Biomarkers of cardio-renal syndrome in uremic myocardiopathy animal model / Biomarcadores de síndrome cardiorrenal em modelo animal de miocardiopatia urêmica

ABSTRACT Introduction: Cardio-renal syndrome subtype 4 (CRS4) is a condition of primary chronic kidney disease that leads to reduction of cardiac function, ventricular hypertrophy, and risk of cardiovascular events. Objective: Our aim was to understand the mechanisms involved on the onset of CRS4. Methods: We used the nephrectomy 5/6 (CKD) animal model and compared to control (SHAM). Serum biomarkers were analyzed at baseline, 4, and 8 weeks. After euthanasia, histology and immunohistochemistry were performed in the myocardium. Results: Troponin I (TnI) was increased at 4 weeks (W) and 8W, but nt-proBNP showed no difference. The greater diameter of cardiomyocytes indicated left ventricular hypertrophy and the highest levels of TNF-α were found at 4W declining in 8W while fibrosis was more intense in 8W. Angiotensin expression showed an increase at 8W. Conclusions: TnI seems to reflect cardiac injury as a consequence of the CKD however nt-proBNP did not change because it reflects stretching. TNF-α characterized an inflammatory peak and fibrosis increased over time in a process connecting heart and kidneys. The angiotensin showed increased activity of the renin-angiotensin axis and corroborates the hypothesis that the inflammatory process and its involvement with CRS4. Therefore, this animal study reinforces the need for renin-angiotensin blockade strategies and the control of CKD to avoid the development of CRS4.

RESUMO Introdução: A síndrome cardiorrenal (SCR) tipo 4 é uma afecção da doença renal crônica primária que leva a redução da função cardíaca, hipertrofia ventricular e risco de eventos cardiovasculares. Objetivo: O objetivo do presente estudo foi compreender os mecanismos envolvidos no surgimento da SCR tipo 4. Métodos: Um modelo animal de nefrectomia 5/6 (DRC) foi comparado a animais de controle (Placebo). Biomarcadores séricos foram analisados no início do estudo e com quatro e oito semanas de estudo. Após eutanásia, foram realizados exames histológicos e de imunoistoquímica no tecido miocárdico. Resultados: Troponina I (TnI) estava aumentada nas semanas quatro (S4) e oito (S8), mas o NT-proBNP não apresentou diferenças. O diâmetro maior dos cardiomiócitos indicava hipertrofia ventricular esquerda. Os níveis mais elevados de TNF-α foram identificados na S4 com redução na S8, enquanto fibrose foi mais intensa na S8. A expressão de angiotensina mostrou elevação na S8. Conclusões: TnI parece sugerir lesões cardíacas em consequência da DRC, porém o NT-proBNP não sofreu alterações por refletir alongamento. O TNF-α evidenciou um pico inflamatório e a fibrose aumentou ao longo do tempo devido ao processo de conexão entre rins e coração. A angiotensina mostrou aumento da atividade do eixo renina-angiotensina, corroborando a hipótese do processo inflamatório e seu envolvimento com SCR tipo 4. Portanto, o presente estudo em modelo animal reforça a necessidade de em adotar estratégias com bloqueadores de renina-angiotensina e controle da DRC para evitar o desenvolvimento de SCR tipo 4.

Biomarkers of cardio-renal syndrome in uremic myocardiopathy animal model.

INTRODUCTION: Cardio-renal syndrome subtype 4 (CRS4) is a condition of primary chronic kidney disease that leads to reduction of cardiac function, ventricular hypertrophy, and risk of cardiovascular events. Objective: Our aim was to understand the mechanisms involved on the onset of CRS4. METHODS: We used the nephrectomy 5/6 (CKD) animal model and compared to control (SHAM). Serum biomarkers were analyzed at baseline, 4, and 8 weeks. After euthanasia, histology and immunohistochemistry were performed in the myocardium. RESULTS: Troponin I (TnI) was increased at 4 weeks (W) and 8W, but nt-proBNP showed no difference. The greater diameter of cardiomyocytes indicated left ventricular hypertrophy and the highest levels of TNF-α were found at 4W declining in 8W while fibrosis was more intense in 8W. Angiotensin expression showed an increase at 8W. CONCLUSIONS: TnI seems to reflect cardiac injury as a consequence of the CKD however nt-proBNP did not change because it reflects stretching. TNF-α characterized an inflammatory peak and fibrosis increased over time in a process connecting heart and kidneys. The angiotensin showed increased activity of the renin-angiotensin axis and corroborates the hypothesis that the inflammatory process and its involvement with CRS4. Therefore, this animal study reinforces the need for renin-angiotensin blockade strategies and the control of CKD to avoid the development of CRS4.

Etiology And In Vitro Antimicrobial Susceptibility Profile Of Strains Isolated From Bovine Mastitis In Dairy Herds From The Midwest Region Of Santa Catarina State, Brazil

Dairy farming is an important social and economic activity in the Midwest region of Santa Catarina State, Brazil. However, despite technological advances in the productive chain, mastitis is still considered the main disease of dairy herds, due its high economic impact. Bacterial pathogens are the main cause of this disease and failures in the treatment of clinical cases are attributed in part to the antimicrobial resistance of these pathogens. As an alternative, in vitro antimicrobial susceptibility tests of strains isolated from bovine mastitis cases have been carried out; the information generated contributes to strategic treatment measures, and also to the control of microorganism resistance. Therefore, the aims of the present study were to evaluate the etiology and in vitro antimicrobial susceptibility profiles of bacterial strains isolated from cases of bovine mastitis in dairy herds from the Midwest region of Santa Catarina State, Brazil. For this purpose, 345 milk samples were collected from 70 herds located in 16 different municipalities. The main pathogens isolated were: staphylococci (55.9%), streptococci (34.8%), Corynebacterium spp. (7.8%) and Escherichia coli (1.4%). The resistance rates of staphylococcus strains to ampicillin and to gentamicin were lower (24.9%) and higher (33%), respectively, than those obtained in other Brazilian studies. The resistance profiles of streptococcus strains were similar to those described in the literature, while Corynebacterium spp., showed high resistance rates to tetracycline (85.2%). Moreover, a considerable prevalence of staphylococcus (27.5%) and streptococcus (11.7%) multiresistant strains was verified. These data reinforce the need for regional characterization of microorganisms.(AU)

Etiology And In Vitro Antimicrobial Susceptibility Profile Of Strains Isolated From Bovine Mastitis In Dairy Herds From The Midwest Region Of Santa Catarina State, Brazil

Dairy farming is an important social and economic activity in the Midwest region of Santa Catarina State, Brazil. However, despite technological advances in the productive chain, mastitis is still considered the main disease of dairy herds, due its high economic impact. Bacterial pathogens are the main cause of this disease and failures in the treatment of clinical cases are attributed in part to the antimicrobial resistance of these pathogens. As an alternative, in vitro antimicrobial susceptibility tests of strains isolated from bovine mastitis cases have been carried out; the information generated contributes to strategic treatment measures, and also to the control of microorganism resistance. Therefore, the aims of the present study were to evaluate the etiology and in vitro antimicrobial susceptibility profiles of bacterial strains isolated from cases of bovine mastitis in dairy herds from the Midwest region of Santa Catarina State, Brazil. For this purpose, 345 milk samples were collected from 70 herds located in 16 different municipalities. The main pathogens isolated were: staphylococci (55.9%), streptococci (34.8%), Corynebacterium spp. (7.8%) and Escherichia coli (1.4%). The resistance rates of staphylococcus strains to ampicillin and to gentamicin were lower (24.9%) and higher (33%), respectively, than those obtained in other Brazilian studies. The resistance profiles of streptococcus strains were similar to those described in the literature, while Corynebacterium spp., showed high resistance rates to tetracycline (85.2%). Moreover, a considerable prevalence of staphylococcus (27.5%) and streptococcus (11.7%) multiresistant strains was verified. These data reinforce the need for regional characterization of microorganisms.

Qualidade de vida em disfagia na doença de Parkinson: uma revisão sistemática / Quality of life in dysphagia in Parkinson's disease: a systematic review

A doença de Parkinson pode causar distúrbios da deglutição em qualquer fase da doença devido às disfunções dos movimentos. Apesar da diversidade de sintomas, normalmente as alterações iniciais na deglutição do parkinsoniano são despercebidas e podem ocasionar prejuízo na qualidade de vida. Contudo, instrumentos que avaliam a qualidade de vida em disfagia na doença de Parkinson não têm sido sistematicamente estudados. Esta revisão sistemática objetivou identificar a utilização do questionário de Qualidade de Vida em Disfagia para avaliação na doença de Parkinson. Foram incluídos artigos com sujeitos de ambos os sexos e com doença de Parkinson idiopática, e excluídos os artigos de avaliação de tratamento e que apresentaram indivíduos com outra forma de parkinsonismo. Após a busca realizada nos portais da Bireme, Pubmed e Banco de Teses da Capes, foram analisados 30 artigos, dos quais dois foram incluídos depois da aplicação da Escala de Jadad modificada. Os dois artigos evidenciaram que o questionário de Qualidade de Vida em Disfagia é um instrumento seguro e relevante para avaliar alterações da deglutição do parkinsoniano nos domínios do instrumento, exceto no sono. Além disso, o questionário pode indicar uma compreensão da qualidade de vida geral. Sendo assim, a utilização do questionário de Qualidade de Vida em Disfagia contribuiu para avaliação da qualidade de vida em disfagia de sujeitos com doença de Parkinson.

Parkinson's disease can cause problems with swallowing at any stage of the disease because of movement dysfunctions. Despite various symptoms, normally the initial swallowing alterations associated with Parkinson's Disease go undiagnosed and can damage quality of life. However, instruments for assessing the effects of quality of life in dysphagia are yet to be studied systematically. The objective of this systematic review was to analyze the adequacy of the Dysphagia's Quality of Life questionnaire in assessing Parkinson's disease. Articles examining both men and women were included, whereas those assessing treatment or that examined patients with Parkinsonism, or another form of disease, were excluded. Thirty articles were included after searches through Bireme, Pubmed and Capes' Databank of Theses. The Jadad Scale was used to assess them, with some modifications. Both articles showed that the Dysphagia's Quality of Life questionnaire is a secure and relevant instrument for assessing Parkinsonian swallowing alterations, except during sleep. Besides, it can indicate a general quality of life understanding. Thus, the use of the questionnaire helped assess quality of life in dysphagia in Parkinson's disease subjects.

Swallowing in patients with Parkinson's disease: a surface electromyography study.

Our goal was to study deglutition of Parkinson's disease (PD) patients and normal controls (NC) using surface electromyography (sEMG). The study included 15 patients with idiopathic PD and 15 age-matched normal controls. Surface electromyography was collected over the suprahyoid muscle group. Conditions were the following: swallow at once 10 and 20 ml of water and 5 and 10 ml of yogurt of firm consistency, and freely drink 100 ml of water. During swallowing, durations of sEMG were significantly longer in PD patients than in normal controls but no significant differences of amplitudes were found. Eighty percent of the PD patients and 20 % of the NC needed more than one swallow to consume 20 ml of water, while 70 % of the PD patients and none of the NC needed more than one swallow to consume 5 ml of yogurt. PD patients took significantly more time and needed significantly more swallows to drink 100 ml of water than normal controls. We conclude that sEMG might be a simple and useful tool to study and monitor deglutition in PD patients.

Mistura de farinhas à base de cereais, para alimentação infantil: multifarinha / Flour mixing of the cereals, for infant food: multiflour

O trabalho teve como objetivo elaborar uma mistura de farinhas (multifarinha), com elevado valor energético-protéico, a ser usada como suplementação de crianças entre 02 a 05 anos atendidas pelo Programa do Leite. Foram desenvolvidas duas formulações de mistura de farinhas, uma a base de farinha de rosca (F1) e outra com farinha de trigo (F2). As amostras cruas foram avaliadas pela análise físico-química. Para as cozidas, foram preparados mamadeiras na concentração de 3 por cento m/V e creme na de 7 por cento m/V e submetidos à análise física e sensorial. Na análise físico-química das amostras cruas foram observados que ambas se encontram dentro dos limites da legislação em vigor. Na análise física as formulações tiveram resultados similares. Na análise sensorial pela ADQ na amostra F1 foi identificada como de melhor aparência, textura, sabor e aroma e no teste de ordenação apresentou diferença significativa ao nível de 5 por cento quanto ao sabor e textura em relação à F2, porém não diferiu do controle. Com base nos dados sugeriu-se a formulação F1 para ser utilizada na produção da multifarinha.

Mistura de farinhas à base de cereais, para alimentação infantil: multifarinha / Flour mixing of the cereals, for infant food: multiflour

O trabalho teve como objetivo elaborar uma mistura de farinhas (multifarinha), com elevado valor energético-protéico, a ser usada como suplementação de crianças entre 02 a 05 anos atendidas pelo Programa do Leite. Foram desenvolvidas duas formulações de mistura de farinhas, uma a base de farinha de rosca (F1) e outra com farinha de trigo (F2). As amostras cruas foram avaliadas pela análise físico-química. Para as cozidas, foram preparados mamadeiras na concentração de 3 por cento m/V e creme na de 7 por cento m/V e submetidos à análise física e sensorial. Na análise físico-química das amostras cruas foram observados que ambas se encontram dentro dos limites da legislação em vigor. Na análise física as formulações tiveram resultados similares. Na análise sensorial pela ADQ na amostra F1 foi identificada como de melhor aparência, textura, sabor e aroma e no teste de ordenação apresentou diferença significativa ao nível de 5 por cento quanto ao sabor e textura em relação à F2, porém não diferiu do controle. Com base nos dados sugeriu-se a formulação F1 para ser utilizada na produção da multifarinha.(AU)

The objective Of this work was the elaboration of the flour mixture (multifarinha) with raised protein-energy value, to be used as children supplementation between 02 the 05 years taken care of for the Program of Milk. Two flour mixture formularizations was developed, one the thread flour base (Fi) and another one with wheat flour (F2). The raw samples were evaluated of the physical-chemical analysis. The boil ones, baby's bottles in the concentration of 3% m/V was the preparation and cream in the one of 7% m/V and submitted to the physical and sensorial analysis. In the physical- chemical analysis of the raw samples they was observed that both meet inside of the limits of the foods legislation. In the analysis physical presented similar results in the formularizations. In the analysis sensorial for the ADQ in the F1 sample was identified better appearance, texture, flavor and aroma and in the ordinance test the flavor and texture in relation to the F2 presented a significant difference when compared to the 5% of the probability, however it did not differ from the control. On the basis of the data it was suggested F1formularization to be used in the production of the multifarinha. (AU)

Nódulos pulmonares múltiplos em um paciente com infecção pelo HIV / Multiple pulmonary nodules in a patient with HIV infection

O padrão de múltiplas lesões pulmonares é uma apresentação radiológica comum em pessoas infectadas pelo HIV. As causas possíveis para este podem ser divididas dentro de duas categorias: infecções e neoplasias. Os autores descrevem o caso de um paciente de 53 anos de idade com carcinoma adenóide cístico de nasofaringe, múltiplos nódulos pulmonares e infecção pelo HIV