Ana Fatima Carvalho Fernandes

Thrombotic episodes account for approximately 80% of deaths in type 2 diabetic patients. Hyperhomocysteinaemia is a well recognized independent risk factor for atherosclerosis and thromboembolism. Increased homocysteine levels may occur due to a number of factors including inherited gene polymorphism of methylenetetrahydrofolate reductase (MTHFR) C677T. Here, we evaluate plas- ma total homocysteine (tHcy) levels and frequency of the MTHFR C677T gene polymorphism in asymptomatic healthy volunteers and type 2 diabetic patients with hypertension but without nephropathy. We have also investigated the relationship between tHcy levels and the presence of MTHFR C677T gene polymorphism. Plasma tHcy levels and MTHFR C677T genotype were investigated in a total of 53 subjects. These included asymptomatic healthy volunteers (n = 16), patients with type 2 diabetes (n = 7), subjects with hypertension (n = 12) and patients with both type 2 diabetes and hypertension (n = 18). Renal function, serum lipids and other metabolites were also assessed. There was no significant difference in tHcy levels between the groups studied. The frequency of MTHFR C677T gene polymorphism observed was similar to that obtained for the general Brazilian population. In patients with type 2 diabetes and hypertension but without impaired renal function, we observed no meaningful correlation between increased tHcy levels and the presence of MTHFR C677T gene polymorphism. Type 2 diabetics who are homozygous or heterozygous for the MTHFR C677T gene polymorphism showed normal tHcy levels. Our results further suggest that diabetes without an associated adverse risk profile is not an independent correlate of increased tHcy levels.

Of the inherited thrombophilias, the Factor V Leiden (FVL) and the prothrombin mutant (FII G20210A) are associated with increased risk of venous thromboembolism (VTE). The C677T mutation of the methylenetetrahydrofolate reductase gene, which may lead to hyperhomocysteinemia, is also considered a risk factor for VTE in some studies. However, the frequency of these genetic risk factors may vary significantly among different populations. The FVL, FII G20210A and C677T mutations were investigated by PCR-RFLP in 275 young VTE Brazilian patients as well as in 324 biologically unrelated individuals selected to compose the control group. The C677T mutation in the MTHFR gene was detected in 135 (49.1%) patients, of which 117 (42.5%) were identified as heterozygous and 18 (6.5%) as homozygous. The G20210A mutation was detected in 14 (5.1%) patients in heterozygosis. In both cases, no significant difference was observed when these results were compared to the frequencies observed in the control group. FVL was detected in heterozygosis in 19 (6.9%) patients, corresponding to a significantly increased frequency when compared to that observed for the control group (1.2%) (OR 5.9; 95% CI 2.08-16.79; p < 0.001). The data indicated that FVL is significantly associated with VTE among young Brazilian patients, but also supported previous evidence that VTE is a multi-factorial disease, resulting from the interaction of genetic and acquired risk factors.

Mesenchymal stromal cells (MSCs) play an important role in tissue regeneration mainly through the secretion of trophic factors that enhance the repair of damaged tissues. The main goal of this work was to study the paracrine mechanisms by which an umbilical cord tissue-derived MSC population (UCX®) promotes the migration capacity of human dermal fibroblasts and keratinocytes, which is highly relevant for skin regeneration. Furthermore, the differences between paracrine activities of MSCs from the umbilical cord tissue and the bone marrow (BM-MSCs) were also evaluated. In vitro scratch assays revealed that conditioned media (CM) obtained from both growing and stationary-phase UCX® cultures induced human dermal fibroblast (HDF) and keratinocyte (HaCaT) migration. These assays showed that the motogenic activity of UCX® CM to HaCaT was significantly higher than to HDF, in opposition to the effect seen with CM produced by BM-MSCs that preferentially induced HDF migration. Accordingly, a comparative quantification of key factors with vital importance in the consecutive stages of wound healing revealed very different secretome profiles between UCX® and BM-MSCs. The relatively higher UCX® expression of EGF, FGF-2 and KGF strongly supports early induction of keratinocyte migration and function, whereas the UCX® -specific expression of G-CSF suggested additional roles in mobilization of healingrelated cells including CD34(-)/CD45(-) precursors (MSCs) known to be involved in tissue regeneration. Accordingly, in vitro chemotaxis assays and an in vivo transplantation model for chemoattraction showed that UCX® are chemotactic to CD34(-)/CD45(-) BM-MSCs via a cell-specific mobilization mechanism mediated by G-CSF. Overall, the results strongly suggest different paracrine activities between MSCs derived from different tissue sources, revealing the potential of UCX® to extend the regenerative capacity of the organism by complementing the role of endogenous BM-MSCs.

Introduccion: El proyecto REATIVA: un estudio del programa de promoción de un envejecimiento saludable se construyó con supuestos como que la jubilación es una transición importante en la vida de los individuos y que en esta fase de transición, se vuelve extremadamente importante continuar promoviendo el envejecimiento activo. Con base en los resultados de las investigaciones llevadas a cabo previamente en el proyecto, pasamos a la fase de construcción del prototipo del programa para implementar a la población de jubilados por menos de cinco años. Objetivo: Construir un prototipo de un programa de promoción de un envejecimiento saludable, a ser aplicado en una investigación pre-experimental en el contexto de la Atención Primaria de la Salud, dirigido a las personas y familias que se encuentran en fase de adaptación a la jubilación. Material y metodo:Estudio cualitativo de la construcción del prototipo a partir de los resultados de la investigación previa que ha utilizado la técnica ...

Introduction: Infection with human papillomavirus 16 (HPV 16) is considered to be the major risk factor for cervical cancer development. Cytokines play an important role in the defense against viral infection. Such differences may be attributed to genetically determined molecular mechanisms including variations in transcription, translation and secretion pathways Genetically determined, has been predominance of Th1 polarization, associated with the clea- rance of HPV infection or, in contrast, with immunosuppressive cytokines associated with persistence of HPV infection and progression to cervical lesions, as interleukine 10 (L-10). Furthermore, the human immunodeficiency virus type 1 (HIV-1) infection is co morbidity to cervical lesions development. Objective: to further evaluate the HPV16 infection influence on immunogenetic factors associated with IL-10 immunoinibitory cytokine production levels in women presenting with HIV infection and squamous intraepithelial lesions. Method: ...

Introduction: Ageing population is a great challenge for modern societies which have to adapt themselves to this new reality. Increasing longevity and low birth rates also contribute to an aged population, with implications both socially and economically. With increased longevity, people live more years after retirement and should be more prepared to deal with the difficulties that can arise from this transition. Retirement is one of the major transitions in adult life and it can originate different kind of vulnerabilities. If it difficult to retire alone, it can be even more difficult when it happens as a couple. Objective The project REATIVA is a Portuguese project funded by the European Union and the Portuguese government which has as goal to promote health during the transition to retirement. We aimed to know the perceptions of couples who experience adaptation to the retirement process and the strategies adopted to address them. Methodology The research team conducted a descrip...

... El concepto de salud de la Teoría Humanística de Enfermería siguió los presupuestos del concepto de salud de la Organización Mundial de la Salud (OMS). ... 2001-2010 Universidadde La Rioja · Todos los derechos reservados. XHTML 1.0; UTF‑8.

... Autor: Mourão, Carla Monique Lopes; Albuquerque, Aline Mara Souza; Silva, Anna Paula Sousa da; Oliveira, Mariza Silva de; Fernandes, Ana Fátima Carvalho. Título: Comunicação em enfermagem: uma revisão bibliográfica / Communication in nursing: a literature review. ...

The present study aimed evaluate the impact of strength training on bone mineral density (BMD) in individuals harboring HIV exhibiting lipodystrophy. The study included 20 subjects (16 men) aged 50.60 ± 6.40 years with reduced BMD, presenting positive serology for HIV, using HAART, and performing no regular practice of physical exercise before being enrolled in the study. BMD levels were evaluated by dual-energy X-ray absorptiometry (DXA) in the lumbar spine, femoral neck and 1/3 radius, before and after 36 sessions (12 weeks) of strength training. Compared to pre-exercise period, the results showed increased BMD in lumbar spine (3.28%; p=0.012), femoral neck (8.45%; p =0.044) and 1/3 radius (5.41%; p =0.035). This is the first study evaluating the impact of strength training in patients living with HIV and exhibiting lipodystrophy, showing an increased BMD in all the regions measured (lumbar spine, femoral neck and 1/3 radius). The present study showed the beneficial impact of the strength training on BMD increased in patients living with HIV as an effective and available approach to improve bone health.

Purple urine bag syndrome (PUBS) was first reported in 1978. PUBS is rare, occurs predominantly in constipated women, chronically catheterized and associated with some bacterial urinary infections that produce sulphatase/phosphatase. The etiology is due to indigo (blue) and indirubin (red) or to their mixture that becomes purple. A chain reaction begins in the gastrointestinal tract with tryptophan as described in the article.

This study was aimed to evaluate the influence of vitamin D (VD) deficiency on cardiac metabolism, morphology, and function. Thus, we investigated the relationship of these changes with the length of the nutrient restriction. Male weanling Wistar rats were allocated into 4 groups: C2 (n=24), animals were fed an AIN-93G diet with 1000 IU VD/kg of chow and were kept under fluorescent light for 2 months; D2 (n=22), animals were fed a VD-deficient AIN-93G diet and were kept under incandescent light for 2 months; C4 (n=21) animals were kept in the same conditions of C2 for 4 months; and D4 (n=23) animals were kept in the same conditions of D2 for 4 months. Biochemical analyses showed lower β-hydroxyacyl coenzyme-A dehydrogenase activity and higher lactate dehydrogenase activity in VD-deficient animals. Furthermore, VD deficiency was related to increased cytokines release, oxidative stress, apoptosis, and fibrosis. Echocardiographic data showed left ventricular hypertrophy and lower fract...

Because of the high prevalence of type 2 diabetes mellitus (DM2) worldwide and the high mortality rate due to thrombotic events, it is extremely important to know about changes in the hemostatic system of such patients. Factor V mutation (G1691A - factor V Leiden) in either heterozygosis or homozygosis confers the activated protein C resistant phenotype, which increases the risk of thrombotic events by a factor of seven. The G20210A mutation of the prothrombin gene results in hyperprothrombinemia, increasing the risk of thrombotic events by a multiple of three. These mutations are of great relevance considering that the presence of one or both can contribute to a hypercoagulability state accelerating complications in diabetes. The aim of this study was to evaluate the incidence of these mutations in controls (n=16), DM2 subjects (n=7), hypertensive subjects (HAS) (n=12) and DM2+HAS subjects (n=18). The frequencies found were low and similar to those observed in the Brazilian population in general. It was not possible to establish any correlation among mutations and specific features of each group. It is still not clear if there is or not a higher prevalence of these mutations in diabetic individuals or if the mutation contributes to an increase in the risk of thrombotic events in these individuals. Further studies involving a larger number of patients are necessary in order to answer these questions.

To determine the possibility of non-invasive estimation of central venous pressure (CVP) through inferior vena cava (IVC) analysis, using transthoracic echocardiography (TTE). A prospective 3-year study. A 16-bed medical/surgical Intensive Care Unit (ICU). Patients admitted to the ICU were enrolled. CVP measurement and TTE (determining cardiac chambers dimension and left ventricular shortening fraction) with IVC analysis (maximum dimension and IVC index) were performed simultaneously. Parametric and non-parametric statistical analysis was performed to establish correlations between variables. 560 patients were admitted to the study, including 477 in whom IVC was analysed, aging 62.2 +/- 17.3 years, a mean ICU stay 11.9 +/- 18.7 days, a APA- CHE II score 23.9 +/- 8.9 and a SAPS II score 55.7 +/- 20.4. Through linear regression analysis CVP was influenced by IVC index (p=0.001), IVC maximum dimension (p=0.013) and presence of mechanical ventilation (p=0.002). A statistically significant correlation was found between the following parameters: an IVC index < 25% and a CVP > 13 mmHg; an IVC index and a CVP 26%-50%; an IVC index > 51% and CVP < 7 mmHg; an IVC maximum dimension > 20mm and a CVP > 13 mmHg; an IVC maximum dimension < 10 mmHg and CVP…