Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 63
Mais filtros

Intervalo de ano de publicação
Phys Rev Lett ; 122(21): 217204, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31283322


We report a longitudinal spin Seebeck effect (SSE) study in epitaxially grown FeF_{2}(110) antiferromagnetic (AFM) thin films with strong uniaxial anisotropy over the temperature range of 3.8-250 K. Both the magnetic-field and temperature-dependent SSE signals below the Néel temperature (T_{N}=70 K) of the FeF_{2} films are consistent with a theoretical model based on the excitations of AFM magnons without any net induced static magnetic moment. In addition to the characteristic low-temperature SSE peak associated with the AFM magnons, there is another SSE peak at T_{N} which extends well into the paramagnetic phase. All the SSE data taken at different magnetic fields up to 12 T near and above the critical point T_{N} follow the critical scaling law very well with the critical exponents for magnetic susceptibility of 3D Ising systems, which suggests that the AFM spin correlation is responsible for the observed SSE near T_{N}.

Microb Ecol ; 78(2): 299-312, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30666368


Taurine, an amino acid-like compound, acts as an osmostress protectant in many marine metazoans and algae and is released via various processes into the oceanic dissolved organic matter pool. Taurine transporters are widespread among members of the marine prokaryotic community, tentatively indicating that taurine might be an important substrate for prokaryotes in the ocean. In this study, we determined prokaryotic taurine assimilation and respiration throughout the water column along two transects in the North Atlantic off the Iberian Peninsula. Taurine assimilation efficiency decreased from the epipelagic waters from 55 ± 14% to 27 ± 20% in the bathypelagic layers (means of both transects). Members of the ubiquitous alphaproteobacterial SAR11 clade accounted for a large fraction of cells taking up taurine, especially in surface waters. Archaea (Thaumarchaeota + Euryarchaeota) were also able to take up taurine in the upper water column, but to a lower extent than Bacteria. The contribution of taurine assimilation to the heterotrophic prokaryotic carbon biomass production ranged from 21% in the epipelagic layer to 16% in the bathypelagic layer. Hence, we conclude that dissolved free taurine is a significant carbon and energy source for prokaryotes throughout the oceanic water column being utilized with similar efficiencies as dissolved free amino acids.

Archaea/metabolismo , Bactérias/metabolismo , Água do Mar/microbiologia , Taurina/metabolismo , Aminoácidos/metabolismo , Archaea/classificação , Archaea/genética , Archaea/isolamento & purificação , Oceano Atlântico , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Carbono/análise , Carbono/metabolismo , Água do Mar/química
Am Surg ; 84(8): 1269-1271, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30185298


The increased use of CT scans has raised concerns regarding the risks of early radiation exposure in the Puerto Rico pediatric population. Available literature sustains that repeated exposure to imaging-related radiation in the pediatric population is associated with a 3-fold increase in the risk of developing pediatric hematogenous and central nervous system malignancies. It is for this reason that an international effort known as the Image Gently Campaign was created, mostly based on the "As Low As Reasonably Achievable" (ALARA) principle described by the Center for Disease Control. With this in mind, our aim was to identify whether there are any discrepancies in imaging tendencies outside our pediatric academic center in Puerto Rico and to determine whether our patients are at increased risk of over-radiation. There were 181 patients; five were excluded because of incomplete data. Our results show that children with appendicitis who are evaluated at nontertiary centers are more likely to have a CT scan performed (93%, OR: 4.054; 95% confidence interval: 2.6-6.4), as opposed to a nonradiating imaging study. In the Pediatric University Hospital, a CT scan was performed as the initial study in 23 per cent of the patients (OR: 0.09; 95% confidence interval: 0.05-0.18), favoring ultrasound as the diagnostic modality of choice. Our concern is that if this trend does not change, our pediatric population might have an increased risk of developing associated malignancies. We believe a local effort toward educational strategies should be implemented to prevent radiation overexposure in our pediatric patients.

Serviço Hospitalar de Emergência , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Criança , Feminino , Hospitais Pediátricos , Hospitais Universitários , Humanos , Masculino , Padrões de Prática Médica , Porto Rico , Estudos Retrospectivos , Ultrassonografia/estatística & dados numéricos
Psicol. Caribe ; 35(2): 131-144, mayo-ago. 2018. tab
Artigo em Espanhol | LILACS-Express | ID: biblio-1002834


Resumen El objetivo general de la presente investigación fue identificar los factores psicosociales in-tralaborales y extralaborales en los trabajadores de una institución del sector salud que presta servicios de alta complejidad (nivel III) de la ciudad de Cali, Colombia. La investigación fue de tipo descriptivo, con un diseño transversal. Se aplicaron la forma A y B del Cuestionario de Factores de Riesgo Psicosocial Intralaboral y el Cuestionario de Factores de Riesgo Psicosocial Extralaboral (Ministerio de Protección Social & Pontificia Universidad Javeriana Bogotá, 2010) a una muestra de 183 trabajadores. Los resultados de la investigación indican que los dominios donde se presenta mayor riesgo psicosocial son demandas del trabajo y control sobre el trabajo. A nivel extralaboral, las condiciones que presentan mayor riesgo son: tiempo fuera del trabajo, situación económica del grupo familiar, características de la vivienda y de su entorno, y desplazamiento vivienda-trabajo. Se concluye a nivel general que la clínica se encuentra en un nivel de riesgo psicosocial alto, por lo cual se requiere la implementación de un Programa de Vigilancia Epidemiológica en Riesgo Psicosocial para prevenir respuestas de estrés y enfermedades asociadas.

Abstract The purpose of this research study was to identify the psychosocial in-workplace and out-of-workplace risk factors in the workers of a health sector institution that provides high complexity services (level III) in the city of Cali, Colombia. This was a study with a descriptive cross-sectional research design. Form A and B of the Questionnaire of Psychosocial Risk Factors In-workplace and the Questionnaire of Factors of Psychosocial and Out-of-workplace Risk (Ministry of Social Protection & Pontificia Universidad Javeriana Bogotá, 2010) were applied to a sample of 183 workers. The results show that the domains where psychosocial risk is most prevalent are labor demands and control over work. At the out-of-workplace level, the conditions that represent the greatest risk are: time away from work, financial situation of the family group, characteristics of the home and its environment, and commuting. We concluded that the clinic is at a high level of psychosocial risk, for which the implementation of an Epidemiological Surveillance Program for Psychosocial Risk is required to prevent stress responses and associated diseases.

Univ. salud ; 20(1): 44-52, ene.-abr. 2018. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-904685


Resumen Introducción: El estrés entendido como el conjunto de respuestas fisiológicas, comportamentales, emocionales y cognoscitivas, que resultan en el proceso de adaptación frente a las demandas derivadas de las condiciones de trabajo ante las cuales las personas evalúan que sus recursos de afrontamiento son insuficientes. Objetivo: Identificar el nivel de estrés laboral en personal con cargos asistenciales de cuatro instituciones de salud nivel III de la ciudad de Cali-Colombia. Materiales y métodos: El estudio fue de tipo descriptivo, con diseño transversal. Se aplicó el cuestionario para la evaluación del estrés tercera versión del Ministerio de la Protección Social a una muestra de 595 participantes, con cargo asistencial que implica la atención sanitaria al paciente, en procedimientos de alta complejidad como cirugía, hospitalización, urgencias, cuidados intensivos. Resultados: El personal con cargo asistencial de las cuatro instituciones de salud nivel III presenta nivel alto de estrés laboral, concretamente en los síntomas fisiológicos, e intelectuales y laborales. Conclusiones: La prevalencia de estrés laboral en el personal asistencial puede asociarse con las características de rol, las condiciones laborales y la exposición permanente a enfermedades contagiosas propias del contexto de las instituciones de salud.

Abstract Introduction: Stress is understood as the set of physiological, behavioral, emotional and cognitive responses, which result in the process of adaptation to the demands derived from the working conditions, before which people evaluate that their coping resources are insufficient. Objective: To identify the level of occupational stress in staff with care positions of four level III health institutions in the city of Cali, Colombia. Materials and methods: A descriptive study with transversal design was made. The third version stress assessment questionnaire was applied Ministry of Social Protection. The sample was 595 participants with care charge, which involves the patient's health care in procedures of high complexity such as surgery, hospitalization, emergencies, intensive care. Results: The staff with healthcare charge of the four level III health institutions presents high level of occupational stress, particularly in the physiological, intellectual and labor symptoms. Conclusions: The prevalence of occupational stress in health care personnel can be associated with the characteristics of role, working conditions and the permanent exposure to communicable diseases inherent in the context of healthcare institutions.

Humanos , Estresse Ocupacional , Agentes Comunitários de Saúde , Instalações de Saúde , Psicologia
Hosp. Aeronáut. Cent ; 13(2): 117-122, 2018. ^egraf
Artigo em Espanhol | LILACS | ID: biblio-1021410


Introducción: El acceso intraóseo es considerado actualmente como una alternativa rápida y eficaz en situaciones en las cuales no es posible lograr un acceso intravenoso en un tiempo preestablecido, principalmente en pacientes que presenten shock grave o paro cardiorrespiratorio, siendo de vital importancia los conocimientos relacionados con su colocación, desde los reparos anatómicos hasta los dispositivos utilizados para su realización. Objetivos: Determinar los conocimientos que poseen los profesionales de la salud acerca del acceso intraóseo. Material y Metodo: Estudio descriptivo y transversal. Encuestas al personal de la salud que concurre a la institución. Resultados: Se realizaron 222 encuestas a enfermeros (37), estudiantes de enfermería (86), médicos (46) y estudiantes de medicina (53). El rango etario fue de 21-59 años. 27, 03% (60) conoce la vía intraósea como acceso vascular; 25, 22% (56) han recibido algún tipo de formación acerca de la colocación de accesos intraóseos, siendo la misma cantidad de profesionales los que pudieron enumerar los sitios anatómicos correspondientes. Sólo un 13, 06% pudieron indicar precisamente los reparos anatómicos necesarios para su colocación y, por último, únicamente 23, 42% de los encuestados conocía si su lugar de desempeño disponía de sets para la colocación de dicha vía. Conclusión: Son muy pocos los profesionales de la salud que tienen conocimientos acerca de la colocación del acceso vascular intraóseo, siendo escasamente promovidos durante su formación. Es de suma importancia promover programas de instrucción para la utilización de dicho acceso, ya que es bien sabido la gran utilidad que presenta el mismo, más aún en casos de riesgo de vida en el que no es posible contar con otro acceso vascular.

Introduction: Intraosseous access is currently considered a quick and effective alternative in situations in which it is not possible to achieve intravenous access in a pre-established time, mainly in patients presenting with severe shock or cardiorespiratory arrest, being of vital importance the knowledge related to its placement, from the anatomical repairs to the devices used for its realization. Objectives: To determine the knowledge held by health professionals about intraosseous access. Material and Method: Descriptive and transversal study. Surveys to health personnel who attend the institution. Results: 222 surveys were carried out to nurses (37), nursing students (86), doctors (46) and medical students (53). The age range was 21-59 years. 27, 03% (60) know the intraosseous route as vascular access; 25, 22% (56) have received some type of training about the placement of intraosseous accesses, with the same number of professionals being able to list the corresponding anatomical sites. Only 13, 06% could precisely indicate the anatomical repairs necessary for their placement and, finally, only 23, 42% of the respondents knew if their place of performance had sets for the placement of said route. Conclusion: Very few health professionals have knowledge about the placement of intraosseous vascular access, being poorly promoted during their training. It is very important to promote instructional programs for the use of such access, since it is well known that it is very useful, especially in cases of life risk in which it is not possible to have another vascular access.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infusões Intraósseas/métodos , Educação Médica , Educação em Enfermagem , Dispositivos de Acesso Vascular , Anatomia/educação , Inquéritos e Questionários
Hosp. Aeronáut. Cent ; 13(1): 41-7, 2018. tabl
Artigo em Espanhol | LILACS | ID: biblio-980309


Introducción: La apendicitis aguda es una de las causas de abdomen agudo quirúrgico más frecuente en nuestro medio, y su diagnóstico es principalmente clínico. Sin embargo, la tasa de apendicetomías negativas o en blanco continúan constantes. Es por ello que el conocimiento de la clínica, el uso de escalas diagnósticas y el uso criterioso de exámenes complementarios aportan hacia un diagnóstico más certero. Objetivo: Correlación clínica con los hallazgos intra-operatorios y anatomo-patológicos. Evaluar la utilidad de las escalas diagnosticas para disminuir los casos negativos. Material y Métodos: Se analizaron pacientes que ingresaron por guardia al Servicio de Cirugía General del Hospital Aeronáutico Central con diagnóstico de Síndrome de fosa iliaca derecha (FID), en el periodo comprendido entre Enero del 2017 y Enero del 2018. Se utilizaron escalas diagnosticas de Alvarado y RIPASA. Se evaluó la utilización de estudios imageneológicos complementarios. Se discriminó según sexo y edad. Se cotejo con los resultados de Anatomía Patológica. Diseño: Prospectivo. Observacional. Comparativo. Resultados: Se analizaron los datos de 118 pacientes que ingresaron por guardia. Masculinos: 61,86 %. Edad promedio masculino: 24 años (R:19-44).Femenino: 28 años (R: 18 -68). Frecuencia de presentación de signos-síntomas: Dolor : 100%. Dolor migratorio: 95,76%. Anorexia: 91,52%. Nauseas: 85,58%. Vómitos: 74,57%. Fiebre: 59,32%. Leucocitosis: 81,35%. Escala de Alvarado: Sensibilidad: 87,28%. Especificidad: 66,01%. Escala de RIPASA: Sensibilidad: 94,78%. Especificidad: 73,3%. Métodos complementarios: Radiografía: 100%, Ecografía abdominal: 93,22%, Patológica: 82,20%. TAC: 11,86%, Patológica: 85,71%. Promedio de hospitalización: 3 días. Ubicación de apéndice cecal: Descendente interna: 55,08%, Retrocecal: 34,74%, otras: 10,16%. Anatomía Patológica: Flegmonosa: 41,52%, Congestiva: 31,35%, Gangrenosa: 16,10%, Perforada: 4,23%, Normal: 4,23%.Conclusión:RIPASA resulto ser el método de mejor desempeño cuando se cotejaron sus resultados con los de anatomía patológica. Es por ello que la clínica y los scores diagnósticos consideramos son fundamentales para acercarnos a un diagnóstico de certeza y disminuir la taza de apendicetomías negativas. En cuanto a los métodos imageneológicos complementarios, usados criteriosamente ante duda diagnostica pueden ser de utilidad

Introduction: Acute appendicitis is one of the most frequent causes of acute surgical abdomen in our environment, and its diagnosis is mainly clinical. However , the rate of negative or blank appendectomies remain constant. For this reason, the knowledge of the clinic, the use of diagnostic scales and of complementary studies contribute to a more accurate diagnosis. Objective: Clinical correlation with intraoperative and anatomopathological findings. Evaluate the utility of diagnostic scales to reduce negative cases. Material and Methods: Patients admitted to the General Surgery Service of the Central Aeronautical Hospital with right iliac fossa syndrome (FID) diagnosis were checked by guard in the period between January 2017 and January 2018. Alvarado and RIPASA diagnostic scales were used. The use of complementary imaging studies was evaluated. It was discriminated according to sex and age. It was compared with the Anatomo Pathological results. Design: Prospective. Observational Comparative. Results: Data from 118 patients admitted by guard were annalized. Male: 61.86%. Male average age: 24 years old (R: 19-44). Female: 28 years old (R: 18 -68). Frequency of presentation of signs and symptoms: Pain: 100%. Migratory pain: 95.76%. Anorexia: 91.52%. Nausea: 85.58%. Vomiting: 74.57%. Fever: 59.32%. Leukocytosis: 81.35%. Alvarado scale: Sensitivity: 87.28%. Specificity: 66.01%. RIPASA scale: Sensitivity: 94.78%. Specificity: 73.3%. Complementary methods: Radiography: 100%, Abdominal ultrasound: 93.22%, Pathological: 82.20%. TAC: 11.86%, Pathological: 85.71%. Average hospitalization: 3 days. Location of cecal appendix: Internal descending: 55.08%, Retrocecal: 34.74%, other: 10.16%. Pathological Anatomy: Phlegmonous: 41.52%, Congestive: 31.35%, Gangrenous: 16.10%, Perforated: 4.23%, Normal: 4.23%.Conclusion: RIPASA turned out to be the best performance method when results were compared with those of pathological anatomy. That is why the clinical and diagnostic scores we consider are fundamental to approach a diagnosis of certainty and decrease the rate of negative appendectomies. As for the complementary imaging methods, used judiciously before diagnostic doubt can be useful

Apendicite/diagnóstico , Apendicite/diagnóstico por imagem , Indicadores Básicos de Saúde
Hosp. Aeronáut. Cent ; 13(1): 59-65, 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-980323


Introducción: Los accesos venosos han sido empleados desde hace varias décadas. La utilización de estas vías para la administración de fluidos, fármacos, nutrición parenteral o determinación de constantes fisiológicas; ha dependido tanto del conocimiento anatómico como de la disponibilidad de material adecuado. Repasaremos los hitos más importantes de la historia de la cateterización venosa que hicieron posible la base para la colocación de accesos venosos centrales en la actualidad.Metodologia: Se realizo una búsqueda bibliográfica entre Enero y Abril de 2018 utilizando escritura científica con lectura critica a base de fuentes de información como libros de texto y búsquedas avanzadas con filtros selectivos en Pubmed. Desarrollo: Antes del conocimiento y la utilización de equipos de punción percutáneo había que proceder a la exposición quirúrgica del vaso para introducir un catéter venoso. La descripción de la Técnica de Seldinger represento una importante ventaja respecto a la venodisección y el advenimiento de la ultrasonografia (US) facilito su inserción y disminuyo las complicaciones. Conclusión:El cateterismo venoso central es un procedimiento frecuente efectuado por primera vez a principios del siglo XX; convirtiéndose en un pilar de la medicina moderna.

Introduction: Venous access has been used since several decades ago. The use of these venous lines in order to dispense fluids, drugs, parenteral nutrition or monitoring physiological parameters has depended on the anatomical knowledge, as well as on the availability of the appropriate material. We will go through the most important facts along the history of the venous catheterization that created the basis of the actual procedure of central venous access.Methods: A bibliographic search has been made, taking into account the period from January to April 2018, using scientific literature and applying critical reading. The sources of information included textbooks and advanced search applying selective filtering in Pubmed.Development: Before the expertise and the use of equipment for the percutaneous puncture it was necessary to perform a surgical exposure of the vessel in order to introduce a venous catheter. The Seldinger Technique represented a major advantage over venousection, and the advent of ultrasonography improved the placement and decreased complications.Results: The central venous catheterization is a frequent procedure, introduced for the first time in the early twentieth century and it became a fundamental pillar in modern medicine.

Humanos , Dispositivos de Acesso Vascular/história , História da Medicina , Cronologia
Rev. esp. cardiol. (Ed. impr.) ; 70(12): 1067-1073, dic. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-169305


Introducción y objetivos: El tratamiento óptimo de pacientes con insuficiencia cardiaca aguda (ICA) y síndrome cardiorrenal tipo 1 (SCR-1) no está bien definido. La hipoperfusión arterial y la congestión venosa tienen un papel fundamental en la fisiopatología del SCR-1. El antígeno carbohidrato 125 (CA125) ha emergido como marcador indirecto de sobrecarga de volumen en la ICA. El objetivo de este estudio es evaluar la utilidad del CA125 para el ajuste del tratamiento diurético de pacientes con SCR-1. Métodos: Ensayo clínico multicéntrico, abierto y paralelo, que incluye a pacientes con ICA y creatinina ≥ 1,4 mg/dl al ingreso, aleatorizados a: a) estrategia convencional: titulación basada en la evaluación clínica y bioquímica habitual, o b) estrategia basada en CA125: dosis altas de diuréticos si CA125 > 35 U/ml y bajas en caso contrario. El objetivo principal es el cambio en la función renal a las 24 y las 72 h tras el comienzo del tratamiento. Como objetivos secundarios: a) cambios clínicos y bioquímicos a las 24 y las 72 h, y b) cambios en la función renal y eventos clínicos mayores a 30 días. Resultados: Los resultados de este estudio aportarán datos relevantes sobre la utilidad del CA125 para guiar el tratamiento diurético en el SCR-1. Además, permitirá ampliar el conocimiento de la fisiopatología de esta compleja entidad clínica. Conclusiones: La hipótesis del presente estudio es que las concentraciones de CA125 aumentadas pueden identificar a una población de pacientes con SCR-1 para quienes una estrategia diurética más intensa puede ser beneficiosa. Por el contrario, las concentraciones bajas de esta glucoproteína seleccionarían a los pacientes para los que serían perjudiciales las dosis altas de diuréticos (AU)

Introduction and objectives: The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1. Methods: Multicenter, open-label, parallel clinical trial, in which patients with AHF and serum creatinine ≥ 1.4 mg/dL on admission will be randomized to: a) standard diuretic strategy: titration-based on conventional clinical and biochemical evaluation, or b) diuretic strategy based on CA125: high dose if CA125 > 35 U/mL, and low doses otherwise. The main endpoint will be renal function changes at 24 and 72 hours after therapy initiation. Secondary endpoints will include: a) clinical and biochemical changes at 24 and 72 hours, and b) renal function changes and major clinical events at 30 days. Results: The results of this study will add important knowledge on the usefulness of CA125 for guiding diuretic treatment in CRS-1. In addition, it will pave the way toward a better knowledge of the pathophysiology of this challenging situation. Conclusions: We hypothesize that higher levels of CA125 will identify a patient population with CRS-1 who could benefit from the use of a more intense diuretic strategy. Conversely, low levels of this glycoprotein could select those patients who would be harmed by high diuretic doses (AU)

Humanos , Insuficiência Cardíaca/terapia , Nefropatias/complicações , Biomarcadores , Diuréticos/uso terapêutico , Insuficiência Cardíaca/complicações , Análise Estatística
BMC Infect Dis ; 17(1): 390, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28583076


BACKGROUND: Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis. Diagnosis is difficult because of unspecific clinical manifestations and low accuracy of conventional tests. Unfortunately, the delayed diagnosis impacts the urinary tract severely. Nucleic acid amplification tests yield fast results, and among these, new technologies can also detect drug resistance. There is lack of consensus regarding the use of these tests in genitourinary tuberculosis; we therefore aimed to assess the accuracy of nucleic acid amplification tests in the diagnosis of genitourinary tuberculosis and to evaluate the heterogeneity between studies. METHODS: We did a systematic review and meta-analysis of research articles comparing the accuracy of a reference standard and a nucleic acid amplification test for diagnosis of urinary tract tuberculosis. We searched Medline, EMBASE, Web of Science, LILACS, Cochrane Library, and Scopus for articles published between Jan 1, 1990, and Apr 14, 2016. Two investigators identified eligible articles and extracted data for individual study sites. We analyzed data in groups with the same index test. Then, we generated pooled summary estimates (95% CIs) for sensitivity and specificity by use of random-effects meta-analysis when studies were not heterogeneous. RESULTS: We identified eleven relevant studies from ten articles, giving information on PCR, LCR and Xpert MTB/RIF tests. All PCR studies were "in-house" tests, with different gene targets and had several quality concerns therefore we did not proceed with a pooled analysis. Only one study used LCR. Xpert studies were of good quality and not heterogeneous, pooled sensitivity was 0·87 (0·66-0·96) and specificity was 0·91 (0·84-0·95). CONCLUSION: PCR studies were highly heterogeneous. Among Xpert MTB/RIF studies, specificity was favorable with an acceptable confidence interval, however new studies can update meta-analysis and get more precise estimates. Further high-quality studies are urgently needed to improve diagnosis of genitourinary tuberculosis. PROTOCOL REGISTRATION: PROSPERO CRD42016039020.

Mycobacterium tuberculosis/genética , Técnicas de Amplificação de Ácido Nucleico/métodos , Tuberculose Urogenital/diagnóstico , Tuberculose Urogenital/urina , Feminino , Humanos , Masculino , Mycobacterium tuberculosis/patogenicidade , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade
Rev Esp Cardiol (Engl Ed) ; 70(12): 1067-1073, 2017 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28341415


INTRODUCTION AND OBJECTIVES: The optimal treatment of patients with acute heart failure (AHF) and cardiorenal syndrome type 1 (CRS-1) is far from being well-defined. Arterial hypoperfusion in concert with venous congestion plays a crucial role in the pathophysiology of CRS-I. Plasma carbohydrate antigen 125 (CA125) has emerged as a surrogate of fluid overload in AHF. The aim of this study was to evaluate the clinical usefulness of CA125 for tailoring the intensity of diuretic therapy in patients with CRS-1. METHODS: Multicenter, open-label, parallel clinical trial, in which patients with AHF and serum creatinine ≥ 1.4mg/dL on admission will be randomized to: a) standard diuretic strategy: titration-based on conventional clinical and biochemical evaluation, or b) diuretic strategy based on CA125: high dose if CA125 > 35 U/mL, and low doses otherwise. The main endpoint will be renal function changes at 24 and 72hours after therapy initiation. Secondary endpoints will include: a) clinical and biochemical changes at 24 and 72hours, and b) renal function changes and major clinical events at 30 days. RESULTS: The results of this study will add important knowledge on the usefulness of CA125 for guiding diuretic treatment in CRS-1. In addition, it will pave the way toward a better knowledge of the pathophysiology of this challenging situation. CONCLUSIONS: We hypothesize that higher levels of CA125 will identify a patient population with CRS-1 who could benefit from the use of a more intense diuretic strategy. Conversely, low levels of this glycoprotein could select those patients who would be harmed by high diuretic doses.

Acetazolamida/uso terapêutico , Antígeno Ca-125/sangue , Síndrome Cardiorrenal/tratamento farmacológico , Clortalidona/uso terapêutico , Diuréticos/uso terapêutico , Furosemida/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Proteínas de Membrana/sangue , Desequilíbrio Hidroeletrolítico/tratamento farmacológico , Doença Aguda , Síndrome Cardiorrenal/sangue , Síndrome Cardiorrenal/complicações , Creatinina/sangue , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/complicações , Humanos , Planejamento de Assistência ao Paciente , Desequilíbrio Hidroeletrolítico/sangue , Desequilíbrio Hidroeletrolítico/etiologia
Hosp. Aeronáut. Cent ; 12(2): 106-13, 2017. ilus, graf
Artigo em Espanhol | LILACS | ID: biblio-910999


Introducción: La atención inicial de los pacientes traumatizados es una de las prácticas médicas más frecuentes en los servicios de urgencias. La adquisición de las habilidades necesarias para el manejo correcto de estos pacientes debe incorporarse desde la formación médica básica. La docencia es una tarea compleja y es necesario implementar múltiples estrategias que garanticen la adquisición de conocimiento, permitiéndole convertirse en una herramienta pedagógica para los médicos en formación y crear nuevas oportunidades para la incorporación de nuevas habilidades para los estudiantes de la escuela de medicina. La correcta identificación de las estructuras anatómicas y la atención inicial del paciente traumatizado permitirán disminuir los posibles eventos adversos y la morbimortalidad de los pacientes quirúrgicos. Objetivos: Demostrar el uso de la enseñanza en la atención inicial del trauma como una herramienta pedagógica para el correcto aprendizaje y entrenamiento del residente de cirugía general. Material y Método: Dos períodos de análisis (enero -diciembre de 2016). En el primer período: sesiones de entrenamiento para residentes de cirugía general en atención inicial en pacientes politraumatizados, aprendizaje de anatomía humana normal en cadáveres formolizados al 10% y el desarrollo de habilidades mediante la aplicación de simuladores básicos y avanzados. En el segundo período: talleres de habilidades iniciales y quirúrgicas destinadas a estudiantes de medicina; dictado por el residente bajo la supervisión de especialistas, evaluando a través de la observación directa y la supervisión de la adquisición de conocimiento. Aprendizaje de los contenidos establecidos y mediante la simulación cognitiva a través del desarrollo de casos clínicos, la retroalimentación y la evolución del médico en entrenamiento. Resultados: 10 residentes de cirugía general. Se evidenció un mejor desempeño de residentes al finalizar el primer periodo evaluando conocimientos teóricos sobre atención inicial de paciente politraumatizado (AIP), identificación de estructuras anatómicas (IEA) y procedimientos y técnicas quirúrgicas (PYTQ). En simulación y habilidades un 70% pudo realizar los ejercicios sin necesidad de participación de instructores. En el segundo periodo se evaluó a estudiantes de grado de la carrera de medicina, los cuales previa instrucción obtuvieron por encima del 60% de conocimientos y habilidades técnicas adquiridas. En este periodo también se pudo evaluar a los residentes en su rol de docentes, los cuales tuvieron un porcentaje promedio de 70% de respuestas positivas sobre el desempeño de estos por parte de los alumnos. Conclusión: El desarrollo de nuevos espacios de aprendizaje favorece la formación continua en trauma de residente. La estrategia pedagógica correctamente planificada y con la supervisión adecuada puede considerarse como una alternativa en los programas de capacitación, y es posible incorporar conocimientos y habilidades en los estudiantes de la carrera de medicina mejorando la calidad educativa de las instituciones

Introduction: The initial care of traumatized patients is one of the most frequent medical practices in the emergency services. The acquisition of the necessary skills for the correct management of these patients should be incorporated from the basic medical training. Teaching is a complex task and it is necessary to implement multiple strategies that guarantee the acquisition of knowledge, allowing it to become a pedagogical tool for doctors in training and create new opportunities for the incorporation of new skills for medical school students. The correct identification of the anatomical structures and the initial care of the traumatized patient will allow to reduce the possible adverse events and the morbidity and mortality of the surgical patients. Objectives: To demonstrate the use of teaching in the initial care of trauma as a pedagogical tool for the correct learning and training of the resident of general surgery. Material and method: : Two periods of analysis (January -December 2016). In the first period: training sessions for residents of general surgery in initial care in polytraumatized patients, learning of normal human anatomy in 10% formolized corpses and the development of skills through the application of basic and advanced simulators. In the second period: workshops of initial and surgical skills aimed at medical students; dictated by the resident under the supervision of specialists, evaluating through the direct observation and supervision of knowledge acquisition. Learning of the established contents by cognitive simulation hrough the development of clinical cases, the feedback and the evolution of the doctor in training. Results: 10 residents of general surgery. A better performance of residents at the end of the first period was evidenced evaluating theoretical knowledge about initial attention of polytraumatized patients (AIP), identification of anatomical structures (IEA) and surgical procedures and techniques (PYTQ). In simulation and skills, 70% could perform the exercises without the need for instructors to participate. In the second period, medical degree students were evaluated, which, after receiving instructions, obtained over 60% of the knowledge and technical skills acquired. In this period it was also possible to evaluate the residents in their role as teachers, who had an average percentage of 70% of positive responses on the performance of these by the students. Conclusions: The development of new learning spaces favors continuous training in resident trauma. The pedagogical strategy correctly planned and with adequate supervision can be considered as an alternative in the training programs, and it is possible to incorporate knowledge and skills in the medical career students improving the educational quality of the institutions

Humanos , Cirurgia Geral/educação , Internato e Residência/tendências , Exercício de Simulação , Ferimentos e Lesões/diagnóstico
Hosp. Aeronáut. Cent ; 12(1): 53-70, 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-911147


Introducción: El exceso de horas de trabajo, la sobrecarga laboral y la falta de descanso llevan a la fatiga mental y física que afectan consecuentemente al rendimiento y al manejo de los pacientes que son el prefacio de una realidad cada vez más frecuente: el error médico. En los profesionales de la salud, la fatiga constituye un peligro importante desde la perspectiva de los factores humanos porque afecta a la mayoría de los aspectos de la capacidad de la persona, repercutiendo en la seguridad de sus pacientes. Objetivos: Exponer la importancia de establecer las acciones tendientes a reducir los eventos adversos por la sobrecarga horaria. Material y Método: Se analizaron 205 encuestas confidenciales y anónimas realizadas a profesionales médicos pertenecientes al servicio de Emergencias del Hospital de Morón Ostaciana C. de Lavignole y el Hospital Aeronáutico Central, en el período comprendido entre el 1de Mayo de 2016 y el 30 de Septiembre de 2016. La población analizada corresponde a 205 médicos, 95 (46,34%) hombres y 110 (53,66%) mujeres, distribuidos según rango etario. Resultados: De la totalidad de los médicos encuestados, solo el 2,43% realiza guardias de 12 horas semanales. 31,7% realizan guardias de 24 horas semanales. 9,75%, guardias de 36 horas semanales. 31,7% cumplen con 48 horas de guardias semanales y el 24,39%, exceden las 48 horas de guardias semanales. El 73,17%, luego de finalizar su guardia, continúa con actividad de planta o quirúrgica, según sea su especialidad. Esto pone de manifiesto que el 73,16% posee pluriempleo. Conclusión: En los profesionales de la salud, la fatiga constituye un peligro importante desde la perspectiva de los factores humanos porque afecta a la mayoría de los aspectos de la capacidad de la persona, repercutiendo en la seguridad de sus pacientes. Los sistemas deberán rediseñar los aspectos sustantivos en la identificación y notificación de errores; como en la prevención del mismo.

Introduction: Excessive hours of work, work overload and lack of rest lead to mental and physical fatigue, affecting performance and patient ́s management that lead to an increasingly frequent reality: the medical error. In health professionals, fatigue is an important danger from human ́s factors perspective because it affects most of the aspects of the professional ́s capacity, affecting patient ́s security. Objective: Expose the importance of establishing action tending to reduce the adverse events of work overload. Material and method: 205 confidential and anonymous surveys were made to health professionals of the Emergency Service from Hospital de Morón Ostaciana C. de Lavignolle and Hospital Aeronáutico Central, between May 1st, 2016 to September 30th, 2016. Results: 2,43% do 12hs weekly guard. 31,7% do 24hs weekly guard. 9,75% do 36hs weekly guard. 31,7% do 48hs weekly guard and 24,39% exceed 48hs weekly guard. 73, 17% after finishing their guard, continuo with their professional activities, having 73,16% more than one job. Conclusions: Fatigue constitute an important danger in health professionals because it affects most of the aspects of the professional ́s capacity, affecting patient ́s security. Mistakes identification and notification must be redesigned including the prevention of them

Esgotamento Profissional , Fadiga , Fadiga Mental/complicações , Médicos , Humanos , Segurança do Paciente , Inquéritos e Questionários
Rev. cuba. salud pública ; 42(1)ene.-mar. 2016. tab
Artigo em Espanhol | LILACS | ID: lil-778108


Introducción: la capacitación de los jóvenes en los contenidos de la violencia puede mejorar sus relaciones con padres, maestros y amigos. Objetivo: evaluar una intervención educativa en salud acerca de la violencia y sus consecuencias en adolescentes. Métodos: investigación de tipo evaluativa realizada en el 2013 en 23 estudiantes identificados con problemas de violencia y que cursan grados intermedios en una escuela pública en Puerto Rico. El primer segmento de la intervención tuvo énfasis en la parte cognoscitiva y en la segunda parte se utilizó una estrategia motivacional para modificar actitudes hacia la violencia. Antes y después de la intervención se aplicó un cuestionario basado en el Modelo de Conocimiento, Actitudes y Prácticas para la prevención de la violencia. Resultados: El 52,17 % (n= 12) eran féminas. La edad promedio fue de 14 ± 1,51 años. Después de la intervención, el 56,53 % (n= 13) de los participantes demostró tener buen conocimiento sobre violencia y el 47,05 % (n= 8) tenían una actitud positiva hacia la misma. La intervención logró un cambio en conocimiento (U=−2,178, p= 0,03), pero no hubo diferencia significativa en cuanto a la actitud hacia la violencia (U=−1,124, p= 0,26). Conclusiones: la intervención realizada es eficaz en el incremento de conocimientos acerca de la violencia, no así para modificar las actitudes hacia la misma. Una sola actividad no es suficiente para causar el cambio deseado. Es indispensable la colaboración de los sectores que pueden ayudar a los jóvenes a adoptar nuevas figuras de autoridad que rechacen la violenci(AU)

Introduction: training of young people in the violence content may improve their relationship with parents, teachers and friends. Objective: to evaluate a health education intervention about violence and its consequences for adolescents. Methods: Evaluative research conducted in 2013 in 23 students with violence problems, who are studying at intermediate grades of a public school in Porto Rico. The first segment of intervention made emphasis on the cognitive aspects whereas the second one used a motivational strategy to modify attitudes towards violence. Before and after the intervention, a questionnaire was provided, which was based on the Knowledge, Attitudes and Practices for the Prevention of Violence Model. Results: in the sample, 52.17 % (n= 12) were females and the average age of participants was 14 ± 1.51 years. After the intervention, 56.53 % (n= 13) proved to have good knowledge about violence and 47.05% (n= 8) had positive attitude toward violence. The intervention managed to change the level of knowledge (U= -2.178, p= 0.03) but no significant difference was observed about attitudes toward violence in the participants (U=-1.124, p= 0.26). Conclusions: the intervention is effective in terms of increasing knowledge about violence rather than modifying positive attitude toward it. Just one activity is not enough to bring about the desired change. It is then indispensable to encourage the cooperation among the sectors that might help the young people to adopt new authoritative attitudes that reject violence(AU)

Humanos , Masculino , Feminino , Criança , Adolescente , Ensino Fundamental e Médio , Violência/prevenção & controle , Porto Rico
Food Chem ; 197 Pt B: 1102-11, 2016 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-26675846


This paper reports the use of a grapevine-shoot stilbene extract (Vineatrol®) as a preservative in red wine. Its effectiveness to preserve red wine quality under two different winemaking systems (traditional and Ganimede) was studied at bottling and after twelve months of storage in bottle. Enological parameters, color related parameters, volatile composition, sensory analysis and olfactometric profile were evaluated. At bottling wines treated with Vineatrol showed higher color related parameters and higher score in sensory analysis than those treated with SO2. The use of SO2 increased ester and alcohol volatile compounds in relation to the use of Vineatrol. Wine olfactometric profile was modified by Vineatrol addition. Two new odorant zones with high modified frequency appeared in wines treated with Vineatrol. After 12months of storage in bottle, wines treated with Vineatrol showed parameters related to oxidation. The weak point of the process seemed to be the evolution during the storage in bottle.

Conservação de Alimentos/métodos , Fenóis , Estilbenos , Vinho/análise , Cor , Ésteres/análise , Oxirredução , Olfato , Paladar
Hosp. Aeronáut. Cent ; 11(2): 95-9, 2016. ilus.
Artigo em Espanhol | LILACS | ID: biblio-910583


Introducción A los efectos de valorar los abordajes quirúrgicos de los vasos subclavios se debe tener en cuenta en primera instancia la disposición y relaciones anatómicas de la región a fin de disminuir los eventos adversos de procedimientos quirúrgicos tanto menores como mayores en la sala de urgencias. La región anatómica del cuello cuenta con elementos nobles de importancia vital. Resulta inabarcable la región a abordar, por lo que es menester delimitarla de manera más específica utilizando reparos anatómicos fácilmente identificables. Objetivos: Es objetivo del siguiente trabajo delimitar zonas de fácil y rápido acceso para el abordaje de los vasos subclavios. Material y Método: se utilizaron n=30 preparaciones cadavéricas formolizadas las cuales fueron disecadas en un periodo comprendido entre marzo hasta septiembre de 2016. Luego del periodo de disección se procedió a un periodo demostración y aprendizaje donde 10 residentes de cirugía general fueron evaluados en cuanto a sus conocimientos anatómicos. En el siguiente periodo fueron abordados 10 vasos subclavios en preparaciones cadavéricas frescas tomándose en cuenta el tiempo utilizado para el abordaje. Se estableció un tiempo límite de 2 minutos 30 segundos. Los residentes que obtuvieron un promedio de tiempo mayor repitieron la etapa de mostración y aprendizaje hasta mejorar el tiempo estipulado. Resultados: El correcto abordaje de los vasos subclavios con el entrenamiento previo proporciona al paciente un escenario de seguridad. El compromiso de los vasos subclavios en la sala de urgencias requiere un abordaje preciso en el menor tiempo posible ya que su lesión es de compromiso vital. Conclusiones: El abordaje de los vasos subclavios en el cuello resulta de especial interés en el sistema de formación de residentes de cirugía general. La incorporación de modelos cadavéricos para la adquisición de habilidades en el control vascular de los vasos subclavios disminuye la morbimortalidad de los pacientes con lesión de los vasos en la sala de urgencias.

Introduction: In order to appreciate subclavian vessels approaches, we should keep in mind in first instance the disposition and anatomical relations of the region in order to reduce adverse effects of surgical procedements, both minor and major at the emergency room. The anatomical region of the neck has noble elements of vital importance. The region to be addressed results unreachable, so it is necessary to delimit it in a specific way using anatomical repairs easily identifiable. Objectives: The objective of the following work is to delimit zones of easy and quick access to approach subclavian vessels. Material and method: we used n: 30 formaldehyde cadaveric preparations which were dissected in a period from march to September 2016. After The dissection period, a period of demonstration and learning was carried out, where 10 General surgery residents were evaluated on their anatomical knowledge. In The following period, ten subclavian vessels were approached in fresh cadaveric preparations taking on account the time used for the boarding. Time Limit of 2 Minutes and 3 Seconds was set. The Residents who obtained a longer average time, repeated the demonstration and learning stage until the stipulated time was improved. Results: The correct approach of subclavian vessels with previous training provides a safe scenary for the patient. The Commitment of the subclavian vessels in emergency room requires the shortest possible time to approach it, cause its injury is vital. Conclusions: The Approach of subclavian vessels in neck is the special interest for training residents of general surgery. The incorporation of Cadaveric models for the acquisition of skills in vascular control of subclavian vessels, decreases the morbidity and mortality of patients with vessel injury in the emergency room.

Humanos , Cirurgia Geral/educação , Artéria Subclávia/anatomia & histologia , Dispositivos de Acesso Vascular
Mol Cell Biochem ; 410(1-2): 65-73, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26314252


The DEAD box RNA helicase DDX5 is a multifunctional protein involved in the regulatory events of gene expression. Herein, we presented evidence indicating that DDX5 is transcriptionally upregulated by calcitriol, the hormonal form of vitamin D3. In silico analysis revealed the presence of two putative vitamin D response elements (VDREs) in the DDX5 promoter region. Using luciferase reporter assays, we demonstrated that the DDX5 promoter containing these putative VDREs significantly increased the luciferase activity in vitamin D receptor (VDR)-positive SiHa cells upon calcitriol treatment. Electrophoretic mobility shift assays showed the ability of VDR and retinoid X receptor to interact only with the most proximal VDRE, while chromatin immunoprecipitation analysis confirmed the occupancy of this VDRE by the VDR. Finally, we demonstrated that calcitriol significantly increased both DDX5 mRNA and protein in SiHa cells. In summary, this study shows that DDX5 gene is transcriptionally upregulated by calcitriol through a VDRE located in its proximal promoter. Given the importance of DDX5 as a master regulator of differentiation programs, our study suggests that the pro-differentiating properties of calcitriol may be related with the induction of DDX5.

Calcitriol/farmacologia , RNA Helicases DEAD-box/metabolismo , Receptores de Calcitriol/agonistas , Transcrição Genética/efeitos dos fármacos , Neoplasias do Colo do Útero/enzimologia , Elemento de Resposta à Vitamina D/efeitos dos fármacos , Sequência de Bases , Sítios de Ligação , Linhagem Celular Tumoral , RNA Helicases DEAD-box/genética , Feminino , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Dados de Sequência Molecular , Receptores de Calcitriol/genética , Receptores de Calcitriol/metabolismo , Receptores X Retinoide/metabolismo , Transfecção , Regulação para Cima , Neoplasias do Colo do Útero/genética
Biochem Cell Biol ; 93(4): 376-84, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26111345


MicroRNAs play important roles in cancer biology. Calcitriol, the hormonal form of vitamin D3, regulates microRNAs expression in tumor cells. In the present study we asked if calcitriol would modify some of the components of the microRNA processing machinery, namely, Drosha and Dicer, in calcitriol-responsive cervical cancer cells. We found that calcitriol treatment did not affect Drosha mRNA; however, it significantly increased Dicer mRNA and protein expression in VDR-positive SiHa and HeLa cells. In VDR-negative C33-A cells, calcitriol had no effect on Dicer mRNA. We also found a vitamin D response element in Dicer promoter that interacts in vitro to vitamin D and retinoid X receptors. To explore the biological plausibility of these results, we asked if calcitriol alters the microRNA expression profile in SiHa cells. Our results revealed that calcitriol regulates the expression of a subset of microRNAs with potential regulatory functions in cancer pathways, such as miR-22, miR-296-3p, and miR-498, which exert tumor-suppressive effects. In summary, the data indicate that in SiHa cells, calcitriol stimulates the expression of Dicer possibly through the vitamin D response element located in its promoter. This may explain the calcitriol-dependent modulation of microRNAs whose target mRNAs are related to anticancer pathways, further adding to the various anticancer mechanisms of calcitriol.

Calcitriol/farmacologia , MicroRNAs/genética , Ribonuclease III/genética , Neoplasias do Colo do Útero/patologia , Linhagem Celular Tumoral , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Regiões Promotoras Genéticas , Receptores de Calcitriol/metabolismo , Receptores X Retinoide/metabolismo , Ribonuclease III/metabolismo , Transcrição Genética , Neoplasias do Colo do Útero/enzimologia , Neoplasias do Colo do Útero/genética
Biochim Biophys Acta ; 1848(5): 1157-64, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25701231


The sodium coupled neutral amino acid transporter 2 (SNAT2/SAT2/ATA2) is expressed in the mammary gland (MG) and plays an important role in the uptake of alanine and glutamine which are the most abundant amino acids transported into this tissue during lactation. Thus, the aim of this study was to assess the amount and localization of SNAT2 before delivery and during lactation in rat MG, and to evaluate whether prolactin and the dietary protein/carbohydrate ratio might influence SNAT2 expression in the MG, liver and adipose tissue during lactation. Our results showed that SNAT2 protein abundance in the MG increased during lactation and this increase was maintained along this period, while 24 h after weaning it tended to decrease. To study the effect of prolactin on SNAT2 expression, we incubated MG explants or T47D cells transfected with the SNAT2 promoter with prolactin, and we observed in both studies an increase in the SNAT2 expression or promoter activity. Consumption of a high-protein/low carbohydrate diet increased prolactin concentration, with a concomitant increase in SNAT2 expression not only in the MG during lactation, but also in the liver and adipose tissue. There was a correlation between SNAT2 expression and serum prolactin levels depending on the amount of dietary protein/carbohydrate ratio consumed. These findings suggest that prolactin actively supports lactation providing amino acids to the gland through SNAT2 for the synthesis of milk proteins.

Sistema A de Transporte de Aminoácidos/metabolismo , Carboidratos da Dieta/metabolismo , Proteínas na Dieta/metabolismo , Lactação/metabolismo , Glândulas Mamárias Animais/metabolismo , Prolactina/metabolismo , Tecido Adiposo/metabolismo , Sistema A de Transporte de Aminoácidos/genética , Fenômenos Fisiológicos da Nutrição Animal , Animais , Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Feminino , Regulação da Expressão Gênica , Lactação/sangue , Lactação/genética , Fígado/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Proteínas do Leite/biossíntese , Estado Nutricional , Gravidez , Prolactina/sangue , Regiões Promotoras Genéticas , RNA Mensageiro/metabolismo , Ratos Wistar , Técnicas de Cultura de Tecidos , Transfecção , Desmame
Genes Nutr ; 10(2): 452, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25576393


The liver is the main organ involved in the metabolism of amino acids (AA), which are oxidized by amino acid catabolizing enzymes (AACE). Peroxisome proliferator-activated receptor-α (PPARα) stimulates fatty acid ß-oxidation, and there is evidence that it can modulate hepatic AA oxidation during the transition of energy fuels. To understand the role and mechanism of PPARα's regulation of AA catabolism, the metabolic and molecular adaptations of Ppara-null mice were studied. The role of PPARα on AA metabolism was examined by in vitro and in vivo studies. In wild-type and Ppara-null mice, fed increasing concentrations of the dietary protein/carbohydrate ratio, we measured metabolic parameters, and livers were analyzed by microarray analysis, histology and Western blot. Functional enrichment analysis, EMSA and gene reporter assays were performed. Ppara-null mice presented increased expression of AACE in liver affecting AA, lipid and carbohydrate metabolism. Ppara-null mice had increased glucagon/insulin ratio (7.2-fold), higher serum urea (73.1 %), lower body protein content (19.7 %) and decreased several serum AA in response to a high-protein/low-carbohydrate diet. A functional network of differentially expressed genes, suggested that changes in the expression of AACE were regulated by an interrelationship between PPARα and HNF4α. Our data indicated that the expression of AACE is down-regulated through PPARα by attenuating HNF4α transcriptional activity as observed in the serine dehydratase gene promoter. PPARα via HNF4α maintains body protein metabolic homeostasis by down-regulating genes involved in amino acid catabolism for preserving body nitrogen.