Produtos naturais ativadores de PPAR e marcadores associados ao processo inflamatório na Síndrome Metabólica / The inflammatory process in the metabolic syndrome: PPAR activators of natural products and markers associated with metabolic disorders

O processo inflamatório é o elo entre a síndrome metabólica e as doenças cardiovasculares. Para verificar a presença e o grau da inflamação, vários biomarcadores têm sido propostos e investigados. Este trabalho tem como objetivo revisar as recentes pesquisas que associam alguns marcadores expressos no tecido adiposo, enfatizando, dentre eles, a adiponectina, a resistina, a leptina e o transportador de glicose GLUT-4 na síndrome metabólica, a relação da inflamação decorrente desse conjunto de desordens metabólicas sob os receptores proliferadores peroxissomais (PPARs), bem como o efeito de diferentes extratos vegetais e produtos naturais bioativos na ativação desses receptores.

The inflammatory process is the link between metabolic syndrome and cardiovascular diseases. To verify the presence and degree of inflammation, several biomarkers have been proposed and different receptors have been investigated. This study aims to review recent researches involving some markers expressed in the adipose tissue, emphasizing, among them, adiponectin, resistin, leptin and glucose transporter GLUT-4 in the metabolic syndrome, the relationship of inflammation arising from this set of metabolic disorders on the peroxisome proliferator receptors (PPARs) and the effect of different bioactive compounds in the activation of these receptors.

Plasmaféresis en el síndrome de activación macrofágica y fracaso multiorgánico como primera manifestación de una dermatomiositis juvenil / Plasmapheresis for macrophage activation syndrome and multiorgan failure as first presentation of juvenile dermatomyositis

El uso de terapias extracorpóreas se ha extendido para el tratamiento de enfermedades en pediatría. La plasmaféresis, una técnica que intercambia componentes del plasma con albúmina o plasma, se ha utilizado en patología reumatológica. Describimos el curso clínico de un niño de 7 años ingresado en la unidad de cuidados intensivos con características clínicas y biológicas de un síndrome de activación macrofágica (SAM) y fracaso multiorgánico (FMO) como forma de presentación de una dermatomiositis juvenil (DMJ), que evolucionó con mala respuesta a metilprednisolona, inmunoglobulinas y ciclosporina. La utilización de una plasmaféresis de rescate a los 4 días de ingreso permitió una evolución favorable, con resolución del FMO y disminución sostenida en parámetros de actividad de DM y SAM. Alta al día 21, sin secuelas y con satisfactoria condición funcional. La plasmaféresis podría ser una terapia de rescate en casos de DMJ complicada de un SAM que no responda a la terapia habitual(AU)

The use of extracorporeal techniques for the treatment of paediatric diseases has expanded dramatically in the past decade. Plasmapheresis, a technique for exchanging plasma components with albumin or plasma, has been used in some rheumatologic conditions. We report the clinical course of a 7 years old boy with clinical and biological features of macrophage activation syndrome and multiorgan failure, at the time of presentation of severe juvenile dermatomyositis, and non responsive to corticosteroids, cyclosporine and immunoglobulin. After 4 days in the paediatric intensive care unit, plasmapheresis was used as rescue therapy. Repeated therapeutic plasmapheresis was effective for improving the multiorgan failure and laboratory abnormalities. The patient was discharged on the 21st hospital day with good functional condition. Plasmapheresis should be considered as rescue treatment in patients with life threatening macrophage activation syndrome and systemic onset of juvenile dermatomyositis(AU)

[Plasmapheresis for macrophage activation syndrome and multiorgan failure as first presentation of juvenile dermatomyositis]. / Plasmaféresis en el síndrome de activación macrofágica y fracaso multiorgánico como primera manifestación de una dermatomiositis juvenil.

The use of extracorporeal techniques for the treatment of paediatric diseases has expanded dramatically in the past decade. Plasmapheresis, a technique for exchanging plasma components with albumin or plasma, has been used in some rheumatologic conditions. We report the clinical course of a 7 years old boy with clinical and biological features of macrophage activation syndrome and multiorgan failure, at the time of presentation of severe juvenile dermatomyositis, and non responsive to corticosteroids, cyclosporine and immunoglobulin. After 4 days in the paediatric intensive care unit, plasmapheresis was used as rescue therapy. Repeated therapeutic plasmapheresis was effective for improving the multiorgan failure and laboratory abnormalities. The patient was discharged on the 21st hospital day with good functional condition. Plasmapheresis should be considered as rescue treatment in patients with life threatening macrophage activation syndrome and systemic onset of juvenile dermatomyositis.

[Determination of colonic transit time in healthy subjects in Mexico City. Prospective study]. / Determinación del tiempo de tránsito colónico en personas sanas de la Ciudad de México. Estudio prospectivo.

UNLABELLED: Colonic transit time (CTT) is determined by multiple factors; currently, normal values for the Mexican population are not available. In order to get an estimate one must look at the values reported in the international literature, but cultural, ethnical, nutritional and economic differences may lead to different values. OBJECTIVE: To determine the normal values of colonic transit time in healthy people in Mexico City by the use of radiopaque markers. PATIENTS AND METHODS: Prospective, longitudinal and observational study, which included healthy patients ranging from 18 to 60 years old; excluding pregnant women. The whole group of patients was given before breakfast a gelatin capsule which had 20 radiopaque markers inside -the markers were each 2mm long, and were made by the researcher-. After that, they were taken a simple abdominal X-ray film every 24 hours until they totally eliminated the markers. Their eating and defecation habits were evaluated and also the total amount of liquid they consumed. Inferential statistics were used; data was validated with both parametric and non-parametric tests, considering a significance of p < 0.05. RESULTS: A hundred patients were included in the sample in which 48% were female and 52% male, they were divided in three groups: group A (31%)from 18 to 25 years, group B (37%)from 26 to 40 and group C (32%)from 41 to 60 years; there were no important differences in their water consumption, which was in average of 1.87 lts. in 24 hours; also, there were no considerable differences regarding to their meat, vegetables and fruits' consumption, which was in average of 4.4 times a week; the whole group eliminated the markers according to X-rays which was in 54% after 72 hrs, 45% after 48 hrs and 1% after 24 hrs. We can observe an increase of the CTT related to age: in group C 94% eliminated the markers after 72 hrs and there was no significant difference (statistically) with regards to the other groups. A tendency of an increase of CTT with regards to age was observed: in group A, 80% eliminated the markers after 48 hrs, in group B 49% eliminated them after 48 hrs and 51% after 72 hrs and, in group C, 94% eliminated them after 72 hrs without any statistically significant differences among the study groups. CONCLUSION: The CTT in healthy patients is in a 100% of the cases studied lower or equal to 72 hrs with a tendency to increase in relation to age.

Morphology of the large granular alveoli of the parotid glands in toad (Bufo ictericus) before and after compression.

The parotid glands of toads are constituted by an accumulation of venom-producing granular alveoli. Parotid glands of Bufo ictericus were manually compressed and immediately excised. Normal glands (not submitted to compression) were also excised and processed for histological and ultrastructural observations. The glandular body of large granular alveoli in parotid glands is formed by a myoepithelial layer, internally covered by a syncytial secretory layer. In the normal parotid gland this layer is very electron dense, thus preventing clear visualization of organelles. Large secretion granules are located in the main secretion mass, near the syncytium. In the compressed parotid gland, the myoepithelium shows a number of alterations, including presence of myelin figures and foci of degradation in the cytoplasm. The organelles of the syncytial cytoplasm are easily observed. The mitochondria are swollen; the cristae are shortened or absent. Syncytial secretion granules and lengthened structures linked to the syncytial matrix are to be seen. A large amount of smooth endoplasmic reticulum is present, while the rough endoplasmic reticulum is reduced. This large quantity of smooth endoplasmic reticulum suggests enhanced synthesis of the cardiotoxic steroids of the venom. Alterations in the mitochondria and the presence of myelin figures and degenerative foci in the cytoplasm may probably be regarded as consequences of the cellular injury provoked by compression.

[Histologic study of the lumbar glands of Pleurodema thaul (Amphibia, Anura, Leptodactylidae)]. / Estudo histológico das glândulas lombares de Pleurodema thaul (Amphibia, Anura, Leptodactylidae).

Frogs of the Pleurodema thaul species have a pair of prominent elevated cutaneous glands dorsolaterally, just posterior to the sacrum, which are named lumbar glands. We have studied histologically these glands and found that their chromatophores are disposed mainly immediately under the epidermis structuring a dermal chromatophore unit. Similar to the other anuran macroglands, the lumbar glands are constituted basically by granular alveoli filled with secretion. The presence of these granular alveoli and the typical distribution of the dermal chromatophores to suggest a defensive role for the lumbar glands. In most of the amphibians granular alveoli contain secretions with toxicity for several vertebrates. On the other hand, chromatophores in this frog species, probably play an aposematic function, since their disposition on the skin permits that the lumbar glands might be taken for eyes, probably giving to an eventual predator the impression that it may be an animal of higher dimensions.