Cristini Klein

Carbonyl groups: Bridging the gap between sleep disordered breathing and coronary artery disease.

Abstract Sleep disordered breathing (SDB) is related to coronary artery disease (CAD), but the mechanisms are uncertain. SDB is characterized by periods of intermittent hypoxia and free radical formation. This study tested the hypothesis that carbonylation can be the link between SDB and CAD. It included 14 cases with CAD and 33 controls with <50% coronary narrowing. CAD cases have higher erythrocyte carbonyl levels than controls (p = 0.012). Positive correlation was observed between apnea-hypopnea index (AHI) and erythrocyte carbonyl concentration (ρ = 0.310; p = 0.027). To predict CAD, including as regressors: AHI, erythrocyte carbonyl, gender, age and body mass index, the significant variables in the Poisson multiple regression model were AHI and erythrocytes carbonyl. An increase of 1 pmol/gHb in erythrocyte carbonyl levels increases by 1.8% the risk of CAD and one unit of AHI increases by 3.8% the risk of CAD. The present findings represent the first evidence in humans that SDB may cause CAD through protein carbonylation.

Risk factors for falls in hospitalized adult patients: an integrative review

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.

Inflammatory and Oxidative Stress Markers after Intravenous Insulin in Percutaneous Coronary Intervention with Stent in Type 2 Diabetes Mellitus: A Randomized Controlled Trial

CONTEXT/OBJECTIVE The objective of the study was to evaluate the effects of normalizing glycemia through iv insulin per 24 h on markers of oxidative stress and inflammation in patients with diabetes submitted to percutaneous coronary intervention (PCI) with stent. PATIENTS/METHODS This was a prospective, open-label, randomized controlled trial, comparing continuous iv insulin per 24 h targeting glycemia less than 110 mg/dl iv insulin treatment (IIT; n = 35) to standard treatment (ST; n = 35, regular insulin if glycemia was greater than 200 mg/dl). Blood samples for glycemia, glycated hemoglobin, lipids, inflammatory markers [C-reactive protein (CRP), soluble CD40 ligand, IL-6, and endothelin 1 (ET-1)] and oxidative stress (total antioxidant status, carbonyl) were collected immediately after and 24 h after PCI. RESULTS Seventy patients were included. Mean age was 60.5 ± 10 yr, 60% were men, glycated hemoglobin was 8.1 ± 1.8 (IIT) vs. 7.6 ± 1.6% (ST) (P = 0.39). The intensive insulin group had lower glycemia (P = 0.006) and higher insulinemia (P < 0.001). Insulin did not change CRP [4.5 (2.1-11.7) vs. 6.8 (2.4-10.3), P = 0.35], soluble CD40 ligand [402 (191-843) vs. 610 (230-1200), P = 0.68], IL-6 [6.21 (3.1.-10.4) vs. 10.37 (5.9-15.3), P = 0.09], and ET-1 [1.02 (0.7-1.8) vs. 1.10 (0.7-1.9), P = 0.657]. CRP, IL-6, and ET-1 increased after PCI in both groups (P < 0.05). No change was observed on protein oxidation (carbonyl, P = 0.70; total antioxidant status, P = 0.33). There was a positive correlation between CRP and glycemia (r = 0.29, P = 0.002). CONCLUSIONS Continuous iv insulin for 24 h increased insulin levels and prevented hyperglycemia. Insulin infusion did not prevent the rise in inflammatory and oxidative stress markers, and no differences were observed between IIT and ST after PCI with a stent.

Fatores de risco para quedas em pacientes adultos hospitalizados: revisão integrativa

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.

Food restriction during pregnancy alters brain's antioxidant network in dams and their offspring.

Abstract Dietary restriction increases life span and protects distinct organisms against a series of diseases, among which, those related to oxidative stress, like neurodegenerative diseases. Interferences in the maternal environment are known to reprogram the offspring metabolism response, impacting in the risk of chronic diseases development in adulthood. We aimed to assess the effects of 40% food restriction on reactive species levels, enzymatic and non-enzymatic antioxidant defenses, and oxidative damage parameters in the cerebellum and total cerebral cortex of pregnant rats and their offspring. Dams and pups showed oxidative modulation caused by food restriction in both structures. Dichlorofluorescein oxidation, reflecting reactive species levels, was reduced in the cerebellum of dams and offspring, while the cerebral cortex was not affected. Decreased mitochondrial superoxide levels were found in the cerebellum and cerebral cortex of pups, while nitric oxide was increased in the cortex. We also measured the activities of important antioxidant enzymes responsible by reactive oxygen species elimination. Superoxide dismutase activity was increased in the cerebellum of dams and in both structures of pups, while it was decreased in dams’ cerebral cortex. Both brain structures were affected concerning to catalase, glutathione peroxidase, and glutaredoxin activities, which were reduced in pups and dams. Non-enzymatic defenses were decreased in pups, while dams showed an adaptive pattern in the cerebellum and no alteration in the cerebral cortex. Even though the results suggest increased oxidative status, lipids and proteins were not oxidatively affected. Our data suggest that intrauterine food restriction may disrupt oxidative status, impairing the antioxidant network.

Factores de riesgo de caídas en pacientes adultos hospitalizados: revisión integradora de la literatura

Objetivo: Identificar os fatores de risco para a ocorrencia de quedas em pacientes adultos hospitalizados. Metodo: Revisao integrativa realizada nas bases de dados LILACS, SciELO, MEDLINE e Web of Science, abrangendo artigos publicados entre 1989 e 2012. Resultados: Setenta e um artigos compuseram a amostra final do estudo. Os fatores de risco para quedas apresentados nesta revisao foram relacionados ao paciente (intrinsecos), ao ambiente hospitalar e ao processo de trabalho dos profissionais da saude, em especial a enfermagem (extrinsecos). Conclusao: A triagem sistematica de fatores de risco para queda foi identificada como fator contribuinte para a reducao desse agravo, auxiliando a nao ocorrencia deste evento que, apesar de ser prevenivel, pode determinar consequencias graves incluindo o obito.OBJECTIVE Identifying risk factors for the occurrence of falls in hospitalized adult patients. METHOD Integrative review carried out in the databases of LILACS, SciELO, MEDLINE and Web of Science, including articles published between 1989 and 2012. RESULTS Seventy-one articles were included in the final sample. Risk factors for falls presented in this review were related to patients (intrinsic), the hospital setting and the working process of health professionals, especially in nursing (extrinsic). CONCLUSION The systematic screening of risk factors for falls was identified as a contributing factor to the reduction of this injury, helping the non-occurrence of this event that, despite being preventable, can have serious consequences including death.