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Background and aims The trans-radial access is becoming the default approach in many cardiac centers worldwide. Data from the Middle East, including Iraq, on the trends and rates of the use of trans-radial access are scarce. The aim of this study is to determine the rates of trans-radial approach (TRA) versus transfemoral approach (TFA) in patients with coronary artery syndromes undergoing coronary angiography and/or percutaneous coronary intervention (PCI) in Iraq. Methods In this multicenter prospective study, we collected 885 cases of coronary artery disease undergoing coronary angiography/PCI from three main cities of the Kurdistan Region in Iraq from 2022 to 2023. Results Of the total sample, 57.2% were diagnostic coronary angiography and 42.8% were PCI, 57.1% of all cases were TFA and 42.9% were TRA, and 64.3% of PCI cases were performed through TFA. Eghty-two percent of total emergency PCI included (primary PCI) cases underwent the procedure through the TFA, and only 18% of such cases were through the TRA. The overall crossover rate between both approaches happened in 14 (3.6%) cases. Conclusions Despite its main benefits, the radial access use in the Cath lab is yet underused in our region. Further steps in training programs are indicated to popularize the use of radial access among interventional cardiologists in addition to transfemoral access.
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OBJECTIVES: To evaluate, in a Saudi Arabian context, how the COVID-19 pandemic psychologically impacted persons with multiple sclerosis (PwMS). METHODS: A cross-sectional study was undertaken during the period from October 2021 to March 2022. 738 participants resident in the Kingdom of Saudi Arabia (KSA) completed a self-administered online questionnaire. The research focused on persons diagnosed with MS. RESULTS: Participant ages spanned from 18 to over 55. The mean was 36.1±12.9 years old. Four hundred eighty-nine (66.3%) of the 738 participants were female. Two hundred sixty-four (35.8%) were single. Four hundred twelve (55.8%) were married. Six hundred eighty-five (92.8%) had received a COVID-19 vaccine. Regarding MS duration, 117 (15.9%) had been diagnosed for less than 2 years, 171 (23.2%) for 2-5 years, while 251 (34%) had the condition for 10 or more years. Regarding psychological health, 11.2% of participants complained of minimal/no depression, 33.3% of mild depression, 28.3% of moderate depression, and 27.1% of moderately severe to severe depression symptoms. Concerning anxiety, 17.2% of participants reported minimal anxiety, 36.9% mild, 23.3% moderate, while 22.6% suffered from severe anxiety symptoms. CONCLUSION: A high prevalence of depression and anxiety was found, along with high prevalence of co-occurrence of these disorders among PwMS.
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COVID-19 , Esclerose Múltipla , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Masculino , COVID-19/epidemiologia , Vacinas contra COVID-19 , Arábia Saudita/epidemiologia , Estudos Transversais , Esclerose Múltipla/epidemiologia , Pandemias , Ansiedade/epidemiologiaRESUMO
Sepsis remains one of the leading causes of death worldwide. Oncostatin M (OSM), an interleukin (IL)-6 family cytokine, can be found at high levels in septic patients. However, little is known about its role in sepsis. This study aimed to determine if the genetic knockout of OSM receptor (OSMR) type II signaling would improve survival in a murine model of sepsis. Aged (>50 weeks) OSMR type II knockout (KO) mice and wild-type (WT) littermates received an intraperitoneal injection of fecal slurry (FS) or vehicle. The KO mice had better survival 48 h after the injection of FS than the WT mice (p = 0.005). Eighteen hours post-FS injection, the KO mice had reduced peritoneal, serum, and tissue cytokine levels (including IL-1ß, IL-6, TNFα, KG/GRO, and IL-10) compared to the WT mice (p < 0.001 for all). Flow cytometry revealed decreased recruitment of CD11b+ F4/80+ Ly6chigh+ macrophages in the peritoneum of KO mice compared to WT mice (34 ± 6 vs. 4 ± 3%, PInt = 0.005). Isolated peritoneal macrophages from aged KO mice had better live E. coli killing capacity than those from WT mice (p < 0.001). Peritoneal lavage revealed greater bacterial counts in KO mice than in WT mice (KO: 305 ± 22 vs. 116 ± 6 CFU (×109)/mL; p < 0.001). In summary, deficiency in OSMR type II receptor signaling provided a survival benefit in the progression of sepsis. This coincided with reduced serum levels of pro-inflammatory (IL-1ß, TNFα, and KC/GRO) and anti-inflammatory markers (IL-10), increased bacterial killing ability of macrophages, and reduced macrophage infiltration into to site of infection.
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INTRODUCTION: The characters of coronary artery disease with its risk factors and coronary angiograms studied elsewhere revealed differences in different populations. We, here, assess the regional characters of coronary artery disease with its major risk factors and coronary angiographic profile in Duhok, Kurdistan region of Iraq. METHODS: We conducted this cross sectional study at the Azadi heart center in Duhok, Iraq. A consecutive sampling procedure was used to enroll a total of 300 adult patients with coronary artery disease (145 men and 155 women) who had undergone coronary angiography. Direct interview was used with designed questionnaire to collect demographic, cardiovascular risk factors and angiographic profiles. RESULTS: The mean patient's age was 55.5 (10.4) years. The most prevalent risk factor was hypertension (55.3%), followed by dyslipidemia (42.7%), type 2 diabetes mellitus (29%), smoking (11%) and ex-smoking (9.3%). Apart from smoking all other risk factors were more frequent in women. Angiographic analysis revealed normal angiograms in (29.3%) versus single vessel disease (23.3%), double vessel disease (14.3%), triple vessel disease (21.3%) and non significant (11.7%). As to the coronary branch involved, the most frequently affected was the left anterior descending artery followed by right coronary artery, left circumflex artery, and left main stem (60.7%, 46.3%, 43.7% and 6% respectively). CONCLUSION: This study showed that the coronary artery disease tends to occur earlier in our population. Although cardiovascular risk factors were clustered among women, older men showed more aggressive coronary angiographic lesions.
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BACKGROUND: Computed tomography (CT) scan quantifying skeletal muscle mass is the gold standard tool to identify sarcopenia. Unfortunately, high cost, limited availability, and radiation exposure limit its use. We suggest that ultrasound of the thigh muscle could be an objective, reproducible, portable, and risk-free tool, used as a surrogate to a CT scan, to help identify frail patients with sarcopenia. MATERIALS AND METHODS: We included 49 patients over 64 y old, referred to the acute care surgery service. An ultrasound of thigh muscle thickness was standardized to patient thigh length (U/Swhole/L). CT skeletal muscle index (SMI) was calculated using skeletal muscle surface area of the L3 region divided by height2. Frailty status was assessed using the Canadian Study of Healthy Aging Clinical Frailty Scale. RESULTS: The mean (SD) age was 76 (8) y, and 34% (n = 17) were men. CT-defined sarcopenia was identified in 65% (n = 11) of men and 75% (n = 24) of women. In general, women had longer stay in hospital than men (mean + SD 14 ± 9 versus 7 ± 3 d, P = 0.003). There was a significant positive correlation between thigh U/Swhole/L and CT SMI. There was an inverse correlation between thigh U/Swhole/L and frailty score; a similar relationship was observed between CT SMI and frailty. There was an association between U/Swhole/L and postoperative major complications. CONCLUSIONS: This prospective observational study illustrates that the U/Swhole/L index can be used as a surrogate to CT scan, whereby it can identify elderly frail patients with sarcopenia. Thigh ultrasound should be further tested as an objective tool to assess for stratifying frailty.
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Fragilidade/diagnóstico , Músculo Esquelético/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Sarcopenia/diagnóstico , Coxa da Perna/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Alberta , Estudos de Viabilidade , Feminino , Fragilidade/epidemiologia , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Projetos Piloto , Complicações Pós-Operatórias/etiologia , Período Pré-Operatório , Estudos Prospectivos , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fatores de Risco , Sarcopenia/epidemiologia , UltrassonografiaRESUMO
OBJECTIVE: The aim of this study was to explore how trust was constructed between surgeons and residents in the operating room. BACKGROUND: Entrustment is increasingly being used as a key element to assess trainees' competence in the clinical workplace. However, the cognitive process involved in the formulation of surgical trust remains poorly understood. METHODS: In semistructured interviews, 9 general surgeons discussed their experiences in making entrustment decisions during laparoscopic cholecystectomy. Template analysis methodology was employed to develop an explanatory model. RESULTS: Surgeons described the construction of trust as a stepwise process taking place before, during, and after the procedure. The main steps were as follows: (1) an initial propensity to trust based on the perceived risk of the case and trustworthiness of the resident; (2) a decision to initiate trust in the resident to begin the surgery; (3) close observation of preliminary steps; (4) an evolving decision based on whether the surgery is "on-track" or "off-track"; (5) intervention if the surgery was "off-track" (withdrawal of trust); (6) re-evaluation of trust for future cases. The main reasons described for withdrawing trust were: inability to follow instructions, failure to progress, and unsafe manoeuvres. CONCLUSIONS: This study showed that surgical trust is constructed through an iterative process involving gathering and valuing of information, decision-making, close observation, and supervisory intervention. There were strong underlying themes of control and responsibility, and trust was noted to increase over time and over repeated observations. The model presented here may be useful in improving judgements on competence in the surgical workplace.
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Colecistectomia Laparoscópica/educação , Competência Clínica , Docentes de Medicina/psicologia , Internato e Residência , Relações Interprofissionais , Confiança , Adulto , Tomada de Decisões , Feminino , Humanos , Entrevistas como Assunto , MasculinoRESUMO
The world is facing the third coronavirus caused pandemic in less than twenty years. The SARS-CoV-2 virus not only affects the human respiratory system, but also the gastrointestinal tract. The virus has been found in human feces, in sewage and in wastewater treatment plants. It has the potential to become a panzootic disease, as it is now proven that several mammalian species become infected. Since it has been shown that the virus can be detected in sewage even before the onset of symptoms in the local population, Wastewater Based Epidemiology should be developed not only to localize infection clusters of the primary wave but also to detect a potential second, or subsequent, wave. To prevent a panzootic, virus removal techniques from wastewater need to be implemented to prevent the virus dissemination into the environment. In that context, this review presents recent improvements in all the fields of wastewater treatment from treatment ponds to the use of algae or nanomaterials with a particular emphasis on membrane-based techniques.
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Organocatalysis is an emerging field, in which small metal-free organic structures catalyze a diversity of reactions with a remarkable stereoselectivity. The ability to selectively switch on such pathways upon demand has proven to be a valuable tool in biological systems. Light as a trigger provides the ultimate spatial and temporal control of activation. However, there have been limited examples of phototriggered catalytic systems. Herein, we describe the synthesis and application of a caged proline system that can initiate organocatalysis upon irradiation. The caged proline was generated using the highly efficient 4-carboxy-5,7-dinitroindolinyl (CDNI) photocleavable protecting group in a four-step synthesis. Advantages of this system include water solubility, biocompatibility, high quantum yield for catalyst release, and responsiveness to two-photon excitation. We showed the light-triggered catalysis of a crossed aldol reaction, a Mannich reaction, and a self-aldol condensation reaction. We also demonstrated light-initiated catalysis, leading to the formation of a biocide in situ, which resulted in the growth inhibition of E. coli, with as little as 3 min of irradiation. This technique can be broadly applied to other systems, by which the formation of active forms of drugs can be catalytically assembled remotely via two-photon irradiation.
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Processos Fotoquímicos , Prolina/química , Antibacterianos/química , Antibacterianos/farmacologia , Catálise , Escherichia coli/efeitos dos fármacos , Indóis/química , Cinética , Prolina/farmacologia , Solubilidade , Água/químicaRESUMO
We tested whether propofol or Intralipid inoculated with Staphylococcus epidermidis would promote bacterial growth within an intravenous (IV) injection hub, a site prone to bacterial contamination. In tubes incubated under optimal conditions, S epidermidis exhibited growth in Intralipid, but not in propofol. In contrast, within the IV hub incubated with either propofol or intralipid at room temperature, S epidermidis bacterial numbers declined with time, and virtually no contamination remained after 12 hours. These data suggest that certain IV lines are inhospitable for S epidermidis.
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Contaminação de Medicamentos , Contaminação de Equipamentos , Fosfolipídeos/análise , Propofol/análise , Óleo de Soja/análise , Staphylococcus epidermidis/crescimento & desenvolvimento , Dispositivos de Acesso Vascular/microbiologia , Emulsões/administração & dosagem , Emulsões/análise , Injeções Intravenosas , Viabilidade Microbiana , Fosfolipídeos/administração & dosagem , Propofol/administração & dosagem , Óleo de Soja/administração & dosagem , Fatores de TempoRESUMO
Inadequate blood supply to the intestine can lead to acute mesenteric ischemia (AMI), with a mortality rate ranging from 60% to 90%. This high mortality rate is partially due to late detection and the lack of efficient early diagnostic tests. There is an urgent need for a point-of-care tool for immediate bedside diagnosis. Here we present for the first time a rapid and non-invasive electrochemical biosensor device based on non-faradic impedance spectroscopy to detect intestinal fatty-acid binding protein (I-FABP) as an indication of AMI. The electrochemical biosensors consist of gold interdigitated electrodes that were fabricated using photolithographic techniques on top of silicon dioxide substrates. The electrode surfaces were functionalized with an I-FABP capture antibody (CAnB) to entice the target protein, while gold nanoparticles (GNPs) functionalized with detection antibodies (DAnB-GNPs) were utilized as a novel mechanism to enhance the detection signal. Quantification of the I-FABP concentration in the medium depended on its attachment to CAnB and DAnB-GNPs in a sandwich manner, where the latter boosts the impedance signal through its binding to the I-FABP. This non-invasive non-faradic electric biosensor device demonstrates the potential for bench-to-bedside translation with the goal of decreasing morbidity and mortality from AMI.
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Proteínas de Ligação a Ácido Graxo/urina , Isquemia Mesentérica/diagnóstico , Doença Aguda , Adulto , Anticorpos/imunologia , Técnicas Biossensoriais/instrumentação , Técnicas Biossensoriais/métodos , Espectroscopia Dielétrica , Técnicas Eletroquímicas/instrumentação , Técnicas Eletroquímicas/métodos , Eletrodos , Proteínas de Ligação a Ácido Graxo/imunologia , Feminino , Ouro/química , Humanos , Imunoensaio/instrumentação , Imunoensaio/métodos , Intestinos/química , Limite de Detecção , Masculino , Nanopartículas Metálicas/química , Sistemas Automatizados de Assistência Junto ao Leito , Adulto JovemRESUMO
BACKGROUND: Video education has many advantages over traditional education including efficiency, convenience, and individualized learning. Learning sterile surgical technique (SST) is imperative for medical students, because proper technique helps prevent surgical site infections (SSIs). We hypothesize that video education is at least as effective as traditional skill demonstration in teaching first-year medical students SST. METHODS: A video series was created to demonstrate SST ( https://www.youtube.com/playlist?list=PLcRU-gvOmxE2mwMWkowouBkxGXkLZ8Uis ). A randomized controlled trial was designed to assess which education method best teaches SST: video education or skill demonstration. First-year medical students (n = 129) were consented and randomly assigned into two groups: those who attended a skill demonstration (control group; n = 70) and those who watched the video series (experimental group; n = 59). The control group attended a pre-existing 90-minute nurse educator-led skill demonstration. Participants then completed a 30-item multiple choice quiz to test their knowledge. Each group then received the alternate education method and completed a 23-item follow-up survey to determine their preferred method. RESULTS: Seven 2- to 6-minute videos (30 minutes total) were created on surgical attire, scrubbing, gowning and gloving, and maintaining sterility. The experimental group (n = 51) scored higher on the quiz compared with the control group (n = 63) (88% ± 1% versus 72% ± 1%; p < 0.0001). Students preferred the videos when it came to convenience, accessibility, efficiency, and review, and preferred the skill demonstration when it came to knowledge retention, preparedness, and ease of completion. CONCLUSIONS: Video education is superior to traditional skill demonstration in providing medical students with knowledge of SST. Students identified strengths to each method of teaching. Video education can augment medical students' knowledge prior to their operating room experience to ensure that a sterile environment is maintained for patients. The ultimate goal is to reduce SSIs.
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Instrução por Computador , Educação Médica , Controle de Infecções/métodos , Procedimentos Cirúrgicos Operatórios/educação , Adulto , Educação Médica/métodos , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Internet , Masculino , Estudantes de Medicina , Inquéritos e Questionários , Gravação em Vídeo , Adulto JovemRESUMO
Sepsis and septic shock are the leading causes of death in critically ill patients. Acute intestinal ischemia/reperfusion (AII/R) is an adaptive response to shock. The high mortality rate from AII/R is due to the severity of the disease and, more importantly, the failure of timely diagnosis. The objective of this investigation is to use nuclear magnetic resonance (NMR) analysis to characterize urine metabolomic profile of AII/R injury in a mouse model. Animals were exposed to sham, early (30 min) or late (60 min) acute intestinal ischemia by complete occlusion of the superior mesenteric artery, followed by 2 hrs of reperfusion. Urine was collected and analyzed by NMR spectroscopy. Urinary metabolite concentrations demonstrated that different profiles could be delineated based on the duration of the intestinal ischemia. Metabolites such as allantoin, creatinine, proline, and methylamine could be predictive of AII/R injury. Lactate, currently used for clinical diagnosis, was found not to significantly contribute to the classification model for either early or late ischemia. This study demonstrates that patterns of changes in urinary metabolites are effective at distinguishing AII/R progression in an animal model. This is a proof-of-concept study to further support examination of metabolites in the clinical diagnosis of intestinal ischemia reperfusion injury in patients. The discovery of a fingerprint metabolite profile of AII/R will be a major advancement in the diagnosis, treatment, and prevention of systemic injury in critically ill patients.
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Intestinos/irrigação sanguínea , Metabolômica , Traumatismo por Reperfusão/metabolismo , Animais , Análise Discriminante , Camundongos , Análise de Componente PrincipalRESUMO
BACKGROUND: Acute mesenteric ischemia (AMI) has a high morbidity and mortality and often presents as a diagnostic challenge. Currently, there is no blood, urine, or radiologic tests that provide a definitive diagnosis of AMI. The aim of this study was to evaluate the clinical accuracy of urine intestinal fatty acid-binding protein (I-FABP) to diagnosis AMI. MATERIALS AND METHODS: Twenty patients referred to the Acute Care Surgery service at University of Alberta Hospital with suspected AMI taken to the operating room for definitive diagnosis were recruited. Pathologic findings from surgical specimens confirmed a gold standard diagnosis for intestinal ischemia. The patients found to be nonischemic became the internal controls. Conventional clinical markers were examined in blood including white blood cell count, lactate, and creatinine. Blood was also examined by enzyme-linked immunosorbent assays (ELISAs) for I-FABP and interleukin-6. Urine was examined preoperatively and 6 and 24 h postoperatively for I-FABP. RESULTS: Thirteen patients were pathologically diagnosed with AMI while five patients were nonischemic; two were excluded due to missing biologic specimens. There was no difference in age or gender between ischemic and nonischemic patients (56 ± 5 versus 66 ± 11 years old, respectively; six females with ischemic and three females in the nonischemic group). There was no difference in serum lactate and creatinine between the two groups. Serum interleukin-6 levels in patients with AMI were significantly higher than nonischemic controls (0.4 ± 0.2 ng/mL versus 0.2 ± 0.07 ng/mL, respectively, P = 0.03). There was a nonstatistically significant increase in serum I-FABP in AMI patients compared to internal controls (9 ± 3 ng/mL versus 2.4 ± 0.9 ng/mL, respectively, P = 0.2). Urine I-FABP was significantly higher in patients diagnosed with AMI than in controls (7 ± 1 ng/mL versus 2 ± 1 ng/mL, respectively, P = 0.007). The receiver operating characteristic curve illustrated that urine I-FABP discriminates significantly between patients with AMI and controls (area under receiver operating characteristic = 0.88, P = 0.03). CONCLUSIONS: The traditional clinical markers lactate and white blood cell count were not able to differentiate AMI from nonischemic bowel. However, we found that urine I-FABP was a noninvasive biomarker with high specificity and sensitivity for accurately diagnosing AMI in patients. A noninvasive accurate tool for AMI would facilitate for a rapid treatment, while preventing unnecessary surgical interventions in high-risk patient populations.
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Proteínas de Ligação a Ácido Graxo/urina , Isquemia Mesentérica/urina , Idoso , Biomarcadores/sangue , Biomarcadores/urina , Procedimentos Cirúrgicos do Sistema Digestório , Proteínas de Ligação a Ácido Graxo/sangue , Feminino , Humanos , Interleucina-6/sangue , Masculino , Isquemia Mesentérica/cirurgia , Pessoa de Meia-Idade , Curva ROCRESUMO
Antecedentes y objetivos. En Uruguay el consumo de cannabis es legal desde 1974, y proporciona un importante contexto permitiendo evaluar prevalencia y actitudes en un régimen legislativo liberal. Los médicos son fuente para el asesoramiento sobre el consumo de cannabis, por lo cual es importante saber en qué medida el consumo personal puede afectar al mismo. Este estudio tuvo como objetivo evaluar la prevalencia de consumo de cannabis en médicos de un hospital. Métodos. Se realizó un estudio transversal con 140 médicos de un hospital público (tasa de respuesta del 100%). El autocuestionario anónimo incluyó: consumo de cannabis, tabaco, ansiedad, depresión formación recibida para abordaje de pacientes, creencias acerca de nocividad y características sociodemográficas. Resultados. Consumieron alguna vez 41,5%, en último año 13,6% y en último mes 2,1%. No hubo consumidores diarios. En una regresión logística multivariable, el uso en el último año se asoció significativamente con el consumo de tabaco (OR ajustada = 4,31; IC de 95% = 1,22 a 15,20) y la edad (OR ajustada = 0,90; IC de 95% = 0,81-0,99); 96,3% informó que creían que el consumo de cannabis es perjudicial para la salud; 41,9% informó haber recibido formación para abordar el consumo de cannabis en pacientes. Conclusiones. El consumo de cannabis ocasional en médicos en Uruguay, un país en el que el uso es legal desde hace más de 40 años, puede ser relativamente común y ligado al consumo de tabaco, a pesar de la aceptación casi universal de que es perjudicial. El uso diario parece ser poco común (AU)
Backgrounds and objectives. In Uruguay cannabis consumption has been legal since 1974, and provides an important context that makes it possible to evaluate prevalence and attitudes in a liberal legislative regime. Physicians are the source for counseling on cannabis consumption, so that it is important to know how much personal consumption may affect it. This study aimed to evaluate prevalence of cannabis consumption in physicians of one hospital. Methods. A cross-sectional study was performed with 140 physicians of a public hospital (response rate: 100%). The anonymous self-questionnaire included: cannabis consumption, smoking, anxiety, depression training received to approach patients, beliefs on harmfulness and sociodemographic characteristics. Results. A total of 41.5% had used cannabis at some time, 13.6% in the last year and 2.1% in the last month. There were no daily consumers. In a multivariable logistic regression, use in the last year was significantly associated with smoking (adjusted OR = 4.31; 95% CI = 1.22 to 15.20) and age (adjusted OR = 0.90; 95% CI = 0.81-0.99); 96.3% reported that they believed cannabis consumption is harmful for health; 41.9% stated they had received training to approach cannabis consumption in patients. Conclusions. Occasional cannabis consumption in physicians in Uruguay, a country where its use has been legal for more than 40 years, may be relatively common and linked to smoking habit, even though there is almost universal acceptance that it is harmful. Daily use seems to be uncommon (AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fumar Maconha/epidemiologia , Fumar Maconha/legislação & jurisprudência , Fumar Maconha/prevenção & controle , Abuso de Maconha/epidemiologia , Abuso de Maconha/prevenção & controle , Médicos/estatística & dados numéricos , Médicos/normas , Estudos Transversais/métodos , Estudos Transversais/estatística & dados numéricos , Modelos Logísticos , Hospitais Públicos , Hospitais Públicos/estatística & dados numéricos , Hospitais Públicos , Uruguai/epidemiologiaRESUMO
Acute mesenteric ischemia (AMI) is a life-threatening condition that can result in multiple organ injury and death. A timely diagnosis and treatment would have a significant impact on the morbidity and mortality in high-risk patient population. The purpose of this study was to investigate if intestinal fatty acid binding protein (I-FABP) and α-defensins can be used as biomarkers for early AMI and resultant lung injury. C57BL/6 mice were subjected to intestinal ischemia by occlusion of the superior mesenteric artery. A time course of intestinal ischemia from 0.5 to 3 h was performed and followed by reperfusion for 2 h. Additional mice were treated with N-acetyl-cysteine (NAC) at 300 mg/kg given intraperitoneally prior to reperfusion. AMI resulted in severe intestinal injury characterized by neutrophil infiltrate, myeloperoxidase (MPO) levels, cytokine/chemokine levels, and tissue histopathology. Pathologic signs of ischemia were evident at 1 h, and by 3 h of ischemia, the full thickness of the intestine mucosa had areas of coagulative necrosis. It was noted that the levels of α-defensins in intestinal tissue peaked at 1 h and I-FABP in plasma peaked at 3 h after AMI. Intestinal ischemia also resulted in lung injury in a time-dependent manner. Pretreatment with NAC decreased the levels of intestinal α-defensins and plasma I-FABP, as well as lung MPO and cytokines. In summary, the concentrations of intestinal α-defensins and plasma I-FABP predicted intestinal ischemia prior to pathological evidence of ischemia and I-FABP directly correlated with resultant lung injury. The antioxidant NAC reduced intestinal and lung injury induced by AMI, suggesting a role for oxidants in the mechanism for distant organ injury. I-FABP and α-defensins are promising biomarkers, and may guide the treatment with antioxidant in early intestinal and distal organ injury.
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Proteínas de Ligação a Ácido Graxo/metabolismo , Lesão Pulmonar/metabolismo , Isquemia Mesentérica/diagnóstico , alfa-Defensinas/metabolismo , Acetilcisteína/administração & dosagem , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Diagnóstico Precoce , Lesão Pulmonar/diagnóstico , Masculino , Isquemia Mesentérica/induzido quimicamente , Isquemia Mesentérica/complicações , Isquemia Mesentérica/metabolismo , Camundongos , Camundongos Endogâmicos C57BLRESUMO
BACKGROUND: Epidemiological associations between early-life air pollution exposure and increased risk of inflammatory bowel diseases have been shown. Our aim was to determine if exposure to airborne particulate matter (PM(10)) during the neonatal period would alter colitis in the interleukin (IL)-10(-/-) mouse model. METHODS: IL-10(-/-) pregnant dams and pups were fed chow ± PM(10) (9 µg/g) and pups were studied at 10, 14, and 20 weeks. Twenty-week-old mice were given 2% dextran sodium sulfate. Metagenomic analysis of stool was performed. Bacterial translocation was assessed by serum lipopolysaccharide and culturing bacteria from mesenteric lymph nodes and spleen. Cytokine expression was measured in gut homogenates using the MesoScale discovery platform. PM(10) was applied to CMT93 cells ± J744 macrophages, and resistance and cytokine secretion were assessed. THP-1 macrophages were incubated with Escherichia coli HB101 ± PM(10) for assessment of uptake and killing. RESULTS: PM(10) exposure increased colonic proinflammatory cytokines and bacterial translocation into mesenteric lymph nodes, whereas IL-17A levels were reduced in PM(10)-fed 10-week-old mice. Bifidobacterium was decreased in mice fed PM(10), whereas serum lipopolysaccharide was increased. PM(10) interfered with phagocytosis and killing in THP-1 cells. In coculture, PM(10) increased tumor necrosis factor α and fluorescein isothiocyanate-dextran flux. After dextran sodium sulfate treatment, PM10-fed mice responded with increased colonic tumor necrosis factor α and IL-1ß and a larger percentage of PM(10)-fed mice had live bacteria in the mesenteric lymph nodes. CONCLUSIONS: Our data suggest that early exposure to pollution particulates can result in an earlier onset of intestinal disease in genetically susceptible hosts and can alter responses to gut injury in later life.
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Infecções Bacterianas/fisiopatologia , Colite/microbiologia , Citocinas/metabolismo , Mucosa Intestinal/microbiologia , Material Particulado/farmacologia , Análise de Variância , Animais , Animais Recém-Nascidos , Translocação Bacteriana/fisiologia , Bifidobacterium/fisiologia , Colite/fisiopatologia , Modelos Animais de Doenças , Feminino , Interleucina-10/deficiência , Mucosa Intestinal/metabolismo , Camundongos , Camundongos Knockout , Material Particulado/efeitos adversos , Gravidez , Distribuição Aleatória , Fatores de TempoRESUMO
Global incidence rates for inflammatory bowel disease (IBD) have gradually risen over the past 20 years. Genome-wide association studies (GWAS) have identified over 160 genetic loci associated with IBD; however, inherited factors only account for a partial contribution to the disease risk. We have recently shown that urban airborne particulate matter (PM) ingested via contaminated food can alter gut microbiome and immune function under normal and inflammatory conditions. In this addendum, we will discuss how PM can modify the gut microbial form and function, provide evidence on changes seen in intestinal barrier, and suggest a working hypothesis of how pollutants affect the gastrointestinal tract. The significance of the work presented could lead to identifying airborne pollutants as potential risk factors and thus provide better patient care management.
Assuntos
Poluição do Ar/efeitos adversos , Trato Gastrointestinal/microbiologia , Animais , Trato Gastrointestinal/efeitos dos fármacos , Humanos , Doenças Inflamatórias Intestinais/microbiologia , Intestinos/efeitos dos fármacos , Intestinos/microbiologia , Microbiota/efeitos dos fármacos , Material Particulado/toxicidadeRESUMO
Gap junctions (GJs) provide a common form of intercellular communication in most animal cells and tissues, from Hydra to human, including electrical synaptic signalling. Cell coupling via GJs has an important role in development in general, and in neural network development in particular. However, quantitative studies monitoring GJ proteins throughout nervous system development are few. Direct investigations demonstrating a role for GJ proteins by way of experimental manipulation of their expression are also rare. In the current work we focused on the role of invertebrate GJ proteins (innexins) in the in vitro development of neural network functional topology, using two-dimensional neural culture preparations derived from the frontal ganglion of the desert locust, Schistocerca gregaria. Immunocytochemistry and quantitative real-time PCR revealed a dynamic expression pattern of the innexins during development of the cultured networks. Changes were observed both in the levels and in the localization of expression. Down-regulating the expression of innexins, by using double-strand RNA for the first time in locust neural cultures, induced clear changes in network morphology, as well as inhibition of synaptogenesis, thus suggesting a role for GJs during the development of the functional topology of neuronal networks.