Implantation of CPT1AM-expressing adipocytes reduces obesity and glucose intolerance in mice.

Obesity and its associated metabolic comorbidities are a rising global health and social issue, with novel therapeutic approaches urgently needed. Adipose tissue plays a key role in the regulation of energy balance and adipose tissue-derived mesenchymal stem cells (AT-MSCs) have gained great interest in cell therapy. Carnitine palmitoyltransferase 1A (CPT1A) is the gatekeeper enzyme for mitochondrial fatty acid oxidation. Here, we aimed to generate adipocytes expressing a constitutively active CPT1A form (CPT1AM) that can improve the obese phenotype in mice after their implantation. AT-MSCs were differentiated into mature adipocytes, subjected to lentivirus-mediated expression of CPT1AM or the GFP control, and subcutaneously implanted into mice fed a high-fat diet (HFD). CPT1AM-implanted mice showed lower body weight, hepatic steatosis and serum insulin and cholesterol levels alongside improved glucose tolerance. HFD-induced increases in adipose tissue hypertrophy, fibrosis, inflammation, endoplasmic reticulum stress and apoptosis were reduced in CPT1AM-implanted mice. In addition, the expression of mitochondrial respiratory chain complexes was enhanced in the adipose tissue of CPT1AM-implanted mice. Our results demonstrate that implantation of CPT1AM-expressing AT-MSC-derived adipocytes into HFD-fed mice improves the obese metabolic phenotype, supporting the future clinical use of this ex vivo gene therapy approach.

[Patient satisfaction in a laboratory test collection unit]. / Satisfação do paciente na unidade de coleta de exames laboratoriais.

This exploratory descriptive study aimed at identifying customer satisfaction attributes in the field of laboratory tests. Data were collected in 2006, using 104 interviews in a laboratorial unit inside a teaching hospital, using the critical incident technique, and submitted to content analysis. Three attribute categories were identified: time spent in waiting for care, interpersonal contact, and technical skills. These results subsidize the assessment of the current satisfaction survey tool, and point to its reformulation. They also allow the identification of improvement needs in customer attention, and provide elements to be taken into account in personnel selection, training programs, personnel performance assessment.

Satisfação do paciente na unidade de coleta de exames laboratoriais / Patient satisfaction in a laboratory test collection unit

O objetivo do estudo consistiu em identificar os atributos de satisfação do cliente na área de exames laboratoriais.Trata-se de uma pesquisa de caráter exploratório e descritivo. Os dados foram coletados em 2006, por meio deentrevistas em uma unidade de coleta de exames laboratoriais de um hospital universitário, utilizando a técnica doincidente crítico. Foram realizadas 104 entrevistas. Utilizando-se a análise de conteúdo, foram identificadas trêscategorias de atributos: rapidez/tempo de espera no atendimento; contato interpessoal e habilidade técnica. Osresultados podem subsidiar a avaliação do instrumento da pesquisa de satisfação utilizado na área, orientando areformulação do mesmo. Possibilitam ainda identificar necessidades de melhorias do atendimento aos clientes efornecem elementos a serem considerados na seleção de pessoal, nos programas de capacitação e na avaliação dedesempenho dos profissionais do setor.

El síndrome de Lyell. Cuidados de enfermería especializados / Lyell's syndrome. Specialized nursing care

La necrólisis epidérmica tóxica (NET) es una enfermedad exfoliativa de la piel que se asocia a una elevada mortalidad. Su fisiopatología es semejante a la de las quemaduras dérmicas superficiales extensas. El tratamiento y cuidado óptimo se lleva a cabo en unidades de grandes quemados, con especial atención a la resucitación con fluidos, soporte ventilatorio, identificación precoz de la sepsis e inmunosupresión con ciclosporina A. El abordaje de estos enfermos es multidisciplinar, y el papel de enfermería tiene una importancia fundamental en la identificación de signos de hipovolemia, vigilancia de la vía respiratoria, detección precoz de signos de infección e identificación de signos de dolor. Entre las medidas específicas de cuidados de enfermos con NET se encuentran los cuidados cutaneomucosos, para evitar secuelas invalidantes como la ceguera. Los cuidados de enfermería especializados contribuyen a aumentar el índice de supervivencia y a disminuir la incidencia de secuelas en estos enfermos

Toxic epidermal necrolysis (TEN) is an exfoliative skin disorder that is associated with a high mortality rate. Its pathophysiology is similar to that of superficial burn injuries. Treatment and optimal care of these patients are best performed in Intensive Care Burn Units, with special attention to fluid resuscitation, respiratory support, early identification of sings of sepsis, and immunosuppresive therapy with cyclosporin A. Approach to the treatment of TEN is multidisciplinary, and there is a central and fundamental role of nursing care, particularly in the identification of signs of hypovolemia, respiratory failure, infection and pain. Among the specific care required by these patients is the care of mucosal surfaces, to prevent serious sequelae such as blindness. Specialized nursing care of patients with TEN contributes to an increase in the survival rate and a decrease in the incidence of complications