Endothelin-1 receptors play a minor role in the protection against acute Trypanosoma cruzi infection in mice.

Chagas' disease, caused by the protozoan Trypanosoma cruzi, is a major cause of cardiovascular disability in countries where it is endemic. Damage to the heart microvasculature has been proposed to be an important factor in the pathogenesis of heart dysfunction. Endothelin-1 (ET-1) is a potent vasoconstrictor and exerts its effects via specific ET A and ET B receptors. A few studies have suggested a role for ET-1 and its receptors in the pathogenesis of Chagas' disease. We investigated the effects of treatment with bosentan, an ET A/ET B receptor antagonist, on the course of T. cruzi infection (Y strain) in C57Bl/6 mice. Treatment with bosentan (100 mg kg-1 day-1) was given per os starting day 0 after infection until sacrifice. Bosentan significantly increased myocardial inflammation, with no effects on parasitemia. Although the total number of nests was similar, a lower number of intact amastigote nests was found in the heart of bosentan-treated animals. Bosentan failed to affect the infection-associated increase in the cardiac levels of the cytokines IFN-g and TNF-a and the chemokines CCL2/MCP-1, CCL3/MIP-1a and CCL5/RANTES. In vitro, pre-incubation with ET-1 (0.1 microM) 4 h before infection enhanced the uptake of the parasites by peritoneal macrophages, and this effect was abrogated when macrophages were pre-treated with bosentan (1 microM) 15 min before incubation with ET-1. However, ET-1 did not alter killing of intracellular parasites after 48 h of in vitro infection. Our data suggest that bosentan-treated mice have a delay in controlling parasitism which is compensated for exacerbated inflammation. Infection is eventually controlled in these animals and lethality is unchanged, demonstrating that ET-1 plays a minor role in the protection against acute murine T. cruzi infection.

Endothelin-1 receptors play a minor role in the protection against acute Trypanosoma cruzi infection in mice

Chagas' disease, caused by the protozoan Trypanosoma cruzi, is a major cause of cardiovascular disability in countries where it is endemic. Damage to the heart microvasculature has been proposed to be an important factor in the pathogenesis of heart dysfunction. Endothelin-1 (ET-1) is a potent vasoconstrictor and exerts its effects via specific ET A and ET B receptors. A few studies have suggested a role for ET-1 and its receptors in the pathogenesis of Chagas' disease. We investigated the effects of treatment with bosentan, an ET A/ET B receptor antagonist, on the course of T. cruzi infection (Y strain) in C57Bl/6 mice. Treatment with bosentan (100 mg kg-1 day-1) was given per os starting day 0 after infection until sacrifice. Bosentan significantly increased myocardial inflammation, with no effects on parasitemia. Although the total number of nests was similar, a lower number of intact amastigote nests was found in the heart of bosentan-treated animals. Bosentan failed to affect the infection-associated increase in the cardiac levels of the cytokines IFN-g and TNF-a and the chemokines CCL2/MCP-1, CCL3/MIP-1a and CCL5/RANTES. In vitro, pre-incubation with ET-1 (0.1 æM) 4 h before infection enhanced the uptake of the parasites by peritoneal macrophages, and this effect was abrogated when macrophages were pre-treated with bosentan (1 æM) 15 min before incubation with ET-1. However, ET-1 did not alter killing of intracellular parasites after 48 h of in vitro infection. Our data suggest that bosentan-treated mice have a delay in controlling parasitism which is compensated for exacerbated inflammation. Infection is eventually controlled in these animals and lethality is unchanged, demonstrating that ET-1 plays a minor role in the protection against acute murine T. cruzi infection.

[Comparative analysis of attributional style and self-esteem in a sample of depressed patients and normal control subjects]. / Análisis comparativo del estilo atribucional y de la autoestima en una muestra de pacientes depresivos y sujetos control normales.

INTRODUCTION: The present study assesses the role of attributions and self-esteem in depressive states. In depression, attributions can become central biased coping mechanisms that guide individual behavior. METHODS: Self-esteem and attribution bias was assessed in 40 depressed and 80 normal controls. RESULTS: Results of this investigation show that depressed patients made more internal attributions to negative events, and more external attributions for positive events than their normal counterparts, confirming an exaggerated attributional bias. CONCLUSIONS: The results suggest that depressed patients tend to blame themselves for their mistakes. Depressed patients made more stable and global attributions for negative events than for positive events, as opposed to what happens with the normal controls, making us believe that this bias will be maintained in time, and will eventually generalize to other life areas. This kind of study seems useful to develop efficient treatment programs and evaluation tools of depression.

Emotion recognition in psychotherapy: impact of therapist level of experience and emotional awareness.

Accurately identifying another person's emotional state is an ability that may be necessary for a psychotherapist to empathize with a patient and that may be required for obtaining valid and reliable psychotherapy process ratings in research. Accuracy of identifying emotions and of rating emotional intensity expressed by a patient was studied in a comparison of 36 experienced therapists and 36 undergraduate psychology students who intended to become psychotherapists. Representative segments of a psychotherapy session were presented in one of three ways to tease apart the relative importance of verbal and nonverbal cues in making accurate ratings. Accuracy was judged against ratings supplied by two experienced and prestigious clinicians based on the same therapy sample. Results indicated that although therapists were more accurate than nontherapists in identifying emotions, they did not differ in the accuracy of rating emotional intensity. Moreover, accuracy of ratings was found to be less reliant on verbal cues among psychotherapists than among nontherapists. Finally, levels of participants' personal awareness of their own emotions had a positive impact on the accuracy of identifying specific emotions but not on the accuracy of rating their intensity.

Cognitive narrative psychotherapy: research foundations.

There has been an increased interest in the study of language processes in psychotherapy. More recently, research and theoretical formulations of the therapeutic process suggested that we must move from the microscopic study of verbal modes to a macroscopic approach in which these modes are organized into narratives. Narratives are conceived, in this perspective, as the basic instruments for meaning making. In this article the research on narrative processes in psychotherapy is reviewed and discussed in terms of its implications for the theory and practice of cognitive narrative psychotherapy. Additionally some of the main data coming from research projects on cognitive narrative psychotherapy are presented.

Sobrevida de pacientes diabéticos em diálise / Survival of diabetic patients in dialysis

OBJETIVO. Diabetes melito é uma causa de insuficiência renal terminal de importância crescente. Nosso objetivo foi avaliar a sobrevida depacientes diabéticos e näo-diabéticos em tratamento dialítico. MATERIAL E MÉTODOS. Foram estudados 295 pacientes em programa de diálise em um centro de referência terciário na cidade de Säo Paulo, entre 1992 e 1994. Setenta e um paciente eram diabéticos (17 do tipo I e 54 do tipo II) e 224 tinham outros diagnósticos dedoença de base. Os dados foram coletados prospectivamente através de formuláriospadronizados, e também retrospectivamente, para pacientes que iniciaram tratamento entre 1992 e junho 1993. Análise de sobrevida foi realizada por meio do método do produto limite. RESULTADOS. Os pacientes diabéticos apresentavam média de idade mais elevada e uma maior proporçäo utilizava diálise peritoneal em relaçäo aos näo-diabéticos. Após um ano, a taxa de sobrevida foi 67 por cento e 86 por cento para pacientes diabéticos e näo-diabéticos (p<0,0001). A diferença de sobrevida se acentuou com a duraçäo do tratamento. Esta diferença foi observada tantoem pacientes mais jovens (ó50 anos) quanto nos mais idosos, embora tenha sido mais precoce nos primeiros. A sobrevida dos diabéticos permaneceu significantemente reduzida, ajustando-se para a idade dos pacientes. CONCLUSÖES. Pacientes diabéticos em diálise apresentam taxa de sobrevida inferior aos näo-diabéticos, independentemente da sua idade média mais elevada. Cuidados especiais devem ser dedicados a estes pacientes, tanto em relaçäo a fatores co-mórbidos pré-diálise quanto durante o tratamento dialítico, a fim de se melhorar a sua sobrevida.

[Survival of dialyzed diabetic patients]. / Sobrevida de pacientes diabéticos em diálise.

OBJECTIVE: Diabetes is a cause of end-stage renal failure of increasing importance. Our aim was to evaluate the survival of diabetic and non-diabetic patients on dialysis treatment. MATERIAL AND METHODS: Two hundred and ninety-five patients on dialysis program in a tertiary referral center of the São Paulo city, from 1992-94, were studied. Seventy-one patients were diabetics (17 type I and 54 type II) and 224 had other diagnoses of renal disease. Data were prospectively collected using standard questionnaires and also retrospectively for patients who started treatment between 1992 and June 1993. Survival analysis was done using the product-limit method. RESULTS: Diabetic patients had a greater mean age and a higher proportion on peritoneal dialysis than non-diabetics. After one year, survival rates were 67% and 86% for diabetics and non-diabetics (p < 0.0001). The difference in survival rates increased with the duration of treatment. This difference was observed both in young (< or = 50 years) and in elderly patients, although it has been noted earlier in the former. Survival of diabetics remained significantly reduced adjusting for the age of the patients. CONCLUSIONS: Diabetic patients on dialysis have lower survival rates than non-diabetics, independently of their greater mean age. Special attention should be given to these patients, both in relation to pre-dialysis comorbidity and during dialysis treatment, to improve their survival experience.