Serotonin transporter-deficient mice display enhanced adipose tissue inflammation after chronic high-fat diet feeding.

Introduction: Serotonin is involved in leukocyte recruitment during inflammation. Deficiency of the serotonin transporter (SERT) is associated with metabolic changes in humans and mice. A possible link and interaction between the inflammatory effects of serotonin and metabolic derangements in SERT-deficient mice has not been investigated so far. Methods: SERT-deficient (Sert -/-) and wild type (WT) mice were fed a high-fat diet, starting at 8 weeks of age. Metabolic phenotyping (metabolic caging, glucose and insulin tolerance testing, body and organ weight measurements, qPCR, histology) and assessment of adipose tissue inflammation (flow cytometry, histology, qPCR) were carried out at the end of the 19-week high-fat diet feeding period. In parallel, Sert -/- and WT mice received a control diet and were analyzed either at the time point equivalent to high-fat diet feeding or as early as 8-11 weeks of age for baseline characterization. Results: After 19 weeks of high-fat diet, Sert -/- and WT mice displayed similar whole-body and fat pad weights despite increased relative weight gain due to lower starting body weight in Sert -/-. In obese Sert -/- animals insulin resistance and liver steatosis were enhanced as compared to WT animals. Leukocyte accumulation and mRNA expression of cytokine signaling mediators were increased in epididymal adipose tissue of obese Sert -/- mice. These effects were associated with higher adipose tissue mRNA expression of the chemokine monocyte chemoattractant protein 1 and presence of monocytosis in blood with an increased proportion of pro-inflammatory Ly6C+ monocytes. By contrast, Sert -/- mice fed a control diet did not display adipose tissue inflammation. Discussion: Our observations suggest that SERT deficiency in mice is associated with inflammatory processes that manifest as increased adipose tissue inflammation upon chronic high-fat diet feeding due to enhanced leukocyte recruitment.

Fatores de risco para mortalidade em idosos admitidos em unidade de terapia intensiva de hospital público / Risk factors for mortality in geriatric patients admitted to the intensive care unit at a public hospital

OBJETIVO: Avaliar fatores de risco para mortalidade em pacientes idosos com internação em uma unidade de terapia intensiva (UTI). MÉTODOS: Foram estudados pacientes idosos admitidos em UTI, em um estudo de coorte histórica. Foi realizada amostragem de conveniência de todos os pacientes com 60 anos ou mais, internados nos 20 leitos de uma UTI de um hospital de alta complexidade. Foi realizada análise de regressão de Cox para estimar os fatores de risco associados à mortalidade. O nível de significância utilizado foi de 5%. RESULTADOS: A proporção de pacientes idosos representou 45% das admissões em UTI no período. A mortalidade hospitalar foi de 38,4%. A variável pós-operatório de cirurgia de urgência e os escores Acute Physiology and Chronic Health Evaluation (APACHE II) e Sequential Organ Failure Assessment (SOFA) da admissão foram identificados como fatores de risco independentes para mortalidade hospitalar. CONCLUSÃO: Os fatores de risco associados à mortalidade foram os escores APACHE II e SOFA da admissão e pós-operatório de cirurgia de urgência.

OBJECTIVE: To evaluate risk factors for mortality in geriatric patients admitted to an intensive care unit (ICU). METHODS: We studied older patients admitted to the ICU in a historical cohort study. Convenience sampling was performed for all patients aged 60 years or older, admitted to the 20 beds of an ICU of a highly complex hospital. Cox regression analysis was performed to estimate risk factors associated with mortality. The significance level used was 5%. RESULTS: The proportion of geriatric patients represented 45% of ICU admissions in the period. In-hospital mortality was 38.4%. The postoperative emergency surgery variable and the Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) admission scores were identified as independent risk factors for in-hospital mortality. CONCLUSION: Risk factors associated with mortality were APACHE II and SOFA scores for admission and postoperative emergency surgery.