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1.
J Cell Physiol ; 239(4): e31199, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38291668

RESUMEN

The effects of exercise training (ET) on the heart of aortic stenosis (AS) rats are controversial and the mechanisms involved in alterations induced by ET have been poorly clarified. In this study, we analyzed the myocardial proteome to identify proteins modulated by moderate-intensity aerobic ET in rats with chronic supravalvular AS. Wistar rats were divided into four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary aortic stenosis (AS-Sed), and exercised AS (AS-Ex). ET consisted of five treadmill running sessions per week for 16 weeks. Statistical analysis was performed by ANOVA or Kruskal-Wallis and Goodman tests. Results were discussed at a significance level of 5%. At the end of the experiment, AS-Ex rats had higher functional capacity, lower blood lactate concentration, and better cardiac structural and left ventricular (LV) functional parameters than the AS-Sed. Myocardial proteome analysis showed that AS-Sed had higher relative protein abundance related to the glycolytic pathway, oxidative stress, and inflammation, and lower relative protein abundance related to beta-oxidation than C-Sed. AS-Ex had higher abundance of one protein related to mitochondrial biogenesis and lower relative protein abundance associated with oxidative stress and inflammation than AS-Sed. Proteomic data were validated for proteins related to lipid and glycolytic metabolism. Chronic pressure overload changes the abundance of myocardial proteins that are mainly involved in lipid and glycolytic energy metabolism in rats. Moderate-intensity aerobic training attenuates changes in proteins related to oxidative stress and inflammation and increases the COX4I1 protein, related to mitochondrial biogenesis. Protein changes are combined with improved functional capacity, cardiac remodeling, and LV function in AS rats.


Asunto(s)
Estenosis de la Válvula Aórtica , Miocardio , Condicionamiento Físico Animal , Proteoma , Animales , Ratas , Estenosis de la Válvula Aórtica/metabolismo , Inflamación , Lípidos , Condicionamiento Físico Animal/métodos , Proteómica , Ratas Wistar , Miocardio/metabolismo
2.
Clin Infect Dis ; 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39012174

RESUMEN

Following the 2022 global mpox outbreak, diagnoses decreased worldwide, even in settings with limited vaccine access. In 2023-2024, a new outbreak emerged in Rio de Janeiro, Brazil, highlighting the importance of continuous surveillance, preventive measures such as vaccination in vulnerable populations, and treatment options, emphasizing equitable global health technology distribution.

3.
J Cell Mol Med ; 27(19): 2956-2969, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37654004

RESUMEN

We employed an early training exercise program, immediately after recovery from surgery, and before severe cardiac hypertrophy, to study the underlying mechanism involved with the amelioration of cardiac dysfunction in aortic stenosis (AS) rats. As ET induces angiogenesis and oxygen support, we aimed to verify the effect of exercise on myocardial lipid metabolism disturbance. Wistar rats were divided into Sham, trained Sham (ShamT), AS and trained AS (AST). The exercise consisted of 5-week sessions of treadmill running for 16 weeks. Statistical analysis was conducted by anova or Kruskal-Wallis test and Goodman test. A global correlation between variables was also performed using a two-tailed Pearson's correlation test. AST rats displayed a higher functional capacity and a lower cardiac remodelling and dysfunction when compared to AS, as well as the myocardial capillary rarefaction was prevented. Regarding metabolic properties, immunoblotting and enzymatic assay raised beneficial effects of exercise on fatty acid transport and oxidation pathways. The correlation assessment indicated a positive correlation between variables of angiogenesis and FA utilisation, as well as between metabolism and echocardiographic parameters. In conclusion, early exercise improves exercise tolerance and attenuates cardiac structural and functional remodelling. In parallel, exercise attenuated myocardial capillary and lipid metabolism derangement in rats with aortic stenosis-induced heart failure.


Asunto(s)
Estenosis de la Válvula Aórtica , Insuficiencia Cardíaca , Condicionamiento Físico Animal , Ratas , Animales , Ratas Wistar , Metabolismo de los Lípidos , Insuficiencia Cardíaca/metabolismo
4.
Int J Mol Sci ; 24(15)2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37569680

RESUMEN

Aerobic exercise training (AET) has been used to manage heart disease. AET may totally or partially restore the activity and/or expression of proteins that regulate calcium (Ca2+) handling, optimize intracellular Ca2+ flow, and attenuate cardiac functional impairment in failing hearts. However, the literature presents conflicting data regarding the effects of AET on Ca2+ transit and cardiac function in rats with heart failure resulting from aortic stenosis (AoS). This study aimed to evaluate the impact of AET on Ca2+ handling and cardiac function in rats with heart failure due to AoS. Wistar rats were distributed into two groups: control (Sham; n = 61) and aortic stenosis (AoS; n = 44). After 18 weeks, the groups were redistributed into: non-exposed to exercise training (Sham, n = 28 and AoS, n = 22) and trained (Sham-ET, n = 33 and AoS-ET, n = 22) for 10 weeks. Treadmill exercise training was performed with a velocity equivalent to the lactate threshold. The cardiac function was analyzed by echocardiogram, isolated papillary muscles, and isolated cardiomyocytes. During assays of isolated papillary muscles and isolated cardiomyocytes, the Ca2+ concentrations were evaluated. The expression of regulatory proteins for diastolic Ca2+ was assessed via Western Blot. AET attenuated the diastolic dysfunction and improved the systolic function. AoS-ET animals presented an enhanced response to post-rest contraction and SERCA2a and L-type Ca2+ channel blockage compared to the AoS. Furthermore, AET was able to improve aspects of the mechanical function and the responsiveness of the myofilaments to the Ca2+ of the AoS-ET animals. AoS animals presented an alteration in the protein expression of SERCA2a and NCX, and AET restored SERCA2a and NCX levels near normal values. Therefore, AET increased SERCA2a activity and myofilament responsiveness to Ca2+ and improved the cellular Ca2+ influx mechanism, attenuating cardiac dysfunction at cellular, tissue, and chamber levels in animals with AoS and heart failure.


Asunto(s)
Estenosis de la Válvula Aórtica , Insuficiencia Cardíaca , Ratas , Animales , Calcio/metabolismo , Ratas Wistar , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/metabolismo , Miocitos Cardíacos/metabolismo , Calcio de la Dieta/metabolismo , Estenosis de la Válvula Aórtica/metabolismo , Ejercicio Físico , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/metabolismo
5.
Int J Mol Sci ; 24(7)2023 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-37047174

RESUMEN

In pathological cardiac hypertrophy, the heart is more dependent on glucose than fatty acids. This shift in energy metabolism occurs due to several factors, including the oxygen deficit, which activates hypoxia-inducible factor-1α (HIF-1α), a critical molecule related to glucose metabolism. However, there are gaps regarding the behavior of key proteins in the glycolytic pathway and HIF-1α during the transition from hypertrophy to heart failure (HF). This study assesses the hypothesis that there is an early change and enhancement of HIF-1α and the glycolytic pathway, as well as an association between them during cardiac remodeling. Sham and aortic stenosis Wistar rats were analyzed at 2, 6, and 18 weeks and in HF (n = 10-18). Cardiac structure and function were investigated by echocardiogram. Myocardial glycolysis, the aerobic and anaerobic pathways and glycogen were analyzed by enzymatic assay, Western blot, and enzyme-linked immunosorbent assay (ELISA). The following were observed: increased left ventricular hypertrophy; early diastolic function change and severe systolic and diastolic dysfunction in HF; increased HIF-1α in the 2nd week and in HF; precocious alteration and intensification of glycolysis with a shift to anaerobic metabolism from the 6th week onwards; association between HIF-1α, glycolysis, and the anaerobic pathway. Our hypothesis was confirmed as there was an early change and intensification in glucose metabolism, alteration in HIF-1α, and an association between data during the progression from hypertrophy to heart failure.


Asunto(s)
Insuficiencia Cardíaca , Remodelación Ventricular , Ratas , Animales , Remodelación Ventricular/fisiología , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Ratas Wistar , Cardiomegalia , Glucólisis/fisiología , Glucosa/metabolismo
6.
Cell Physiol Biochem ; 54(4): 665-681, 2020 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-32639114

RESUMEN

BACKGROUND/AIMS: Aortic stenosis-induced chronic pressure overload leads to cardiac dysfunction and congestive heart failure. The pathophysiological mechanisms of the myocardial impairment are multifactorial and include maladaptive ß-adrenergic signaling. Exercise training (ET) has been used as a non-pharmacological therapy for heart failure management. The present study tested the hypothesis that exercise training attenuates diastolic dysfunction through ß-adrenergic signaling preservation. METHODS: Wistar rats were submitted to ascending aortic stenosis (AS) surgery, and after 18 weeks, a moderate aerobic exercise training protocol was performed for ten weeks. RESULTS: ET attenuated diastolic dysfunction, evaluated by echocardiogram and isolated papillary muscle (IPM) assay. Also, ET reduced features of heart failure, cross-sectional cardiomyocyte area, and exercise intolerance, assessed by treadmill exercise testing. The ß2 adrenergic receptor protein expression was increased in AS rats independently of exercise. Interestingly, ET restored the protein levels of phosphorylated phospholamban at Serine 16 and preserved the ß-adrenergic receptor responsiveness as visualized by the lower myocardial compliance decline and time to 50% tension development and relaxation during ß-adrenergic stimulation in the IPM than untrained rats. Additionally, AS rats presented higher levels of TNFα and iNOS, which were attenuated by ET. CONCLUSION: Moderate ET improves exercise tolerance, reduces heart failure features, and attenuates diastolic dysfunction. In the myocardium, ET decreases the cross-sectional area of the cardiomyocyte and preserves the ß-adrenergic responsiveness, which reveals that the adjustments in ß-adrenergic signaling contribute to the amelioration of cardiac dysfunction by mild exercise training in aortic stenosis rats.


Asunto(s)
Estenosis Aórtica Supravalvular/metabolismo , Insuficiencia Cardíaca Diastólica/terapia , Miocitos Cardíacos/metabolismo , Condicionamiento Físico Animal/fisiología , Receptores Adrenérgicos beta/metabolismo , Animales , Estenosis Aórtica Supravalvular/terapia , Proteínas de Unión al Calcio/metabolismo , Ecocardiografía , Prueba de Esfuerzo , Masculino , Miocardio/metabolismo , Miocitos Cardíacos/fisiología , Óxido Nítrico Sintasa de Tipo II/metabolismo , Músculos Papilares/fisiología , Fosforilación , Ratas , Ratas Wistar , Receptores Adrenérgicos beta/fisiología , Transducción de Señal/fisiología , Factor de Necrosis Tumoral alfa/metabolismo
7.
Cell Physiol Biochem ; 54(4): 719-735, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32730701

RESUMEN

BACKGROUND/AIMS: The beneficial effect of aerobic exercise training (ET) on cardiac remodeling caused by supravalvar aortic stenosis (AS) has been demonstrated in experimental studies; however, the mechanisms responsible for improving cardiac function are not entirely understood. We evaluated whether ET-generated cardioprotection in pressure-overloaded rats is dependent on cardiomyocyte proliferation, increased angiotensin-(1-7) (Ang-1-7) levels, and its receptor in the myocardium. METHODS: Eighteen weeks after ascending AS surgery, Wistar rats were randomly assigned to four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary aortic stenosis (AS-Sed) and exercised aortic stenosis (AS-Ex) groups. The moderate treadmill exercise protocol was performed for ten weeks. The functional capacity was assessed by treadmill exercise testing. Cardiac structure and function were evaluated by echocardiogram. Cardiomyocyte proliferation was evaluated by flow cytometry. Expression of cell cycle regulatory genes as CCND2, AURKB, CDK1, and MEIS1 was verified by RT-qPCR. Cardiac and plasma angiotensin I (Ang I), angiotensin II (Ang II), and Ang-(1-7) levels were analyzed by high-performance liquid chromatography (HPLC). The angiotensin-converting enzyme (ACE) activity was assessed by the fluorometric method and protein expression of AT1 and Mas receptors by Western blot. RESULTS: The AS-Ex group showed reduced left ventricular wall relative thickness and improved ejection fraction; also, it showed decreased gene expression of myocyte cell cycle regulators, ACE, Ang I, Ang II and Ang II/Ang-(1-7) ratio levels compared to AS-Sed group. However, ET did not induce alterations in Ang-(1-7) and cardiac Mas receptor expression and myocyte proliferation. CONCLUSION: Aerobic exercise training improves systolic function regardless of myocyte proliferation and Ang-(1-7)/Mas receptor levels. However, the ET negatively modulates the vasoconstrictor/hypertrophic axis (ACE/Ang II) and decreases the expression of negative regulatory genes of the cell cycle in cardiomyocytes of rats with supravalvular aortic stenosis.


Asunto(s)
Angiotensina I/metabolismo , Estenosis Aórtica Supravalvular/metabolismo , Miocardio/metabolismo , Miocitos Cardíacos/metabolismo , Fragmentos de Péptidos/metabolismo , Condicionamiento Físico Animal/fisiología , Sistema Renina-Angiotensina/fisiología , Angiotensina II/metabolismo , Enzima Convertidora de Angiotensina 2/metabolismo , Animales , Estenosis Aórtica Supravalvular/enzimología , Estenosis Aórtica Supravalvular/genética , Aurora Quinasa B/genética , Aurora Quinasa B/metabolismo , Ciclo Celular/genética , Proliferación Celular/fisiología , Cromatografía Líquida de Alta Presión , Ciclina D2/genética , Ciclina D2/metabolismo , Ecocardiografía , Prueba de Esfuerzo , Masculino , Proteína 1 del Sitio de Integración Viral Ecotrópica Mieloide/genética , Proteína 1 del Sitio de Integración Viral Ecotrópica Mieloide/metabolismo , Ratas , Ratas Wistar
8.
Pathophysiology ; 25(4): 373-379, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30030016

RESUMEN

Cardiac remodeling (CR) is a structural change of the heart due to chronic hemodynamic overload related to changes in both myocyte and extracellular matrix (ECM). We investigated that the imbalance of collagen V promotes cardiomyocyte apoptosis that contributes to heart failure and cell death. Aortic stenosis was induced surgically and male Wistar rats were randomized to 18 weeks (Sham 18 w, n = 12; AoS 18 w, n = 12) and severe of heart failure (Sham HF, n = 12; AoS HF, n = 12) groups. Functional and structural echocardiogram, immunohistochemistry for Ki-67, TUNEL assay and Immunofluorescence for collagen were performed. Our main results were: (1) Progressive reduction of cardiac functional capacity due to cardiac remodeling with decreased eject fraction in heart failure; (2) Imbalance of collagen deposition with increased, crowded and irregular collagen I in situ expression; (3) Dysregulation of dynamic control of collagen fibers with exposed epitopes of collagen V; (4) Additional apoptosis that are dependent to cardiac injury. The collagen V expression in cardiac remodeling is for the first time described and may be related to additional apoptosis and autoimmune response. Our findings suggest a critical role of collagen V in cardiac remodeling to modulate and promote heart failure and death.

9.
Dig Dis Sci ; 62(1): 93-104, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27864656

RESUMEN

AIM: The objective was to evaluate the effects of nitric oxide (NO) and hydrogen sulfide (H2S) donors and possible interactions between these two systems in modulating gastric function. METHODS: Mice received saline, sodium nitroprusside (SNP), or sodium hydrosulfite (NaHS), and after 1 h, the animals were killed for immunofluorescence analysis of CSE or eNOS expressions, respectively. Other groups received saline, SNP, NaHS, Lawesson's reagent (H2S donor), PAG + SNP, L-NAME, L-NAME + NaHS, or L-NAME + Lawesson's reagent. Then, the gastric secretions (mucous and acid), gastric blood flow, gastric defense against ethanol, and gastric motility (gastric emptying and gastric contractility) were evaluated. RESULTS: SNP and NaHS increased the expression of CSE or eNOS, respectively. SNP or Lawesson's reagent did not alter gastric acid secretion but increased mucus production, and these effects reverted with PAG and L-NAME treatment, respectively. SNP or NaHS increased gastric blood flow and protected the gastric mucosa against ethanol injury, and these effects reverted with PAG and L-NAME treatments, respectively. SNP delayed gastric emptying when compared with saline, and PAG partially reversed this effect. NaHS accelerate gastric emptying, and L-NAME partially reversed this effect. SNP and NaHS alone induced gastric fundus and pylorus relaxation. However, pretreatment with PAG or L-NAME reversed these relaxant effects only in the pylorus but not in the gastric fundus. CONCLUSION: NO and H2S interact in gastric physiological functions, and this "cross-talk" is important in the control of mucus secretion, gastric blood flow, gastric mucosal defense, and gastric motility, but not in the control of basal gastric acid secretion.


Asunto(s)
Cistationina gamma-Liasa/efectos de los fármacos , Vaciamiento Gástrico/efectos de los fármacos , Donantes de Óxido Nítrico/farmacología , Óxido Nítrico Sintasa de Tipo III/efectos de los fármacos , Nitroprusiato/farmacología , Estómago/efectos de los fármacos , Sulfuros/farmacología , Alquinos/farmacología , Animales , Depresores del Sistema Nervioso Central/farmacología , Cistationina gamma-Liasa/antagonistas & inhibidores , Cistationina gamma-Liasa/metabolismo , Interacciones Farmacológicas , Inhibidores Enzimáticos/farmacología , Etanol/farmacología , Técnica del Anticuerpo Fluorescente , Ácido Gástrico/metabolismo , Fundus Gástrico/efectos de los fármacos , Mucosa Gástrica/efectos de los fármacos , Mucosa Gástrica/metabolismo , Glutatión/efectos de los fármacos , Glutatión/metabolismo , Glicina/análogos & derivados , Glicina/farmacología , Flujometría por Láser-Doppler , Masculino , Malondialdehído/metabolismo , Ratones , Moco/efectos de los fármacos , Moco/metabolismo , Contracción Muscular/efectos de los fármacos , NG-Nitroarginina Metil Éster/farmacología , Óxido Nítrico Sintasa de Tipo III/antagonistas & inhibidores , Óxido Nítrico Sintasa de Tipo III/metabolismo , Píloro/efectos de los fármacos , Ratas , Ratas Wistar , Flujo Sanguíneo Regional , Estómago/irrigación sanguínea
10.
Nitric Oxide ; 45: 35-42, 2015 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-25681154

RESUMEN

Here, we have evaluated the protective effect of the NO donor cis-[Ru(bpy)2(SO3)NO](PF6) (FOR0810) in experimental models of gastric damage induced by naproxen or ethanol in mice, and the involvement of soluble guanylate cyclase (sGC) and ATP-sensitive K(+) channels (KATP) in these events. Swiss mice were pre-treated with saline, ODQ (a soluble guanylate cyclase inhibitor; 10 mg kg(-1)) or glibenclamide (a KATP channels blocker; 10 mg kg(-1)). After either 30 min or 1 h, FOR0810 (3 mg kg(-1)) was administered. At the end of 30 min, the animals received naproxen (300 mg kg(-1)) by gavage. After 6 h, the animals were sacrificed and gastric damage, myeloperoxidase (MPO) activity, and TNF-α and IL-1ß gastric concentrations were evaluated. In addition, the effects of FOR0810 on naproxen-induced mesenteric leukocyte adherence were determined by intravital microscopy. Other groups, were pre-treated with saline, ODQ or glibenclamide. After either 30 min or 1 h, FOR0810 was administered. At the end of 30 min, the animals received 50% ethanol by gavage. After 1 h, the animals were sacrificed, and gastric damage, gastric reduced glutathione (GSH) concentration and malondialdehyde (MDA) levels were determined. In naproxen-induced gastric damage, FOR0810 prevented gastric injury, decreased gastric MPO activity and leukocyte adherence, associated with a decrease in TNFα and IL-1ß gastric concentrations. FOR0810 also prevented ethanol-induced gastric damage by increase in GSH levels and decrease in MDA levels. ODQ and glibenclamide completely reversed FOR0810's ability to prevent gastric damage by either naproxen or ethanol. We infer that FOR0810 prevented gastric damage through the activation of both sGC and KATP channels, which triggered a decrease in both free radical and cytokine production via the blocking of neutrophil adhesion and infiltration.


Asunto(s)
Mucosa Gástrica/efectos de los fármacos , Guanilato Ciclasa/metabolismo , Canales KATP/metabolismo , Donantes de Óxido Nítrico/farmacología , Sustancias Protectoras/farmacología , Receptores Citoplasmáticos y Nucleares/metabolismo , 2,2'-Dipiridil/análogos & derivados , Animales , Citocinas/análisis , Citocinas/metabolismo , Etanol/efectos adversos , Mucosa Gástrica/metabolismo , Inflamación/inducido químicamente , Ratones , Naproxeno/efectos adversos , Nitratos/análisis , Donantes de Óxido Nítrico/química , Nitritos/análisis , Compuestos Organometálicos , Peroxidasa/análisis , Peroxidasa/metabolismo , Sustancias Protectoras/química , Guanilil Ciclasa Soluble
11.
Chin J Physiol ; 57(6): 315-9, 2014 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-25575519

RESUMEN

The aim of this study was to evaluate the early effect of the endurance training (ET) on systolic blood pressure (SBP), heart rate (HR) and rate pressure-product (RPP) after acute cigarette smoke exposure. Twenty male Wistar rats were randomly allocated into two groups: trained (TEx; n = 10) and control (CEx; n = 10), exposed to smoke. TEx rats undertook ET during 2 weeks (swimming, 5 days/week; 1 h/session) and CEx group was kept in sedentary lifestyle. After ET protocol both groups were exposed to cigarette smoke only once (total 1 h; 2 × 30 min with interval of 10 min between exposures; rate of 10 cigarettes/30 min). SBP, HR and RPP were measured after 2 weeks and just after (5 min) acute cigarette smoke (tail plethysmograph). All parameters did not differ (P > 0.05) between TEx (RPP = 45018 ± 1970 mmHg/bpm) and CEx (43695 ± 2579 mmHg/bpm) after ET protocol. However, all cardiovascular parameters increased (P < 0.05) only for CEx just after the cigarette smoke exposure. We concluded that ET can attenuate the aggression from acute smoking to cardiovascular system, with a few days of training and even with no chronic effect on these parameters at basal condition.


Asunto(s)
Presión Sanguínea , Frecuencia Cardíaca , Nicotiana/efectos adversos , Condicionamiento Físico Animal , Humo/efectos adversos , Animales , Masculino , Resistencia Física , Ratas , Ratas Wistar
12.
Artículo en Inglés | MEDLINE | ID: mdl-38500005

RESUMEN

The overprescription of antibiotics due to diagnostic uncertainty and inappropriate patient expectations influence antimicrobial resistance. This research assesses (i) whether communicating diagnostic uncertainty reduces expectations of receiving antibiotics and (ii) which communication strategies minimise unintended consequences of such communication. In two experimental online studies conducted in January and April 2023, participants read a vignette describing a doctor consultation for an ear infection and expressed their expectations of receiving antibiotics, trust in their doctor, rated the doctor's reputation and provided their intention to get a second doctor's opinion. Study 1 (N = 2213) investigated whether communicating diagnostic uncertainty and social externalities of antibiotic use (the negative social impacts of developing antibiotic resistance) decreases expectations for antibiotics and explores potential unintended consequences on the doctor-patient relationship. In Study 2 (N = 527), we aimed to replicate and extend the findings by adding specific treatment recommendations. Disclosing diagnostic uncertainty (vs. certainty) and communicating (vs. not communicating) the social externalities of antibiotic overuse reduced patients' expectations of receiving antibiotics. Yet, communicating uncertainty impaired trust in the doctor and the doctor's reputation. Combining the communication of uncertainty with specific treatment recommendations-particularly delayed antibiotic prescriptions-showed important to prevent these unintended consequences.

13.
Health Psychol ; 43(3): 194-202, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37870788

RESUMEN

OBJECTIVE: Antimicrobial resistance is a global health threat perpetuated by the overprescribing of antibiotics in primary care. One strategy to reduce antibiotic use in this setting is delayed prescribing. However, several psychological factors might undermine its effectiveness. The aim of the study was to test whether different interventions aiming at helping patients to manage diagnostic uncertainty in the period of watchful waiting promote appropriate antibiotic use. METHOD: We conducted a preregistered online experiment (N = 690 adult participants from the United Kingdom) in which we modeled delayed prescription in a decision task with behavior-contingent incentives. Participants had either a fictional viral or bacterial infection and received interventions that aimed at facilitating symptom monitoring (i.e., passive monitoring) and engaging participants in the task (i.e., active monitoring). RESULTS: Both interventions decreased antibiotic use when the disease was viral. Active monitoring was more efficient in decreasing antibiotic use than passive monitoring. CONCLUSIONS: The findings have practical implications for managing uncertainty and fostering appropriate antibiotic use in delayed prescribing situations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Antibacterianos , Infecciones del Sistema Respiratorio , Adulto , Humanos , Antibacterianos/uso terapéutico , Reino Unido , Prescripciones , Pautas de la Práctica en Medicina , Infecciones del Sistema Respiratorio/tratamiento farmacológico
14.
J Health Psychol ; 28(11): 1024-1037, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-36721947

RESUMEN

Understanding individuals' preferences for antibiotics can help mitigate the acceleration of antibiotic resistance. Similar to the climate crisis, individuals "today" need to appropriately use antibiotics to reduce the negative consequences of antibiotic resistance for individuals "tomorrow." We use an established-yet novel in this research field-behavioral game approach to investigate individuals' preferences for antibiotics in the face of a between-generations conflict. In an online study, we investigated whether a between-generations (vs within-generations) conflict in antibiotic intake leads to larger overuse and how to promote appropriate use of antibiotics. Results indicate that overuse in the face of a between-generations (vs within-generations) conflict increased. Eliciting empathy toward future generations in the case of a between-generations conflict decreased overuse. Findings suggest that different representations of this social dilemma can influence people's preferences for antibiotics, and that empathy-based interventions might promote appropriate antibiotic use.


Asunto(s)
Antibacterianos , Conducta Social , Humanos , Antibacterianos/uso terapéutico , Empatía , Responsabilidad Social
15.
Lancet Reg Health Am ; 17: 100406, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36776570

RESUMEN

Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

16.
Mar Drugs ; 10(12): 2618-33, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23342384

RESUMEN

Red seaweeds synthesize a great variety of sulfated galactans. Sulfated polysaccharides (PLSs) from seaweed are comprised of substances with pharmaceutical and biomedical potential. The aim of the present study was to evaluate the protective effect of the PLS fraction extracted from the seaweed Gracilaria birdiae in rats with naproxen-induced gastrointestinal damage. Male Wistar rats were pretreated with 0.5% carboxymethylcellulose (control group-vehicle) or PLS (10, 30, and 90 mg/kg, p.o.) twice daily (at 09:00 and 21:00) for 2 days. After 1 h, naproxen (80 mg/kg, p.o.) was administered. The rats were killed on day two, 4 h after naproxen treatment. The stomachs were promptly excised, opened along the greater curvature, and measured using digital calipers. Furthermore, the guts of the animals were removed, and a 5-cm portion of the small intestine (jejunum and ileum) was used for the evaluation of macroscopic scores. Samples of the stomach and the small intestine were used for histological evaluation, morphometric analysis and in assays for glutathione (GSH) levels, malonyldialdehyde (MDA) concentration, and myeloperoxidase (MPO) activity. PLS treatment reduced the macroscopic and microscopic naproxen-induced gastrointestinal damage in a dose-dependent manner. Our results suggest that the PLS fraction has a protective effect against gastrointestinal damage through mechanisms that involve the inhibition of inflammatory cell infiltration and lipid peroxidation.


Asunto(s)
Enfermedades Gastrointestinales/prevención & control , Gracilaria/química , Polisacáridos/farmacología , Animales , Relación Dosis-Respuesta a Droga , Enfermedades Gastrointestinales/inducido químicamente , Glutatión/metabolismo , Inflamación/inducido químicamente , Inflamación/prevención & control , Peroxidación de Lípido/efectos de los fármacos , Masculino , Malondialdehído/metabolismo , Naproxeno/toxicidad , Peroxidasa/metabolismo , Polisacáridos/administración & dosificación , Polisacáridos/aislamiento & purificación , Ratas , Ratas Wistar
17.
PLoS One ; 17(3): e0265892, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35349583

RESUMEN

BACKGROUND: Regarding the COVID-19 pandemic, concerted efforts have been invested in research to investigate and communicate the importance of complying with protective behaviors, such as handwashing and mask wearing. Protective measures vary in how effective they are in protecting the individual against infection, how much experience people have with them, whether they provide individual or societal protection, and how they are perceived on these dimensions. METHODS: This study assessed the willingness to follow recommended measures, depending on these features, among participants from Germany (n = 333), Hong Kong (n = 367), and the U.S. (n = 495). From April 24th to May 1st, 2020, individuals completed an online survey that assessed the antecedents of interest. RESULTS: It was shown that assumed effectiveness, previous experience, and intended self- and other-protection positively predicted willingness to comply across countries. When measures were mainly perceived as protecting others (vs. the self), individuals were less prone to adopt them. When a measure's effectiveness to protect the individual was perceived as lower, willingness to adopt the measure increased with higher levels of prior experience and collectivism. Moreover, protecting others was more strongly related to adoption when individuals had higher levels of collectivism and lower levels of individualism. CONCLUSIONS: Emphasizing the benefit for others could be a means to lower the potential detrimental effects of low assumed effectiveness for individual protection.


Asunto(s)
COVID-19/prevención & control , SARS-CoV-2 , COVID-19/epidemiología , COVID-19/psicología , Estudios Transversales , Desinfección de las Manos , Humanos , Máscaras , Pandemias/prevención & control , Equipo de Protección Personal
18.
Appl Psychol Health Well Being ; 14(3): 757-775, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35103398

RESUMEN

The increasing development of resistant pathogens is one of the greatest global health challenges. As antibiotic overuse amplifies antibiotic resistance, antibiotic intake poses a social dilemma in which individuals need to decide whether to prosocially reduce their intake in the collective interest versus to (over)use it even in case of mild diseases. We devise a novel behavioral game paradigm to model the social dilemma of antibiotic intake. Using this new method in an incentivized laboratory experiment (N = 272 German participants), we varied whether players had mutual knowledge about their antibiotic intake. The results indicate that there was substantial antibiotic overuse in the absence of social information. Overuse decreased when social information was present. Our postexperimental survey data further suggest that social information impacts people's behavioral motivation, evaluation of the other player, and positive affect. Taken together, providing social information about people's antibiotic intake may help in reducing antibiotic overuse. On a more general level, the novel behavioral game may be adapted to study other aspects of antibiotic intake to promote prudent use of antibiotics.


Asunto(s)
Antibacterianos , Motivación , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Farmacorresistencia Microbiana , Humanos , Encuestas y Cuestionarios
19.
Arq Bras Cardiol ; 118(2): 463-475, 2022 02.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35262582

RESUMEN

BACKGROUND: Maladaptive cardiac remodelling is characterized by diastolic and systolic dysfunction, culminating in heart failure. In this context, the dysfunctional scenario of cardiac calcium (Ca2+) handling has been poorly studied. An experimental model of aortic stenosis has been extensively used to improve knowledge about the key mechanisms of cardiac pathologic remodelling. OBJECTIVE: To understand the dysfunctional process of the major components responsible for Ca2+ balance and its influence on cardiac function in heart failure induced by aortic stenosis. METHODS: Male 21-day-old Wistar rats were distributed into two groups: control (sham; n= 28) and aortic stenosis (AoS; n= 18). Cardiac function was analysed by echocardiogram, isolated papillary muscle, and isolated cardiomyocytes. In the papillary muscle assay, SERCA2a and L-type Ca2+ channel activity was evaluated. The isolated cardiomyocyte assay evaluated Ca2+ handling. Ca2+ handling protein expression was analysed by western blot. Statistical significance was set at p <0.05. RESULTS: Papillary muscles and cardiomyocytes from AoS hearts displayed mechanical malfunction. AoS rats presented a slower time to the Ca2+ peak, reduced Ca2+ myofilament sensitivity, impaired sarcoplasmic reticulum Ca2+ influx and reuptake ability, and SERCA2a and L-type calcium channel (LTCC) dysfunction. Moreover, AoS animals presented increased expression of SERCA2a, LTCCs, and the Na+/Ca2+ exchanger. CONCLUSION: Systolic and diastolic heart failure due to supravalvular aortic stenosis was paralleled by impairment of cellular Ca2+ influx and inhibition of sarcoplasmic reticulum Ca2+ reuptake due to LTCC and SERCA2a dysfunction, as well as changes in Ca2+ handling and expression of the major proteins responsible for cellular Ca2+ homeostasis.


FUNDAMENTO: O remodelamento cardíaco patológico se caracteriza por disfunção diastólica e sistólica, levando à insuficiência cardíaca. Neste contexto, o cenário disfuncional do trânsito de cálcio miocárdico (Ca2+) tem sido pouco estudado. Um modelo experimental de estenose aórtica tem sido extensamente utilizado para aprimorar os conhecimentos sobre os principais mecanismos do remodelamento patológico cardíaco. OBJETIVO: Entender o processo disfuncional dos principais componentes responsáveis pelo equilíbrio do cálcio miocárdico e sua influência sobre a função cardíaca na insuficiência cardíaca induzida pela estenose aórtica. MÉTODOS: Ratos Wistar de 21 dias de idade foram distribuídos em dois grupos: controle (placebo; n=28) e estenose aórtica (EaO; n=18). A função cardíaca foi analisada com o ecocardiograma, músculo papilar isolado e cardiomiócitos isolados. No ensaio do músculo papilar, SERCA2a e a atividade do canal de Ca2+ do tipo L foram avaliados. O ensaio de cardiomiócitos isolados avaliou o trânsito de cálcio. A expressão proteica da proteínas do trânsito de cálcio foi analisada com o western blot. Os resultados foram estatisticamente significativos quando p <0,05. RESULTADOS: Os músculos papilares e cardiomiócitos dos corações no grupo EaO demonstraram falhas mecânicas. Os ratos com EaO apresentaram menor tempo de pico do Ca2+, menor sensibilidade das miofibrilas do Ca2+, prejuízos nos processos de entrada e recaptura de cálcio pelo retículo sarcoplasmático, bem como disfunção no canal de cálcio do tipo L (CCTL). Além disso, os animais com EaO apresentaram maior expressão de SERCA2a, CCTL e trocador de Na+/Ca2+. CONCLUSÃO: Insuficiência cardíaca sistólica e diastólica devido à estenose aórtica supravalvular acarretou comprometimento da entrada de Ca2+ celular e inibição da recaptura de cálcio pelo retículo sarcoplasmático devido à disfunção no CCTL e SERCA2a, assim como mudanças no trânsito de cálcio e na expressão das principais proteínas responsáveis pela homeostase de Ca2+ celular.


Asunto(s)
Estenosis de la Válvula Aórtica , Insuficiencia Cardíaca , Animales , Estenosis de la Válvula Aórtica/patología , Calcio/metabolismo , Insuficiencia Cardíaca/patología , Masculino , Contracción Miocárdica/fisiología , Miocitos Cardíacos/patología , Músculos Papilares , Ratas , Ratas Wistar , ATPasas Transportadoras de Calcio del Retículo Sarcoplásmico/metabolismo
20.
Dig Dis Sci ; 56(2): 314-22, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20552398

RESUMEN

BACKGROUND: Amifostine has been widely tested as a cytoprotective agent against a number of aggressors in different organs. Recently, a gastroprotective effect was observed for this drug in a model of indomethacin-induced gastric injury. Our objective was to investigate the effect of amifostine on ethanol-induced gastric injury and the role played in this mechanism by afferent sensory neurons, non-protein sulfhydryl groups, nitric oxide, ATP-sensitive potassium channels, and cyclooxygenase-2. METHODS: Rats were treated with amifostine (22.5, 45, 90, or 180 mg/kg, PO or SC). After 30 min, the rats received absolute ethanol (5 ml kg(-1), PO). One hour later, gastric damage was quantified with a planimeter. Samples from the stomach were also taken for histopathological assessment and for assays of non-protein sulfhydryl groups. The other groups were pretreated with L-NAME (10 mg kg(-1), IP), glibenclamide (10 mg kg(-1), PO), or celecoxib (10 mg kg(-1), PO). After 30 min, the animals were given amifostine (90 mg kg(-1), PO or SC), followed 30 min later by gavage with absolute ethanol (5 ml kg(-1)). Other rats were desensitized with capsaicin (125 mg kg(-1), SC) 8 days prior to amifostine treatment. RESULTS: Amifostine administration PO and SC significantly and dose-dependently reduced ethanol-induced macroscopic and microscopic gastric damage by restoring glutathione levels in the stomach mucosa. Amifostine-promoted gastroprotection against ethanol-induced stomach injury was reversed by pretreatment with neurotoxic doses of capsaicin, but not by L-NAME, glibenclamide, or celecoxib. CONCLUSIONS: Amifostine protects against ethanol-induced gastric injury by increasing glutathione levels and stimulating the afferent sensory neurons in the stomach.


Asunto(s)
Amifostina/farmacología , Capsaicina/farmacología , Etanol/toxicidad , Neuronas Aferentes/efectos de los fármacos , Gastropatías/inducido químicamente , Compuestos de Sulfhidrilo/metabolismo , Amifostina/administración & dosificación , Animales , Relación Dosis-Respuesta a Droga , Vías de Administración de Medicamentos , Mucosa Gástrica/efectos de los fármacos , Masculino , Protectores contra Radiación/farmacología , Ratas , Ratas Wistar , Gastropatías/prevención & control
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