A Gravidade da Doença Afeta os Parâmetros de Repolarização Ventricular em Pacientes com COVID-19 / Disease Severity Affects Ventricular Repolarization Parameters in Patients With COVID-19

Resumo Fundamento: Não há estudos avaliando o intervalo Tpico-Tfim (Tpe), a relação Tpe/QT e a relação Tpe/QTc para avaliar arritmias cardíacas em pacientes com COVID-19. Objetivo: Visamos investigar se há alterações nos intervalos QT, QTc e Tpe e nas relações Tpe/QT e Tpe/QTc em pacientes com COVID-19. Métodos: O estudo incluiu 90 pacientes com infecção por COVID-19 e 30 controles saudáveis pareados por sexo e idade. Foram aferidos os intervalos QT, QTc e Tpe e as relações Tpe/QT e Tpe/QTc. Os participantes incluídos no estudo foram divididos nos seguintes 4 grupos: controles saudáveis (grupo I), pacientes com COVID-19 sem pneumonia (grupo II), pacientes com COVID-19 e pneumonia leve (grupo III) e pacientes com COVID-19 e pneumonia grave (grupo IV). Significância estatística foi definida por valor p < 0,05. Resultados: Verificou-se que a frequência cardíaca basal, a presença de hipertensão e diabetes, a contagem de leucócitos, o nitrogênio ureico no sangue, a creatinina, o potássio, o aspartato aminotransferase, a alanina aminotransferase, o NT-proBNP, a proteína C reativa de alta sensibilidade, o dímero-D, a TncI-as, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc aumentaram do grupo I para o grupo IV e foram significativamente mais altos em todos os pacientes do grupo IV (p < 0,05). A pressão arterial sistólica, a hemoglobina e os níveis de cálcio eram menores no grupo IV e significativamente menores em comparação com os demais grupos (< 0,05). Os intervalos QT e QTc eram semelhantes entre grupos. Determinou-se que os níveis elevados de frequência cardíaca, cálcio, dímero-D, NT-proBNP e PCR-as eram significativamente relacionados a Tpe, Tpe/QT e Tpe/QTc. Conclusões: Em pacientes com COVID-19 e pneumonia grave, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc, que estão entre os parâmetros de repolarização ventricular, foram aumentados, sem prolongação dos intervalos QT e QTc. A partir deste estudo, não podemos definitivamente concluir que as alterações eletrocardiográficas observadas estão diretamente relacionadas à infecção por COVID-19 ou à inflamação, mas sim associadas a cenários graves de COVID-19, que podem envolver outras causas de inflamação e comorbidades.

Abstract Background: There is no study evaluating the Tpeak-Tend (Tpe) interval, Tpe/QT ratio, and Tpe/QTc ratio to assess cardiac arrhythmias in patients with COVID-19. Objective: We aimed to examine whether there is a change in QT, QTc, Tpe interval, Tpe/QT ratio, and Tpe/QTc ratio in patients with COVID-19. Methods: The study included 90 patients with COVID-19 infection and 30 age-and-sex-matched healthy controls. QT, QTc, Tpe interval, Tpe/QT ratio, and Tpe/QTc ratio were measured. The participants included in the study were divided into the following 4 groups: healthy controls (group I), patients with COVID-19 without pneumonia (group II), patients with COVID-19 and mild pneumonia (group III), and patients with COVID-19 and severe pneumonia (group IV). Statistical significance was set at p < 0.05. Results: It was found that baseline heart rate, presence of hypertension and diabetes, white blood cell count, blood urea nitrogen, creatinine, potassium, aspartate aminotransferase, alanine aminotransferase, NT-proBNP, high sensitive C reactive protein, D-dimer, hs-cTnI, Tpe, Tpe/QT, and Tpe/QTc increased from group I to group IV, and they were significantly higher in all patients in group IV (p < 0.05). Systolic-diastolic blood pressure, hemoglobin, and calcium levels were found to be lowest in group IV and significantly lower than in other groups (< 0.05). QT and QTc intervals were similar between groups. It was determined that increased heart rate, calcium, D-dimer, NT-proBNP and hs-CRP levels were significantly related to Tpe, Tpe/QT, and Tpe/QTc. Conclusions: In patients with COVID-19 and severe pneumonia, Tpe, Tpe/QT ratio, and Tpe/QTc ratio, which are among ventricular repolarization parameters, were found to be increased, without prolonged QT and QTc intervals. In this study, we cannot definitively conclude that the ECG changes observed are directly related to COVID-19 infection or inflammation, but rather associated with severe COVID-19 scenarios, which might involve other causes of inflammation and comorbidities. (Arq Bras Cardiol. 2020; 115(5):907-913)

Diabetes insípida nefrogénica inducida por litio: reporte de 2 casos en niños con trastorno del ánimo / Lithium-induced Nephrogenic Diabetes Insipidus: Report of 2 Cases in Children with Mood Disorder

La diabetes insípida (DI) es un síndrome caracterizado por poliuria y polidipsia asociado a la producción crónica de grandes volúmenes de orina diluida, secundario a una disminución de la secreción o acción de la hormona antidiurética (ADH) [1]. El litio es el principal fármaco implicado en la inducción de esta patología cuando se presenta de forma secundaria. [2]. Se presentan 2 reportes de casos de niños de 10 y 12 años con uso de litio por diagnóstico de trastorno del ánimo. Palabras Clave: Diabetes Melitus, trastornos del ánimo, nefrogénica, litio, hormona antidiurética

Diabetes insipidus (DI) is a syndrome characterized by polyuria and polydipsia associated with the production of large volumes of diluted urine, secondary to a decrease in the secretion or action of antidiuretic hormone (ADH) [1]. Lithium is the main drug involved in the induction of this pathology when it appears with a preventable cause [2]. Two case reports of children 10 and 12 years old with mood disorder and lithium use are presented with the intention of being alert to clinical manifestations and observation by caregivers.Key words: Diabetes insipidus, mood disorders, nephogenic, lithium, antidiuretic hormone.

A comparative evaluation of total antioxidant capacity of saliva in children with and without Gingivitis

Gingivitis is a reversible and non-destructive form of periodontal disease. Oxidative stress contributes in the pathogenesis of periodontal diseases5. The oxidative stress has been implicated as one of the important contributory etiologic factors in many of the oral inflammatory pathologies including gingivitis. This research analyzed the "Total antioxidant capacity" (TAC) of biological fluids including saliva. The present cross-sectional study was conducted to evaluate the total antioxidant capacity (TAC) of saliva in children with/ without gingivitis and its relation with Age and Gender. For measuring the TAC of saliva: Cayman's Antioxidant Assay Kit was used and Gingival Index Measured through The Gingival Index (Löe and Silness, 1963). The results were analyzed using descriptive statistics and making comparisons between cases and control by using SPSS software version 20. In this result, mean TAC of saliva in case children group was found lower 0.203 ± 0.053 compared to control children group was higher 0.236 ± 0.048. While, in male and female children of aged 3-5 years were found antioxidant activity (TAC) lower in compared to control groups. But among males aged 6-13 years it was found that the mean antioxidant capacity of saliva in case group was 0.259 ± 0.040 while in control group it was 0.295 ± 0.026. The TAC of saliva in males was found high compared to female. A weak negative correlation was found between the TAC and gingival index. In conclusion TAC decreases in children with gingivitis compared to healthy children. The gingivitis was more observed in female leading to lower TAC value

Association of GLUT-1 (XbaI) Gene Polymorphism in Diabetes and Diabetes Nephropathy Patients of North Indian Population

Diabetic nephropathy (DN) is a chronic complication of both type 1 and type 2 diabetes. However, there is still inadequate understanding of the exact mechanism related to progressive diabetic renal disease. The GLUT-1 XbaI gene polymorphism in the glucose transporter has been suggested in the development of DN. However, its association with T2DM and DN is controversial and has not been established in different ethnic populations. To enhance the understanding of GLUT-1 XbaI gene polymorphism in the context of T2DM and DN. We investigated the possible genetic association of GLUT-1 XbaI polymorphism with T2DM and DN in North Indian population. 100 T2DM patients and 100 patients of DN with 100 healthy controls were included in the study. GLUT-1 XbaI polymorphism was determined by PCR (polymerase chain reaction) and RFLP (restriction fragment length polymorphism). The obtained data showed no significant association between GLUT-1 XbaI gene polymorphism with T2DM and DN leading us to conclude that GLUT-1 XbaI gene polymorphism may not have major effects on T2DM and DN in North Indian population.

Correlation of Serum and Urine Sialic Acid Levels with Lipid Profile and Anthropometric Indices in Type 2 Diabetes Mellitus and Diabetic Nephropathy

Introduction:Sialic acid is a component of vascular cell membranes; the elevated levels indicate excessive vascular damage leading to diabetic complications. Therefore sialicacid can be considered to be newly established potential risk factor for the development of diabetic nephropathy. Aims:To study the correlation between sialic acid levels with lipid profile and anthropometric variables in type 2 diabetes mellitus and type 2 diabetics with nephropathy. Study Design:Case control study Place and duration of study: study was conducted at department of biochemistry and department of medicine at aj institute of medical sciences, mangalore for a period of 2 years.Methodology:Study population included 75 subjects in the age group of 40-70 years out of whom 25 subjects were type 2 diabetics (newly diagnosed or known diabetics on treatment without any complications), 25 subjects were type 2 diabetics with nephropathyand 25 were age andsex matched normal controls. Serum and urine sialic acid, lipid profile and anthropometric variables were measured in study subjects

Influence of peer support on blood glucose management of type 2 diabetic patients / 中国基层医药

Objective To explore the influence of peer support on blood glucose management of type 2 diabetic patients.Methods From April 2017 to December 2017,the study subjects were selected according to the inclusion criteria from all type 2 diabetes patients who admitted in the Fourth People′s Hosipital of Ningbo.The patients in bed 1-9 were assigned into observation group,and patients in bed 10-20 were assigned into control group.All beds were assigned randomly from a random number generator.Standard diabetes education was provided to both two groups,while peer support was added to the experimental group.The average hospitalization costs and length of hospital stay were compared between the two groups using t-test.Results The average hospitalization cost of the observation group was(6218.48 ±1432.75)yuan,which of the control group was(6913.32 ±1426.34)yuan,the average hospitalization time of the observation group was(6.49 ±1.91)d,which of the control group was(7.41 ±1.99)d,the differences between the two groups were significant(t=-4.480,-4.347,all P<0.01).Conclusion Application of peer support to the glucose management in patients with type 2 diabetes can effectively enhance education effect and reduce hospitalization cost and length of hospital stay.

Perfil dos pacientes obesos no primeiro atendimento em Ambulatório de Nutrologia Municipal de Ribeirão Preto (SP) / Profile of obese patients in first care in the Ambulatory of Nutrology of Ribeirão Preto (SP)

Objetivo: levantar o perfil dos pacientes com diagnóstico de obesidade, no primeiro atendimento no Ambulatório de Nutrologia Municipal de Ribeirão Preto -SP, de outubro de 2008 a dezembro de 2013. Método: trata-se de um estudo transversal, retrospectivo e descritivo, com levantamento dos dados de prontuários dos pacientes com diagnóstico de obesidade. Resultados: total de pacientes 1386, sendo 71,7% do sexo feminino e 28,3% masculino; 8,0% crianças, 19,8% adolescentes, 63,7% adultos e 8,5% idosos que, respectivamente, têm Hipertensão Arterial Sistêmica, 0,9%, 3,6%, 49,9% e 83,9%; Diabetes Mellitus tipo 2, 0%, 0%, 19,3% e 47,5%; Dislipidemia 83,8%, 81,1%, 33,3% e 39,8%; não utilizavam medicamentos 83,3%, 69,8%, 21,4% e 5,1%; e usavam 5 ou mais medicamentos, 0%, 0%, 17,5% e 51,7%; não consumiam refrigerante, 4,5%, 6,5%,13,6% e 16,1% e consumiam diariamente 41,4%, 40,7%, 33,7% e 19,5%; não praticavam atividade física, 41,4%, 41,4%,78% e 78% e praticavam 5 a 7x/semana, 1,8%,10,2%, 8,1% e 4,2%; consumiam álcool, 0%, 5,5%, 38,8% e 23,7%; eram tabagistas, 0%, 1,1%, 11,9% e 0,8% e pararam de fumar 0%, 0%, 16,9% e 30,5%. Dos adultos 12,5% eram obesos grau I e dos idosos, 15,3% e, respectivamente, grau II, 21,3% e 20,3% e grau III, 66,2% e 64,4%. Conclusão: houve maior procura do sexo feminino pelo serviço, prevalência elevada de comorbidades e hábitos potencialmente modificáveis que podem ser relevantes tanto na prevenção quanto no tratamento da obesidade. (AU)

Objective: bring up the profile of patients diagnosed with obesity, in first care in the Ambulatory of Nutrology of Municipal Board of Ribeirão Preto (RP), from October 2008 to December of 2013. Method: this is a cross-sectional, retrospective and descriptive study based on survey data from medical records of patients diagnosed with obesity. Results: this study was conducted with 1386 patients data, 71,7% female and 28,3% male; 8% being children, 19.8% adolescents, 63.7% adults and 8.5% elderly and respectively have Systemic Arterial Hypertension, 0.9%, 3.6%, 49.9% and 83.9%; type 2 Diabetes Mellitus, 0%, 0%, 19.3% and 47.5%; Dyslipidemia, 83.8%, 81.1%, 33.3% and 39.8%; do not use any medicines, 83.3%, 69.8%, 21.4% and 5.1% and use 5 or more medicines, 0%, 0%, 17.5% and 51.7%; do not consume soft drinks, 4.5%, 6.5%, 13.6% and 16.1% and consume soft drinks on a daily basis, 41.4%, 40.7%, 33.7% and 19.5%; do not practice physical activity, 41.4%, 41.4%, 78% and 78% and practice 5-7 times a week, 1.8%, 10.2%, 8.1% and 4.2%; consume alcoholic drinks, 0%, 5.5%, 38.8% and 23.7%; are smokers, 0%, 1.1%, 11.9% and 0.8% and quit smoking, 0%, 0%, 16.9% and 30.5%. In the adult group, 12.5% are class I obese and in the elderly group, 15.3% and respectively class II, 21.3% and 20.3% and class III, 66.2% and 64.4%. Conclusion: there was a prevalence of females in demand for the medical care service, the increase of comorbidities is significant and potentially modifiable habits may be relevant both for the prevention and the treatment of Obesity (AU)

Feasibility of umbilical cord blood stem cell transplantation for the treatment of diabetic lower limb ischemia / 中国组织工程研究

BACKGROUND:Diabetic lower limb ischemia is prone to involve distal lower limb arteries, and a conventional treatment is often unable to obtain the ideal effect. OBJECTIVE:To investigate the effect and safety of umbilical cord blood stem cel transplantation in the treatment of diabetic lower limb ischemia. METHODS: A diabetic rat model of lower limb ischemia was established, and along the femoral artery, five points were selected for injection of human umbilical cord mesenchymal stem cel suspension, 20 μL per point. At 1, 2, 4 weeks after transplantation, transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region, and incidence of adverse reactions were recorded. RESULTS AND CONCLUSION:At 1, 2 and 4 weeks after transplantation, the transcutaneous oxygen pressure, vascular density and vascular endothelial growth factor level in the ischemic region were found increasing, which were significantly different from those before transplantation (P < 0.05). At different time after transplantation, al animals had no inflammatory reactions such as skin bleeding and dermatitis, and local red, sweling, hot, pain, and had no tumor-like growth in organs. These findings indicate that umbilical cord blood stem cel transplantation can safely and significantly improve symptoms of diabetic lower limb ischemia, which has certain application feasibility. Cite this article:Xie LH, Xing L, Zheng H. Feasibility of umbilical cord blood stem cel transplantation for the treatment of diabetic lower limb ischemia. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):78-82.

Diabetes mellitus aggravates cerebral ischemia-reperfusion injury in rats by inflammatory response / 国际脑血管病杂志

Objective To investigate the roles of tumor necrosisfactor-α(TNF-α) and nuclear factor-κB (NF-κB) in cerebral ischemia-reperfusion injury in rats w ith diabetes mel itus. Methods Thirty-six healthy male Sprague-Daw ley rats w ere divided into a euglycemic sham operation group, a euglycemic isc hemia-reperfusion group, and a diabetes ischemia-reperfusion group (n=12 in each group) according to a random number table. A diabetes model w as induced by intraperitoneal injection of streptozotocin, and then a focal cerebral ischemia-reperfusion model w as induced by the suture method. The neurological deficit score was performed at 24 h after reperfusion. 2,3,5 triphenyl tetrazolium staining was used to measure the cerebral infarction area. Western blotting w as used to detect the expression levels of NF-κB and TNF-αon the ischemic sides. Results The neurological function scores w ere 0.00 ±0.00, 2.50 ±1.08, and 3.20 ± 1.03, respectively in the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups, and there w ere significant differences (F=38.015, P<0.001). The neurological deficit scores of the diabetes cerebral ischemia-reperfusion group w ere significantly aggravated compared with the euglycemic cerebral ischemia-reperfusion group (P<0.05). The infarct areas of the euglycemic sham operation, euglycemic cerebral ischemia-reperfusion and diabetes cerebral ischemia-reperfusion groups w ere 0.00% ±0.00%, 33.09% ±5.17%, and 55.45% ±9.29%, respectively, and there w ere significant differences among the groups (F=206.614, P<0.001), in w hich the infarct area in the diabetes cerebral ischemia-reperfusion group w as enlarged significantly compared w ith the euglycemic cerebral ischemia-reperfusion group ( P< 0.05 ). At 24 h after reperfusion, there w ere no significant differences in the expression levels of the cortical NF-κB (F=29.993, P<0.001) and TNF-α(F=28.722, P<0.001) on the ischemic sides in each group, in w hich the expression levels of NF-κB and TNF-αin the diabetes cerebral ischemia-reperfusion group w ere increased significantly compared w ith the euglycemic cerebral ischemia-reperfusion group (al P<0.05). Conclusions Diabetes may aggravate cerebral ischemia reperfusion injury. The upregulated expression of TNF-αand NF-κB may be one of the mechanisms of diabetes aggravating cerebral ischemia-reperfusion injury.

Effect of interleukin-10 gene on liver pancreatic and duodenal homeobox 1 expression in nonobese diabetic mice / 中国组织工程研究

BACKGROUND:Studies have found that liver cels can synthesize insulin after giving pancreatic and duodenal homeobox 1 (PDX1) gene. Anti-CD20 monoclonal antibody can inhibit the immune reaction of insulin-producing liver cels, but the mechanism is unclear. OBJECTIVE:To observe the influence of interleukin-10 gene on liver cels and liver PDX1 expression in nonobese diabetic mice after interfered by adenovirus vector-mediated murine interleukin-10 and anti-CD20 monoclonal antibody. METHOD:Forty nonobese diabetic female mice aged 3-5 weeks were randomly divided into anti-CD20, anti-CD20 + interleukin-10, interleukin, and control groups. Mice in each group were respectively injected with anti-CD20 monoclonal antibody, anti-CD20 monoclonal antibody + adenovirus vector-mediated murine interleukin-10, adenovirus vector-mediated murine interleukin-10 and normal saline on days 1, 8, 15 and 21via tail vein. RESULTS AND CONCLUSION:At 12 weeks, the blood glucose level of mice treated with anti-CD20 monoclonal antibody and/or interleukin-10 was significantly reduced compared with the control group, while the insulin, interleukin-10 and CD20 expression levels in the serum and liver were significantly increased, the liver PDX1 expression was also upregulated. Anti-CD20 monoclonal antibody with interleukin-10 had more obvious effects than the single use. No matter the combined intervention or single use, anti-CD20 monoclonal antibody and interleukin-10 show no impact on the inflammation of liver cels. Anti-CD20 monoclonal antibody and/or interleukin-10 increases PDX1 expression in nonobese diabetic mice.

Human telomerase reverse transcriptase transfection of bone marrow mesenchymal stem cells in the treatment of diabetic rats / 中国组织工程研究

BACKGROUND:Human telomerase reverse transcriptase (hTERT) is the first choice for regulating the proliferation and directional differentiation, with multiple biological effects. OBJECTIVE:To observe the therapeutic effect of hTERT-transfected bone marrow mesenchymal stem cels transplantation in diabetic rats. METHODS: Bone marrow mesenchymal stem cels from Sprague-Dawley rats were culturedin vitro and transfected with retrovirus PLXSN carrying hTERT. RT-PCR was used to detect the hTERT expression in the bone marrow mesenchymal stem cels before and after transfection. Sixty male Sprague-Dawley rats were selected and equaly randomized into four groups: normal control group, transfection group, cel transplantation group, and model group. In the latter three groups, rats were injected with 45 mg/kg chain urea to establish diabetes models, and then injectedvia the tail vein with 0.2 mL hTERT-transfected bone marrow mesenchymal stem cels, 0.2 mL bone marrow mesenchymal stem cels, and 0.2 mL normal saline, respectively. RESULTS AND CONCLUSION:At 48 hours after hTERT transfection, the expression of hTERT mRNA was detected in the bone marrow mesenchymal stem cels, and mainly concentrated in the nuclei. At 14 days after transfection, the fasting glucose level in the model group was higher than that in the normal control group (P 0.05). These findings indicate that the transplantation of hTERT-transfected bone marrow mesenchymal stem cels is effective in the treatment of diabetic rats.

Diabetic ketoacidosis and stroke in children / 国际脑血管病杂志

Up to 80% of type 1 diabetes melitus children present with diabetic ketoacidosis (DKA). Stroke in children with DKA children is uncommon but life-threatening. Various types of stroke, such as ischemic, cerebral venous thrombosis, and hemorrhagic stroke were observed in children with DKA. In this article, we review the literatures regarding stroke in children with DKA.

Stability of a rat model of type 2 diabetic mellitus induced by streptozotocin combined with high-fat feeding and its eye disease characteristics / 中国组织工程研究

BACKGROUND:Streptozotocin-induced diabetic ophthalmopathy is commonly used in animal models, but the pathological changes are local that mainly emphasize on the retina. Little evidence is found about the animal models of the pathology of diabetic ophthalmopathy. OBJECTIVE:To investigate the long-term stability of type 2 diabetic melitus rat models induced by streptozotocin combined with high-fat feeding and to observe the characteristics of eye disease. METHODS: Rats were randomly divided into control group and diabetes group. Control group was given normal feeding, while diabetes group was given intraperitoneal injection of streptozotocin combined with high-fat feeding to establish diabetic models. RESULTS AND CONCLUSION:Compared with the control group, at 1 month after modeling, the fasting blood glucose levels increased, and the insulin sensitivity index decreased in the diabetic group (P < 0.05). Evans blue staining results showed that, at 3 months after modeling, retinal cel lesions exacerbated in the diabetic group; at 5 months after modeling, retinal blood vessels traveled in circuity and disorderly, accompanied by the leakage in the diabetic group, Evans blue content in the retina increased as the time after modeling went by (P < 0.05). Under transmission electron microscopy, at 5 months after modeling, the eye lenses in the diabetes group were flocculent pieces, which were the typical characteristics of cataract. Experimental findings indicate that the rat model of type 2 diabetic melitus induced by streptozotocin combined with high-fat feeding has a long-term stability, and its eye changes are consistent with the characteristics of diabetic ophthalmopathy. Therefore, it is an ideal animal model for diabetic ophthalmopathy.

Animal models of nutritional induction of type 2 diabetes mellitus / Modelos animales de inducción nutricional para diabetes mellitus tipo 2

Type 2 diabetes mellitus (DM2) is the most common chronic metabolic disease, affecting approximately 6% of the adult population in the Western world. This condition is a major cause of cardiovascular disease, blindness, renal failure, and amputations, with increasing prevalence worldwide. The inuence of obesity on type 2 diabetes risk is determined by the degree of obesity and by body fat localization, with insulin resistance (IR) being the main link between these metabolic diseases. Experimental studies have shown that dietary factors, and particularly lipids, are strongly positively associated with body mass (BM) gain; IR; and, consequently, type 2 diabetes. Similarly, excessive consumption of energy-dense carbohydrate-rich foods can trigger the onset of type 2 diabetes. Additionally, maternal dietary inadequacies at conception and/or during the gestational period have been proposed to lead to developmental programming of excessive BM gain and metabolic disturbances in offspring, such as abnormal glucose homeostasis, reduced whole-body insulin sensitivity, impaired beta-cell insulin secretion and changes in the structure of the pancreas. Metabolic disruption is strongly associated with deleterious effects on beta-cell development and function. However, alterations in the amount and quality of dietary fat can modify glucose metabolism and insulin sensitivity. In this way, certain oils have gained attention in experimental research for their beneficial effects. Olive oil, a source of monounsaturated fatty acids (MUFAs), got attention in the past for its capacity to prevent cardiovascular diseases. Nevertheless, it is currently known that this oil also improves insulin sensitivity and glycemic control. Canola oil, flaxseed oil and especially fish oil (rich in n-3 polyunsaturated fatty acids) were first described as effective dietary nutrients against hypertriglyceridemia but now are known to have positive effects on glucose metabolism as well.

La diabetes mellitus tipo 2 (DM2) es la enfermedad metabólica crónica más común, afectando aproximadamente al 6% de la población adulta en el mundo occidental. Esta condición es una causa importante de las enfermedades cardiovasculares, la ceguera, la insuficiencia renal, y las amputaciones, con un aumento de su prevalencia en todo el mundo. El riesgo de obesidad en la diabetes tipo 2 está determinado por el grado de obesidad y localización de la grasa corporal, siendo la resistencia a la insulina (RI) la principal relación entre estas enfermedades metabólicas. Los estudios experimentales han demostrado que los factores dietéticos, y en particular los lípidos, se asocian de manera importante con la masa corporal (MC), la IR y la diabetes tipo 2. Asimismo, el consumo excesivo de alimentos ricos en carbohidratos de alto contenido energético pueden provocar la diabetes tipo 2. Además, se ha sugerido que una dieta materna inadecuada al momento de concebir o durante el período de gestación daría lugar al desarrollo de la excesiva MC y de trastornos metabólicos en los hijos, tales como la homeostasis anormal de la glucosa, reducción de la sensibilidad a la insulina en todo el cuerpo, el deterioro en la función de células beta, resistencia a la insulina y cambios en la estructura del páncreas. La alteración metabólica está asociada de forma importante con los efectos dañinos sobre el desarrollo y función de las células beta. Sin embargo, las alteraciones en la cantidad y la calidad de la grasa dietética pueden modificar el metabolismo de la glucosa como también la sensibilidad a la insulina. De esta manera, la investigación experimental ha enfocado la atención en algunos aceites debido a sus efectos beneficiosos. El aceite de oliva, es una fuente de monoinsaturados y actualmente se sabe que este aceite también mejora la sensibilidad a la insulina y el control glucémico El aceite de canola, el aceite de linaza y especialmente el aceite de pescado (rico en omega-3 los ácidos grasos poliinsaturados (PUFAs)) fueron descritos por primera vez como nutrientes de la dieta eficaces contra la hipertrigliceridemia, sin embargo, es sabido que además tienen efectos positivos sobre el metabolismo de la glucosa.

Umbilical cord mesenchymal stem cell transplantation for the treatment of diabetes mellitus in rats / 中国组织工程研究

BACKGROUND:Umbilical cord mesenchymal stem cels have strong proliferation and differentiation capacities, and can be induced to differentiate into pancreatic β cels, thereby playing a therapeutic effect on diabetes mel itus. OBJECTIVE:To study the therapeutic effects of transplantation of umbilical cord mesenchymal stem cels for treatment of diabetes melitus in rats. METHODS: Thirty male Sprague-Dawley rats were randomly divided into control group (n=6), transplantation group (n=12) and diabetic group (n=12). Rats in the control group were given normal saline injection. Rats in the other two groups were injected with streptozotocin at a dose of 45 mg/kg to establish diabetic models. After modeling, transplantation of umbilical cord mesenchymal stem celsviatail vein was given in the transplantation group. RESULTS AND CONCLUSION:Thirty days after modeling, the fasting blood glucose was maintained at a higher level in comparison with the control group (P 0.05), but in the diabetic group, the fasting blood glucose level was stil higher and the body mass continued to decrease. These findings indicate that the transplantation of umbilical cord mesenchymal stem cels can be effective in the treatment of diabetes melitus in rats.

Angiotensin II-transient receptor potential channel C6 signaling pathway mediates podocyte injury / 中国组织工程研究

BACKGROUND:Transient receptor potential channel C6 (TRPC6) is a new and important slit diaphragm-associated protein in podocytes involved in regulating glomerular filter function. Glomerular TRPC6 expression is closely associated with proteinuria in diabetic kidney disease. OBJECTIVE: To investigate the expression of canonical TRPC6 in mouse podocytes induced by high glucose, and to explore the possible mechanism of diabetic kidney disease. METHODS:Mouse podocyte cels were cultured and divided into normal glucose group (5.6 mmol/L D-glucose), normal control group (5.6 mmol/L D-glucose+25 mmol/L mannitol) and experimental groups which were in the environment of high glucose (30 mmol/L). The experimental groups included high glucose group, valsartan treatment groups (10-5 mol/L) and U73122 control group (10μmol/L U73122). After 48 hours, the expressions of mRNA and proteins of TRPC6, nephrin and angiotensin II (AngII) were detected respectively by real-time quantitative PCR and western blot analysis. RESULTS AND CONCLUSION:Compared with the normal control group, the expressions of mRNA and proteins of TRPC6 and angiotensin II were markedly elevated in the high glucose group (P 0.05). Angiotensin II-TRPC6 signaling pathway may mediate high glucose-induced podocyte injury, meanwhile it provides a new theoretical basis for the treatment of diabetic kidney disease, by which the angiotensin receptor blockers can protect podocytes in diabetic kidney disease.

Tratamento periodontal em pacientes com diabetes mellitus tipo 1 e tipo 2: caso clínico / Periodontal treatment in patients with diabetes mellitus type 1 and type 2: Case report

Introdução: é comprovado o papel do diabetes mellitus (DM) na patogenia da doença periodontal, havendo entre as duas condições uma relação bidirecional na resposta inflamatória. Pacientes portadores de diabetes mellitus com descontrole glicêmico apresentam quadro periodontal inflamatório exacerbado, observando-se, também, maior dificuldade de controle metabólico. Os tipos 1 e 2 do diabetes mellitus tem suas peculiaridades e diferenças clínicas, tanto para o controle glicêmico como para a terapia periodontal. Objetivo: apresentar dois casos clínicos de pacientes com diabetes e doença periodontal, sendo um referente a uma paciente portadora de diabetes mellitus tipo 1 e outro de um paciente portador de diabetes mellitus tipo 2. Conclusão: o resultado pós-operatório de ambos demonstrou resolução da inflamação periodontal, observando-se ausência de bolsas periodontais, supuração e sangramento à sondagem. No entanto, a abordagem clínica para cada uma das formas de diabetes foi individualizada. O uso de antibióticos sistêmicos concomitante à terapia mecânica foi necessário apenas no caso de diabetes Tipo 1.

Introduction: It is unquestionable the influence of diabetes mellitus (DM) on the pathogenesis of periodontaldisease. Both conditions have got a bidirectional relation on the inflammatory response. Patients with diabetes mellitus and without a proper metabolic control show a worse status of the periodontal disease and also more difficult in the glicemic control of DM. Types 1 and 2 of DM have their particularities and clinical differences related to the metabolic control or to the periodontal therapy. Objective: This paper reports two cases of patients with diabetes mellitus and periodontal disease, being one of DM type 1 and the other of DM type 2. Conclusion: The post-operatory result showed resolution of the periodontal inflammation in both cases. After therapy, there were no periodontal pockets nor suppuration or bleeding on probing. However,the clinical management of both forms of DM was individualized. The use of systemic antibiotics associated to periodontal therapy was necessary only for the patient with type 1 DM.

Characteristics of pharmaceutical drugs' profile used by diabetic 2 patients from Bauru's diabetics association (BDA), regarding to class, frequency of use, associations and interactions / Características do perfil dos medicamentos usados por pacientes com diabetes 2 da Associação dos diabéticos de Bauru (BDA), em relação à classe, freqüência de uso, associações e interações

Introduction: Diabetes mellitus (DM) is a chronic disease caused by genetic, metabolic and/or acquired factors that cause insulin deficiency or resistance that result in hyperglycemia. Objective: to characterizing pharmaceutical drugs profile in that concerns the frequency of use, pharmacological classes and possible associations and interactions Method: This prospective study was done by applying a questionnaire to 62 individuals with diabetes mellitus 2 (DM2) that have been watched by educational activities at Bauru's Diabetics Association (BDA. ATC classification (Anatomical Therapeutic Classification/2008) was used for pharmaceutic drug classification. Results:The group A (alimentary tract and metabolism) showed to be the most used (54%), followed by group C (cardiovascular) (33%). Metformin (52%) and glyburide (25%) were the most used oral hypoglycemic agents (OHA), with only 10% being in use of insulin, alone or associated with other drugs. Metformin was the most used in multiple therapies. Discussion: Although the assessment of pharmacotherapeutic follow-up of patients were observed 23 potential drug interactions between combinations of drugs used.The need of different therapies for DM2 is justified by the occurrence of other com orbidities such as hypertension, obesity and dyslipidemia. However, in many cases, the use of all these drugs together can lead to drugs interactions deteriorating patient's quality of life. Conclusion: the multidisciplinary team approach is to be aware of the prescribed drugs to DM2 and teach them the correct use these drugs in such a way that patient's quality of life not be endangered or worsened.

Introdução: Diabetes mellitus (DM) é uma doença crônica causada por fatores genéticos, metabólicos e / ou adquiridas que causam deficiência de insulina ou resistência que resultam em hiperglicemia. Objetivo: caracterizar o perfil de drogas farmacêuticas, no que diz respeito à frequência de uso, classes farmacológicas e possíveis associações e interações. Metodologia: este estudo prospectivo foi realizado com a aplicação de um questionário a 62 indivíduos com diabetes 2 (DM2) que compareceram às atividades educativas da Associação de Diabéticos de Bauru (ADB). A Classificação ATC (Anatomical Therapeutic chemical/ 2008) foi utilizada para a classificação das drogas farmacêuticas. Resultados: drogas do grupo A (trato digestivo e metabolismo) mostrou ser a mais utilizada (54%), seguidos pelos do grupo C (cardiovascular) (33%). Metformina (52%) e glibenclamida (25%) foram os hipoglicemiantes orais mais utilizados, com apenas 10% em uso de insulina, isoladamente ou associados a outras drogas. A metformina foi a mais utilizada em terapias múltiplas. Discussão: na avaliação do seguimento farmacoterapêutico dos pacientes foram observadas 23 interações medicamentosas potenciais entre as combinações de medicamentos utilizados. A necessidade de diferentes terapias de DM2 é justificada pela ocorrência de outras co-morbidades como hipertensão, obesidade e dislipidemia. No entanto, em muitos casos, a utilização de todas estas drogas em conjunto, podem levar a interações de drogas que deterioram a qualidade de vida do paciente. Conclusão: a abordagem da equipe multidisciplinar consiste em estar consciente dos medicamentos prescritos para DM2 e ensinar o uso correto deles de tal forma que a qualidade de vida do paciente não tenha riscos ou piora.

Conhecimento dos alunos de graduação da FOP/UPE em relação à indicação de anestésicos locais para pacientes especiais / FOP/UPE´S graduation students knowledge about local anaesthetics indications to special patients

Objetivo: verificar e analisar o conhecimento dos alunos de graduação, nas clínicas da Faculdade de Odontologia de Pernambuco, em relação às indicações de anestésicos locais em pacientes especiais. Material e métodos: foi realizado um estudo prospectivo, transversal, aplicando-se questionários aos alunos de graduação do 6º ao 9º períodos da Faculdade de Odontologia de Pernambuco – FOP/UPE, em atendimento nas clínicas da faculdade a fim de verificar e analisar seu conhecimento em relação à dosagem e indicações de anestésico local, nos diversos procedimentos constituintes da prática odontológica. Resultados: após a análise da amostra total de 176 alunos, verificou-se que quando questionados sobre indicação de sal anestésico de primeira escolha para pacientes diabéticos, asmáticos, com hipertireoidismo e usuários de medicamentos antidepressivos, a resposta “Não sabe” esteve predominante, variando entre 38,1 a 85,2%, sendo um mínimo percentual de acertos para cada um dos grupos de pacientes. Conclusões: tais resultados denotam falta de preparo por parte dos alunos sobre conhecimentos teóricos e práticos da anestesiologia aplicada à pacientes com necessidades especiais. Uma maior atenção deve ser dada ao tema, dada sua importância e relevância dentro da prática clínica diária do cirurgião dentista.

Aim: to verify and analyze the graduation students knowledge, at FOP/UPE’s clinics, related to local anesthetics indications for special patients. Material and methods: in a transversal prospective study, questionnaires were asked to the FOP/UPE`s 6th to 9th periods graduation students, attending on the college clinics, in order to verify and analyze their answers about local anesthetics dosages and indications, in the dentistry practice main procedures. Results: after the 176 students data analysis, it was verified that when questioned about local anesthetics indications for patients with diabetes, asthma, hyperthyroidism and antidepressants users, the answer “don´t know” was most prevalent, varying between 38,1 and 85,2%. Conclusions: such results suggest lack of prepare of the students on theoretical and practical anesthesiology information applied to patients with special conditions. A better attention must be given to the theme, once its importance and relevance on the dentist clinical daily practice.

Uso de papaina no tratamento de lesões ulcerativas de pacientes portadores de pé diabético: relato de cinco casos / Use of the papaine in the treatment of injuries ulceratives of patients with diabetic foot

Objetivo: testar os efeitos cicatrizantes e debridantes de soluções de papaína a 2%, 4%, 6% e 10% sobre lesões dopé diabético. Método: foram estudados cinco pacientes de ambos os sexos, com feridas de etiologias variadas, nãoresponsivas ao tratamento convencional, internados no Hospital Universitário João de Barros Barreto da UFPA, Belém -Pará. Resultados: a papaína mostrou-se capaz de promover a debridação e estimular a cicatrização tecidual com baixoscustos e efeitos colaterais. Considerações finais: a escolha deste tratamento foi capaz de reduzir o risco de amputaçãodos membros acometidos

Objectives: test the healing and debriding effects of 2%, 4%, 6% and 10% papaine solutions on diabetic foot lesions.Methods: Five patients (males and females) were included in the study; they had wounds of varied etiology, werenot responsive to conventional therapy, and were hospitalized in the Hospital Universitário João de Barros Barretoda UFPA, in Belém, Pará. Results: papaine revealed capable to promote the debriding; it stimulated tissue healing, atlow cost and with few collateral affects. Conclusions: choice of this treatment can reduce the risk of amputate affectedmembers.