Governo local e serviços odontológicos: análise da desigualdade na utilização / Local government and public dental health services: an analysis of inequality in use / Gobierno local y servicios odontológicos: análisis de la desigualdad en el uso

O objetivo deste estudo foi identificar fatores associados à utilização dos serviços odontológicos, públicos (básicos e especializados) e privados. Foi realizado inquérito populacional de base domiciliar em dois municípios da Bahia, Brasil. Informantes-chave forneceram dados socioeconômicos e de utilização dos serviços odontológicos (desfecho). A organização do serviço público odontológico local foi classificada em pior/melhor. Realizou-se regressão logística politômica uni e múltipla. Do total de 1.290 indivíduos, 38,76% usaram o serviço privado, 33,80% atenção básica e 17,29% atenção básica e o Centro de Especialidades Odontológicas (CEO). Um perfil de vulnerabilidade social foi associado ao uso do serviço público, quando comparado ao privado. Menor escolaridade (OR = 1,47; IC95%: 1,03-2,10) e pior organização do serviço (OR = 1,74; IC95%: 1,22-2,48) foram associados ao menor uso da rede de serviços atenção básica e CEO em comparação ao uso exclusivo da atenção básica. A desigualdade na utilização dos serviços odontológicos foi observada mesmo quando comparados grupos mais homogêneos, como os usuários dos serviços públicos.

The aim of this study was to identify factors associated with the use of primary and specialized public dental health services and private services. A population-based household survey was conducted in two cities of Bahia State, Brazil. Key informants provided data on socioeconomic variables and use of dental health services. Organization of the local public dental health service was ranked as worse versus better. Univariate and multivariate polytomous logistic regression was performed. Of the total of 1,290 individuals, 38.76% used private services, 33.80% used public primary care, and 17.29% used both primary care and the Center for Dental Specialties. Less use of both primary care and specialized public services was associated with lower education (OR = 1.47; 95%CI: 1.03-2.10) and worse organization of services (OR = 1.74; 95%CI: 1.22-2.48), when compared to the exclusive use of primary care. The study showed inequality in the use of dental services, even when comparing more homogeneous groups, namely users of public services.

El objetivo de este estudio fue identificar los factores asociados al uso de los servicios odontológicos (primarios y especializados) públicos y privados. Se realizó una encuesta poblacional en dos ciudades de Bahía, Brasil. Los informantes clave contestaron cuestiones socioeconómicas y de utilización de los servicios odontológicos (resultado). La organización de los servicios odontológicos públicos locales fue clasificada en peor/mejor. Se realizó regresión simple y múltiple con variable politómica. Del total de 1.290 personas, un 38,76% utilizaron el servicio privado, un 33,80% la atención primaria y un 17,29% atención primaria y el Centro de Especialidades Dentales (CED). Una menor escolaridad (OR = 1,47; IC95%: 1.03-2.10) y una peor organización de servicio (OR = 1,74; IC95%: 1,22-2,48) se asociaron con un menor uso de la red de servicios de atención primaria y CED, en comparación con el uso exclusivo de la atención primaria. La desigualdad en el uso de los servicios dentales se observó incluso cuando se comparan grupos más homogéneos, como usuarios de servicios públicos.

Effect of exercise training on Ca2+ release units of left ventricular myocytes of spontaneously hypertensive rats

In cardiomyocytes, calcium (Ca2+) release units comprise clusters of intracellular Ca2+ release channels located on the sarcoplasmic reticulum, and hypertension is well established as a cause of defects in calcium release unit function. Our objective was to determine whether endurance exercise training could attenuate the deleterious effects of hypertension on calcium release unit components and Ca2+ sparks in left ventricular myocytes of spontaneously hypertensive rats. Male Wistar and spontaneously hypertensive rats (4 months of age) were divided into 4 groups: normotensive (NC) and hypertensive control (HC), and normotensive (NT) and hypertensive trained (HT) animals (7 rats per group). NC and HC rats were submitted to a low-intensity treadmill running protocol (5 days/week, 1 h/day, 0% grade, and 50-60% of maximal running speed) for 8 weeks. Gene expression of the ryanodine receptor type 2 (RyR2) and FK506 binding protein (FKBP12.6) increased (270%) and decreased (88%), respectively, in HC compared to NC rats. Endurance exercise training reversed these changes by reducing RyR2 (230%) and normalizing FKBP12.6 gene expression (112%). Hypertension also increased the frequency of Ca2+ sparks (HC=7.61±0.26 vs NC=4.79±0.19 per 100 µm/s) and decreased its amplitude (HC=0.260±0.08 vs NC=0.324±0.10 ΔF/F0), full width at half-maximum amplitude (HC=1.05±0.08 vs NC=1.26±0.01 µm), total duration (HC=11.51±0.12 vs NC=14.97±0.24 ms), time to peak (HC=4.84±0.06 vs NC=6.31±0.14 ms), and time constant of decay (HC=8.68±0.12 vs NC=10.21±0.22 ms). These changes were partially reversed in HT rats (frequency of Ca2+ sparks=6.26±0.19 µm/s, amplitude=0.282±0.10 ΔF/F0, full width at half-maximum amplitude=1.14±0.01 µm, total duration=13.34±0.17 ms, time to peak=5.43±0.08 ms, and time constant of decay=9.43±0.15 ms). Endurance exercise training attenuated the deleterious effects of hypertension on calcium release units of left ventricular myocytes.

La redistribución dinámica mitocondria-núcleo de la inmunofilina FKBP51 es regulada por pka para modular la expresión de genes durante el proceso de adipogénesis / [The dynamic mitochondria-nuclear redistribution of FKBP51 during the process of adipocyte differentiation is regulated by PKA].

Glucocorticoids play an important role in adipogenesis via the glucocorticoid receptor (GR) that forms a heterocomplex with Hsp90-Hsp70 and a high molecular weight immunophilin FKBP51 or FKBP52. We have found that FKBP51 level of expression progressively increases, FKBP52 decreases, whereas Hsp90, Hsp70, and p23 remain unchanged when 3T3-L1 preadipocytes differentiate. Interestingly, FKBP51 translocates from mitochondria to the nucleus at the onset of adipogenesis. FKBP51 transiently concentrates in the nuclear lamina, at a time that this nuclear compartment undergoes its reorganization. FKBP51 nuclear localization is transient, after 48 h it cycles back to mitochondria. We found that the dynamic FKBP51 mitochondrial-nuclear shuttling is regulated by glucocorticoids and mainly on cAMP-PKA signaling since PKA inhibition by myristoilated-PKI, abrogated FKBP51 nuclear translocation induced by 3-isobutyl-1-methylxanthine (IBMX). It has been reported that PKA interacts with GR in a ligand dependent manner potentiating its transcriptional capacity. GR transcriptional capacity is reduced when cells are incubated in the presence of IBMX, forskolin or dibutyryl-cAMP, compounds that induced nuclear translocation of FKBP51, therefore PKA may exert a dual role in the control of GR. In summary, the presence of FKBP51 in the nucleus may be critical for GR transcriptional control, and possibly for the control of other transcription factors that are not members of the nuclear receptor family but are regulated by PKA signaling pathway, when transcription has to be strictly controlled to succeed in the acquisition of the adipocyte phenotype.

Aspirin-induced Bcl-2 translocation and its phosphorylation in the nucleus trigger apoptosis in breast cancer cells

Here, we report that B-cell lymphoma 2 (Bcl-2) is a novel target molecule of aspirin in breast cancer cells. Aspirin influenced the formation of a complex by Bcl-2 and FKBP38 and induced the nuclear translocation of Bcl-2 and its phosphorylation. These events inhibited cancer cell proliferation and subsequently enhanced MCF-7 breast cancer cell apoptosis. Bcl-2 knockdown using small interfering RNA (siRNA) delayed apoptotic cell death, which correlated with increased proliferation following aspirin exposure. In contrast, Bcl-2 overexpression enhanced the onset of aspirin-induced apoptosis, which was also associated with a significant increase in Bcl-2 phosphorylation in the nucleus. Therefore, this study may provide novel insight into the molecular mechanism of aspirin, particularly its anticancer effects in Bcl-2- and estrogen receptor-positive breast cancer cells.