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1.
Methods Mol Biol ; 2067: 287-306, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31701458

RESUMO

Molecular studies of the proteome and metabolome in readily available body fluids such as urine and blood performed in a comprehensive qualitative and quantitative way are a valuable source of information for kidney disease research. They provide potential biomarkers of disease progression, markers of efficacy of interventions, as well as information on the underlying pathophysiology. Identified proteins and metabolites may point to dysregulated biological pathways and this knowledge may be useful in the identification of new treatment targets.Many studies, focusing on chronic kidney disease as well as diabetic nephropathy, demonstrate that peptidome and metabolome analysis can substantially contribute to early detection and prediction of disease progression, but also stratification of kidney disease in clinical practice. An innovative, well-explored application of urinary peptidome analysis is the back-translation of results obtained in humans to animals, for animal model validation and improvement of the preclinical readouts. In this chapter, we provide an overview of urinary proteomic analysis with the CE-MS analytical platform, a strategy that has been successfully employed in several studies for the identification and validation of biomarkers in kidney diseases. We describe how to obtain the orthology between the animal model and humans. We also deliver an overview of the analysis of the metabolome with the GC×GC-TOF-MS and UHPLC-Q-TOF-MS analytical platforms for blood and serum as new methods being applied in kidney disease.It is expected that a systems medicine approach to kidney disease including multiple omics methods will provide us with the best way to understand and treat diabetic kidney disease in the future.

2.
Pathophysiology ; 2019 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-31668916

RESUMO

Arthur de Carvalho Drops® (ACD) is a traditional Brazilian herbal medicine used to treat functional gastrointestinal disorders (FGIDs). ACD is a formulation of herbal extracts from Matricaria recutita (chamomile), Foeniculum vulgare (fennel) and Gentiana lutea L. (gentian). Considering the popular use for FGIDs, the aim of this work was to investigate the ACD effect on gastric and intestinal parameters with emphasis in a mechanistic approach using isolated duodenal preparations of rodents. Analytical method was developed and validated for quantify three actives principles/markers (Apigenin-7-glucoside, gentiopicroside and anethole) in ACD. The treatment with ACD significantly reduced the emetogenic stimuli induced by cisplatin in rats, showed a laxative effect, reduced the bethanechol-enhanced gastrointestinal transit and completely reversed the contraction induced by carbachol in rat duodenum. However, ACD did not alter the secretory gastric volume or total gastric acidity. The ACD affect the contractions of duodenal smooth muscle mediated by Ca2+ channels and it is also able to inhibit the contractile response mediated by the release from its intracellular store. Furthermore, the relaxant effects of ACD appear independent of the nitric oxide pathway in rat duodenum. These results suggest that ACD could be beneficial for the treatment of disorders of the gastrointestinal tract.

3.
Biomolecules ; 9(11)2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31694351

RESUMO

Human epidermal growth factor 2 (HER2) is a ligand-free tyrosine kinase receptor of the HER family that is overexpressed in some of the most aggressive tumours. Although it is known that HER2 dimerization involves a specific region of its extracellular domain, the so-called "dimerization arm", the mechanism of dimerization inhibition remains uncertain. However, uncovering how antibody interactions lead to inhibition of HER2 dimerization is of key importance in understanding its role in tumour progression and therapy. Herein, we employed several computational modelling techniques for a molecular-level understanding of the interactions between HER and specific anti-HER2 antibodies, namely an antigen-binding (Fab) fragment (F0178) and a single-chain variable fragment from Trastuzumab (scFv). Specifically, we investigated the effects of antibody-HER2 interactions on the key residues of "dimerization arm" from molecular dynamics (MD) simulations of unbound HER (in a total of 1 µs), as well as ScFv:HER2 and F0178:HER2 complexes (for a total of 2.5 µs). A deep surface analysis of HER receptor revealed that the binding of specific anti-HER2 antibodies induced conformational changes both in the interfacial residues, which was expected, and in the ECDII (extracellular domain), in particular at the "dimerization arm", which is critical in establishing protein-protein interface (PPI) interactions. Our results support and advance the knowledge on the already described trastuzumab effect on blocking HER2 dimerization through synergistic inhibition and/or steric hindrance. Furthermore, our approach offers a new strategy for fine-tuning target activity through allosteric ligands.

4.
Mol Neurobiol ; 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31729632

RESUMO

The pathophysiology of bipolar disorder remains incompletely elucidated. The purinergic receptor, P2X7 (P2X7R), plays a central role in neuroinflammation, the establishment, and maintenance of microglial activation and neuronal damage/death, all characteristics of bipolar disorder pathology. The present study aims to explore the participation of the P2X7R in a preclinical pharmacological model of mania. We analyzed the modulatory effects of the P2X7R antagonist, brilliant blue, on behavior, monoamines, gene expression, serum purine levels, and cell typing in a pharmacological model of mania induced by D-amphetamine (AMPH) in mice. Our results corroborate an association between the P2X7 receptor and the preclinical animal model of mania, as demonstrated by the decreased responsiveness to AMPH in animals with pharmacologically blocked P2X7R. This study further suggests a possible dopaminergic mechanism for the action of P2X7 receptor antagonism. Additionally, we observed increased peripheral levels of adenosine, a neuroprotective molecule, and increased central expression of Entpd3 and Entpd1 leading to the hydrolysis of ATP, a danger signal, possibly as an attempt to compensate for the damage induced by AMPH. Lastly, P2X7R antagonism in the AMPH model was found to potentially modulate astrogliosis. Our results support the hypothesis that P2X7R plays a vital role in the pathophysiology of mania, possibly by modulating the dopaminergic pathway and astrogliosis, as reflected in the behavioral changes observed. Taken together, this study suggests that a purinergic system imbalance is associated with the AMPH-induced preclinical animal model of mania. P2X7R may represent a promising molecular therapeutic target for bipolar disorder.

5.
Rev. Fac. Med. (Bogotá) ; 67(3): 201-208, jul.-set. 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1041144

RESUMO

Abstract Introduction: In Brazil, violence, regardless of the type, is the leading cause of death in adolescents and young adults. Objective: To describe the characteristics of the homicides in which female children and adolescents were the victims based on the autopsy reports recorded in the morgue of the city of Porto Alegre, Brazil. Materials and methods: Cross-sectional study in which 70 autopsy reports of girls and female adolescents who were killed between January 2010 and December 2016 were analyzed. The cases were evaluated according to the homicide motive or the homicide perpetrator, and five categories were established: drug trafficking related death, femicide, homicide perpetrated by a family member, death preceded by sexual violence, and death related to other transgressions. Results: There was a significant increase in the number of girls and female adolescents who were murdered between 2010 (n=7) and 2016 (n=19). Most of the homicides (64.2%) were related to drug, while femicide occurred in 15.7% of the cases. Homicides perpetrated by a family member, or preceded by sexual violence or related with other transgressions were less frequent as they occurred in 10%, 5.7% and 4.2% of the cases, respectively. Conclusion: Greater attention must be paid to the increase in the number of drug trafficking related homicides among female adolescents when creating and implementing relevant public policies.


Resumen Introducción. En Brasil, la violencia, en sus diferentes manifestaciones, es la primera causa de muerte entre adolescentes y adultos jóvenes de ambos sexos. Objetivo. Describir las características de los homicidios de niñas y adolescentes registrados en la morgue de Porto Alegre, Brasil. Materiales y métodos. Estudio transversal que analizó 70 pericias de necropsia de jóvenes víctimas de homicidio entre enero de 2010 y diciembre de 2016. Los casos fueron evaluados según los motivos de los crímenes, identificando 5 categorías: muertes causadas por tráfico de drogas, feminicidios, homicidios familiares, muertes por violencia sexual y homicidios relacionados con otras infracciones legales. Resultados. Hubo un aumento significativo en el número de niñas y mujeres adolescentes víctimas de homicidio entre 2010 (n=7) y 2016 (n=19). La mayoría de casos estuvieron relacionados con el tráfico de estupefacientes (64.2%), mientras que los casos de feminicidio representaron 15.7% da la muestra. Los homicidios cometidos por un familiar, los precedidos de violencia sexual y aquellos relacionados con otras actividades ilegales fueron menos frecuentes con un 10%, 5.7% y 4.2%, respectivamente. Conclusiones. Es necesario prestar más atención al aumento de los homicidios en esta población relacionados con el tráfico de estupefacientes a la hora de crear e implementar políticas públicas al respecto.

6.
Epilepsy Behav ; : 106428, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31400936

RESUMO

Genetic epidemiology studies have shown that most epilepsies involve some genetic cause. In addition, twin studies have helped strengthen the hypothesis that in most patients with epilepsy, a complex inheritance is involved. More recently, with the development of high-density single-nucleotide polymorphism (SNP) microarrays and next-generation sequencing (NGS) technologies, the discovery of genes related to the epilepsies has accelerated tremendously. Especially, the use of whole exome sequencing (WES) has had a considerable impact on the identification of rare genetic variants with large effect sizes, including inherited or de novo mutations in severe forms of childhood epilepsies. The identification of pathogenic variants in patients with these childhood epilepsies provides many benefits for patients and families, such as the confirmation of the genetic nature of the diseases. This process will allow for better genetic counseling, more accurate therapy decisions, and a significant positive emotional impact. However, to study the genetic component of the more common forms of epilepsy, the use of high-density SNP arrays in genome-wide association studies (GWAS) seems to be the strategy of choice. As such, researchers can identify loci containing genetic variants associated with the common forms of epilepsy. The knowledge generated over the past two decades about the effects of the mutations that cause the monogenic epilepsy is tremendous; however, the scientific community is just starting to apply this information in order to generate better target treatments.

7.
Artigo em Inglês | MEDLINE | ID: mdl-31420719

RESUMO

Neryl butyrate is a constituent of volatile oils obtained from aromatic plants. Aliphatic organic compound analogues chemically close to neryl butyrate possess vasodilator properties in rat aorta. To evaluate whether neryl butyrate has relaxing properties, this study tested its effects on isolated rat aorta. Unlike the analogues, neryl butyrate did not show relaxant profile in aortic rings precontracted with phenylephrine, but induced a contraction when it stimulated aortic rings under resting tonus. The contractile effect augmented in endothelium-denuded aortic rings. Treatment of endothelium-intact preparations with the nitric oxide synthase inhibitor L-NAME or the guanylyl cyclase inhibitor ODQ also augmented the contractile effect of neryl butyrate. Such phenomenon was absent in the presence of the cyclooxygenase inhibitor indomethacin. Contractile responses decreased in the presence of verapamil, a L-type Ca2+ channel blocker, or when Ca2+ was removed from the extracellular solution. Antagonists of α-adrenergic receptors (prazosin and yohimbine), but not the thromboxane-prostanoid receptor seratrodast, reversed the contraction induced by neryl butyrate. The α1A selective antagonist RS-17053 antagonized the neryl butyrate-induced contraction. The contraction caused by neryl butyrate was decreased by inhibiting the phospholipase C or the rho-associated kinase with U-73122 or Y-27632, respectively. Injected intravenously to awake rats, neryl butyrate induced arterial hypotension and bradycardia. Decreased frequency was also present in isolated right atrium preparations. In conclusion, the contractile effects of neryl butyrate were inhibited by α-adrenergic antagonists, indicating the involvement of α-adrenoceptors in the mechanism of action. In vivo, neryl butyrate caused hypotension, suggesting that other systemic influence than vasoconstriction may occur.

8.
Arq Neuropsiquiatr ; 77(6): 404-411, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31314842

RESUMO

OBJECTIVE: Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are available. To measure the costs of stroke care in a public hospital in Joinville, Brazil. METHODS: We prospectively assessed all medical and nonmedical costs of inpatients admitted with a diagnosis of any stroke or transient ischemic attack over one year, analyzed costs per type of stroke and treatment, length of stay (LOS) and compared hospital costs with government reimbursement. RESULTS: We evaluated 274 patients. The total cost for the year was US$1,307,114; the government reimbursed the hospital US$1,095,118. We found a significant linear correlation between LOS and costs (r = 0.71). The median cost of 134 IS inpatients who did not undergo cerebral reperfusion (National Institutes of Health Stroke Scale [NIHSS] median = 3 ) was US$2,803; for IS patients who underwent intravenous (IV) alteplase (NIHSS 10), the median was US$5,099, and for IS patients who underwent IV plus an intra-arterial (IA) thrombectomy (NIHSS > 10), the median cost was US$10,997. The median costs of a primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack were US$2,436, US$8,031 and US$2,677, respectively. CONCLUSIONS: Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary.

9.
Carbohydr Res ; 483: 107753, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31362136

RESUMO

Artemisia annua is cultivated mainly for isolation of artemisinin, a potent antimalarial compound. Moderate salt stress has been proved to increase the artemisinin synthesis by the plant. The aim of this study was to evaluate the influence of salt stress on physiological parameters and cell wall polysaccharides of A. annua. Plants subjected to salt stress displayed reduction in the biomass and length and showed high damage of cellular membranes. Cell wall polysaccharides extracted from aerial parts with hot water, EDTA and NaOH also exhibited modifications in the yield and monosaccharide composition. The main changes were found in the pectic polysaccharides: increase of homogalacturonan domain, increase of neutral side chains and increase in the methyl esterification. 1H NMR analyses of pectins indicated that for A. annua, arabinans have an important role in coping with salt stress. Hemicellulose domain was also modified under salt stress, with increased xylose contents. The results indicated adaptations in the cell wall of A. annua under salt stress.

10.
Arq. neuropsiquiatr ; 77(6): 404-411, June 2019. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-1011360

RESUMO

ABSTRACT Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are available. Objective To measure the costs of stroke care in a public hospital in Joinville, Brazil. Methods We prospectively assessed all medical and nonmedical costs of inpatients admitted with a diagnosis of any stroke or transient ischemic attack over one year, analyzed costs per type of stroke and treatment, length of stay (LOS) and compared hospital costs with government reimbursement. Results We evaluated 274 patients. The total cost for the year was US$1,307,114; the government reimbursed the hospital US$1,095,118. We found a significant linear correlation between LOS and costs (r = 0.71). The median cost of 134 IS inpatients who did not undergo cerebral reperfusion (National Institutes of Health Stroke Scale [NIHSS] median = 3 ) was US$2,803; for IS patients who underwent intravenous (IV) alteplase (NIHSS 10), the median was US$5,099, and for IS patients who underwent IV plus an intra-arterial (IA) thrombectomy (NIHSS > 10), the median cost was US$10,997. The median costs of a primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack were US$2,436, US$8,031 and US$2,677, respectively. Conclusions Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary.


RESUMO Os países de baixa e media renda enfrentam orçamentos apertados na saúde, não somente devido aos novos recursos terapêuticos, mas relacionado ao custo oneroso do tratamento do acidente vascular cerebral. No entanto, poucos dados prospectivos sobre os custos do AVC, incluindo reperfusão cerebral de países de baixa e média renda estão disponíveis. Objetivo Mensurar os custos do atendimento ao AVC em um hospital público. Métodos Avaliamos prospectivamente todos os custos médicos e não médicos de pacientes internados com diagnóstico de acidente vascular cerebral ou AIT durante 1 ano, analisamos os custos por tipo de AVC e tratamento, tempo de permanência e comparamos os custos hospitalares com o reembolso governamental. Resultados Foram avaliados 274 pacientes. O custo total em um ano foi de US$ 1.307,114; o governo reembolsou o hospital no valor de US$ 1.095.118. Encontramos uma correlação linear significativa entre LOS e custos (r = 0,71). A mediana do custo do AVCI em 134 pacientes que não sofreram reperfusão cerebral (National Institutes of Health Stroke Scale [NIHSS] mediana = 3) foi de US$ 2.803; para pacientes submetidos a alteplase intravenosa (IV) (NIHSS 10), a mediana foi de US$ 5.099 e para os pacientes submetidos a trombectomia intra-arterial (IA) (NIHSS > 10), o custo mediano foi de US$ 10.997. A mediana do custo de uma hemorragia intracerebral primária, hemorragia subaracnóidea e AIT foram de US$ 2.436, US$ 8.031 e US$ 2.677, respectivamente. Conclusões Os tratamentos de reperfusão foram duas a quatro vezes mais caros do que o tratamento conservador. Estudo de custo-efetividade para o tratamento do AVC são necessários.

11.
Artigo em Inglês | MEDLINE | ID: mdl-30942264

RESUMO

INTRODUCTION: Exercising regularly has benefits for people with bipolar disorder. Nevertheless, as a group, these patients tend to be less physically active than the general population and little is known from the viewpoint of the patients about the barriers and facilitators to such a practice. OBJECTIVE: To know the barriers and facilitators perceived by people with bipolar disorder for the practice of exercise. METHODS: This study had a descriptive, qualitative, exploratory nature. The investigation method used for data collection was a semi-structured in-depth interview, using grounded theory as theoretical framework. RESULTS: The data analysis generated two main areas of interest: adherence to regular physical exercise (barriers and facilitators) and the participants' exercise history and perception of disease management, as described below. The main findings were: most of our sample did not exercise regularly, nor knew how exercise can positively influence their disorder; with regard to adherence to physical exercise, the presence of symptoms and stigma were the most important barriers to the practice of physical exercise. Social support, especially from family and friends, could be a facilitator to the practice of exercise. CONCLUSIONS: Even considering the limitations for generalization of qualitative and exploratory studies, understanding perceived barriers and facilitators for the practice of exercise among people who suffer with bipolar disorder may contribute to the promotion of activities in which people with mental illness can participate.

12.
Fundam Clin Pharmacol ; 33(6): 612-620, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31012153

RESUMO

A group of nitro compounds contains a benzene ring in a short aliphatic chain with the NO2 group, property that supposedly favors its vasodilator profile. In this study, we evaluated in isolated rat aorta the effects of 1-nitro-2-propylbenzene (NPB), a nitro compound containing the NO2 in the aromatic ring. In aorta precontracted with KCl, NPB (1-3000 µm) induced full endothelium-independent relaxation. In endothelium-intact preparations, phenylephrine-induced contractions were fully relaxed by NPB, effect unaltered by N(ω)-nitro-L-arginine methyl ester (L-NAME) or 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ). In the concentration range of 30-300 µm, NPB slightly but significantly potentiated the phenylephrine-induced contraction. Such potentiation was unaltered by the thromboxane-prostanoid receptor antagonist seratrodast, but was abolished by endothelium removal or by preincubation of endothelium-intact preparations with L-NAME, ODQ or by ruthenium red and HC-030031, blockers of subtype 1 of ankyrin transient receptor potential (TRPA1 ) channels. Verapamil exacerbated the potentiating effect of NPB. The potentiating effect was undetectable in preparations precontracted by 9,11-dideoxy-11α,9α-epoxymethanoprostaglandin F2α (U-46619). Relaxation was reduced by ruthenium red while it was enhanced by HC-030031. In conclusion, NPB has vasodilator properties but with a mechanism of action distinct from its analogues. Contrary to other nitro compounds, its relaxing effects did not involve recruitment of the guanylyl cyclase pathway. NPB has also endothelium-dependent potentiating properties on phenylephrine-induced contractions, a phenomenon that putatively required a role of endothelial TRPA1 channels. The present findings reinforce the notion that the functional group NO2 in the aliphatic chain of these nitro compounds determines favorably their vasodilator properties.

13.
Trends Psychiatry Psychother ; 41(1): 1-8, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30994778

RESUMO

INTRODUCTION: Exercising regularly has benefits for people with bipolar disorder. Nevertheless, as a group, these patients tend to be less physically active than the general population and little is known from the viewpoint of the patients about the barriers and facilitators to such a practice. OBJECTIVE: To know the barriers and facilitators perceived by people with bipolar disorder for the practice of exercise. METHODS: This study had a descriptive, qualitative, exploratory nature. The investigation method used for data collection was a semi-structured in-depth interview, using grounded theory as theoretical framework. RESULTS: The data analysis generated two main areas of interest: adherence to regular physical exercise (barriers and facilitators) and the participants' exercise history and perception of disease management, as described below. The main findings were: most of our sample did not exercise regularly, nor knew how exercise can positively influence their disorder; with regard to adherence to physical exercise, the presence of symptoms and stigma were the most important barriers to the practice of physical exercise. Social support, especially from family and friends, could be a facilitator to the practice of exercise. CONCLUSIONS: Even considering the limitations for generalization of qualitative and exploratory studies, understanding perceived barriers and facilitators for the practice of exercise among people who suffer with bipolar disorder may contribute to the promotion of activities in which people with mental illness can participate.


Assuntos
Transtorno Bipolar/psicologia , Terapia por Exercício/psicologia , Exercício/psicologia , Adulto , Idoso , Transtorno Bipolar/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
14.
Psychiatry Res ; 275: 228-232, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30928726

RESUMO

Childhood trauma is a complex experience, much reported by subjects with bipolar disorder. There are still few studies that assess its consequences in a community sample of bipolar in early stage. The aim of the present study is to assess the association between childhood trauma and clinical outcomes, including the global functioning, in a community sample of young adults with bipolar disorder. This is a cross-sectional study with a community sample of subjects with bipolar disorder, from 23 to 30 years old, with and without childhood trauma. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The functioning was assessed by Functioning Assessment Short Test (FAST). Ninety subjects with bipolar disorder were included in the study (30 with childhood trauma and 60 without childhood trauma). Young adults with bipolar disorder and childhood trauma showed higher prevalence of current suicide risk, higher severity of depressive symptoms, and higher functioning impairment as compared to subjects with bipolar disorder without childhood trauma. The childhood trauma experiences appear to be an environmental risk factor for worse clinical outcomes and higher functional impairment.

15.
Rev. bras. psiquiatr ; 41(1): 38-43, Jan.-Mar. 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-985355

RESUMO

Objective: To identify the association of metabolic syndrome (MetS) and psychiatric disorders in young adults in southern Brazil. Methods: This population based cross-sectional study involved a total of 1,023 young adults between the ages of 21 and 32 years. Current episodes of psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview - Plus version. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). Results: Of the 1,023 participants, 24.3% were identified with MetS, 13.5% were diagnosed with anxiety disorders, 7.5% with current depression, 3.9% with bipolar disorders and 10.1% were at risk of suicide. MetS was associated with ethnicity (p = 0.022), excess weight (p < 0.001), current anxiety disorders (p < 0.001), current mood disorders (bipolar disorder in mood episode and current depression) (p < 0.001), and suicide risk (p < 0.001). Conclusions: MetS was associated with psychiatric disorders. Awareness of factors associated with MetS can help identify high-risk individuals and stimulate disease prevention and control programs, as well as lifestyle changes.

16.
Trends psychiatry psychother. (Impr.) ; 41(1): 1-8, Jan.-Mar. 2019. tab
Artigo em Inglês | LILACS-Express | ID: biblio-1004837

RESUMO

Abstract Introduction Exercising regularly has benefits for people with bipolar disorder. Nevertheless, as a group, these patients tend to be less physically active than the general population and little is known from the viewpoint of the patients about the barriers and facilitators to such a practice. Objective To know the barriers and facilitators perceived by people with bipolar disorder for the practice of exercise. Methods This study had a descriptive, qualitative, exploratory nature. The investigation method used for data collection was a semi-structured in-depth interview, using grounded theory as theoretical framework. Results The data analysis generated two main areas of interest: adherence to regular physical exercise (barriers and facilitators) and the participants' exercise history and perception of disease management, as described below. The main findings were: most of our sample did not exercise regularly, nor knew how exercise can positively influence their disorder; with regard to adherence to physical exercise, the presence of symptoms and stigma were the most important barriers to the practice of physical exercise. Social support, especially from family and friends, could be a facilitator to the practice of exercise. Conclusions Even considering the limitations for generalization of qualitative and exploratory studies, understanding perceived barriers and facilitators for the practice of exercise among people who suffer with bipolar disorder may contribute to the promotion of activities in which people with mental illness can participate.


Resumo Introdução A prática regular de exercício físico tem benefícios para pessoas com transtorno bipolar. No entanto, como grupo, esses pacientes tendem a ser mais sedentários do que a população geral, e pouco se sabe do ponto de vista dos pacientes sobre as barreiras e facilitadores para tal prática. Objetivo Conhecer as barreiras e facilitadores percebidos por pessoas com transtorno bipolar para a prática de exercício. Métodos Este foi um estudo descritivo, qualitativo e exploratório. O método de investigação utilizado na coleta de dados foi entrevista semiestruturada em profundidade, segundo a grounded theory. Resultados A análise dos conteúdos que surgiram nas entrevistas gerou duas principais áreas de interesse: adesão ao exercício físico regular (barreiras e facilitadores) e a história de exercícios dos participantes e a percepção do manejo da doença. Os principais achados foram: a maioria da nossa amostra não se exercitava regularmente, nem mesmo sabia como a prática regular podia influenciar positivamente sua doença; em relação à adesão ao exercício físico, a presença dos sintomas e do estigma foram as barreiras mais importantes para praticar o exercício físico. O apoio social, especialmente da família e dos amigos, pode ser um facilitador da adesão ao exercício. Conclusões Apesar das limitações de um estudo qualitativo e exploratório, conhecer as barreiras e os facilitadores percebidos para a prática de exercício entre pessoas que sofrem de transtorno bipolar pode facilitar a promoção de atividades onde essas pessoas possam participar e se beneficiar efetivamente.

17.
J Psychopharmacol ; 33(4): 502-510, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30835152

RESUMO

OBJECTIVE: The purpose of this study was to assess the efficacy and tolerability of tianeptine as an adjunctive maintenance treatment for bipolar depression. METHODS: This is a multicenter double-blind randomized placebo-controlled maintenance trial of adjunctive tianeptine 37.5 mg/day. Participants ( n=161) had a Montgomery-Asberg Depression Rating Scale ⩾12 at entry. After eight weeks of open-label tianeptine treatment, those who responded to tianeptine ( n=69) were randomized to adjunctive tianeptine ( n=36) or placebo ( n=33) in addition to usual treatment. Kaplan-Meier estimates and the Mantel-Cox log-rank test were used to evaluate differences in time to intervention for a mood episode between the tianeptine and placebo groups. We also assessed overall functioning, biological rhythms, quality of life, rates of manic switch and serum brain-derived neurotrophic factor levels. RESULTS: There were no differences between adjunctive tianeptine or placebo regarding time to intervention or depression scores in the 24-week double-blind controlled phase. Patients in the tianeptine group showed better performance in the letter-number sequencing subtest from the Wechsler Adult Intelligence Scale at the endpoint ( p=0.014). Tianeptine was well tolerated and not associated with higher risk for manic switch compared to placebo. CONCLUSION: Tianeptine was not more effective than placebo in the maintenance treatment of bipolar depression. There is preliminary evidence suggesting a pro-cognitive effect of tianeptine in working memory compared to placebo.

18.
Soc Psychiatry Psychiatr Epidemiol ; 54(7): 857-860, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30895355

RESUMO

PURPOSE: To evaluate changes in standardized suicide rates in Brazil between 2000 and 2016, stratified by sex and age. METHODS: Descriptive analyses of data from the Brazilian Mortality Information System were performed. RESULTS: 156,292 suicides were registered in the period, with a standardized rate of 4.82/100,000. The risk for males was 3.81 times higher than for females, without meaningful regional variations. This ratio was 8.2 at the 80+ group. An increase from 2000 to 2016 was demonstrated in nearly all subgroups over the 17, especially men aged 20-39 and women aged 40-59. CONCLUSIONS: Suicide rates continue to rise in Brazil, especially among young men and middle-aged women. Older men remain exposed to the highest absolute risk.


Assuntos
Suicídio/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Adulto Jovem
19.
Sci Rep ; 9(1): 2225, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30778115

RESUMO

Renal Cysts and Diabetes Syndrome (RCAD) is an autosomal dominant disorder caused by mutations in the HNF1B gene encoding for the transcriptional factor hepatocyte nuclear factor-1B. RCAD is characterized as a multi-organ disease, with a broad spectrum of symptoms including kidney abnormalities (renal cysts, renal hypodysplasia, single kidney, horseshoe kidneys, hydronephrosis), early-onset diabetes mellitus, abnormal liver function, pancreatic hypoplasia and genital tract malformations. In the present study, using capillary electrophoresis coupled to mass spectrometry (CE-MS), we investigated the urinary proteome of a pediatric cohort of RCAD patients and different controls to identify peptide biomarkers and obtain further insights into the pathophysiology of this disorder. As a result, 146 peptides were found to be associated with RCAD in 22 pediatric patients when compared to 22 healthy age-matched controls. A classifier based on these peptides was generated and further tested on an independent cohort, clearly discriminating RCAD patients from different groups of controls. This study demonstrates that the urinary proteome of pediatric RCAD patients differs from autosomal dominant polycystic kidney disease (PKD1, PKD2), congenital nephrotic syndrome (NPHS1, NPHS2, NPHS4, NPHS9) as well as from chronic kidney disease conditions, suggesting differences between the pathophysiology behind these disorders.

20.
Eur J Pharmacol ; 849: 154-159, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30716310

RESUMO

Previously, we showed that the synthetic nitroderivative trans-4-methyl-ß-nitrostyrene (T4MeN) induced vasorelaxant effects in rat isolated aortic rings. Here, we investigated the mechanisms underlying the cardiovascular effects of T4MeN in normotensive rats. In pentobarbital-anesthetized rats, intravenous (i.v.) injection of T4MeN (0.03-0.5 mg/kg) induced a rapid (onset time of 1-2 s) and dose-dependent bradycardia and hypotension. These cardiovascular responses to T4MeN were abolished by bilateral cervical vagotomy or selective blockade of neural conduction of vagal C-fiber afferents by perineural treatment of both cervical vagus nerves with capsaicin. Hypotension and bradycardia were also recorded when T4MeN was directly injected in the right, but not into the left ventricle. Furthermore, they were significantly reduced by i.v. pretreatment with capsazepine but remained unaltered by ondansetron or suramin. In conscious rats, the dose-dependent hypotension and bradycardia evoked by T4MeN were abolished by i.v. methylatropine pretreatment. In conclusion, bradycardiac and depressor responses induced by T4MeN has a vago-vagal reflex origin resulting from the vagal pulmonary afferents stimulation. The transduction mechanism seems to involve the activation of vanilloid TRPV1, but not purinergic (P2X) or 5-HT3 receptors located on vagal pulmonary sensory nerves.


Assuntos
Bradicardia/induzido quimicamente , Pulmão/inervação , Fibras Nervosas Amielínicas/efeitos dos fármacos , Reflexo/efeitos dos fármacos , Estirenos/farmacologia , Canais de Cátion TRPV/metabolismo , Nervo Vago/efeitos dos fármacos , Animais , Bradicardia/metabolismo , Bradicardia/fisiopatologia , Masculino , Fibras Nervosas Amielínicas/metabolismo , Fibras Nervosas Amielínicas/fisiologia , Ratos , Ratos Wistar
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