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INTRODUCTION: Pollution harms the health of people with asthma. The effect of the anti-inflammatory cholinergic pathway in chronic allergic inflammation associated to pollution is poorly understood. METHODS: One hundred eight animals were divided into 18 groups (6 animals). Groups included: wild type mice (WT), genetically modified with reduced VAChT (VAChTKD), and those sensitized with ovalbumin (VAChTKDA), exposed to metal powder due to iron pelletizing in mining company (Local1) or 3.21 miles away from a mining company (Local2) in their locations for 2 weeks during summer and winter seasons. It was analyzed for hyperresponsivity, inflammation, remodeling, oxidative stress responses and the cholinergic system. RESULTS: During summer, animals without changes in the cholinergic system revealed that Local1 exposure increased the hyperresponsiveness (%Rrs, %Raw), and inflammation (IL-17) relative to vivarium animals, while animals exposed to Local2 also exhibited elevated IL-17. During winter, animals without changes in the cholinergic system revealed that Local2 exposure increased the hyperresponsiveness (%Rrs) relative to vivarium animals. Comparing the exposure local of these animals during summer, animals exposed to Local1 showed elevated %Rrs, Raw, and IL-5 compared to Local 2, while in winter, Local2 exposure led to more IL-17 than Local1. Animals with VAChT attenuation displayed increased %Rrs, NFkappaB, IL-5, and IL-13 but reduced alpha-7 compared to animals without changes in the cholinergic system WT. Animals with VAChT attenuation and asthma showed increased the hyperresponsiveness, all inflammatory markers, remodeling and oxidative stress compared to animals without chronic lung inflammation. Exposure to Local1 exacerbated the hyperresponsiveness, oxidative stressand inflammation in animals with VAChT attenuation associated asthma, while Local2 exposure led to increased inflammation, remodeling and oxidative stress. CONCLUSIONS: Reduced cholinergic signaling amplifies lung inflammation in a model of chronic allergic lung inflammation. Furthermore, when associated with pollution, it can aggravate specific responses related to inflammation, oxidative stress, and remodeling.
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Significant sums are spent every year to find effective treatments to control inflammation and speed up the repair of damaged skin. This study investigated the main mechanisms involved in the skin wound cure. Consequently, it offered guidance to develop new therapies to control OxInflammation and infection and decrease functional loss and cost issues. This systematic review was conducted using the PRISMA guidelines, with a structured search in the MEDLINE (PubMed), Scopus, and Web of Science databases, analyzing 23 original studies. Bias analysis and study quality were assessed using the SYRCLE tool (Prospero number is CRD262 936). Our results highlight the activation of membrane receptors (IFN-δ, TNF-α, toll-like) in phagocytes, especially macrophages, during early wound healing. The STAT1, IP3, and NF-kß pathways are positively regulated, while Ca2+ mobilization correlates with ROS production and NLRP3 inflammasome activation. This pathway activation leads to the proteolytic cleavage of caspase-1, releasing IL-1ß and IL-18, which are responsible for immune modulation and vasodilation. Mediators such as IL-1, iNOS, TNF-α, and TGF-ß are released, influencing pro- and anti-inflammatory cascades, increasing ROS levels, and inducing the oxidation of lipids, proteins, and DNA. During healing, the respiratory burst depletes antioxidant defenses (SOD, CAT, GST), creating a pro-oxidative environment. The IFN-δ pathway, ROS production, and inflammatory markers establish a positive feedback loop, recruiting more polymorphonuclear cells and reinforcing the positive interaction between oxidative stress and inflammation. This process is crucial because, in the immune system, the vicious positive cycle between ROS, the oxidative environment, and, above all, the activation of the NLRP3 inflammasome inappropriately triggers hypoxia, increases ROS levels, activates pro-inflammatory cytokines and inhibits the antioxidant action and resolution of anti-inflammatory cytokines, contributing to the evolution of chronic inflammation and tissue damage.
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BACKGROUND: Previous studies have shown that failure to control inflammatory processes mediated by regulatory T (Treg) cells contributes to chronic obstructive pulmonary disease (COPD) development and progression. The activity of Treg cells depends on their phenotypic characteristics: resting Treg (rTreg, CD3+CD4+CD25+FOXP3+CD25++CD45RA+) and activated Treg (aTreg, CD3+CD4+CD25+FOXP3+CD25+++CD45RA-) cells exhibit immunosuppressive activity, while cytokine-secreting T cells (FrIII, CD3+CD4+CD25+FOXP3+CD25++CD45RA-) exhibit proinflammatory activity. Previous findings have shown an increased density of cytokine-secreting T cells in COPD patients experiencing exacerbation. However, the methods for evaluating COPD under stable conditions are lacking. AIM: To evaluate Treg cell phenotypes in patients with different stages of COPD under stable conditions. METHODS: Peripheral blood mononuclear cells (PBMCs) were isolated from non-obstructed smokers and ex-smokers (NOS group, n = 19) and COPD patients at different stages (COPD I-II group, n = 25; COPD III-IV group, n = 25). The phenotypic characteristics of Treg cells and Th17 cells and their respective intracellular cytokines were analyzed by flow cytometry. RESULTS: Both obstructed groups showed an increase in the proportion of rTregs, while the COPD III-IV group showed additional increases in total Treg and Th17 cells and in IL-10+ cells. There was an increase in proinflammatory mediators (CD3+CD4+IL-17+ cells; CD3+CD4+RORγt+ cells) in the COPD I-II group. In contrast, the NOS group demonstrated high proportions of proinflammatory Treg cells and proinflammatory CD8+ T cells (CD3+CD8+IL-17+). CONCLUSION: Despite the increase in both total Treg cells and the rTreg phenotype from the early stages of COPD, there was a decrease in cells expressing IL-10, suggesting a failure in controlling the inflammatory process. These events precede the progression of the inflammatory process mediated by Th17 cells.
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OBJECTIVE: to map scientific productions on the application of the Neuman Systems Model to the Nursing practice focused on health care for aged people. METHOD: a scoping review based on the methodology proposed by the Joanna Briggs Institute. Seven electronic databases were consulted. Regarding the eligibility criteria, the following were considered: Population - Aged people; Concept - Application of the Neuman Systems Model in the Nursing practice; and Research Context - Health services. RESULTS: a total of 14 studies made up the sample. The data were analyzed and summarized into two categories: implementation of the Neuman Systems Model in hospital, institutional and outpatient settings; and use of the Neuman Systems Model in community and home environments. CONCLUSION: the application of Neuman Systems approach to the Gerontology Nursing practice, in different care scenarios, proved to be promising, considering aged people as comprehensive individuals with multiple dimensions. This perspective has shown adaptability and effectiveness in meeting the diverse needs of older adults, resulting in an improvement in their quality of life in old age.
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Enfermagem Geriátrica , Modelos de Enfermagem , Humanos , Enfermagem Geriátrica/normas , IdosoRESUMO
Tuberculous paradoxical reaction presents as clinical deterioration during appropriate tuberculosis therapy and is a separate entity from treatment failure and drug resistance. We describe a case of central nervous system paradoxical reaction following tuberculous meningoencephalitis treatment in an immunocompromised patient with systemic lupus erythematosus.
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This study evaluated the effects of supplementation of rumen-protected methionine (RPM) on body thermoregulation and conception rate of Nelore cows exposed to high temperature-humidity index (THI). On -31 days before the artificial insemination protocol, 562 lactating, multiparous cows were assigned to receive (MG) or not (CG) RPM supplementation (3 g/cow mixed into 100 g of mineral supplement). Both groups remained in tropical pastures and received supplementation for 77 days. A subset of cows (n = 142) remained with an intravaginal thermometer collecting intravaginal temperature (IT). The respective minimum, average, and maximum environmental THI were 72.8, 78.0, and 83.3. Effects of treatment × hour of the day were detected (P < 0.0001) for IT. From 1330 to 1730 h and 1830 to 1900 h, IT was higher (P < 0.05) for CG versus MG cows when exposed to moderate and high THI. The supplementation with RPM did not affect conception rate (CG = 64.4% vs. MG = 58.2%; P > 0.05). In conclusion, 3 g of RPM supplementation lowered internal body temperature and possibly altered critical THI threshold in Nelore cows with no impact on reproduction.
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Temperatura Corporal , Suplementos Nutricionais , Metionina , Rúmen , Animais , Bovinos/fisiologia , Metionina/administração & dosagem , Metionina/farmacologia , Feminino , Rúmen/metabolismo , Temperatura Corporal/efeitos dos fármacos , Temperatura Alta/efeitos adversos , Fatores de Tempo , Transtornos de Estresse por Calor/veterinária , Transtornos de Estresse por Calor/prevenção & controle , Regulação da Temperatura Corporal/efeitos dos fármacos , Umidade , Resposta ao Choque Térmico/efeitos dos fármacos , Fertilização/efeitos dos fármacos , Ração Animal , Dieta/veterinária , Inseminação Artificial/veterinária , Inseminação Artificial/métodosRESUMO
Women living with human immunodeficiency virus are at an increased risk of developing cancers related to human papillomavirus (HPV). Thus, it is important to combine clinical assessments, serological screening, and HPV data for planning prevention policies. This study aimed to identify HPV and its specific types in the cervical, anal, and oral mucosa of HIV-seropositive women, associating it with viral load and lymphocyte count. Sociodemographic characteristics, health data (CD4+ and CD8+ T cell counts and viral load), and biological samples (cervical, anal, and oral) were collected from 86 HIV-positive women undergoing antiretroviral therapy. Data were classified according to the presence or absence of HPV-DNA, HPV-DNA presence at one or more anatomic sites, and level of oncogenic risk, considering low- and high-risk oncogenic HPV-DNA groups. The presence of HPV in the cervicovaginal site was 65.9%, 63.8% in anal canal, and 4.2% in oral mucosa. A viral load ≥75 HIV copies/mL was associated with the presence of HPV-DNA. There was an association between viral load and the low-risk HPV or high-risk HPV groups. We found a high prevalence of HPV infection in HIV-seropositive women, particularly in the cervical and anal mucosa, with viral load ≥75 HIV copies/mL being associated with HPV-DNA presence.
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Colo do Útero , DNA Viral , Infecções por HIV , Infecções por Papillomavirus , Carga Viral , Humanos , Feminino , Infecções por Papillomavirus/complicações , Adulto , Infecções por HIV/complicações , Infecções por HIV/virologia , DNA Viral/análise , Colo do Útero/virologia , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Pessoa de Meia-Idade , Contagem de Linfócitos , Mucosa Bucal/virologia , Canal Anal/virologia , Prevalência , Estudos Transversais , Fatores Socioeconômicos , Contagem de Linfócito CD4 , Fatores de Risco , Papillomavirus HumanoRESUMO
The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case-control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women.
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Líquido do Sulco Gengival , Metaloproteinase 8 da Matriz , Período Pós-Parto , Humanos , Feminino , Metaloproteinase 8 da Matriz/metabolismo , Metaloproteinase 8 da Matriz/análise , Adulto , Estudos de Casos e Controles , Líquido do Sulco Gengival/enzimologia , Gravidez , Doenças Periodontais/enzimologia , Biomarcadores/metabolismo , Adulto JovemRESUMO
Biosurfactants (BSFs) are molecules produced by microorganisms from various carbon sources, with applications in bioremediation and petroleum recovery. However, the production cost limits large-scale applications. This study optimized BSFs production by Bacillus velezensis (strain MO13) using residual glycerin as a substrate. The spherical quadratic central composite design (CCD) model was used to standardize carbon source concentration (30 g/L), temperature (34 °C), pH (7.2), stirring (239 rpm), and aeration (0.775 vvm) in a 5-L bioreactor. Maximum BSFs production reached 1527.6 mg/L of surfactins and 176.88 mg/L of iturins, a threefold increase through optimization. Microbial development, substrate consumption, concentration of BSFs, and surface tension were also evaluated on the bioprocess dynamics. Mass spectrometry Q-TOF-MS identified five surfactin and two iturin isoforms produced by B. velezensis MO13. This study demonstrates significant progress on BSF production using industrial waste as a microbial substrate, surpassing reported concentrations in the literature.
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Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis, characterized by heterogeneous clinical manifestations and variable disease progression. Ultrasonography has emerged as a valuable tool in the diagnosis and monitoring of PsA, providing real-time visualization of joint and soft tissue abnormalities. This review highlights recent advancements in ultrasonographic techniques for the assessment of PsA, including the identification of typical features, the role of power Doppler imaging in detecting active inflammation, and the potential of ultrasound for guiding treatment decisions. Additionally, we discuss the utility of ultrasound in assessing treatment response and monitoring disease progression in patients with PsA, with a focus on novel imaging modalities. By elucidating the evolving role of ultrasonography in PsA management, this article aims to enhance clinicians' understanding of its utility in facilitating early diagnosis, optimizing treatment strategies, and improving patient outcomes.
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BACKGROUND: Bronchiectasis is a condition characterized by abnormal and irreversible bronchial dilation resulting from lung tissue damage and can be categorized into two main groups: cystic fibrosis (CF) and non-CF bronchiectasis (NCFB). Both diseases are marked by recurrent infections, inflammatory exacerbations, and lung damage. Given that infections are the primary drivers of disease progression, characterization of the respiratory microbiome can shed light on compositional alterations and susceptibility to antimicrobial drugs in these cases compared to healthy individuals. METHODS: To assess the microbiota in the two studied diseases, 35 subjects were recruited, comprising 10 NCFB and 13 CF patients and 12 healthy individuals. Nasopharyngeal swabs and induced sputum were collected, and total DNA was extracted. The DNA was then sequenced by the shotgun method and evaluated using the SqueezeMeta pipeline and R. RESULTS: We observed reduced species diversity in both disease cohorts, along with distinct microbial compositions and profiles of antimicrobial resistance genes, compared to healthy individuals. The nasopharynx exhibited a consistent microbiota composition across all cohorts. Enrichment of members of the Burkholderiaceae family and an increased Firmicutes/Bacteroidetes ratio in the CF cohort emerged as key distinguishing factors compared to NCFB group. Staphylococcus aureus and Prevotella shahii also presented differential abundance in the CF and NCFB cohorts, respectively, in the lower respiratory tract. Considering antimicrobial resistance, a high number of genes related to antibiotic efflux were detected in both disease groups, which correlated with the patient's clinical data. CONCLUSIONS: Bronchiectasis is associated with reduced microbial diversity and a shift in microbial and resistome composition compared to healthy subjects. Despite some similarities, CF and NCFB present significant differences in microbiome composition and antimicrobial resistance profiles, suggesting the need for customized management strategies for each disease.
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Bronquiectasia , Fibrose Cística , Microbiota , Humanos , Bronquiectasia/microbiologia , Bronquiectasia/tratamento farmacológico , Bronquiectasia/diagnóstico , Fibrose Cística/microbiologia , Fibrose Cística/tratamento farmacológico , Fibrose Cística/diagnóstico , Masculino , Feminino , Microbiota/fisiologia , Microbiota/efeitos dos fármacos , Adulto , Pessoa de Meia-Idade , Escarro/microbiologia , Adulto Jovem , Estudos de Coortes , IdosoRESUMO
The peptide derived from E. contortisiliquum trypsin inhibitor (Pep-3-EcTI), peptide derived from kallikrein inhibitor isolated from B. bauhinioides (Pep-BbKI), and B. rufa peptide modified from B. bauhinioides (Pep-BrTI) peptides exhibit anti-inflammatory and antioxidant activities, suggesting their potential for treating asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO). We compared the effects of these peptides with dexamethasone (DX) treatment in an ACO model. In this study, 11 groups of male BALB/c mice were pre-treated under different conditions, including sensitization with intraperitoneal injection and inhalation of ovalbumin (OVA), intratracheal instillation of porcine pancreatic elastase (ELA), sensitization with intraperitoneal injection, and various combinations of peptide treatments with Pep-3-EcTI, Pep-BbKI, Pep-BrTI, dexamethasone, and non-treated controls (SAL-saline). Respiratory system resistance, airway resistance, lung tissue resistance, exhaled nitric oxide, linear mean intercept, immune cell counts in the bronchoalveolar lavage fluid, cytokine expression, extracellular matrix remodeling, and oxidative stress in the airways and alveolar septa were evaluated on day 28. Results showed increased respiratory parameters, inflammatory markers, and tissue remodeling in the ACO group compared to controls. Treatment with the peptides or DX attenuated or reversed these responses, with the peptides showing effectiveness in controlling hyperresponsiveness, inflammation, remodeling, and oxidative stress markers. These peptides demonstrated an efficacy comparable to that of corticosteroids in the ACO model. However, this study highlights the need for further research to assess their safety, mechanisms of action, and potential translation to clinical studies before considering these peptides for human use.
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FUNDAMENTOS: A prevenção de acidente vascular encefálico é uma das prioridades no tratamento da fibrilação atrial (FA). Devido ao alto custo dos anticoagulantes diretos, os antagonistas da vitamina K (AVK) representam importante estratégia terapêutica oferecida pelo SUS aos pacientes com FA no Brasil. Entretanto, os preditores de desfechos clínicos relevantes foram pouco estudados no mundo real. O objetivo do estudo foi identificar a incidência e os preditores independentes de morte cardiovascular, eventos tromboembólicos, sangramento maior e não-maior clinicamente relevante, em pacientes com FA tratados com AVK. MÉTODOS: Coorte prospectiva de pacientes com FA recebendo ≥1 ano de varfarina ou femprocumona, incluídos em 2017/2018 e seguidos até 2019. Foram classificados como FA valvar ou não valvar de acordo com as diretrizes vigentes à época. Os desfechos clínicos foram morte cardiovascular, eventos tromboembólicos, sangramento maior e não maior clinicamente relevante, separadamente e como desfecho composto, e adjudicados de forma independente. Foram coletados o tempo na faixa terapêutica (TFT), os escores CHADS2, CHA2DS2-VASc, HAS-BLED e SAMe-TT2R2. RESULTADOS: Foram incluídos 1.350 pacientes, com idade média de 69,2 (±11,8) anos e 53,6% do sexo feminino, e seguimento de 17 (15-19) meses. A mediana do TFT foi 65%. Prevalência de comorbidades foi elevada e 38,4% apresentavam doença reumática. Incidência anual de eventos tromboembólicos e morte cardiovascular foi 4,4% e preditores foram tromboembolismo prévio (HR 2,12 [IC95% 1,22-3,67], TFT <50% (HR 1,98 [IC95% 1,16-3,37]) e taxa de filtração glomerular (TFG) <45mL/min/1,73m2 (HR 2,76 [IC95% 4,82-1,58]). Sangramento maior e não-maior clinicamente relevante foram 3,24%/ano (IC95% 2,47-4,14), e preditores foram sangramento prévio (HR 2,60 [IC95% 1,47- 4,61]) e prótese valvar mecânica (HR 1,91 [IC95% 1,15-3,15]). A incidência do desfecho composto por eventos tromboembólicos e hemorrágicos foi 8,7%/ano e preditores foram sangramento prévio (HR 1,70 [IC95% 1,07-2,70]), TFT <41% (HR 1,79 [IC95% 1,11-2,86]) e átrio esquerdo >44mm (HR 1,97 [IC95% 3,26-1,19]). A incidência anual de eventos aumentou gradualmente de acordo com pontuações mais altas dos escores de risco CHADS2, CHA2DS2-VASc e HAS-BLED. Os valores de TFT foram significativamente menores entre os pacientes com ≥3 pontos no escore SAMe-TT2R2. CONCLUSÕES: Tromboembolismo ou sangramento prévios, TFG e TFT reduzidos, prótese valvar mecânica, e átrio esquerdo aumentado foram preditores de desfechos clínicos em pacientes com FA tratados com AVK.
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Fibrilação Atrial , Vitamina K , Acidente Vascular Cerebral/prevenção & controle , AnticoagulantesRESUMO
Prolonged exposure to iron powder and other mineral dusts can threaten the health of individuals, especially those with COPD. The goal of this study was to determine how environmental exposure to metal dust from two different mining centers in Brazil affects lung mechanics, inflammation, remodeling and oxidative stress responses in healthy and elastase-exposed mice. This study divided 72 male C57Bl/6 mice into two groups, the summer group and the winter group. These groups were further divided into six groups: control, nonexposed (SAL); nonexposed, given elastase (ELA); exposed to metal powder at a mining company (SAL-L1 and ELA-L1); and exposed to a location three miles away from the mining company (SAL-L2 and ELA-L2) for four weeks. On the 29th day of the protocol, the researchers assessed lung mechanics, bronchoalveolar lavage fluid (BALF), inflammation, remodeling, oxidative stress, macrophage iron and alveolar wall alterations (mean linear intercept-Lm). The Lm was increased in the ELA, ELA-L1 and ELA-L2 groups compared to the SAL group (p < 0.05). There was an increase in the total number of cells and macrophages in the ELA-L1 and ELA-L2 groups compared to the other groups (p < 0.05). Compared to the ELA and SAL groups, the exposed groups (ELA-L1, ELA-L2, SAL-L1, and SAL-L2) exhibited increased expression of IL-1ß, IL-6, IL-10, IL-17, TNF-α, neutrophil elastase, TIMP-1, MMP-9, MMP-12, TGF-ß, collagen fibers, MUC5AC, iNOS, Gp91phox, NFkB and iron positive macrophages (p < 0.05). Although we did not find differences in lung mechanics across all groups, there were low to moderate correlations between inflammation remodeling, oxidative stress and NFkB with elastance, resistance of lung tissue and iron positive macrophages (p < 0.05). Environmental exposure to iron, confirmed by evaluation of iron in alveolar macrophages and in air, exacerbated inflammation, initiated remodeling, and induced oxidative stress responses in exposed mice with and without emphysema. Activation of the iNOS, Gp91phox and NFkB pathways play a role in these changes.
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Exposição Ambiental , Ferro , Elastase Pancreática , Animais , Masculino , Camundongos , Líquido da Lavagem Broncoalveolar/química , Exposição Ambiental/efeitos adversos , Inflamação/metabolismo , Inflamação/induzido quimicamente , Ferro/toxicidade , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Camundongos Endogâmicos C57BL , Estresse Oxidativo/efeitos dos fármacos , Elastase Pancreática/metabolismo , Elastase Pancreática/farmacologia , Pós/toxicidadeRESUMO
Objective Evaluate the results of the implementation of the Fast Track Protocol (FTP), a medical practice based on scientific evidence, for elective total hip arthroplasty surgery, mainly comparing the National Average Hospital Admission Rate of 7.1 days. Methods 98 patients who underwent elective total hip arthroplasty surgery via the direct anterior approach, anterolateral approach and posterior approach were included in the FTP from December 2018 to March 2020, being followed up preoperatively, intraoperatively and immediately postoperatively. Results The average length of hospital stay was 2.8 days, being 2.1 days for the direct anterior approach, 3.0 days for the anterolateral access approach and 4.1 days for the posterior access approach. The average surgery time was 90 minutes, 19 (19.39%) of the patients were referred to the ICU in the postoperative period, however, none of them underwent surgery using the direct anterior approach. We had no cases of deep vein thrombosis (DVT), pulmonary embolism (PTE) or neurological injury, 19 (19.39%) patients had postoperative bleeding requiring dressing change, 4 (4.08%) needed blood transfusion, 2 (2.04%) patients had implant instability, 1 (1.02%) patient had a fracture during surgery and 1 (1.02%) patient died of cardiac complications. Conclusion FTP may be a viable alternative to reduce the length of stay and immediate postoperative complications for elective total hip arthroplasty surgery decreasing the length of stay of patients by 2 to 3 times when compared to the national average of 7.1 days.
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To compare different criteria for the diagnosis of periodontitis and to evaluate the association of this condition with prematurity, this case-control study was conducted on 283 mothers of infants, divided into two groups based on gestational age (cases: <37 weeks, controls: ≥37 weeks), with 71 cases and 212 controls. The periodontal evaluation included probing depth (PD), clinical attachment level (CAL), plaque index, and bleeding on probing (BOP). Participants were classified regarding periodontitis per 14 criteria based on different periodontal parameters. The criterion selected as the gold standard was the presence of at least four teeth with one or more sites with a PD ≥ 4 mm, CAL ≥ 3 mm, and BOP at the same site. The prevalence of periodontal disease ranged from 8.1% to 55.1%. Moreover, compared to the gold standard, the sensitivities of the other criteria were 100%, while specificity ranged from 50.4% to 96.4%. Periodontitis, defined by six of the selected criteria, was associated with prematurity after multivariate adjustment, with OR ranging from 1.85 to 2.69 and 95% CI from 1.01 to 5.56; one of them was the gold standard mentioned above. Measurements using the clinical parameters of PD, CAL, and bleeding at the same site (criteria 5, 6, 7, 8), CPI (criterion 10), and at least four teeth with a PD ≥ 4 mm and CAL ≥ 3 mm (criterion 11) to define periodontitis showed a statistically significant association (p < 0.05). Given this study's limitations, we can conclude that the diagnostic criteria for a periodontitis definition using a PD ≥ 4 mm and CAL ≥ 3 mm in two or more teeth, with BOP at the same site, seem stronger when detecting an association between periodontitis and prematurity.
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Doenças Periodontais , Periodontite , Feminino , Humanos , Recém-Nascido , Lactente , Estudos de Casos e Controles , Recém-Nascido Prematuro , Periodontite/diagnóstico , Periodontite/epidemiologia , Periodontite/complicações , Doenças Periodontais/complicações , MãesRESUMO
Pulmonary emphysema is a primary component of chronic obstructive pulmonary disease (COPD), a life-threatening disorder characterized by lung inflammation and restricted airflow, primarily resulting from the destruction of small airways and alveolar walls. Cumulative evidence suggests that nicotinic receptors, especially the α7 subtype (α7nAChR), is required for anti-inflammatory cholinergic responses. We postulated that the stimulation of α7nAChR could offer therapeutic benefits in the context of pulmonary emphysema. To investigate this, we assessed the potential protective effects of PNU-282987, a selective α7nAChR agonist, using an experimental emphysema model. Male mice (C57BL/6) were submitted to a nasal instillation of porcine pancreatic elastase (PPE) (50 µl, 0.667 IU) to induce emphysema. Treatment with PNU-282987 (2.0 mg/kg, ip) was performed pre and post-emphysema induction by measuring anti-inflammatory effects (inflammatory cells, cytokines) as well as anti-remodeling and anti-oxidant effects. Elastase-induced emphysema led to an increase in the number of α7nAChR-positive cells in the lungs. Notably, both groups treated with PNU-282987 (prior to and following emphysema induction) exhibited a significant decrease in the number of α7nAChR-positive cells. Furthermore, both groups treated with PNU-282987 demonstrated decreased levels of macrophages, IL-6, IL-1ß, collagen, and elastic fiber deposition. Additionally, both groups exhibited reduced STAT3 phosphorylation and lower levels of SOCS3. Of particular note, in the post-treated group, PNU-282987 successfully attenuated alveolar enlargement, decreased IL-17 and TNF-α levels, and reduced the recruitment of polymorphonuclear cells to the lung parenchyma. Significantly, it is worth noting that MLA, an antagonist of α7nAChR, counteracted the protective effects of PNU-282987 in relation to certain crucial inflammatory parameters. In summary, these findings unequivocally demonstrate the protective abilities of α7nAChR against elastase-induced emphysema, strongly supporting α7nAChR as a pivotal therapeutic target for ameliorating pulmonary emphysema.
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Benzamidas , Compostos Bicíclicos com Pontes , Camundongos Endogâmicos C57BL , Agonistas Nicotínicos , Elastase Pancreática , Enfisema Pulmonar , Receptor Nicotínico de Acetilcolina alfa7 , Animais , Receptor Nicotínico de Acetilcolina alfa7/agonistas , Receptor Nicotínico de Acetilcolina alfa7/metabolismo , Enfisema Pulmonar/tratamento farmacológico , Enfisema Pulmonar/induzido quimicamente , Enfisema Pulmonar/metabolismo , Enfisema Pulmonar/prevenção & controle , Camundongos , Benzamidas/farmacologia , Benzamidas/uso terapêutico , Masculino , Compostos Bicíclicos com Pontes/farmacologia , Compostos Bicíclicos com Pontes/uso terapêutico , Agonistas Nicotínicos/farmacologia , Agonistas Nicotínicos/uso terapêutico , Pulmão/patologia , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêuticoRESUMO
BACKGROUND: Multiple sclerosis (MS) is an important cause of acquired neurological disability in young adults, characterized by multicentric inflammation, demyelination, and axonal damage. OBJECTIVE: The objective is to investigate white matter (WM) damage progression in a Brazilian MS patient cohort, using diffusion tensor imaging (DTI) post-processed by tract-based spatial statistics (TBSS). METHODS: DTI scans were acquired from 76 MS patients and 37 sex-and-age matched controls. Patients were divided into three groups based on disease duration. DTI was performed along 30 non-collinear directions by using a 1.5T imager. For TBSS analysis, the WM skeleton was created, and a 5000 permutation-based inference with a threshold of p < .05 was used, to enable the identification of abnormalities in fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). RESULTS: Decreased FA and increased RD, MD, and AD were seen in patients compared to controls and a decreased FA and increased MD and RD were seen, predominantly after the first 5 years of disease, when compared between groups. CONCLUSION: Progressive WM deterioration is seen over time with a more prominent pattern after 5 years of disease onset, providing evidence that the early years might be a window to optimize treatment and prevent disability.
Assuntos
Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Substância Branca , Adulto Jovem , Humanos , Substância Branca/diagnóstico por imagem , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Brasil , Anisotropia , EncéfaloRESUMO
OBJECTIVE: Executive functions (EFs) are a multifaceted construct, important for several outcomes throughout life. The most commonly addressed executive components are inhibitory control, working memory, and cognitive flexibility. To map how other executive components are addressed conceptually and methodologically in the literature, a scoping review was carried out. METHOD: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline was used. The database search (2017-2022) was carried out on the APA PsycInfo, Medline, Scopus, LILACS, and SciELO databases. A total of 3,473 articles were identified; 1,302 remained after screening. Given the large number of articles, a sample calculation was performed (95% CI and 5% error), with 297 articles randomly selected for full-text reading and 242 studies included for analysis. RESULTS: There was a predominance of health application studies in adults and older adults and in developed countries. There is relative conceptual consensus that EF are a multidimensional construct; however, there is no explicit identification of the theoretical model used in the studies. A diversity of EF was evidenced, which broadens the understanding of the construct, its assessment, and intervention targets. Furthermore, there was a variety of instruments used to assess these skills, with a predominance of performance tests, often with construct-instrument ambivalence between studies. CONCLUSIONS: The mapping showed a diversity of skills referred to as EF in addition to the core components and identified the instruments used in their assessment. Greater conceptual and structural clarity and greater methodological care are fundamental to support the assessment of EF and their intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).