Marcadores de estrés oxidativo en pacientes con esclerosis múltiple durante un brote y su remisión / Oxidative stress markers in patients with multiple sclerosis during an outbreak and its remission / Marcadores de estresse oxidativo em pacientes com esclerose múltipla durante um surto e sua remissão

La esclerosis múltiple remitente-recurrente (EM-RR) es una enfermedad desmielinizante del sistema nervioso central. A fin de entender la asociación del estrés oxidativo a nivel periférico con la recaída de la enfermedad se determinaron los niveles de marcadores de estrés oxidativo en plasma de pacientes en la recaída o brote y una semana después de la misma. Se analizaron muestras de 60 personas (20 pacientes con recaída, 20 pacientes sin recaída y 20 controles sanos). Se cuantificaron mediante métodos espectrofotométricos las actividades enzimáticas de óxido nítrico sintasa (ONS), glutatión peroxidasa (GPx), los niveles de lipoperóxidos y nitritos-nitratos y la fluidez de membrana. En el brote de la enfermedad aumentan significativamente los niveles de las actividades enzimáticas de ONS y GPx y los niveles de nitritos-nitratos y lipoperóxidos (p<0,01 en todos los casos), al ser comparados con los de individuos sanos. Dichos parámetros disminuyeron significativamente una semana después de iniciado el brote. Además, los parámetros evaluados se mantuvieron elevados en pacientes que no experimentaron un brote de la enfermedad cuando se los comparó con individuos sanos. La fluidez de membrana en los pacientes con y sin brote fue similar a la de los controles. En conclusión, el estrés oxidativo es un componente importante en los pacientes con esclerosis múltiple.

Recurrent-remitting multiple sclerosis (RR-MS) is a demyelinating disease of the central nervous system. In order to understand the association of oxidative stress at the peripheral level with the relapse of the disease, the levels of oxidative stress markers in plasma of patients in the relapse or outbreak and one week after relapse were determined. Samples of 60 subjects were analyzed (20 patients in relapse, 20 patients without relapse, and 20 healthy controls). The enzymatic activities of nitric oxide synthase (NOS), glutathione peroxidase (GPx), lipoperoxides and nitrite-nitrate levels and membrane fluidity were quantified by spectrophotometric methods. In relapse, the levels of enzymatic activities of NOS and GPx, and the levels of lipoperoxides and nitrites-nitrates were significantly increased (p<0.01, in all cases), compared with healthy individuals. These parameters decreased significantly 1 week after the start of the outbreak. In addition, the parameters evaluated remained high in patients who did not experience an outbreak of the disease compared to healthy subjects. The membrane fluidity in the patients with and without outbreak was similar to that of the controls. In conclusion, oxidative stress is an important component in patients with multiple sclerosis.

A esclerose múltipla recorrente-remitente (EM-RR) é uma doença desmielinizante do sistema nervoso central. Para compreender a associação do estresse oxidativo a nível periférico com a recaída da doença foram determinados os níveis de marcadores de estresse oxidativo em plasma de doentes na recaída ou surto e uma semana após a recaída. Foram analisadas a amostras de 60 pessoas (20 pacientes com recaída, 20 pacientes sem recaída e 20 controles saudáveis). As atividades enzimáticas de óxido nítrico sintase (ONS), glutationa peroxidase (GPX), os níveis de lipoperóxidos e nitritos-nitratos e a fluidez de membrana foram quantificadas por métodos espectrofotométricos. No surto da doença aumentam em forma significativa os níveis da atividade enzimática de ONS e GPX, e os níveis de nitritos-nitratos e lipoperóxidos (p<0,01 em todos os casos), em comparação com os indivíduos saudáveis. Esses parâmetros diminuíram significativamente uma semana após o início do surto. Além disso, os parâmetros avaliados permaneceram elevados em pacientes que não experimentaram um surto da doença quando comparados com indivíduos saudáveis. A fluência de membrana nos pacientes com e sem surto foi semelhante à dos controles. Em conclusão, o estresse oxidativo é um componente importante nos pacientes com esclerose múltipla.

Exposición a nitratos en agua y su relación con disfunción de la glándula tiroides: revisión sistemática ¿Existen riesgos para la salud de la población? / Exposure to nitrates in drinking water and its association with thyroid gland dysfunction

Background: Nitrate exposure may be associated with thyroid gland dysfunction. Aim: To review the available evidence about the relationship between nitrates in drinking water and thyroid gland dysfunction. Material and Methods: A wide search was performed using Medline, Cochrane, Lilacs, IBECS and Scielo databases using pertinent keywords, finding a total of 66 related studies. After filtering and in depth reviewing, a total of 12 studies were included in this review. Results: The main results reveal the importance of this ion for human health, finding evidence both in animals and human beings that suggest pathological changes in the gland as its relationship with the occurrence of subclinical hypothyroidism, and potentially cancer of the thyroid gland. In Chile, nitrate is not considered a critical contaminant so its regular measuring and control is not enforced. Conclusions: In light of the present review we believe that there is evidence to consider nitrate as a critical contaminant whose measurement, registration and correct implementation of valid policies would have a direct benefit for the population of this country. Without this information, it is not possible to quantify the damage to human health, especially in vulnerable groups residing in areas at greatest risk of exposure.

Metahemoglobinemia relacionada con ingesta de puré de acelgas / Methemoglobinemia due to ingestion of chard puree

La metahemoglobinemia es un síndrome clínico dado por la presencia de una forma aberrante de hemoglobina, ocasionada por diversos agentes oxidantes. Se describe un caso clínico de metahemoglobinemia severa asociada a la ingesta de puré de acelgas con alto contenido en nitratos y nitritos. Paciente de un año, con antecedentes de comunicación interauricular (CIA), que presentó un cambio en coloración de la piel 7 h antes, en forma progresiva, acompañado de vómitos. Ingresó al Departamento de Emergencia con cianosis generalizada que no mejoró con oxigenoterapia, taquicardia y tendencia a hipotensión arterial. En cuidados intensivos se realizó ecocardiograma que evidenció CIA sin repercusión hemodinámica. Metahemoglobinemia 37%. Se realizó dosis de azul de metileno al 1% por vía intravenosa, con franca mejoría clínica a la hora de la administración del antídoto y descenso de niveles de metahemoglobina. Alta médica a las 36 horas del ingreso. Existía una relación cronológica entre la exposición a nitratos por ingesta de un puré de acelgas y la aparición del cuadro. Los niveles de nitratos hallados en dicho alimento fueron muy elevados considerando estándares internacionales, lo que sumado a una inadecuada conservación del alimento cocido los días previos, permitió confirmar el planteo etiológico realizado. Resulta importante sospechar esta entidad patológica poco frecuente frente a cianosis que no mejora con oxígeno, y prevenir cuadros similares al descrito mediante una adecuada manipulación y conservación de las verduras con alto contenido en nitratos.

Methemoglobinemia is a clinical syndrome due to the presence of an aberrant form of hemoglobin, caused by various oxidizing agents. The study reports a case of severe methemoglobinemia associated with the ingestion of chard puree with high levels of nitrates and nitrites. A 1-year-old patient with a history of atrial septal defect (ASD), who progressively showed change of skin color 7 hours earlier, accompanied by vomiting. She was admitted to the Emergency Department with generalized cyanosis not improving with oxygen therapy, tachycardia and tendency to hypotension. In the intensive care unit, an echocardiogram showed ASD without hemodynamic complications. Methemoglobinemia 37%. A 1% methylene blue dose was administered intravenously, with clinical improvement one hour after antidote administration and decrease in methemoglobin levels. Medical discharge at 36 hours of admission. There was a chronological relationship between nitrates exposure by ingestion of chard puree and the clinical onset of methemoglobinemia. The toxic cause was confirmed after high nitrates levels were found in this vegetable considering international standards, and an inadequate preservation of the cooked chard on previous days. It is important to suspect this rare pathological entity when cyanosis fails to improve with oxygen, and to prevent poisonings similar to those described by an adequate manipulation and preservation of vegetables with high nitrate levels.

Analysis on the exposure level and geographic distribution trend of toxicological indicators in rural drinking water, Shandong Province, in 2015 / 中华预防医学杂志

Objective@#To analyze the exposure level and the geographical distribution trend of toxicological indicators of rural drinking water in Shandong Province.@*Methods@#The drawing method was used to randomly select no less than 60% villages and towns from 137 counties (cities, districts) of 17 cities in Shandong Province in 2015, and then 1-3 rural centralized water supply units were selected according to the circumstance of rural centralized water supply units in each village and town. In total, 735 villages and towns, 1 473 rural centralized water supply units were selected, and 1 473 water samples were collected. The water treatment process, water supply population and other circumstances of the rural centralized water supply units were investigated, the water quality was monitored, the content of toxicological indicators of drinking water in different areas was compared, and the trend surface isogram of excessive toxicological indicators was drawn.@*Results@#The qualified rate of toxicological indicators in 1 473 water samples was 83.64% (n=1 232). The main toxicological indicators that affected the qualified rate of toxicological indicators of drinking water in rural areas in Shandong Province were nitrate and fluoride. The excessive rate of fluoride was 5.70% (n=84) and the exposed population was 1 736 709 (4.22%). The excessive rate of nitrate (as nitrogen) was 12.29% (n=181) and the exposed population was 1 393 612 (3.39%). The P50 content of fluoride in the eastern, middle and western regions was 0.24, 0.29 and 0.59 mg/L, respective;which was higher in the western region than in the east and the middle regions (P<0.05). There was no significant difference between the eastern and the middle regions (P>0.05). The P50 content of nitrate (as nitrogen) in the eastern, middle and western regions was 8.00, 7.48, and 2.00 mg/L, which was higher in the eastern and middle regions than in the west region (P<0.05), there was no significant difference between the eastern and the middle regions (P>0.05). The trend surface isogram of nitrate and fluoride content showed that the content of nitrate (as nitrogen) in rural drinking water in the eastern region was significantly higher than that in the western region, especially there was a high peak area in the northeastern region, and this high content distribution extended diagonally to the central region, while the other regions were in a relatively low range. The content of fluoride in rural drinking water in the western region was significantly higher than that in the eastern region, and there were high peaks in the southwest and northwest regions, and the other regions were in a relatively low range.@*Conclusion@#The high exposed toxicological indicators in rural drinking water in Shandong Province were nitrate (as nitrogen) and fluoride, and their distribution showed obvious geographical distribution trend.

Uric Acid Level Has a U-shaped Association with Clinical Outcomes in Patients with Vasospastic Angina

No data are available on the association of serum uric acid and vasospastic angina (VSA) which has endothelial dysfunction as a possible pathophysiologic mechanism. Low uric acid level might cause adverse outcomes in VSA in connection with endothelial dysfunction. We enrolled 818 VSA patients whose uric acid level was measured at admission. Patients were categorized according to tertiles of uric acid level: group I, ≤ 4.8 mg/dL; group II, 4.9–5.9 mg/dL; and group III, ≥ 6.0 mg/dL. Primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, acute myocardial infarction (MI), ischemic stroke, coronary revascularization, and rehospitalization for angina. Median follow-up duration was 49.2 months. Median uric acid values were 4.1 mg/dL for group I, 5.4 mg/dL for group II, and 6.7 mg/dL for group III. In the overall population, group II had a significantly lower incidence of MACE compared to group I (47 [17.1%] vs. 66 [24.6%]; hazard ratio [HR], 1.52; 95% confidence interval [CI], 1.02–2.26; P = 0.040) and a tendency of lower incidence of MACEs compared to Group III (47 [17.1%] vs. 62 [22.5%]; HR, 1.44; 95% CI, 0.98–2.13; P = 0.067). Among group I patients, those who received nitrates had a higher incidence of MACEs than those without nitrate therapy (P < 0.001). Low uric acid level was associated with adverse clinical outcomes, while high uric acid level had a trend toward an increase in it. Use of nitrate in patients with low uric acid level might have adverse effects on clinical outcomes of VSA.

Effects of Nitrate Intake on Myocardial Ischemia-Reperfusion Injury in Diabetic Rats / Efeitos do Consumo de Nitrato na Lesão de Isquemia-Reperfusão Miocárdica em Ratos Diabéticos

Abstract Background: Coronary artery disease is 2-3 times more common in diabetic individuals. Dietary nitrate/nitrite has beneficial effects in both diabetes and cardiovascular disease. It also has protective effects against myocardial ischemia-reperfusion (IR) injury in healthy animals. However, the effects of nitrate on myocardial IR injury in diabetic rats have not yet been investigated. Objective: We examined the effects of dietary nitrate on myocardial IR injury in streptozotocin-nicotinamide-induced diabetic rats. Method: Rats were divided into four groups (n=7 in each group): control, control+nitrate, diabetes, and diabetes+nitrate. Type 2 diabetes was induced by injection of streptozotocin and nicotinamide. Nitrate (sodium nitrate) was added to drinking water (100 mg/L) for 2 months. The hearts were perfused in a Langendorff apparatus at 2 months and assessed before (baseline) and after myocardial IR for the following parameters: left ventricular developed pressure (LVDP), minimum and maximum rates of pressure change in the left ventricle (±dP/dt), endothelial nitric oxide (NO) synthase (eNOS) and inducible NO synthase (iNOS) mRNA expression, and levels of malondialdehyde (MDA) and NO metabolites (NOx). Results: Recovery of LVDP and ±dP/dt was lower in diabetic rats versus controls, but almost normalized after nitrate intake. Diabetic rats had lower eNOS and higher iNOS expression both at baseline and after IR, and dietary nitrate restored these parameters to normal values after IR. Compared with controls, heart NOx level was lower in diabetic rats at baseline but was higher after IR. Diabetic rats had higher MDA levels both at baseline and after IR, which along with heart NOx levels decreased following nitrate intake. Conclusion: Dietary nitrate in diabetic rats provides cardioprotection against IR injury by regulating eNOS and iNOS expression and inhibiting lipid peroxidation in the heart.

Resumo Fundamentos: A doença arterial coronariana é duas a três vezes mais comum em indivíduos diabéticos. O nitrato/nitrito dietético tem efeitos benéficos tanto para o diabetes quanto para a doença cardiovascular, assim como efeitos protetores contra a lesão de isquemia-reperfusão (IR) miocárdica em animais saudáveis. Porém, os efeitos do nitrato na lesão de IR miocárdica em ratos diabéticos ainda não foram investigados. Objetivos: Foram examinados os efeitos sobre a lesão de IR miocárdica da adição de nitrato à dieta de ratos com diabetes mellitus tipo 2 induzido por estreptozotocina-nicotinamida. Métodos: Os ratos foram divididos em quatro grupos (n = 7 em cada grupo): controle, controle+nitrato, diabetes e diabetes+nitrato. O diabetes foi induzido nos animais por injeção de estreptozotocina e nicotinamida. Nitrato (nitrato de sódio) foi adicionado à água de beber (100 mg/L) por 2 meses. Os corações foram perfundidos em sistema de Langendorff aos 2 meses e avaliados antes (basal) e após IR miocárdica em relação aos seguintes parâmetros: pressão desenvolvida no ventrículo esquerdo (PDVE), taxas máximas de variação positiva e negativa da pressão ventricular esquerda (±dP/dt), expressão do RNAm da óxido nítrico (NO) sintase (NOS) endotelial (eNOS) e da NOS induzível (iNOS), além de níveis de malondialdeído (MDA) e metabólitos do óxido nítrico (NOx). Resultados: A recuperação da PDVE e ±dP/dt foi inferior nos ratos diabéticos versus controles, mas quase normalizou após ingestão de nitrato. Ratos diabéticos apresentaram expressão diminuída de eNOS e aumentada de iNOS tanto no estado basal quanto após IR, e o consumo dietético de nitrato restaurou estes valores para o estado normal após a IR. O nível de NOx cardíaco foi menor nos ratos diabéticos em comparação aos controles no momento basal, mas foi superior após a IR. Ratos diabéticos apresentaram níveis mais elevados de MDA tanto no estado basal quanto após IR que, juntamente com os níveis cardíacos de NOx, reduziram após consumo dietético do nitrato. Conclusões: O consumo dietético de nitrato por ratos diabéticos ofereceu cardioproteção contra a lesão de IR através da regulação da expressão de eNOS e iNOS e inibição da peroxidação lipídica no coração.

Cambios reversibles de alteraciones basales de la contractilidad parietal del ventrículo izquierdo con drogas antiisquémicas: Estudio ecocardiográfico / Reversible changes in left ventricular resting wall-motion contractile abnormalities with anti-ischemic drugs: An echocardiographic study

Objetivos: determinar la utilidad clínica de la detección ecocardiográfica de alteraciones parietales basales de la contractilidad (ABC) reversibles con drogas antiisquémicas en pacientes con cardiopatía isquémica (CI) estable sospechada o conocida. Antecedentes: no hay referencias en la literatura al respecto. Población y método: estudio prospectivo observacional de la práctica clínica corriente en 93 pacientes ambulatorios, consecutivos (52,7% hombres, mediana 69,7 años), con indicación de ecoestrés mostrando ABC no cicatrizales. En su lugar se aplicó un protocolo con nitritos y metoprolol. Se consignaron los cambios del score segmentario (SS), del ángor y del electrocardiograma (ECG). Los pacientes fueron derivados directamente a cateterismo (n=9), internación (n=34) o domicilio (n=50). Se realizó un seguimiento a largo plazo (3,25 años-personas). Resultados: los cambios del SS, ángor y ECG fueron significativos (p < 0,001). La mortalidad global fue 6,34 p-mes-1 x 1000, con tratamiento médico versus invasivo: 8,59 vs 3,8 p-mes-1 x 1000, cateterismo directo vs internados con cateterismo diferido: 3,93 vs 7,22 p-mes-1 x 1000, internados sin cateterismo: 18,62 p-mes-1 x 1000 y domiciliarios con y sin cateterismo: 4,03 vs 4,05 p-mes-1 x 1000, respectivamente. Los pacientes con cateterismo presentaron lesiones severas mayormente de múltiples vasos. Conclusiones: la detección ecocardiográfica de ABC reversibles con drogas antiisquémicas en pacientes con CI evoca la presencia de isquemia miocárdica de reposo en una población de alto riesgo y tiene un importante valor pronóstico.

Objectives: to determine the clinical usefulness in detecting reversible resting echocardiographic segmental wall motion contractile abnormalities (ABC) in patients with stable coronary artery disease (CI). Background: There are no references in the literature. Population and method: This is a current clinical practice prospective observational study on 93 consecutive patients (58% men, median 69,7 years) with stress echocardiograms requested and showing non scarring ABC who were submitted to echocardiograms with nitrates and metoprolol instead. Left ventricular segmental wall motion score index (SS), electrocardiographic abnormalities (ECG) and chest pain changes were determined. Patients were referred either to direct catheterization (n=9), hospitalization (n=34) or to their residences (n=50). A 3,25-years-persons follow-up was performed. Results: SS, ECG abnormalities and chest pain changed significantly (p<0,001). The higher SS, the higher mortality. Global mortality was 6,34 p-mes-1 x 1000; patients with medical vs. invasive treatment: 8,59 vs 3,8 p-mes-1 x 1000, with direct catheterization vs. those hospitalized with deferred catheterization: 3,93 vs 7,22 p-mes-1 x 1000, patients hospitalized without catheterization: 18,62 p-mes-1 x 1000, and domiciliary patients with and without catheterization: 4,03 vs 4,05 p-mes-1 x 1000. Patients with catheterization showed severe multi-vessel disease mainly. Conclusions: Reversible echocardiographic ABC with anti-ischemic drugs evokes resting myocardial ischemia, a high risk CI population and has important prognostic value.

Asociación entre niveles de proteína C-reactiva y óxido nítrico con el pronóstico de pacientes con infarto cerebral agudo / Association of C-reactive protein and nitric oxide levels with the prognosis of acute ischemic stroke

Introducción: La inflamación y alteraciones en la biodisponibilidad del óxido nítrico (NO) han sido involucradas en la fisiopatología de la enfermedad cerebrovascular. Objetivo: El objetivo del estudio fue determinar el valor pronóstico de la medición de metabolitos del NO y marcadores inflamatorios en pacientes con infarto cerebral agudo. Materiales y métodos: Se incluyeron 158 pacientes con diagnóstico de infarto cerebral agudo en un estudio observacional de cohorte. Entre 48 y 72 horas del inicio de los síntomas se tomó una muestra de sangre para determinación del perfil bioquímico, marcadores inflamatorios (PCR, IL1-β, IL6, TNF-α) y nitritos/nitratos plasmáticos. Se realizó seguimiento durante 2 años para determinar la aparición de un nuevo evento (infarto cerebral, infarto de miocardio, falla cardiaca) o muerte de origen vascular. Un análisis de regresión multivariada de Cox permitió determinar los factores asociados independientemente con el desenlace. Resultados: La edad promedio fue 70,5 ± 12,8 años. El 39,2% de los sujetos incluidos presentó el desenlace durante los primeros 24 meses de seguimiento. Los niveles de PCR > 12 mg/L (HR 2,22, IC 95% 1,07-4,59) y el puntaje > 13 en la escala NIHSS al ingreso (HR 2,81 IC 95% 1,46-5,41) se encontraron significativamente asociados con mayor riesgo de presentar un nuevo evento. La combinación de niveles de PCR < 12 mg/L y nitritos/nitratos < 35,5 µmol/L se identificó como un factor protector (HR 0,21, IC 95% 0,06-0,71). Conclusión: Este estudio sugiere que la determinación de nitritos/nitratos en conjunto con los niveles de PCR puede ser de utilidad para estratificar el riesgo de nuevos eventos en pacientes con infarto cerebral agudo.

Introduction: Inflammation and alterations in the bioavailability of nitric oxide (NO) have been involved in the pathophysiology of cerebrovascular disease. Objective: The aim of the study was to determine the prognostic value of measuring NO metabolites and inflammatory markers in patients with acute ischemic stroke. Materials and methods: A total of 158 patients with acute ischemic stroke were included in an observational cohort study. Between 48 and 72 hours post admission, a fasting blood sample was taken to determine the biochemical profile, inflammatory markers (CRP, IL1-β, IL6, TNF-α) and nitrites/nitrates plasma levels. The cohort's follow-up was conducted for two years to determine the occurrence of a new event (stroke, myocardial infarction, heart failure) or death of vascular origin. Comparisons between groups were made using the log-rank test. A Cox multivariate regression analysis permitted to determine factors independently associated with the outcome. Result: The mean age was 70.5 ± 12.8 years. 39.2% of the subjects presented the outcome during the first 24 months of follow-up. CRP levels > 12 mg/L (HR 2.22, 95% CI 1.07-4.59) and a score > 13 on the NIHSS scale at admission (HR 2.81 95% CI 1.46-5.41) were significantly associated with an increased risk of a new event. The combination of CRP levels < 12 mg/L and nitrites/nitrates levels < 35.5 mmol/L was identified as a protective factor (HR 0.21, 95% CI 0.06-0.71). Conclusion: This study demonstrates that the determination of CRP and NOx levels could be beneficial in clinical practice to stratify the risk of future events or death of vascular origin in acute ischemic stroke patients.

Levels of nitrates in a urea fertilized Kikuyu (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) pasture on the high plains of Antioquia, Colombia / Niveles de nitrato en pasto Kikuyo (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) fertilizado con urea en el antiplano de Antioquia, Colombia / Niveles de nitrato en pasto Kikuyo (Cenchrus clandestinus (Hochst. ex Chiov.) Morrone) fertilizado con urea en el antiplano de Antioquia, Colombia

Abstract Fertilization is one of the factors that can contribute to build-up of nitrates in kikuyu (Cenchrus clandestinus) pastures of the tropics. Field studies to evaluate the influence of nitrogen fertilization on yield and nitrate concentrations were conducted between December 2012 and June 2013 at the Agricultural Station of the National University at Santa Elena (Antioquia). The experimental design was a 4 x 4 block design with four replications in a monoculture paddock of kikuyu grass. Treatments were four levels of nitrogen applied as topdressing urea granules (0, 50, 100 and 200 kg/ha per plot). Whole grass samples (blades and stems) were collected at 42 days post-fertilization to mimic cattle grazing exposure. Biomass was estimated as dry matter yield per hectare and nitrates were measured by ion chromatography and expressed as parts per million (ppm) on dry matter content. No significant difference in biomass was observed between urea application rates; however, all treated plots produced more biomass than non-treated plots (mean 2.14 vs 1.12 Tons/ha, p<0,05). Mean ± SEM concentrations of NO3 for all time intervals combined increased from 369 ± 216 ppm with no fertilization, to 878 ± 881 ppm at the highest application rate. In spite of the large variation within each group, the highest NO3 level attained was 5600 ppm NO3, which are considered safe for cattle consumption. It can be concluded that nitrate levels in kikuyu pastures fertilized with 4 times the usual rate of nitrogen did not accumulate to pose a health risk in cattle; however, other factors that could also influence nitrate accumulation were not determined in this study.

Resumen La fertilización es uno de los factores que contribuye a la acumulación de nitratos en el pasto kikuyo (Cenchrus clandestinus) en el trópico. Este estudio, realizado entre diciembre de 2012 y junio de 2013 en la Hacienda Paysandú de la Universidad Nacional, ubicada en Santa Elena-Medellín (Antioquia), evaluó la influencia de la fertilización con nitrógeno sobre la producción y las concentraciones de nitratos. El diseño experimental fue en bloques de 4 x 4 con cuatro repeticiones de parcelas monocultivo de pasto kikuyo. Los tratamientos fueron cuatro niveles de nitrógeno aplicado como gránulos de urea sobre la superficie (0, 50, 100 y 200 kg/ha por corte). Las muestras de pasto completo (hojas y tallos) se colectaron a los 42 días posfertilización, con el fin de simular la exposición al pastoreo con ganado. La biomasa se midió como la producción de materia seca por hectárea; los nitratos se midieron por cromatografía iónica, expresada en partes por millón (ppm) sobre el contenido de materia seca. No hubo diferencia significativa en la producción de biomasa entre las diferentes tasas de aplicación de urea; sin embargo todas las parcelas tratadas produjeron más biomasa comparadas con las parcelas no tratadas (promedio 2.14 vs 1.12 ton/ha, p<0,05). Las concentraciones promedio ± SEM de NO3 para todos los tiempos de muestreo combinados, se incrementaron de 369 ± 216 ppm sin fertilización a 878 ± 881 ppm con la más alta tasa de fertilización aplicada. A pesar de la gran variación dentro de cada grupo, los niveles más altos de NO3 obtenidos fueron de 5600 ppm NO3, los cuales se consideran seguros para el consumo en ganado. Se puede concluir que los niveles de nitrato en el pasto kikuyu fertilizado con cuatro veces la tasa normal de nitrógeno, no se acumulan como para plantear un riesgo para la salud en el ganado. Sin embargo, es importante señalar que otros factores que pueden influir en la acumulación de nitratos no se evaluaron en este estudio.

Resumo A adubação é um dos fatores que contribuem na acumulação de nitratos da pastagem kikuyo (Cenchrus clandestinus) do trópico. Este estudo foi realizado entre dezembro de 2012 e junho de 2013 na fazenda Paysandu da Universidade Nacional da Colômbia, localizada no corregimento Santa Elena da cidade de Medellín, Antioquia. Avaliou-se a influência da adubação com nitrogênio sobre a produção e as concentrações de nitratos. O desenho experimental foi de blocos de 4 x 4 com quatro repetições nas parcelas da monocultura de pastagem kikuyo. Os tratamentos foram quatro níveis de nitrogênio aplicado como grânulos de uréia sobre a superfície (0, 50, 100 e 200 kg/ha por safra). As amostras da pastagem completa (folhas e talhos) coletaram-se aos 42 dias após adubação, com o intuito de simular a exposição ao pastoreio com gado. A biomassa mediou-se com a produção de matéria seca por hectare; os nitratos mediram-se por cromatografia iônica, expressada em partes por milhão (ppm) sobre o conteúdo de matéria seca. Não houve diferença significativa na produção de biomassa entre as diferentes taxas de aplicação de uréia; embora, todas as parcelas experimentais produziram maior biomassa comparada com as parcelas não tratadas (media 2.14 vs 1.12 ton/ha, p<0,05). As concentrações medias ± SEM de NO3 para todos os tempos de amostragem combinadas, se incrementaram de 369 ± 216 ppm sem adubação até 878 ± 881 ppm com a maior adubação aplicada. Ainda que houve grande variação dentro de cada grupo, os níveis maiores de NO3 obtidos foram de 5600 ppm NO3, os quais se consideram seguros para o consumo do gado. Pode-se concluir que os níveis de nitrato na pastagem kikuyo adubado com quatro vezes a taxa normal de nitrogênio, não apresentam acumulação como para ter um risco de saúde quando é consumido pelo gado. Embora, outros fatores são importantes para ter em conta, pois eles podem influir na acumulação de nitratos que não foram avaliados neste estudo.

Ameliorative Effects of Alcohol on Human Diabetic Volunteers – A Prospective Study.

Aims: The purpose of this study is to assess and confirm the ameliorative effects of alcohol consumption on biochemical indices of blood i.e., blood glucose, HbA1c, NO2, NO3, lipid profiles, hs-CRP (high sensitive C–Reactive protein) and membrane lipid peroxidation of diabetics. Study Design: Pre-clinical and Biochemical experimental study. Place and Duration of Study: Department of Biochemistry, Acharya Nagarjuna University and Dept. of Biotechnology, K L University, Guntur, A.P and Dept. of Biochemistry, Katuri Medical College, Katuri Nagar, Guntur, A.P and Dept. of Biochemistry, Sri Krishna Devaraya University, Anantapur, A.P and Dept. of Basic Sciences, Madanapalle Institute of Technology and Science (MITS), Post Box No: 14, Angallu (V), Madanapalle, A. P., India, during 2008– 2013. Methodology: The study is conducted on 4 groups (n= 1200) of people of different ages ranging from 35 to 50 years at community health centers in Prakasam, Warangal, Srikakulam districts of Andhra Pradesh, India. The first group consists of type-II diabetic patients who have been consuming alcohol (arithmetic mean ranging from 14.16 to 31.61ml/day) moderately for the past 3 to 10 years. The second group consists of nondiabetic, moderately alcohol consuming healthy individuals. The third group consists of patients who are type-II diabetics (who do not drink) taking medical treatment for minimum period of 1 year. The fourth group consists of non-drinking, non-diabetic healthy individuals. Relationships of alcohol intake with lipid profile, hs-CRP and HBA1c are compared among the three groups. Results: In lipid profile analysis of moderately drinking diabetic group, the HDL levels are found to be higher while the remaining factors such as total cholesterol, LDL, VLDL (P<0.05), triglycerides (P<0.01) and membrane lipid peroxidation are significantly lower. Fasting serum glucose levels are lowered, while serum nitrites and nitrates are found to be significantly higher. These differences are not found in abstainers group and Diabetic group who do not drink. Conclusion: Moderate consumption of alcohol in diabetic individuals is found to have an inverse association with the risky factors like LDL cholesterol, Triglycerides, etc. that are the etiological factors for some of the sequelae of diabetes mellitus i.e., coronary heart diseases, Retinopathy, etc. and has a direct association with the positive factors such as HDL and nitric oxide production. Experimental results are very significant and indicate that moderate consumption of alcohol has ameliorative effects on diabetics.

Concentrações do nitrogênio amoniacal, nitritoe nitrato em áreas de engorda de ostras nomunicípio de Cananeia-SP / Concentrations of ammoniac nitrogen, nitrite and nitrate inareas of oyster culture in Cananeia-SP, Brazil

O nitrogênio possui um papel-chave em sistemas aquáticos, especialmente nos ambientes de transição entre águas marinhase doces como os estuários. Assim sendo, muitos organismos, como as ostras, podem ser afetados pelo aumentoda concentração em determinadas épocas, limitando assim seu cultivo. O objetivo deste estudo foi avaliar aspectos daqualidade da água das áreas utilizadas para o cultivo da ostra do mangue Crassostrea spp. em Cananeia (SP, Brasil) e desua adequabilidade para o cultivo dos moluscos com relação às concentrações de nitrogênio amoniacal, nitrito e nitrato.O nitrogênio amoniacal variou de 0,8 a 3,2 μmol/L, o nitrito, de 0,1 a 3,2 μmol/L, e o nitrato, de 0,1 a 1,9 μmol/L. Ao analisaresses dados em todas as estações, verificou-se que o nitrogênio amoniacal, o nitrito e o nitrato foram estatisticamentediferentes entre as marés de quadratura e alta de sizígia. Como não houve diferença entre as estações que fazem a engordadas ostras e a estação Agrossolar (controle), concluiu-se que a atividade no estuário de Cananeia não causa incrementosignificativo nas concentrações de amônia, nitrito e nitrato. As concentrações registradas em Cananeia são similares àsobservadas para outras regiões tropicais e subtropicais estuarinas do mundo.

Nitrogen plays a key role in aquatic systems, especially in environments which are influenced both by marine and freshwater,such as estuaries. The aim of this study was to evaluate aspects of water quality of Crassostrea spp. aquaculture sites inCananeia (SP, Brazil) and adequacy thereof for the cultivation of mollusks in relation to concentrations of total ammoniacalnitrogen, nitrite and nitrate. Variations in concentrations of total ammoniacal nitrogen were 0.8 to 3.2 μmol/L, nitrite 0.1to 3.2 μmol/L, and nitrate from 0.1 to 1.9 μmol/L. Analyzing these data in all seasons together, we found that average totalammoniacal nitrogen and nitrite levels were significantly different for the tides and neap tide. These concentrations recordedat Cananeia are similar to those observed for other estuarine tropical and subtropical regions of the world.

Emisiones antrooogénicas de amoniaco, nitratos óxido nitroso: compuestos nitrrogenados que afectan el medio ambiente en el sector agropecuario Colmbbiano / Anthrpogenic emiissions of ammonia, nitrates and nitrous oxide: nitrogen compounds that affect the environment in the Colombian agricultural sector

El cambio climático es un fenómeno global actual que posee diversas causas, tales como el incremento antropogénico en las emisiones de gases de efecto invernadero y su influencia en el planeta. El óxido nitroso (N2O) es un gas con un potencial de calentamiento 298 veces mayor que el CO2; es emitido por diversos sectores económicos, entre ellos la agricultura y la ganadería por el empleo de fertilizantes nitrogenados. Este uso no incrementa únicamente las emisiones de N2O, sino que afecta todos los eslabones del ciclo del nitrógeno, siendo importante reconocer las interacciones entre sus reacciones (amonificación, nitrificación, denitrificación, etc.) para comprender los efectos sobre la lixiviación de nitratos, volatilización de amoniaco y emisiones de N2O, tres compuestos naturales que afectan el medio ambiente. En Colombia, el IDEAM reportó que en 2004 el sector agropecuario nacional produjo 94,91 gigagramos (Gg) de N2O, pues los sistemas de producción agrícolas y bovinos utilizan altas cantidades de fertilizantes nitrogenados con bajos índices de asimilación. Por ello adquiere importancia implementar buenas prácticas que midan y mitiguen estas emisiones en campo, buscando mayor eficiencia en la transformación de componentes nitrogenados dentro del sistema. En este artículo se enfatiza un manejo adecuado del suelo y la utilización de inhibidores de nitrificación naturales (presentes en algunas plantas tropicales) o químicos, como la nitrapyrina, DCD y NBPT (este último como inhibidor de la amonificación), observando su forma de acción y medición, su efecto mitigador y los incrementos productivos. La presente es una revisión bibliográfica que aborda la problemática ambiental de la ganadería bovina.

Climate change is a global effect currently present with several causes, such as the increased of anthropogenic emissions of greenhouse gases and its influence on the planet. Nitrous oxide (N2O) is a gas with a global warming potential 298 times greater than CO, which comes of many sectors, one of them is the agriculture and livestock through the use of nitrogen fertilizers. This use not only increases N2O emissions, its affects all stages of the nitrogen cycle, being important to observe the interactions between their reactions (ammonification, nitrification, denitrification etc.) to understand the effects over nitrate leaching, ammonia volatilization and N2O emissions, three natural chemicals that affect the environment. In Colombia, IDEAM reports that for 2004, the national agricultural sector produced 94.91 Gg of N2O, knowing the agricultural and livestock productions use high quantities of nitrogen fertilizers, with low assimila2tion rates. Therefore, some adaptable practices and methodologies become important to measure and mitigate these emissions in the field, seeking greater efficiency in the transformation of nitrogen components in the system, being reviewed on this paper the appropriate land management or implementation of natural nitrification inhibitors (present in some tropical plants) or chemical inhibitors, such as nitrapyrina, DCD and NBPT (as an ammonification inhibitor). This is a literature review that approaches the environmental problems of livestock.

Metodología de análisis del riesgo por contaminación de agroquímicos: cuenca del Río San Blas, Costa Rica / Risk analysis methodology for agrochemical contamination: San Blasriver basin, Costa Rica

Establecer parámetros edafológicos e hidrogeológicos de la cuenca; y físico-químicos de fertilizantes y plaguicidas, que pudieran servir para el análisis del riesgo de su infiltración. Materiales y métodos: se realizó una investigación exploratoria de campo y gabinete para caracterizar hidrogeológicamente la cuenca. Se analizaron las concentraciones de plaguicidas y nitratos en aguas subterráneas y superficiales. Se consideraron algunas características de vulnerabilidad intrínsecas del acuífero, y otras relacionadas con la retención de contaminantes en suelos. Se determinó el coeficiente de distribución suelo/agua y el factor de retardo para seis sustancias de alto uso y se estimó su riesgo relativo hacia aguas subterráneas. Resultados: Las aguas subterráneas en zonas agrícolas muestran concentraciones de nitrato de dos a tres veces las concentraciones halladas en aguas para consumo humano. Se detectó glifosato en canales de irrigación agrícola. Los parámetros químicos del suelo más fuertemente correlacionados con la concentración de nitratos en aguas subterráneas fueron: a) capacidad de intercambio catiónico, b) relación aluminio: sílice, c) por ciento de retención de nitratos y d) pH del suelo en agua destilada. La concentración de nitratos en aguas subterráneas se relacionó directamente con el porcentaje de materiales finos (por ciento arcillas + por ciento limos) en los suelos. Discusión: Se proponen par metros para la evaluación del riesgo en acuíferos aluviales en la costa Pacífica de Costa Rica donde predomina el uso agrícola. Se considera que la terbutilazina, ametrina, carbendazim, diuron y nitratos representan amenaza importante al acuífero...

Acalásia idiopática com resposta duradoura ao tratamento farmacológico: relato de caso / Idiopathic acalasia with term response to medical treatment: case report

A acalásia é caracterizada pela aperistalse do corpo esofágico e pelo relaxamento incompleto ou ausente do esfíncter esofagiano inferior. De acordo com sua etiologia, pode ser classificada em chagásica ou idiopática. O tratamento pode ser farmacológico, endoscópico ou cirúrgico. O tratamento farmacológico é considerado pouco eficaz, pois seus efeitos não são permanentes, além de causar efeitos colaterais pronunciados em muitos casos, como cefaleia e hipotensão. As medicações de escolha são os bloqueadores dos canais de cálcio e os nitratos. Os autores relatam o caso de uma paciente com diagnóstico de acalásia idiopática cujo tratamento farmacológico tem sido eficaz ao longo de cinco anos. Tal modalidade foi instituída considerando a cronicidade da doença, a idade avançada da paciente e a presença de comorbidades.

Achalasia is characterized by esophageal body aperistalsis and incomplete or absent relaxation of the lower esophageal sphincter. According to its ethiology, it is classified in chagasic or idiopathic. The treatment options are pharmacological, endoscopical or surgery. Pharmacological treatment has low effectiveness, because clinical results are not permanent and can cause pronounced side effects, such as headache and hypotension. The drugs of choice are calcium channel blockers and nitrates. The authors report a case of a patient diagnosed with idiopathic achalasia whose pharmacological treatment has been effective for five years long. Such choice was made considering the chronic aspects of the disease, patients advanced age and comorbidities presented.

Medición de nitratos y nitritos en agua y saliva de población rural precordillerana de la VIII región / Nitrate and nitrite in water and saliva of rural population in the Andes foothills of the VIII Region

Introducción: Un factor de riesgo para las neoplasias escamosas de faringe son las nitrosaminas, las que derivan de los nitratos salivales que provienen de la dieta y en especial del agua si los niveles están por sobre la norma. Objetivos: Conocer y comparar los niveles de nitratos y nitritos en agua y saliva de habitantes de la región precordillerana y en población urbana de Concepción. Material y método: Estudio prospectivo, tipo caso y control. Determinan niveles de nitratos y nitritos en agua de la zona precordillerana y en agua de Concepción y en saliva de habitantes de la zona rural y de grupo control de Concepción. Resultados: Se obtienen 10 muestras de agua del sector rural y 1 muestra de agua potable de Concepción. Nivel de nitratos en agua rural 23,29 mg/L, en agua urbana 3,6 mg/L (p <0,05). En saliva, grupo estudio (n =15) con nivel de nitritos de 9,58 mg/ml, grupo control (n =24) nivel de 3,8 mg/ml (p <0,05). Conclusión: En la zona rural hay niveles significativamente mayores de nitratos en el agua y nitritos en saliva. Los niveles en agua son superiores a normas nacionales e internacionales. Nuestros resultados resaltan la posible importancia de las nitrosaminas y sus precursores como elementos carcinogónicos en los carcinomas escamosos orofaríngeos.

Introduction: A risk factor for squamous carcinomas of the oropharynx are the nitrosamines, which are derived from salivary nitrate coming from diet and water, especially if the levels are above the allowed levels. Aim: To determine and compare the levels of nitrates and nitrites in drinking water and saliva of people at the foothills of our region and urban population of Concepcion. Material and method: A descriptive cross sectional study. Determination of levels of nitrates and nitrites in drinking water in the Andean foothills and Concepcion and in saliva of people from same locations. Results: We obtained 10 rural water samples and 1 from Concepcion drinking water. Nitrate levels in rural water were 23.29 mg/L and 3.6 mg/L (p <0.05) in urban water. In saliva, the study group (n =15) had 9.58 mg/ml nitrite in saliva, the control group (n =24) 3.8 mg/ml (p <0.05). Conclusion: In rural areas there are significantly higher levels of nitrates in drinking water and saliva. The water levels are higher than national and international standards. Our results confirm high amounts of nitrogen cycle products (nitrites and nitrates) in drinking water and in saliva so it could be considered as carcinogenic elements in oropharyngeal squamous cell carcinomas.

Contribución deuun afluente tributario a la eutrofización del lago de tota (boyacá, Colombia) / Cotribution of aa tributary stream to eutrophication of lake tota (boyacá, Colombia) / Contribuição d aafluentes à eutrofização do lago tota (boyacá, Colômbia)

El objetivo de este estudio fue caracterizar fisicoquímicamente la corriente Las Cintas, afluente al lago de Tota, ubicado en el departamento de Boyacá. Se determinaron los parámetros de temperatura, pH, conductividad, oxígeno disuelto, DQO, DBO5, concentración de especies de nitrógeno (nitratos y nitritos) y concentración de especies de fósforo (fósforo total, fósforo hidrolizable total, ortofosfato total y fósforo orgánico total), para lo cual se efectuaron seis muestreos entre septiembre y noviembre del 2009, en cinco puntos seleccionados sobre la corriente. Estos análisis se realizaron siguiendo metodologías normalizadas para el análisis de aguas. En los resultados se observan comportamientos de poca variabilidad en los parámetros de temperatura, pH, conductividad y oxígeno disuelto; en cuanto al aporte de nitratos, se determinó que el desarrollo de cultivos en las proximidades de la corriente aumenta la concentración de estos iones, que pueden ser arrastrados al lago. Respecto a las diferentes especies de fósforo evaluadas permiten establecer la escasa contribución de fósforo orgánico hacia el cuerpo de agua, además del aporte significativo de fósforo por detergentes vertidos en la corriente. Basándose en la caracterización efectuada, se puede establecer que la actividad agrícola aporta nutrientes que probablemente favorecen el desarrollo del proceso de eutrofización en el lago de Tota.

The aim of this study was to characterize physicochemically “Las Cintas” stream located at Tota Lake, Boyacá department. Temperature, pH, conductivity, dissolved oxygen, COD, BOD5, concentration of nitrogen (nitrates and nitrites) and phosphorus (total phosphorus, total hydrolysable phosphorous, total orthophosphate and total organic phosphorus) were measured. To perform the characterization, samples were collected in six sampling dates, between September and November of 2009, at five points selected along the stream. The analyses were carried out following normalized procedures for water analysis. The results obtained show little changes in temperature, pH, conductivity and dissolved oxygen behavior; Nitrate values indicating that the proximity of the crops to the stream, rises the concentration of these ions, which can be carried to the Lake by run off; The different phosphorous species evaluated allow to establish the highest contribution of organic phosphorus towards the water body, and the input of phosphorous by detergents spilled in the stream. With results it can be established that onions crops provides nutrients which probably support eutrophication processes at the Lake Tota.

O objetivo deste estudo foi caracterizar aphysicochemically afluente do Lago Tota localizada no departamento de Boyacá, e afluente do Lago Tota. Para determinar os parâmetros de temperatura, pH, condutividade elétrica, oxigênio dissolvido, DQO, DBO5 concentração de espécies de nitrogênio (nitrato e nitrito) e da concentração de fósforo de espécies (fósforo total, fósforo hidrolisável total, fósforo total e ortofosfato orgânico total) para os quais seis amostras foram realizadas entre setembro e novembro de 2009 em cinco pontos selecionados no fluxo. Estes testes foram realizados de acordo com metodologias padronizadas para análise de água. Os resultados de comportamento, de pouca variabilidade nos parâmetros de temperatura, pH, condutividade e oxigênio dissolvido na ingestão de nitrato, foi determinado que o desenvolvimento das culturas nas proximidades do córrego aumenta a concentração destes íons pode sendo jogado no lago, enquanto que as diferentes espécies de fósforo possível estabelecer a baixa contribuição de fósforo orgânico o corpo de água, além de significativa contribuição das descargas de fósforo em detergente no córrego. Com base na caracterização realizada, você pode definir que a agricultura fornece nutrientes que estimulam o desenvolvimento da eutrofização no Lago Tota.

Composition of Inhalable Atmospheric Particulates in Rustenburg, South Africa.

In this study, inhalable particulate matter was sampled using the TEOM series 1400a, the elemental composition of the particulate matter was determined using Scanning Electron Microscopy coupled with Energy Dispersive Spectrometer (SEM/EDS) and the concentration of particulate nitrates and sulphates was analyzed using Ion Chromatography (IC). These parameters were evaluated to obtain an estimate of the composition of inhalable particulate matter (PM10) in Rustenburg, South Africa. The toxicity was also determined in terms of ratios of toxic metals to PM10, as well as to elemental carbon, nitrates and sulphates. The components of PM10 were obtained as follows: organic, halides, sulphates, crustal metals, toxic metals, nitrates, and carbon. The main toxic metals were obtained in order of decreasing abundance as Cr>Pb>Ni>V. Seasonal variations showed high levels of PM10 and sulphates in spring and high nitrate levels in summer. The SEM/EDS showed the presence of atmospheric particles of complex composition including S, Si, Al, Mg, Ca, Pb, Fe, Cr, Ni, V, and Pb.

Therapeutic effect of nitrate on dextran sulfate sodium induced acute experimental colitis in mice / 中华消化杂志

Objective To investigate the effect of nitrate on acute experimental colitis in mice.Methods A total of 40 BALB/c mice were evenly divided into model group and treatment group.Model group were fed with 4％ dextran sulfate sodium (DSS) solution and treatment group were given 4％ DSS solution and nitrate (1.5 g/L) for seven days.The disease activity index (DAI) of mice was scored.The colon tissue of mice was taken for hematoxylin-eosin staining and myeloperoxidase (MPO)immunohistochemical staining observation.The MPO and activity of nitric oxide in colon tissue were measured by MPO and nitric oxide detecting kit.The data were analyzed by t test.Results At the 6th day and 7th day,the difference of DAI between treatment group and model group was statistically significant (t=5.12 and 6.72,P=0.012 and 0.008).At the 7th day,the tissue score of model group (2.5±0.5) was higher than that of treatment group (1.9±0.4) and the difference was statistically significant (t=3.82,P＜ 0.01).Compared with model group,the histopathological injury of colon tissue in treatment group mice significantly reduced and neutrophil infiltration also decreased.At the 7th day,the concentration of MPO,NO2-and NO3-of model group was (2.8±0.6) U/g,(10.4±4.3) mmol/g and (100.3±50.1) mmol/g respectively,treatment group was (1.5±0.3) U/g,(17.5±7.0) mmol/g and (190.7 ±85.3) mmol/g respectively.The differences were statistically significant (t=11.23,3.81 and 4.50,all P＜0.01).Conclusion Nitrate can reduce DSS-induced acute experimental colitis in mice.

Via nitrato-nitrito-óxido-nítrico: aspectos fisiológicos e terapêuticos / Nitrate-nitrite nitric oxide pathway: physiological and therapeutical aspects

A formação de NO nitrito-dependente é uma via que complementa a via enzimática, pois atuam em paralelo, porém, quando a suplementação de oxigênio está comprometida, há redução na expressão das enzimas NOS, comprometendo a formação de NO a partir desta via. Então, entra em ação a via nitrito-dependente, a qual desempenha funções favoráveis em condições de déficit de oxigênio. Assim sendo, esta é uma via de papel importantíssimo em condições patológicas que cursam com isquemia, tornando necessário garantir o armazenamento deste substrato, seja via farmacológica ou pela dieta alimentar. O papel na fisiologia, fisiopatologia, nutrição e terapêutica do nitrito e nitrato podem gerar frutos promissores para o desenvolvimento de novos caminhos na abordagem de algumas doenças e mudar a visão atual sobre os constituintes alimentares, no âmbito da saúde e doença. O presente texto tem como objetivo revisar e discutir as funções biológicas e o metabolismo do NO independente da via enzimática no organismo, além de abordar o uso terapêutico de nitrato ou nitrito em condições de doença.

The nitrite-dependent NO pathway is one that complements the enzymatic pathway of NO release, because they act in parallel, but when oxygen supplementation is compromised there is a reduction in the expression of NOS enzymes affecting the formation of NO from this pathway. Thus, the nitrite-dependent pathway swings into action, which plays favorableroles under oxygen deficit conditions. Therefore this is a very important role in pathological conditions that occurs with ischemia, making it necessary to ensure the storage of this substrate, either through a pharmacological or nutritional diet. The role in physiology, pathophysiology, nutrition and treatment of nitrite and nitrate can bear fruit for the development of promising new grounds in addressing some diseases and to change the current view on foods, health and diseases. The aim of this paper is to review and discuss the biological functions and metabolism of NO enzymatic-independent pathway in the body and to discuss the therapeutic use of nitrate or nitrite in disease conditions.