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1.
J Ethn Subst Abuse ; 22(2): 350-371, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34339341

RESUMO

American Indian and Alaska Native (AIAN) communities have higher rates of substance use than other racial and ethnic groups. Substance use disorder (SUD) is tied to the increased risk of experiencing homelessness. National policies have also led to the disproportionate rates of homelessness among AIAN communities. However, specific experiences related to the occurrence of SUD and homelessness among AIAN in California, as well as seeking and accessing SUD treatment, are not well understood. This study explored potential SUD risk and resilience factors for AIANs experiencing homelessness and their experiences when seeking services for SUD. Nineteen interviews were conducted in northern, central, and southern California. Thematic analysis was used for these data. The five primary codes were: (1) risk factors for SUD, (2) resilience related to SUD service seeking, (3) services available, (4) barriers accessing services, and (5) services needed. Based on the results, themes for risk were trauma, mental health, and community conditions. Themes for resilience were identified at individual and community levels and included personal motivation and community support and inclusiveness. Themes for services available were limited knowledge about service types and services' location. The themes for barriers accessing services were identified at internal and external levels, and included lack of readiness and transportation challenges, respectively. Themes for services needed included continuum of care, integrated care, and culturally sensitive services. Findings highlight the importance of addressing the potential risk factors and service needs of AIANs experiencing homelessness to provide comprehensive and culturally sensitive services to reduce substance use.


Assuntos
Indígena Americano ou Nativo do Alasca , Pessoas Mal Alojadas , Transtornos Relacionados ao Uso de Substâncias , Humanos , Indígena Americano ou Nativo do Alasca/psicologia , California , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
2.
Mol Plant Microbe Interact ; 35(3): 274-289, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34889653

RESUMO

The Mla (Mildew resistance locus a) of barley (Hordeum vulgare L.) is an effective model for cereal immunity against fungal pathogens. Like many resistance proteins, variants of the MLA coiled-coil nucleotide-binding leucine-rich repeat (CC-NLR) receptor often require the HRS complex (HSP90, RAR1, and SGT1) to function. However, functional analysis of Sgt1 has been particularly difficult, as deletions are often lethal. Recently, we identified rar3 (required for Mla6 resistance 3), an in-frame Sgt1ΔKL308-309 mutation in the SGT1-specific domain, that alters resistance conferred by MLA but without lethality. Here, we use autoactive MLA6 and recombinant yeast-two-hybrid strains with stably integrated HvRar1 and HvHsp90 to determine that this mutation weakens but does not entirely disrupt the interaction between SGT1 and MLA. This causes a concomitant reduction in MLA6 protein accumulation below the apparent threshold required for effective resistance. The ΔKL308-309 deletion had a lesser effect on intramolecular interactions than alanine or arginine substitutions, and MLA variants that display diminished interactions with SGT1 appear to be disproportionately affected by the SGT1ΔKL308-309 mutation. We hypothesize that those dimeric plant CC-NLRs that appear unaffected by Sgt1 silencing are those with the strongest intermolecular interactions with it. Combining our data with recent work in CC-NLRs, we propose a cyclical model of the MLA-HRS resistosome interactions.[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 "No Rights Reserved" license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2022.


Assuntos
Hordeum , Hordeum/microbiologia , Mutação , Proteínas NLR/genética , Doenças das Plantas/microbiologia , Proteínas de Plantas/metabolismo
3.
Molecules ; 27(12)2022 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-35744846

RESUMO

Plant gums are bio-organic substances that are derived from the barks of trees. They are biodegradable and non-adverse complex polysaccharides that have been gaining usage in recent years due to a number of advantages they contribute to various applications. In this study, gum was collected from Moringa oleifera and Azadirachta indica trees, then dried and powdered. Characterizations of gum polysaccharides were performed using TLC, GC-MS, NMR, etc., and sugar molecules such as glucose and xylose were found to be present. Effects of the gums on Abelmoschus esculentus growth were observed through root growth, shoot growth, and biomass content. The exposure of the seeds to the plant gums led to bio stimulation in the growth of the plants. Poor quality soil was exposed to the gum polysaccharide, where the polysaccharide was found to improve soil quality, which was observed through soil analysis and SEM analysis of soil porosity and structure. Furthermore, the plant gums were also found to have bio-pesticidal activity against mealybugs, which showed certain interstitial damage evident through histopathological analysis.


Assuntos
Azadirachta , Moringa oleifera , Praguicidas , Moringa oleifera/química , Gomas Vegetais/química , Gomas Vegetais/farmacologia , Plantas , Polissacarídeos/química , Polissacarídeos/farmacologia , Solo
4.
Medicina (Kaunas) ; 57(7)2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34356991

RESUMO

Background and Objectives: Matrix metalloproteinases (MMP) have been implicated as major determinants of tumour growth and metastasis, which are considered two of the main hallmarks of cancer. The interaction of MMP8 and other signalling molecules within and adjacent tumoral tissues, including immune cells, are rather elusive, particularly of adenocarcinoma cell type. In this study, we aimed to investigate the role of MMP8 in non-small cell lung cancer proliferation and invasiveness potential. Materials and Methods: We individually lipofected with two different single guide RNA (sgRNAs) that specifically targeted on MMP8, with CRISPR-Cas 9 protein into the cells. Results: Our results clearly indicated that the lipofection of these complexes could lead to reduced ability of A549 cells to survive and proliferate to form colonies. In addition, when compared to non-transfected cells, the experimental cell groups receiving sgRNAs demonstrated relatively decreased migration rate, hence, wider wound gaps in scratch assay. The quantitative real time-polymerase chain reaction (qRT-PCR) demonstrated significant reduction in the MAP-K, survivin and PI3-K gene expression. MMP8 might have protective roles over tumour growth and spread in our body. Conclusions: The delivery of sgRNAs targeting on the MMP8 gene could induce tumour cell death and arrest cell migratory activity.


Assuntos
Adenocarcinoma de Pulmão , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/genética , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Humanos , Neoplasias Pulmonares/genética , Metaloproteinase 8 da Matriz , Invasividade Neoplásica , RNA Guia de Cinetoplastídeos
5.
Medicina (Kaunas) ; 57(8)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34441045

RESUMO

Biofilms comprising aggregates of microorganisms or multicellular communities have been a major issue as they cause resistance against antimicrobial agents and biofouling. To date, numerous biofilm-forming microorganisms have been identified, which have been shown to result in major effects including biofouling and biofilm-related infections. Quorum sensing (which describes the cell communication within biofilms) plays a vital role in the regulation of biofilm formation and its virulence. As such, elucidating the various mechanisms responsible for biofilm resistance (including quorum sensing) will assist in developing strategies to inhibit and control the formation of biofilms in nature. Employing biological control measures (such as the use of bioactive compounds) in targeting biofilms is of great interest since they naturally possess antimicrobial activity among other favorable attributes and can also possibly act as potent antibiofilm agents. As an effort to re-establish the current notion and understanding of biofilms, the present review discuss the stages involved in biofilm formation, the factors contributing to its development, the effects of biofilms in various industries, and the use of various bioactive compounds and their strategies in biofilm inhibition.


Assuntos
Biofilmes , Percepção de Quorum , Antibacterianos/farmacologia
6.
Mol Plant Microbe Interact ; 32(5): 550-565, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30480480

RESUMO

The Pseudomonas syringae cysteine protease AvrPphB activates the Arabidopsis resistance protein RPS5 by cleaving a second host protein, PBS1. AvrPphB induces defense responses in other plant species, but the genes and mechanisms mediating AvrPphB recognition in those species have not been defined. Here, we show that AvrPphB induces defense responses in diverse barley cultivars. We also show that barley contains two PBS1 orthologs, that their products are cleaved by AvrPphB, and that the barley AvrPphB response maps to a single locus containing a nucleotide-binding leucine-rich repeat (NLR) gene, which we termed AvrPphB Response 1 (Pbr1). Transient coexpression of PBR1 with wild-type AvrPphB but not with a protease inactive mutant triggered defense responses, indicating that PBR1 detects AvrPphB protease activity. Additionally, PBR1 coimmunoprecipitated with barley and Nicotiana benthamiana PBS1 proteins, suggesting mechanistic similarity to detection by RPS5. Lastly, we determined that wheat cultivars also recognize AvrPphB protease activity and contain two putative Pbr1 orthologs. Phylogenetic analyses showed, however, that Pbr1 is not orthologous to RPS5. Our results indicate that the ability to recognize AvrPphB evolved convergently and imply that selection to guard PBS1-like proteins occurs across species. Also, these results suggest that PBS1-based decoys may be used to engineer protease effector recognition-based resistance in barley and wheat.


Assuntos
Arabidopsis , Evolução Biológica , Hordeum , Peptídeo Hidrolases/metabolismo , Arabidopsis/classificação , Arabidopsis/metabolismo , Proteínas de Bactérias/genética , Hordeum/classificação , Hordeum/metabolismo , Filogenia , Doenças das Plantas/imunologia , Pseudomonas syringae/enzimologia
7.
Inorg Chem ; 55(3): 1108-23, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-26745551

RESUMO

Palladium atoms generated by thermal evaporation and laser ablation were reacted with and trapped in F2/Ar, F2/Ne, and neat F2 matrices. The products were characterized by electronic absorption and infrared spectroscopy, together with relativistic density functional theory calculations as well as coupled cluster calculations. Vibrational modes at 540 and 617 cm(-1) in argon matrices were assigned to molecular PdF and PdF2, and a band at 692 cm(-1) was assigned to molecular PdF4. A band at 624 cm(-1) can be assigned to either PdF3 or PdF6, with the former preferred from experimental considerations. Although calculations might support the latter assignment, our conclusion is that in these detailed experiments there is no convincing evidence for PdF6.

8.
Life (Basel) ; 13(3)2023 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-36983922

RESUMO

Nanotechnology is used in a variety of scientific, medical, and research domains. It is significant to mention that there are negative and severe repercussions of nanotechnology on both individuals and the environment. The toxic effect of nanoparticles exerted on living beings is termed as nanotoxicity. Nanoparticles are synthesized by various methods such as chemical, biological, physical, etc. These nanoparticles' nanotoxicity has been observed to vary depending on the synthesis process, precursors, size of the particles, etc. Nanoparticles can enter the cell in different ways and can cause cytotoxic effects. In this review, the toxicity caused in the reproductive system and the role of the antioxidants against the nanotoxicity are briefly explained.

9.
Antioxidants (Basel) ; 12(7)2023 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-37507944

RESUMO

Reactive oxygen species (ROS) play a significant role in the survival and decline of various biological systems. In liver-related metabolic disorders such as steatohepatitis, ROS can act as both a cause and a consequence. Alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH) are two distinct types of steatohepatitis. Recently, there has been growing interest in using medications that target ROS formation and reduce ROS levels as a therapeutic approach for oxidative stress-related liver disorders. Mammalian systems have developed various antioxidant defenses to protect against excessive ROS generation. These defenses modulate ROS through a series of reactions, limiting their potential impact. However, as the condition worsens, exogenous antioxidants become necessary to control ROS levels. Nanotechnology has emerged as a promising avenue, utilizing nanocomplex systems as efficient nano-antioxidants. These systems demonstrate enhanced delivery of antioxidants to the target site, minimizing leakage and improving targeting accuracy. Therefore, it is essential to explore the evolving field of nanotechnology as an effective means to lower ROS levels and establish efficient therapeutic interventions for oxidative stress-related liver disorders.

10.
Polymers (Basel) ; 15(6)2023 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-36987305

RESUMO

Biological macromolecules like polysaccharides/proteins/glycoproteins have been widely used in the field of tissue engineering due to their ability to mimic the extracellular matrix of tissue. In addition to this, these macromolecules are found to have higher biocompatibility and no/lesser toxicity when compared to synthetic polymers. In recent years, scaffolds made up of proteins, polysaccharides, or glycoproteins have been highly used due to their tensile strength, biodegradability, and flexibility. This review is about the fabrication methods and applications of scaffolds made using various biological macromolecules, including polysaccharides like chitosan, agarose, cellulose, and dextran and proteins like soy proteins, zein proteins, etc. Biopolymer-based nanocomposite production and its application and limitations are also discussed in this review. This review also emphasizes the importance of using natural polymers rather than synthetic ones for developing scaffolds, as natural polymers have unique properties, like high biocompatibility, biodegradability, accessibility, stability, absence of toxicity, and low cost.

11.
J Am Chem Soc ; 134(33): 13896-901, 2012 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-22856647

RESUMO

The hitherto elusive silaisocyanoacetylene molecule (HCCNSi)-a member of the silaisocyanide family-has been synthesized for the first time through the reaction of the silicon nitride radical (SiN) with acetylene (C(2)H(2)) in the gas phase under single collision conditions. Compared to the isoelectronic reaction of the cyano radical (CN) with acetylene, the replacement of the carbon atom in the cyano group by an isovalent silicon atom has a pronounced effect on the reactivity. Whereas the silicon nitride radical was found to pass an entrance barrier and adds with the nitrogen atom to the acetylene molecule, the cyano radical adds barrierlessly with the carbon atom forming the HCCH(NSi) and HCCH(CN) intermediates, respectively. These structures undergo hydrogen loss to form the linear silaisocyanoacetylene (HCCNSi) and cyanoacetylene molecules (HCCCN), respectively. Therefore, the isovalency of the silicon atom was found to bear little resemblance with the carbon atom having a dramatic effect not only on the reactivity, but also on the reaction mechanism, thermochemistry, and chemical bonding of the isoelectronic silaisocyanoacetylene and cyanoacetylene products, effectively reversing the thermodynamical stability of the nitrile versus isonitrile and silanitrile versus isosilanitrile isomer pairs.

12.
Eur Respir J ; 39(1): 133-40, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21737551

RESUMO

Idiopathic pulmonary fibrosis (IPF) is characterised by myofibroblast proliferation leading to architectural destruction. Neither the origin nor the continued proliferation of myofibroblasts is well understood. Explanted human IPF lungs were stained by immunohistochemistry for calretinin, a marker of pleural mesothelial cells (PMCs). Chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) lungs acted as controls. The number of PMCs per 100 nucleated cells and per photomicrograph was estimated along with the Ashcroft score of fibrosis. Mouse PMCs expressing green fluorescent protein (GFP) or labelled with nanoparticles were injected into the pleural space of mice given intranasal transforming growth factor (TGF)-ß1. Mouse lungs were lavaged and examined for the presence of GFP, smooth muscle α-actin (α-SMA) and calretinin. Calretinin-positive PMCs were found throughout IPF lungs, but not in COPD or CF lungs. The number of PMCs correlated with the Ashcroft score. In mice, nanoparticle-laden PMCs were recoverable by bronchoalveolar lavage, depending on the TGF-ß1 dose. Fluorescent staining showed α-SMA expression in GFP-expressing PMCs, with co-localisation of GFP and α-SMA. PMCs can traffic through the lung and show myofibroblast phenotypic markers. PMCs are present in IPF lungs, and their number correlates with IPF severity. Since IPF presumably begins subpleurally, PMCs could play a pathogenetic role via mesothelial-mesenchymal transition.


Assuntos
Epitélio/patologia , Fibrose Pulmonar Idiopática/fisiopatologia , Pulmão/metabolismo , Proteína G de Ligação ao Cálcio S100/sangue , Adolescente , Adulto , Idoso , Animais , Calbindina 2 , Núcleo Celular/metabolismo , Criança , Fibrose Cística/metabolismo , Transição Epitelial-Mesenquimal , Feminino , Proteínas Ligadas por GPI/sangue , Humanos , Imuno-Histoquímica/métodos , Masculino , Mesotelina , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Miofibroblastos/citologia , Pleura/metabolismo , Doença Pulmonar Obstrutiva Crônica/metabolismo
13.
Phys Chem Chem Phys ; 14(2): 477-81, 2012 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-22120638

RESUMO

The atom-radical reaction of ground state carbon atoms (C((3)P)) with the vinyl radical (C(2)H(3)(X(2)A')) was conducted under single collision conditions at a collision energy of 32.3 ± 2.9 kJ mol(-1). The reaction dynamics were found to involve a complex forming reaction mechanism, which is initiated by the barrier-less addition of atomic carbon to the carbon-carbon-double bond of the vinyl radical forming a cyclic C(3)H(3) radical intermediate. The latter has a lifetime of at least 1.5 times its rotational period and decomposes via a tight exit transition state located about 45 kJ mol(-1) above the separated products through atomic hydrogen loss to the cyclopropenylidene isomer (c-C(3)H(2)) as detected toward cold molecular clouds and in star forming regions.

14.
Indian J Ophthalmol ; 70(3): 1026-1029, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35225566

RESUMO

Purpose: The COVID-19 pandemic imposed challenges to access rehabilitation intervention to individuals with visual impairment, thereby increasing their disability effects. This study explored the viability maintaining the continuum of care through telerehabilitation. Methods: This study is a retrospective analysis of individuals with vision impairment who underwent telerehabilitation at the center of excellence in eye care at Hyderabad, Telangana, India, between April and September 2020. The International Classification of Functioning, Disability and Health framework was followed to provide services such as counseling for mental well-being, information and resources, educational interventions, Assistive Technology programs, therapeutic interventions for children with multiple disabilities, access to digital audio books and rehabilitation helpline.A team of professionals involved in the service care. Phone and what's app calls were used to facilitate the training.The duration and the number of training sessions were individual need-based with an average of 45 minutes per session and 175 training sessions. Results: Three hundred and fifty individuals and their families benefited. The service include early intervention (n = 129), and low vision care (n = 176) inclusive of computer training (n = 53), soft skills (n = 53), digital books (n = 55).Nearly two-thirds of the participants were male (n = 205). Conclusion: Evidence from this study suggests telerehabilitation as a successful model of care.A well-planned telerehabilitation approach can expand the scope of reaching the visually impaired from geographically isolated areas where scarcity of service providers and service centers.


Assuntos
COVID-19 , Telerreabilitação , COVID-19/epidemiologia , Criança , Humanos , Masculino , Pandemias , Estudos Retrospectivos , SARS-CoV-2
15.
Front Endocrinol (Lausanne) ; 13: 1074568, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36714604

RESUMO

Wound healing is a programmed process of continuous events which is impaired in the case of diabetic patients. This impaired process of healing in diabetics leads to amputation, longer hospitalisation, immobilisation, low self-esteem, and mortality in some patients. This problem has paved the way for several innovative strategies like the use of nanotechnology for the treatment of wounds in diabetic patients. The use of biomaterials, nanomaterials have advanced approaches in tissue engineering by designing multi-functional nanocomposite scaffolds. Stimuli-responsive scaffolds that interact with the wound microenvironment and controlled release of bioactive molecules have helped in overcoming barriers in healing. The use of different types of nanocomposite scaffolds for faster healing of diabetic wounds is constantly being studied. Nanocomposites have helped in addressing specific issues with respect to healing and improving angiogenesis. Method: A literature search was followed to retrieve the articles on strategies for wound healing in diabetes across several databases like PubMed, EMBASE, Scopus and Cochrane database. The search was performed in May 2022 by two researchers independently. They keywords used were "diabetic wounds, nanotechnology, nanocomposites, nanoparticles, chronic diabetic wounds, diabetic foot ulcer, hydrogel". Exclusion criteria included insulin resistance, burn wound, dressing material.


Assuntos
Diabetes Mellitus , Pé Diabético , Nanocompostos , Nanopartículas , Humanos , Cicatrização , Bandagens , Pé Diabético/terapia , Diabetes Mellitus/terapia
16.
Vaccines (Basel) ; 10(5)2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35632493

RESUMO

In December 2019, an unknown viral infection emerged and quickly spread worldwide, resulting in a global pandemic. This novel virus caused severe pneumonia and acute respiratory distress syndrome caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It has caused 6.25 millions of deaths worldwide and remains a major concern for health, society, and the economy. As vaccination is one of the most efficient ways to combat this pandemic, different vaccines were developed in a short period. This review article discusses how coronavirus affected the top nations of the world and the vaccines being used for the prevention. Amongst the vaccines, some vaccines have already been approved, and some have been involved in clinical studies. The article also provides insight into different COVID-19 vaccine platforms, their preparation, working, efficacy, and side effects.

17.
Toxics ; 11(1)2022 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-36668735

RESUMO

Metal nanoparticles, such as gold nanoparticles, silver nanoparticles, etc., have many benefits and have been in use for a very long time. Nevertheless, a number of concerns have been raised about the environmental impact and the possibility of exposure to various living systems at the moment. Thus, in this study, silver nanoparticles were synthesized by using plant gum from Bauhinia purpurea and characterization was done using UV-Visible Spectroscopy, Scanning Electron Microscopy, X-ray Diffraction, etc. To determine the accumulation and toxic effects caused by the nanoparticles, Eudrilus eugeniae, Danio rerio, and their embryos were exposed to the synthesized silver nanoparticles and evaluated using microscopic observation, histology, and Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES).

18.
Toxics ; 10(12)2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36548575

RESUMO

Nanoparticles are potential candidates for wastewater treatment especially for the removal of heavy metals due to their strong affinity. Many biopolymers are used as adsorbents and encapsulation of nanoparticle onto them can increase their efficiency. In this study, SPIONs, alginate, and SPIONs incorporated on alginate beads have been synthesized and characterized both microscopically and spectroscopically. These were then used for the removal of chromium metal and the percentage of removal was evaluated using a batch adsorption study. The percent removal of chromium using SPIONs, alginate and alginate-SPIONs beads were recorded to be 93%, 91% and 94%, respectively. The adsorption of chromium using SPIONs and alginate-SPIONs beads followed the Tempkin isotherm, whereas adsorption of chromium metal by alginate beads was found to be homogeneous in nature and followed the Langmuir isotherm with an R2 value of 0.9784. An in-vivo study using Danio rerio as a model organism was done to examine the toxicity and the removal efficiency of the samples. It was observed that chromium water treated with alginate-SPIONs beads, which were removed after water treatment showed less damage to the fishes when compared to SPIONs and alginate beads treated with chromium water where the SPIONs and alginate beads were not removed after the treatment period.

19.
Crit Care Med ; 39(6): 1282-8, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21336122

RESUMO

OBJECTIVES: Although enteral nutrition is standard care for critically ill patients, nutrient absorption has not been quantified in this group and may be impaired due to intestinal dysmotility. The objectives of this study were to measure small intestinal glucose absorption and duodenocecal transit and determine their relationship with glycemia in the critically ill. DESIGN: Prospective observational study of healthy and critically ill subjects. SETTING: Tertiary mixed medical-surgical adult intensive care unit. SUBJECTS: Twenty-eight critically ill patients and 16 healthy subjects were studied. MATERIALS AND MAIN RESULTS: Liquid feed (100 kcal/100 mL), labeled with Tc-sulfur colloid and including 3 g of 3-O-methylglucose, was infused into the duodenum. Glucose absorption and duodenocecal transit were measured using the area under the 3-O-methylglucose concentration curve and scintigraphy, respectively. Data are median (range). RESULTS AND DISCUSSION: Glucose absorption was reduced in critical illness when compared to health (area under the concentration curve: 16 [1-32] vs. 20 [14-34] mmol/L·min; p = .03). Small intestinal transit times were comparable in patients and healthy subjects (192 [9-240] vs. 168 [6-240] min; p = .99) and were not related to glucose absorption. Despite higher fasting blood glucose concentrations (6.3 [5.1-9.3] vs. 5.7 [4.6-7.6] mmol/L; p < .05), the increment in blood glucose was sustained for longer in the critically ill (Δ glucose at t = 60; 1.9 [-2.1-5.0] mmol/L vs. -0.2 [-1.3-2.3] mmol/L; p < .01). CONCLUSIONS: Critical illness is associated with reduced small intestinal glucose absorption, but despite this, the glycemic response to enteral nutrient is sustained for longer.


Assuntos
Estado Terminal , Duodeno/fisiologia , Trânsito Gastrointestinal/fisiologia , Glucose/metabolismo , Hiperglicemia/etiologia , Absorção Intestinal/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Ceco/fisiologia , Nutrição Enteral , Feminino , Humanos , Hiperglicemia/metabolismo , Hiperglicemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Crit Care ; 15(1): R35, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21255422

RESUMO

INTRODUCTION: Glucagon-like peptide-1 (GLP-1) attenuates the glycaemic response to small intestinal nutrient infusion in stress-induced hyperglycaemia and reduces fasting glucose concentrations in critically ill patients with type-2 diabetes. The objective of this study was to evaluate the effects of acute administration of GLP-1 on the glycaemic response to small intestinal nutrient infusion in critically ill patients with pre-existing type-2 diabetes. METHODS: Eleven critically ill mechanically-ventilated patients with known type-2 diabetes received intravenous infusions of GLP-1 (1.2 pmol/kg/minute) and placebo from t = 0 to 270 minutes on separate days in randomised double-blind fashion. Between t = 30 to 270 minutes a liquid nutrient was infused intraduodenally at a rate of 1 kcal/min via a naso-enteric catheter. Blood glucose, serum insulin and C-peptide, and plasma glucagon were measured. Data are mean ± SEM. RESULTS: GLP-1 attenuated the overall glycaemic response to nutrient (blood glucose AUC30-270 min: GLP-1 2,244 ± 184 vs. placebo 2,679 ± 233 mmol/l/minute; P = 0.02). Blood glucose was maintained at < 10 mmol/l in 6/11 patients when receiving GLP-1 and 4/11 with placebo. GLP-1 increased serum insulin at 270 minutes (GLP-1: 23.4 ± 6.7 vs. placebo: 16.4 ± 5.5 mU/l; P < 0.05), but had no effect on the change in plasma glucagon. CONCLUSIONS: Exogenous GLP-1 in a dose of 1.2 pmol/kg/minute attenuates the glycaemic response to small intestinal nutrient in critically ill patients with type-2 diabetes. Given the modest magnitude of the reduction in glycaemia the effects of GLP-1 at higher doses and/or when administered in combination with insulin, warrant evaluation in this group. TRIAL REGISTRATION: ANZCTR:ACTRN12610000185066.


Assuntos
Glicemia/efeitos dos fármacos , Cuidados Críticos/métodos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Nutrição Enteral/métodos , Peptídeo 1 Semelhante ao Glucagon/uso terapêutico , Hipoglicemiantes/uso terapêutico , Estado Terminal , Diabetes Mellitus Tipo 2/terapia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Piloro , Resultado do Tratamento
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