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1.
Neurophysiol Clin ; 45(4-5): 241-54, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26602955

RESUMO

The degree to which others in our environment influence sensorimotor processing has been a particular focus of cognitive neuroscience for the past two decades. This process of self-other resonance, or shared body representation, has only recently been extended to more global bodily processes such as self-location, self-motion perception, balance and perspective taking. In this review, we outline these previously overlooked areas of research to bridge the distinct field of social neuroscience with global self-perception, vestibular processing and postural control. Firstly, we outline research showing that the presence and movement of others can modulate two fundamental experiences of the self: self-location (the experience of where the self is located in space) and self-motion perception (the experience that oneself has moved or has been moved in space). Secondly, we outline recent research that has shown perturbations in balance control as a result of instability in others in our environment. Conversely to this, we also highlight studies in virtual reality demonstrating the potential benefits of the presence of others in our environment for those undergoing vestibular rehabilitation. Thirdly, we outline studies of first- and third-person perspective taking, which is the ability to have or take a visuo-spatial perspective within and out-with the confines of our own body. These studies demonstrate a contamination of perspective taking processes (i.e. automatic, implicit, third-person perspective taking) in the presence of others. This collection of research highlights the importance of social cues in the more global processing of the self and its accompanying sensory inputs, particularly vestibular signals. Future research will need to better determine the mechanisms of self-other resonance within these processes, including the role of individual differences in the susceptibility to the influence of another.


Assuntos
Imagem Corporal , Orientação/fisiologia , Equilíbrio Postural , Desempenho Psicomotor/fisiologia , Vestíbulo do Labirinto/fisiologia , Humanos , Percepção de Movimento/fisiologia , Percepção Espacial/fisiologia
2.
J Hum Nutr Diet ; 28(1): 47-55, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26295077

RESUMO

BACKGROUND: The present study aimed to explore parental perceptions of overweight children and associated health risks after receiving National Child Measurement Programme (NCMP) weight feedback. METHODS: Fifty-two parents of overweight and obese children aged 4-5 years and 10-11 years enrolled in the NCMP programme in England in 2010-2011 participated in qualitative, semi-structured interviews about their perceptions of their child's weight and health risk after receiving weight feedback. Interviews were audio tape recorded and were conducted either by telephone (n = 9) or in the respondents' homes (n = 41). Interviews were transcribed verbatim and analysed using interpretative thematic analysis. RESULTS: Parents who received NCMP written feedback informing them that their child was overweight disregarded the results because they viewed 'health and happiness as being more important than weight'. The feedback was viewed as less credible because it did not consider the individual child's lifestyle.'Broad definitions of healthy' were described that did not include weight,such as reference to the child having good emotional and physical health and a healthy diet. Parents attributed weight to 'inherited/acquired factors' such as genetics or puppy fat, or did not regard their child's 'appearance' as reflecting being overweight. 'Cultural influence' also meant that being overweight was not viewed negatively by some non-white parents. CONCLUSIONS: After receiving written weight feedback, parents use methods other than actual weight when evaluating their child's weight status and health risks. Parents' conceptions of health and weight should be considered when communicating with parents, with the aim of bridging the gap between parental recognition of being overweight and subsequent behaviour change.


Assuntos
Atitude Frente a Saúde , Peso Corporal , Felicidade , Saúde , Sobrepeso/psicologia , Pais/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Estilo de Vida , Masculino , Sobrepeso/etnologia , Notificação aos Pais , Obesidade Infantil/etnologia , Obesidade Infantil/psicologia , Pesquisa Qualitativa
3.
Nutr Metab Cardiovasc Dis ; 24(9): 956-62, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24925122

RESUMO

BACKGROUND AND AIMS: We investigated whether objectively measured sedentary time was associated with markers of inflammation in adults with newly diagnosed type 2 diabetes. METHODS AND RESULTS: We studied 285 adults (184 men, 101 women, mean age 59.0 ± 9.7) who had been recruited to the Early ACTivity in Diabetes (Early ACTID) randomised controlled trial. C-reactive protein (CRP), adiponectin, soluble intracellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), and accelerometer-determined sedentary time and moderate-vigorous physical activity (MVPA) were measured at baseline and after six-months. Linear regression analysis was used to investigate the independent cross-sectional and longitudinal associations of sedentary time with markers of inflammation. At baseline, associations between sedentary time and IL-6 were observed in men and women, an association that was attenuated following adjustment for waist circumference. After 6 months of follow-up, sedentary time was reduced by 0.4 ± 1.2 h per day in women, with the change in sedentary time predicting CRP at follow-up. Every hour decrease in sedentary time between baseline and six-months was associated with 24% (1, 48) lower CRP. No changes in sedentary time between baseline and 6 months were seen in men. CONCLUSIONS: Higher sedentary time is associated with IL-6 in men and women with type 2 diabetes, and reducing sedentary time is associated with improved levels of CRP in women. Interventions to reduce sedentary time may help to reduce inflammation in women with type 2 diabetes.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Inflamação/sangue , Atividade Motora , Comportamento Sedentário , Adiponectina/sangue , Idoso , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Seguimentos , Humanos , Molécula 1 de Adesão Intercelular/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Circunferência da Cintura
4.
Int Urogynecol J ; 24(8): 1265-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23563892

RESUMO

INTRODUCTION AND HYPOTHESIS: The minimally invasive tension-free vaginal tape (TVT) operation has become the "gold standard" of incontinence surgery. The aim of the present study was to evaluate the long-term effect of the tape material and to assess the continence status 17 years after surgery METHODS: A cohort of 90 women operated upon with the TVT procedure at three Nordic centers has been prospectively followed for 17 years. All of the women alive according to national registries were contacted and invited to visit the clinics for evaluation. Pelvic examination was performed to reveal any adverse effects of the tape material. Objective and subjective continence status were assessed by a cough stress test and the patients' global impression of improvement as well as by condition-specific quality of life questionnaires. RESULTS: Seventy-eight percent of the potentially assessable women were evaluated either by a clinic visit or by a telephone interview. One case of a minimal, symptom-free tape extrusion was seen. No other tape complications occurred. Over 90 % of the women were objectively continent. Eighty-seven per cent were subjectively cured or significantly improved. CONCLUSION: The TVT operation is durable for 17 years, with a high satisfaction rate and no serious long-term tape-induced adverse effects.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/métodos , Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Finlândia , Seguimentos , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida , Slings Suburetrais/efeitos adversos , Suécia , Resultado do Tratamento
5.
Obes Rev ; 13(11): 985-1000, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22731928

RESUMO

The objective of this study was to evaluate the evidence on whether childhood obesity is a risk factor for adult disease, independent of adult body mass index (BMI). Ovid MEDLINE (1948-May 2011), EMBASE (1980-2011 week 18) and the Cochrane Library (1990-2011) were searched for published studies of BMI from directly measured weight and height in childhood (2-19 years) and disease outcomes in adulthood. Data were synthesized in a narrative fashion. Thirty-nine studies (n 181-1.1 million) were included in the review. There was evidence for associations between childhood BMI and type 2 diabetes, hypertension and coronary heart disease. Few studies examined associations independent of adult BMI; these showed that effect sizes were attenuated after adjustment for adult BMI in standard regression analyses. Although there is a consistent body of evidence for associations between childhood BMI and cardiovascular outcomes, there is a lack of evidence for effects independent of adult BMI. Studies have attempted to examine independent effects using standard adjustment for adult BMI, which is subject to over-adjustment and problems with interpretation. Studies that use more robust designs and analytical techniques are needed to establish whether childhood obesity is an independent risk factor for adult disease.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/etiologia , Obesidade/complicações , Adolescente , Adulto , Idoso , Envelhecimento , Doenças Cardiovasculares/epidemiologia , Causas de Morte , Criança , Pré-Escolar , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/etiologia , Obesidade/epidemiologia , Medição de Risco , Fatores de Risco , Adulto Jovem
8.
Int Urogynecol J Pelvic Floor Dysfunct ; 19(8): 1043-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18535753

RESUMO

The aim of this study was to evaluate the long-term effectiveness and safety of the tension-free vaginal tape (TVT) procedure. In a Nordic three-center prospective observational cohort study, 90 women with primary stress incontinence had a TVT operation performed in local anesthesia. Assessment included a 24-h pad test, a stress test, physical examination, and a visual analog scale for assessing the degree of bother. Patient's global impression of cure was obtained, and condition specific quality of life questionnaires were used. Seventy-seven percent of the initial cohort of 90 women and 89% of those alive and capable of cooperating were assessed 11.5 years after the TVT operation. Ninety percent of the women had both a negative stress test and a negative pad test being objectively cured. Subjective cure by patients global impression was found in 77%, 20% being improved and only 3% regarded the operation as a failure. No late-onset adverse effects of the operation were found, and no case of tape erosion was seen. The TVT procedure is safe and effective for more than 10 years.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Qualidade de Vida
9.
Int J Obes (Lond) ; 32(8): 1312-8, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18475273

RESUMO

OBJECTIVE: To assess the impact on sexual function attributed to lower urinary tract dysfunction in a female obese population. DESIGN: We performed a case-control study based on the registry of a university hospital obesity unit. A consecutive sample of women with body mass index(BMI) >or=30 (obese) was randomly matched by age, gender and residential county to control subjects using the computerized Register of the Total Population. Data were collected by a self-reported postal survey including the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). RESULTS: The questionnaire was completed and returned by 279/446 patients (62%) and 430/892 control subjects (48%). Obese women reported significantly lesser satisfaction with their sexual life, more frequent symptoms of urinary incontinence at intercourse, more often fear of urine leakage at intercourse, a higher tendency toward avoiding intercourse and more frequent feelings of guilt and disgust during intercourse (P<0.001). While considering sexual function in a subset of women with urge or stress urinary incontinence, the overall PISQ-12 scores were significantly lower in obese women compared to their age-matched nonobese controls for both the conditions (P<0.001). In an adjusted multivariate analysis, a BMI >30 was independently associated with a significantly increased risk for sexual dysfunction (odds ratio (OR) 1.8; 95% confidence interval (CI) 1.1-2.9), as were symptoms of urge or stress urinary incontinence (OR, 2.0; 95% CI, 1.3-3.1 and OR, 2.6; 95% CI, 1.7-4.0), respectively. CONCLUSION: Urge and stress urinary incontinences are more common and have greater impact on sexual function in obese women.


Assuntos
Obesidade/complicações , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Incontinência Urinária/etiologia , Adulto , Antropometria , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Fatores Socioeconômicos , Incontinência Urinária por Estresse/etiologia , Circunferência da Cintura
10.
Scand J Clin Lab Invest ; 62(3): 167-75, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12088335

RESUMO

Endometrial regrowth is associated with intense angiogenesis, for which vascular endothelial growth factor-A (VEGF-A) is an important regulator. However, the expression of other members of the VEGF family is less well documented. The aim of this study was to localize members of the VEGF family (VEGF-A, -B and -C), and their receptors (VEGFR1, 2 and 3) in human endometrial blood vessels. Endometrial biopsies collected from four healthy and fertile women were used for immunohistochemistry assessments. Co-localization of VEGF-family proteins with CD34 stained endothelial structures was determined by image analysis. We demonstrate here the marked expression of VEGF-A as well as VEGFR2 and 3 in capillaries. Arterioles expressed VEGF-B, VEGFR1, 2, and 3 moderately and VEGF-A variably. Venules expressed only VEGFR3 markedly. In contrast, VEGF-C was not expressed in the arterioles, but moderately in the capillaries and weakly in the venules. VEGF-B was expressed in all blood vessels; however, VEGF-B was weakly expressed in capillaries and arterioles and moderately expressed in venules and arterioles. Thus, expression of VEGF-A. B and C and VEGF receptors 1-3 in endometrial blood vessels indicates a highly structured involvement of VEGF in the regulation of angiogenesis in the human endometrium.


Assuntos
Indutores da Angiogênese/análise , Endométrio/irrigação sanguínea , Fatores de Crescimento Endotelial/análise , Fator A de Crescimento do Endotélio Vascular , Adulto , Arteríolas/química , Biópsia , Capilares/química , Feminino , Humanos , Imuno-Histoquímica , Neovascularização Fisiológica , Receptores de Complemento 3b/análise , Fator B de Crescimento do Endotélio Vascular , Fator C de Crescimento do Endotélio Vascular , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/análise , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/análise , Receptor 3 de Fatores de Crescimento do Endotélio Vascular/análise , Vênulas/química
11.
Int Urogynecol J Pelvic Floor Dysfunct ; 12 Suppl 2: S12-14, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11450973

RESUMO

In a prospective long-term study 49 women with stress incontinence and ISD (intrinsic sphincter deficiency) were followed for a mean of 4 years (range 3-5) after TVT operation. Preoperatively all patients underwent urodynamic investigations, quality of life evaluation, a 24-hour pad test and a gynecologic examination to properly verify the incontinence symptoms. The same protocol was used for postoperative evaluation. The mean age of the women was 66 years (+/- 11) and mean parity 2 (range 0-4). A standard TVT operation was performed under local anesthesia. At the postoperative evaluations 36 patients (74%) were completely cured of their incontinence problems. In addition, 6 women (12%) were significantly improved. In 7 patients (14%) no improvement was found. The majority of these not cured patients were >70 years of age and had urethral resting pressure of <10 cmH2O. Few intra- and postoperative complications occurred. It is concluded that TVT can be used for surgical treatment of patients with ISD and stress incontinence. However, older patients (>70 years) with a very low resting urethral pressure and an immobile urethra seem to constitute a risk group where TVT surgery is less successful.


Assuntos
Doenças Uretrais/complicações , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Idoso , Feminino , Seguimentos , Humanos , Estudos Prospectivos , Fatores de Tempo , Vagina
12.
Int Urogynecol J Pelvic Floor Dysfunct ; 12 Suppl 2: S19-23, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11450975

RESUMO

The aim of this study was to investigate the influence on the paraurethral connective tissue of different sling materials used in incontinence surgery. Biopsies from the paraurethral connective tissue were obtained intraoperatively from 16 women with stress urinary incontinence; all were operated on with the TVT procedure, 6 with Mersilene as the sling material and 10 with Prolene. Biopsies from 4 continent women with uterine bleeding irregularities, matched for age and parity, served as controls. New biopsies were obtained from all women after 2 years. The biopsies were examined histologically and analyzed for collagen concentration and solubility. An obvious inflammatory reaction with a significant increase in collagen extractability by pepsin was identified in patients where Mersilene was used as the sling material. A minimal inflammatory reaction without a significant change in collagen solubility was found in the Prolene group. In the control group no inflammatory reaction was seen. Mersilene gave rise to a significant foreign-body reaction in the paraurethral connective tissue after surgery. Such a reaction was not found with Prolene.


Assuntos
Tecido Conjuntivo/metabolismo , Polietilenotereftalatos , Polipropilenos , Telas Cirúrgicas , Incontinência Urinária por Estresse/metabolismo , Incontinência Urinária por Estresse/cirurgia , Idoso , Biópsia , Tecido Conjuntivo/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Incontinência Urinária por Estresse/patologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-11450979

RESUMO

In a prospective long-term Nordic multicenter study, 90 consecutive patients who had a tension-free vaginal tape (TVT) operation performed because of stress urinary incontinence were evaluated according to a strict protocol after approximately 5 years (range 48-70 months). Eighty-five patients could be evaluated according to the protocol. Another 5 elderly patients had to be interviewed by telephone at the final check-up after 5 years. The study protocol involved pre- and postoperative objective and subjective evaluation. The median follow-up time was 56 months. Seventy-two of the 85 patients who were fully evaluated (84.7%) were both objectively and subjectively completely cured. Another 9 patients (10.6%) were significantly improved and 4 (4.7%) were regarded as failures. No patient complained of long-term voiding difficulties and there were no signs of defective healing or rejection of the tape material. All patients had suffered from primary stress incontinence, and 25 also had preoperative complaints of urge. In 14 of these (56%) the urge symptoms were relieved postoperatively. We conclude that the TVT procedure seems to fulfil the expectations of high long-term cure rates, as suggested in previous short-term reports.


Assuntos
Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Vagina
14.
Acta Obstet Gynecol Scand ; 80(7): 638-44, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11437722

RESUMO

BACKGROUND: Although women with vulvar vestibulitis syndrome have principal symptoms of inflammation such as local erythema and pain in the mucosa around the vaginal introitus, it is not clear if vestibulitis is an inflammatory condition. Cyclooxygenase 2 and inducible nitric oxide synthase are known to be upregulated during inflammation. The aim of the present study was to analyze the expression of these enzymes in the vestibular mucosa in order to evaluate the inflammatory activity in the tissue. METHODS: Ten women fulfilling Friedrich's criteria of vulvar vestibulitis syndrome and ten control subjects were included in the study. Punch biopsies were obtained from the vestibular mucosa for analysis of cyclooxygenas 2 and inducible nitric oxide synthase, using indirect immunohistochemistry and Western dot-blot analyses. RESULTS: Both methods used showed low expression of cyclooxygenas 2 and inducible nitric oxide synthase in the vestibular mucosa of all women. There was no difference observed between the groups. CONCLUSIONS: There is a low expression of the inflammatory markers cyclooxygenas 2 and inducible nitric oxide synthase in the vestibular mucosa of women with vulvar vestibulitis syndrome as well as in healthy control subjects. The results indicate no active inflammation present and imply that topical corticosteroids in the treatment of vulvar vestibulitis are unfounded.


Assuntos
Isoenzimas/biossíntese , Óxido Nítrico Sintase/biossíntese , Prostaglandina-Endoperóxido Sintases/biossíntese , Vulvite/enzimologia , Adulto , Biópsia , Western Blotting , Ciclo-Oxigenase 2 , Feminino , Regulação Enzimológica da Expressão Gênica , Humanos , Imuno-Histoquímica , Isoenzimas/genética , Proteínas de Membrana , Mucosa/enzimologia , Óxido Nítrico Sintase/genética , Óxido Nítrico Sintase Tipo II , Prostaglandina-Endoperóxido Sintases/genética , Vulvite/imunologia , Vulvite/patologia
15.
Acta Obstet Gynecol Scand ; 80(1): 52-7, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11167189

RESUMO

BACKGROUND: An evaluation of the performance and safety of the prototype of a new device, MemoTreat (Atos Medical) for thermal endometrial balloon ablation in patients with menorrhagia. The evaluation was performed at four Swedish hospitals. METHODS: In total 51 consecutive, premenopausal patients, suffering from menorrhagia due to benign causes and not responding to conventional treatment, were treated between March 1997 and March 1998. The treatment entailed heated (85 degrees C) sterile saline circulated in a uterine balloon at a treatment pressure of 200 mmHg for 11 minutes. The procedure was performed mainly under general anesthesia and no pre-treatment endometrial thinning was performed. A validated pictorial assessment technique was used to evaluate changes in menstrual blood loss before and after treatment. Changes in quality of life and severity of dysmenorrhea were also evaluated. Data analysis was based on the 'intention to treat' method. RESULTS: The success rate in terms of a 50% reduction in menstrual bleeding was 84.3% at 6 months after treatment. Five patients became amenorrheic. The quality of life assessment showed substantial improvement and the severity of dysmenorrhea was markedly reduced. No intra-operative treatment complications occurred and the post-treatment morbidity was similar to that reported for other similar treatment methods. CONCLUSIONS: MenoTreat significantly reduced menstrual bleeding in menorrhagic patients, with a concomitant improvement in quality of life. The findings in this study resulted in a redesigned device with a thinner balloon catheter, improved cervical protection and treatment temperatures kept at a constant level.


Assuntos
Cateterismo/métodos , Endométrio/patologia , Hipertermia Induzida/métodos , Menorragia/terapia , Adulto , Cateterismo/instrumentação , Colo do Útero/patologia , Dismenorreia , Feminino , Humanos , Hipertermia Induzida/instrumentação , Pessoa de Meia-Idade , Hemorragia Pós-Operatória , Pressão , Qualidade de Vida
16.
Obstet Gynecol ; 98(6): 1067-74, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11755555

RESUMO

OBJECTIVE: To evaluate vascular changes as a possible underlying cause of mucosal erythema in women with vulvar vestibulitis. METHODS: Laser Doppler perfusion imaging was used to map the superficial blood flow in the vestibular mucosa in 20 women with vestibulitis and in 21 healthy control subjects. A possible correlation between perfusion values and graded erythema (1-5) around the vaginal introitus was analyzed. Changes in microvascular density in the posterior part of the mucosa were investigated in sections from ten patients and ten controls by a computer-assisted image-processing program. Induced vasoconstriction of terminal arterioles in the same posterior area was also studied. RESULTS: Significant increases in perfusion values were registered in the posterior parts of the vestibular mucosa in patients compared with controls. The highest blood flow was registered in the posterior fourchette. The most pronounced erythema was also located in the posterior vestibule in the patients. However, there was no significant correlation between perfusion values and degree of erythema in the same individual. The microvascular density or the ability of vestibular arterioles to constrict did not differ between patients and controls. CONCLUSION: Women with vestibulitis have an increased superficial blood flow and erythema in the posterior parts of the vestibular mucosa. The increased perfusion, most probably caused by a neurogenic vasodilatation contributes to, but does not fully explain the erythema. Atrophic changes of the surface epithelium should also be considered in the evaluation of an erythema.


Assuntos
Eritema/fisiopatologia , Vulva/irrigação sanguínea , Vulvite/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Fluxometria por Laser-Doppler , Microcirculação/fisiopatologia , Mucosa/irrigação sanguínea , Índice de Gravidade de Doença
17.
J Bacteriol ; 182(22): 6401-11, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11053384

RESUMO

In Pseudomonas aeruginosa, many exoproduct virulence determinants are regulated via a hierarchical quorum-sensing cascade involving the transcriptional regulators LasR and RhlR and their cognate activators, N-(3-oxododecanoyl)-L-homoserine lactone (3O-C12-HSL) and N-butanoyl-L-homoserine lactone (C4-HSL). In this paper, we demonstrate that the cytotoxic lectins PA-IL and PA-IIL are regulated via quorum sensing. Using immunoblot analysis, the production of both lectins was found to be directly dependent on the rhl locus while, in a lasR mutant, the onset of lectin synthesis was delayed but not abolished. The PA-IL structural gene, lecA, was cloned and sequenced. Transcript analysis indicated a monocistronic organization with a transcriptional start site 70 bp upstream of the lecA translational start codon. A lux box-type element together with RpoS (sigma(S)) consensus sequences was identified upstream of the putative promoter region. In Escherichia coli, expression of a lecA::lux reporter fusion was activated by RhlR/C4-HSL, but not by LasR/3O-C12-HSL, confirming direct regulation by RhlR/C4-HSL. Similarly, in P. aeruginosa PAO1, the expression of a chromosomal lecA::lux fusion was enhanced but not advanced by the addition of exogenous C4-HSL but not 3O-C12-HSL. Furthermore, mutation of rpoS abolished lectin synthesis in P. aeruginosa, demonstrating that both RpoS and RhlR/C4-HSL are required. Although the C4-HSL-dependent expression of the lecA::lux reporter in E. coli could be inhibited by the presence of 3O-C12-HSL, this did not occur in P. aeruginosa. This suggests that, in the homologous genetic background, 3O-C12-HSL does not function as a posttranslational regulator of the RhlR/C4-HSL-dependent activation of lecA expression.


Assuntos
Proteínas de Bactérias/genética , Regulação Bacteriana da Expressão Gênica , Lectinas/genética , Pseudomonas aeruginosa/genética , Proteínas Repressoras/genética , Fator sigma/genética , Adesinas Bacterianas/genética , Adesinas Bacterianas/metabolismo , Sequência de Aminoácidos , Proteínas de Ligação a DNA/genética , Proteínas de Homeodomínio/genética , Lactonas/farmacologia , Lectinas/metabolismo , Dados de Sequência Molecular , Mutação , Pseudomonas aeruginosa/metabolismo , Transativadores/genética , Transcrição Gênica
18.
J Clin Pharm Ther ; 25(3): 161-4, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10886460

RESUMO

Otitis media occurs commonly in children, and is usually treated with an antibiotic. In this case report, amoxicillin was prescribed for a 6-year-old boy suffering from acute otitis media. As he had previously experienced a rash after the administration of a penicillin, the medication order was switched from amoxicillin to trimethoprim/sulfamethoxazole (TMP/SMX). In an effort to determine whether or not this intervention was appropriate, references were found using Medline, International Pharmaceutical Abstracts and the Cochrane Library. Issues to be addressed included the need for antibiotics in acute otitis media, the comparative efficacy and tolerability of antimicrobial agents and the reliability of reported penicillin allergies. Amoxicillin and TMP/SMX were found to be first-line agents in the treatment of acute otitis media owing to their efficacy, safety and cost, with neither drug being significantly better than the other. The need to treat otitis media with antibiotics remains controversial. Reported penicillin allergies were found to be an unreliable indicator of a potentially serious reaction. In conclusion, it was found that treatment with TMP/SMX was an appropriate intervention.


Assuntos
Anti-Infecciosos/uso terapêutico , Toxidermias , Otite Média/tratamento farmacológico , Penicilinas , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Doença Aguda , Criança , Bases de Dados Factuais , Toxidermias/etiologia , Humanos , Masculino , Penicilinas/efeitos adversos , Resultado do Tratamento
19.
Gynecol Obstet Invest ; 48(4): 270-5, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10592432

RESUMO

Women with vulvar vestibulitis syndrome (VVS) have a distinct burning pain provoked by almost any stimuli in the area around the vaginal introitus. In a previous study we observed an increased number of intraepithelial free nerve endings in women with VVS. The aim of the present study was to neurochemically characterize the superficial nerves in the vulvar vestibular mucosa of women with VVS. Immunohistochemical methods were used to detect neuropeptides normally found in various types of nerve fibers. Calcitonin gene-related peptide, which is known to exist in nociceptive afferent nerves, was the only neuropeptide detected in the superficial nerves of the vestibular mucosa. These findings confirm our previous theory that the free nerve endings within the epithelium are nociceptors.


Assuntos
Neuropeptídeos/análise , Nervo Vestibular/química , Doenças do Nervo Vestibulococlear/metabolismo , Vulva/inervação , Adolescente , Adulto , Peptídeo Relacionado com Gene de Calcitonina/análise , Feminino , Imunofluorescência , Galanina/análise , Humanos , Mucosa/química , Fibras Nervosas/química , Neuropeptídeo Y/análise , Substância P/análise , Peptídeo Intestinal Vasoativo/análise
20.
Curr Opin Obstet Gynecol ; 11(5): 509-15, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10526931

RESUMO

An effective closure of the female urethra in stress situations is dependent on an integrated action of various anatomical structures connected to the organ. The most important of these structures - from a functional aspect - are the suburethral vaginal wall, the pubourethral ligaments, the pubococcygeus muscles and the paraurethral connective tissues. In all these structures connective tissue is an essential ingredient. Hence, defects in the actual connective tissue - in particular the paraurethral connective tissue that connects the aforementioned structures to each other and to the urethra - will bring about an ineffective urethral closure. Female urinary incontinence may then be caused by defective connective tissue per se and/or by a disconnection of the aforementioned structures, whereby the urethra cannot be 'kinked' - that is, closed off in stress situations.


Assuntos
Tecido Conjuntivo/ultraestrutura , Uretra/ultraestrutura , Incontinência Urinária por Estresse/patologia , Colágeno/ultraestrutura , Feminino , Humanos , Menopausa
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