The role of atenolol in the modulation of the expression of genes encoding pro- (caspase-1) and anti- (Bcl2L1) apoptotic proteins in endothelial cells exposed to intestinal ischemia and reperfusion in rats

Abstract Purpose: To investigate the role of atenolol in the gene expression of caspase 1 (Casp1) and Bcl2L1 on vascular endothelium of rat intestine after ischemia and reperfusion (IR). Methods: Eighteen adult male Wistar rats were randomly divided into 3 groups (n=6): SG (Sham group): no clamping of the superior mesenteric artery; IRG: IR plus saline group: IRG+At: IR plus Atenolol group. Rats from IRG and IRG+At were subjected to 60 min of intestinal ischemia and 120 min of reperfusion. Atenolol (2mg/kg) or saline were injected in the femoral vein 5 min before ischemia, 5 min and 55 min after reperfusion. Thereafter, intestinal segments were appropriately removed and processed for Endothelial Cell Biology Rat RT2 Profiler PCR Array. Results: the anti-apoptotic Bcl2L1 gene expression was significantly down-regulated (-1.10) in the IRG and significantly up-regulated in the IRG+At (+14.15). Meanwhile, despite Casp1 gene expression was upregulated in both groups, it was significantly higher in the IRG (+35.06) than the IRG+At (+6.68). Conclusions: Atenolol presents antiapoptotic effects on rat intestine subjected to IR partly by the up-regulation of the anti-apoptotic Bcl2L1 gene expression. Moreover, atenolol can mitigate the pro-apoptotic and pro-inflammatory effects of Casp1 gene on rat intestine after IR.

The role of atenolol in the modulation of the expression of genes encoding pro- (caspase-1) and anti- (Bcl2L1) apoptotic proteins in endothelial cells exposed to intestinal ischemia and reperfusion in rats.

PURPOSE: To investigate the role of atenolol in the gene expression of caspase 1 (Casp1) and Bcl2L1 on vascular endothelium of rat intestine after ischemia and reperfusion (IR). METHODS: Eighteen adult male Wistar rats were randomly divided into 3 groups (n=6): SG (Sham group): no clamping of the superior mesenteric artery; IRG: IR plus saline group: IRG+At: IR plus Atenolol group. Rats from IRG and IRG+At were subjected to 60 min of intestinal ischemia and 120 min of reperfusion. Atenolol (2mg/kg) or saline were injected in the femoral vein 5 min before ischemia, 5 min and 55 min after reperfusion. Thereafter, intestinal segments were appropriately removed and processed for Endothelial Cell Biology Rat RT2 Profiler PCR Array. RESULTS: the anti-apoptotic Bcl2L1 gene expression was significantly down-regulated (-1.10) in the IRG and significantly up-regulated in the IRG+At (+14.15). Meanwhile, despite Casp1 gene expression was upregulated in both groups, it was significantly higher in the IRG (+35.06) than the IRG+At (+6.68). CONCLUSIONS: Atenolol presents antiapoptotic effects on rat intestine subjected to IR partly by the up-regulation of the anti-apoptotic Bcl2L1 gene expression. Moreover, atenolol can mitigate the pro-apoptotic and pro-inflammatory effects of Casp1 gene on rat intestine after IR.

Olfactory alterations in patients with multiple sclerosis / Alterações de olfato em portadores de esclerose múltipla

ABSTRACT This cross-sectional study involves 100 multiple sclerosis (MS) and 100 non-MS patients, under the age of 60 years old, with nasal obstruction, traumatic brain injury, previous rhinoplasty or neurosurgery, and so forth. Objective To assess olfactory function using the Connecticut test and verify correlations between olfactory alteration, disease duration and the Expanded Disability Status Scale (EDSS). Methods One hundred MS patients and 100 healthy control patients responded to a questionnaire. Those with olfactory alteration underwent a facial CT to exclude other causes. Results Thirty-two percent of patients showed alterations, compared with 3% in the healthy control group. Patients having EDSS above 4, showed a 5.2-times increased risk of dysfunction. Patients over 38 years of age have a 2.2-times increased risk over younger patients. Conclusions Because MS patients are likely to experience olfactory alterations, this study is a useful tool in follow-up care, although more studies are necessary to evaluate the correlations in MS evolution.

RESUMO Estudo transversal em que pacientes portadores de esclerose múltipla (EM) do ambulatório do CATEM e controles saudáveis foram submetidos a avaliação de função olfativa. Objetivo Avaliar a função olfativa através do teste de Connecticut (CCCRC) em pacientes com EM e verificar possível correlação entre a alteração de olfato com o tempo de doença e o Expanded Disability Status Scale (EDSS). Métodos No total, 100 pacientes com EM e 100 pacientes controles participaram do estudo. Aqueles que apresentaram alteração de olfato realizaram TC de face para excluir outras possíveis causas para a alteração olfativa. Resultados 32% apresentaram alterações do olfato, enquanto apenas 3% dos controles apresentaram semelhante alteração. Obtendo-se uma correlação entre o EDSS e alteração olfatória para pacientes com EDSS acima de 4. Pacientes com mais de 38 anos apresentam 2,2 vezes mais risco de ter alterações no olfato. Conclusões Neste estudo observou-se que a alteração olfativa está presente nos pacientes portadores de EM e essa alteração pode ser uma ferramenta útil no acompanhamento desses pacientes.

[The academic background of the physician and the communication of a patient's death to family members]. / O preparo do médico e a comunicação com familiares sobre a morte.

UNLABELLED: Communicating the death of a patient always brings about a certain degree of insecurity in the physician. METHODS: To evaluate this issue, 121 family members of patients who died at our hospital as well as the professional who conveyed the information were interviewed. RESULTS: We verified that 12.1% of the families disapproved of how they were told about the death, and that 26.4% did not receive any attention at all from the medical staff. Physicians find that the most difficult situations arise when they have to notify the death of young patients (43.3%), death from an acute disease (56.6%), and when the family does not understand the situation (17%). Only 18.9% of the professionals considered their academic background adequate on this subject. CONCLUSION: Communication between the medical staff and the family members should take place after the death. The more difficult cases require a good relationship between the parties. Training of the professionals on the subject should be improved since it directly affects how family and relatives are dealt with.

O preparo do médico e a comunicação com familiares sobre a morte / The academic background of the physician and the communication of a patient's death to family members

OBJETIVO: A abordagem deste tema e o relacionamento com familiares de pacientes que faleceram sempre causaram inseguranças ao profissional. MÉTODOS: Para avaliar esta questão foram entrevistados 121 familiares de pacientes que vieram a óbito no nosso hospital e os profissionais que deram informações sobre o óbito. RESULTADOS: Verificamos que 12,1 por cento dos familiares reprovaram a forma pela qual foram avisados do falecimento e 26,4 por cento não receberam qualquer atenção da equipe médica. Para os médicos, as situações mais difíceis de se conversar com a família são principalmente casos de paciente jovens (43,4 por cento), morte por quadro agudo (56,6 por cento) e quando a família não entende o caso (17 por cento). Apenas 18,9 por cento dos profissionais consideram a formação acadêmica sobre o assunto adequada. CONCLUSÃO: A comunicação entre equipe e familiares deve existir após o óbito e casos de maior dificuldade necessitam de um bom relacionamento dos profissionais com a família. A formação deve ser melhorada, pois reflete diretamente sobre a forma de lidar com familiares.