ABSTRACT
This study addresses the increasing prevalence of obesity, especially among postmenopausal. Estrogen plays a crucial role in regulating adipose tissue in women, with its absence after menopause associated with metabolic complications. The study aimed to determine the lipolytic activity in different adipose tissue depots of ovariectomized rats submitted to a high-fat diet. Also, to analyze the expression of estrogen receptors in adipose tissues and perform histological and morphometric analyzes of these deposits. Female rats were ovariectomized (O) or sham operated (S). The animals were divided into groups: ovariectomized with high-fat diet (OF), sham-operated with high-fat diet (SF), ovariectomized with control diet (OC) or sham-operated with control diet as the control group (SC). After 24 weeks of consuming the diets, rats were killed and adipose tissue deposits were removed. Polymerase chain reaction was performed to analyze the expression of estrogen receptors in adipose tissues, lipolysis assay and histological analysis. Both the high-fat diet and ovariectomy increased body weight and adiposity. There was hypertrophy of adipocytes. Estrogen replacement therapy modulate lipolytic activity in different adipose depots, with different responses in relation to estrogen receptors. Estrogen receptor expression varied between fat depots. Mesenteric adipose tissue showed greater sensitivity to estrogen compared with others. Estrogen increased lipolytic activity in some fat depots, reducing in others. Expression of ERs depends of hormonal status and adipose tissue location, which may explain distinct actions of estrogen on the metabolism of adipose tissue and on the production of adipokines by them.
ABSTRACT
ABSTRACT Objective: to investigate the level of knowledge of nurses in Basic Health Units and their engagement in monitoring patients with sickle cell disease and other hemoglobinopathies. Methods: this is a qualitative, descriptive-exploratory study, carried out with 12 nurses from basic health units in the municipality of Santa Luzia/Minas Gerais between August 2018 and February 2019. The semi-structured interview was the technique used for data collection, which was analyzed using Content Analysis. Results: the analysis of the interviews emerged in the construction of three categories: understanding of sickle cell disease, risk factors, and alterations on physical examination; nursing care at the health unit according to the recommendation of the Ministry of Health; obstacles and facilitators for the tracking and identification of patients. Discourse analysis highlighted: the outstanding presence of misconceptions regarding sickle cell disease; the absence of effective follow-up of patients in the area covered by the nurse; and the non-existence of a positive sickle cell disease patient link with primary care. Conclusion: although nursing plays a fundamental role in monitoring and assisting patients with sickle cell disease, the study revealed a significant gap between care recommendations and practice in basic health units.
RESUMEN Objetivo: investigar el nivel de conocimiento de los enfermeros de las Unidades Básicas de Salud y su participación en el seguimiento de pacientes con enfermedad de células falciformes y otras hemoglobinopatías. Método: se trata de un estudio cualitativo descriptivo-exploratorio, realizado con 12 enfermeros de unidades básicas de salud de la ciudad de Santa Luzia/Minas Gerais entre agosto de 2018 y febrero de 2019. La entrevista semiestructurada fue la técnica utilizada para la recolección de datos, que fueron analizados mediante el Análisis de Contenido. Resultados: el análisis de las entrevistas emergió en la construcción de tres categorías: comprensión sobre la enfermedad de células falciformes, factores de riesgo y alteraciones en el examen físico; atención de enfermería en la unidad de salud según recomendación del Ministerio de salud; obstáculos y facilitadores para el seguimiento e identificación de pacientes. El análisis del discurso destacó: la marcada presencia de conceptos erróneos en relación con la enfermedad de células falciformes; la falta de seguimiento efectivo de los pacientes en el área cubierta por la enfermera; y la inexistencia de un vínculo positivo entre el paciente y la enfermedad células falciformes con atención primaria. Conclusiones: si bien la enfermería tiene un papel fundamental en la conducción del seguimiento y atención de los pacientes con enfermedad de células falciformes, el estudio reveló una brecha significativa entre las recomendaciones de atención y la práctica en las unidades básicas de salud.
RESUMO Objetivos: investigar o nível de conhecimento dos enfermeiros das Unidades Básicas de Saúde e o engajamento destes no acompanhamento de pacientes com doença falciforme e outras hemoglobinopatias. Métodos: este é um estudo qualitativo descritivo-exploratório, realizado com 12 enfermeiros de unidades básicas de saúde do município de Santa Luzia/Minas Gerais entre agosto de 2018 a fevereiro de 2019. A entrevista semiestruturada foi a técnica utilizada para coleta de dados, as quais foram analisadas usando a Análise de Conteúdo. Resultados a análise das entrevistas emergiu na construção de três categorias: compreensão sobre a doença falciforme, fatores de risco e alterações ao exame físico; assistência do enfermeiro na unidade de saúde segundo a recomendação do Ministério da Saúde; dificultadores e facilitadores para o rastreamento e identificação dos pacientes. A análise do discurso destacou: a presença marcante de conceitos equivocados em relação à doença falciforme; a ausência de acompanhamento efetivo dos pacientes da área de abrangência do enfermeiro; e a não existência de vínculo entre paciente com doença falciforme positivo e a atenção básica ou uma lacuna significativa entre as recomendações de cuidado e a prática nas unidades básicas de saúde. Conclusão: embora a enfermagem desempenhe um papel fundamental no monitoramento e na assistência aos pacientes com doença falciforme, o estudo revelou uma lacuna significativa entre as recomendações de cuidados e a prática nas unidades básicas de saúde.
ABSTRACT
Ischemia-reperfusion injury (IRI) is the main cause of morbidity and mortality due to graft rejection after liver transplantation. During IRI, an intense inflammatory process occurs in the liver. This hepatic inflammation is initiated by the ischemic period but occurs mainly during the reperfusion phase, and is characterized by a large neutrophil recruitment to the liver. Production of cytokines, chemokines, and danger signals results in activation of resident hepatocytes, leukocytes, and Kupffer cells. The role of neutrophils as the main amplifiers of liver injury in IRI has been recognized in many publications. Several studies have shown that elimination of excessive neutrophils or inhibition of their function leads to reduction of liver injury and inflammation. However, the mechanisms involved in neutrophil recruitment during liver IRI are not well known. In addition, the molecules necessary for this type of migration are poorly defined, as the liver presents an atypical sinusoidal vasculature in which the classical leukocyte migration paradigm only partially applies. This review summarizes recent advances in neutrophil-mediated liver damage, and its application to liver IRI. Basic mechanisms of activation of neutrophils and their unique mechanisms of recruitment into the liver vasculature are discussed. In particular, the role of danger signals, adhesion molecules, chemokines, glycosaminoglycans (GAGs), and metalloproteinases is explored. The precise definition of the molecular events that govern the recruitment of neutrophils and their movement into inflamed tissue may offer new therapeutic alternatives for hepatic injury by IRI and other inflammatory diseases of the liver.
