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1.
Rev. bras. enferm ; 77(1): e20230321, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1559454

RESUMO

ABSTRACT Objectives: to describe the profile of older adults who access the internet to search for health information and identify the factors that can influence older adults' decisions about their health based on information collected online. Methods: 391 older adults answered an online questionnaire regarding habits and satisfaction with information about health collected on the internet. Data processing involved Logistic Regression. Results: higher education reduces by 44% the likelihood of an older adult following the health recommendations on internet sites. However, social activities and self-perceived health increase the possibility of following the recommendations by 83% and 71%, respectively. The belief that the internet promotes healthy habits increases by 29.2 times the probability of an older adult following the advice. Final Considerations: knowing the profile of older adults who use the Internet can help professionals formulate public policies and build good information platforms on health and well-being.


RESUMO Objetivos: descrever o perfil dos idosos que acessam a internet para buscar informações sobre saúde e identificar os fatores que podem influenciar as decisões dos idosos sobre sua saúde com base nas informações coletadas online. Métodos: 391 idosos responderam a um questionário online sobre hábitos e satisfação com informações sobre saúde coletadas na internet. Processamento dos dados envolveu regressão logística. Resultados: ensino superior reduz em 44% a probabilidade de idosos seguirem recomendações de saúde em sites da internet. Porém, atividades sociais e autopercepção de saúde aumentam a possibilidade de seguir as recomendações em 83% e 71%, respectivamente. A crença de que a internet promove hábitos saudáveis aumenta em 29,2 vezes a probabilidade de idosos seguirem os conselhos. Considerações Finais: conhecer o perfil dos idosos que utilizam a internet pode auxiliar os profissionais na formulação de políticas públicas e na construção de boas plataformas de informação sobre saúde e bem-estar.


RESUMEN Objetivos: describir el perfil de los ancianos que acceden a internet para buscar información de salud e identificar los factores que pueden influir en las decisiones de los ancianos sobre su salud a partir de la información recopilada en línea. Métodos: 391 ancianos respondieron a un cuestionario online sobre hábitos y satisfacción con la información de salud recogida en internet. El procesamiento de datos implicó regresión logística. Resultados: la educación superior reduce en un 44% la probabilidad de que un anciano siga las recomendaciones de salud en los sitios web. Sin embargo, las actividades sociales y la salud autopercibida aumentan la posibilidad de seguir las recomendaciones en un 83% y un 71%, respectivamente. La creencia de que internet promueve hábitos saludables aumenta 29,2 veces la probabilidad de que un anciano siga un consejo. Consideraciones Finales: conocer el perfil de los ancianos que utilizan internet puede ayudar a los profesionales a formular políticas públicas y construir buenas plataformas de información sobre salud y bienestar.

2.
Acta Cir Bras ; 38: e384723, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37878985

RESUMO

PURPOSE: To evaluate local and systemic effects of 24-hour fasting in liver ischemia and reperfusion injury. METHODS: Twenty-one adult male Wistar rats (330-390 g) were submitted to 60 minutes of hepatic ischemia followed by 24 hours of reperfusion. Before the day of the experiment, the animals fasted, but free access to water was allowed. Two groups were constituted: Control: non-fasted, that is, feeding ad libitum before surgical procedure; Fasting: rats underwent previous fasting of 24 hours. Hepatic ischemia was performed using vascular clamp in hepatic pedicle. At 24 hours after liver reperfusion, blood and tissue samples were collected. To analysis, liver lobes submitted to ischemia was identified as ischemic liver and paracaval non-ischemic lobes as non-ischemic liver. We evaluated: malondialdehyde levels, hepatocellular function (alanine aminotransferase, aspartate aminotransferase activities, and both ratio), cytokines (interleukins-6, -10, and tumor necrosis factor-alpha), hepatic ischemia and reperfusion injury (histology). RESULTS: Malondialdehyde measured in non-ischemic and ischemic liver samples, hepatocellular function and cytokines were comparable between groups. Histological findings were distinct in three regions evaluated. Microvesicular steatosis was comparable between 24-hour fasting and non-fasted control groups in periportal region of hepatic lobe. In contrast, steatosis was more pronounced in zones 2 and 3 of ischemic liver samples of fasting compared to control groups. CONCLUSIONS: These data indicates that fasting does not protect, but it can be also detrimental to liver submitted to ischemia/reperfusion damage. At that time, using long fasting before liver surgery in the real world may be contraindicated.


Assuntos
Hepatopatias , Traumatismo por Reperfusão , Ratos , Masculino , Animais , Ratos Wistar , Fígado/patologia , Isquemia/patologia , Traumatismo por Reperfusão/patologia , Hepatopatias/patologia , Citocinas , Jejum , Alanina Transaminase , Malondialdeído
3.
Surg Endosc ; 37(12): 9263-9274, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37880447

RESUMO

BACKGROUND: The effects of hernia repair on testicular function remain uncertain, regardless of the technique used. Studies that analyze testicular volume and flow after hernia repair or hormonal measurements are scarce and show contradictory results. This study aimed to evaluate the impact of bilateral inguinal hernia repair on male fertility in surgical patients in whom the Lichtenstein and laparoscopic transabdominal preperitoneal (TAPP) techniques were used. METHODS: A randomized clinical trial comparing open (Lichtenstein) versus laparoscopic (TAPP) hernia repair using polypropylene mesh was performed in 48 adult patients (20 to 60 years old) with primary bilateral inguinal hernia. Patients were evaluated preoperatively and 90 and 180 postoperative (PO) days. Sex hormones (Testosterone, FSH, LH and SHGB) analysis, testicular ultrasonography, semen quality sexual activity changes and quality of life (QoL) were performed. Postoperative pain was evaluated using the visual analog scale (VAS). RESULTS: Thirty-seven patients with aged of 44 ± 11 years were included, 19 operated on Lichtenstein and 18 operated on TAPP. The surgical time was similar between techniques. The pain was greater in the Lichtenstein group on the 7th PO day. The biochemical and hormonal analyses, testicular ultrasonography (Doppler, testicular volume, and morphological findings) and sperm quality were similar between groups. However, the sperm morphology was better in the Lichtenstein group after 180 days (p < 0.05 vs. preoperative) and two patients who underwent Lichtenstein hernia repair had oligospermia after 180 days. The QoL evaluation showed a significant improvement after surgery in the following domains: physical function, role emotional, bodily pain and general health (p < 0.05). On comparison of Lichtenstein vs. TAPP none of the domains showed statistically significant differences. No patient reported sexual changes. CONCLUSION: Bilateral inguinal hernia repair with polypropylene mesh, whether using Lichtenstein or TAPP, does not impair male fertility in terms of long-term outcomes. TRIAL REGISTRATION: Approved by the Ethics Committee for the Analysis of Research Projects (CAPPesq) of the HC/FMUSP, Number 2.974.457, in June 2015, Registered on Plataforma Brasil in October 2015 under Protocol 45535015.4.0000.0068. Registered on Clinicaltrials.gov, NCT05799742. Enrollment of the first subject in January 2016.


Assuntos
Hérnia Inguinal , Laparoscopia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fertilidade , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Dor Pós-Operatória/cirurgia , Polipropilenos , Qualidade de Vida , Sêmen , Análise do Sêmen , Telas Cirúrgicas , Resultado do Tratamento
4.
Acta Cir Bras ; 37(12): e371204, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36651429

RESUMO

PURPOSE: To evaluate effect of N-acetylcysteine (NAC) associated with Ringer lactate or hypertonic saline in inflammation and bacterial translocation on experimental intestinal obstruction (IO). METHODS: Wistar rats was subjected to IO. Six or 24 hours after, rats were subjected to enterectomy and fluid resuscitation: IO, RL (subjected to the same procedures but with fluid resuscitation using Ringer's lactate solution); RLNAC (added NAC to Ringer's solution); and HSNAC (surgical procedure + fluid reposition with 7.5% hypertonic saline and NAC). After 24 h, tissues were collected to cytokines, bacterial translocation, and histological assessments. RESULTS: In kidney, interleukin-1beta (IL-1beta) was lower in the groups with fluid resuscitation compared to IO group. The RLNAC showed lower levels compared to the RL. Interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), and (IFN-gamma) were lower in the treatment groups than in IO. In lung, IL-1beta and IL-6 were lower in RLNAC compared to IO. IL-10 was lower in RL, RLNAC and HSNAC compared to IO. TNF-alpha was higher in HSNAC compared to both RL and RLNAC. Bacterial translocation was observed in all animals of IO group. In kidneys, inflammation and congestion degrees were lower in HSNAC compared to RL. In lungs, inflammation levels were higher in RLNAC compared with the sham group. CONCLUSIONS: The data indicates that NAC associated with RL can promote a decrease in the inflammatory process in the kidneys and lungs in rats, following intestinal obstruction and ischemia in rats.


Assuntos
Obstrução Intestinal , Choque Hemorrágico , Ratos , Animais , Ratos Wistar , Interleucina-10 , Acetilcisteína/farmacologia , Acetilcisteína/uso terapêutico , Interleucina-6 , Fator de Necrose Tumoral alfa , Translocação Bacteriana , Solução Salina Hipertônica/farmacologia , Isquemia , Inflamação/tratamento farmacológico , Ressuscitação/métodos
5.
Acta cir. bras ; 38: e384723, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1519880

RESUMO

Purpose: To evaluate local and systemic effects of 24-hour fasting in liver ischemia and reperfusion injury. Methods: Twenty-one adult male Wistar rats (330-390 g) were submitted to 60 minutes of hepatic ischemia followed by 24 hours of reperfusion. Before the day of the experiment, the animals fasted, but free access to water was allowed. Two groups were constituted: Control: non-fasted, that is, feeding ad libitum before surgical procedure; Fasting: rats underwent previous fasting of 24 hours. Hepatic ischemia was performed using vascular clamp in hepatic pedicle. At 24 hours after liver reperfusion, blood and tissue samples were collected. To analysis, liver lobes submitted to ischemia was identified as ischemic liver and paracaval non-ischemic lobes as non-ischemic liver. We evaluated: malondialdehyde levels, hepatocellular function (alanine aminotransferase, aspartate aminotransferase activities, and both ratio), cytokines (interleukins-6, -10, and tumor necrosis factor-alpha), hepatic ischemia and reperfusion injury (histology). Results: Malondialdehyde measured in non-ischemic and ischemic liver samples, hepatocellular function and cytokines were comparable between groups. Histological findings were distinct in three regions evaluated. Microvesicular steatosis was comparable between 24-hour fasting and non-fasted control groups in periportal region of hepatic lobe. In contrast, steatosis was more pronounced in zones 2 and 3 of ischemic liver samples of fasting compared to control groups. Conclusions: These data indicates that fasting does not protect, but it can be also detrimental to liver submitted to ischemia/reperfusion damage. At that time, using long fasting before liver surgery in the real world may be contraindicated.


Assuntos
Animais , Ratos , Traumatismo por Reperfusão , Jejum , Isquemia , Fígado
6.
J Trauma Acute Care Surg ; 93(6): 838-845, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-35393381

RESUMO

BACKGROUND: Trauma-induced secondary cardiac injury has been associated with significant adverse cardiovascular events. Speckle tracking echocardiography is a novel technology that allows an accurate and reproducible cardiac structure and function assessment. We evaluated the left ventricle (LV) myocardial deformation by speckle tracking echocardiography in a hemorrhagic shock (HS) swine model. METHODS: Seven healthy male Landrace pigs were included in this study. Severe HS was reached through three sequentially blood withdraws of 20% of estimated blood volume, and it was maintained for 60 minutes. Volume resuscitation was performed using all precollected blood volume. A 1.8- to 4.2-MHz phased-array transducer was used to acquire the two-dimensional echocardiography images. Strain measurements were obtained semiautomatically by wall motion tracking software. Results are presented as medians and interquartile ranges and compared using Wilcoxon rank-sum test. A p value of <0.05 was considered statistically significant. RESULTS: The median weight was 32 (26.1-33) kg, and the median total blood volume withdrawn was 1,100 (1,080-1,190) mL. During the severe HS period, the median arterial systemic pressure was 39 (36-46) mm Hg, and the cardiac index was 1.7 (1.6-2.0) L/min/m 2 . There was statistically significant absolute decrease in the global longitudinal strain 2 hours postresuscitation comparing with the basal measurements (-9.6% [-10.7 to -8.0%] vs. -7.9% [-8.1 to -7.4%], p = 0.03). There were no statistically significant differences between the basal and 2 hours postresuscitation assessments in the invasive/noninvasive hemodynamic, other two-dimensional echocardiogram (LV ejection fraction, 49.2% [44-54.3%] vs. 53.2% [51.5-55%]; p = 0.09), and circumferential strain (-10.6% [-14.4 to -9.0%] vs. -8.5% [-8.6 to -5.2%], p = 0.06) parameters. CONCLUSION: In this experimental swine model of controlled HS, LV global longitudinal strain analysis accurately characterizes the timing and magnitude of subclinical cardiac dysfunction associated with trauma-induced secondary cardiac injury.


Assuntos
Ecocardiografia Tridimensional , Choque Hemorrágico , Masculino , Suínos , Animais , Ventrículos do Coração/diagnóstico por imagem , Ecocardiografia Tridimensional/métodos , Choque Hemorrágico/diagnóstico por imagem , Reprodutibilidade dos Testes , Ecocardiografia/métodos
7.
Artigo em Inglês, Português | LILACS | ID: biblio-1377888

RESUMO

Objetivo: Analisar a qualidade de vida (QV) da população com sobrepeso referenciada ou assistida pela Atenção Básica de Saúde (ABS), evidenciando fatores clínicos e sociodemográficos associados aos aspectos da QV. Métodos: Estudo transversal analítico de caráter epidemiológico, desenvolvido em 2017-2020, em um município de Minas Gerais, Brasil, com 269 pessoas com sobrepeso e índice de massa corpórea (IMC) igual ou acima de 25 kg/m². Aplicaram-se instrumentos para avaliação da QV, contendo dados sociodemográficos, ansiedade, depressão, compulsão alimentar periódica e percepção da autoimagem. Utilizou-se análise univariada, regressão linear simples e múltipla com p<0,05. Resultados: Encontrou-se 74,3% (n=200) do sexo feminino, idade média de 39,43 ± 14,46 anos, 55% (n=149) obesidade moderada. 50% (n=134) apresentaram sintomas de ansiedade, 42,4% (n=114) sintomas depressivos, 20% (n=54) com compulsão alimentar e 32% (n=86) consideraram comprometimento negativo na sua autoimagem. 62,1% (n=167) apresentaram insuficiência na dimensão vitalidade. Quanto aos aspectos de correlação, IMC elevado, uso de medicação, aumento da idade, estado civil viúvo, presença de sintomas de ansiedade, depressão, compulsão alimentar e ausência de atividade física apresentaram diminuição em dimensões da QV. Conclusão: O estudo apontou que, entre as oito dimensões analisadas, apenas a dimensão "vitalidade" apresentou dados significativamente baixos entre os participantes, sendo possível identificar variáveis sociodemográficas que se correlacionaram, tendendo a diminuir aspectos ou dimensões da qualidade de vida: obesidade grave, fazer uso de medicação, apresentar estado civil viúvo, não realizar atividades físicas regularmente, apresentar sintomas de ansiedade, depressão e compulsão alimentar periódica em nível grave.


Objective: To analyze the Quality of Life (QoL) of the overweight population referred to or assisted by Primary Health Care (PHC), evidencing clinical and sociodemographic factors associated with aspects of QoL. Methods: Analytical cross-sectional epidemiological study, carried out in 2017-2020, in a municipality of Minas Gerais, Brazil, with 269 overweight people with a body mass index (BMI) equal to or above 25 kg/m². Instruments were applied to assess QoL, sociodemographic data, anxiety, depression, binge eating, and self-image perception. Simple and multiple linear regression were used. Results: 74.3% (n=200) were female, mean age of 39.43 ± 14.46 years, 55% (n=149) were moderately obese. 50% (n=134) had symptoms of anxiety, 42.4% (n=114) had depressive symptoms, 20% (n=54) had binge eating and 32% (n=86) considered their self-image to be negatively affected. 62.1% (n=167) showed insufficiency in the vitality dimension. As for the correlation aspects, high BMI, medication use, increasing age, widowed marital status, symptoms of anxiety, depression, binge eating, and lack of physical activity showed a decrease in QOL dimensions. Conclusion: The study showed that among the eight dimensions analyzed, only the "vitality" dimension presented significantly low data among the participants, making it possible to identify sociodemographic variables that were correlated, tending to decrease aspects or dimensions of quality of life: severe obesity, using of medication, being widowed, not performing physical activities regularly, presenting symptoms of anxiety, depression, and binge eating at a severe level.


Objetivo: Analizar la calidad de vida (CV) de la población con sobrepeso referenciada o asistida por la Atención Primaria de Salud (APS), evidenciando factores clínicos y sociodemográficos asociados a los aspectos de la CV. Métodos: Estudio transversal analítico de carácter epidemiológico, desarrollado en 2017-2020, en un municipio de Minas Gerais, Brasil, con 269 personas consobrepeso e índice de masa corporal (IMC) igual o superior a 25kg/m². Fueron aplicados instrumentos para evaluación de la CV, conteniendo datos sociodemográficos, ansiedad, depresión, trastorno de hiperfagia compulsiva y percepción de autoimagen. Fue utilizado análisis univariado, regresión linear simple y múltiple con p<0,05. Resultados: Se encontró 74,3% (n=200) del sexo femenino, edad média de 39,43 ± 14,46 años, 55% (n=149) obesidad moderada. 50% (n=134) presentaron síntomas de ansiedad, 42,4% (n=114) síntomas depresivos, 20% (n=54) con trastorno de hiperfagia compulsiva e 32% (n=86) consideraron comprometimiento negativo en su autoimagen. 62,1% (n=167) presentaron insuficiencia en la dimensión vitalidad. Cuanto a los aspectos de correlación, IMC alto, uso de medicación, aumento de la edad, estado civil viudo, presencia de síntomas de ansiedad, depresión, trastorno de hiperfagia compulsiva y ausencia de actividad física presentaron disminución en dimensiones de la CV. Conclusión: El estudio indicó que, entre las ocho dimensiones analizadas, solamente la dimensión "vitalidad" presentó datos significativamente bajos entre los participantes, posibilitando la identificación de variables sociodemográficas que se correlacionaron, tendiendo a disminuir aspectos o dimensiones de la calidad de vida: obesidad grave, uso de medicación, presentar estado civil viudo, no realizar actividades físicas regularmente, presentar síntomas de ansiedad, depresión y trastornode hiperfagia compulsiva en nivel grave.


Assuntos
Atenção Primária à Saúde , Qualidade de Vida , Obesidade , Sobrepeso
8.
Einstein (Säo Paulo) ; 19: eAO6088, 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1286288

RESUMO

ABSTRACT Objective: To compare the traditional printed form of the Behavioral Regulation in Exercise Questionnaire with a proposed online form in terms of validity, reliability, and applicability. Methods: A crossover design study was conducted with 157 undergraduate students. Half of the sample answered the printed questionnaire first and then answered the online questionnaire 7 days later, while the other half of the sample did the inverse. Cronbach's alpha was used to analyze the internal consistency of both the online and printed questionnaires. The construct validity was analyzed by confirmatory factor analysis, using a weighted least square mean and adjusted variance estimation and oblique rotation. The quality of the model was tested with fit indices. Results: The confirmatory factor analysis showed the 19-item structure with five factors: χ2 of 230.718; degrees of freedom of 142; χ2/degrees of freedom of 1.625; comparative fit index of 0.978 and root mean square error of approximation of 0.073. All items presented factorial loads above 0.5. There was also excellent consistency between the formats of administration in all dimensions, with Cronbach's alpha values above 0.70. The stability between the formats of administration varied between 0.78 (95%CI: 0.69-0.85) and 0.84 (95%CI: 0.77-0.89), suggesting desirable confidence between both formats of administration. Conclusion: The five-factor model of the online Behavioral Regulation in Exercise Questionnaire shows internal consistency both in terms of the scale dimensions as well as in terms of the total items.


RESUMO Objetivo: Comparar a forma tradicional impressa do Behavioral Regulation in Exercise Questionnaire com uma proposta de formulário on-line, em termos de validade, confiabilidade e aplicabilidade. Métodos: Estudo de delineamento cruzado (crossover) realizado com 157 estudantes universitários de graduação. Metade da amostra respondeu primeiro ao questionário impresso e, 7 dias depois, ao questionário on-line, enquanto a outra metade da amostra fez o inverso. O coeficiente alfa de Cronbach foi usado para analisar a consistência interna dos questionários on-line e impressos. A validade de construção foi verificada por análise fatorial confirmatória, utilizando-se um estimador de mínimos quadrados ajustados pela média e variância e rotação oblíqua. A qualidade do modelo foi testada com índices de ajuste. Resultados: A análise fatorial confirmatória mostrou a estrutura de 19 itens com cinco fatores: χ2 de 230,718; graus de liberdade de 142; χ2/grau de liberdade de 1,625; índice de ajuste comparativo de 0,978 e raiz do erro quadrático médio de aproximação de 0,073. Todos os itens apresentaram cargas fatoriais acima de 0,5. Também houve excelente consistência entre os formatos de administração em todas as dimensões, com valores de alfa de Cronbach acima de 0,70. A estabilidade entre os formatos de administração variou entre 0,78 (IC95%: 0,69-0,85) e 0,84 (IC95%: 0,77-0,89), sugerindo confiança desejável entre os dois formatos de administração. Conclusão: O modelo de cinco fatores do Behavioral Regulation in Exercise Questionnaire on-line apresenta consistência interna tanto em relação às dimensões da escala quanto em relação ao total de itens.


Assuntos
Humanos , Exercício Físico , Psicometria , Inquéritos e Questionários , Reprodutibilidade dos Testes , Análise Fatorial
10.
Patient Prefer Adherence ; 13: 1619-1628, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31686788

RESUMO

OBJECTIVE: To evaluate medication adherence and associated socioeconomic factors in elderly Brazilians. METHODOLOGY: This observational study was conducted with 159 elderly retired in an outpatient clinic in the city of São Paulo. Treatment adherence was assessed with the questions from the Morisky Green Levine Medication Adherence Questionnaire, and medications were classified using the Anatomical Therapeutic Chemical system. Statistical tests and adjusted Poisson regression models were used to analyze variables. RESULTS: The study population was mostly female (67.5%), had an average age of, and took an average of 6.5 medications per day. The most commonly used drugs were agents acting on the renin-angiotensin system (67.9%), statins (62.3%), antithrombotic agents (48.4%), and biguanides (37.1%) for the treatment of hypertension (76.7%), dyslipidemia (54.1%), and diabetes (47.8%). The rate of adherence was below 60% in the groups of participants that were analyzed except for the high household income category, which had a rate of 75.8%. CONCLUSION: Medication adherence among the elderly was low in all categories except for the high household income category, a relevant finding that will help to understand medication adherence patterns in elderly Brazilians.

12.
Patient Prefer Adherence ; 13: 1-10, 2019.
Artigo em Inglês | LILACS, CONASS, Coleciona SUS, Sec. Est. Saúde SP, SESSP-CVEPROD, Sec. Est. Saúde SP | ID: biblio-1418524

RESUMO

Objective: To evaluate medication adherence and associated socioeconomic factors in elderly Brazilians. Methodology: This observational study was conducted with 159 elderly retired in an outpatient clinic in the city of São Paulo. Treatment adherence was assessed with the questions from the Morisky Green Levine Medication Adherence Questionnaire, and medications were classified using the Anatomical Therapeutic Chemical system. Statistical tests and adjusted Poisson regression models were used to analyze variables. Results: The study population was mostly female (67.5%), had an average age of, and took an average of 6.5 medications per day. The most commonly used drugs were agents acting on the renin-angiotensin system (67.9%), statins (62.3%), antithrombotic agents (48.4%), and biguanides (37.1%) for the treatment of hypertension (76.7%), dyslipidemia (54.1%), and diabetes (47.8%). The rate of adherence was below 60% in the groups of participants that were analyzed except for the high household income category, which had a rate of 75.8%. Conclusion: Medication adherence among the elderly was low in all categories except for the high household income category, a relevant finding that will help to understand medication adherence patterns in elderly Brazilians.


Assuntos
População , Terapêutica , Características da Família
13.
Clinics ; 74: e787, 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1011911

RESUMO

OBJECTIVES: Intestinal obstruction has a high mortality rate when therapeutic treatment is delayed. Resuscitation in intestinal obstruction requires a large volume of fluid, and fluid combinations have been studied. Therefore, we evaluated the effects of hypertonic saline solution (HS) with pentoxifylline (PTX) on apoptosis, oxidative stress and survival rate. METHODS: Wistar rats were subjected to intestinal obstruction and ischemia through a closed loop ligation of the terminal ileum and its vessels. After 24 hours, the necrotic bowel segment was resected, and the animals were randomized into four groups according to the following resuscitation strategies: Ringer's lactate solution (RL) (RL-32 ml/kg); RL+PTX (25 mg/kg); HS+PTX (HS, 7.5%, 4 ml/kg), and no resuscitation (IO-intestinal obstruction and ischemia). Euthanasia was performed 3 hours after resuscitation to obtain kidney and intestine samples. A malondialdehyde (MDA) assay was performed to evaluate oxidative stress, and histochemical analyses (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling [TUNEL], Bcl-2 and Bax) were conducted to evaluate kidney apoptosis. Survival was analyzed with another series of animals that were observed for 15 days. RESULTS: PTX in combination with RL or HS reduced the MDA levels (nmol/mg of protein), as follows: kidney IO=0.42; RL=0.49; RL+PTX=0.31; HS+PTX=0.34 (p<0.05); intestine: IO=0.42; RL=0.48; RL+PTX=0.29; HS+PTX=0.26 (p<0.05). The number of labeled cells for TUNEL and Bax was lower in the HS+PTX group than in the other groups (p<0.05). The Bax/Bcl-2 ratio was lower in the HS+PTX group than in the other groups (p<0.05). The survival rate on the 15th day was higher in the HS+PTX group (77%) than in the RL+PTX group (11%). CONCLUSION: PTX in combination with HS enhanced survival and attenuated oxidative stress and apoptosis. However, when combined with RL, PTX did not reduce apoptosis or mortality.


Assuntos
Animais , Masculino , Pentoxifilina/farmacologia , Ressuscitação/métodos , Solução Salina Hipertônica/farmacologia , Apoptose/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Obstrução Intestinal/metabolismo , Imuno-Histoquímica , Peroxidação de Lipídeos/efeitos dos fármacos , Distribuição Aleatória , Reprodutibilidade dos Testes , Ratos Wistar , Marcação In Situ das Extremidades Cortadas , Modelos Animais de Doenças , Estimativa de Kaplan-Meier , Obstrução Intestinal/mortalidade , Obstrução Intestinal/prevenção & controle , Intestino Delgado/efeitos dos fármacos , Intestino Delgado/metabolismo , Rim/efeitos dos fármacos , Rim/metabolismo , Malondialdeído/análise
14.
Acta cir. bras ; 33(9): 753-761, Sept. 2018. graf
Artigo em Inglês | LILACS | ID: biblio-973501

RESUMO

Abstract Purpose: To evaluate the oxidative stress, resulting from ischemia and hepatic reperfusion, in mice with non-alcoholic hepatic steatosis and steatohepatitis. Methods: C57BL/6 male mice were used. Part of them were ob/ob mice, and the other part was fed with standard or MCD diets - this last used to develop steatohepatitis. The animals - MCD-I/R, ob/ob-I/R and I/R groups - were submitted to 30 minutes of partial hepatic ischemia, followed by reperfusion for 24 hours. The blood was collected, for biochemical analysis of AST, and the liver removed for assessment of TBARS and nitrite, and of histology. Results: After the I/R, the animal fed with MCD diet presented higher AST levels (MCD-I/R: 967±349U/L / ob/ob-I/R: 606±18 U/L / I/R: 311±172 U/L), TBARS (MCD-I/R: 7±1 nM/mg protein / ob/ob-I/R: 3±1 nM/mg protein / I/R: 3±1 nM/mg protein) and nitrite (MCD-I/R: 614±87 µg/mL / ob/ob-I/R: 512±81 µg/mL / I/R: 459±29 µg/mL) than the ob/ob mice, when both groups were compared to animals fed with standard diet. Regarding histology, the steatosis level (azonal macrovesicular steatosis of level 3 - >66%) and hepatic fibrosis (periportal and perisinusoidal of level 2) was also more intense, but both animal models presented lobular inflammation of level 3 (>66%). Conclusions: The murine model fed with MCD diet is suitable for the assessment of oxidative stress in hepatic I/R injury associated with the nonalcoholic fatty liver disease. Although both murine models showed inflammatory infiltrate and macro and micro vesicular steatosis.


Assuntos
Animais , Masculino , Ratos , Peroxidação de Lipídeos/fisiologia , Traumatismo por Reperfusão/metabolismo , Estresse Oxidativo/fisiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Nitritos/metabolismo , Traumatismo por Reperfusão/patologia , Modelos Animais de Doenças , Hepatopatia Gordurosa não Alcoólica/patologia , Camundongos Endogâmicos C57BL
15.
J Surg Res ; 225: 118-124, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29605021

RESUMO

BACKGROUND: Intestinal ischemia reperfusion is a common clinical condition that causes functional impairment. Once tight junctions are damaged, barrier function is compromised, and the intestines become a source for entry of bacterial and inflammatory mediators into the circulation, leading to systemic inflammatory response syndrome, multiple organ failure, and death. It is possible that diazoxide could protect the intestines against ischemia reperfusion. The aim of this study is to determine whether diazoxide can provide protection in a rat model of intestinal ischemia reperfusion. METHODS: A total of 32 adult male specific pathogen-free Wistar rats were randomized into three groups: a control group, n = 6; a saline group, n = 13; and a diazoxide group, n = 13. The saline and diazoxide groups underwent clamping of the superior mesenteric artery for 1 h, with samples in all the groups being collected 12 h later. RESULTS: Intestinal histology showed greater damage in the intestinal ischemia reperfusion groups. mRNA expression of zonula occludens-1 and occludin (tight junction proteins) and interleukin-6 and cyclooxygenase-2 was the highest in the Saline group. The Diazoxide group showed a reduction in aspartate aminotransferase serum levels compared with the other groups. CONCLUSIONS: Increased expression of zonula occludens-1, occludin, and cyclooxygenase-2 suggested a greater regenerative effort because of more severe lesions in the saline group. In addition, increased expression of interleukin-6 in the saline group was suggestive of inflammation, indicating that diazoxide had protective effects in the diazoxide group. Reduced aspartate aminotransferase in the diazoxide group suggested liver protection. Diazoxide protects the intestines and liver from intestinal ischemia reperfusion lesions in rats.


Assuntos
Diazóxido/farmacologia , Isquemia Mesentérica/tratamento farmacológico , Substâncias Protetoras/farmacologia , Traumatismo por Reperfusão/tratamento farmacológico , Animais , Aspartato Aminotransferases/sangue , Ciclo-Oxigenase 2/metabolismo , Diazóxido/uso terapêutico , Modelos Animais de Doenças , Coração/efeitos dos fármacos , Humanos , Interleucina-6/metabolismo , Mucosa Intestinal/irrigação sanguínea , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/patologia , Fígado/efeitos dos fármacos , Fígado/patologia , Masculino , Artéria Mesentérica Superior/cirurgia , Isquemia Mesentérica/etiologia , Isquemia Mesentérica/patologia , Miocárdio/patologia , Ocludina/metabolismo , Substâncias Protetoras/uso terapêutico , Distribuição Aleatória , Ratos , Ratos Wistar , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/patologia , Organismos Livres de Patógenos Específicos , Junções Íntimas/metabolismo , Resultado do Tratamento , Proteína da Zônula de Oclusão-1/metabolismo
16.
Arch. endocrinol. metab. (Online) ; 61(6): 600-607, Dec. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-887610

RESUMO

ABSTRACT Objective: Selenium (Se) supplementation has been used to help prevent the progression of Graves' ophthalmopathy (GO) and autoimmune thyroid diseases (AITD) patients. We investigated Se serum and selenoprotein P (SePP) levels in Graves' disease (GD) with and without GO, Hashimoto's thyroiditis (HT) patients and in 27 control individuals (C). Subjects and methods: We studied 54 female and 19 male patients: 19 with GD without GO, 21 GD with GO, 14 with HT and 19 with HT+LT4. Se values were measured using graphite furnace atomic absorption spectrophotometry. Serum SePP levels were measured by ELISA. Results: Median Se levels were similar among all groups; GD patients: 54.2 (46.5-61.1 μg/L), GO: 53.6 (43.5-60.0 μg/L), HT: 51.9 (44.6-58.5 μg/L), HT+LT4 54.4 (44-63.4) and C group patients: 56.0 (52.4-61.5 μg/L); P = 0.48. However, serum SePP was lower in GO patients: 0.30 (0.15-1.05 μg/mL) and in HT patients: 0.35 (0.2-1.17 μg/mL) compared to C group patients: 1.00 (0.564.21 μg/mL) as well as to GD patients: 1.19 (0.62-2.5 μg/mL) and HT+LT4 patients: 0.7 (0,25-1.95); P = 0.002. Linear regression analysis showed a significant relationship between SePP and TPOAb values (r = 0.445, R2 = 0.293; P < 0.0001). Multiple regression analysis found no independent variables related to Se or SePP. Conclusion: A serum Se concentration was lower than in some other countries, but not significantly among AITD patients. The low serum SePP levels in GO and HT patients seems to express inflammatory reactions with a subsequent increase in Se-dependent protein consumption remains unclear.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Selênio/sangue , Doença de Graves/sangue , Doença de Hashimoto/sangue , Selenoproteína P/sangue , Espectrofotometria Atômica , Biomarcadores/sangue , Estudos de Casos e Controles , Estudos Transversais , Progressão da Doença , Oftalmopatia de Graves/sangue
17.
Acta cir. bras ; 32(8): 641-647, Aug. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-886231

RESUMO

Abstract Purpose: To develop an experimental model of intestinal ischemia and obstruction followed by surgical resection of the damaged segment and reestablishment of intestinal transit, looking at bacterial translocation and survival. Methods: After anesthesia, Wistar rats was subject to laparotomy, intestinal ischemia and obstruction through an ileal ligature 1.5cm of ileum cecal valve; and the mesenteric vessels that irrigate upstream of the obstruction site to approximately 7 to 10 cm were ligated. Abdominal wall was closed. Three, six or twenty-four hours after, rats were subject to enterectomy followed by an end to end anastomosis. After 24h, mesenteric lymph nodes, liver, spleen and lung tissues were surgically removed. It was studied survival rate and bacterial translocation. GraphPadPrism statistical program was used. Results: Animals with intestinal ischemia and obstruction for 3 hours survived 24 hours after enterectomy; 6hx24h: survival was 70% at 24 hours; 24hx24h: survival was 70% and 40%, before and after enterectomy, respectively. Culture of tissues showed positivity on the 6hx24h and negativity on the 3hx24h. Conclusion: The model that best approached the clinic was the one of 6x24h of ischemia and intestinal obstruction, in which it was observed bacterial translocation and low mortality rate.


Assuntos
Animais , Masculino , Translocação Bacteriana/fisiologia , Modelos Animais de Doenças , Isquemia Mesentérica/microbiologia , Valva Ileocecal/irrigação sanguínea , Valva Ileocecal/microbiologia , Obstrução Intestinal/microbiologia , Fatores de Tempo , Contagem de Colônia Microbiana , Taxa de Sobrevida , Reprodutibilidade dos Testes , Ratos Wistar , Isquemia Mesentérica/cirurgia , Isquemia Mesentérica/mortalidade , Bactérias Anaeróbias Gram-Negativas/isolamento & purificação , Bactérias Anaeróbias Gram-Negativas/fisiologia , Valva Ileocecal/cirurgia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/mortalidade , Ligadura
18.
Clinics (Sao Paulo) ; 72(2): 125-129, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28273237

RESUMO

OBJECTIVE:: We aimed to assess the effects of diazoxide on the mortality, pancreatic injury, and inflammatory response in an experimental model of acute pancreatitis. METHODS:: Male Wistar rats (200-400 g) were divided randomly into two groups. Fifteen minutes before surgery, animals received physiological (0.9%) saline (3 mL/kg) (control group) or 45 mg/kg diazoxide (treatment group) via the intravenous route. Acute pancreatitis was induced by injection of 2.5% sodium taurocholate via the biliopancreatic duct. Mortality (n=38) was observed for 72 h and analyzed by the Mantel-Cox Log-rank test. To study pancreatic lesions and systemic inflammation, rats (10 from each group) were killed 3 h after acute pancreatitis induction; ascites volume was measured and blood as well as pancreases were collected. Pancreatic injury was assessed according to Schmidt's scale. Cytokine expression in plasma was evaluated by the multiplex method. RESULTS:: Mortality at 72 h was 33% in the control group and 60% in the treatment group (p=0.07). Ascites volumes and plasma levels of cytokines between groups were similar. No difference was observed in edema or infiltration of inflammatory cells in pancreatic tissues from either group. However, necrosis of acinar cells was lower in the treatment group compared to the control group (3.5 vs. 3.75, p=0.015). CONCLUSIONS:: Treatment with diazoxide can reduce necrosis of acinar cells in an experimental model of acute pancreatitis, but does not affect the inflammatory response or mortality after 72 h.


Assuntos
Diazóxido/farmacologia , Pancreatite Necrosante Aguda/tratamento farmacológico , Vasodilatadores/farmacologia , Animais , Colagogos e Coleréticos , Diazóxido/administração & dosagem , Modelos Animais de Doenças , Masculino , Pancreatite Necrosante Aguda/induzido quimicamente , Pancreatite Necrosante Aguda/mortalidade , Pancreatite Necrosante Aguda/patologia , Distribuição Aleatória , Ratos , Ratos Wistar , Ácido Taurocólico , Vasodilatadores/administração & dosagem
19.
Clinics ; 72(2): 125-129, Feb. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039536

RESUMO

OBJECTIVE: We aimed to assess the effects of diazoxide on the mortality, pancreatic injury, and inflammatory response in an experimental model of acute pancreatitis. METHODS: Male Wistar rats (200-400 g) were divided randomly into two groups. Fifteen minutes before surgery, animals received physiological (0.9%) saline (3 mL/kg) (control group) or 45 mg/kg diazoxide (treatment group) via the intravenous route. Acute pancreatitis was induced by injection of 2.5% sodium taurocholate via the biliopancreatic duct. Mortality (n=38) was observed for 72 h and analyzed by the Mantel-Cox Log-rank test. To study pancreatic lesions and systemic inflammation, rats (10 from each group) were killed 3 h after acute pancreatitis induction; ascites volume was measured and blood as well as pancreases were collected. Pancreatic injury was assessed according to Schmidt's scale. Cytokine expression in plasma was evaluated by the multiplex method. RESULTS: Mortality at 72 h was 33% in the control group and 60% in the treatment group (p=0.07). Ascites volumes and plasma levels of cytokines between groups were similar. No difference was observed in edema or infiltration of inflammatory cells in pancreatic tissues from either group. However, necrosis of acinar cells was lower in the treatment group compared to the control group (3.5 vs. 3.75, p=0.015). CONCLUSIONS: Treatment with diazoxide can reduce necrosis of acinar cells in an experimental model of acute pancreatitis, but does not affect the inflammatory response or mortality after 72 h.


Assuntos
Animais , Masculino , Ratos , Vasodilatadores/farmacologia , Pancreatite Necrosante Aguda/tratamento farmacológico , Diazóxido/farmacologia , Ácido Taurocólico , Vasodilatadores/administração & dosagem , Colagogos e Coleréticos , Distribuição Aleatória , Ratos Wistar , Pancreatite Necrosante Aguda/induzido quimicamente , Pancreatite Necrosante Aguda/mortalidade , Pancreatite Necrosante Aguda/patologia , Diazóxido/administração & dosagem , Modelos Animais de Doenças
20.
Acta Cir Bras ; 31(10): 675-679, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27828601

RESUMO

PURPOSE:: To evaluate the effect of remote ischemic preconditioning (IPC-R) in the fetal small bowel transplantation model. METHODS:: Two groups were constituted: The Isogenic transplant (ISO, C57BL/6 mice, n=24) and the allogenic transplant (ALO, BALB/c mice, n=24). In each group, the animals were distributed with and without IPC-R. It was obtained the following subgroups: Tx, IPC-R, Fk, IPC-Fk, in both strains. Intestinal grafts were stained with hematoxylin and eosin and immunohistochemically. RESULTS:: The graft development evaluation in ISO group showed that IPC-R reduced the development compared with ISO-Tx (5.2±0.4 vs 9.0±0.8) and IPC-R-Fk increased the graft development compared with IPC-R (11.2±0.7 and 10.2±0.8). In ALO group, IPC-Fk increased the development compared with ALO-Tx and ALO with IPC-R (6.0±0.8, 9.0±1.2, 0.0±0.0, 0.5±0.3). The PCNA expression was increased in ISO group treated with Fk and IPC-R compared to other groups (12.2±0.8 vs Tx: 8.8±0.9, IPC-R: 8.0±0.4 and Fk: 9.0±0.6). The graft rejection was lower in groups treated with IPC-R (-18%), Fk (-68%) or both (-61%) compared with ALO-Tx. CONCLUSION:: Remote ischemic preconditioning showed benefic effect even associate with Tacrolimus on the development and acute rejection of the fetal small bowel graft in the Isogenic and Allogenic transplants.


Assuntos
Transplante de Tecido Fetal/métodos , Imunossupressores/uso terapêutico , Intestino Delgado/irrigação sanguínea , Intestino Delgado/transplante , Precondicionamento Isquêmico/métodos , Tacrolimo/uso terapêutico , Animais , Proliferação de Células/efeitos dos fármacos , Feminino , Rejeição de Enxerto/prevenção & controle , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Reprodutibilidade dos Testes , Fatores de Tempo , Transplante Isogênico , Resultado do Tratamento
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