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1.
Aquat Toxicol ; 170: 1-12, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26562184

RESUMO

Nickel compounds are widely used in industries and have been massively introduced in the environment in different chemical forms. Here we report the effect of two different chemical forms of nickel, NiCl2 and nickel nanoparticles (NiNPs), on the reproduction of the marine calanoid copepod Acartia tonsa. The behavior of nickel nanoparticles was analyzed with different techniques and with two protocols. In the "sonicated experiment" (SON) NiNP solution was sonicated while in the "non-sonicated experiment" (NON-SON) the solution was vigorously shaken by hand. Final nominal concentrations of 5, 10 and 50mgL(-1) and 1, 5 and 10mgL(-1) NiNPs were used for the acute and semichronic tests, respectively. Nanoparticle size did not change over time except for the highest concentration of 50mgL(-1) NiNPs, in which the diameter increased up to 843nm after 48h. The concentration of Ni dissolved in the water increased with NP concentration and was similar for SON and NON-SON solutions. Our results indicate that sonication does not modify toxicity for the copepod A. tonsa. Mean EC50 values were similar for NON-SON (20.2mgL(-1)) and SON experiments (22.14mgL(-1)) in the acute test. Similarly, no differences occurred between the two different protocols in the semichronic test, with an EC50 of 7.45mgL(-1) and 6.97mgL(-1) for NON-SON and SON experiments, respectively. Acute and semichronic tests, conducted exposing A. tonsa embryos to NiCl2 concentrations from 0.025 to 0.63mgL(-1), showed EC50 of 0.164 and 0.039mgL(-1), respectively. Overall, A. tonsa is more sensitive to NiCl2 than NiNPs with EC50 being one order of magnitude higher for NiNPs. Finally, we exposed adult copepods for 4 days to NiCl2 and NiNPs (chronic exposure) to study the effect on fecundity in terms of daily egg production and naupliar viability. Egg production is not affected by either form of nickel, whereas egg viability is significantly reduced by 0.025mgL(-1) NiCl2 and by 8.5mgL(-1) NiNPs. At NiNP concentration below the acute EC50 (17mgL(-1)) only 9% of embryos hatched after 4 days. Interestingly, the percentage of naupliar mortality (>82%) observed in the semichronic test at the nominal concentration of 10mgL(-1) NiNPs corresponding to almost 0.10mgL(-1) of dissolved Ni, was similar to that recorded at the same Ni salt concentration. Electron microscopical analyses revealed that A. tonsa adults ingest NiNPs and excrete them through fecal pellets. To the best of our knowledge, this is the first study investigating the toxicity of two different forms of Ni on the reproductive physiology of the copepod A. tonsa and showing the ability of the calanoid copepod to ingest nanoparticles from seawater.


Assuntos
Organismos Aquáticos/efeitos dos fármacos , Copépodes/efeitos dos fármacos , Nanopartículas/toxicidade , Níquel/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Bioensaio , Feminino , Nanopartículas/ultraestrutura , Tamanho da Partícula , Espectrofotometria Atômica , Eletricidade Estática , Testes de Toxicidade Aguda , Testes de Toxicidade Crônica
2.
Br Dent J ; 219(11): 547-51, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26657443

RESUMO

Spain is the second largest EU Member State with an area of 504,645 km(2) and is the fifth most populated one with a total of 46.5 million inhabitants. The number of dentists working in Spain has grown rapidly in the last 20 years. In December 2014, there were 33,346 practising dentists with a ratio of one dentist for every 1394 inhabitants. Oral health of children has improved; with a fall in the national mean DMFT index (decayed, missing and filled permanent teeth) among 12-year-olds, from 4.20 in 1984 to 1.12 in 2010. The percentage of the population that has visited a dentist within the last three months has risen from 13.5% (1987) to 16.9% (2011-2012). Forty-three percent of the Spanish population visited a dentist in the last year in 2009. The Spanish National Health System (SNS) provides comprehensive cover for general health, but very little oral healthcare for adults. Only emergency care and oral surgery (dental extractions) for adults are provided in publicly funded clinics. The vast majority of oral health care is provided in the private sector and over 90% of dental professionals work in the private sector. Nevertherless, children aged 7-15 years are covered (with some restrictions) by publicly funded oral healthcare with different care models, depending on the local health authority, and some of them are funded by a capitation system which was introduced 25 years ago.


Assuntos
Atenção à Saúde/organização & administração , Programas Nacionais de Saúde/organização & administração , Saúde Bucal , Adolescente , Adulto , Idoso , Criança , Índice CPO , Assistência Odontológica/organização & administração , Assistência Odontológica/estatística & dados numéricos , Odontólogos/provisão & distribuição , Serviços Médicos de Emergência/organização & administração , Humanos , Pessoa de Meia-Idade , Espanha/epidemiologia , Cirurgia Bucal/organização & administração , Adulto Jovem
3.
Eur J Obstet Gynecol Reprod Biol ; 189: 13-8, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25827079

RESUMO

OBJECTIVE: To compare a contingent strategy with a combined strategy for prenatal detection of Down's syndrome (DS) in terms of cost, outcomes and safety. STUDY DESIGN: The contingent strategy was based on a simulation, removing measurement of the free beta subunit of human chorionic gonadotropin (free ßhCG) and calculating the DS risk retrospectively in 32,371 pregnant women who had been screened with the combined strategy in the first trimester. In the contingent strategy, a risk between 1:31 and 1:1000 in the first trimester indicated further testing in the second trimester (alpha-fetoprotein, inhibin A, unconjugated oestriol and free ßhCG). The cut-off risk values for the contingent and combined strategies in the first trimester were 1:30 and 1:250, respectively, and the cut-off risk value for integrated screening in the second trimester was 1:250. Costs were compared in terms of avoided DS births, and the ratio of loss of healthy fetuses following invasive procedures per avoided DS birth was calculated. RESULTS: The combined strategy had sensitivity of 40/44 (90.9%) and a false-positive rate of 2.8%. Corresponding values for the contingent strategy were 39/44 (88.6%) and 1.3%, respectively. Only 11% of pregnant women required tests in the second trimester, and the approximate cost reduction for each avoided DS birth was 5000€. The ratio of lost healthy fetuses following invasive procedures per avoided DS birth improved by up to 0.65. CONCLUSION: The contingent strategy has similar effectiveness to the combined strategy, but has lower costs and fewer invasive procedures.


Assuntos
Custos e Análise de Custo , Síndrome de Down/diagnóstico , Diagnóstico Pré-Natal/economia , Diagnóstico Pré-Natal/métodos , Adulto , Gonadotropina Coriônica Humana Subunidade beta/sangue , Estriol/sangue , Reações Falso-Positivas , Feminino , Idade Gestacional , Humanos , Inibinas/sangue , Gravidez , Primeiro Trimestre da Gravidez , Segundo Trimestre da Gravidez , Diagnóstico Pré-Natal/efeitos adversos , Risco , Medição de Risco , alfa-Fetoproteínas/análise
4.
Nutr Metab Cardiovasc Dis ; 21(1): 46-53, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19819677

RESUMO

BACKGROUND AND AIMS: Several studies have shown that moderate alcohol consumption reduces the risk of coronary heart disease, a disease related to oxidative stress. However, the effects of different alcoholic beverages on antioxidant status are not fully known. Our aim was therefore to compare the effects of a moderate intake of an alcoholic beverage with high polyphenol content (red wine) and another without polyphenol content (gin) on plasma antioxidant vitamins, lipid profile and oxidability of low-density lipoprotein (LDL) particles. METHODS AND RESULTS: Forty healthy men (mean age, 38 years) were included in a randomised cross-over trial. After a 15-day washout period, subjects received 30 g/ethanol/d as either wine or gin for 28 days. Diet and exercise were monitored. Before and after each intervention, we measured serum vitamins, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase activities, lipid profile, oxidized LDL and LDL resistance to ex-vivo oxidative stress. Compared to gin intervention, wine intake reduced plasma SOD activity [-8.1 U/gHb (95% confidence interval, CI, -138 to -25; P=0.009)] and MDA levels [-11.9 nmol/L (CI, -21.4 to-2.5; P=0.020)]. Lag phase time of LDL oxidation analysis also increased 11.0 min (CI, 1.2-20.8; P=0.032) after wine, compared to gin, whereas no differences were observed between the two interventions in oxidation rate of LDL particles. Peroxide concentration in LDL particles also decreased after wine [-0.18 nmol/mL (CI, -0.3 to-0.08;P=0.020)], as did plasma oxidized LDL concentrations [-11.0 U/L (CI,-17.3 to -6.1; P=0.009)]. CONCLUSION: Compared to gin, red wine intake has greater antioxidant effects, probably due to its high polyphenolic content.


Assuntos
Bebidas Alcoólicas , Eritrócitos/efeitos dos fármacos , Eritrócitos/enzimologia , Superóxido Dismutase/sangue , Vinho , Adulto , Antioxidantes/metabolismo , Coagulação Sanguínea/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Estudos Cross-Over , Dieta , Exercício Físico/fisiologia , Comportamento Alimentar , Flavonoides/farmacologia , Humanos , Lipídeos/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Fenóis/farmacologia , Polifenóis , Estudos Prospectivos , Vitaminas/sangue
5.
Rehabilitación (Madr., Ed. impr.) ; 44(3): 205-210, jul.-sept. 2010. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-80863

RESUMO

Introducción. La cervicalgia mecánica crónica es la segunda causa de consulta en nuestros centros de atención primaria. La alta demanda de recursos que genera nos plantea introducir estrategias de gestión que sean eficaces y eficientes. Para ello diseñamos un programa de tratamiento integral del raquis (PIR) cervical, que optimiza los recursos disponibles. El objetivo del estudio es demostrar su efectividad. Material y método. Estudio prospectivo y de costes de pacientes que han participado en el PIR cervical de septiembre de 2008 a enero de 2009. Son 208 pacientes, 33 hombres y 175 mujeres, de 25–89 años. El programa es multidisciplinario y consta de 14 sesiones grupales de 1h de duración, incluyendo 2 charlas educativas (psicólogo y médico rehabilitador). Las variables recogidas son edad, sexo, escala visual analógica de dolor pretratamiento y postratamiento, y cuestionario de Northwick Park pretratamiento y postratamiento. Resultados. Disminuye un 50% las visitas y un 40% las horas de tratamiento fisioterapéutico, aunque se ha necesitado una inversión inicial única en equipamiento. La disminución del dolor mediante escala visual analógica y la mejora de la funcionalidad mediante el cuestionario de Northwik Park han sido altamente significativas desde el punto de vista estadístico. Conclusión. El PIR cervical se ha demostrado útil en la gestión de los recursos disponibles para el tratamiento del dolor cervical crónico (AU)


Introduction. Chronic mechanical neck pain is the second cause of consultation in our primary care centers. The high demand for resources generated for it, leading us introduce management strategies that are effective and efficient. For this reason, we designed an integral neck program (PIR), which optimizes available resources, and the aim of this study is demonstrate their effectiveness. Material and methods. Prospective and cost analysis study of patients who have participated in the PIR cervical, from September 2008 to January 2009. Are 208 patients, 33 men and 175 women aged 25 to 89 years. The program is multidisciplinary and consists of 14 group sessions of 1h, including 2 educational lectures (psychologist and rehabilitation physician). As variables are set age, sex, pain Visual Analog Scale (VAS) pre-and post-treatment and Northwick Pack Neck Pain Questionnaire before and after treatment. Results. We have decreased visits by 50% and 40% the hours of physiotherapy, but has needed a single initial investment in equipment. The decrease in pain by VAS and improved functionality through the Northwik Park Neck Pain Questionnaire have been highly significant statistically. Conclusion. The integral rehabilitation Neck Program is useful in the management of the resources available for the treatment of chronic neck pain (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças da Coluna Vertebral/economia , Doenças da Coluna Vertebral/reabilitação , Cervicalgia/economia , Cervicalgia/reabilitação , Modalidades de Fisioterapia/economia , Modalidades de Fisioterapia , Especialidade de Fisioterapia/economia , Modalidades de Fisioterapia/organização & administração , Especialidade de Fisioterapia/organização & administração , Especialidade de Fisioterapia/normas , Estudos Prospectivos , Atenção Primária à Saúde/métodos , Inquéritos e Questionários , Alocação de Custos/estatística & dados numéricos , Custos e Análise de Custo/normas
6.
Prog. diagn. trat. prenat. (Ed. impr.) ; 21(1): 15-19, ene.-mar. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-76785

RESUMO

El cribado del sindrome de Down, en el primer trimestrede gestaci¨®n, incorporando dos parsmetros bioquimicos¡ªproteina plasmstica asociada al embarazo (PAPP-A) y fracciona libre de la hormona gonadotrofina cori¨®nica (f¦ÂhCG)¡ª,y un parametro ecografico ¡ªtranslucencia nucal (TN)¡ª, permiteuna mayor tasa de deteccion (96,55 % en esta serie),asumiendo una tasa de falsos positivos del 5 %. Estos resultadosmejoran de forma significativa los resultados obtenidoscon el cribado ya establecido de segundo trimestre.La incorporacion de los parsmetros bioquimicos se traduceprincipalmente en una disminuci¨®n de los falsos positivos,con la consecuente disminuci¨®n de pruebas invasivas a realizar.La tasa de detecci¨®n en este estudio es algo superior alas mostradas en otras series, hecho atribuible a la edad delas gestantes incluidas en el mismo.Debido al menor porcentaje de falsos positivos, a la mayortasa de deteccion y a la precocidad diagnostica, esta modalidadde cribado es, hoy por hoy, el metodo de eleccion pararealizar un cribado poblacional (AU)


First-trimester screening for Down¡¯s syndrome, combiningtwo biochemical markers ¨CPregnancy associatedplasma protein-A (PAPP-A) and free ¦Â human chorionicgonadotropin (f¦ÂhCG)-, and an ultrasound marker -nuchaltranslucency (NT)¨C, allows a higher detection rate(96.55% in our series) assuming a false positive rate of 5%. These results increase significantly those obtainedwith the second trimester screening.The incorporation of biochemical markers impliesmainly a reduction in the false positive rate, and consequentlya reduction of invasive methods to perform.Detection rate in this study is higher to detection ratepublished in other series. This fact can be due to the ageof pregnant women included in the present paper.The lower false positive rate, the higher detectionrate an the early diagnosis make this screening, actually,a good method to apply to general population.. (AU)


Assuntos
Humanos , Feminino , Gravidez , Primeiro Trimestre da Gravidez , Testes Genéticos/métodos , Síndrome de Down/diagnóstico , Valor Preditivo dos Testes
8.
Ultrasound Obstet Gynecol ; 30(7): 941-5, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18000942

RESUMO

OBJECTIVE: To assess second-trimester screening for trisomy 21 by combining ultrasound nuchal fold (NF) measurement with maternal serum biochemistry. METHODS: NF, maternal serum alpha-fetoprotein (AFP) and free beta-human chorionic gonadotropin (beta-hCG) were determined concurrently at 14-19 weeks' gestation in a study population comprising 1813 women with singleton pregnancies, including 1257 unselected women undergoing serum screening for trisomy 21 (1999-2002), and 556 high-risk pregnancies prior to amniocentesis (2003-2005), 402 of whom had positive serum screening tests. The results were expressed in multiples of the gestation-specific normal median (MoMs). RESULTS: There were 1799 unaffected singleton pregnancies, and their NF values approximately fitted a log Gaussian distribution over a wide range. There was a weak but statistically significant correlation between log NF and log AFP (r = - 0.069, P < 0.005) and the correlation coefficient between log NF and log free beta-hCG was even smaller and not statistically significant (r = 0.038, P = 0.11). Among the seven trisomy 21 pregnancies, the median NF level was 1.53 MoM (geometric mean 1.75 MoM), a highly statistically significant increase compared with unaffected pregnancies (P < 0.0001, one-tail Wilcoxon Rank Sum Test). In pregnancies referred because of positive serum screening tests (391 unaffected, seven cases of trisomy 21, one of monosomy X and three other chromosomal anomalies) the use of NF to modify the serum screening risk would have reduced the invasive procedures in unaffected pregnancies by 46% without affecting the detection rate of trisomy 21 or other anomalies. Statistical modeling predicted that adding NF to AFP and free beta-hCG would increase detection more than would adding unconjugated estriol as well as inhibin-A, an analyte that is difficult to measure with precision. CONCLUSIONS: The addition of NF measurement to second-trimester biochemical markers improves screening performance, and could overcome drawbacks in the implementation of inhibin-A assay in clinical practice.


Assuntos
Gonadotropina Coriônica Humana Subunidade beta/sangue , Síndrome de Down/diagnóstico , Medição da Translucência Nucal , alfa-Fetoproteínas/análise , Biomarcadores/sangue , Síndrome de Down/sangue , Síndrome de Down/diagnóstico por imagem , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , Diagnóstico Pré-Natal/métodos
9.
Transplant Proc ; 39(7): 2217-8, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17889142

RESUMO

INTRODUCTION: Dyslipidemia is an important cardiovascular risk factor and is implicated in the pathogenesis of chronic graft failure in renal transplant recipients. Apolipoprotein E (apoE), a hepatic glycoprotein involved in lipid metabolism, has been associated with hypercholesterolemia and premature coronary disease. AIM: This study assessed the impact of apoE polymorphism on the evolution of renal transplant recipients. METHODS: A total of 517 patients (age, 47 +/- 14 years; 62% men), who had undergone renal transplantation at least 12 months before enrollment, were assessed (mean follow-up, 5.4 +/- 2.2 years). ApoE polymorphisms (E2, E3, and E4 alleles) were analyzed using polymerase chain reaction (PCR) using genomic DNA. Donor-recipient clinical variables were assessed using univariate methods and Cox multivariate regression model. RESULTS: Genotype frequency was as follows: E2/E2 <1%, E2/E3 10%, E3/E3 71%, E2/E4 2%, E3/E4 16%, and E4/E4 1%, with no differences between sexes. In the univariate study, E2/E4, E3/E4, and E4/E4 genotypes were related with poorer patient survival (P = .0045). In the multivariate study, the E4 allele was associated with a higher independent risk of graft loss (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.44-7.21; P < .0001) and death of the patient (OR, 16.03; 95% CI, 3.28-75.18; P < .0001), but only in patients older than 60 years of age. In patients with the E4 allele, 45% of deaths were due to cardiovascular causes. CONCLUSIONS: The genetic polymorphism of apoE (E4 allele) has an independent negative impact on patient and graft survival in the long term, particularly in older patients.


Assuntos
Apolipoproteínas E/genética , Transplante de Rim/fisiologia , Polimorfismo Genético , DNA/sangue , DNA/genética , Primers do DNA , Feminino , Seguimentos , Frequência do Gene , Genótipo , Rejeição de Enxerto/epidemiologia , Rejeição de Enxerto/genética , Humanos , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Análise de Sobrevida , Resultado do Tratamento
10.
Prog. obstet. ginecol. (Ed. impr.) ; 48(5): 223-230, mayo 2005. ilus, tab
Artigo em Es | IBECS | ID: ibc-036883

RESUMO

Objetivo: Evaluar la efectividad del Test Combinado (bioquímica y ecografía en el primer trimestre) para la detección prenatal del síndrome de Down en la población general. Material y métodos: Se determinaron los marcadores bioquímicos de primer trimestre (proteína plasmática A asociada al embarazo y fracción libre de la gonadotropina coriónica) en suero materno a las 7-12 semanas. La translucencia nucal fetal y la edad gestacional se determinaron mediante ecografía a las 10-14 semanas. Se estimó el riesgo combinado el mismo día de la ecografía y se ofreció el diagnóstico citogenético mediante biopsia de corion si el riesgo era de 1:250 o superior. Resultados: La edad gestacional media en la determinación bioquímica fue de 9,5 semanas y de 12,1 para la ecografía. En las 4.447 gestaciones estudiadas con seguimiento completo, los índices de detección fueron del 91% (10/11) para la trisomía 21 y del 83% (5/6) para la trisomía 18 o 13, con una tasa de falsos positivos del 3,8% (167/4.423). Conclusión: El Test Combinado, al determinar los valores de marcadores bioquímicos y de translucencia nucal en intervalos gestacionales óptimos durante el primer trimestre, mostró una tasa de detección del 91% para la trisomía 21 con una reducción en la tasa de falsos positivos al 3,8%


Objetive: To assess the efectiveness of the Combined Test (first-trimester biochemistry and ultrasound) in the prenatal detection of Down syndrome in the general pregnant population. Material and methods: First-trimester biochemical markers (pregnancy associated plasma protein-A and free -hCG) were determined in maternal serum at 7-12 weeks. Nuchal translucency and the gestational age were assessed in a 10-14 weeks scan. The estimated combined risk was delivered the same day of the scan, and when it was 1:250 or above, cytogentic diagnosis was offered by means of chorion villus sampling. Results: The mean gestational age at biochemistry was 9.5 weeks and 12.1 for ultrasound. In the 4,447 studied pregnancies with a complete follow-up, detection rate for trisomy 21 was 91% (10/11), 83% (5/6) for trisomies 18-13, with a 3.8% (167/4423) false-positive rate. Conclusion: The Combined Test, with the assessment of biochemical markers and nuchal translucency in their optimal gestational periods during the first trimester, showed a 91% detection rate for trisomy 21 with a reduced false-positive rate of 3.8%


Assuntos
Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Humanos , Síndrome de Down/epidemiologia , Programas de Rastreamento , Diagnóstico Pré-Natal/métodos , Marcadores Genéticos , Trissomia/diagnóstico , Idade Materna
13.
Prog. obstet. ginecol. (Ed. impr.) ; 47(6): 257-263, jun. 2004. tab
Artigo em Es | IBECS | ID: ibc-33659

RESUMO

Objetivo: Estudio de la efectividad del cribado bioquímico y ecográfico en el segundo trimestre de la gestación para la detección prenatal de trisomía 21 en población de bajo riesgo de aneuploidía. Método: Estudio prospectivo de intervención de 8.894 gestaciones únicas de bajo riesgo de aneuploidía. Se realizó ecografía y extracción simultánea de sangre materna para determinación de alfafetoproteína (AFP) y fracción Beta de la gonadotropina coriónica (Beta-hCG) entre las 14 y 18 semanas. Se consideró como criterio de riesgo para ofrecer amniocentesis una estimación de riesgo superior a 1/270 combinando la edad materna y los valores de marcadores bioquímicos, valores séricos de AFP <= 0,4 múltiplos de la mediana (MoM), de Beta-hCG <= 0,2 MoM (riesgo de trisomía 18), o pliegue nucal superior al percentil 95 para la edad gestacional. Resultados: Las tasas de detección para la trisomía 21 fueron las siguientes: 65 por ciento para la bioquímica y edad materna (con un 11 por ciento de falsos positivos) y 45 por ciento para el pliegue nucal (con 5,3 por ciento de falsos positivos). Los resultados obtenidos con la aplicación de los criterios de riesgo proporcionados indistintamente por cualquiera de ambos parámetros, bioquímica o pliegue nucal, mostraron una tasa de detección del 75 por ciento con una tasa del 14,9 por ciento de falsos positivos. Conclusión: La aplicación simultánea e independiente de los marcadores bioquímicos (AFP y Beta-hCG) y del pliegue nucal para la estimación del riesgo de trisomía 21 en el segundo trimestre permitió detectar el 75 por ciento de fetos afectados, con una tasa de falsos positivos del 14,9 por ciento (AU)


Assuntos
Adolescente , Adulto , Gravidez , Feminino , Humanos , Aneuploidia , Complicações na Gravidez/diagnóstico , Síndrome de Down/diagnóstico , Diagnóstico Pré-Natal/métodos , Estudos Prospectivos , alfa-Fetoproteínas , Idade Materna , Amniocentese , Programas de Rastreamento , Biomarcadores Tumorais , Segundo Trimestre da Gravidez , Gonadotropina Coriônica
14.
Diabet Med ; 21(2): 142-9, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14984449

RESUMO

AIMS: To compare the effects of a high-carbohydrate (CHO) diet and a high-monounsaturated fatty acid (MUFA) diet on LDL oxidative resistance in free-living individuals with Type 2 diabetes mellitus. METHODS: Twenty-two men and women out-patients with Type 2 diabetes, with mean age 61 years and in fair metabolic control (HbA1c<8.0%), were enrolled at a university hospital lipid clinic in a randomized, crossover feeding trial comparing two isocaloric diets for 6 weeks each: CHO (fat, 28% energy) and MUFA (fat, 40% energy) based on virgin olive oil. Outcome measurements were changes in LDL susceptibility to oxidation, body weight, glycaemic control, and lipoprotein profiles. RESULTS: Planned and observed diets were well matched. Participants preferred the MUFA diet over the CHO diet. The lag time of conjugated diene formation during Cu2+-induced LDL oxidation was similar after the CHO and MUFA diets (36.4 +/- 12.2 min and 36.0 +/- 13.7 min, respectively). Body weight, glycaemic control, total triglycerides, and total, LDL- and HDL-cholesterol levels also were similar after the two diets. Compared with the CHO diet, the MUFA diet lowered VLDL-cholesterol by 35% (P=0.023) and VLDL triglyceride by 16% (P=0.016). CONCLUSIONS: Natural food-based high-CHO and high-MUFA diets have similar effects on LDL oxidative resistance and metabolic control in subjects with Type 2 diabetes. A MUFA diet is a good alternative to high-CHO diets for nutrition therapy of diabetes because it also has a beneficial effect on the lipid profile and superior patient acceptance.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Carboidratos da Dieta/administração & dosagem , Ácidos Graxos Monoinsaturados/administração & dosagem , Óleos de Plantas/administração & dosagem , Idoso , LDL-Colesterol/sangue , Estudos Cross-Over , Diabetes Mellitus Tipo 2/sangue , Dieta para Diabéticos , Feminino , Humanos , Masculino , Azeite de Oliva , Oxirredução
15.
Transplant Proc ; 35(5): 1725-6, 2003 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12962772

RESUMO

Cardiovascular disease (CVD) is the main cause of mortality among long-term renal transplant recipients (RTR). On the other hand, allograft chronic nephropathy is the primary cause of graft loss among long-term RTR. Hyperlipidemia is a predisposing factor for both conditions. Polymorphisms of the apolipoproteins modulate lipid metabolism. The aim of the study was to evaluate the effect of apo A-I, apo A-IV and apo C-III genotypes on the long-term results of renal transplantation. Clinical assessment (renal allograft and patient survival) and genotyping for apo A-I (+83C/T), apo C-III (Sst I), and apo A-IV (Thr347Ser and Gln360His) polymorphisms were evaluated in 516 kidney transplant patients and correlated with the clinical evolution over 12 months. The distribution of the apo A-I (+83C/T) polymorphisms was: CC 91.9%, CT 7.9%, and TT 0.2%. The apo C-III genotype showed: S1S1 84.4%, S1S2 15.2%, and S2S2 0.4%. The apo A-IV (Pvu II) polymorphism was: GG 82%, GT 18%, and 0% TT. Finally, the frequency of apo A-IV (Hinf I) polymorphism was: AA 69%, AT 27%, and TT 4%. The frequency of polymorphisms was similar between men and women. In conclusion, there was no significant influence of apolipoprotein polymorphisms on renal and patient survival.


Assuntos
Apolipoproteínas/genética , Transplante de Rim/fisiologia , Polimorfismo Genético , Apolipoproteína A-I/genética , Apolipoproteína C-III , Apolipoproteínas A/genética , Apolipoproteínas C/genética , Genótipo , Humanos , Transplante de Rim/mortalidade , Análise de Sobrevida
16.
Diabet Med ; 20(9): 743-5, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12925055

RESUMO

AIMS: To investigate the effects of atorvastatin on glucose homeostasis, the basal and postprandial lipid profiles and the CRP levels (C reactive protein) in subjects with impaired fasting glucose (IFG). METHODS: Thirty-three subjects (22 men and 11 women) were included in our study. All displayed an IFG (fasting plasma glucose between 6.1 and 7.0 mmol/l) on at least two occasions during the last 6 months prior the study. They were randomly assigned to receive either 40 mg atorvastatin/day (n=16) or placebo (n=17) over 16 weeks, in a double-blind design. Before and after the end of the study all participants underwent on three consecutive days: a 75-g oral glucose tolerance test, a frequent sampling intravenous glucose tolerance test with Minimal Model analysis and a meal tolerance test (glucose, insulin and triglycerides). CRP was measured before and after the treatment period. RESULTS: CRP decreased significantly in the atorvastatin-treated group compared with the placebo group (percent change respect initial values; -42.3 %[-21.5 to - 63.1] and -9.6%[15.0 to -34.0], respectively, p<0.01). Atorvastatin treatment did not produce any change in oral glucose tolerance categories or induce any change in glucose and insulin response in OGTT. The statin produced a trend towards a significant improvement in insulin sensitivity as expressed by a change in Si from baseline to the end of treatment. Atorvastatin reduced the postprandial response of triglycerides to the meal test compared with placebo (19-26 % across the meal test, p<0.05) correlating with the amelioration observed in Si (-0.34, p<0.05; percentage changes). CONCLUSION: Our results suggest that the use of statins in subjects with IFG seems to include other potentially beneficial actions in addition to their cholesterol-lowering effects.


Assuntos
Anticolesterolemiantes/uso terapêutico , Glicemia/metabolismo , Intolerância à Glucose/tratamento farmacológico , Ácidos Heptanoicos/uso terapêutico , Pirróis/uso terapêutico , Triglicerídeos/sangue , Adulto , Idoso , Atorvastatina , Glicemia/efeitos dos fármacos , Proteína C-Reativa/efeitos dos fármacos , Proteína C-Reativa/metabolismo , Método Duplo-Cego , Jejum/sangue , Feminino , Intolerância à Glucose/sangue , Teste de Tolerância a Glucose , Homeostase/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial
17.
Maturitas ; 45(1): 59-66, 2003 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-12753945

RESUMO

BACKGROUND: Different hormonal replacement regimens are used for treating climacteric complaints; however, not all of them have the same clinical profile. Cardiovascular disease (CVD) is a major health problem and tibolone, raloxifene, estradiol (alone or with cyproterone acetate) have been added to cholesterol-fed rabbits to study atherosclerosis. METHODS: A total of 48 cholesterol-fed New Zealand white rabbits were studied for 4 months. Forty rabbits underwent bilateral ovariectomy and the other eight were sham operated (group S). The ovariectomized rabbits were allocated to five groups of eight animals each receiving tibolone (Group T, 6 mg/day), raloxifene (R, 35 mg/day), estradiol valerate (E, 3 mg/day), estradiol valerate plus cyproterone acetate (EC, 3+0.5 mg/day, respectively), and no treatment for the control group (C). The sham group received no treatment too. RESULTS: After 4 months the percentage of the extent of atherosclerosis in the aorta was 30.4% in C group, 24.5% in S group, 10.2% in T group, 30.3% in R group, 17.9% in E group and 28.1% in EC group (P<0.05 T vs. C, R, EC). The aortic cholesterol content compared with aortic weight was 8.55 microg/mg in C group, 11.97 microg/mg in S group, 1.86 microg/mg in T group, 3.82 microg/mg in R group, 2.86 microg/mg in E group and 5.24 microg/mg in EC group (P<0.05 T vs. EC, C, S; R vs. C, S; E vs. C, S). Uterine weights in grams were: 1.89 (C group), 2.24 (S), 7.38 (T), 1.94 (R), 9.92 (E), and 5.94 (EC); P<0.05 (C, S, R, vs. T, E, EC; T vs. E; EC vs. T, E). CONCLUSION: Our study showed a decrease in the extent of aortic atherosclerosis in oophorectomized cholesterol-fed rabbits treated with tibolone or estradiol, and a decrease in aortic cholesterol content in rabbits treated with tibolone, raloxifene and estradiol. However, rabbits treated with tibolone showed an increased uterine weight, which is contrary to that observed in humans.


Assuntos
Arteriosclerose/tratamento farmacológico , Acetato de Ciproterona/farmacologia , Estradiol/farmacologia , Norpregnenos/farmacologia , Cloridrato de Raloxifeno/farmacologia , Útero/efeitos dos fármacos , Animais , Aorta/efeitos dos fármacos , Colesterol na Dieta , Acetato de Ciproterona/uso terapêutico , Modelos Animais de Doenças , Estradiol/uso terapêutico , Terapia de Reposição de Estrogênios , Feminino , Norpregnenos/uso terapêutico , Ovariectomia , Coelhos , Cloridrato de Raloxifeno/uso terapêutico
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