Phosphodiesterase Inhibition in the Treatment of Preeclampsia: What Is New?

PURPOSE OF REVIEW: The present study intends to review the possibility of using phosphodiesterase inhibitors as a treatment option for preeclampsia, addressing potential risks and benefits. RECENT FINDINGS: Preeclampsia is the most common hypertensive disorder of pregnancy, often responsible for severe maternal and fetal complications, which can lead to early pregnancy termination and death. Despite the numerous studies, its pathophysiology is still unclear, although it seems to involve a multiplicity of complex factors related to angiogenesis, ineffective vasodilation, oxidative stress, inflammatory cytokines, and endothelial dysfunction. It has been hypothetically suggested that the use of phosphodiesterase inhibitors is capable of improving placental and fetal perfusion, contributing to gestational scenario, by decreasing the symptomatology and severity of this syndrome. In this literature review, it has been found that most of the studies were conducted in animal models, and there is still lack of evidence supporting its use in clinical practice. Research in human indicates conflicting findings; randomized controlled trials were scarce and did not demonstrate any benefit in morbidity or mortality. Data regarding to pathophysiological and interventional research are described and commented in this review. The use of phosphodiesterase inhibitors in the treatment of preeclampsia is controversial and should not be encouraged taking into account recent data.

Phosphodiesterases and preeclampsia.

Antagonizing vasodilation has been considered one of the potential mechanisms underlying the pathophysiology of preeclampsia. Phosphodiesterases hydrolyze cGMP, interfering with the action of nitric oxide on vascular smooth muscle, thus causing vasoconstriction. We hypothesize that the phosphodiesterases in maternal plasma, phosphodiesterase-5 in particular, may be linked to clinical manifestations in preeclampsia syndrome.

Prevalência de Parasitoses em Idosos residentes e trabalhadores de Instituições de Longa Permanênciana Região Metropolitana de Porto Alegre e na Região Serrana do Rio Grande do Sul / Prevalence of Parasitosis in Elderly residents and Workers of Institutionsof Long Permanence in the Metropolitan Region of Porto Alegre and the Mountain Region of Rio Grande do Sul

Apesar dos enteroparasitos comprometerem o estado nutricional de idosos e a qualidade da saúde em geral, estudos abordandoocorrência e prevenção de parasitas intestinais, nesse segmento populacional, são escassos. O escopo do presente estudo éanalisar o perfil de enteroparasitos nos idosos institucionalizados e funcionários desses lares geriátricos, correlacionando-os comvariáveis sóciodemográficas, econômicas, hábitos de higiene e sintomatologia. Trata-se de um estudo transversal realizado emInstituições de Longa Permanência na Região Metropolitana de Porto Alegre e na Região Serrana do Rio Grande do Sul. Através daaplicação de questionários e coletas de amostras fecais, 12 lares geriátricos foram pesquisados e 200 amostras de fezes de idosos,com média de idade de 79,4±9,5 anos, foram analisadas pelo exame parasitológico de fezes (EPF). Também coletamos amostrasde 26 funcionários (com faixa etária entre 19 a 60 anos). Verificou-se prevalência de 4,0% de enteroparasitoses em relação aosidosos, sendo maior positividade encontrada nas mulheres 4,8% (n=7), enquanto nos homens 1,8% (n=1). Dos quais, 75,0%(n=6) correspondiam a Endolimax nana e 25,0% (n=2) a Entamoeba coli. Identificou-se nos funcionários, prevalência de 19,2%,dos quais 60,0% (n=3) correspondiam a E. nana, 20,0% (n=1) a E. coli e 20,0% (n=1) de biparasitismo. Evidenciamos condiçõespeculiares nestas duas regiões gaúchas. Pois o envelhecimento traz alguns desafios para a sociedade, exigindo implantação eefetivação de políticas públicas sociais e de saúde condizentes com a realidade. Assim, melhoraríamos a qualidade de vidadestes idosos e trabalhadores em relação as suas variáveis sociodemográficas, econômicas, hábitos de higiene e sintomatologia.(AU)

Despite enteroparasites compromise the nutritional status of the elderly and health care quality in general, studies addressingthe occurrence and prevention of intestinal parasites in this population segment are scarce. The scope of this study is to analyzethe enteroparasites profile in the elderly and employees working in long-term institutions, correlating them to sociodemographicand economic variables, hygiene habits and symptoms. It is a cross-sectional study in long-term institutions in the MetropolitanArea of Porto Alegre and in the Mountain Region of Rio Grande do Sul. Through the use of questionnaires and collection of stoolsamples, 12 long-term institutions were searched and 200 stool samples of feces, with an average of 79.4 ± 9.5 years old, wereanalyzed by Parasitological Examination of Stools. In addition, we collect 26 samples from employees (aged between 19-60years old). It was found a prevalence of 4.0% of intestinal parasites in relation to the elderly, the higher positivity found in women4.8% (n=7), while in men 1.8% (n= 1). Of which 75.0% (n=6) corresponded to Endolimax nana and 25.0% (n=2) Entamoebacoli. It was identified in employees, prevalence of 19.2%, of which 60.0% (n=3) accounted for E. nana, 20.0% (n=1) E. coli and20.0% (n=1) of hyperparasitism. Both regions show peculiar conditions, aging brings some challenges to society, demandingthe implementation and effectiveness of social policies of public health congruent to the current reality to improve the lifequality for elderly and workers regarding their sociodemographic variables, economic, hygienic habits and symptomatology.(AU)

Prevalência de Parasitoses em Idosos residentes etrabalhadores de Instituições de Longa Permanênciana Região Metropolitana de Porto Alegre e na Região Serrana do Rio Grande do Sul / Prevalence of Parasitosis in Elderly residents and Workers of Institutionsof Long Permanence in the Metropolitan Region of Porto Alegre and theMountain Region of Rio Grande do Sul

Apesar dos enteroparasitos comprometerem o estado nutricional de idosos e a qualidade da saúde em geral, estudos abordandoocorrência e prevenção de parasitas intestinais, nesse segmento populacional, são escassos. O escopo do presente estudo éanalisar o perfil de enteroparasitos nos idosos institucionalizados e funcionários desses lares geriátricos, correlacionando-os comvariáveis sóciodemográficas, econômicas, hábitos de higiene e sintomatologia. Trata-se de um estudo transversal realizado emInstituições de Longa Permanência na Região Metropolitana de Porto Alegre e na Região Serrana do Rio Grande do Sul. Através daaplicação de questionários e coletas de amostras fecais, 12 lares geriátricos foram pesquisados e 200 amostras de fezes de idosos,com média de idade de 79,4±9,5 anos, foram analisadas pelo exame parasitológico de fezes (EPF). Também coletamos amostrasde 26 funcionários (com faixa etária entre 19 a 60 anos). Verificou-se prevalência de 4,0% de enteroparasitoses em relação aosidosos, sendo maior positividade encontrada nas mulheres 4,8% (n=7), enquanto nos homens 1,8% (n=1). Dos quais, 75,0%(n=6) correspondiam a Endolimax nana e 25,0% (n=2) a Entamoeba coli. Identificou-se nos funcionários, prevalência de 19,2%,dos quais 60,0% (n=3) correspondiam a E. nana, 20,0% (n=1) a E. coli e 20,0% (n=1) de biparasitismo. Evidenciamos condiçõespeculiares nestas duas regiões gaúchas. Pois o envelhecimento traz alguns desafios para a sociedade, exigindo implantação eefetivação de políticas públicas sociais e de saúde condizentes com a realidade. Assim, melhoraríamos a qualidade de vidadestes idosos e trabalhadores em relação as suas variáveis sociodemográficas, econômicas, hábitos de higiene e sintomatologia.

Despite enteroparasites compromise the nutritional status of the elderly and health care quality in general, studies addressingthe occurrence and prevention of intestinal parasites in this population segment are scarce. The scope of this study is to analyzethe enteroparasites profile in the elderly and employees working in long-term institutions, correlating them to sociodemographicand economic variables, hygiene habits and symptoms. It is a cross-sectional study in long-term institutions in the MetropolitanArea of Porto Alegre and in the Mountain Region of Rio Grande do Sul. Through the use of questionnaires and collection of stoolsamples, 12 long-term institutions were searched and 200 stool samples of feces, with an average of 79.4 ± 9.5 years old, wereanalyzed by Parasitological Examination of Stools. In addition, we collect 26 samples from employees (aged between 19-60years old). It was found a prevalence of 4.0% of intestinal parasites in relation to the elderly, the higher positivity found in women4.8% (n=7), while in men 1.8% (n= 1). Of which 75.0% (n=6) corresponded to Endolimax nana and 25.0% (n=2) Entamoebacoli. It was identified in employees, prevalence of 19.2%, of which 60.0% (n=3) accounted for E. nana, 20.0% (n=1) E. coli and20.0% (n=1) of hyperparasitism. Both regions show peculiar conditions, aging brings some challenges to society, demandingthe implementation and effectiveness of social policies of public health congruent to the current reality to improve the lifequality for elderly and workers regarding their sociodemographic variables, economic, hygienic habits and symptomatology.

Morphological aspects of Monocercomonas sp. and investigation on probable pseudocysts occurrence.

Monocercomonas sp. is a flagellate protozoan found in the large intestine of snakes and in insects. Light microscopy revealed the measurements of morphological features of the trophozoites. Scanning electron microscopy showed in detail the emergence of the three anterior flagella, the recurrent flagellum, the axostyle, and the absence of undulating membrane. In addition, we described spherical forms which are probably pseudocysts. The investigation on the occurrence of this process was carried out through the incubation of Monocercomonas sp. trophozoites in several stressful conditions, such as pH change, nutrient depletion and different temperatures. Results revealed high pseudocyst formation at acidic pH values (4.0, 5.0, and 6.0), in absence of serum and in incubation at 37 degrees C. The occurrence of these pseudocystic forms in trichomonads life cycle is under investigation. This study describes the external structure of Monocercomonas sp., as demonstrated by light and scanning electron microscopy. Moreover, to our knowledge, this is the first time that formation of probable pseudocysts is shown in Monocercomonas sp., contributing to the research field on termite protozoa biology.

Characterization of an ecto-5'-nucleotidase (EC 3.1.3.5) activity in intact trophozoites of Trichomonas gallinae.

This study describes the enzymatic properties of an ecto-5'-nucleotidase in Trichomonas gallinae. The enzyme hydrolyzes nucleoside monophosphates at pH 7.2 and is activated by divalent cations, such as magnesium. Ecto-5'-nucleotidase activity was insensitive to levamisole, tetramisole (alkaline phosphatase inhibitors), and AMPCP (adenosine 5'-[alpha,beta-methylene]diphosphate), an ecto-5'-nucleotidase inhibitor, whereas 0.1mM ammonium molybdate (considered a potent inhibitor of 5'-nucleotidase activity) completely inhibited the enzyme activity. The apparent K(M) (Michaelis constant) and Vmax (maximum velocity) values for Mg2+-AMP were 466+/-57 microM and 3.7+/-0.59 nmolPi/min/10(6) trichomonads, respectively. Considering that trichomonads lack the ability to synthesize purines and pyrimidines de novo, the presence of an ecto-5'-nucleotidase in intact trophozoites of T. gallinae could be important in regulating the extracellular nucleotide levels and generating adenosine, essential for the survival strategies of the parasite.