ABSTRACT
Resumen Objetivo: Explorar los conocimientos, importancia, utilidad y preferencias en población adulta del Gran Área Metropolitana de Costa Rica del etiquetado frontal de alimentos procesados como insumo para la toma de decisiones y ejecución de acciones en alimentación y nutrición. Método: Estudio cuali-cuantitativo exploratorio basado en un cuestionario estructurado. Se realizaron 100 encuestas en Facebook a hombres y mujeres entre 20 a 64 años del Gran Área Metropolitana de Costa Rica durante noviembre 2016. Resultados: Las encuestadas fueron adultas jóvenes, costarricenses y con algún nivel universitario. La mayoría afirmó conocer el etiquetado frontal, especialmente los esquemas Guía Diaria de Alimentación monocromático y coloreado. Se encontró que el etiquetado frontal podría incrementar la lectura y mejorar la interpretación de la información nutricional. Además, parece influir en la decisión de compra y visualizado como una herramienta útil para prevenir enfermedades crónicas no transmisibles. La Guía Diaria de Alimentación coloreada y el esquema semáforo, fueron preferidos por la población en estudio. Apoyaron un etiquetado frontal único, simple y estandarizado en todas las categorías de alimentos. Los colores y descriptores nutricionales resultaron relevantes para definir el esquema para Costa Rica. Conclusiones: El etiquetado frontal de fácil interpretación, como lo es el Guía Diaria de Alimentación coloreado fue preferido por una población educada que representa un posible agente de cambio en la práctica de una alimentación saludable, donde puede haber mayor impacto por los hábitos alimenticios que los caracterizan y el interés mostrado.
Abstract Objective: To explore the knowledge, relevance, use, and preferences of the adult population in the Greater Metropolitan Area of Costa Rica about the front-of-pack nutritional labeling of food processed for intake when making decisions and taking actions related to diet and nutrition. Methodology: The present is an explorative, quali-quantitative study based on a structured questionnaire. Men and women who were from 20 to 64 years old from the Greater Metropolitan Area of Costa Rica gave over one hundred interviews during November 2016. Results: The interviewees were Costa Rican young adults with some university degree. Most interviewees admitted knowing front-of-pack nutritional labeling of food, especially those that are part of the monochromatic and colored Guideline Daily Amount. Results also showed that the front-of-pack nutritional labeling might improve the reading and interpretation of nutritional information. Additionally, the aforementioned labeling seems to also have an effect on food purchases just as it is considered a useful tool to prevent non-transmissible chronic diseases. Population study preferred the Guideline Daily Amount and "traffic light" labels over other types and supported the idea of using a unique, simple, and standard front-of-pack labeling in all food categories. Colors and nutritional descriptors were fundamental to define the nutritional labeling used in Costa Rica. Conclusion: A front-of-pack nutritional labeling easy to interpret like a colored Guideline Daily Amounte was thought preferable by a educated population who represents a possible agent of change when it comes to healthy eating habits that, at the same time, might bepositively impacted by this population's characteristic healthy eating choices.
Subject(s)
Humans , Adult , Middle Aged , Eating , Food Packaging , Food Labeling , Chronic Disease/prevention & control , Costa RicaABSTRACT
Accumulation evidence links obesity-induced inflammation as an important contributor to the development of insulin resistance, which plays a key role in the pathophysiology of obesity-related diseases such as type 2 diabetes and nonalcoholic fatty liver disease. Cyclooxygenase (COX)-1 and -2 catalyze the first step in prostanoid biosynthesis. Because adult hepatocytes fail to induce COX-2 expression regardless of the proinflammatory stimuli used, we have evaluated whether this lack of expression under mild proinflammatory conditions might constitute a permissive condition for the onset of insulin resistance. Our results show that constitutive expression of human COX-2 (hCOX-2) in hepatocytes protects against adiposity, inflammation, and, hence, insulin resistance induced by a high-fat diet, as demonstrated by decreased hepatic steatosis, adiposity, plasmatic and hepatic triglycerides and free fatty acids, increased adiponectin-to-leptin ratio, and decreased levels of proinflammatory cytokines, together with an enhancement of insulin sensitivity and glucose tolerance. Furthermore, hCOX-2 transgenic mice exhibited increased whole-body energy expenditure due in part by induction of thermogenesis and fatty acid oxidation. The analysis of hepatic insulin signaling revealed an increase in insulin receptor-mediated Akt phosphorylation in hCOX-2 transgenic mice. In conclusion, our results point to COX-2 as a potential therapeutic target against obesity-associated metabolic dysfunction.
Subject(s)
Cyclooxygenase 2/metabolism , Dietary Fats/adverse effects , Fatty Liver/metabolism , Insulin Resistance/physiology , Liver/enzymology , Obesity/metabolism , Animals , Cyclooxygenase 2/genetics , Dietary Fats/administration & dosage , Gene Expression Regulation, Enzymologic/drug effects , Humans , Inflammation/metabolism , Insulin/metabolism , Mice , Mice, TransgenicABSTRACT
Increased expression of COX-2 has been linked to inflammation and carcinogenesis. Constitutive expression of COX-2 protects hepatocytes from several pro-apoptotic stimuli. Increased hepatic apoptosis has been observed in experimental models of diabetes. Our present aim was to analyze the role of COX-2 as a regulator of apoptosis in diabetic mouse liver. Mice of C57BL/6 strain wild type (Wt) and transgenic in COX-2 (hCOX-2 Tg) were separated into Control (vehicle) and SID (streptozotocin induced diabetes, 200 mg/kg body weight, i.p.). Seven days post-injection, Wt diabetic animals showed a decrease in PI3K activity and P-Akt levels, an increase of P-JNK, P-p38, pro-apoptotic Bad and Bax, release of cytochrome c and activities of caspases-3 and -9, leading to an increased apoptotic index. This situation was improved in diabetic COX-2 Tg. In addition, SID COX-2 Tg showed increased expression of anti-apoptotic Mcl-1 and XIAP. Pro-apoptotic state in the liver of diabetic animals was improved by over-expression of COX-2. We also analyzed the roles of high glucose-induced apoptosis and hCOX-2 in vitro. Non-transfected and hCOX-2-transfected cells were cultured at 5 and 25 mM of glucose by 72 h. At 25 mM there was an increase in apoptosis in non-transfected cells versus those exposed to 5 mM. This increase was partly prevented in transfected cells at 25 mM. Moreover, the protective effect observed in hCOX-2-transfected cells was suppressed by addition of DFU (COX-2 selective inhibitor), and mimicked by addition of PGE(2) in non-transfected cells. Taken together, these results demonstrate that hyperglycemia-induced hepatic apoptosis is protected by hCOX-2 expression.
Subject(s)
Apoptosis , Cyclooxygenase 2/metabolism , Hyperglycemia/metabolism , Liver/metabolism , Animals , Caspase 3/metabolism , Caspase 9/metabolism , Cell Line , Cyclooxygenase 2/genetics , Cytochromes c/biosynthesis , Diabetes Mellitus, Experimental/metabolism , Glucose/metabolism , Humans , JNK Mitogen-Activated Protein Kinases/biosynthesis , Liver/physiology , Male , Mice , Mice, Inbred C57BL , Mice, Transgenic , Myeloid Cell Leukemia Sequence 1 Protein , Phosphatidylinositol 3-Kinases/metabolism , Proto-Oncogene Proteins c-akt/metabolism , Proto-Oncogene Proteins c-bcl-2/biosynthesis , Streptozocin , X-Linked Inhibitor of Apoptosis Protein/biosynthesis , bcl-2-Associated X Protein/biosynthesis , bcl-Associated Death Protein/biosynthesis , p38 Mitogen-Activated Protein Kinases/biosynthesisABSTRACT
O artigo procura oferecer uma visão das principais arritmias cardíacas em pacientes pediátricos, desmistificando uma suposta importância clínica atribuída a muitas delas, que apresentam um caráter benigno, não requerendo qualquer tipo de abordagem terapêutica
Subject(s)
Humans , Child , Arrhythmias, Cardiac , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/physiopathology , Arrhythmia, Sinus , Echocardiography , Tachycardia, VentricularABSTRACT
Purpose - To evaluate the clinical findings and complementary investigation to support the diagnosis of arrhythmogenic right ventricular dysplasia.Methods - Six males with a mean age of 40 years old with episodes of sustained ventricular tachycardia with left bundle branch block pattern. All patients were submitted to a clinical investigation, EKG X rays and echocardiograms. In five patients an electrophysiologic study was performed. All patients were treated with anti-arrhythmic drugs. Results - Palpitation was the most common complaint. T-wave inversion in leads V1-V3 was present in 4 patients. An epsilon wave was noted in 2 patients. The chest X ray was abnormal in only 1 patient. All patients had an abnormal echocardiogram, with consisted in the dilatation of the outflow tract of the RV and hypocontractility. In 2 patients aneurysm of the basal RV free wall below tricuspid valva were detected. Ventricular post-excitation waves were present in 4 patients. After a mean follow-up of 37 months, 5 patients were asyntomatic with antiarrhythmic drugs and one in therapeutic adjustment. Conclusion - In patients with ventricular tachycardia with left bundle branch block pattern, the diagnosis of arrhythmogenic right ventricular dysplasia was substantiated by echocardiographic data and electrocardiographic findings such a T-wave inversion during sinus rhythm and ventricular post-excitation waves. The results obtained with anti-arrhythmic drugs in our study group, suggest that drug therapy should be the first and best approach to treat patients with this type of pathology
Subject(s)
Tachycardia/diagnosis , Tachycardia/physiopathology , Tachycardia/drug therapy , Echocardiography , Follow-Up Studies , Electrocardiography , Electrophysiology , Anti-Arrhythmia Agents/administration & dosage , Anti-Arrhythmia Agents/therapeutic use , Diagnosis, Differential , Physical Examination , Prognosis , Radiography, Thoracic , Exercise Test , Heart Ventricles/abnormalitiesABSTRACT
Os autores apresentam sua experiência com monitorizaçäo eletrocardiográfica ambulatorial (Holter) na detecçäo de isquemia miocárdica (IM) anginosa 159 pacientes com doença coronária crônica: 76 com infarto prévio, 66 com cirurgia para revascularizaçäo miocárdica, 13 com lesäo obstrutiva na coronariografia e 4 submetidos à coronarioplasita. Em 51 pacientes (32%) foram registrados episódios de IM, embora estivessem sob medicaçäo anginosa profilática. Em 44 pacientes (86%) todos episódios foram de IMS, 6 pacientes tiveram 16 episódios de IMS e 12 episódios de IMA e 1 paciente só teve 1 IMA. Houve um total de 119 episódios de IM, 106 de IMS (89,1%) e 13 de IMA (10,9%). A duraçäo total dos episódios de IMS por pacientes variou de 1 a 235 min e a duraçäo máxima de 1 IMS foi de 221 min. Nos 6 pacientes com IMS e IMA a duraçäo total dos episódios de IMS foi de 461 min e de IMA de 306 min. A incidência no nictemero da IMS foi: de 6 às 12 h - 33,3%, de 12 às 18 h - 31,4%, de 18 às 24 h - 27,6% e de 24 h às 6 h - 7,7%. A atividade dos pacientes durante a IMS em 89 episódios foi: atividade física 46%, sono (23,6%), repouso (22,4%) e outra (8%). A depressäo do segmento ST nos 106 episódios de IMS foi em média de -2,25 mm e nos 13 de IMA, de - 3,25 mm. Os autores ressaltam que a medicaçäo antianginosa profilática foi incapaz de prevenir a IM em 32% dos pacientes. Assim, nesses pacientes a medicaçäo era antianginosa mas näo anti-isquêmica. O tratamento da IMS deve ser feito em todos os pacientes...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Coronary Disease/diagnosis , Electrocardiography , Monitoring, Physiologic , Aged, 80 and over , Coronary Disease/physiopathology , Coronary Disease/drug therapy , Anti-Arrhythmia Agents/therapeutic use , Ambulatory Care , Chronic Disease , Heart Rate , PrognosisABSTRACT
Nove pacientes com infarto agudo do miocárdio e sinais de hipoperfusäo periferica foram estudados do ponto de vista clínico e hemodinâmico. Näo apresentavam sinais clínicos e/ou radiológicos de congestäo pulmonar, enquadrados no grupo III da classificaçäo de Forrester e col. Em dois pacientes, a hipovolemia ocorreu por uso de diuréticos e em outro por hemorragia decorrente de rotura de aneurisma da aorta abdominal. Nos demais seis pacientes, näo houve causa aparente e responsável pela hipovolemia. Seis indivíduos morreram, sendo quatro na fase hospitalar. Este estudo mostra que a hipoperfusäo periféricia no infarto agudo do miocárdio constitui síndrome multifatorial da qual fazem parte: pacientes realmente hipovolêmicos que respondem a administraçäo de líquidos, pacientes com infarto de ventrículo direito e pacientes com infarto extenso, alteraçäo estrutural acentuada e prognóstico reservado