RESUMO
Previous studies have failed to explain why the mortality rate of cancer patients is higher in Poland than other countries in the European Union. We aimed to evaluate the health care system in Poland during the diagnosis and treatment of cancer. In this multicentre study, 125 cancer patients treated at 15 centres across Poland participated in focus group interviews in 2014. We identified and assessed crucial elements that affect a patients' experience from the early onset of symptoms, through to diagnosis and treatment. We found that the majority of patients were dissatisfied with the length of time taken to diagnose cancer. Throughout diagnosis, treatment and follow-up, patients reported a lack of communication from health care professionals. While dealings with oncologists and medical staff were viewed favourably, patients felt the cancer centres were not well organised. Patients recommended that having one doctor in charge of an individual's treatment and follow-up would improve patient care and well-being. A late cancer diagnosis may be contributing to the high mortality rate observed in Poland. In the future, new policies should be developed to reduce the time to cancer diagnosis, increase communication with health care professionals and improve the organisation of cancer care for patients.
Assuntos
Atitude Frente a Saúde , Institutos de Câncer/organização & administração , Comunicação , Diagnóstico Tardio , Pessoal de Saúde , Neoplasias/diagnóstico , Satisfação do Paciente , Adulto , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias/terapia , Relações Médico-Paciente , Polônia , Pesquisa Qualitativa , Fatores de TempoRESUMO
In this study, emulsions of three different natural oils were prepared using spontaneous emulsification technique. The effect of three emulsifiers, AOT, lecithin and cholesterol on emulsion properties was studied. Their influence on interfacial tension at oil/water interface was evaluated by the pendant drop shape analysis method. Then, the mean droplet size, zeta potential and stability of emulsions were investigated in relation with the type of oil, surfactant, oil-to-ethanol ratio and surfactant concentration. We found that in the case of linseed oil, fine emulsion droplets are formed without any surfactant due to its low oil/water interfacial tension. A hydrophobic dye (Coumarin 6) was encapsulated within oil cores and its presence was confirmed by fluorescence spectroscopy and microscopy. The obtained emulsions can be used alone or as the cores for layer-by-layer encapsulation, which was demonstrated by enclosing droplets within first layer of synthetic polycation poly(allyamine hydrochloride) (PAH).
Assuntos
Emulsificantes/química , Emulsões/química , Óleo de Semente do Linho/química , Óleo de Soja/química , Ceras/química , Colesterol/química , Composição de Medicamentos , Lecitinas/química , Tensão SuperficialRESUMO
BACKGROUND AND AIM: Adiponectin is an anti-inflammatory protein secreted almost exclusively by adipocytes which improves insulin sensitivity and presents antiatherogenic properties. Plasma adiponectin concentration is almost 3 times higher in hemodialysis patients and markedly decreased after successful kidney transplantation. However, until now, there are no studies analyzing plasma adiponectin concentration in kidney transplant patients (KTx) during the long-term period after transplantation. Therefore, the aim of present study was to examine plasma adiponectin concentration in KTx patients during the wide range of time after transplantation. MATERIAL AND METHOD: Single center, cross-sectional study including 228 KTx adult recipients (143 M and 85 F) with estimated glomerular filtration rate (eGFR) > or = 15 ml/min, 80 hemodialysis patients (34 M and 46 F) and 52 healthy subjects (33 M and 19 F). Plasma adiponectin concentration was estimated together with HOMA-IR (homeostasis model assessment insulin resistance index) and plasma lipid profile. RESULTS: In KTx patients plasma adiponectin concentration 14.0 (13.1-15.0) microg/ml was significantly (p < 0.001), lower than in hemodialysis ones 29.0 (24.7-33.3) microg/ml, however, significantly (p < 0.001) higher than in healthy subjects 10.1 (8.8-11.5) microg/ml. Among KTx patients the highest plasma adiponectin concentration was observed in the subgroup of patients surviving with the functioning graft more than 8 years after transplantation. In KTx patients, significant, negative correlations were found between plasma adiponectin concentration and BMI (p = 0.017), HOMA-IR (p = 0.02) and estimated GFR (p < 0.009), respectively. Multiple regression analysis performed in the group of KTx patients, with plasma adiponectin concentration as the dependent variable and BMI, age, gender, estimated GFR as independent variables showed that in this model (R2 = 0.09) plasma adiponectin concentration significantly depends on BMI (p = 0.035), gender (p = 0.004) and eGFR (p = 0.023). CONCLUSIONS: Patients with long-term renal graft survival are characterized by a higher plasma adiponectin concentration. Kidney graft function (assessed as estimated GFR) is an important factor influencing plasma adiponectin concentration.
Assuntos
Adiponectina/sangue , Transplante de Rim/fisiologia , Adulto , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Imunossupressores/uso terapêutico , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Diálise Renal , Fatores de TempoRESUMO
BACKGROUND: Cardiovascular diseases are among the most frequent causes of patient death after liver transplantation. The aim of this retrospective clinical study was to estimate the prevalence of arterial hypertension among patients after successful liver transplantation and the role of immunosuppressive drugs in the pathogenesis of hypertension in these patients. PATIENTS AND METHODS: A total of 88 patients (age 47â.5 ± â12.1 years; 33 women and 55 men) who had undergone successful liver transplantation and completed 24 months follow-up were studied. The results are presented as means with standard deviations. RESULTS: At 1, 12, and 24 months after liver transplantation, the prevalences of hypertension were 44.3%, 54.5%, and 62.5%, respectively. Systolic and diastolic blood pressure in these months were 124.1 ± 14.8, 132.8 ± 19.1, and 135.2 ± 17.3 mm Hg and 83.3 ± 12.0, 87.3 ± 11.1, and 87.9 ± 11.1 mm Hg, respectively. The estimated glomerular filtration rates were 77.8 ± 32.3, 80.3 ± 30.8, and 78.8 ± 29.1 mL/min/1.73 m(2), respectively. Arterial hypertension was significantly more frequent in patients treated with cyclosporine A than in those treated with tacrolimus (P = .004) or everolimus (P = .005). In patients treated with tacrolimus, a positive correlation was found between tacrolimus blood concentration and systolic blood pressure (R = 0.34; P = .01) and a negative correlation was found between estimated glomerular filtration rate and systolic blood pressure (R = -0.28; P = .02). CONCLUSIONS: Based on study findings, the following conclusions were drawn: arterial hypertension occurs in more than 50% of patients after liver transplantation (significantly higher frequency than in the general population); calcineurin inhibitors may participate in the pathogenesis of arterial hypertension in patients after successful liver transplantation; and the clinical importance of these findings and the influence on cardiovascular outcome of the liver transplant recipients need further investigation.
Assuntos
Hipertensão/induzido quimicamente , Imunossupressores/efeitos adversos , Transplante de Fígado/efeitos adversos , Adulto , Pressão Sanguínea/fisiologia , Inibidores de Calcineurina/efeitos adversos , Ciclosporina/efeitos adversos , Doença Hepática Terminal/etiologia , Doença Hepática Terminal/cirurgia , Everolimo/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/induzido quimicamente , Estudos Retrospectivos , Tacrolimo/efeitos adversosRESUMO
PURPOSE: Many hypertensive patients have other, usually long-term diseases. Antihypertensive therapy may interfere with these diseases and their therapies. In the present study, the possible interactions of the ACE-inhibitor perindopril with several of the most common long-term diseases was evaluated. PATIENTS AND METHODS: In a multicenter, double-blind, randomized, placebo-controlled trial, the effect of perindopril was evaluated in 490 patients with mild essential hypertension and any one of the following concomitant diseases: hyperlipidemia, type II diabetes mellitus, ischemic heart disease, cardiac arrhythmia, peripheral arterial occlusive disease, nephropathy with proteinuria, chronic obstructive pulmonary disease, or degenerative joint disease treated with nonsteroidal anti-inflammatory drugs (NSAIDs). After a 3-week single-blind placebo run-in, the patients received either perindopril (4 mg/d) or matching placebo for 6 weeks. RESULTS: Blood pressure was effectively reduced by perindopril irrespective of the associated disease. The rate of spontaneously reported side effects was low. Treatment with perindopril was free from adverse interactions with the concomitant diseases and therapies. Moreover, favorable actions could be observed in patients with ischemic heart disease (reduction of maximal ST-segment depression during peak exercise and decrease in the number of angina attacks), in patients with proteinuria (decrease in albuminuria in patients with normal serum creatinine levels), and in patients with NSAID-treatment (increase in prostaglandin E2 concentration in gastric mucosa suggesting gastric cytoprotection). CONCLUSION: This trial shows that ACE-inhibition with perindopril represents a simple, safe, and effective short-term therapeutic option for the large proportion of patients with mild essential hypertension and concomitant diseases and therapies.
Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Indóis/uso terapêutico , Adulto , Idoso , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Anti-Hipertensivos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Indóis/efeitos adversos , Masculino , Pessoa de Meia-Idade , Perindopril , Resultado do TratamentoRESUMO
Amlodipine, a dihydropyrimidine calcium antagonist, is effective in the treatment of patients with mild to moderate hypertension at doses of 5-10 mg daily. The aim of the study reported here was to determine whether an early increase in dosage of amlodipine provided an advantage in terms of antihypertensive effect. This was a single-blind, randomised study in 115 patients with mild to moderate hypertension (diastolic blood pressure 95-114 mmHg) conducted at 10 centres with two parallel groups. Group I received amlodipine 5 mg once daily for the entire 10-week treatment period, while group II received amlodipine 5 mg once daily for two weeks, with the option to increase the dose to 10 mg once daily were the diastolic blood pressure to exceed 90 mmHg. The dose was increased in 40% of group II patients (20/50). Diastolic and systolic blood pressure decreased steadily until the end of the sixth week of treatment in both groups, with no statistically significant difference between the groups. The response rate (diastolic blood pressure < or = 90 mmHg) at the end of treatment was 84% in both groups. Because there is no advantage in an early increase in dosage of amlodipine in terms of antihypertensive effect, a dose increase should not be considered until after six weeks of treatment at 5 mg once daily.
Assuntos
Anlodipino/administração & dosagem , Bloqueadores dos Canais de Cálcio/administração & dosagem , Hipertensão/tratamento farmacológico , Anlodipino/farmacologia , Análise de Variância , Pressão Sanguínea/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/farmacologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Método Simples-CegoRESUMO
Both leptin and the renin-angiotensin system (RAS) can influence the activity of the sympathetic nervous system, water and electrolyte metabolism as well as vascular remodelling, which are all involved in the regulation of arterial blood pressure. Thus leptin and the RAS may act together in the pathogenesis of essential hypertension. The present study aimed to answer the following question: does an interrelationship exist between leptinaemia and the plasma renin activity (PRA) profile in normotensive and hypertensive subjects? Forty-three patients with essential hypertension (EHP) (23 females, 20 males, mean age 39.0 +/- 1.8 years, mean body mass index (BMI) 26. 8 +/- 0.6 kg/m2, mean arterial pressure (MAP) 123 +/- 2 mm Hg) and 32 healthy subjects (NTS) (18 females, 14 males, mean age 38.6 +/- 2. 2 years, mean BMI 25.4 +/- 0.5 kg/m2, MAP 95 +/- 1 mm Hg) were examined. Plasma leptin levels were estimated once after the administration of a diet containing 100-120 mmol Na/day and after overnight 8-h recumbency. PRA was estimated twice: first after the administration of a diet containing 100-120 mmol Na day and overnight 8-h recumbency (PRA I), and a second time after 3 days of sodium restriction (20 mmol Na/day), and 3 h of upright position (PRA II). Antihypertensive drugs were withdrawn 7 days before the study. In EHP plasma leptin concentration was insignificantly higher than in NTS (14.0 +/- 2.0 vs10.8 +/- 1.5 ng/ml respectively). Only females with hypertension showed a significant positive correlation between plasma leptin concentrations (expressed as the logarithmic values) and PRA I. Using the multiple regression analysis, in all studied subjects (EHP and NTS together), logarithm (log) of plasma leptin concentrations was significantly related to gender, BMI and MAP. Multiple regression analysis performed separately for EHP or NTS revealed a significant relation of log plasma leptin concentrations with gender and BMI. A significant correlation was found between log leptinaemia values and BMI, mean and systolic blood pressure respectively if the whole group of subjects (EHP+NTS) or EHP and NTS separately were analysed. Especially in hypertensive women a highly significant correlation was found between log plasma leptin concentrations and MAP. We conclude that a significant relationship between leptinaemia and PRA does exist in females with EH and that participation of both PRA and leptin in the pathogenesis of EH in females seems to be likely.
Assuntos
Hipertensão/sangue , Leptina/sangue , Renina/sangue , Adulto , Pressão Sanguínea , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Valores de Referência , Caracteres Sexuais , SístoleRESUMO
Patients with chronic renal failure are frequently characterized by malnutrition, hyperleptinaemia and metabolic acidosis. Both hyperleptinaemia and chronic metabolic acidosis are presumed to contribute to the pathogenesis of malnutrition observed in this group of patients. It has been reported, that in vitro adipocytes exposed to acidotic medium decrease leptin secretion. The aim of present study was to analyze the possible impact of uraemic metabolic acidosis on leptinaemia in haemodialysis patients with chronic renal failure. - 94 haemodialysed patients (58 M, 36 F; mean age 45 +/- 1 years) were enrolled in this study. 56 patients were on haemodialysis treatment for one year using an acetate dialysis fluid, while 38 patients were haemodialysed at least for 3 months with a dialysate buffered with bicarbonate. Plasma leptin concentration, blood gases and body composition were assessed in all examined subjects. - Patients haemodialysed with an acetate and bicarbonate buffered dialysate did not differ with respect to body weight, body mass index (BMI), total fat mass (TFM) and plasma leptin concentration. Patients haemodialysed with an acetate buffered dialysate were characterized by a significantly more severe metabolic acidosis than patients on bicarbonate haemodialysis. Patients were divided according to the actual hydrogen ion concentration: over 60 nmol/l, 45-60 nmol/l and below 45 nmol/l. These subgroups did not differ significantly by body weight, BMI and TFM. Only a slightly (not significantly), lower median leptinaemia was found in patients with elevated hydrogen ion concentration. No significant correlation was noticed between blood hydrogen or hydrocarbonate ion concentration respectively and logarithmic values of plasma leptin concentration (tau = 0.025, p = 0.72; tau = - 0.021, p = 0.76 respectively). - From results obtained in this study we may conclude that, blood hydrogen ion concentration does not influence substantially or only moderately to plasma leptin concentration in haemodialysed patients.
Assuntos
Acidose/sangue , Falência Renal Crônica/sangue , Leptina/sangue , Diálise Renal , Bicarbonatos/sangue , Composição Corporal , Feminino , Humanos , Concentração de Íons de Hidrogênio , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estatísticas não ParamétricasRESUMO
BACKGROUND: Females are characterized by significantly higher plasma leptin concentration than males. It seems likely that sex hormones influence leptinemia independently from differences in body composition. The aim of the present study was to analyze the contribution of plasma concentrations of testosterone and estradiol on leptinemia in hemodialyzed patients. METHODS: 110 hemodialyzed patients--HD (60 M, 50 F) and 70 healthy subjects (HS) (30 M, 40 F) were enrolled in this study. Plasma leptin, testosterone or estradiol and CRP concentrations and body composition by dual-energy X-ray absorptiometry (DEXA) were assessed. RESULTS: Total body fat was significantly higher in females than in males (27.5 +/- 1.5% vs. 17.2 +/- 1.0% of body weight in HD and 36.0 +/- 1.0% vs. 18.2 +/- 1.4% in HS, respectively). Plasma leptin concentrations were markedly higher in females than in males both in HD (27.9 +/- 5.4 ng/ml vs. 9.6 +/- 1.9 ng/ml) and HS (16.5 +/- 1.7 ng/ml vs.3.1 +/- 0.4 ng/ml). A highly significant, strong positive correlation was found between total fat mass (TFM) and leptinemia in all studied groups. No significant univaried correlation between plasma leptin and testosterone or estradiol concentrations respectively was found both in HD and HS. Multiple regression analyses showed that the main determinant of leptinemia is TFM (beta = 0.623 and 0.798 in HS females and males respectively, and beta = 1.058 and 0.797 in HD females and males respectively). Plasma concentration of testosterone (beta = -0.139 and beta = -0.075 in male HD and HS respectively) and estradiol (beta = 0.199 and beta = 0.046 in females HD and HS, respectively) contributed to leptinemia only in a minor degree. CONCLUSION: Both testosterone and estradiol are minor contributors to leptinemia both in HS and HD patients. The main determinant of leptinemia in these subjects is total body fat mass.
Assuntos
Composição Corporal , Estradiol/sangue , Falência Renal Crônica/terapia , Leptina/sangue , Diálise Renal , Testosterona/sangue , Absorciometria de Fóton , Tecido Adiposo/metabolismo , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Falência Renal Crônica/sangue , Masculino , Pessoa de Meia-Idade , Análise de RegressãoRESUMO
Cardiovascular complications are a major clinical problem in patients with chronic kidney disease and end stage renal failure. Death from cardiac causes accounts for 40%-50% of all deaths in these patients and is thus up to 20 times more common in uremic patients than in the general population. Cardiovascular pathology in patients with renal failure is complex, but accelerated atherosclerosis has repeatedly been discussed as one major cause. The prevalence of coronary atheroma in uremic patients is approximately 30% by autopsy and coronary angiography studies. Not only is the prevalence of atherosclerotic lesions very high, but also the case fatality rate of myocardial infarction. Recently, excess mortality in uremic patients having had a myocardial infarct was noted; the one year mortality was 55.4% and 62.3% in uremic patients with and without diabetes, respectively, compared to about 10-15% in non-uremic patients. This study goes beyond the well-known notion that urea is associated with more severe atherosclerosis and shows that, in addition, the adaptation to coronary perfusion deficits is inappropriate. Recent clinical and autoptical studies in pre-dialysis and dialysis cohorts have documented increased intima and media thickness which appear early in the course of renal disease; Vascular wall thickening in renal failure seems to be modified at least in part by parathyroidhormone (PTH) and endothelin-1 (ET-1) which are both elevated in patients with renal failure. In experimental renal failure a direct effect of high phosphorus diet in arterial wall thickening was also documented. In addition to thickening of the vascular wall marked structural alterations were noted in renal failure i.e. a decrease in elastic fibre content and an increase in extracellular matrix. Furthermore, increased calcification of coronary atherosclerotic plaques and of the media of the aorta and some peripheral arteries has been documented in patients with renal failure. Factors contributing to this increased calcification process may be deposition of abundant circulating calcium, microinflammation, oxidative stress, de novo expression of bone morphogenous proteins and lack of inhibitors of calcifcation. These changes in vascular wall composition may alter vessel elasticity and thus contribute to impaired vessel function in renal failure. It is obvious from the above mentioned facts that cardiovascular disease in the renal patient is certainly multifaetorial in origin. There are, however, important issues to adress in the future, like (I) the characterization of vascular morphology in the different vascular beds, (II) the pathomechanisms of vascular and plaque calcification as well as the potential beneficial effect of rigorous control of non-classical risk factors (i.e. high P or Ca x P, inflammation, oxidative stress, etc.), (III) an additive or supraadditive effect of various classical and non-classical risk factors and (IV) the role of diabetes mellitus in modifying these vascular alterations.
Assuntos
Arteriosclerose/etiologia , Arteriosclerose/fisiopatologia , Falência Renal Crônica/complicações , Falência Renal Crônica/fisiopatologia , Animais , Arteriosclerose/patologia , Modelos Animais de Doenças , Humanos , Falência Renal Crônica/patologiaRESUMO
AIMS: Both parathyroid hormone and advanced glycated end products (AGEs) are uremic toxins. The present study aimed to examine the likely interrelationship between these compounds. METHODS: Seventy-four hemodialyzed patients (41 female, 33 male; mean age 47 +/- 2 years, mean duration on hemodialysis 36 +/- 6 months) were enrolled in this study. In all subjects, the body mass index (BMI) was calculated and total lean mass (TLM) and total fat mass (TFM) were assessed by dual X-ray absorptiometry. Blood samples for estimation of plasma calcium, phosphorus, carboxymethyl lysine (as marker of AGEs) and PTH-1-84 were obtained after overnight fasting, before subsequent hemodialysis session. RESULTS: BMI, TFM and TLM were 23.6 +/- 0.5 kg/m2, 16.3 +/- 1.0 kg and 46.3 +/- 1.1 kg, respectively. PTH plasma level (223 +/- 32 pg/ml) and plasma CML (1,837 +/- 84 ng/ml) were markedly elevated as compared with reference values. A significant positive correlation was found between TLM and CML levels (tau = 0.225; p = 0.04) and between plasma PTH and CML levels (tau = 0.224; p = 0.04). CONCLUSION: It seems likely that PTH and AGEs are interrelated. The pathophysiological relevance of this finding in the pathogenesis of uremic toxicity remains to be elucidated.
Assuntos
Produtos Finais de Glicação Avançada/sangue , Lisina/análogos & derivados , Lisina/sangue , Hormônio Paratireóideo/sangue , Diálise Renal , Uremia/sangue , Uremia/terapia , Índice de Massa Corporal , Cálcio/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fósforo/sangue , Uremia/fisiopatologiaRESUMO
BACKGROUND: Acute renal failure (ARF) is characterized by impaired excretory, endocrine, homeostatic and metabolic function of the kidneys. It is well-known that leptin is an adipose-derived polypeptide hormone which is predominantly biodegraded by the kidneys. Therefore, plasma leptin concentration is increased in chronic renal failure (CRF). However, its' concentrations in patients with ARF were not investigated until now. The aim of the present study was to evaluate plasma leptin concentration in patients with ARF. PATIENTS AND METHODS: 27 patients with ARF (age 44 +/- 4 years, BMI 26.0 +/- 0.9 kg/m2, means +/- SEM, 17 patients 15 M, 2 F recovered kidney function and 10 patients 7 M, 3 F died during the anuric phase), 27 hemodialysis patients (22 M, 5 F; age 45 +/- 2 years; BMI 26.2 +/- 0.8 kg/m2) with chronic renal failure (CRF) and 27 healthy subjects (HS) (22 M, 5 F; age 42 +/- 3 years; BMI 25.9 +/- 0.6 kg/m2) were examined. In patients with ARF, blood samples for plasma leptin and routinely assessed biochemical parameters were withdrawn before the first HD session (I), and in patients who survived a second time 5 days later during the anuric/oliguric phase (II), and a third one during the polyuric phase before discharge of the patient from hospital (III). In patients with CRF all examined parameters were estimated only once before a subsequent HD session. RESULTS: Patients with ARF (before the first HD session) and CRF did not differ significantly with respect to BMI, serum creatinine and blood hydrogen ion concentrations. Plasma leptin level in patients with ARF before the first HD session was similar to values obtained in HS, but significantly lower (p < 0.01) than in patients with CRF (2.5 (1.9 - 8.2) vs. 3.4 (2.5 - 8.3) vs. 8.4 (2.9 - 16.9) ng/ml in ARF, HS and CRF, respectively). There was no significant difference in leptinemia between patients with ARF who survived and who died. In patients with ARF who survived, improvement ofrenal function was accompanied by a slightly (not significant) declining tendency in plasma leptin concentration (5.6 +/- 2.2 vs. 4.8 +/- 1.7 vs. 4.5 +/- 1.3 ng/ml; I, II, III phases of ARF, respectively). CONCLUSIONS: In contrast to hemodialysis patients with chronic renal failure, patients with acute renal failure are characterized by normal plasma leptin concentration. Thus, difference in leptinemia between patients with chronic and acute renal failure seems to be due to preservation of large amounts of active renal parenchyma in ARF patients.
Assuntos
Injúria Renal Aguda/sangue , Leptina/sangue , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Adiponectin, a protein secreted exclusively by adipocytes, is presumed to be involved in the pathogenesis of atherosclerosis and insulin resistance. An elevated plasma adiponectin concentration was found in ESRD patients on hemodialysis (HD). However, the role of kidneys in adiponectin biodegradation/elimination is unknown. Therefore, we assessed plasma adiponectin concentrations in ESRD patients before and after successful kidney transplantation. METHODS: Among 44 hemodialyzed patients (29 men, 15 women; mean age 39 +/- 11 years; mean body mass index [BMI] 23.6 +/- 3.5 kg/m(2); mean duration of HD treatment before kidney transplantation 27 +/- 26 months), plasma adiponectin concentrations and insulin resistance indices (HOMA-R) were measured twice: immediately before kidney transplantation (Tx) and 1-2 days before patient discharge from the hospital with stable kidney transplant function (mean serum creatinine level 191 +/- 105 micromol/L). The control group consisted of 22 normotensive healthy subjects (12 men, 10 women). RESULTS: Among uremic patients, before Tx, plasma adiponectin concentrations were significantly higher than in healthy subjects (20.8 +/- 8.3 vs 8.7 +/- 4.8 microg/mL; P <.001) After successful Tx, plasma adiponectin concentrations decreased significantly (20.8 +/- 8.3 vs 15.7 +/- 7.0 microg/mL before and after Tx, respectively; P <.001). Simultaneously, after successful kidney transplantation, an increase in HOMA-R was observed (1.01 +/- 0.61 vs 1.43 +/- 0.83; P =.002). However, changes in adiponectinemia did not significantly correlate with serum creatinine or HOMA-R. CONCLUSION: The kidneys seem to play an important role in adiponectin biodegradation and/or elimination.
Assuntos
Biomarcadores/sangue , Peptídeos e Proteínas de Sinalização Intercelular , Falência Renal Crônica/sangue , Transplante de Rim/fisiologia , Proteínas/análise , Diálise Renal , Adiponectina , Adulto , Creatinina/sangue , Quimioterapia Combinada , Feminino , Humanos , Imunossupressores/uso terapêutico , Falência Renal Crônica/cirurgia , Falência Renal Crônica/terapia , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Valores de Referência , Uremia/sangue , Uremia/cirurgiaRESUMO
The experiments showed the possibility of the MLM type structured triacylglycerol synthesis. Such sTAGs should have polyene acids positioned in sn-2 (in this case evening primrose oil was the source of polyene acids) and caprylic acid in the sn-1 and sn-3 positions. The sTAG synthesis was carried out in two-stages: 1. alcoholysis and synthesis of 2-MAG; 2. 2-MAG esterification with caprylic acid. For further experiments 4 lipase preparations were selected: MCL, RDL, Lipozyme RM and TL. The lipase preparations synthesized 2-MAG with the yields of 85.7%,. 87.5%,. 54.3%,. 65.2%, respectively. The 2-MAGs separated by crystallization contained over 70% of C18:1 acid and over 7% of C18:3, n-6 acid. The two-staged sTAG synthesis was shown to be more efficient by analyzing the products composition. The two- stage process gave over 70% of MLM type triacylglycerols and about 3% of side-products, whereas the acidolysis or interesterification produced only about 30% MLM or MLL type triacylglycerols.
Assuntos
Caprilatos/metabolismo , Ácidos Graxos/metabolismo , Proteínas Fúngicas/metabolismo , Ácidos Linoleicos/metabolismo , Lipase/metabolismo , Óleos de Plantas/metabolismo , Ácido gama-Linolênico/metabolismo , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Fina , Ionização de Chama , Fungos/enzimologia , Oenothera biennis/química , Triglicerídeos/metabolismoRESUMO
Selectivity is one of the most important lipase properties which depends on a wide range of factors. In order to choose the right enzyme for a special purpose, it is necessary to check its selectivity. Fatty acid selectivity of lipases determined for natural substrales was different from that determined for p-nitrophenyl esters and those determined for each substrate. Enantoiselectivity of lipase from Mucor circinelloides (MCL) determined for 2 was over 100 (E > > 100). In this case, inversion of enantiopreferences was observed; the conversion was 10% and (R)-alcohol was preferentially produced
Assuntos
Etanol/metabolismo , Proteínas Fúngicas/genética , Fungos/genética , Lipase/genética , Ésteres/metabolismo , Ácidos Graxos/metabolismo , Proteínas Fúngicas/química , Proteínas Fúngicas/metabolismo , Fungos/enzimologia , Lipase/química , Lipase/metabolismo , Espectrofotometria , Especificidade por SubstratoRESUMO
Ethanol fermentation of lactose mash by biocatalyzers immobilized in sodium alginate was studied in order to improve the process productivity and economy. The fermentation effectiveness of S.cerevisiae co-immobilized with a p-galactosidase and the directly lactose- fermenting immobilized yeast: K. fragilis and C. pseudotropicalis were compared The application of the immobilized K. fragilis produced desirable results and even after its 9th (18 days) fermentation, the immobilized yeast provided the stable high fermentation level (on average about 6 ralvol of ethano/) while maintaining its activity. Such lactose-mash fermentation was greater than in conventional method (by free cells). In addition, the application of s. cerevisiae co-immobilized with p-galactosidase produced somewhat greater ferm levels than the conventional method, however, the system stability deteriorated after 6 days of fermentation.
Assuntos
Etanol/metabolismo , Galactosidases/metabolismo , Microbiologia Industrial/métodos , Lactose/metabolismo , Leveduras/enzimologia , Alginatos/química , Células Imobilizadas/metabolismo , Fermentação , Ácido Glucurônico/química , Ácidos Hexurônicos/químicaRESUMO
In the present work, the CdSe/ZnS hydrophobic quantum dots were embedded within the polyelectrolyte nanocapsules. The core of the capsules, which consists of a mixture of the linseed oil with chloroform, was prepared using the spontaneous emulsification technique. The obtained emulsions were stabilized with lecithin and encapsulated using the layer-by-layer (LbL) adsorption of polyelectrolytes. The pair of biocompatible polyelectrolytes was used: the cationic poly-l-lysine hydrobromide (PLL) together with the anionic poly-d-glutamic acid sodium salt. The saturation LbL method, which is based on the stepwise formation of consecutive layers on the initial emulsion without the intermediate rinsing step, was applied to form the capsule shells. Their growth was evidenced by the capsule size and electrophoretic mobility measurements. The emulsion and the capsules were deposited on a mica surface and the deposit topology was examined by the means of atomic force microscopy (AFM). The presence of quantum dots within the oil cores was confirmed by recording the fluorescent spectra of the samples containing CdSe/ZnS. In order to evaluate cytotoxicity of the capsules, their influence on the viability of mouse embryonic fibroblasts was examined using the MTT test, followed by optical-microscope observation of morphology of the cells after hematoxylin-eosin staining.
Assuntos
Compostos de Cádmio/química , Sistemas de Liberação de Medicamentos , Óleo de Semente do Linho/química , Nanocápsulas/química , Pontos Quânticos , Compostos de Selênio/química , Sulfato de Zinco/química , Animais , Compostos de Cádmio/farmacologia , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Eletrólitos/química , Eletrólitos/farmacologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/patologia , Interações Hidrofóbicas e Hidrofílicas , Óleo de Semente do Linho/farmacologia , Camundongos , Estrutura Molecular , Células NIH 3T3 , Tamanho da Partícula , Polímeros/química , Polímeros/farmacologia , Compostos de Selênio/farmacologia , Relação Estrutura-Atividade , Propriedades de Superfície , Sulfato de Zinco/farmacologiaRESUMO
The aim of this work was to encapsulate the CdTe quantum dots within the nanocapsules that were prepared by the layer-by-layer adsorption of polyelectrolytes. Two different polyelectrolyte pairs were used as components of the shell: synthetic polycation poly(allyamine hydrochloride) (PAH), together with anionic poly(sodium styrene sulfonate) (PSS), and biocompatible cationic poly-L-lysine hydrobromide in a pair with biocompatible anionic poly-D-glutamic acid sodium salt (PGA). The saturation method was used for formation of consecutive layers on the initial CdTe-polyelectrolyte complex. A growth of the polyelectrolyte shell was followed with the electrophoretic mobility and light scattering measurements, in order to determine the zeta potential and the size of capsules, respectively. The fluorescent spectra of the quantum dots, which are embedded within the capsules, were characterized with spectrofluorimeter. Later on, they were deposited on a negatively charged mica surface and studied by the means of atomic force microscopy (AFM). In order to estimate the cytotoxicity of capsules, their influence on the B-lymphoblastoid cell line proliferation and on unspecific binding to the P-blood mononuclear cells was examined using the flow cytometry.
Assuntos
Materiais Biocompatíveis/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Preparações de Ação Retardada/metabolismo , Portadores de Fármacos/metabolismo , Composição de Medicamentos/métodos , Nanocápsulas/química , Nanomedicina/métodos , Adsorção , Materiais Biocompatíveis/química , Preparações de Ação Retardada/química , Portadores de Fármacos/química , Eletrólitos , Citometria de Fluxo , Humanos , Microscopia de Força Atômica , Nanocápsulas/toxicidade , Nanocápsulas/ultraestrutura , Poliaminas/química , Polieletrólitos , Polímeros/química , Pontos Quânticos , Espectrometria de Fluorescência , Ácidos Sulfônicos/química , Propriedades de Superfície , Células Tumorais CultivadasAssuntos
Denervação , Hipertensão/cirurgia , Rim/inervação , Monoaminoxidase/sangue , Artéria Renal/inervação , Simpatectomia/métodos , Animais , Pressão Sanguínea/fisiologia , Ablação por Cateter , Humanos , Rim/efeitos dos fármacos , Rim/enzimologia , Masculino , Monoaminoxidase/metabolismo , Ratos , Artéria Renal/efeitos dos fármacosRESUMO
Renal artery stenosis (RAS) is an important cause of arterial hypertension and chronic kidney disease. The aims of our study were to assess the prevalence of RAS and to examine the frequency of variants of renal vasculature, that is, multiple and/or accessory renal arteries in hypertensive patients referred to renal angiography. We evaluated retrospectively 1554 arteriographies of hypertensive patients. Angiograms were evaluated to find RAS, significant RAS (>60% stenosis of the lumen), radiological signs of atherosclerosis, aneurysms of the renal arteries or aorta and variants of kidney vascularization. The frequency of RAS including occlusions was 15.1% (21.3% of them were significant and suitable for revascularization). Variants of renal arterial vascularization were found in 26.5% of patients (multiple renal arteries-11.2% and accessory renal arteries-15.3%). Significant RAS was found more frequently in patients older than 60 years-OR 4.76 (2.08-10.86). Coronary artery disease, history of myocardial infarction or stroke significantly increased the chance of RAS detection. The frequency of renal accessory arteries was lower in patients older than 60 years and in patients with the radiological signs of atherosclerosis. Results of this study indicate that haemodynamically important RAS is found more frequently in hypertensive patients older than 60 years. Symptomatic atherosclerotic disease found in the peripheral and/or coronary arteries and diabetes mellitus increases the chance of RAS detection. Decreased occurrence of renal accessory arteries was found in hypertensive patients with radiological signs of atherosclerosis.