Assuntos
Terapia de Salvação/ética , Assistência Terminal/ética , Assistência Terminal/organização & administração , Fatores Etários , Serviço Hospitalar de Emergência/ética , Serviço Hospitalar de Emergência/organização & administração , Cuidados Paliativos na Terminalidade da Vida/ética , Cuidados Paliativos na Terminalidade da Vida/organização & administração , Humanos , Oncologia/ética , Oncologia/organização & administração , Cuidados Paliativos/ética , Cuidados Paliativos/organização & administração , Autonomia Pessoal , Atenção Primária à Saúde/ética , Atenção Primária à Saúde/organização & administração , Qualidade de VidaAssuntos
Estado Terminal/terapia , Peroxidação de Lipídeos/fisiologia , Nitrogênio/metabolismo , Estado Nutricional , Obesidade/metabolismo , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Nutrição Parenteral , Assistência Perioperatória/métodos , Resultado do Tratamento , Estados Unidos/epidemiologiaRESUMO
Obesity has become an epidemic in the United States, with other western countries also reporting increases in incidence of obesity. With many associated comorbidities, it is the most common nutritional disorder facing the medical team. However, the assessment of macronutrient needs for nutrition support regimens in obese adults is controversial. This review summarizes existing research on popular predictive approaches, including the Harris-Benedict equation, kilocalories per kilogram, and the Ireton-Jones equations. Complications including special considerations for patients who have undergone bariatric surgeries and current evidence on hypocaloric regimens are also discussed.
RESUMO
BACKGROUND: The human aldehyde dehydrogenase-2 promoter contains sites that bind members of the nuclear receptor family, and one (designated FP330-3') is predicted to bind retinoic acid receptors. METHODS: Binding of retinoid receptors to the FP330-3' oligonucleotide duplex and point mutations thereof was assayed using electrophoretic mobility shift assays. The function of the promoter element was determined in transfection assays. RESULTS: Heterodimers of retinoic acid receptor (RAR)alpha, beta, and gamma with retinoid X receptor (RXR)alpha bound the FP330-3' site. Mutagenesis of the FP330-3' site suggested that either the upstream DR-5 or downstream DR-1 could mediate binding of RAR/RXR. FP330-3' oligonucleotide duplexes were not bound by in vitro translated RXR homodimers but weakly competed with a synthetic DR-1 oligonucleotide duplex for binding by RXR. A reporter construct carrying four copies of the FP330-3' element was induced by cotransfection of rat hepatoma cells with a construct encoding RARalpha, when the RAR-specific ligand AM580 was present. Each of the three RXR isoforms alpha, beta, and gamma stimulated the expression of reporter constructs containing the FP330-3' sites in a 9-cis retinoic acid-dependent fashion in cells in culture. This was confirmed in the case of RXRalpha using the RXR-specific ligand methoprene. CONCLUSION: The human aldehyde dehydrogenase-2 promoter contains a retinoid response element, which may contribute to regulation of the gene.
