ABSTRACT
RATIONALE: The FDA-approved Dimethyl Fumarate (DMF) as an oral drug for Multiple Sclerosis (MS) treatment based on its immunomodulatory activities. However, it also caused severe adverse effects mainly related to the gastrointestinal system. OBJECTIVE: Investigated the potential effects of solid lipid nanoparticles (SLNs) containing DMF, administered by inhalation on the clinical signs, central nervous system (CNS) inflammatory response, and lung function changes in mice with experimental autoimmune encephalomyelitis (EAE). MATERIALS AND METHODS: EAE was induced using MOG35-55 peptide in female C57BL/6J mice and the mice were treated via inhalation with DMF-encapsulated SLN (CTRL/SLN/DMF and EAE/SLN/DMF), empty SLN (CTRL/SLN and EAE/SLN), or saline solution (CTRL/saline and EAE/saline), every 72 h during 21 days. RESULTS: After 21 days post-induction, EAE mice treated with DMF-loaded SLN, when compared with EAE/saline and EAE/SLN, showed decreased clinical score and weight loss, reduction in brain and spinal cord injury and inflammation, also related to the increased influx of Foxp3+ cells into the spinal cord and lung tissues. Moreover, our data revealed that EAE mice showed signs of respiratory disease, marked by increased vascular permeability, leukocyte influx, production of TNF-α and IL-17, perivascular and peribronchial inflammation, with pulmonary mechanical dysfunction associated with loss of respiratory volumes and elasticity, which DMF-encapsulated reverted in SLN nebulization. CONCLUSION: Our study suggests that inhalation of DMF-encapsulated SLN is an effective therapeutic protocol that reduces not only the CNS inflammatory process and disability progression, characteristic of EAE disease, but also protects mice from lung inflammation and pulmonary dysfunction.
Subject(s)
Dimethyl Fumarate/administration & dosage , Encephalomyelitis, Autoimmune, Experimental/drug therapy , Liposomes/administration & dosage , Nanoparticles/administration & dosage , Pneumonia/drug therapy , Administration, Inhalation , Animals , Disease Models, Animal , Female , Immunosuppressive Agents/administration & dosage , Mice, Inbred C57BL , Multiple SclerosisABSTRACT
Introdução: Nos últimos anos, com o avanço tecnológico e da medicina, a sobrevida dos pacientes internados nas unidades de terapia intensiva (UTI) tem aumentado consideravelmente. No entanto, muitos desses pacientes permanecem imóveis e restritos ao leito causando diversas consequências deletérias associadas à imobilidade prolongada. Objetivo: Elucidar os efeitos sistêmicos da mobilização precoce em pacientes adultos internados na UTI. Métodos: Trata-se de uma revisão realizada nas bases de dados eletrônica: Pubmed, Scielo e Web of Science. Foram selecionados artigos indexados publicados entre o período de 2012 a 2017. Foram encontrados 9 estudos relevantes a essa revisão. Resultados: De forma geral, essa prática proporcionou aumento da força muscular, aumento da pressão inspiratória máxima, redução na produção de citocinas pró-inflamatórias e do estresse oxidativo, menor permanência na ventilação mecânica (VM), menor tempo de internação hospitalar e maior qualidade de vida. Conclusão: A fisioterapia torna-se essencial no desenvolvimento da mobilização precoce, contribuindo para a melhora da funcionalidade e da qualidade de vida do paciente tanto no meio hospitalar quanto pós-alta.
Introduction: In recent years, with advances in technology and medicine, the survival of patients admitted to intensive care units (ICU) has increased considerably. However, many of these patients remain immobile and restricted in the beds causing several deleterious consequences associated with prolonged immobility. Objective: To elucidate the systemic effects of early mobilization in adult patients hospitalized in the ICU. Methods: This is a review carried out in the electronic databases: PubMed, Scielo and Web of Science. We selected indexed articles between 2012 and 2017. We found 9 studies relevant to this review. Results: In general, this practice increased muscle strength, increased maximal inspiratory pressure, reduced production of proinflammatory cytokines and oxidative stress, shorter mechanical ventilation (MV), shorter hospital stay and higher quality of life. Conclusion: Physical therapy becomes essential in the development of early mobilization, contributing to improve the functionality and quality of life of the patient both in hospital and post-discharge.
ABSTRACT
Introdução: As infecções respiratórias agudas (IRA) são as causas mais comuns de morbimortalidade na infância. O Boletim de Silverman-Andersen (BSA) é um instrumento utilizado na prática clínica pediátrica para avaliar cinco aspectos do desconforto respiratório e quantificá-los. Objetivo: Comparar a efetividade do tratamento fisioterapêutico com 1 ou 2 sessões diárias durante 2 dias consecutivos, em crianças entre 0 e 3 anos hospitalizadas com IRA, utilizando o BSA. Métodos: Trata-se de um estudo clínico cego realizado com 23 crianças que foram separadas em dois grupos aleatoriamente: o G1, composto por crianças que apenas foram submetidas ao tratamento oferecido pelo hospital e o G2 que, além dessa mesma intervenção, foram submetidas a um segundo atendimento padronizado. Os resultados foram analisados através do programa Prisma versão 5.0. Resultados: Nas análises dos dados da reavaliação de ambos os grupos, foi evidenciada diferença estatisticamente significativa nos escores do Boletim de Silverman Andersen (p = 0,0114). Conclusão: Observou-se que houve melhora do esforço respiratório e das condições clínicas em curto prazo das crianças submetidas a dois atendimentos fisioterapêuticos diários. (AU)
Introduction: Acute respiratory infections (ARI) are the most common causes of morbidity and mortality in childhood. The Bulletin Silverman-Andersen (BSA) is an instrument used in pediatric clinical practice to evaluate five aspects of respiratory distress and quantifies them. Objective: To compare the effectiveness of physical therapy with 1 or 2 sessions daily for 2 consecutive days, in children aged 0 to 3 years hospitalized with ARI using the BSA. Methods: This is a clinical blind randomized study of 23 children who were separated into two groups: the G1, composed of children who were only subjected to the treatment provided by the hospital and the G2 that, beyond such intervention were submitted a second standard care. The results were analyzed using the Prism software, version 5.0. Results: In the analysis of the re-evaluation of data from both groups was evidenced statistically significant difference in Silverman Andersen Bulletin scores (p = 0.0114). Conclusion: It was demonstrating improved respiratory effort and clinical conditions in the short term of children undergoing two daily physical therapy sessions.(AU)
