Denizar Alberto da Silva Melo

Treatment with N-methyl-d-aspartate receptor antagonist (MK-801) protects against oxidative stress in lipopolysaccharide-induced acute lung injury in the rat

Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are common syndromes that affect both clinical and surgical patients. This study describes the effects of a potent and specific N-methyl-d-aspartate receptor antagonist (MK-801) against oxidative stress in acute lung injury induced by intratracheal lipopolysaccharide (LPS) injection. This study was performed using male Wistar rats weighing 200-250g. Rats were randomly divided into four groups: control with isotonic saline instillation (n=6); LPS (100μg/100g of body weight) treated with saline (n=6); LPS treated with MK-801 (0.3mg/kg, intraperitoneally; n=6); LPS treated with MK-801 (0.3mg/kg, intratracheally; n=6). Twelve hours after the LPS instillation, rats were anesthetized and a bronchoalveolar lavage (BAL) was performed in order to determine the alveolar-capillary membrane alterations and the inflammatory infiltrate level. Blood and lung samples were isolated and assayed for oxidative stress variables and histopathologic analysis. The use of MK-801 decreased bronchoalveolar lavage fluid protein, LDH activity and inflammatory cells. Indeed, the treatment with MK-801 significantly attenuated lung oxidative damage and histopathologic alterations after LPS instillation. Our data provide the first experimental demonstration that MK-801 decreases oxidative stress and limits inflammatory response and alveolar disarray in lipopolysaccharide-induced acute lung injury.

Gallic acid reduces the effect of LPS on apoptosis and inhibits the formation of neutrophil extracellular traps

Apoptosis and NETosis of neutrophils are two major mechanisms of programmed cell death that differ in their morphological characteristics and effects on the immune system. Apoptosis can be delayed by the presence of pathogens or chemical components such as lipopolysaccharide (LPS). Neutrophils have other antimicrobial strategy, called neutrophil extracellular traps (NETs), which contributes to the elimination and control of the pathogen. NETosis is induced by infection, inflammation or trauma and represents an innate immune activation mechanism. The objective of this study was to evaluate the effect of gallic acid (GA) in the modulation of apoptosis and NETs release. The results show that GA decreased the anti-apoptotic effect of LPS, blocked the induction of NETs and prevented the formation of free radicals induced by LPS. These findings demonstrate that the GA is a novel therapeutic agent for decreasing the exacerbated response of the body against an infectious agent.

Qualidade de vida de idosos com incontinência urinária

Objective: To assess the prevalence of urinary incontinence (UI) in an elderly citizen sample in Porto Alegre, RS, as well as to determine whether there is a difference in the quality of life between incontinent and continent people. Materials and Methods: A crosscut survey with 509 elderly citizens. Barthel’s Index and a closed question were used to evaluate the UI and WHOQOL-Bref. Data were analyzed by SPSS 11.5. The study was carried out according to Resolution 196/96-CNS/MS. Results: Analyzing the Barthel’s Index, 24% presented UI; among women, 29.4% and 10.3% among men. In the single question, 50% have mentioned UI. There was an association between sex and incontinence, prevailing the women (p<0.001), and between UI and the quality of life global assessment and health (p<0.05). The results confirm the findings of other surveys. Conclusion: The quality of life and health are better among the continent subjects. Planning and investment in therapeutic interventions, with interdisciplinary approaches, are essential to improve the quality of life in such population group.

Antioxidant, analgesic and anti-inflammatory effects of lavender essential oil

Several studies have investigated the antinociceptive, immunomodulatory and anti-inflammatory properties of compounds found in the lavender essential oil (LEO), however to date, there is still lack of substantial data. The objective of this study was to assess the antioxidant, anti-inflammatory and antinociceptive effects of lavender essential oil. The 1,1-diphenyl-2-picrylhydrazyl radical decolorization assay was used for antioxidant activity evaluation. The anti-inflammatory activity was tested using two models of acute inflammation: carrageenan-induced pleurisy and croton oil-induced ear edema. The antinociceptive activity was tested using the pain model induced by formalin. LEO has antioxidant activity, which is dose-dependent response. The inflammatory response evoked by carrageenan and by croton oil was reduced through the pre-treatment of animals with LEO. In the pleurisy model, the drug used as positive control, dexamethasone, was more efficacious. However, in the ear swelling, the antiedematogenic effect of the oil was similar to that observed for dexamethasone. In the formalin test, LEO consistently inhibited spontaneous nociception and presented a similar effect to that of tramadol. The results of this study reveal (in vivo) the analgesic and anti-inflammatory activities of LEO and demonstrates its important therapeutic potential.

Mobilidade funcional em idosos institucionalizados e não institucionalizados

INTRODUCTION: Falls are a major cause of morbidity and mortality in old age, with consequences ranging from minor injuries to death. The measure of functional mobility can be used to predict the risk of falls and to measure the result of interventions that seek to reduce it. OBJECTIVES: To assess and compare a functional mobility measure in elderly people living in the community and in a long stay institution (LSI), and determine its relation to age and sex in the different places of residence. MATERIALS AND METHOD: This observational, analytical and cross-sectional study used data from two other observational studies carried out in the city of Porto Alegre, Brazil. A total of 413 elderly people took part in this study; out of those 72 were institutionalized (average age = 80.9 ± 8.1years) and 341 lived in the community (69.8 ± 7.5 years). The Timed Up and Go Test (TUG) was used to evaluate the degree of functional mobility. RESULTS: No statistical difference was found in the TUG mean values presented by the genders, both in the community (p>0.05) and in the LSI (p>0.05). Institutionalized men and women showed significantly higher TUG mean than those living in the community (p<0.01). A significant difference was detected between the TUG means, when compared in terms of age group (p = 0.003). CONCLUSION: Functional mobility decreases with age in men and women, but does not differ between the sexes. Elderly people living in the community were faster than the institutionalized ones and therefore had a lower risk of falls. It is clear that there is a need for interventions that help both groups improve their mobility and reduce the risk of falls.

Biochemical and inflammatory aspects in patients with severe sepsis and septic shock: The predictive role of IL-18 in mortality

BACKGROUND Sepsis is a major health care problem, with a significant mortality rate in intensive care units. We evaluated biochemical and inflammatory markers in patients with severe sepsis and septic shock and its association of with mortality rates. METHODS Critically ill patients with diagnoses of sepsis - severe sepsis group (n=23) and septic shock group (n=25), and a control group (n=17) were recruited within 24h of entry into the ICU. Serum levels of inflammatory mediators were measured (IL-1β, IL-6, IL-8, IL-10, TNF-α, IL-18 and nitric oxide). We have also collected clinical parameters and laboratorial tests to estimate severity and organ dysfunction (APACHE II, SOFA, lactate). These results were compared between survivors and no survivors. RESULTS IL-18 was directly related to mortality independently of other inflammatory mediators, especially IL-1β, although the inflammatory pathway is closely linked to inflammasome activation and both have simultaneous release in the infectious process. Mortality was directly proportional to IL-18 plasma levels, which did not occur with other inflammatory mediators. CONCLUSIONS IL-18 is an important predictor of mortality in humans with both severe sepsis and septic shock, independent of IL-1β.

Therapeutic ultrasound stimulates MC3T3-E1 cell proliferation through the activation of NF-κB1, p38α, and mTOR

As the population ages, osteometabolic diseases and osteoporotic fractures emerge, resulting in substantial healthcare resource utilization and impaired quality of life. Many types of mechanical stimulation have the potential of being recognized by bone cells after a mechanical sign is transformed into a biological one (a process called mechanotransduction). The therapeutic ultrasound (TU) is one of several resources capable of promoting bone cell mechanical stimulation. Therefore, the main purpose of present study was to evaluate the effect of TU on the proliferation of pre‐osteoblasts using in vitro bioassays.

Low-intensity pulsed ultrasound (LIPUS) stimulates mineralization of MC3T3-E1 cells through calcium and phosphate uptake

HighlightsLIPUS can stimulate the pre‐osteoblast bone cell mineralization.LIPUS stimulates mineralization through calcium and phosphate uptake.LIPUS promote HA formation deposited in a framework of collagen fibers. ABSTRACT The present study aimed to evaluate the effect of low‐intensity pulsed ultrasound (LIPUS) on pre‐osteoblast mineralization using in vitro bioassays. Pre‐osteoblastic MC3T3‐E1 cells were exposed to LIPUS at 1 MHz frequency, 0.2 W/cm2 intensity and 20% duty cycle for 30 min. The analyses were carried out up to 336 h (14 days) after exposure. The concentration of collagen, phosphate, alkaline phosphatase, calcium and transforming growth factor beta 1 (TGF‐&bgr;1) in cell supernatant and the presence of calcium deposits in the cells were analyzed. Our results showed that LIPUS promotes mineralized nodules formation. Collagen, phosphate, and calcium levels were decreased in cell supernatant at 192 h after LIPUS exposure. However, alkaline phosphatase and TGF‐&bgr;1 concentrations remained unchanged. Therapeutic pulsed ultrasound is capable of stimulating differentiation and mineralization of pre‐osteoblastic MC3T3‐E1 cells by calcium and phosphate uptake with consequent hydroxyapatite formation.

Chordata method combined with electrotherapy in functional recovery after brachial plexus injury: report of three clinical cases

Aims: To report three clinical cases of complex brachial plexus injury treated with an innovative physical therapy program, the Chordata Method, combined with electrotherapy. Case description: Three patients suffered a complex brachial plexus injury. They were submitted to surgery and to long-term rehabilitation with the Chordata method (including suspension and tilting exercises) combined with electrotherapy. All patients exhibited significant signs of recovery in post-treatment electroneuromyography. Moreover, improvements in muscle strength and in the range of motion of the injured upper limb were also observed, leading to better posture and gains in activities of daily living (e.g., driving a modified car, holding objects, performing household chores, and doing leisure activities). Conclusions: There was great functional recovery after the physical therapy program with the Chordata Method combined with electrotherapy, with an impact on patients’ daily lives as well as on electroneuromyography findings. Randomized clinical trials are needed to confirm or refute this new non-pharmacological strategy for the treatment of brachial plexus injuries.

Incontinência urinária e obesidade

Esta edição da Revista Ciência & Saúde inclui um artigo cujo tema é a Incontinência Urinária (IU). A International Continence Society define IU como a perda involuntária de urina, que é um problema social e higiênico. Estima-se que no Brasil há cerca de 18 milhões de pessoas que sofrem com o problema, dos quais 80% são mulheres. Existem vários fatores de risco para o desenvolvimento da incontinência urinária, entre eles temos história de histerectomia, gravidez, parto vaginal, queda dos níveis de estrogênio, menopausa, sobrepeso, obesidade, medicações, cirurgias e IU gestacional ou pós-parto. Para muitas mulheres a IU trás aflição e incapacidade afetando a vida social, ocupacional, doméstica, física e sexual. A intensidade com que ela ocorre influencia na qualidade de vida da mulher incontinente. A IU representa um grande desafio para os profissionais da saúde, na busca de alternativas de tratamento de um problema que muitas vezes é subestimado, gerando implicações negativas sociais, emocionais e econômicas para a pessoa incontinente e todos os que a cercam. Nesta edição um dos artigos, aborda a avaliação a força da musculatura do assoalho pélvico em obesas e não obesas relacionando aos sinais de perda involuntária de urina. O tema escolhido reveste-se de importância, pois acolhe em si, além da IU, a questão da obesidade, que dentre as disfunções sistêmicas que acarreta, também influencia de forma significativa na perda involuntária de urina. A qualidade de vida das pessoas que sofrem com esse problema é reduzida de forma significativa e os tratamentos até outrora convencionais, embora complexos, apresentavam resultados restritos. O treinamento da musculatura do assoalho pélvico através de exercícios específicos e gerais, associado com estimulação elétrica, tem se mostrado uma alternativa muito promissora, pois além de resolver muitos casos de forma rápida e eficiente, é simples e de baixo custo. Ampliar esta modalidade terapêutica, alcançando todas as classes sociais da população brasileira, é um desafio a ser enfrentado pelo Ministério da Saúde, uma vez que o impacto na saúde das pessoas é significativo. A associação de fatores como: alta resolutibilidade e baixo custo, em uma doença de alta prevalência, que pode ser resolvida na maioria dos casos em ambulatórios das Unidades Básicas de Saúde, além de desafogar importante parcela dos ambulatórios hospitalares de uroginecologia, ampliará o bem estar social da importante parcela da população afetada pela IU.