Ratas nascidas com restrição de crescimento intrauterino submetidas à natação antes e durante a prenhez: repercussões maternas e perinatais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeito do plasma rico em glicose na apoptose de neutrófilos de cães

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Impacto do controle glicêmico sobre as complicações associadas ao diabetes mellitus na osseointegração

The increased prevalence of diabetic individuals has become a public health problem. Diabetes Mellitus is a metabolic disorder characterized by an increase in plasma glucose levels. It impairs the physiological equilibrium in utilization of carbohydrate by tissues. The persistent hyperglycemia can produce deleterious effects on bone formation due the microvascular complication. The present paper reviews the bibliography linking the impact of glycemic control at complications associated at diabetes mellitus on osseointegration. In experimental models of diabetes it was observed a reduced level of bone-implant contact. This failure can be reduced by means of hyperglycemia control. Also, several studies point the beneficial effect of coated implant on osseointegration process. It is necessary to take special care into account for the placement of implants in diabetic patient and improve the percentages of implant survival. A rigorous control of plasma glycaemia, together with other measures, like as absence of chronic complications, good oral hygiene and regular medical follow-up has been related to rising the percentages of successful in diabetic patients.

Doença periodontal, diabete mellitus e hipertensão em gestantes usuárias do Sistema Único de Saúde (SUS)

Purpose: To evaluate the association among periodontal disease, diabetes mellitus and arterial hypertension in pregnant women users of the Brazilian Health System (SUS). Methods: The sample consisted of 86 women, with pregnant age between the 4th and 7 th month, submitted to pre-natal attendance in Health Basic Unities (HBUs). Periodontal condition was evaluated by 2 calibrated researchers (Kappa = 0.91) through the Community Periodontal Index (CPI). A sphygmomanometer was used to check the arterial pressure, what was accomplished by the professionals from the HBUs; glycemia test was accomplished through a blood sample collected from the middle finger with a disposable lancet adapted to a lance device (Accu-Chek Softclix Pro; Roche, USA), and for checking the glycemia level, a glycemia monitor was used (Accu-Chek Advantage II, Roche, USA). Data were written on a numbered register form, avoiding patient identification. After, the same data were statistically analyzed through the Fisher Exact Test, in order to evaluate the existence of association between the variables blood glucose and periodontal disease. In this test, a significance level of 0,05 was adopted. Results – Most of the pregnant woman presented periodontal health (58,1%); 41,9% of the research subjects showed at least one sign of periodontal disease, with 31,4% presenting gingivitis and 10,5% periodontitis. Hyperglycemia was detected in 51,2% and it was not found a value of arterial pressure higher than what is considered to be normal. Conclusion: it was not verified a significant association among the presence of periodontal disease, glycemia alteration and arterial hypertension in pregnant women who comprised this research.

Diabetes mellitus gestacional: enfoque nos novos critérios diagnósticos

Alterations in maternal metabolism are important in order to supply the demands of the fetus. However, pregnant women with some degree of insulin resistance, such as in cases of overweight/obesity, central obesity and polycystic ovaries syndrome, associated to the action of anti-insulin placental hormones, contribute to a case of hyperglycemia of varied intensity, characterizing gestational diabetes mellitus (GDM) and leading to adverse effects both maternal and fetal. At the absence of a universal consensus to the tracking and diagnosis of GDM, this review had the purpose of listing the various protocols that have been proposed, as well as highlighting the risk factors associated with GDM and its complications. The most recent protocol is the one from the American Diabetes Association, with changes that would be justified by the alarming raise in worldwide obesity and, consequently, the potential increase to the occurrence of type 2 diabetes mellitus, not always diagnosed before the gestational period. The intention of this protocol is to identify the gestating women that could benefit from hyperglycemia control, improving the prognostic of these pregnancies and preventing future complications for mothers and their children.

Hiperadrenocorticismo em cães: revisão

Hyperadrenocorticism is a relatively common endocrinopathy in dogs, which is associated to an excessive production or administration of cortisol. The most affected breeds are Poodles, Teckels, Boxers, Boston Terriers and Beagles. The clinical signs most commonly observed are polyuria, polydipsia, polyfagia, panting, distended abdomen, endocrine alopecia, muscular weakness and lethargy. Laboratorial abnormalities include stress leukogram, increase in alkaline phosphatase and alanine aminotransferase activities, hypercholesterolemia, lipemia, hyperglycemia and hyposthenuria. The preferred essay to evaluate adrenal gland function is the low-dose dexamethasone suppression test, whereas the most used treatments include mitotane and trilostane. The objective of this paper is to review hyperadrenocorticism in dogs, because this disease is relatively common in small animal clinics and has many long-term complications.

Incidental mild hyperglycemia in children: two MODY 2 families identified in Brazilian subjects

Maturity-onset diabetes of the young (MODY) is characterized by an autosomal dominant mode of inheritance, early onset of hyperglycemia, and defects of insulin secretion. MODY subtypes described present genetic, metabolic, and clinical differences. MODY 2 is characterized by mild asymptomatic fasting hyperglycemia, and rarely requires pharmacological treatment. Hence, precise diagnosis of MODY is important for determining management and prognosis. We report two heterozygous GCK mutations identified during the investigation of short stature. Case 1: a prepubertal 14-year-old boy was evaluated for constitutional delay of growth and puberty. During follow-up, he showed abnormal fasting glucose (113 mg/dL), increased level of HbA1c (6.6%), and negative beta-cell antibodies. His father and two siblings also had slightly elevated blood glucose levels. The mother had normal glycemia. A GCK heterozygous missense mutation, p.Arg191Trp, was identified in the proband. Eighteen family members were screened for this mutation, and 11 had the mutation in heterozygous state. Case 2: a 4-year-old boy investigated for short stature revealed no other laboratorial alterations than elevated glycemia (118 mg/dL); beta-cell antibodies were negative. His father, a paternal aunt, and the paternal grandmother also had slightly elevated glycemia, whereas his mother had normal glycemia. A GCK heterozygous missense mutation, p.Glu221Lys, was identified in the index patient and in four family members. All affected patients had mild elevated glycemia. Individuals with normal glycemia did not harbor mutations. GCK mutation screening should be considered in patients with chronic mild early-onset hyperglycemia, family history of impaired glycemia, and negative beta-cell antibodies. Arq Bras Endocrinol Metab. 2012;56(8):519-24

PGC-1 alfa como regulador inflamatório na esteato-hepatite não-alcoólica

A doença hepática gordurosa não-alcoólica (NAFLD, do inglês) é a manifestação clínica hepática da síndrome metabólica, cuja incidência aumenta consideravelmente em todo o mundo. A NAFLD pode progredir para um estado de esteatohepatite não-alcoólica (NASH, do inglês), caracterizado por inflamação hepatocelular, com ou sem fibrose. Dados na literatura mostram que o coativador-1 alfa do receptor ativado por proliferadores de peroxissoma gama (PGC-1alfa), além de estar envolvido em diversos processos metabólicos, representa uma estratégia terapêutica promissora na modulação da inflamação. Neste projeto investigamos as alterações inflamatórias no fígado induzida por dieta hiperlipídica e o papel do PGC-1alfa nesse processo. Camundongos C57black/6 receberam dieta hiperlipídica contendo 30% de gordura por 10 semanas. O peso dos animais foi avaliado semanalmente. Após a eutanásia, o tecido adiposo intra-abdominal (retroperitoneal e periepididimal) foi coletado e pesado. Analisamos o perfil glicêmico e lipídico sérico e expressão de genes envolvidos no metabolismo glicêmico e lipídico. Avaliou-se também o aspecto histológico e a inflamação do tecido hepático por quantificação das citocinas IL-6, TNF-alfa e IL-1beta. A dieta rica em gordura conduziu a um aumento dos depósitos de gordura intra-abdominal, hiperglicemia e hiperlipidemia. Os animais também apresentavam esteatohepatite, com aumento de citocinas pró-inflamatórias e diminuição na expressão de PGC-1alfa no tecido hepático. O envolvimento do PGC-1alfa na produção de mediadores inflamatórios por hepatócitos foi avaliado em células HepG2 utilizando RNA de interferência (RNAi). O knockdown da expressão de PGC-1alfa causou aumento na expressão e liberação de IL-6 em hepatócitos via aumento na fosforilação de IkBalfa e consequente ativação do NFkB. Portanto, nossos dados mostram que o PGC-1alfa inibe a produção de mediadores inflamatórios (IL-6) em hepatócitos, e fornecem novas evidências das conexões existentes entre as vias metabólicas e imunes

A vitamina D na diabetes mellitus tipo 2 : uma forma terapêutica a explorar

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Complicações pós-cirúrgicas em pacientes com diabetes mellitus

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Paciente odontopediátrico portador de diabetes

Dissertação para obtenção do grau de Mestre no Instituto Superior de Ciências da Saúde Egas Moniz

Efeitos da terapia laser de baixa intensidade associada ao exercício aeróbio no reparo de tenotomia do tendão de aquiles de ratos diabéticos

Diabetes Mellitus (DM ) is a complex disease that requires continuous medical care for the reduction of risk factors in addition to glycemic control. The typical hyperglycemia of this disease produces glycosylation of proteins and so the consequence is the accumulation of glycosylation final products in various human tissues, among them, the tendon. The aerobic exercise (AE) and the low level laser therapy (LLLT) have been used to treat tendinopathies in individuals with or without DM. Objective: The aim of this study was to watch the effect of the LLLT and the AE, in association, in partial tenotomy of the tissue repair of the Achilles tendon (AT) of diabetic rats. Methods: 91 animals were utilized and divided in to the following groups: control group (GC), injured control group (GCL), diabetic group (GD), diabetic group LLLT (GD – TLBI), diabetic group trained (GD - EX) and diabetic group trained laser (GD-EX+TLBI). The animals were submitted to intervention with AE, using a protocol with a progressive increase of time (12 to 60 min) and speed of (4 to 9 m/min), and the LLLT (660 nm laser, 10mW, 4 J/cm², single point for 16 seconds, three times for week). It was analyzed morphological, biomechanical and molecular characteristics. For data showing normal distribution was used one-way ANOVA test and post hoc Tukey and data without normal distribution was used Mann Whitney test and post hoc Dunn's. It was accepted p <0.05 for statistical significance Results: The biomechanical tests indicated major improvement in the GC and GD-EX+TLBI groups when compared with the diabetic groups in the following variables: maximum load, strain, absorbed energy, stress, cross section area, elastic modulus and energy density (p<0.05). The analysis through molecular biology indicated that the association of aerobic exercise and LLLT generated an increase of the collagen I gene expression and modulated the expression of the MMP2 and MMP9 (p<0.05). No observed any major improvement in the morphological variable studied. Conclusion: the LLLT associated with aerobic exercise promotes and increase of the mechanical properties, in the control of collagen I gene expression and of the MMP2 and MMP9 of the diabetic rats.

Efeito da oxigenação hiperbárica no reparo ósseo de ratos diabéticos

The chronic state of hyperglycemia due to diabetes mellitus affects multiples organs impairing life quality. In bone, diabetes alters strength and mineral density and also suppresses the osteoblast activity, leading to an unbalanced bone healing process. Hyperbaric oxygen therapy (HBO) is suggested as an adjuvant treatment to accelerate bone repair. This study evaluated the effects of HBO in the number of mast cells and in new bone formation at the initial stage of bone repair in normoglycemic and diabetic rats. It was hypothesized that HBO treatment may improve bone repair in diabetic bone. The rats were equally divided in four groups: Control (C); Control + HBO (CH); Diabetes (D) and Diabetes + HBO (DH). Diabetes was induced by streptozotocin (65mg/kg) and femoral bone defects were created thirty days after diabetes induction in all groups. HBO initiated immediately after surgery procedure and was performed daily, for 7 days, in the CH e DH groups. Seven days after surgery, all animals were euthanized. The femur diaphyses were removed, fixated, decalcified and processed for paraffin embedding. The semi-serial histological sections obtained were stained with Hematoxylin-Eosin (HE), Mallory Trichrome and Toluidine Blue. The qualitative analysis was conducted in the histology slides stained with HE, where it was evaluated the morphological aspects of bone repair in the lesion area, observing the presence of clot, inflammatory cells, granulation tissue, type of bone tissue, morphology of bone cells, and thickness and organization of bone trabeculae. In the slides stained with Mallory Trichrome and Toluidine Blue were evaluated the percentage of new bone formation and number of mast cells, respectively. The qualitative analysis showed that the CH group presented a more advanced stage of bone repair compared to the C group, showing thicker trabeculae and greater bone filling of the lesion area. In D and DH group, the lesion area was partially filled with new bone formation tissue and presented thinner trabeculae and fewer areas associated to osteoclasts compared to control group. The histomorphometric analysis showed a significant improvement in new bone formation (p<0.001) comparing CH (38.08 ± 4.05) and C (32.05 ± 5.51); C and D (24.62 ± 2.28 and CH and DH (27.14 ± 4.21) groups. In the normoglycemic rats there was a significant increasing in the number of mast cells (p<0.05) comparing C (8.06 ± 5.15) and CH (21.06 ± 4.91) groups. In conclusion, this study showed that diabetes impaired bone repair and HBO was only able to increase new bone formation and the number of mast cells in the normoglycemic animals.

Desenvolvimento de um iogurte suplementado com Spirulina platensis: aaracterização físico-química, microbiológica e sensorial

O iogurte é um produto lácteo que é obtido a partir da acidificação controlada ou espontânea do leite, sendo o seu processo de fermentação desencadeado pela ação de culturas láticas. Este produto apresenta propriedades benéficas para a saúde, como é o caso da regulação do balanço da microflora intestinal, melhoramento da resposta imunitária, redução dos sintomas alérgicos, redução do colesterol sérico e níveis séricos de glicose. Em relação à alga S. platensis, esta apresenta benefícios cardiovasculares, é eficaz no tratamento de certas alergias, cancro, doenças virais, hiperglicemia, imunodeficiência e processos inflamatórios. Esta dissertação teve como objetivo desenvolver um iogurte suplementado com a microalga Spirulina platensis, com posterior caracterização do produto final, em termos físico-químicos, microbiológicos e sensoriais. Foram efetuadas várias experiências de receitas de iogurte até chegar à formulação final, tendo sido testadas diversas variantes. Na avaliação da qualidade físico-química, o iogurte produzido com Spirulina apresentou ao longo do tempo sempre valores mais elevados nos seguintes parâmetros: teor de proteína bruta, teor de lactose, teor de fibras e hidratos de carbono. Foram detetadas diferenças estatisticamente significativas entre os parâmetros e o tipo de iogurte nos seguintes casos: teor de matéria gorda, teor de proteína bruta, teor de humidade, hidratos de carbono, valor energético e pH. Foram detetadas diferenças estatisticamente significativas entre os parâmetros e o tempo de produção apenas no teor de cinzas. Na avaliação da qualidade microbiológica, o iogurte produzido com Spirulina não se destacou por apresentar valores mais elevados. Quando avaliados os fatores tipo de iogurte e tempo de produção, não foram detetadas diferenças estatisticamente significativas em nenhum dos parâmetros microbiológicos. Na avaliação da qualidade sensorial, no iogurte produzido com leite meio gordo com lactose, foi possível verificar que todos os parâmetros sensoriais analisados e as amostras de iogurte são independentes. Em relação ao iogurte produzido com leite meio gordo sem lactose, verificou-se que os parâmetros doce e ácido não são independentes das amostras de iogurte. Em termos de preferência, 71% dos provadores escolheram o iogurte com agar. Relativamente à prova afetiva, não foram detetadas diferenças estatisticamente significativas entre a amostra preferida e qualquer um dos fatores avaliados (idade e género do provador). Em termos de preferência, 66% dos provadores escolheram o iogurte sem lactose. No que diz respeito à prova triangular, não foram detetadas diferenças estatisticamente significativas entre as escolhas da amostra diferente e amostra preferida em relação ao género do provador. Apesar de 63% dos provadores terem preferido a amostra com 0 dias, apenas 44% conseguiram distinguir entre o iogurte com 0 dias e com 30 dias, o que sugere que mesmo ao fim de 1 mês, o iogurte continua agradável. Com base em todos os resultados obtidos, conclui-se que o iogurte produzido com S. platensis é um produto inovador e saudável, pelos inúmeros benefícios presentes no iogurte, conjugados com os benefícios da microalga.