RESUMO
Background: Heart failure affects about 64 million people worldwide, and despite the economic resources employed to improve its prognosis, mortality is still alarming. The aim of this study was to investigate the impact of patients' characteristics on survival probability during one-year follow-up after an index hospitalization for heart failure. Study design: A three-year retrospective study was conducted on the records of the Hospitals belonging the Local Health Unit of L'Aquila, a Healthcare Facility located in the centre of Italy. Methods: Patients admitted to hospital with a heart failure event as main diagnosis were selected and followed up for one year after their discharge to obtain data for survival analysis. Results: During the observational period for 1,929 patients hospitalized with a Heart failure index event, 1,655 (85.8%) of them were discharged alive and followed up for one year after the discharge. Fourteen percent of patients (n = 232) died for reasons related to Heart failure during the follow-up period. Fifty percent of them (n = 116), died within three months from the index hospitalization discharge. Age ≥75 years (HR 3.192, 95% CI 1.964-5.188), discharging to home (HR 0.399, 95% CI 0.297-0.536), length of stay ≥8 days during the index hospitalization (HR 1.533, 95% CI 1.163-2.019), and high education level (HR 0.517, 95% CI 0.273-0.977), were found to be associated with the survival probability. Conclusion: Study results indicate that older patients, especially those with a low educational level, those with longer index hospitalization, and those not sent directly to home, deserve more care and attention after discharge.
Assuntos
Insuficiência Cardíaca , Hospitalização , Idoso , Seguimentos , Insuficiência Cardíaca/terapia , Humanos , Itália , Probabilidade , Estudos RetrospectivosRESUMO
Background: The body art (tattoos, body piercing and other aesthetic practices) is increasing at global level and involves different aspects of public health, from epidemiological feature to cultural and psychosocial determinants and regulatory issues. The study is aimed at estimating the prevalence of tattooed and pierced in youth, focusing on emerging profiles. Study design: A cross-sectional study has been conducted on 575 students at the first year of degree courses of an Italian University. Methods: Students were asked to fill an online questionnaire. Logistic regression models were evaluated in order to identify predictive factors and determinants of practice (tattoos, piercing, body art). Results: The 41.9% of participants underwent at least one body art intervention, with a higher prevalence in females. Multivariate logistic regression suggested an association of body art practice with type of school and university course, as well as lifestyle characteristics (smoking, alcohol abuse). In addition, the intention to undergo to body art intervention in the future appeared significantly higher in women and more frequent in apparently 'protected' categories such as medical students and non-problematic alcohol users. Conclusions: The study confirmed the importance of the surveillance and social and behavioural research on body art practice and suggested different health promotion perspectives, such as early intervention towards adolescents and late intervention towards young adults belonging to lesser risky population groups.
Assuntos
Piercing Corporal , Tatuagem , Adolescente , Piercing Corporal/psicologia , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Fatores de Risco , Inquéritos e Questionários , Tatuagem/psicologia , Adulto JovemRESUMO
BACKGROUND: In daily clinical practice, healthcare workers face end-of-life issues, such as futility, which is generally defined as the provision of treatments that do not produce any meaningful benefit for patients. STUDY DESIGN: To investigate the end-of-life issues according to Italian nurses' and physicians' opinions and to detect any differences between them, a secondary analysis of existing data from a cross-sectional study was conducted. METHODS: A validated questionnaire was used involving 351 nurses and 128 physicians from four hospitals in Central Italy. RESULTS: Regarding the definition of futility, nurses mainly focused on agony, suffering, and risks, while physicians paid more attention to the hope of healing. Nevertheless, both were distressed by different aspects of the treatments; in particular, nurses by the 'invasiveness of the treatments' and physicians by the 'over-medicalization of death'. Instead, nurses and physicians similarly recognized patients' right to seek to anticipate the end of life when they are terminally-ill and to express freely their desire not to be revived. CONCLUSIONS: The description of experiences and opinions of health professionals could represent a valid basis to develop a 'regulatory system' aimed to guide and support daily clinical and nursing activities.
Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Enfermeiras e Enfermeiros/psicologia , Médicos/psicologia , Assistência Terminal , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Low academic success rates lead to fewer than the required number of nurses entering the national health systems, impacting on the supply of nurses and with negative consequences for global health care since low nurse-to-patient ratios are associated with an increase of patients' adverse outcomes. OBJECTIVES: This study was mainly aimed at documenting any of the academic outcomes' potential predictors among Nursing Degree Program (NDP) students' characteristics. DESIGN: A retrospective multi-cohort study was conducted. PARTICIPANTS AND SETTING: Ten cohorts of nursing students enrolled in a central Italy university were involved. METHODS: Qualitative and quantitative data on entry characteristics and academic outcomes were retrieved, observing retrospectively 10 cohorts of Italian nursing students for 13 academic years (2004-2017). Multiple regression analyses were conducted to assess if potential predictors reporting a p-valueâ¯<â¯0.05 in univariate analyses were independently related to academic outcomes. RESULTS: A total of 2278 students were enrolled in this study. Multivariate analyses showed that 'female gender', 'having attended classical or scientific upper-secondary school', and 'having higher upper-secondary diploma grade' were associated both with the qualitative outcomes (graduation within the legal duration of NDP) and the quantitative ones (final degree exam grade). The weight of the 'admission-test score' in explaining the variance of academic performances was very low (ßâ¯=â¯0.03, 95% CIâ¯=â¯0.01 to 0.05) compared to the 'upper-secondary diploma grade' (ßâ¯=â¯0.14, 95% CIâ¯=â¯0.12 to 0.16). CONCLUSIONS: This evidence should lead to a reflection on the entry-selection methods for NDP, especially in those countries such as Italy, where these methods are essentially based on the entry-test, which in this study was shown to have a very low predictive power for academic outcomes.
Assuntos
Sucesso Acadêmico , Bacharelado em Enfermagem/tendências , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Feminino , Humanos , Itália , Masculino , Estudos Retrospectivos , Critérios de Admissão Escolar , Escolas de EnfermagemRESUMO
INTRODUCTION: The university educational sphere has many dilemmas. The question of sufficient knowledge and skills for students to acquire abilities to provide care in different clinical setting is one important dilemma. AIM: To measure the level of competencies by nursing students and its application in different clinical environments. METHODS: Nursing students of two Italian universities participated in the research. Data collection took place April to July 2015 using the Nurse Competence Scale. The Strengthening Reporting of Observational Studies in Epidemiology Guidelines was used to describe the study. Pearson's chi-square test, Student's t test, and regression tests were used for statistical analysis. RESULTS: The questionnaire response rate was 87.27% (n = 698). Most of the nursing students assessed their level of competency as 'good' and evaluated themselves as more competent than their actual nursing role. Students also appraised themselves as competent either via their clinical practices accomplished or in the therapeutic interventions. CONCLUSION: This study shows that the self-evaluation of the competencies acquired by nursing students in clinical settings in Latium and Abruzzo is of a good standard. This study also affirms that NCS is a valuable and reliable tool to measure clinical competencies in different clinical settings.
Assuntos
Competência Clínica , Estudantes de Enfermagem/psicologia , Adulto , Estudos Transversais , Avaliação Educacional , Feminino , Humanos , Itália , Masculino , Escolas de Enfermagem , Autoavaliação (Psicologia) , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: The Nurse Competence Scale is a tool for evaluating nursing clinical competence. This tool has been used and psychometrically validated previously in different countries but never in Italy. Assessing the validity and reliability of the Nurse Competence Scale in the Italian context has been a strong necessity for many years. AIM: To test the psychometric properties and evaluate the internal construct validity of the Italian version of the Nurse Competence Scale. METHODS: This study is a secondary analysis on a database of 698 bachelor nursing students who were trained in different clinical settings at two Italian universities. Internal consistency was examined with Cronbach's alpha coefficients and inter-item analysis, and construct validity was evaluated by Exploratory Factor Analysis with Oblimin rotation with Kaiser normalization, and eventually Confirmatory Factor Analysis. RESULTS: The results highlighted the necessity for refinements of the Nurse Competence Scale in the Italian Context. The original model of the Nurse Competence Scale (73 items) was not confirmed. The confirmatory factor analysis presented significant values of Chi-squared test = 10942.766, with degrees of freedom being 2.534 and a ratio of χ²/df = 4.318. The Comparative Fit Index value was significant 0.809 and the Normed Fit Index 0.765 was noteworthy too. The value of Root Mean Square Error of Approximation was significant 0.069. The Cronbach's α coefficient for the new scale was excellent (0.922). The exploratory factor analysis resulted in the Italian Nurse Competence Scale composed of 58 items divided into seven dimensions: using the research, professional awareness, ethical values, tutorial functions, professional leadership, educational interventions, and management of care processes. CONCLUSIONS: The Italian version of the Nurse Competence Scale with 7 dimension and 58 items is an appropriate tool for describing and comparing self-assessed competencies by nurses. Such evaluations could constitute an important contribution to have better educational environments. Self-assessment of competencies can also raise a stronger awareness of individual educational needs.
Assuntos
Competência Clínica , Educação em Enfermagem/normas , Estudantes de Enfermagem , Adulto , Distribuição de Qui-Quadrado , Pesquisa em Enfermagem Clínica , Estudos Transversais , Ética em Enfermagem , Análise Fatorial , Feminino , Humanos , Itália , Liderança , Masculino , Tutoria , Pessoa de Meia-Idade , Diagnóstico de Enfermagem/normas , Processo de Enfermagem , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , Autoavaliação (Psicologia) , Adulto JovemRESUMO
BACKGROUND: In spite of the high number of tools designed to measure the complexity of care, there is still great diversity in the meaning of this concept. METHODS: The study was carried out using the concept analysis method as described by Beth Rodgers; 27 international papers were selected using PubMed, Web of Science and CINAHL data sets, without any time constraints. RESULTS: A number of similar concepts relating to multiplicity, intensity of care and workload were selected. The antecedents were classified according to personal and clinical features of patients, the characteristics of care, the social and organizational features; the tools that emerged measure the risk of complexity of care. Among the consequences, those that emerged were related to patients, operators and organization. The two attributes of complexity of care are connected with measurement, on the one side, and uncertainly, on the other. CONCLUSIONS: As difficult as it is to define complexity of care, the analysis states that its classification should be targeted at redefining hospital organization.
Assuntos
Atenção à Saúde/organização & administração , Avaliação de Resultados em Cuidados de Saúde/métodos , Assistência ao Paciente/métodos , Humanos , Terminologia como Assunto , Incerteza , Carga de TrabalhoRESUMO
For nurses working in mental health service settings, it is a priority to perform patient assessments to identify patients' general and behavioural risks and nursing care complexity using objective criteria, to meet the demand for care and to improve the quality of service by reducing health threat conditions to the patients' selves or to others (adverse events). This study highlights that there is a relationship between the complexity of psychiatric patient care, which was assigned a numerical value after the nursing assessment, and the occurrence of psychiatric adverse events in the recent histories of the patients. The results suggest that nursing supervision should be enhanced for patients with high care complexity scores.
Assuntos
Enfermagem Psiquiátrica/métodos , Enfermagem Psiquiátrica/normas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Ethical problems in healthcare practices are increasing. Therefore, healthcare professionals encounter difficult ethical problems more frequently in their professional activities. For this reason, in several countries Ethics Consultation Services have been created, and a debate concerning their role and organization model has developed. Despite the great interest of healthcare professionals in ethics support, Ethics Consultation Services are scarcely diffused in Italy. METHODS: A survey was conducted to identify the levels of the nurses' experience and knowledge in the field of ethics and to assess their willingness to use a consultation service to approach ethical issues in healthcare. A questionnaire was administered and completed personally by 374 nurses appropriately instructed beforehand on its use. They were recruited from post-basic training courses at the Faculty of Medicine and Surgery of the University of L'Aquila. RESULTS: The willingness to recur to an ethical consultation, indicated by 90.3% of respondents, would confirm the hypothesis that the increasing ethical difficulties encountered in healthcare activities determined a greater interest towards this kind of service. The results of the study underline both the need and expectations the nurses have for ethics consultation and support to face ethical difficulties in patient care, and describe the characteristics of potential users. CONCLUSION: In our country the delay in approaching such problems is in contrast with the marked interest the healthcare professionals have for a possible request for support to face ethical problems in patient care. The study shows the respondents' high degree of appreciation of the contents of an ethics consultation activity and, consequently, it is desirable that the creation of an Ethics Consultation Service takes into consideration the indications given by the potential users, in addition to the experiences coming from other countries.
Assuntos
Atenção à Saúde/ética , Consultoria Ética , Conhecimentos, Atitudes e Prática em Saúde , Papel do Profissional de Enfermagem , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Fifteen Klebsiella pneumoniae clinical isolates showing non-susceptibility to carbapenems and resistant to colistin were collected in an Italian hospital. All isolates resulted negative to AmpC, MBL and ESBL production but positive to modified Hodge test, therefore were evaluated as KPC producers. The presence of blaKPC genes was verified by polymerase chain reaction (PCR) and sequencing. Furthermore, molecular typing was performed by multilocus sequence typing (MLST). PCR analysis and nucleotide sequencing revealed that all 15 isolates carried the blaKPC-3 gene. MLST analysis attributed the isolates from all patients to belong to the sequence type ST512. All isolates showed extensively drug-resistant (XDR) phenotype. The emergence of colistin-resistant K. pneumoniae underscores the implementation of strict control measures to prevent the dissemination of these organisms in hospitals.
Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Colistina/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Klebsiella pneumoniae/efeitos dos fármacos , Resistência beta-Lactâmica/genética , beta-Lactamases/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/metabolismo , Feminino , Genótipo , Humanos , Itália , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/crescimento & desenvolvimento , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fenótipo , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , beta-Lactamases/metabolismoRESUMO
Rheumatoid arthritis (RA) is an autoimmune disease in which T-cell activation plays a pivotal role in the induction of articular damage. CD4+/OX40+ T cells accumulate in the synovial fluid (SF) of RA patients, which suggests that they are involved in the pathogenesis of the disease. In this study, we assessed the intracellular cytokine production of peripheral blood and SF CD4+ and CD4+/OX40+ T cells from RA patients in order to evaluate their role in this disorder. Our results show that SF CD4+ cells are predominantly interferon gamma (IFN-gamma)-positive and express a Th1-like cytokine pattern. In SF, significantly more CD4+/OX40+ T cells expressed interleukin-4 (IL-4) and IL4/IFN-gamma than IFN-gamma alone. Our data demonstrate that SF CD4+/OX40+ T cells express a Th2/Th0 cytokine profile, which suggests that they are involved in inflammatory responses in RA joints.
Assuntos
Artrite Reumatoide/imunologia , Receptores OX40/análise , Líquido Sinovial/imunologia , Linfócitos T/imunologia , Células Th2/imunologia , Adolescente , Adulto , Idoso , Linfócitos T CD4-Positivos/imunologia , Polaridade Celular , Feminino , Humanos , Imunofenotipagem , Interferon gama/biossíntese , Interleucina-4/biossíntese , Masculino , Pessoa de Meia-IdadeRESUMO
Computation of sunlight exposure doses allows one to valuate the risk of skin cancer types for which not only the action spectrum but also the dose-response relationship are known. The Green model is particularly appropriate for this purpose since it calculates the solar ultraviolet spectral irradiance through an analytical approach and then makes dose computation easy and fast. However, somewhat lengthy preliminary work is required to trace the entire Green model which is presented in several papers and is quite difficult to find, and to sum up the information concerning quantification of the risk of ultraviolet induced carcinogenesis from the existing experimental and epidemiological literature. This present paper provides a brief but complete description of the Green model and a short review concerning risk assessment of carcinogenesis induced by exposure to sunlight. Thus it summarises all the physical and health-related aspects involved in performing this task by applying the Green model in order to assist an interested researcher to quickly assimilate all the necessary information.
Assuntos
Algoritmos , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Modelos Biológicos , Neoplasias Induzidas por Radiação/etiologia , Radiometria/métodos , Medição de Risco/métodos , Raios Ultravioleta , Carga Corporal (Radioterapia) , Relação Dose-Resposta à Radiação , Humanos , Doses de Radiação , Proteção Radiológica/métodos , Eficiência Biológica Relativa , Luz SolarRESUMO
The expression of the five somatostatin receptor subtypes, sst1-5 was compared on tissue containing glial tumours (glioblastomas or oligodendrogliomas), medulloblastomas, and on normal human cortex. By semiquantitative reverse transcription coupled to polymerase chain reaction, the receptor expression profiles were high in cortex and in tissue containing oligodendrogliomas. It was moderate in medulloblastomas. Tissue containing glioblastomas displayed lower expression of somatostatin receptor subtypes, sst1 and sst3 being mostly expressed. By 125I-Tyr0DTrp8 somatostatin-14 or 125I-Leu8DTrp22 Tyr25 somatostatin-28 autoradiography combined with synaptophysin immunohistochemistry, it was possible to differentiate between isolated tumoral cell component infiltrating the cerebral parenchyma (cortex or white matter) and tumoral tissue (without residual parenchyma) in glioblastomas or oligodendrogliomas. Glial tumoral tissue per se presented few somatostatin receptors. By contrast, medulloblastoma tumoral cells exhibited numerous octreotide sensitive somatostatin receptors. sst2 immunocytochemistry demonstrated immunostaining of neuronal cells and neuropile; sst2 and sst3 immunostaining was identified on glioblastoma proliferating vessels endothelial cells and on medulloblastomas tumoral cells. Faint sst2 immunostaining among glial tumoral cells was due to microglia, while glioma cells did not significantly stain. In summary, medulloblastoma tumoral cells express sst2/sst3 receptors at a high level while glioma cells do not. In gliomas, sst expression is restricted to endothelial cells on proliferating vessels (displaying both sst2 and sst3 receptors), including parenchyma and reactive microglia (only sst2). The differential expression of sst2/sst3 receptors on gliomas and medulloblastomas has implications for the therapy of these tumours.
Assuntos
Neoplasias Encefálicas/metabolismo , Neoplasias Cerebelares/metabolismo , Glioma/metabolismo , Meduloblastoma/metabolismo , Receptores de Somatostatina/metabolismo , Adolescente , Adulto , Idoso , Autorradiografia , Neoplasias Encefálicas/patologia , Neoplasias Cerebelares/patologia , Feminino , Glioma/patologia , Humanos , Imuno-Histoquímica , Masculino , Meduloblastoma/patologia , Pessoa de Meia-Idade , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , RNA Mensageiro/metabolismo , Receptores de Somatostatina/genética , Somatostatina/metabolismoRESUMO
The peptide hormone/neurotransmitter somatostatin (somatotropin release inhibiting factor; SRIF) and its receptors (sst(1)-sst(5)) appear to regulate many physiological functions in the CNS. Semi-quantitative analysis of the densities of mRNA expression for sst(1-5) receptors and SRIF receptor binding sites were established in sst(2) receptor knock-out (KO) mice. Patterns of sst(1-5) receptor mRNA expression were largely conserved for sst(1,3,4) and sst(5) selective oligonucleotide probes; whereas sst(2) signals were completely absent in KO mouse brain. Autoradiographic analysis demonstrated [(125)I]LTT SRIF(28), [(125)I]CGP 23996 (two radioligands known to label all five recombinant SRIF receptors) and [(125)I]Tyr(3)-octreotide (sst(2) and sst(5) receptor selective) binding in wild type (WT) mouse brain sections; yet no specific binding of [(125)I]Tyr(3)-octreotide in KO mice. In contrast, [(125)I]LTT SRIF(28) and [(125)I]CGP 23996 binding was still present in a number of brain areas in KO mice, although to a lesser degree than in those regions where [(125)I]Tyr(3)-octreotide binding was found, in WT animals. The present data suggest first, that both sst(2) receptor protein and mRNA were completely absent in the brain of these KO animals. Second, there was little evidence of compensatory regulation, at the mRNA level, of the other SRIF receptors as a consequence of the sst(2) KO. Third, the absence of any [(125)I]Tyr(3)-octreotide binding, in KO mice, suggests that this particular ligand is selective for the sst(2) receptor subtype (under the conditions utilised); or that sst(5) receptors are only marginally expressed in brain. Fourth, there were regions where the binding of [(125)I]LTT SRIF(28) and [(125)I]CGP 23996 were moderately affected by the sst(2) KO, suggesting that additional SRIF receptors may well contribute to the binding of the aforementioned radioligands. Finally, since the relative distribution of these two ligands were not entirely superimposable, it suggests that their respective selectivity profiles towards the different SRIF receptor subtypes in situ are not identical.
Assuntos
Química Encefálica/genética , Encéfalo/metabolismo , RNA Mensageiro/metabolismo , Receptores de Somatostatina/biossíntese , Receptores de Somatostatina/metabolismo , Animais , Autorradiografia/métodos , Sítios de Ligação/genética , Feminino , Histocitoquímica/métodos , Hibridização In Situ/métodos , Masculino , Proteínas de Membrana , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Receptores de Somatostatina/deficiência , Receptores de Somatostatina/genética , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Somatostatin (somatotropin release-inhibiting factor, SRIF) receptor subtypes are expressed by several retinal neurons, suggesting that SRIF acts at multiple levels of the retinal circuitry, although functional data on this issue are scarce. Of the SRIF receptors, the sst2A isoform is expressed by rod bipolar cells (RBCs) of the rabbit retina, and in isolated RBCs we studied the role of sst2 receptors in modulating both K+ current (IK) and the intracellular free [Ca2+] ([Ca2+]i) using both voltage-clamp and Ca2+-imaging techniques. SRIF and octreotide (a SRIF agonist that binds to sst2 receptors) inhibited that component of IK corresponding to the activation of large-conductance, Ca2+- and voltage-dependent K+ channels (IBK) and reduced the K+-induced [Ca2+]i accumulation, suggesting that SRIF effects on IBK may have been secondary to inhibition of Ca2+ channels. Octreotide effects on IBK or on [Ca2+]i accumulation were prevented by RBC treatment with L-Tyr8-Cyanamid 154806, a novel sst2 receptor antagonist, indicating that SRIF effects were mediated by sst2 receptor activation. The present data indicate that SRIF may modulate the information flow through second-order retinal neurons via an action predominantly at sst2 receptors, contribute to the proposition that SRIF be added to the growing list of retinal neuromodulators, and suggest that one of its possible roles in the retina is to regulate transmitter release from RBCs.
Assuntos
Cálcio/metabolismo , Receptores de Somatostatina/fisiologia , Células Fotorreceptoras Retinianas Bastonetes/efeitos dos fármacos , Somatostatina/farmacologia , Animais , Eletrofisiologia , Octreotida/farmacologia , Técnicas de Patch-Clamp , Coelhos , Receptores de Somatostatina/agonistas , Células Fotorreceptoras Retinianas Bastonetes/metabolismo , Células Fotorreceptoras Retinianas Bastonetes/patologiaRESUMO
PURPOSE: To detect mRNAs for somatostatin (somatotropin release-inhibiting factor [SRIF]) receptor subtypes 1 to 5 (sst(1) through sst(5)) in rabbit retinas by reverse transcription-polymerase chain reaction (RT-PCR) and to investigate the distribution of sst(1) by single- and double-label immunocytochemistry. METHODS: Semiquantitative RT-PCR using sst-specific primers from mouse sequences was performed. sst(1) was localized using a polyclonal antiserum directed to human sst(1) in cryostat sections of retinas from either normal or optic nerve-transected animals. Immunolabeled cell sizes and densities were measured in wholemounted retinas using computer-assisted image analysis. Double-label immunofluorescence was performed using the sst(1) antiserum in conjunction with monoclonal antibodies directed to SRIF, tyrosine hydroxylase (TH), parvalbumin (PV), or gamma-aminobutyric acid (GABA). RESULTS: With RT-PCR it was found that all five sst mRNAs were expressed in the rabbit retina, with highest levels of sst(1) mRNA. sst(1) immunolabeling was localized to amacrine cells in the proximal inner nuclear layer (INL) of all retinal regions and to displaced amacrine cells in the ganglion cell layer (GCL) of the ventral retina. Some large sst(1)-immunoreactive (IR) somata were also present in the GCL. They were not observed after optic nerve transection. Double-label immunofluorescence showed sst(1) expression by all TH-IR amacrine cells and by other amacrine cells that were neither PV-IR nor GABA-IR. In addition, sst(1) was expressed by all SRIF-containing displaced amacrine cells. CONCLUSIONS: All five sst mRNAs are expressed in the rabbit retina. The localization of sst(1) suggests that it may mediate SRIF actions onto amacrine (including dopaminergic) and sparse ganglion cells. sst(1) expression in SRIF-IR cells suggests that this receptor may also act as an autoreceptor.
Assuntos
RNA Mensageiro/metabolismo , Receptores de Somatostatina/genética , Retina/metabolismo , Animais , Axotomia , Contagem de Células , Tamanho Celular , Primers do DNA/química , Expressão Gênica , Técnicas Imunoenzimáticas , Microscopia Confocal , Neuroglia/metabolismo , Nervo Óptico/fisiologia , Parvalbuminas/metabolismo , Coelhos , Receptores de Somatostatina/metabolismo , Retina/citologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tirosina 3-Mono-Oxigenase/metabolismo , Ácido gama-Aminobutírico/metabolismoRESUMO
1. In rat pituitary tumour cells (GC cells), spontaneous oscillations of the intracellular concentration of Ca2+ ([Ca2+]i) induce growth hormone (GH) secretion that is inhibited by octreotide, a somatostatin (SRIF) agonist which binds to SRIF subtype (sst) receptor 2. The effects of its functional activation on the control of [Ca2+]i were investigated using fluorimetric measurements of [Ca2+]i. 2. SRIF decreases the basal [Ca2+]i and the [Ca2+]i rise in response to forskolin (FSK) through the inhibition of L-type voltage-dependent Ca2+ channels. 3. Pretreatment with octreotide or with L-Tyr8++ Cyanamid 154806, a sst2 receptor antagonist, abolishes the SRIF-induced inhibition of [Ca2+]i. Octreotide is known to operate through agonist-induced desensitization, while the antagonist operates through receptor blockade. 4. sst1 and sst2 receptor-immunoreactivities (-IRs) are localized to cell membranes. sst2, but not sst1 receptor-IR, internalizes after cell exposure to octreotide. 5. SRIF-induced inhibition of basal [Ca2+]i or FSK-induced Ca2+ entry is blocked by pertussis toxin (PTX). 6. FSK-induced cyclic AMP accumulation is only partially decreased by SRIF or octreotide, indicating that sst2 receptors are coupled to intracellular pathways other than adenylyl cyclase (AC) inhibition. 7. In the presence of H-89, an inhibitor of cyclic AMP-dependent protein kinase (PKA), SRIF-induced inhibition of basal [Ca2+]i is still present, although reduced in amplitude. 8. SRIF inhibits [Ca2+]i by activating sst2 receptors. Inhibition of AC activity is only partly responsible for this effect, and other transduction pathways may be involved.
Assuntos
Cálcio/metabolismo , Citosol/metabolismo , Antagonistas de Hormônios/farmacologia , Hipófise/metabolismo , Somatostatina/farmacologia , Animais , AMP Cíclico/metabolismo , Citosol/efeitos dos fármacos , Imunofluorescência , Fluorometria , Imuno-Histoquímica , Potenciais da Membrana/fisiologia , Microscopia Confocal , Hipófise/citologia , Hipófise/efeitos dos fármacos , Ratos , Receptores de Somatostatina/efeitos dos fármacos , Receptores de Somatostatina/metabolismo , Transdução de Sinais/efeitos dos fármacos , Células Tumorais CultivadasRESUMO
A clinical case of a patient bearing systemic paracoccidioidomycosis with regional ganglionic and oral exposure and later pulmonary involvement is presented. The patient was treated with specific drugs (amphotericin B, itraconazole, sulfamethoxazole-trimethoprim) and followed throughout a 6-year period and eventually died showing an extensive involvement of the central nervous system.
Assuntos
Doenças do Sistema Nervoso Central/etiologia , Paracoccidioidomicose/complicações , Adulto , Anti-Infecciosos/uso terapêutico , Antifúngicos/uso terapêutico , Doenças do Sistema Nervoso Central/diagnóstico , Doenças do Sistema Nervoso Central/tratamento farmacológico , Quimioterapia Combinada , Evolução Fatal , Humanos , Itraconazol/uso terapêutico , Masculino , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Trimetoprima/uso terapêutico , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
This study was performed in order to assess the cytotoxic activity, both natural (NK) and antibody-dependent (ADCC), of PBMC from 38 IBD patients and correlate it with their clinical features. Cytotoxicity assays were performed using sensitive target cells for NK and ADCC activities. In some experiments, highly purified NK cells, obtained both by Percoll density gradient and by co-culturing non-adherent PBMC with RPMI 8866 feeder cells, were used as effector cells. Furthermore, we evaluated NK cell parameters such as number, surface expression of adhesion molecules (CD11a/CD18, CD49d and CD54) and response to different stimuli. We observed a decreased NK cytotoxicity of PBMC from IBD patients, both in ulcerative colitis (UC) and Crohn's disease (CD), independently of the clinical activity of disease. In contrast, the ADCC lytic activity was within normal range. The lower NK cytotoxic activity observed in our IBD patients cannot be related to a decreased number of NK cells, surface expression of adhesion molecules, defective response to IL-2 and maturative defect. Decreased NK activity was induced in PBMC of controls when serum of patients was added and this was unrelated to monocyte-derived modulating factor(s). Our data show a decreased natural killing by fresh PBMC from IBD patients. This lower activity seems to be unrelated to a primary NK cell defect, since purified NK cells exhibited normal levels of killing. It might be hypothesized that serum factors, possibly derived from lymphocytes, with inhibitory properties on NK activity, might be functionally active in the blood of IBD patients, thus modulating NK activity.
Assuntos
Doenças Inflamatórias Intestinais/sangue , Células Matadoras Naturais/fisiologia , Leucócitos Mononucleares/imunologia , Adolescente , Adulto , Idoso , Citotoxicidade Celular Dependente de Anticorpos/fisiologia , Feminino , Humanos , Interleucina-2/farmacologia , Células Matadoras Naturais/efeitos dos fármacos , Células Matadoras Naturais/imunologia , Leucócitos Mononucleares/química , Masculino , Pessoa de Meia-Idade , Fenótipo , Fator de Necrose Tumoral alfa/análiseRESUMO
The rat pheochromocytoma cell line PC12 forms neurites in response to nerve growth factor (NGF), and it was also reported to extend processes in the presence of somatostatin (somatotropin release-inhibiting factor, SRIF), a neuroactive peptide that seems to act as a morphogenetic factor in the developing nervous system. In the present study, we re-evaluated the effects of SRIF on PC12 cell differentiation. Our results indicate that SRIF alone is ineffective in promoting neurite outgrowth. Instead, SRIF or its analogue, octreotide (a SRIF agonist on the receptor subtypes 2, 3 and 5), potentiates neurite extension induced by NGF. These results suggest that SRIF enhances neurite formation in PC12 cells without directly promoting neurite outgrowth. SRIF potentiation of NGF-induced neurite outgrowth persists at least in part in the presence of pertussis toxin (PTX), suggesting the involvement of PTX-insensitive G-proteins. In addition, protein kinase-dependent pathways are likely to mediate SRIF effects on NGF-induced differentiation.