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Obesity treatment is often burdensome for patients. We used the combination of moderate caloric restriction (CR) with hypoglycemic metformin to assess their multidirectional effect in obese patients. One group was treated only with moderate CR (n=21) the second was treated with moderate CR and 800 mg metformin twice daily (n=23). Serum was drawn before and after treatment. The following parameters were monitored: anthropometric, cardiovascular, inflammatory, metabolic, and markers characteristic for thyroid, liver, pancreas, and kidney functions. Both tested groups did not significantly differ in most tested parameters after the treatment. Two groups reduced anthropometric parameters (body mass, body mass index (BMI), waist circumference) and fat mass but also muscle and fat-free mass, improving systolic blood pressure, insulin and leptin concentration, insulin sensitivity, leptin to adiponectin ratio, and inflammatory markers. Unfortunately, there was little impact on improving dyslipidemia and the thyroid and liver parameters. Free triiodothyronine (fT3) and gamma glutamyl transferase (GGT) activity were decreased in both groups, but triglycerides were reduced only in patients treated with moderate CR. Metformin with CR treatment decreases uric acid and aspartate aminotransferase (AspAT) activity. Metformin treatment with moderate CR in obese patients mainly improved insulin sensitivity, resulting in a reduction of patients with glucose intolerance, improved anthropometric, cardiovascular, and inflammatory mediators, and only slightly enhanced liver and thyroid function. No changes in kidney and pancreas function were observed during the treatment. In conclusion, eight weeks of CR alone and CR with metformin in obese adults improved anthropometric and metabolic markers, reduced muscle mass, fT3, GGT, proinflammatory, and CV parameters, and displayed no changes in kidney and pancreas function. The group treated with metformin after the treatment was still more obese and had higher C-reactive protein (CRP) and homeostasis model assessment-an index of insulin resistance (HOMA-IR), but despite this, considerably reduced the number of patients with glucose intolerance.
Assuntos
Restrição Calórica , Hipoglicemiantes , Metformina , Obesidade , Humanos , Metformina/uso terapêutico , Obesidade/tratamento farmacológico , Obesidade/sangue , Obesidade/metabolismo , Restrição Calórica/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hipoglicemiantes/uso terapêutico , Resistência à InsulinaRESUMO
The changing of microbiome could precede the development of coeliac disease (CeD). We compared the bacterial profile of microbiota of tissues collected simultaneously from the stomach and duodenum in newly diagnosed patients with CeD. Biopsies were collected from 60 children and adolescents aged 2-18 years: (1) 40 patients with CeD; (2) 20 children as control group. The evaluation of the bacterial microbiota was carried out by sequencing the V3-V4 regions of the 16S rRNA subunit, using next-generation sequencing (NGS). The composition of bacterial microbiota was correlated with clinical and blood parameters. The beta diversity analysis revealed a significant dissimilarity in the gastric samples between the CeD and control group (Bray-Curtis index, P = 0.008, and weighted UniFrac distance, P = 0.024). At L2 (phylum level), Campylobacterota was only present in the stomach of the CeD group. A comparison of the abundance of bacteria between the stomach and duodenum showed significant differences in 10 OTUs (operational taxonomic units) in the control and 9 OTUs in the CeD group at L6 (genus) and in 8 OTUs and in 6 OTUs, respectively, at L7 (species). A significant correlation was observed between the genus Novosphingobium in stomach of CeD group and possession of the DQ2.5 and DQ 8 allele, and in the duodenum - between the DQ 8 allele and the species Blautia wexlerae. Significant differences in selected, little-known genera of bacteria suggest their potential role as new biomarkers in the development of CeD. To fully understand the mechanism of CeD development in genetically predisposed individuals, it is necessary to take into account not only the abundance of a given genus or species of bacteria, but also the anatomical location of its occurrence.
Assuntos
Bactérias , Biomarcadores , Doença Celíaca , Duodeno , Microbioma Gastrointestinal , RNA Ribossômico 16S , Estômago , Humanos , Doença Celíaca/microbiologia , Doença Celíaca/diagnóstico , Criança , Projetos Piloto , Pré-Escolar , Duodeno/microbiologia , Duodeno/patologia , Adolescente , Masculino , RNA Ribossômico 16S/genética , Feminino , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Estômago/microbiologia , Estômago/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Biópsia , DNA Bacteriano/genéticaRESUMO
The Body Advocacy Movement (BAM) is a novel, cognitive-dissonance-based intervention designed to target fatphobia and anti-fat bias as mechanisms to drive reductions in eating disorder (ED) risk. Previous dissonance-based programs (i.e. the Body Project; BP) have successfully targeted thin-ideal internalization as an intervention mechanism. As burgeoning research indicates that fatphobia and anti-fat bias may play a central role in the maintenance of ED pathology, a focused intervention designed to target these constructs could bolster prevention efforts. The aims of this pilot study include confirming acceptability and feasibility of BAM and developing preliminary estimates of its effects on intervention targets, along with benchmarking these effects against the BP intervention. BAM was found to be accepted by participants and feasible to facilitate in a peer-led model. Preliminary results from 50 participants (BAM: N = 26; BP: N = 24) reveal small-to-moderate pre-to-post intervention effects on fatphobia, anti-fat bias, thin-ideal internalization, and eating pathology, which dissipated at 8-week follow-up. The BAM intervention has the potential to supplement the existing suite of ED prevention programs by specifically targeting anti-fat bias, though additional testing in larger and more diverse samples is necessary to clarify its impact on both hypothesized risk mechanisms and ED outcomes.
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BACKGROUND: The sinus microbiome in patients with chronic rhinosinusitis (CRS) is considered homogenous across the sinonasal cavity. The middle nasal meatus is the recommended sampling site for 16S rRNA sequencing. However, individuals with unusually high between-site variability between the middle meatus and the sinuses were identified in previous studies. This study aimed to identify which factors determine increased microbial heterogeneity between sampling sites in the sinuses. METHODOLOGY: In this cross-sectional study samples for 16S rRNA sequencing were obtained from the middle meatus, the maxillary and the frontal sinus in 50 patients with CRS. The microbiome diversity between sampling sites was analysed in relation to the size of the sinus ostia and clinical metadata. RESULTS: In approximately 15% of study participants, the differences between sampling sites within one patient were greater than between the patient and other individuals. Contrary to a popular hypothesis, obstruction of the sinus ostium resulted in decreased dissimilarity between the sinus and the middle meatus. The dissimilarity between the sampling sites was patient-specific: greater between-sinus differences were associated with greater meatus-sinus differences, regardless of the drainage pathway patency. Decreased spatial variability was observed in patients with nasal polyps and extensive mucosal changes in the sinuses. CONCLUSIONS: Sampling from the middle meatus is not universally representative of the sinus microbiome. The differences between sites cannot be predicted from the patency of communication pathways between them.
Assuntos
Seio Frontal , Microbiota , Rinite , Rinossinusite , Sinusite , Humanos , RNA Ribossômico 16S/genética , Estudos Transversais , Bactérias/genética , Doença Crônica , Microbiota/genéticaRESUMO
Intestinal dysbiosis can lead to the induction of systemic immune-mediated inflammatory diseases, such as Crohn's disease Although archaea are part of the commensal microbiota, they are still one of the least studied microorganisms. The aim of our study was the standardization of the optimal conditions and primers for sequencing of the gut archaeome using Next Generation Sequencing, and evaluation of the differences between the composition of archaea in patients and healthy volunteers, as well as analysis of the changes that occur in the archaeome of patients depending on disease activity. Newly diagnosed patients were characterized by similar archeal profiles at every taxonomic level as in healthy individuals (the dominance of Methanobacteria at the class level, and Methanobrevibacter at the genus level). In turn, in patients previously diagnosed with Crohn's disease (both in active and remission phase), an increased prevalence of Thermoplasmata, Thermoprotei, Halobacteria (at the class level), and Halococcus, Methanospaera or Picrophilus (at the genus level) were observed. Furthermore, we have found a significant correlation between the patient's parameters and the individual class or species of Archaea. Our study confirms changes in archaeal composition in pediatric patients with Crohn's disease, however, only in long-standing disease. At the beginning of the disease, the archeal profile is similar to that of healthy people. However, in the chronic form of the disease, significant differences in the composition of archaeome begin to appear. It seems that some archaea may be a good indicator of the chronicity and activity of Crohn's disease.
Assuntos
Doença de Crohn , Microbioma Gastrointestinal , Humanos , Criança , Archaea/genética , Projetos Piloto , Doença de Crohn/genética , Microbioma Gastrointestinal/genética , Sequenciamento de Nucleotídeos em Larga EscalaRESUMO
Rebaudioside A (RebA) is a steviol glycoside used for production of sweeteners. It was shown that the glycosides affect memory and learning processes. The aim of the study was to investigate neurons immunoreactive for acetylcholinesterase (AChE) and M1 muscarinic receptors (mAChRs-M1) of the hippocampal CA1 and CA3 fields and striatal caudateputamen (CP) and globus pallidus (GP) in rats receiving RebA. RebA was administrated to adult rats for 45 days in dilutions of 1 mg and 2 mg RebA/ml water. Indirect peroxidase-antiperoxidase immunohistochemical reaction was conducted on frontal sections containing the hippocampus and striatum with use of antibodies against AChE and mAChRs-M1. Immunoreactive for the studied proteins neurons were morphologically and morphometrically assessed in hippocampal CA1 and CA3 fields and in CP and GP. Microscopic observations did not reveal significant changes in morphology of immunoreactive neurons, which suggests no neurotoxic effect of the studied glycoside on these cells. Morphometric analyses revealed an increase in the density of AChE and mAChRs-M1 immunoreactive neurons. A decrease in reaction intensity of AChE-positive neurons was also demonstrated in the hippocampal CA1 field and in GP. In contrast, an increase in reaction intensity of mAChRs-M1-positive neurons was found in CA1, CA3 fields and in CP and GP. The results of our preliminary studies indicate that RebA administrated to rats has an impact on cholinergic neurons in the studied area. The results suggest a possible increase in the activity of the cholinergic system, responsible for memory and learning processes, after administration of RebA.
Assuntos
Diterpenos do Tipo Caurano , Receptor Muscarínico M1 , Acetilcolinesterase/metabolismo , Animais , Diterpenos do Tipo Caurano/metabolismo , Diterpenos do Tipo Caurano/farmacologia , Hipocampo , Ratos , Receptor Muscarínico M1/metabolismoRESUMO
In the ongoing SARS CoV-2 pandemic, effective disinfection measures are needed, and guidance based on the methodological framework of the European Committee for Standardization (CEN) may enable the choice of effective disinfectants on an immediate basis. This study aimed to elucidate whether disinfectants claiming 'virucidal activity against enveloped viruses' as specified in the European Standard EN 14476 as well as in the German Association for the Control of Viral Diseases/Robert Koch Institute (DVV/RKI) guideline are effectively inactivating SARS-CoV-2. Two commercially available formulations for surface disinfection and one formulation for hand disinfection were studied regarding their virucidal activity. Based on the data of this study the enveloped SARS-CoV-2 is at least equally susceptible compared to the standard test virus vaccinia used in the EN 14476 and DVV/RKI guidelines. Thus, chemical disinfectants claiming 'virucidal activity against enveloped viruses' based on the EN 14476 and DVV/RKI guidelines will be an effective choice to target enveloped SARS-CoV-2 as a preventive measure.
Assuntos
Antivirais/farmacologia , Desinfetantes/farmacologia , Desinfecção/normas , Desinfecção das Mãos/normas , SARS-CoV-2/efeitos dos fármacos , Antivirais/química , COVID-19/prevenção & controle , Desinfetantes/química , Desinfecção/classificação , Desinfecção das Mãos/métodos , Humanos , Viroses/prevenção & controleRESUMO
The outbreak of the SARS-CoV-2 pandemic is triggering a global health emergency alert. Until vaccination becomes available, a bundle of effective preventive measures is desperately needed. Recent research is indicating the relevance of aerosols in the spread of SARS-CoV-2. Thus, in this study commercially available antiseptic mouthwashes based on the active ingredients chlorhexidine digluconate and octenidine dihydrochloride (OCT) were investigated regarding their efficacy against SARS-CoV-2 using the European Standard 14476. Based on the requirement of EN 14476 in which reduction of at least four decimal logarithms (≥4 log10) of viral titre is requested to state efficacy, the OCT-based formulation was found to be effective within a contact time of only 15 s against SARS-CoV-2. Based on this in-vitro data the OCT mouthwash thus constitutes an interesting candidate for future clinical studies to prove its effectiveness in a potential prevention of SARS-CoV-2 transmission by aerosols.
Assuntos
Anti-Infecciosos Locais/normas , Antivirais/farmacologia , Antivirais/normas , COVID-19/prevenção & controle , Clorexidina/farmacologia , Clorexidina/normas , Antissépticos Bucais/normas , Anti-Infecciosos Locais/farmacologia , Humanos , Pandemias , Padrões de Referência , SARS-CoV-2RESUMO
Calretinin (CR), a calcium-binding protein from EF-hand family, is localised in non-pyramidal GABA-ergic interneurons of the hippocampus. CR takes part in maintaining calcium binding homeostasis, which suggests its neuroprotective role. Hippocampal neurons contain membrane transient receptor potential vanilloid 1 (TRPV1) which binds to capsaicin (CAP) contained in habanero pepper fruits. Few in vivo studies have revealed the effect of CAP on interneurons containing CR. The aim of the present study was to investigate the CR immunoreac- tivity in interneurons of the hippocampal CA1 field and dentate gyrus (DG) in adult rats after intragastric admin- istration of the habanero pepper fruits. Wistar rats received a peanut oil - control group (C), and oil suspension of habanero pepper fruits at doses of 0.025 g dm/kg b.w. - group I and 0.08 g dm/kg b.w. - group II for 28 days. After euthanasia, the brains were collected and embedded in paraffin blocks using a routine histological tech- nique. Frontal hippocampal sections were immunohistochemically stained for CR by using a peroxidase-antiper- oxidase method. CR immunoreactive (CR-IR) interneurons were morphologically and morphometrically ana- lyzed under a light microscope. The results showed similar shapes and distribution of cells in both areas of the brain in group C and I of animals. However, CR-IR interneurons in the hippocampal CA1 field and in DG were occasionally observed in the group II of rats. The results of morphometric studies did not reveal statistically significant differences in the surface area and shape index of cells between examined brain regions from groups I and II compared to group C. Only in group II of rats, an increase in the digital immunostaining intensity of CR-IR interneurons was found in DG. Low number of CR-IR interneurons in the hippocampal CA1 field and in the DG, under the influence of a large dose of habanero pepper fruits containing CAP, may be caused by the activation of TRPV1 receptors and the increase in Ca2+ ions in these cells. This phenomenon may ultimately lead to neuronal death and may disturb neuronal conduction.
Assuntos
Região CA1 Hipocampal/citologia , Calbindina 2/metabolismo , Capsicum , Giro Denteado/citologia , Interneurônios/fisiologia , Animais , Região CA1 Hipocampal/fisiologia , Giro Denteado/fisiologia , Masculino , Ratos , Ratos WistarRESUMO
AIMS: The aim of the study was to evaluate the microbicidal effectiveness of radiant catalytic ionization (RCI) against Listeria monocytogenes strains in the form of planktonic cells and biofilm on food products and food contact surfaces as a method of food preservation. METHODS AND RESULTS: The study material comprised six strains of L. monocytogenes, isolated from food. Samples of different types of food available by retail (raw carrot, frozen salmon filets, soft cheese) and the fragments of surfaces (stainless steel AISI 304, rubber, milled rock tiles, polypropylene) were used in the experiment. The obtained results showed the effectiveness of RCI in the inactivation of both forms of the tested L. monocytogenes strains on all the surfaces. The effectiveness of RCI for biofilm forms was lower as compared with planktonic forms. The PRR value ranged from 18·19 to 99·97% for planktonic form and from 3·92 to 70·10% for biofilm. CONCLUSIONS: The RCI phenomenon induces the inactivation of L. monocytogenes on surfaces of food and materials used in the processing industry to a varying degree, depending on the manner of surface contamination, the properties of the contaminated materials as well as on the origin of the strain and the properties of surrounding dispersive environment in which the micro-organisms were suspended. SIGNIFICANCE AND IMPACT OF THE STUDY: Searching of new actions aimed at the reduction of the microbial contamination of food and food contact surfaces are extremely important. RCI method has been already described as an effective technique of microbial and abiotic pollution removal from air. However, our studies provide new, additional data related to evaluation the RCI efficacy against microbes on different surfaces, both in planktonic and biofilm form.
Assuntos
Biofilmes/efeitos da radiação , Conservação de Alimentos/métodos , Listeria monocytogenes/efeitos da radiação , Plâncton/efeitos da radiação , Radiação Ionizante , Microbiologia de AlimentosRESUMO
Habanero pepper fruits contain capsaicin (CAP) characterised by a spicy taste. Astrocytes express vanilloid receptor (TRPV1), which interacts with cannabinoids including CAP. Only a few studies revealed that CAP leads to alterations of the arcuate nucleus (ARC) structures. The aim of this study was to analyse the GFAP (GFAP-IR) and S100ß (S100ß-IR) immunoreactive astrocytes of ARC in adult rats after intragastric administration of habanero pepper fruits. Adult, Wistar rats received a peanut oil - control group (C) - and oil suspension of habanero pepper fruits at a dose of 0.08 g dm/kg b.w. for 7 days - E1 group - and 28 days - E2 group. After euthanasia, the brains were embedded in paraffin blocks using a routine histological technique. Frontal slices of ARC were immunohistochemically stained for GFAP and S100ß using specific antibodies in the peroxidase-antiperoxidase method. Astrocytes of ARC were morphologically and morphometrically analysed under a light microscope. The results of the study did not reveal statistically significant changes in the density of GFAP-IR cells in E1 and E2 groups of rats in comparison with group C. A statistically significant increase in the density of S100ß-IR astrocytes was observed in the E1 group and a decrease in the E2 group. Astrocytes with expression of both studied proteins were characterised by morphological alterations in ARC in the E2 group. The obtained results suggest an influence of CAP contained in habanero pepper fruits on the reactivity of astroglia, which may have an impact on the astrocyte-neuron interactions in order to maintain a proper activity of nervous cells in ARC.
Assuntos
Núcleo Arqueado do Hipotálamo/citologia , Astrócitos/efeitos dos fármacos , Capsicum/química , Imuno-Histoquímica/métodos , Animais , Astrócitos/citologia , Astrócitos/imunologia , Frutas/química , Proteína Glial Fibrilar Ácida/genética , Proteína Glial Fibrilar Ácida/metabolismo , Masculino , Ratos , Ratos Wistar , Subunidade beta da Proteína Ligante de Cálcio S100/genética , Subunidade beta da Proteína Ligante de Cálcio S100/metabolismoRESUMO
Binocular vision disorders (BVD) are quite common in subjects with cerebellar dysfunctions. Also individuals with strabismus often suffer from many motor deficits, such as impaired body balance and walking. It is known that the cerebellum is necessary to maintain proper body posture but also to learn motor skills. It is conceivable that subjects with BVD would also have deficits in procedural (implicit) motor learning, one of the primary cerebellar functions. The primary aim of this study was to explore motor learning abilities in subjects with BVD (strabismic group, SG). Modified versions of a single reaction time task were used in the scheme proposed by Molinari et al. in 1997. A set of three different tasks (Experiment 1) were performed under dominant eye viewing to investigate (a) procedural (implicit) motor learning, (b) declarative (explicit) learning, and (c) simple stimulus-response associative learning. Because each task examined different aspects of motor learning abilities, it could be revealed which motor learning pathway is impaired in SG. Results showed that the SG had slower reaction times in all three tasks and demonstrated poor implicit motor learning ability compared to controls. To verify if these results were caused by reduced binocular vision or cerebellar deficits, per se, a nonstrabismic binocular anomalies group (NSG) was introduced, and all the same tests were performed (Experiment 2). These results revealed that there were no differences between the NSG and the control group with good binocularity. To conclude, the poor procedural learning ability and slower reaction times in strabismic subjects should not be explained as an effect of incomplete binocular vision that influences the maturity of the visual cortex and transformation of visual information into a motor program because binocular anomaly individuals without strabismus have motor learning abilities close to the controls. Some cerebellar deficits appear to be the origin of observed anomalies.
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Aprendizagem/fisiologia , Transtornos das Habilidades Motoras/fisiopatologia , Estrabismo/fisiopatologia , Transtornos da Visão/fisiopatologia , Visão Binocular/fisiologia , Adulto , Feminino , Humanos , Masculino , Tempo de Reação/fisiologia , Adulto JovemRESUMO
We aimed to evaluate the ecological integrity of a large river, which receives agricultural and urban effluents and is used to water public supply. The fish species Astyanax bifasciatus was used as bioindicator during winter and spring 2012, and summer 2013 at the Middle Iguaçu River basin in Paraná state, Brazil. Water chemical and physical measures and ecotoxicological tests were carried out as well biochemical and genetic biomarkers in sampled fish in each period. The studied area was divided in three sample points: SP1, located where the water is collected to public supply; SP2, located in an urbanized area, and SP3, located at an urbanized area with the discharge of the sewage treatment. Although water chemical and physical analyzes were range of the Brazilian law to hydric bodies, anticholinesterasic effects were found in winter, oxidative stress in summer and spring. The higher genotoxic effect was in winter to all sample points. The temporal variation in biomarkers and the detection of caffeine in the water call attention to the water quality in this river mainly to be used to public supply.
Assuntos
Monitoramento Ambiental/métodos , Peixes/metabolismo , Poluentes Químicos da Água/toxicidade , Animais , Biomarcadores/metabolismo , Brasil , Rios , Estações do Ano , Água , Poluentes Químicos da Água/análise , Qualidade da Água , Abastecimento de ÁguaRESUMO
High concentration of glutamate (Glu) is excitotoxic for nervous system structures. This may lead to glial reactivity ie. increased expression of glial fibrillary acidic protein (GFAP) and S100ß protein, and also to hypertrophy and proliferation of cells which are determined by the presence of Ki-67 antigen. The aim of the study was to analyse the immunoreactivity of the GFAP, S100ß and Ki-67 proteins in astrocytes of hippocampal CA1 region in young rats after administration of monosodium glutamate (MSG) at two doses: 2 g/kg b.w. (I group) and 4 g/kg b.w. (II group). In rats from I and II group morphologically altered astrocytes with the GFAP expression were observed in the SLM of the hippocampal CA1 region. The cells had eccentrically located nuclei and on the opposite site of the nuclei there were single or double, long and weakly branched processes. Moreover, in the SLM the increase of the number of GFAP and S100ß immunopositive astrocytes and nuclei with Ki-67 expression, in contrary to control individuals, was observed. These results suggest the increased expression of the proteins in early reactions or hyperplasia which, together with cell hypertrophy, indicate late reactivity of astroglia in response to glutamate noxious effect.
Assuntos
Astrócitos/efeitos dos fármacos , Região CA1 Hipocampal/citologia , Imuno-Histoquímica/métodos , Glutamato de Sódio/farmacologia , Animais , Animais Recém-Nascidos , Astrócitos/fisiologia , Regulação da Expressão Gênica/efeitos dos fármacos , Proteína Glial Fibrilar Ácida/genética , Proteína Glial Fibrilar Ácida/metabolismo , Ácido Glutâmico/metabolismo , Antígeno Ki-67/genética , Antígeno Ki-67/metabolismo , Ratos , Subunidade beta da Proteína Ligante de Cálcio S100/genética , Subunidade beta da Proteína Ligante de Cálcio S100/metabolismoRESUMO
Educational efforts targeting parents of preadolescents may help them make informed decisions about having their children vaccinated against the human papillomavirus (HPV). We conducted a pilot study examining knowledge, attitudes, and beliefs of community-based health educators and counselors who routinely disseminate sexual health and prevention information through counseling and supporting these parents. We evaluated the impact of a single, brief workshop by administering questionnaires before and after the session. The workshop consisted of an educational intervention that was presented orally by an expert in gynecological oncology and was followed by an open discussion period. Following the information and discussion session, improvements were seen in knowledge accuracy, confidence in being able to discuss HPV vaccine issues with parents, greater willingness to recommend the vaccine, and a better understanding of potential barriers to vaccine uptake. These results suggest that health educators and counselors may be better prepared to encourage their clients to make well-informed decisions regarding HPV vaccination.
Assuntos
Atitude Frente a Saúde , Agentes Comunitários de Saúde/educação , Aconselhamento/educação , Educadores em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinação/psicologia , Adulto , Serviços de Saúde Comunitária , Agentes Comunitários de Saúde/organização & administração , Feminino , Seguimentos , Educação em Saúde , Humanos , Pessoa de Meia-Idade , Papillomaviridae , Infecções por Papillomavirus/psicologia , Vacinas contra Papillomavirus/uso terapêutico , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , PrognósticoRESUMO
Efficient urine production after kidney transplantation is often evidence of good graft function. If severe organ injury occurs, we have oliguria or anuria and the patient requires postoperative hemodialysis. In most cases, graft function recovers after a few hemodialysis treatments-delayed graft function (DGF). Therefore, recognition of factors influencing the onset of DGF is crucial. We examined the state of the circulatory system by a thermodilution method in 101 organ donors, taking into account mean arterial pressure (MAP), central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index. We also examined 232 kidney recipients, based on age, gender, panel-reactive antibody, cold ischemia time, and reason for renal insufficiency. We defined DGF as at least one hemodialysis after kidney transplantation. In logistic regression analysis, we showed that donor MAP, CVP, and PCWP of the substantially influenced the occurrence of DGF among kidney transplant recipients. Maintaining an adequate MAP and a sufficient volume in the donor circulatory system substantially decreased the occurrence of DGF after kidney transplantation.
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Sobrevivência de Enxerto/fisiologia , Transplante de Rim/fisiologia , Adulto , Anuria/etiologia , Pressão Sanguínea , Causas de Morte , Feminino , Frequência Cardíaca , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Oligúria/etiologia , Circulação Pulmonar/fisiologia , Análise de Regressão , Fatores de Tempo , Doadores de Tecidos/estatística & dados numéricosRESUMO
The serum creatinine level is one of the earliest metrics of kidney metabolic function. We examined 146 potential donors and their 232 kidney recipients. Donor data included gender, age, cause of death, mean arterial pressure (MAP), central venous pressure (CVP), pulmonary capillary wedge pressure (PCWP), systemic vascular resistance index, cardiac output (CO), and dopamine consumption. Recipient data were age, gender, time of hemodialysis before transplantation, panel reactive antibodies (PRA), cold ischemia time (CIT), etiology of renal insufficiency, duration/number of postoperative dialyses and serum creatinine levels on posttransplant days 1, 2, 3, 7, 14, 30, 90 and 180 day. Univariate correlates of higher serum creatinine levels in kidney recipients were CIT, time of hemodialysis before transplantation, PRA level as well as donor MAP, CVP, and PCWP. Multivariate analysis revealed that MAP < 70 mmHg in organ donors and CIT > 24 hours contributed to higher serum creatinine levels in kidney recipients up to 14 days posttransplantation (P < .01). There was a significant relation (P < .02) between low donor CO or CVP and an increased recipient serum creatinine level after 14 days posttransplantation. We concluded that decreased donor MAP and prolonged CIT predicted higher creatinine level in kidney recipients in the first 14 days posttransplantation. Donor CO and CVP influenced later serum creatinine levels in kidney recipients.