The nuclear factor E2-related factor 2 and age-related macular degeneration / O fator 2 relacionado a NF-E2 e a degeneração macular relacionada à idade

ABSTRACT After the discovery of anti-vascular endothelial growth factor agents as treatment of wet age-related macular degeneration, the number of studies with the objective to understand the molecular mechanisms involved in the age-re lated macular degeneration genesis has increased. The importance of the nuclear factor e2-related factor 2 lies in its activation-derived proteins being involved in the maintenance of the redox balance and consequent prevention of degenerative macular disease. This article aims to present the characteristics of nuclear factor e2-related factor 2 and describe the main nuclear factor e2-related factor 2-activated antioxidant enzymes that contribute to the preservation of vision.

RESUMO Após a descoberta do anti fator de crescimento en dotelial vascular no tratamento da degeneração macular relacionada à idade úmida, muitas pesquisas têm sido realizadas com o intuito de elucidar os mecanismos moleculares envolvidos na gênese da degeneração macular relacionada à idade. O fator nuclear eritroide 2 relacionado ao fator 2 destaca-se pelo fato de diversas proteínas, oriundas de sua ativação, estarem envolvidas na manutenção do equilíbrio do estado redox e consequente prevenção da doença macular degenerativa. Este artigo mostra as características do fator nuclear eritroide 2 relacionado ao fator 2 e descreve as principais enzimas antioxidantes originadas da ativação que contribuem para a preservação da visão.

The nuclear factor E2-related factor 2 and age-related macular degeneration.

After the discovery of anti-vascular endothelial growth factor agents as treatment of wet age-related macular degeneration, the number of studies with the objective to understand the molecular mechanisms involved in the age-re lated macular degeneration genesis has increased. The importance of the nuclear factor e2-related factor 2 lies in its activation-derived proteins being involved in the maintenance of the redox balance and consequent prevention of degenerative macular disease. This article aims to present the characteristics of nuclear factor e2-related factor 2 and describe the main nuclear factor e2-related factor 2-activated antioxidant enzymes that contribute to the preservation of vision.

Gamma-oryzanol reduces renal inflammation and oxidative stress by modulating AGEs/RAGE axis in animals submitted to high sugar-fat diet / Gama-orizanol reduz a inflamação e o estresse oxidativo nos rins pela modulação do eixo RAGE/AGEs em animais submetidos a uma dieta rica em gordura e açúcar

Abstract Introduction: The receptor for AGEs (RAGE) is a multiligand member of the immunoglobulin superfamily of cell surface receptors expressed in many organs, among them, the kidneys. When activated, RAGE leads to a sequence of signaling that results in inflammation and oxidative stress, both involved in kidney disease pathogenesis. Gamma-oryzanol (γOz) comprises a mixture of ferulic acid (FA) esters and phytosterols (sterols and triterpene alcohols) mainly found in rice, with antioxidant and anti-inflammatory activities. Aim: To evaluate the effect of γOz to reduce renal inflammation and oxidative stress by modulating AGEs/RAGE axis in animals submitted to a high sugar-fat diet. Methods: Male Wistar rats (±187g) were randomly divided into two experimental groups: control (n = 7 animals) and high sugar-fat diet (HSF, n = 14 animals) for 20 weeks. After this period, when the presence of renal disease risk factors was detected in the HSF group (insulin resistance, dyslipidemia, increased systolic blood pressure and obesity), the HSF animals were divided to begin the treatment with γOz or continue receiving only HSF for 10 more weeks. Results: No effect of γOz on obesity and metabolic parameters was observed. However, kidney inflammation and oxidative stress decreased as soon as RAGE levels were reduced in HSF + γOz. Conclusion: It is possible to conclude that the gamma- oryzanol was effective in reducing inflammation and oxidative stress in the kidney by modulating the AGEs/RAGE axis.

Resumo Introdução: O receptor para AGEs (RAGE) é um membro multiligante da superfamília das imunoglobulinas dos receptores de superfície celular expresso em muitos órgãos, entre eles, os rins. Quando ativado, o RAGE leva a uma sequência de sinalização que resulta em inflamação e estresse oxidativo, ambos envolvidos na patogênese de doenças renais. O gama-orizanol (γOz) compreende uma mistura de ésteres de ácido ferúlico (AF) e fitoesteróis (esteróis e álcoois triterpenos) encontrados principalmente no arroz, com atividades antioxidantes e anti-inflamatórias. Objetivo: Avaliar o efeito do γOz para reduzir a inflamação renal e o estresse oxidativo pela modulação do eixo RAGE/AGEs em animais submetidos a uma dieta rica em gordura e açúcar. Métodos: Ratos Wistar machos (±187g) foram divididos aleatoriamente em dois grupos experimentais: controle (n = 7 animais) e dieta rica em gordura e açúcar (HSF, do inglês high sugar-fat diet, n = 14 animais) por 20 semanas. Após este período, quando foi detectada a presença de fatores de risco de doença renal no grupo HSF (resistência à insulina, dislipidemia, aumento da pressão arterial sistólica e obesidade), os animais HSF foram divididos para iniciar o tratamento com γOz ou continuar recebendo apenas HSF por mais 10 semanas. Resultados: Não foi observado nenhum efeito do γOz na obesidade e nos parâmetros metabólicos. No entanto, a inflamação e o estresse oxidativo renais diminuíram assim que os níveis de RAGE foram reduzidos em HSF + γOz. Conclusão: É possível concluir que o gama- orizanol foi eficaz em reduzir a inflamação e o estresse oxidativo no rim pela modulação do eixo RAGE/AGEs.

Rice bran modulates renal disease risk factors in animals submitted to high sugar-fat diet / Farelo de arroz modula os fatores de risco de doença renal em animais submetidos a uma dieta rica em gordura e açúcar

Abstract Introduction: Obesity, diabetes, and hypertension are common risk factors for chronic kidney disease (CKD). CKD arises due to many pathological insults, including inflammation and oxidative stress, which affect renal function and destroy nephrons. Rice bran (RB) is rich in vitamins and minerals, and contains significant amount of antioxidants. The aim of this study was to evaluate the preventive effect of RB on renal disease risk factors. Methods: Male Wistar rats (±325 g) were divided into two experimental groups to received a high sugar-fat diet (HSF, n = 8) or high sugar-fat diet with rice bran (HSF + RB, n = 8) for 20 weeks. At the end, renal function, body composition, metabolic parameters, renal inflammatory and oxidative stress markers were analyzed. Results: RB prevented obesity [AI (HSF= 9.92 ± 1.19 vs HSF + RB= 6.62 ± 0.78)], insulin resistance [HOMA (HSF= 83 ± 8 vs. HSF + RB= 42 ± 11)], dyslipidemia [TG (HSF= 167 ± 41 vs. HSF + RB=92 ± 40)], inflammation [TNF-α (HSF= 80 ± 12 vs. HSF + RB=57 ± 14), IL-6 (903 ± 274 vs. HSF + RB=535 ± 277)], oxidative stress [protein carbonylation (HSF= 3.38 ± 0.18 vs. HSF + RB=2.68 ± 0.29), RAGE (HSF=702 ± 36 vs. RSF + RB=570 ± 190)], and renal disease [protein/creatinine ratio (HSF=1.10 ± 0.38 vs. HSF + RB=0.49 ± 0.16)]. Conclusion: In conclusion, rice bran prevented renal disease by modulating risk factors.

Resumo Introdução: Obesidade, diabetes e hipertensão arterial são fatores de risco comuns para doenças renais crônicas (DRC). A DRC surge devido a muitos insultos patológicos, incluindo inflamação e estresse oxidativo, que afetam a função renal e destroem os néfrons. O farelo de arroz (FA) é rico em vitaminas e minerais, e contém uma quantidade significativa de antioxidantes. O objetivo deste estudo foi avaliar o efeito preventivo do FA nos fatores de risco de doenças renais. Métodos: Ratos Wistar machos (±325 g) foram divididos em dois grupos experimentais para receber uma dieta rica em gordura e açúcar (DRGA, n = 8) ou uma dieta rica em gordura e açúcar com farelo de arroz (DRGA + FA, n = 8) por 20 semanas. Ao final, foram analisados a função renal, composição corporal, parâmetros metabólicos, marcadores renais inflamatórios e de estresse oxidativo. Resultados: FA preveniu a obesidade [IA (DRGA= 9,92 ± 1,19 vs. DRGA + FA= 6,62 ± 0. 78)], resistência à insulina [HOMA (DRGA= 83 ± 8 vs DRGA + FA= 42 ± 11)], dislipidemia [TG (DRGA= 167 ± 41 vs. DRGA + FA=92 ± 40)], inflamação [FNT-α (DRGA= 80 ± 12 vs. DRGA + FA=57 ± 14), IL-6 (903 ± 274 vs. DRGA + FA= 535 ± 277)], estresse oxidativo [carbonilação de proteína (DRGA= 3. 38 ± 0,18 vs. DRGA + FA=2,68 ± 0,29), RAGE (DRGA=702 ± 36 vs. DRGA + FA=570 ± 190)], e doença renal [relação proteína/creatinina (DRGA=1,10 ± 0,38 vs. DRGA + FA=0,49 ± 0,16)]. Conclusão: Em conclusão, o farelo de arroz preveniu doenças renais através da modulação dos fatores de risco.

Effect of doxorubicin on cardiac lipid metabolism-related transcriptome and the protective activity of Alda-1.

The use of doxorubicin (DOX) as an antineoplastic drug is compromised by its cardiotoxicity risk. Although several mechanisms have been proposed for DOX-induced cardiac dysfunction, there is still increased interest in assessing its effects. Likewise, it is important to find protocols that can prevent or minimize the side effects of DOX without hindering its antitumor activity. Thus, this study was designed to investigate the molecular mechanisms underlying DOX cardiotoxicity, with a special focus on cardiac energy metabolism and the ability of Alda-1 (ALDH2 agonist) to prevent DOX-induced cardiac alterations. We explored the effects of DOX on the histological morphology of the myocardium, on lipid profile, and on the expression of genes related to fatty acid metabolism, in the presence and absence of Alda-1 (8 mg/kg body weight; b.wt.). Two DOX treatment protocols were used: a single dose of DOX (4 mg/kg b.wt.); four doses of DOX (4 mg/kg b.wt.), one dose/week, for 4 weeks. Treatment with DOX caused a progressive injury in the cardiac tissue and an increase in the blood total cholesterol, high-density lipoproteins, very low-density lipoproteins and triglyceride, as well as an up-regulation of FABP4 (DOX and DOX + Alda-1 groups) and Slc27a2 (in DOX-treated animals). Alda-1 administration promoted reduction in the severity of the histopathological injuries (after single dose of DOX) and Slc27a2 overexpression was restored. In conclusion, the study revealed novel insights regarding the development of DOX-mediated cardiomyopathy, indicating a relationship between DOX exposure and FABP4 and Slc27a2 overexpression, and confirmed the cardioprotective effect of Alda-1.

Age-related macular degeneration: an overview / Degeneração macular relacionada à idade: um panorama geral

ABSTRACT Age-related macular degeneration is the most important cause of irreversible vision loss in the elderly and has been considered a severe public health problem. Current treatments have only been successful in delaying the loss of central vision. Due to increased life expectancy, governments and researchers have been challenged to seek more efficient and successful treatments for age-related macular degeneration. Considering its relevance for public health and the need of further research, this article aims to address age-related macular degeneration objectively, tackling on the current knowledge about its pathophysiology, potential molecular biomarkers, main prevention procedures and treatments, as well as introducing possible molecules that may be a therapeutic target in this disease.

RESUMO Degeneração macular relacionada à idade é a causa mais importante de perda irreversível da visão em idosos, e é considerada um sério problema de saúde pública. Os tratamentos atuais são bem-sucedidos apenas ao postergar a perda da visão central. Devido à maior expectativa de vida, os governos e pesquisadores têm dificuldade de encontrar tratamentos mais eficientes e exitosos para degeneração macular relacionada à idade. Considerando sua relevância para saúde pública e a necessidade de mais pesquisas, este artigo procura abordar a degeneração macular relacionada à idade de forma objetiva, abordando os conhecimentos atuais sobre sua fisiopatologia, potenciais biomarcadores moleculares, principais procedimentos de prevenção e tratamentos, e apresentar possíveis moléculas que podem ser alvo terapêutico nessa doença.

Tomato-Oleoresin Anti-Inflammatory Effect Recovers Obesity-Induced Cardiac Dysfunction by Modulating Myocardial Calcium Handling.

BACKGROUND/AIMS: Considering the importance of inflammation on obesity-related disorders pathogenesis, including cardiac dysfunction, the interest in natural anti-inflammatory therapeutic strategies has emerged. The lycopene is a carotenoid presents in tomato and red fruits that displays anti-inflammatory properties. In this sense, we will evaluate the anti-inflamma-tory effect of tomato-oleoresin supplementation on obesity- related cardiac dysfunction by modulating myocardial calcium kinetic. METHODS: Male Wistar rats were initially randomized into 2 experimental groups: (Control, n= 20) or high sugar- fat diet (HSF, n=20) for 20 weeks. At week 20th, once detected the cardiac dysfunction (cardiac remodeling, systolic and diastolic dysfunction) by echocardiography in HSF group, animals were randomly divided to begin the treatment with tomato-oleoresin, performing 4 groups: Control (n= 10); Control + tomato tomato-oleoresin supplementation (Control + Ly, n= 10); HSF (n= 10) or HSF + tomato tomato-oleoresin supplementation (HSF + Ly, n= 10). Tomato oleoresin was mixed with maize oil equivalent to 10mg lycopene/kg body weight (BW) per day and given orally, by gavage, every morning for a 10-week period. It was analyzed cardiac inflammatory parameters by the enzyme-linked immunosorbent assay (ELISA) and in vivo (echocardiography) and in vitro (studying isolated papillary muscles from the left ventricle) cardiac function. The groups were compared by Two-Way analysis of variance (ANOVA). RESULTS: The HSF diet induced cardiac dysfunction (FS(%) C: 60.4±1.3; C+Ly: 60.9±1.3; HSF: 51.7±1.3; HSF+Ly: 59.4±1.4) and inflammation (TNF-α: C:1.88±0.41; C+Ly: 1.93±1.01; HSF: 4.58±1.99; HSF+Ly: 2.03±0.55; IL-6: C:0.58±0.16; C+Ly: 0.40±0.16; HSF: 2.00±0.45; HSF+Ly: 0.53±0.26; MCP-1: C:0.31±0.08; C+Ly: 0.43±0.22; HSF: 1.54±0.32; HSF+Ly: 0.50±0.16). Tomato-oleoresin supplementation improved cardiac remodeling and dysfunction, cardiac inflammation and myocardial calcium kinetic. CONCLUSION: the anti-inflammatory effect of tomato-oleoresin supplementation treated the obesity-induced cardiac dysfunction by modulating myocardial calcium handling.

Protective Effect of Tomato-Oleoresin Supplementation on Oxidative Injury Recoveries Cardiac Function by Improving ß-Adrenergic Response in a Diet-Obesity Induced Model.

The system redox imbalance is one of the pathways related to obesity-related cardiac dysfunction. Lycopene is considered one of the best antioxidants. The aim of this study was to test if the tomato-oleoresin would be able to recovery cardiac function by improving ß-adrenergic response due its antioxidant effect. A total of 40 animals were randomly divided into two experimental groups to receive either the control diet (Control, n = 20) or a high sugar-fat diet (HSF, n = 20) for 20 weeks. Once cardiac dysfunction was detected by echocardiogram in the HSF group, animals were re- divided to begin the treatment with Tomato-oleoresin or vehicle, performing four groups: Control (n = 6); (Control + Ly, n = 6); HSF (n = 6) and (HSF + Ly, n = 6). Tomato oleoresin (10 mg lycopene/kg body weight (BW) per day) was given orally every morning for a 10-week period. The analysis included nutritional and plasma biochemical parameters, systolic blood pressure, oxidative parameters in plasma, heart, and cardiac analyses in vivo and in vitro. A comparison among the groups was performed by two-way analysis of variance (ANOVA). Results: The HSF diet was able to induce obesity, insulin-resistance, cardiac dysfunction, and oxidative damage. However, the tomato-oleoresin supplementation improved insulin-resistance, cardiac remodeling, and dysfunction by improving the ß-adrenergic response. It is possible to conclude that tomato-oleoresin is able to reduce the oxidative damage by improving the system's ß-adrenergic response, thus recovering cardiac function.

Lycopene Modulates Pathophysiological Processes of Non-Alcoholic Fatty Liver Disease in Obese Rats.

Background: The higher consumption of fat and sugar are associated with obesity development and its related diseases such as non-alcoholic fatty liver disease (NAFLD). Lycopene is an antioxidant whose protective potential on fatty liver degeneration has been investigated. The aim of this study was to present the therapeutic effects of lycopene on NAFLD related to the obesity induced by a hypercaloric diet. Methods: Wistar rats were distributed in two groups: Control (Co, n = 12) and hypercaloric (Ob, n = 12). After 20 weeks, the animals were redistributed into the control group (Co, n = 6), control group supplemented with lycopene (Co+Ly, n = 6), obese group (Ob, n = 6), and obese group supplemented with lycopene (Ob+Ly, n = 6). Ob groups also received water + sucrose (25%). Animals received lycopene solution (10 mg/kg/day) or vehicle (corn oil) via gavage for 10 weeks. Results: Animals which consumed the hypercaloric diet had higher adiposity index, increased fasting blood glucose, hepatic and blood triglycerides, and also presented in the liver macro and microvesicular steatosis, besides elevated levels of tumor necrosis factor-α (TNF-α). Lycopene has shown therapeutic effects on blood and hepatic lipids, increased high-density lipoprotein cholesterol (HDL), mitigated TNF-α, and malondialdehyde (MDA) and further improved the hepatic antioxidant capacity. Conclusion: Lycopene shows therapeutic potential to NAFLD.

Custos da busca pelo diagnóstico da tuberculose: impacto na economia familiar / Costs of the search for tuberculosis diagnosis: impact on the family economy / Costos de la búsqueda de diagnóstico de la tuberculosis: impacto en la economía familiar

Resumo Introdução A tuberculose persiste como um grave problema de saúde pública, o diagnóstico e tratamento ocasiona dificuldade econômica ao cuidado, pois determina relevantes custos ao doente e à família, assim o objetivo foi estimar custos da busca pelo diagnóstico da tuberculose para sintomáticos respiratórios e seus familiares em um Centro de Saúde Escola em Belém, Pará. Materiais e Métodos Estudo quantitativo, transversal, com 40 sintomáticos respiratórios. Utilizado instrumento de coleta de dados socioeconômicos e custos do diagnóstico da doença. Análise descritiva, com distribuição de frequências e medidas sumárias de médias e desvio padrão e testes qui-quadrado, com nível de significância de 5%. Resultados Houve redução das horas de trabalho/dia após o aparecimento dos sintomas respiratórios e perda do emprego em 20%, repercutindo em redução média da renda. Os custos diretos e indiretos foram responsáveis pela perda de 1 a 20% da renda familiar. Discussão Demonstrando que a busca pelo diagnóstico da tuberculose sobrecarrega os orçamentos familiares, com isso pode haver a demora em procurar os serviços de saúde. Conclusão A busca pelo diagnóstico de tuberculose representa ônus importante para pacientes e familiares. A doença é ligada a vulnerabilidade socioeconômica, embora as ações para diagnóstico sejam ofertadas na rede pública, os custos recaem sobre as famílias.

Abstract Introduction Tuberculosis continues to be a serious public health problem. Its diagnosis and treatment generate economic difficulties as its care requires significant costs for the patient and their family. Therefore, the objective of this study was to calculate the costs of searching for tuberculosis diagnosis for symptomatic respiratory patients and their relatives at a Health School Center in Belém, Pará. Materials and Methods Quantitative, cross-sectional study with 40 symptomatic respiratory patients. Collection of socioeconomic data and costs of disease diagnosis was used as an instrument. A descriptive analysis was conducted, with a distribution of frequencies and measures added to the averages, standard deviation, and chi-squared tests with a significance level of 5%. Results There was a reduction in working hours per day after the onset of respiratory symptoms and loss of employment by 20%, which had an impact on the average reduction in income. Direct and indirect costs were responsible for the loss of 1 to 20% of family income. Discussion The search for tuberculosis diagnosis has been shown to overburden family budgets, which may lead the patient to postpone the search for diagnosis in health services. Conclusions The search for a tuberculosis diagnosis represents a significant expense for patients and their families. This disease is related to a socio-economic vulnerability because although the diagnosis is offered in the public health network, costs are borne by families.

Resumen Introducción La tuberculosis continúa siendo un grave problema de salud pública, el diagnóstico y tratamiento genera dificultad económica, pues su cuidado exige costos importantes al enfermo y a la familia. Por ello, el objetivo del presente estudio fue calcular los costos de la búsqueda de diagnóstico de la tuberculosis para pacientes sintomáticos respiratorios y sus familiares en un Centro de Salud Escuela en Belém, Pará. Materiales y Métodos Estudio cuantitativo, transversal, con 40 pacientes sintomáticos respiratorios. Se utilizó como instrumento la recolección de datos socioeconómicos y los costos del diagnóstico de la enfermedad. Se realizó un análisis descriptivo, con distribución de frecuencias y medidas sumadas de los promedios, desviación estándar y pruebas de chi cuadrado, con un nivel de significancia del 5%. Resultados Hubo reducción de las horas de trabajo por día después de la aparición de los síntomas respiratorios y pérdida del empleo en un 20%, lo que influyó en la reducción media del ingreso. Los costos directos e indirectos fueron responsables por la pérdida del 1 al 20% del ingreso familiar. Discusión Se demostró que la búsqueda del diagnóstico de la tuberculosis sobrecarga los presupuestos familiares, lo que puede llevar a que el paciente posponga la búsqueda del diagnóstico en los servicios de salud. Conclusiones La búsqueda del diagnóstico de la tuberculosis representa un gasto importante para los pacientes y sus familiares. La enfermedad está relacionada con la vulnerabilidad socioeconómica puesto que, aunque el diagnóstico se ofrece en la red pública de salud, los costos recaen en las familias.

Associations among body composition, inflammatory profile and disease extent in ulcerative colitis patients / Associações entre composição corporal, perfil inflamatório e extensão da doença em pacientes com retocolite ulcerativa

Summary Objective: The aim of our study was to assess body composition status and its association with inflammatory profile and extent of intestinal damage in ulcerative colitis patients during clinical remission. Method: This is a cross-sectional study in which body composition data (phase angle [PhA], fat mass [FM], triceps skin fold thickness [TSFt], mid-arm circumference [MAC], mid-arm muscle circumference [MAMC], adductor pollicis muscle thickness [APMt]), inflammatory profile (C-reactive protein [CRP], a1-acid glycoprotein, erythrocyte sedimentation rate [ESR]) and disease extent were recorded. Results: The mean age of the 59 patients was 48.1 years; 53.3% were women. Most patients were in clinical remission (94.9%) and 3.4% was malnourished according to body mass index. PhA was inversely correlated with inflammatory markers such as CRP (R=-0.59; p<0.001) and ESR (R=-0.46; p<0.001) and directly correlated with lean mass: MAMC (R=0.31; p=0.01) and APMt (R=0.47; p<0.001). Lean mass was inversely correlated with non-specific inflammation marker (APMt vs. ESR) and directly correlated with hemoglobin values (MAMC vs. hemoglobin). Logistic regression analysis revealed that body cell mass was associated with disease extent (OR 0.92; 95CI 0.87-0.97; p<0.01). Conclusion: PhA was inversely correlated with inflammatory markers and directly correlated with lean mass. Acute inflammatory markers were correlated with disease extent. Body cell mass was associated with disease extent.

Resumo Objetivo: Avaliar a composição corporal de pacientes portadores de retocolite ulcerativa em remissão clínica e sua associação com o perfil inflamatório e a extensão da lesão intestinal. Método: Foi realizado um estudo transversal. Os dados relacionados à composição corporal foram ângulo de fase (AF), massa adiposa (MA), dobra cutânea triciptal (DCT), circunferência do braço (CB), circunferência muscular do braço (CMB) e espessura do músculo adutor do polegar (EMAP). O perfil inflamatório foi avaliado através da dosagem da proteína-C reativa (PCR), a1-glicoproteína ácida e velocidade de hemossedimentação (VHS) e a extensão da doença foi avaliada de acordo com o exame endoscópico. Resultados: Foram avaliados 59 pacientes. A média de idade foi de 48,1 anos e 53,3% eram mulheres. A maioria dos pacientes (94,9%) estava em remissão clínica da doença e 3,4% foi classificada como desnutrida de acordo com o IMC. Observou-se uma correlação inversa entre AF e marcadores inflamatórios como a PCR (R=-0,59; p<0,001) e VHS (R=-0,46; p<0,001) e uma correlação direta entre AF e os indicadores de massa magra como CMB (R=0,31; p=0,01) e EMAP (R=0,47; p<0,001). A massa magra foi inversamente correlacionada com marcadores inflamatórios não específicos, como a VHS, e diretamente correlacionada com a hemoglobina. De acordo com a análise de regressão logística, a massa celular corporal foi associada com extensão da lesão intestinal (OR 0,92; IC95% 0,87-0,97; p<0,01). Conclusão: AF foi inversamente correlacionado com marcadores inflamatórios e diretamente correlacionado com a massa magra. Marcadores inflamatórios de fase aguda e massa celular corporal foram correlacionados com extensão da lesão intestinal.

Avaliação do curso de aperfeiçoamento Impactos da Violência na Saúde, modalidade a distância: reflexos e possibilidades / Evaluation of the improvement course Impacts of Violence in Health, distance modality: reflexes and possibilities

O capítulo pretende refletir a respeito do ensino do tema da violência na modalidade a distância no âmbito da saúde a partir da experiência específica de avaliação das quatro primeiras turmas do curso aperfeiçoamento Impactos da Violência na saúde, realizadas pelo Departamento de Estudos sobre Violência e Saúde Jorge Careli (Claves) da Escola Nacional de Saúde Pública Sergio Arouca (Ensp) da Fundação Oswaldo Cruz (Fiocruz). foram apontados questões que interferiram no curso, como sua estrutura, os processos desenvolvidos no decorrer de sua realização e os impactos dessa ação educativa. (AU)

Factors that influence the redox state in children: An exploratory study

OBJECTIVE: The aim of the present study was to investigate the association of the redox state via malondialdehyde (MDA) as a lipid peroxidation biomarker and hydrophilic antioxidant capacity (HAC) with dietary, anthropometric, demographic, socio-economic and clinical variables as well as the serum concentrations of vitamins in children aged 20-36 months. This cross-sectional study was conducted from May 2013 to May 2014 and included a total of 100 children. METHODS: The variables studied included anthropometric measurements, dietary intake by the Food Frequency Questionnaire (FFQ), socio-demographic features, clinical attributes, serum redox status, and serum vitamin concentrations. RESULTS: Children with a family income above the minimum wage and adequate body mass index (BMI) presented higher HAC. The MDA concentration was higher in children older than 24 months. Breastfeeding for up to 120 days provided greater antioxidant capacity. Children classified in the 2nd tertile for "fruit and vegetables" and "milk and dairy products" consumption showed lower levels of MDA. There was a positive correlation of MDA with serum vitamin A levels. These results show that among children in the 20-36 months age group, family income, breastfeeding, BMI and intake of fruits and vegetables can have an influence on the imbalance of the redox state. CONCLUSION: One strategy to prevent the imbalance between oxidants and antioxidants could be for health professionals to raise awareness among families, as such knowledge could repress/prevent the progression/initiation of several diseases in adult life.

The role of oxidative stress on the pathophysiology of metabolic syndrome / O papel do estresse oxidativo na fisiopatologia da síndrome metabólica

Summary Metabolic syndrome (MetS) has a high prevalence around the world. Considering the components used to classify MetS, it is clear that it is closely related to obesity. These two conditions begin with an increase in abdominal adipose tissue, which is metabolically more active, containing a greater amount of resident macrophages compared to other fat deposits. Abdominal adiposity promotes inflammation and oxidative stress, which are precursors of various complications involving MetS components, namely insulin resistance, hypertension and hyperlipidemia. One way to block the effects of oxidative stress would be through the antioxidant defense system, which offsets the excess free radicals. It is known that individuals with metabolic syndrome and obesity have high consumption of fats and sugars originated from processed foods containing high levels of sodium as well as low intake of fruits and vegetables, thus maintaining a state of oxidative stress, that can speed up the onset of MetS. Healthy eating habits could prevent or delay MetS by adding antioxidant-rich foods into the diet.

Resumo A síndrome metabólica apresenta elevada prevalência na população mundial. De acordo com os componentes que a classificam, nota-se que está intimamente relacionada com a obesidade. Essas duas condições se iniciam com o aumento do tecido adiposo abdominal, o qual é metabolicamente mais ativo, contendo uma quantidade maior de macrófagos residentes em comparação com outros depósitos de gordura. Essa situação favorece a inflamação e o estresse oxidativo, ambos precursores de diversas complicações, mas principalmente as envolvidas na síndrome metabólica, como resistência à insulina, hipertensão arterial e hiperlipidemia. Uma maneira de bloquear os efeitos do estresse oxidativo seria pelo sistema de defesa antioxidante, o qual anula os radicais livres em excesso. É sabido que indivíduos portadores de síndrome metabólica e obesos apresentam um alto consumo de gorduras, açúcares oriundos de alimentos industrializados com alto teor de sódio e uma baixa ingestão de frutas e verduras, apresentando uma condição de estresse oxidativo contínuo. A manutenção de hábitos alimentares saudáveis, com a inclusão de alimentos ricos em antioxidantes, poderia prevenir ou retardar o surgimento da SM.

As percepções de um usuário de substâncias psicoativas em abstinência sobre os motivos de recaída: um estudo de caso / The perceptions of a user of abstinence psychoactive substances on the reasons for relapse: a case study

Prevenção da recaída é a manutenção do processo de mudança de hábitos e automanejo. Tem como objetivo ensinar o indivíduo a lidar com seu problema e prever uma possível recaída, além disso se refere a mudança de qualquer comportamento relacionado ao problema. O objetivo deste estudo foi identificar de acordo com as percepções de um usuário em abstinência quais foram os motivos de recaída no consumo de substâncias psicoativas. Foi realizada uma pesquisa qualitativa por meio de um estudo de caso em uma instituição de apoio. A análise dos dados foi conduzida por análise de conteúdo que originou 5 categorias. Dentre elas, percepções dos motivos de recaída, a combinação de fatores de risco e proteção se mesclaram para os problemas apresentados por Gabriel e também para as resiliências que foram emergindo ao longo do percurso de vida. O processo de recuperação requer aprendizagem e manejo das adversidades que ocorrem em função dos TRSA. Neste estudo de caso, pode-se perceber que G. não se coloca em situações de risco no momento atual, pois aprimorou seus recursos de autoconhecimento e assertividade, dentre elas as estratégias de prevenção de recaída.(AU)

Preventing relapse is the maintenance of the process of changing habits and self management. It aims to teach the individual to deal with their problem and predict a possible relapse, in addition it refers to changing any behavior related to the problem. The objective of this study was to identify according to the perceptions of a user in abstinence what were the reasons for relapse in the consumption of psychoactive substances. A qualitative research was carried out by means of a case study in a support institution. The analysis of the data was conducted by content analysis that originated 5 categories. Among them, perceptions of the reasons for relapse. The combination of risk and protection factors blended into the problems presented by Gabriel and also to the resiliencies that have emerged along the course of life. The recovery process requires learning and managing the adversities that occur due to TRSA. In this case study, one can see that G. does not place himself in situations of risk at the present moment, since he has improved his resources of self-knowledge and assertiveness, among them the relapse prevention strategies.(AU)

Inflamação renal, alterações metabólicas e oxidativas após 6 semanas de dieta de cafeteria em ratos / Renal inflammatory and oxidative and metabolic changes after 6 weeks of cafeteria diet in rats

Resumo Introdução: A obesidade é uma doença em que a inflamação está inteiramente envolvida e pode causar insuficiência renal. Objetivo: Avaliar a influência da exposição a curto prazo de uma dieta de cafeteria sobre a inflamação no tecido renal e a formação de produtos de glicação avançada (AGEs) no plasma de rato. Métodos: Ratos Wistar machos (10 semanas de idade, pesando 350 g) foram designados para receber dieta de ração comercial (C; n = 8 animais/grupo, 5% de energia a partir de gordura) ou dieta de cafeteria (CAF-D, n = 8 animais/grupo: 29% de energia de gordura) e de sacarose em água (300 g/L) de beber durante 6 semanas. Resultados: Índice de adiposidade em seis semanas foi maior no grupo CAF-D em comparação com C. O mesmo comportamento foi observado para os níveis plasmáticos de glicose, triglicerídeos, leptina, insulina e AGEs. A expressão do gene de IL-6 e TNF-α em tecido renal foi maior no grupo D-CAF e nenhuma diferença significativa no tecido adiposo. Não houve aumento destas citocinas no plasma ou rim. Houve uma diminuição significativa de adiponectina no grupo CAF-D. Conclusão: A exposição a curto prazo da CAF-D reflete alterações no metabolismo, aumento dos níveis plasmáticos de AGEs, o que pode refletir o aumento expressão de citocinas inflamatórias no rim.

Abstract Introduction: Obesity is a disease in which inflammation is directly involved and can lead to impaired renal function. Objective: To evaluate the influence of short term exposure to cafeteria diet on kidney tissue inflammation and advanced glycation end products (AGEs) in the rat plasma. Methods: Male Wistar rats (10 weeks of age, weighing 350 g) were assigned to receive commercial chow diet (C; n = 8 animals/group, 5% of energy from fat) or cafeteria diet (CAF-D, n = 8 animals/group: 29% energy fat) and sucrose in drinking water (300 g/L) for 6 weeks. Results: adiposity index at six weeks was higher in CAF-D group compared to C. The same behavior was observed for plasma levels of glucose, triglycerides, leptin, insulin and AGEs. The gene expression of IL-6 and TNF-α in renal tissue was higher in CAF-D group and no significant difference in adipose tissue. There was no increase of these cytokines in plasma and kidney or histologically. There was a significant decrease of adiponectin in the CAF-D group. Conclusion: The short exposure CAF-D reflects changes in metabolism, increased plasma levels of AGEs, which may reflect the increased expression of inflammatory cytokines in the kidney.

Novel scalable 3D cell based model for in vitro neurotoxicity testing: Combining human differentiated neurospheres with gene expression and functional endpoints.

There is an urgent need for new in vitro strategies to identify neurotoxic agents with speed, reliability and respect for animal welfare. Cell models should include distinct brain cell types and represent brain microenvironment to attain higher relevance. The main goal of this study was to develop and validate a human 3D neural model containing both neurons and glial cells, applicable for toxicity testing in high-throughput platforms. To achieve this, a scalable bioprocess for neural differentiation of human NTera2/cl.D1 cells in stirred culture systems was developed. Endpoints based on neuronal- and astrocytic-specific gene expression and functionality in 3D were implemented in multi-well format and used for toxicity assessment. The prototypical neurotoxicant acrylamide affected primarily neurons, impairing synaptic function; our results suggest that gene expression of the presynaptic marker synaptophysin can be used as sensitive endpoint. Chloramphenicol, described as neurotoxicant affected both cell types, with cytoskeleton markers' expression significantly reduced, particularly in astrocytes. In conclusion, a scalable and reproducible process for production of differentiated neurospheres enriched in mature neurons and functional astrocytes was obtained. This 3D approach allowed efficient production of large numbers of human differentiated neurospheres, which in combination with gene expression and functional endpoints are a powerful cell model to evaluate human neuronal and astrocytic toxicity.

Balanced anesthesia with sevoflurane does not alter redox status in patients undergoing surgical procedures.

Despite the effectiveness and safety of anesthetics, some unanswered questions remain concerning their toxicity and effects on cellular redox balance. To test for possible toxic effects of balanced anesthesia maintained with the volatile anesthetic sevoflurane, we evaluated oxidative stress during and after general anesthesia in 15 adult patients without comorbidities who underwent elective minor surgical procedures. Venous blood samples were collected at baseline, before anesthesia (t0); after anesthesia induction and immediately before surgery (t1); 2h after the beginning of anesthesia (t2); and on the day following surgery (t3). Antioxidant defense was determined by fluorometry. Oxidative stress markers included oxidative DNA damage, evaluated by the alkaline comet assay, and plasma malondialdehyde (MDA), assessed by high performance liquid chromatography (HPLC). No increase in oxidized DNA damage or antioxidant defense was observed. Plasma MDA increased only at t3 compared with t2. Balanced sevoflurane-maintained anesthesia appears neither to damage DNA nor to alter redox status.