Prevalência de cefaleia em uma unidade de diálise / Prevalence of headache in a dialysis clinic

Introdução: De acordo com a Sociedade Internacional de Cefaleia, a cefaleia é uma dor localizada acima da linha orbitomeatal, classificada como primária e secundária. A cefaleia da diálise consiste em uma dor de cabeça inespecífica que ocorre no período da diálise, podendo persistir após o término da sessão. Apesar de ser um sintoma comum em pacientes submetidos à hemodiálise, a cefaleia decorrente da terapia dialítica é pobremente estudada. Não se tem a sua etiologia precisa, porém infere-se que a gênese da cefaleia seja multifatorial. Objetivo: Avaliar a prevalência da cefaleia em pacientes submetidos à hemodiálise. Além disso, classificar as cefaleias apresentadas pelos pacientes estudados, inclusive as que não são decorrentes da diálise. Métodos: Trata-se de um estudo constituído por pacientes submetidos à terapia dialítica em uma clínica, de uma cidade brasileira, no período de maio a agosto de 2014. Este foi composto por 152 pacientes. Resultados: Foram analisados 77 (50,7%) pacientes do sexo masculino e 75 (49,3%) do sexo feminino. Dos 61 pacientes (40,1%) que afirmaram apresentar episódios de cefaleia, os tipos mais prevalentes foram cefaleia do tipo tensional ­ CTT (41%) e cefaleia da diálise (37,7%), sendo outros tipos menos frequentes. Ou seja, 23 (15,1%) dos 152 pacientes foram diagnosticados com cefaleia da diálise, isolada ou associada a outros tipos de cefaleia. Conclusão: Diante da elevada prevalência de tal condição, elaborar planos de ação para melhoria da qualidade de vida desses pacientes é uma medida relevante.

Introduction: According to the International Society of Headache, headache is a pain located above the orbitomeatal line, classified as primary and secondary. The dialysis headache isclassified as secondary and consists of a nonspecific headache that occurs during the period of dialysis and may persist after the end of the session. Despite being a common symptom in patients undergoing hemodialysis, headache resulting from dialysis is poorly studied. It does not have a precise etiology, however it appears that the genesis of the headache is multifactorial. Background. Evaluate the prevalence of headache in patients submitted to hemodialysis. Besides classify headaches evidenced by patient studied, including those which are not decurrent from dialysis. Methods. It´s a study consists of patients who had dialysis performed at a clinic, in a brazilian city, from May to August, 2014. This was composed of 152 patients. Results. 77 (50,7%) patients were males and 75 (49,3%) were females. Of the 61 (40,1%) affirmed evince headache episodes, the most prevalence types were tension type headache ­ CTT (41%) and headache from dialysis (37,7%), and other less common types. So, 23 (15,1%) of 152 patients were diagnosed with headache from dialysis, irrespective of being or not being associated with other types of headache. Conclusion. Such high prevalence of this condition, draw up action plans to improve the quality of life of these patients is a relevant measure.

Aberrant signaling in T-cell acute lymphoblastic leukemia: biological and therapeutic implications

T-cell acute lymphoblastic leukemia (T-ALL) is a biologically heterogeneous disease with respect to phenotype, gene expression profile and activation of particular intracellular signaling pathways. Despite very significant improvements, current therapeutic regimens still fail to cure a portion of the patients and frequently implicate the use of aggressive protocols with long-term side effects. In this review, we focused on how deregulation of critical signaling pathways, in particular Notch, PI3K/Akt, MAPK, Jak/STAT and TGF-ß, may contribute to T-ALL. Identifying the alterations that affect intracellular pathways that regulate cell cycle and apoptosis is essential to understanding the biology of this malignancy, to define more effective markers for the correct stratification of patients into appropriate therapeutic regimens and to identify novel targets for the development of specific, less detrimental therapies for T-ALL.

Partial characterization of folate uptake in microvillous membrane vesicles isolated from human placenta

The purpose of the present study was to determine biochemical parameters of folate uptake, and the putative contribution of the membrane-anchored folate receptor in microvillous membrane vesicles obtained from the syncytiotrophoblast of human term placenta. Uptake of [3H]-pteroylglutamic acid (PGA) by microvillous membrane vesicles was pH dependent with a maximum at pH 6.0, and attained equilibrium at 60 min of incubation. Uptake was higher in the presence of an inward pH gradient (pHout = 6.0; pHin = 7.5) than in the absence of the gradient (pHout = pHin = 6.0). The effect of changes in medium osmolality showed that both binding to the vesicular membrane and internalization contributed to the measured [3H]-PGA uptake. Equilibrium uptake experiments using [3H]-PGA concentrations within the physiological range of folate in blood serum showed that saturation was achieved at 30 nM and revealed a single class of binding sites with a Kd of 1.8 nM for [3H]-PGA. Cleavage of the glycosyl-phosphatidylinositol moiety of the folate receptor, which anchors the receptor to the membrane, with phosphatidylinositolspecific phospholipase C resulted in a reduction of about 80 per cent in [3H]-PGA uptake. In conclusion, our results showed that the folate uptake in the maternally facing membrane of the human placenta presents a saturable component and is mediated by the folate receptor to ensure an adequate maternal-fetal folate transfer.