzed by testing the reaction between ozone and indigo, for determining the presence of ozone, and subjected to the chromotropic acid test for determining the presence of formaldehyde. It was observed complete absence of ozone in all samples tested and presence of formaldehyde. The bactericidal and healing action of ozonized oils could be attributed to products formed by the ozonation of mineral oils, such as formaldehyde, not to the ozone itself.

8490 downloads

15.

ATP - bioluminescence as a technique to evaluate the microbiological quality of water in food industry
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Costa, Patrícia Dolabela

; Andrade, Nélio José de

; Passos, Frederico José Vieira

; Brandão, Sebastião César Cardoso

; Rodrigues, Carolina Gonçalves Freire

Brazilian Archives of Biology and Technology

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jul 2004, Volume 47 N. 3 Pages 399 - 405

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A qualidade microbiológica da água do manancial de captação para tratamento na ETA/UFV, da água de resfriamento de amônia e da água industrial de uso em um laticínio foi avaliada pela técnica de ATP-bioluminescência. Nas águas, foram efetuadas, também, as contagens de mesófilos aeróbios, expressos em UFC.mL-1 e coliformes totais, expressos em NMP.100 mL-1. Foi utilizado um luminômetro para os testes de determinação de ATP total e livre, expressos em Unidades Relativas de Luz (URL), nas diversas águas. O ATP microbiano foi determinado pela diferença entre o ATP total e livre. Em relação à água industrial, houve a concordância entre os métodos de bioluminescência e de contagem de mesófilos aeróbios e coliformes totais. As amostras de água de manancial e de resfriamento não apresentaram diferença (p>0,05), pelo teste de Tukey, para as quantidades de ATP total, livre e também para as contagens microbianas. Constataram-se concentrações diferentes de ATP microbiano para essas amostras de água. Os resultados indicam que o teste de ATP total é o mais recomendado para avaliar a qualidade microbiológica da água e sugerem que a qualidade físico-química da mesma pode afetar a formação de luz.

ATP-bioluminescence was used to evaluate the microbiological quality of water samples collected from the water supply, the water treatment system and from a dairy plant, including ammonia-cooling water and industrial water. For industrial water, there was relation between the ATP-bioluminescence technique and microbial count. There were no differences (p>0.05) between water supply and ammonia-cooling water samples for total and free ATP concentrations nor for the microbial counts. Different microbial ATP concentrations were found for these water samples. The results suggested that the physical chemical quality of ammonia cooling water decreased the RLU measurements slightly. It could be concluded that the total ATP concentration was the most effective technique to evaluate the microbiological quality of water used in the food indsutry by ATP-bioluminescence.

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