RESUMEN
Over the last decades, modern lifestyle and environment have contributed to a shift in gut microbial colonization patterns and composition. Not only intestinal but also extraintestinal disorders have been proposed to be linked to changes in the gut microbiome. There is increasing evidence from clinical, epidemiologic and animal studies exploring associations between the dysbiotic microbiome and an increased risk of allergic, inflammatory, autoimmune, and metabolic diseases. The fetus is essentially sterile until the amniotic sac ruptures. After that, the maternal microbiota of the mouth, intestine, vagina and urinary tract contribute to the initial seeding of neonatal microbiota. Newborns are mainly inoculated at birth in the passage through the birth canal (vertical transmission). A number of exposure events occur afterwards (horizontal transmission), and by age 2, an infant's microbiota composition becomes indistinguishable from that of an adult. In mammalian evolution, the potential loss or change in vertical transmission of microbiota from mother to offspring could be compensated through horizontally transmitted microbiota (fecally contaminated drinking and bathing water, frequent physical contact, social crowding, and large families). However, the progressive loss of vertically transmitted microbiota without horizontal replacement represents a cumulative birth cohort phenomenon. Events that decrease microbiota diversity have been classically associated with risk of disease
En las últimas décadas, el estilo de vida y el ambiente moderno, han contribuido a un cambio en los patrones y la composición de colonización microbiana intestinal. No sólo se ha propuesto que los trastornos intestinales, sino también los extraintestinales, estarían relacionados con cambios en la microbioma intestinal. Cada vez hay más evidencias de estudios clínicos, epidemiológicos y en animales que exploran las asociaciones entre el microbioma disbiótico y un mayor riesgo de enfermedades alérgicas, inflamatorias, autoinmunes y metabólicas. El feto es esencialmente estéril hasta que el saco amniótico se rompe. Después de eso, la microbiota materna de la boca, el intestino, la vagina y el tracto urinario contribuye a la siembra inicial de la microbiota neonatal. Los recién nacidos se inoculan principalmente al nacer en el pasaje a través del canal de parto (transmisión vertical). Después de una serie de eventos de exposición (transmisión horizontal), a los 2 años, la composición de microbiota de un bebé se vuelve indistinguible de la de un adulto. En la evolución de los mamíferos, la pérdida o cambio potencial en la transmisión vertical de la microbiota de la madre a la descendencia podría compensarse mediante la microbiota transmitida horizontalmente (agua potable y de baño contaminada con heces, contacto físico frecuente, aglomeración social y familias numerosas). Sin embargo, la pérdida progresiva de microbiota transmitida verticalmente sin reemplazo horizontal representa un fenómeno de cohorte de nacimiento acumulativo. Los eventos que disminuyen la diversidad de la microbiota se han asociado clásicamente con el riesgo de enfermedad.
Asunto(s)
Humanos , Tracto Gastrointestinal/microbiología , Microbioma Gastrointestinal , Envejecimiento , Factores de Edad , MicrobiotaRESUMEN
The impact of statins on airway inflammation has not yet been established and it may differ from their cholesterol-lowering effects. Oral administration of statins at large-doses may have adverse effects. It is possible to overcome the side effect to increase the clinical efficacy through the inhalation route. Female BALB/c mice were randomly divided into four groups including the control group (NS-vehicle), model group[ovalbumim (OVA)-vehicle], simvastatin (Sim) group and dexamethasone (DXM) group at 10 mice in each group. In this study, we hypothesize Sim as a potential anti-inflammatory drug with biological and pharmacokinetic properties suitable for delivery through the inhalation route. Mice were immunized with OVA and then challenged with OVA aerosol to induce the asthma reaction. Sim was inhaled at a dosage (5 mg ·mL-1, ih, 15 min) or administrated by intraperitoneal injection (40 mg·kg-1, ip) or gavage (40 mg·kg-1, ig) during the OVA-challenge. In the mouse model of asthma, Sim significantly attenuated the total inflammatory cell counts and eosinophil counts (PP-1, ih, significantly decreased the total inflammatory cell counts and eosinophil counts in alveolar lavage fluid (BALF) (Pvia inhalation. Both of DXM and Sim at 5, 20 mg·mL-1, ih, were more potent than that of Sim at 1 mg·mL-1, ih. Sim significantly decreased IL-4 and IL-5 mRNA expression of lung at 5, 20 mg·mL-1, ih (PP-1, ih) significantly decreased levels of IL-4 and IL-5 in BALF (P P -1) declined slightly on IL-4 level in BALF. Sim at 5, 20 mg·mL-1 had a greater rate of decline in IL-5 than at 1 mg·mL-1. These results suggest Sim with different doses as a potential anti-inflammatory drug for airway inflammatory diseases with properties suitable for delivery by inhalation, which probably overcome the side effects and low clinical efficacy of oral Sim.
RESUMEN
O índice de cesarianas vem aumentando progressivamente nos últimos anos. O presente estudo trata sobre preferência de puérperas em relação à via de parto. Objetiva identificar a via de parto de preferência das mulheres que tiveram filho na maternidade do HU/ULBRA; verificar fatores que influenciam a escolha; e comparar a indicação médica da cesariana com o entendimento sobre a justificativa da intervenção. Métodos: Estudo descritivo de amostra consecutiva no período de 01/05/2010 a 30/06/10. Foi aplicado um questionário em 400 puérperas internadas no Alojamento Conjunto do Hospital Universitário da ULBRA. Resultados: O parto vaginal foi a via de preferência em 72,8% das mulheres. Recuperação mais rápida, menor dor e sofrimento, procedimento mais rápido e menor risco de morte materna foram as principais justificativas dadas pelas puérperas para suas preferências pela via de parto. Interferiu significativamente na decisão ter companheiro, grau de instrução, renda familiar e tempo de ruptura de membranas. A principal indicação médica de cesárea foi a desproporção cefalopélvica (22,6%). E 35% das mulheres acreditam ter sido a falha na indução a razão da indicação por via abdominal. Conclusão: O parto vaginal é o preferido da maioria das mulheres entrevistadas (n=291). O perfil das pacientes que tem preferência por parto vaginal foi: mulheres mais jovens, com maior grau de instrução, menor renda familiar, com companheiro fixo e menor tempo de ruptura de membranas. Percebemos discordância entre as causas alegadas pelas puérperas e a indicação médica da cesárea.
The cesarean section rate has been increasing steadily in recent years. This study focuses on mothers preferences concerning mode of delivery. It was designed to identify the preferred route of delivery among women who gave birth at the maternity ward of HU/ULBRA; to identify factors that influence their choice, and to compare medical indications for cesarean section with mothers perception of the reasons for the intervention. Methods: A descriptive study of a consecutive sample from May 1 2010 to June 30 2010. A questionnaire was responded by 400 postpartum women admitted to the Quarters of ULBRA University Hospital . Results: The vaginal route was preferred by 72.8% of mothers. Faster recovery, less pain and suffering, quicker procedure, and lower risk of death were the main reasons reported by pregnant women for their preference for delivery route. Having a partner, level of education, family income, and time of rupture of membranes were reported as significantly influential in the decision. The main medical indications for cesarean section was cephalopelvic disproportion (22.6%). And 35% of women believed that failure in induction was the reason for the abdominal route. Conclusion: Vaginal delivery is preferred for most of the women interviewed (n = 291). Patients who prefer vaginal delivery had the following profile: younger women with higher levels of education, lower family income, with a steady partner and shorter duration of membrane rupture. We noticed a discrepancy between the causes reported by pregnant women and the medical indications for cesarean section.