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Coluna/Columna ; 19(4): 302-307, Oct.-Dec. 2020. graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1133593


ABSTRACT Herbert von Luschka, a German anatomist, was the first to describe the developmental changes in the anatomical structures of the cervical spine. Degenerative cervical myelopathy (DCM) represents a collection of pathological entities that cause compression of the cervical spinal cord, resulting in a clinical syndrome typified by spasticity, hyperreflexia, pathologic reflexes, finger/hand clumsiness, gait disturbance and sphincter dysfunction. In the cervical spine, certain patients are more likely to have myelopathy due to a congenitally narrowed cervical spine canal. Degenerative changes are more common at C5 and C6 or C6 and C7 due to the increased motion at these levels. Additional contributors to canal narrowing are infolding of the ligamentum flavum, olisthesis, osteophytes, and facet hypertrophy. Myelopathy will develop in approximately 100% of patients with canal stenosis greater than 60% (less than 6 mm sagittal disc cord space). Classically it has an insidious onset, progressing in a stepwise manner with functional decline. Without treatment, patients may progress toward significant paralysis and loss of function. Treatment requires surgery with either anterior or posterior decompression of the area of narrowing, and probable fusion. Factors of a poor prognosis include symptoms lasting for more than 18 months, increased range of motion in the cervical spine, and female gender. In this study, we give an overview of the state-of-the-art in DCM, with a focus on the pathophysiology, clinical presentation, differential diagnosis, imaging evaluation, natural history, treatment options and complications. Level of evidence III; Review article.

RESUMO Herbert von Luschka, anatomista alemão, foi o primeiro a descrever as mudanças no desenvolvimento das estruturas anatômicas da coluna cervical. A mielopatia cervical degenerativa (MCD) representa um conjunto de entidades patológicas que causam compressão da medula espinhal cervical, resultando em uma síndrome clínica caracterizada por espasticidade, hiperreflexia, reflexos patológicos, perda de destreza manual, distúrbios de marcha e disfunção de esfíncteres. Certos pacientes têm maior probabilidade de desenvolver mielopatia na coluna cervical em decorrência de estenose congênita do canal cervical. As alterações degenerativas são mais comuns em C5 e C6 ou C6 e C7 devido ao aumento da mobilidade nesses níveis. Outros fatores que contribuem para a estenose do canal medular são hipertrofia do ligamento amarelo, listese, osteofitose e hipertrofia de facetas. A mielopatia cervical ocorre em aproximadamente 100% dos pacientes com estenose do canal superior a 60%, isto é, espaço da medula discal sagital menor que 6 mm. Em geral, tem início insidioso, progredindo gradualmente com declínio funcional. Sem tratamento, os pacientes podem progredir para paralisia significativa e perda de função. O tratamento requer cirurgia de descompressão anterior ou posterior da área estenosada e provável fusão. Os fatores de mau prognóstico prevalecem no sexo feminino e incluem sintomatologia com duração superior a 18 meses e aumento da amplitude de movimento da coluna cervical. Neste estudo, apresentamos uma visão geral do estado da arte em MCD, com ênfase de fisiopatologia, apresentação clínica, diagnóstico diferencial, avaliação por imagem, história natural, opções de tratamento e complicações. Nível de evidência III; Artigo de revisão.

RESUMEN Herbert von Luschka, anatomista alemán, fue el primero en describir los cambios en el desarrollo de las estructuras anatómicas de la columna cervical. La mielopatía cervical degenerativa (MCD) representa un conjunto de entidades patológicas que causan compresión de la médula espinal cervical, resultando en un síndrome clínico caracterizado por espasticidad, hiperreflexia, reflejos patológicos, pérdida de destreza manual, disturbios de marcha y disfunción de esfínteres. Ciertos pacientes tienen mayor probabilidad de desarrollar mielopatía en la columna cervical como consecuencia de estenosis congénita del canal cervical. Las alteraciones degenerativas son más comunes en C5 y C6 o C6 y C7, debido al aumento de la movilidad en esos niveles. Otros factores que contribuyen para la estenosis del canal medular son la hipertrofia del ligamento amarillo, listesis, osteofitosis e hipertrofia de facetas. La mielopatía cervical ocurre en aproximadamente 100% de los pacientes con estenosis del canal superior a 60%, esto es, espacio de la médula discal sagital menor que 6mm). En general, tiene inicio insidioso, progresando gradualmente con disminución funcional. Sin tratamiento, los pacientes pueden progresar para parálisis significativa y pérdida de función. El tratamiento requiere cirugía de descompresión anterior o posterior del área estenosada y probable fusión. Los factores de mal pronóstico prevalecen en el sexo femenino e incluyen sintomatología con duración superior a 18 meses y aumento de la amplitud de movimiento de la columna cervical. En este estudio, presentamos una visión general del estado del arte en MCD, con énfasis de fisiopatología, presentación clínica, diagnóstico diferencial, evaluación por imagen, historia natural, opciones de tratamiento y complicaciones. Nivel de evidencia III; Artículo de revisión.

Spine Deform ; 8(4): 647-653, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32072488


PURPOSE: To evaluate the impact of proximal thoracic segment (T1-T5) on global thoracic kyphosis, as well as its influence on cervical alignment (lordotic, kyphotic or straight) in patients with adolescent idiopathic scoliosis (AIS). METHODS: We conducted a retrospective study of 80 patients with AIS. The inclusion criteria were patients between 10 and 18 years of age with a posteroanterior (PA) and lateral full-length radiographs, excluding those subjected to surgery, orthotic treatment, with other spinal disease or with poor X-ray quality. The parameters evaluated were age, sex, pelvic incidence (PI), sacral slop (SS), pelvic tilt (PT), global sagittal balance (GSB), scoliotic curvatures (differentiated according to primary curve, lumbar modifier and sagittal modifier), cervical spine alignment, thoracic sagittal Cobb angle between T1 and T5, T5 and T12 and between T1 and T12. RESULTS: In patients with AIS, the proximal sagittal thoracic Cobb segment, contrary to the distal, demonstrated a significant positive correlation with cervical spine alignment (p < 0.05). As there is an increase in proximal thoracic angle, there is an increase in cervical lordosis. We also demonstrated that the correlation between an increase in scoliotic curvature and a decrease in kyphosis only occurred in the distal thoracic segment (T5-T12). Relative to the spinopelvic parameters, the PI was not related with the dorsal kyphosis or shape of the cervical spine. CONCLUSIONS: In AIS, proximal (T1-T5) and distal (T5-T12) thoracic kyphosis have different contributions on the global thoracic sagittal curvature and in the phenomenon of hypokyphosis. On the other hand, only the proximal segment is significantly related to the shape of the cervical spine. LEVEL OF EVIDENCE: IV.

Desviación Ósea/etiología , Cifosis/etiología , Escoliosis/diagnóstico por imagen , Escoliosis/etiología , Vértebras Torácicas/diagnóstico por imagen , Adolescente , Desviación Ósea/diagnóstico por imagen , Vértebras Cervicales/diagnóstico por imagen , Niño , Femenino , Humanos , Cifosis/diagnóstico por imagen , Masculino , Radiografía , Estudios Retrospectivos
Coluna/Columna ; 18(3): 192-195, July-Sept. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1019771


ABSTRACT Objective The objective of this study is to evaluate leg length discrepancy in adolescent idiopathic scoliosis. Methods A retrospective study of 80 subjects with adolescent idiopathic scoliosis (AIS) was conducted. The inclusion criteria were patients aged 10 to 18 years old with posteroanterior (PA) and lateral full-length radiographs. The exclusion criteria were patients subjected to surgery or orthotic treatment, those with other spinal disease, and those with poor quality x-rays. The parameters evaluated were: age, sex, Risser stage (RS), triradiate cartilage (TC), scoliotic curvatures, differentiated according to Lenke classification, sagittal (SB) and coronal balance (CB), and leg length discrepancy, which was assessed through the difference between the femoral heads (LLD) and through the assessment of pelvic obliquity (PO). Results The majority of patients with AIS demonstrated a mild LLD (<1 cm). The mean LLD was significantly different (p<0.01) between the scoliotic population with a main thoracolumbar curvature and those with a main lumbar curvature. When there was an LLD, it was the left limb that was shortened in most cases. The side of the longer lower limb had a direct influence on the CB (p=0.052). Conclusions This study demonstrates that in an AIS population with small LLD values, the extent of the shortening has a stronger impact on coronal balance and location than on the dimension of the main scoliotic curvature. These results demonstrate the importance of a more in-depth study on the effects of LLD <1 cm in the development of AIS and coronal imbalance. Level of evidence IV; Case Series.

RESUMO Objetivo O objetivo deste estudo é avaliar a discrepância no comprimento dos membros inferiores numa população com escoliose idiopática do adolescente. Métodos Foi realizado um estudo retrospetivo de 80 indivíduos com escoliose idiopática do adolescente (AIS). Os critérios de inclusão foram pacientes de 10 a 18 anos com radiografias coronais e sagitais extralongas, excluindo-se aqueles submetidos à cirurgia ou tratamento com coletes Milwaukee ou Boston, com outras doenças da coluna vertebral ou com exames que não cumpriam a qualidade radiográfica protocolada pelo Centro Hospitalar. Os parâmetros avaliados foram: idade, sexo, estadio de Risser (RS), cartilagem trirradiada (TC), curvaturas escolióticas diferenciadas segundo a classificação de Lenke, balanço sagital (SB), coronal (CB) e discrepância no comprimento dos membros inferiores, avaliado pelo desnível entre as cabeças femorais (LLD) e através da avaliação da obliquidade pélvica (PO). Resultados A maioria dos pacientes com AIS demonstrou LLD ligeira (<1 cm). A média de discrepância no comprimento dos membros inferiores foi significativamente diferente (p<0,01) entre a população escoliótica com uma curvatura toracolombar principal em relação àquela com uma curvatura lombar principal. Quando existe LLD, o membro esquerdo encontra-se encurtado na maioria dos casos e a discrepância dos membros inferiores influencia diretamente no balanço coronal (p=0,052). Conclusão A partir deste estudo, verificamos que, na população com AIS com pequenos valores de LLD, a magnitude do encurtamento tem um impacto de maior relevo no equilíbrio coronal e na localização do que na dimensão da curvatura escoliótica principal. Estes resultados levantam a importância de um estudo mais aprofundado sobre a importância da LLD <1 cm no desenvolvimento de AIS e no desequilíbrio coronal. Nível de evidência IV; Série de Casos.

RESUMEN Objetivos El objetivo de este estudio es evaluar la diferencia de la longitud de los miembros inferiores en la escoliosis idiopática del adolescente. Métodos Se realizó un estudio retrospectivo de 80 pacientes con escoliosis idiopática de adolescente (EIA). Los criterios de inclusión fueron los pacientes de 10 a 18 años con radiografías posteroanteriores (PA) y laterales de longitud completa. Los criterios de exclusión fueron los pacientes sometidos a cirugía o tratamiento ortopédico, aquellos con otra enfermedad de la columna y aquellos con radiografías de mala calidad. Los parámetros evaluados fueron: edad, sexo, estadio Risser (RS), cartílago trirradiado (CT), curvaturas escolióticas, diferenciadas según la clasificación de Lenke, balance sagital (BS) y coronal (BC) y discrepancia en la longitud de la pierna (DLP), que se evaluó a través de la diferencia entre las cabezas femorales y mediante la evaluación de la oblicuidad pélvica (OP). Resultados La mayoría de los pacientes con EIA demostró DLP leve (< 1 cm). La media de la DLP fue significativamente distinta (p < 0,01) entre la población escoliótica con una curvatura toracolumbar principal y los pacientes con curvatura lumbar principal. Cuando había DLP, la extremidad izquierda se acortaba en la mayoría de los casos. El lado de la extremidad más larga tuvo influencia directa en el BC (p = 0,052). Conclusiones Este estudio demuestra que en una población con EIA y bajos valores de DLP, la extensión del acortamiento tiene impacto mayor en el balance y la ubicación coronal que en la dimensión de la curvatura escoliótica principal. Estos resultados muestran la importancia de un estudio más profundo sobre los efectos de DLP < 1 cm en el desarrollo de EIA y el desequilibrio coronal. Nivel de evidencia - IV; Serie de Casos.

Humanos , Escoliosis , Columna Vertebral , Adolescente
Coluna/Columna ; 18(3): 182-186, July-Sept. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1019779


ABSTRACT Objective The objective of this study is to achieve a better understanding of the parameters that influence sagittal balance in a population with adolescent idiopathic scoliosis (AIS). Methods A retrospective study of 80 patients with adolescent idiopathic scoliosis (AIS) was conducted. The parameters evaluated were: age, sex, pelvic incidence (PI), sacral slop (SS), pelvic tilt (PT), sagittal balance (SB), coronal balance (CB), lumbar lordosis (LL), thoracic kyphosis (TK) divided into upper (between T1 and T5) and lower (between T5 and T12), cervical spine alignment (CSA), and Cobb's coronal angle (CCA) of primary scoliotic curvature. Results Regarding the sagittal balance, this study demonstrated a significant statistical positive correlation with cervical shape (p<0.01) and upper thoracic kyphosis (from T1 to T5) (p<0.05), but not with the other variables. LL had a strong influence on lower thoracic curvature (from T5 to T12) and was strongly influenced by the PI and SS. Conclusions Sagittal balance is a parameter that is influenced by multiple factors. In fact, it is closely related to cervical shape and the upper thoracic curvature (from T1 to T5), which in turn, is closely linked to the severity of the scoliotic kyphosis. The Cobb angle of the lower thoracic spine (from T5 to T12) is more closely correlated with the angle of lumbar lordosis than with the upper thoracic kyphosis (from T1 to T5). Level of evidence IV; Case Series.

RESUMO Objetivo O objetivo deste estudo é obter uma melhor compreensão dos parâmetros que influenciam o equilíbrio sagital em uma população com escoliose idiopática do adolescente (AIS). Métodos Foi realizado um estudo retrospectivo de 80 pacientes com escoliose idiopática do adolescente (AIS). Os parâmetros avaliados foram: idade, sexo, incidência pélvica (PI), sacral slope (SS), pelvic tilt (PT), equilíbrio sagital (SB), balanço coronal (CB), lordose lombar (LL), cifose torácica (TK) dividida em alta (entre T1 e T5) e baixa (entre T5 e T12), alinhamento da coluna cervical (CSA) e ângulo de Cobb coronal de curvatura escoliótica principal (CCA). Resultados Em relação ao equilíbrio sagital, demonstrou-se uma correlação positiva significativamente estatística com o formato da coluna cervical (p <0,01) e com o ângulo de cifose da porção superior da coluna torácica (de T1 para T5) (p <0,05), mas não com as demais variáveis. A LL exerce uma forte influência sobre a porção inferior da curvatura torácica (de T5 a T12) e é fortemente influenciada pela PI e SS. Conclusões O equilíbrio sagital é um parâmetro influenciado por múltiplos fatores. De fato, está extremamente relacionado com o formato da coluna cervical e com a coluna torácica superior (de T1 a T5) que, por sua vez, apresenta uma simbiose com a gravidade da curvatura escoliótica. O ângulo de Cobb da porção inferior da coluna torácica (de T5 a T12) apresenta uma relação maior com o ângulo da lordose lombar do que com a curvatura torácica superior (de T1 a T5). Nível de evidência IV; Série de Casos.

RESUMEN Objetivo El objetivo de este estudio es lograr una mejor comprensión de los parámetros que influyen en el equilibrio sagital en una población con escoliosis idiopática del adolescente (EIA). Métodos Se realizó un estudio retrospectivo de 80 pacientes con escoliosis idiopática del adolescente (EIA). Los parámetros evaluados fueron: edad, sexo, incidencia pélvica (IP), inclinación sacra (IS), inclinación pélvica (InP), balance sagital (BS), balance coronal (BC), lordosis lumbar (LL), cifosis torácica (CT) divididos en alta (entre T1 y T5) y baja (entre T5 y T12), alineación de la columna cervical (AC) y ángulo coronal de Cobb (ACC) de curvatura escoliótica primaria. Resultados Con respecto al balance sagital, este estudio demostró una correlación positiva estadísticamente significativa con la forma cervical (p < 0,01) y cifosis de la porción superior de la columna (de T1 a T5) (p < 0,05), pero no con las otras variables. LL tuvo una fuerte influencia en la parte inferior de la curvatura torácica (de T5 a T12) y fue fuertemente influenciada por la IP y la IS. Conclusiones El balance sagital es un parámetro influenciado por múltiples factores. De hecho, está estrechamente relacionado con la forma cervical y la curvatura torácica superior (de T1 a T5), que a su vez, está estrechamente relacionada con la gravedad de la cifosis escoliótica. El ángulo de Cobb de la porción inferior de la columna torácica (de T5 a T12) presenta mayor relación con el ángulo de lordosis lumbar que con la cifosis torácica superior (de T1 a T5). Nivel de evidencia IV; Serie de Casos.

Humanos , Escoliosis , Columna Vertebral , Adolescente , Cifosis
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 7(2): 2393-2404, abr.-jun. 2015.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: lil-755379


Objective: to know the developed strategies by crack users to deal with arising risks of drug consumption. Method: qualitative, descriptive and exploratory study. Data collection occurred in 2011, in a downtown city of Rio Grande do Sul, with five users of crack who made use of the drug for at least one year. Data was recollected through semi structured interview with the aid of a recorder. Results: the main risks pointed to crack users are psychological and physical. To reduce the risks, they mentioned the individual use, keep the self-care, condom use, marijuana after crack use, the control of quantity of drug used and pipe care. Conclusion: the most part of users knows the risks that come with the drug consumption, but not everyone adopts strategies of harm reduction.

Objetivo: Conhecer as estratégias desenvolvidas por usuários de crack para lidar com os riscos decorrentes do consumo da droga. Método: Estudo qualitativo, descritivo e exploratório. A coleta de dados ocorreu no ano de 2011, em uma cidade do interior do Rio Grande do Sul com cinco usuários de crack que fizeram uso da droga por no mínimo um ano. Os dados foram coletados por meio de entrevista semiestruturada com o auxílio de gravador. Resultados: Os principais riscos apontados pelos usuários de crack são o psicológico e físico. Para reduzir os riscos os usuários referiram fazer o uso da droga individualmente, manter o autocuidado, o uso de preservativo, uso de maconha após o uso do crack, o controle da quantidade de droga usada e cuidados com o cachimbo. Conclusão: A maioria dos usuários conhece os riscos decorrentes do consumo da droga, mas nem todos adotam as estratégias de redução de danos.

Objetivo: Conocer estrategias desenvueltas por usuarios de crack para lidiar con riesgos derivados del consumo de la droga. Método: Estudio cualitativo, descriptivo y exploratorio. La recolección de datos ocurrió en el año 2011, en una ciudad del interior de Río Grande del Sur con 5 usuarios de crack que hicieron uso de la droga por lo menos un año. Los datos fueron recolectados por medio de entrevista semiestructurada con auxilio de grabador. Resultados: Los principales riesgos señalados por los usuarios son el psicológico y físico. Para reducir los riesgos los usuarios refirieron hacer uso de la droga individualmente, mantener el autocuidado, uso del preservativo, uso de marihuana después del uso de crack, el control de la cantidad de droga usada y cuidados con la pipa. Conclusión: La mayoría de los usuarios conoce los riesgos consiguientes del consumo de la droga, pero ni todos adoptan la estrategias de reducción de daños.

Humanos , Masculino , Femenino , Cocaína Crack/efectos adversos , Cocaína/efectos adversos , Grupos de Riesgo , Trastornos Relacionados con Cocaína , Consumidores de Drogas , Brasil , Estrategias
Coluna/Columna ; 12(3): 192-195, 2013. ilus, tab
Artículo en Portugués | LILACS | ID: lil-694034


OBJETIVO: Verificar a presença do sinal de sedimentação nos pacientes com canal lombar estreito (CLE) comparando-os com os pacientes sem CLE. MÉTODOS: Realizado um estudo retrospectivo, transversal e descritivo. Realizada a revisão dos processos imagiológicos dos pacientes com CLE operados entre 1 de janeiro de 2008 e 31 de dezembro de 2009, comparando-os com os dos pacientes sem CLE observados em consulta externa. Os pacientes foram divididos em dois grupos: grupo I com 34 pacientes com diagnóstico de CLE. Critérios diagnósticos: existência de lombalgia e/ou claudicação neurogénica e/ou radiculopatia, associados a um diâmetro anteroposterior do canal menor que 10mm e grupo II com 40 pacientes observados em consulta externa por lombalgia sem clínica de CLE. Foi feita a medicação do diâmetro do canal e verificada a presença do sinal de sedimentação entre D12 a S1. RESULTADOS: O sinal da sedimentação foi positivo em 31 dos 34 pacientes do grupo I (91,2%), em dois destes 31 pacientes apenas abaixo da estenose. Este sinal não foi encontrado em nenhum paciente do segundo grupo. Verifica-se uma correlação estatisticamente significativa entre as variáveis "diâmetro do canal" e a "presença do sinal da sedimentação" (p<0.01) no grupo de pacientes com canal lombar estreito. CONCLUSÕES: O diagnóstico de CLE nem sempre é fácil atendendo à frequente dissonância entre os achados clínicos e imagiológicos. O sinal de sedimentação é positivo em pacientes com CLE entre os níveis L1 e L5, podendo ser um sinal válido para complementar o diagnóstico de CLE.

OBJECTIVE: To verify the presence of the sedimentation sign in patients with lumbar spinal stenosis (LSS) in comparison to those without LSS. METHODS: Retrospective, cross-sectional and descriptive study. Review of the imaging processes of patients with LSS operated between January 1, 2008 and December 31, 2009, comparing with patients without LSS observed in outpatient consultations. Patients were divided into two groups: group I had 34 patients with a diagnosis of LSS. Diagnostic criteria: existence of low back pain and/or neurogenic claudication and/or radiculopathy, associated with an anteroposterior canal diameter of less than 10 mm. Group II had 40 patients observed in outpatient consultations for low back pain without clinical LSS. The canal diameter was measured and the presence of the sedimentation sign between D12 and S1 was verified. RESULTS: A positive sedimentation sign was identified in 31 of the 34 patients in group I (91.2%); only below the stenosis in two of these 31 patients. The sign was not observed in the patients in group II. A statistically significant correlation was observed between the variables "canal diameter" and "presence of sedimentation sign" (p < 0.01) in the group of patients with lumbar spinal stenosis. CONCLUSION: The diagnosis of LSS is not always easy due to the frequent dissonance between the clinical and imaging findings. The sedimentation sign is positive in patients with LSS between L1 and L5 and can be a valid sign to complement the diagnosis of LSS.

OBJETIVO: Verificar la presencia de la señal de sedimentación en los pacientes con Canal Lumbar Estrecho (CLE), comparándolos con los pacientes sin CLE. MÉTODOS: Realizado un estudio retrospectivo, transversal y descriptivo. Realizada la revisión de los procesos de imagen de los pacientes con CLE operados entre el 1ro de enero de 2008 y el 31 de diciembre de 2009, en comparación con los pacientes sin CLE observados en las consultas externas. Creamos dos grupos de pacientes: grupo I, 34 pacientes con diagnóstico de CLE. Criterios de diagnósticos: existencia de lumbago y/o claudicación neurogénica y/o radiculopatía, asociados a un diámetro del canal menor de 10 mm. Grupo II, 40 pacientes observados en consultas externas por lumbago sin clínica de CLE. Se realizó la medicación del diámetro del canal y fue verificada la presencia de la señal de sedimentación entre D12 y S1. RESULTADOS: La señal de la sedimentación fue positiva en 31 de los 34 pacientes del grupo I (91,2 %), en dos de estos 31 pacientes solamente por debajo de la estenosis. Esta señal no se encontró en ningún paciente del segundo grupo. Se verificó una correlación, estadísticamente significativa, entre las variables "diámetro del canal" y la "presencia de la señal de la sedimentación" (p<0,01) en el grupo de pacientes con canal lumbar estrecho. CONCLUSIONES: El diagnóstico de CLE no siempre es fácil atendiendo a la frecuente discrepancia entre los hallazgos clínicos y de imagen. La señal de sedimentación es positiva en pacientes con CLE entre los niveles L1 y L5, pudiendo ser una señal válida para complementar el diagnóstico de CLE.

Humanos , Espectroscopía de Resonancia Magnética , Diagnóstico por Imagen , Cauda Equina , Sedimentación , Constricción Patológica
PLoS One ; 5(1): e8542, 2010 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-20066045


BACKGROUND: During seed germination, beta-conglutin undergoes a major cycle of limited proteolysis in which many of its constituent subunits are processed into a 20 kDa polypeptide termed blad. Blad is the main component of a glycooligomer, accumulating exclusively in the cotyledons of Lupinus species, between days 4 and 12 after the onset of germination. PRINCIPAL FINDINGS: The sequence of the gene encoding beta-conglutin precursor (1791 nucleotides) is reported. This gene, which shares 44 to 57% similarity and 20 to 37% identity with other vicilin-like protein genes, includes several features in common with these globulins, but also specific hallmarks. Most notable is the presence of an ubiquitin interacting motif (UIM), which possibly links the unique catabolic route of beta-conglutin to the ubiquitin/proteasome proteolytic pathway. SIGNIFICANCE: Blad forms through a unique route from and is a stable intermediary product of its precursor, beta-conglutin, the major Lupinus seed storage protein. It is composed of 173 amino acid residues, is encoded by an intron-containing, internal fragment of the gene that codes for beta-conglutin precursor (nucleotides 394 to 913) and exhibits an isoelectric point of 9.6 and a molecular mass of 20,404.85 Da. Consistent with its role as a storage protein, blad contains an extremely high proportion of the nitrogen-rich amino acids.

Genes de Plantas , Lupinus/genética , Proteínas de Almacenamiento de Semillas/genética , Secuencia de Aminoácidos , Secuencia de Bases , Cartilla de ADN , Electroforesis en Gel de Poliacrilamida , Germinación , Lupinus/fisiología , Datos de Secuencia Molecular , Proteínas de Plantas/química , Proteínas de Plantas/genética , Homología de Secuencia de Aminoácido
Phytochemistry ; 68(4): 416-25, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17188723


It was recently shown that wines contain typically a huge diversity of structurally similar polypeptides that exhibit a high degree of homology to pathogenesis-related (PR) proteins. This observation suggested the existence of one or a few precursors in mature grapes, common to most or all the wine PR proteins. Limited proteolysis and chemical modification of the precursor(s) during fruit ripening and winemaking could then generate the large number of distinct wine polypeptides. However, the patterns of PR proteins extracted from grape berries regularly harvested from the onset of development until maturity did not confirm the previous hypothesis. Two different methodologies, involving 2-D immunoblotting and a combination of FPLC cation/anion exchange chromatographies with 1-D immunoblotting, indicate that the total concentration of PR proteins is increased but its diversity is reduced from the early stages of berry development until maturity. These results indicate that PR proteins are synthesized in a wide variety of forms from the early stages of grape development, eliminating the hypothesis previously formulated on the existence of one or few precursors common to the wine proteins.

Proteínas de Plantas/toxicidad , Vitis/crecimiento & desarrollo , Secuencia de Aminoácidos , Frutas , Variación Genética , Proteínas de Plantas/química , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Alineación de Secuencia , Vino
Mol Plant Pathol ; 8(5): 677-700, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20507530


SUMMARY It is becoming increasingly evident that a plant-pathogen interaction may be compared to an open warfare, whose major weapons are proteins synthesized by both organisms. These weapons were gradually developed in what must have been a multimillion-year evolutionary game of ping-pong. The outcome of each battle results in the establishment of resistance or pathogenesis. The plethora of resistance mechanisms exhibited by plants may be grouped into constitutive and inducible, and range from morphological to structural and chemical defences. Most of these mechanisms are defensive, exhibiting a passive role, but some are highly active against pathogens, using as major targets the fungal cell wall, the plasma membrane or intracellular targets. A considerable overlap exists between pathogenesis-related (PR) proteins and antifungal proteins. However, many of the now considered 17 families of PR proteins do not present any known role as antipathogen activity, whereas among the 13 classes of antifungal proteins, most are not PR proteins. Discovery of novel antifungal proteins and peptides continues at a rapid pace. In their long coevolution with plants, phytopathogens have evolved ways to avoid or circumvent the plant defence weaponry. These include protection of fungal structures from plant defence reactions, inhibition of elicitor-induced plant defence responses and suppression of plant defences. A detailed understanding of the molecular events that take place during a plant-pathogen interaction is an essential goal for disease control in the future.

Rev Panam Salud Publica ; 19(6): 403-7, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16968595


OBJECTIVES: The efficacy of BCG vaccination in preterm babies is unknown, and available data on conversion rates to tuberculin in this age group are scarce and controversial. This study assessed the tuberculin response in preterm infants after BCG vaccination. METHODS: This randomized cohort study was carried out at the Neonatal Department, University Hospital, Federal University of Minas Gerais in Brazil during 2001 and 2002. The BCG vaccine was administered at birth to 65 full-term (control) and 40 preterm newborns. All of them were tested with 5 tuberculin units of purified protein derivative-S approximately 3 months after vaccination. RESULTS: A typical BCG scar was verified in 96.9% of the control group and in 90.0% of the preterm infants (P = 0.19). Indurations > 5 mm in diameter were recorded in 87.7% of the full-term and 67.5% of the preterm infants (P = 0.02). Indurations > 10 mm were recorded in 70.8% of the full-term and 42.5% of the preterm infants (P = 0.007). For indurations > 5 mm the upper and the lower limits of the 95% confidence interval for the difference between proportions were 8.5% to 31.8%, and for indurations > 10 mm these limits were 18.0% to 38.4%. No adverse reactions were observed in the study population. CONCLUSION: BCG vaccination could be recommended for preterm infants upon discharge from the neonatal unit to reduce morbidity and mortality in infants at risk for tuberculous infection, and to increase BCG vaccination coverage rates, especially in countries with high prevalence rates of tuberculosis.

Vacuna BCG/inmunología , Recien Nacido Prematuro/inmunología , Prueba de Tuberculina , Brasil , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Masculino
Plant Cell Physiol ; 47(9): 1262-73, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16926164


In animal cells, arsenite has been reported to cause sulfhydryl depletion, generate reactive oxygen species and increase the level of large ubiquitin-protein conjugates. Plant viability tests and DNA laddering experiments have shown that Lemna minor remains viable after exposure to 50 microM NaAsO(2) for periods of at least 6 h. However, protein metabolism is affected in two major ways: the synthesis of an array of stress proteins, which confer thermotolerance; and an increase in the amount of large ubiquitin-protein conjugates, particularly evident after 2-3 h of stress, indicative of a role for the ubiquitin/proteasome pathway. This outcome is primarily attributed to an increased availability of protein substrates during arsenite treatment for three main reasons: an increase in protein carbonyl content after 1-2 h of stress; moderate increments in the transcript levels of the sequences coding for the ubiquitin pathway components chosen as markers (polyubiquitin, E1 and E2, and the beta subunit and the ATPase subunits of the 26S proteasome); the observed increase in ubiquitin conjugates does not depend on de novo protein synthesis. This study is the first report on the involvement of the ubiquitin/proteasome pathway in response to arsenite in plants. In addition, it addresses the simultaneous expression of selected genes encoding the various components of the pathway. The results suggest that in plants, unlike in animals, the response to a relatively low level of arsenite does not induce apoptotic cell death. As a whole, the response to arsenite apparently involves a conjugation of salvage and proteolytic machineries, including heat shock protein synthesis and the ubiquitin/proteasome pathway.

Araceae/efectos de los fármacos , Araceae/metabolismo , Arsenitos/farmacología , Complejo de la Endopetidasa Proteasomal/metabolismo , Compuestos de Sodio/farmacología , Ubiquitina/metabolismo , Araceae/citología , Araceae/genética , Regulación de la Expresión Génica de las Plantas , Redes y Vías Metabólicas/efectos de los fármacos , Datos de Secuencia Molecular , Ubiquitina/genética
Rev. panam. salud pública ; 19(6): 403-407, jun. 2006. tab
Artículo en Inglés | LILACS | ID: lil-433460


OBJETIVOS: Se desconoce la eficacia de la vacunación con Bacilo de Calmette-Guérin (BCG) en neonatos prematuros, y los datos que existen acerca de la proporción de casos de conversión tuberculínica en este grupo de edad son pocos y cuestionables. En este estudio se evaluó la respuesta a la prueba de tuberculina de neonatos prematuros tras la vacunación con BCG.MÉTODOS: Este estudio de cohorte aleatorizado se llevó a cabo en el Departamento de Neonatología del Hospital Universitario de la Universidad Federal de Minas Gerais, Brasil, en 2001 y 2002. Se administró la vacuna BCG en el momento de nacer a 65 lactantes nacidos a término (grupo testigo) y a 40 neonatos prematuros. Todos los niños recibieron 5 unidades tuberculínicas de derivado proteínico purificado (PPD) alrededor de 3 meses después de la vacunación.RESULTADOS: La típica cicatriz que deja la BCG se verificó en 96,9% del grupo testigo y en 90,0% de los neonatos prematuros (P = 0,19). Induraciones de > 5 mm de diámetro se documentaron en 87,7% de los neonatos nacidos a término y en 67,5% de los nacidos prematuramente (P = 0,02). Induraciones de > 10 mm se documentaron en 70,8% de los neonatos nacidos a término y en 42,5% de los prematuros (P = 0,007). En el caso de induraciones de > 5 mm, los límites inferior y superior del intervalo de 95% de la diferencia entre proporciones fueron 8,5% y 31,8%, y en el caso de induraciones de > 10 mm, estos límites fueron 18,0% y 38,4%. No se observaron reacciones adversas en la población estudiada.CONCLUSIÓN: La vacunación con BCG se podría recomendar para neonatos prematuros al darles de alta de la unidad de cuidados neonatales, con la finalidad de reducir la morbilidad y mortalidad de los que están en riesgo de contraer una infección tuberculosa y de aumentar las tasas de cobertura de la vacunación con BCG, sobre todo en países con una alta prevalencia de tuberculosis.

Femenino , Humanos , Recién Nacido , Masculino , Vacuna BCG/inmunología , Recien Nacido Prematuro/inmunología , Prueba de Tuberculina , Brasil , Estudios de Cohortes
J Agric Food Chem ; 52(15): 4913-20, 2004 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-15264935


The proteins from Vicia sativa L. (common vetch) seeds were investigated. Protein comprises approximately 11.4% of the seed fresh weight, >50.8% of which is composed by globulins and 43.6% by albumins. The globulins may be fractionated into two main components, which were named alpha-vicinin (comprising 73% of the total globulin fraction, and hence >37% of the total seed protein) and beta-vicinin. Two minor globulin components are also present, gamma-vicinin and delta-vicinin. alpha-Vicinin, the legumin-like globulin, with a sedimentation coefficient of 10.6 S, is a nonglycosylated, disulfide-bond-containing globulin, composed of a group of subunits with molecular masses ranging from 50 to 78 kDa. Upon reduction, each of these subunits releases a heavy polypeptide chain (34-66 kDa) and a light polypeptide chain (21-23 kDa). beta-Vicinin, the vicilin-like globulin, with a sedimentation coefficient of 7.7 S, is a nonglycosylated globulin that contains no disulfide bonds and consists of two major polypeptides with molecular masses of 58 and 66 kDa. gamma-Vicinin is a minor, glycosylated, disulfide-bond-containing globulin. In the reduced form, it comprises six polypeptide chains with molecular masses of 12, 19, 21, 22, 23, and 31 kDa. Finally, delta-vicinin is a minor, highly glycosylated globulin that exhibits hemagglutinating activity. It is composed of a major 47 kDa polypeptide and two minor (33 and 38 kDa) polypeptides. N-terminal sequencing of the delta-vicinin 47 kDa polypeptide revealed no homology to any other known storage protein.

Proteínas de Plantas/análisis , Semillas/química , Vicia sativa/química , Albúminas/análisis , Fenómenos Químicos , Química Física , Globulinas/análisis , Hemaglutininas/análisis , Péptidos/análisis , Péptidos/química , Proteínas de Plantas/química , Proteínas de Almacenamiento de Semillas
Trends Biotechnol ; 22(4): 168-73, 2004 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15038921


The vast majority of wine proteins have recently been identified as pathogenesis-related (PR) proteins. During the growing season, these proteins are expressed in developmentally dependent and inducible manners in grapevine leaves and grape berries, in which they are believed to play an important role in protection against fungal pathogens and possibly other stresses. Because of their inherent resistance to proteolytic attack and to the low pH values characteristic of wines, vinification can be seen as a "purification strategy" for grape PR proteins. The inevitable consequent accumulation of these proteins in wines becomes a technological nuisance because they adversely affect the clarity and stability of wines. Genetically modified vines underexpressing PR proteins would certainly lead to stable wines but would increase the plant susceptibility to fungal attack, and the actual trend seems to be in the opposite direction, that is overexpressing these proteins to obtain plants with enhanced resistance to pathogens--a trend that will probably augment problems associated with protein instability in the resulting wines.

Hongos/patogenicidad , Ingeniería Genética/métodos , Vitis/genética , Vino , Predisposición Genética a la Enfermedad , Concentración de Iones de Hidrógeno , Enfermedades de las Plantas/genética , Proteínas de Plantas/genética , Vitis/microbiología
J Agric Food Chem ; 52(6): 1682-7, 2004 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-15030230


The proteins from Vigna unguiculata (L.) Walp. (cowpea) seeds were investigated. Globulins constitute over 51% of the total seed protein, with albumins composing approximately 45%. The globulins may be fractionated by native electrophoresis or anion exchange chromatography into three main components, which were termed (in decreasing order of anodic mobility) alpha-vignin, beta-vignin, and gamma-vignin. alpha-Vignin, with a sedimentation coefficient of 16.5S, is a major, nonglycosylated globulin, composed of a major 80 kDa subunit, which upon reduction, produces two polypeptides (20 and 60 kDa). beta-Vignin, with a sedimentation coefficient of 13S, is a major, glycosylated globulin, composed of two main polypeptides (55 and 60 kDa) with no disulfide bonds. Finally, gamma-vignin, a minor globulin, is composed by one main type of subunit (22 kDa), which upon reduction, is converted into a single, apparently heavier polypeptide chain (30 kDa) due to the presence of an internal disulfide bond. Immunological analyses revealed structural homology between beta-vignin and beta-conglutin (the vicilin from Lupinus seeds) but not between alpha- or gamma-vignins and their Lupinus counterparts. Haemagglutination activity toward trypsinized rabbit erythrocytes was found exclusively in the albumin fraction and was strongly inhibited by N-acetylglucosamine or chitin.

Fabaceae/química , Proteínas de Plantas/aislamiento & purificación , Semillas/química , Albúminas/química , Albúminas/aislamiento & purificación , Globulinas/química , Globulinas/aislamiento & purificación , Glicosilación , Proteínas de Plantas/química
J Agric Food Chem ; 51(14): 4046-53, 2003 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-12822945


Despite recent reports in the literature that chitinases comprise approximately 50% of the soluble proteins present in mature Vitis vinifera L. (cv. Moscatel) grapes, with the other major proteins being thaumatin-like proteins, a careful inspection of the published data reveals inconsistencies as to which proteins actually accumulate in mature grapes. Mature Moscatel grapes were harvested in the same vineyard in two consecutive years, 1999 and 2000. The grapes exhibited widely distinct polypeptide patterns when analyzed by either FPLC cation exchange chromatography or two-dimensional electrophoresis: whrereas the 2000 grapes possessed a much higher protein content (1.96 versus 1.11 mg g(-)(1) of fresh weight), the 1999 grapes contained a greater heterogeneity of polypeptides. In addition, highly specific antibodies that recognize the pathogenesis-related proteins present in the grapes demonstrated that the 2000 harvest grapes had a wider variety of pathogenesis-related polypeptides. N-Terminal sequencing of the major polypeptides revealed differences in the relative abundance and amino acid sequence of thaumatin-like and osmotin-like polypeptides present in the 1999 and 2000 harvest Moscatel grapes and did not detect the presence of chitinase. As a whole, the data indicate that the expression and accumulation of the major proteins in grapes is essentially determined by the environmental and/or pathological conditions prevailing during grape development and maturation. The potential physiological and technological implications are discussed. The results of the present work suggest that it is not possible to base varietal differentiation of grapes on the profile of the pathogenesis-related polypeptides present in the mature berries.

Ambiente , Frutas/crecimiento & desarrollo , Proteínas de Plantas/análisis , Vitis/crecimiento & desarrollo , Secuencia de Aminoácidos , Quitinasas/análisis , Quitinasas/química , Cromatografía Líquida de Alta Presión , Electroforesis en Gel Bidimensional , Frutas/química , Datos de Secuencia Molecular , Fragmentos de Péptidos/química , Proteínas de Plantas/química , Proteínas de Plantas/aislamiento & purificación , Estaciones del Año , Edulcorantes/análisis , Edulcorantes/química , Vitis/química
FEBS Lett ; 534(1-3): 106-10, 2003 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-12527369


Conglutins are multisubunit, glycosylated, major storage proteins present in Lupinus seeds that self-aggregate in a calcium/magnesium-dependent manner. Two of these globulins exhibit lectin activity. The 210 kDa globulin derived from beta-conglutin that accumulates in Lupinus cotyledons during germination was used as a model protein to establish whether the self-aggregation process is electrostatic in nature or lectin-mediated. This protein binds in a very strong manner to chitin and recognizes a variety of glycoproteins including immunoglobulins G. Several compounds were tested for their inhibitory effect on the cation-dependent self-aggregation process. Sialic acid and phytin were the most effective whereas chitin and mucin were totally ineffective. The inability of the oligosaccharidic side chains of the 210 kDa protein, beta-conglutin and immunoglobulin G to interfere with the aggregation strongly supports the view that Ca/Mg are electrostatically involved in the in vitro self-aggregation of Lupinus globulins. The results suggest that calcium and magnesium ions are also electrostatically involved in vivo in the macromolecular aggregation of legume seed storage proteins, ensuring their efficient packing inside the protein storage vacuoles. This mechanism is responsible for the typical insolubility of legume globulins in water.

Lectinas/metabolismo , Lupinus/metabolismo , Proteínas de Plantas/metabolismo , Vacuolas/metabolismo , Aminoácidos/farmacología , Animales , Calcio/metabolismo , Fabaceae , Glicosilación , Magnesio/metabolismo , Monosacáridos/farmacología , Oligosacáridos/farmacología , Proteínas de Plantas/química , Proteínas de Plantas/efectos de los fármacos , Proteínas de Almacenamiento de Semillas , Semillas/metabolismo , Electricidad Estática
Phytopathology ; 93(12): 1505-12, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18943614


ABSTRACT Little information is available concerning the expression of pathogenesis-related (PR) proteins in grapevine (Vitis vinifera) and their effect properties on the major fungal pathogens of grape. A systematic study was performed on the effect of total or individual grape proteins on mycelial growth, spore germination, and germ tube growth of Uncinula necator, Phomopsis viticola, and Botrytis cinerea. Two proteins, identified as PR proteins by immunological methods and by N-terminal sequencing as osmotin and thaumatin-like protein, exhibited strong antifungal activities in vitro, blocking the growth of Phomopsis viticola and Botrytis cinerea mycelia. In addition, they inhibited spore germination and germ tube growth of U. necator, Phomopsis viticola, and Botrytis cinerea. The presence of both proteins displayed a synergistic effect. The expression of osmotin and thaumatin-like protein was induced in grapevine leaves and berries infected with U. necator and Phomopsis viticola. Thaumatin previously was thought to occur exclusively in berries. Immunoblot analyses revealed the accumulation of the two PR proteins in infected leaves and berries, supporting a role in vivo in increasing the resistance of grapevine to fungal attack.