Estudo comparativo das complicações terapêuticas no Lúpus Eritematoso Sistêmico e nas glomerulopatias idiopáticas.

PURPOSE: To evaluate the therapeutic complications due to the use of immunosupressors in patients with nephropathy. METHODS: 76 patients who had used steroids and cyclophosphamide were retrospectively studied. The cases were divided into three groups: G1= 15 patients with Systemic Lupus Erythematosus without renal lesion; G2= 33 patients with lupus nephritis and G3= 28 patients with nephrotic syndrome owing to idiopathic glomerulopathy. RESULTS: There were no differences related to time of follow up (G1= 42.4 +/- 51, G2= 52.3 +/- 51, G3= 41.8 +/- 47.8 months), total used dosage of steroids (G1= 20, G2= 28, G3= 16 grams) and time of drug use (G1= 20, G2= 26, G3= 14.5 months). About cyclophosphamide use, there was no difference in the percentage of patients who used it (13% in G1, 51% in G2, 28% in G3), but the patients from G1 received lower total dosage than those from G2 (p<0.05). Cushingoid appearance, epigastric distress, psychiatric disorders, diabetes mellitus and ocular alterations occurred in all the three groups, with no statistically significant differences. The infections complications, those considered more severe clinically, were more frequent in G2 (G1= 6%, G2= 15%, G3= 0% - p<0.05), the same occurring with the deaths (7% in G1, 30% in G2, 0% in G3 - p<0.05). CONCLUSION: In patients with lupus nephritis there were more infections complications owing to prolonged immunosuppresion what may indicate a severity marker of this type of lesion.

Prevalence of yeasts in the oral cavity of children treated with inhaled corticosteroids

The aim of this study was to observe the prevalence of Candida spp. in the oral cavity of children undergoing treatment with inhaled corticosteroids. Thirty children treated with inhaled corticosteroids and thirty control children were studied. Saliva samples were collected through oral rinses with phosphate buffered saline (PBS). The samples were plated on Sabouraud's dextrose agar and incubated at 37 degrees C for 48 h. After this period, the number of colony-forming units per ml (cfu/ml) of saliva was calculated. The isolates were identified by phenotypic characterization. Candida spp. was isolated from 43.33% of the samples of children treated with corticosteroids, with a mean of 780 cfu/ml of saliva, and from 30% of the samples of the control group, with a mean of 560 cfu/ml of saliva. No significant statistical difference was observed between the groups. C. albicans was the prevalent species in both groups, followed by C. guilliermondii, C. parapsilosis and C. stellatoidea. Furthermore, Rhodotorula rubra and C. lusitaniae were also isolated from the treated group. We concluded that there was no significant increase in the prevalence and number of Candida spp. in the oral cavity of children treated with inhaled corticosteroids.

Antenatal corticosteroid use and clinical evolution of preterm newborn infants

Objectives: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. Methods: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal interview, analysis of medical records, and follow-up of the newborn infants. Data analysis was performed with the use of chi-square, t Student, Mann-Whitney, and ANOVA tests and multiple logistic regression, with level of significance set at 5%. Results: Treatment was directly associated with the number of prenatal visits, with maternal hypertension and with the antenatal use of tocolytic agents. Babies from treated pregnant women presented better Apgar scores at the 1st and 5th minute, reduced need for intervention in the delivery room and lower SNAPPE II. They were born with higher birth weight, longer gestational age and needed less surfactant use, ventilation, and oxygenation time. After multiple logistic regression, the use of antenatal corticosteroid independently improved birth conditions, decreased ventilation time, being related to increased occurrence of neonatal sepsis. Conclusions: The use of corticosteroid was associated with better prenatal care and birth conditions, better preterm evolution but higher risk of infection. Copyright © 2004 by Sociedade Brasileira de Pediatria.

Baseline and stress-induced plasma corticosterone concentrations of mice selectively bred for high voluntary wheel running

The hypothalamic-pituitary-adrenal (HPA) axis is important in regulating energy metabolism and in mediating responses to stressors, including increasing energy availability during physical exercise. In addition, glucocorticoids act directly on the central nervous system and influence behavior, including locomotor activity. To explore potential changes in the HPA axis as animals evolve higher voluntary activity levels, we characterized plasma corticosterone (CORT) concentrations and adrenal mass in four replicate lines of house mice that had been selectively bred for high voluntary wheel running (HR lines) for 34 generations and in four nonselected control (C) lines. We determined CORT concentrations under baseline conditions and immediately after exposure to a novel stressor (40 min of physical restraint) in mice that were housed without access to wheels. Resting daytime CORT concentrations were approximately twice as high in HR as in C mice for both sexes. Physical restraint increased CORT to similar concentrations in HR and C mice; consequently, the proportional response to restraint was smaller in HR than in C animals. Adrenal mass did not significantly differ between HR and C mice. Females had significantly higher baseline and postrestraint CORT concentrations and significantly larger adrenal glands than males in both HR and C lines. Replicate lines showed significant variation in body mass, length, baseline CORT concentrations, and postrestraint CORT concentrations in one or both sexes. Among lines, both body mass and length were significantly negatively correlated with baseline CORT concentrations, suggesting that CORT suppresses growth. Our results suggest that selection for increased locomotor activity has caused correlated changes in the HPA axis, resulting in higher baseline CORT concentrations and, possibly, reduced stress responsiveness and a lower growth rate. © 2007 by The University of Chicago. All rights reserved.

Different stress biomarkers sensitivity during acute treadmill running exercise in rats

The level of stress during acute or chronic exercise is important since higher levels of stress may impair homeostasis. The adrenal gland is an essential stress-responsive organ involved in the hypothalamic-pituitary-adrenal axis. The aim of the study was to analyze the sensitivity of different stress biomarkers of the adrenal gland during acute treadmill running at different intensities. Adult rats performed three 25 min running tests at velocities of 15, 20 and 25 m/min, for determination of maximum lactate steady state (MLSS). After obtaining individual MLSS animals were assigned to two groups: M, sacrificed after 25 minutes of exercise at MLSS, and AM, sacrificed after exercise at 25% above MLSS. For comparison, a control group C was sacrificed at rest. Blood corticosterone concentrations, as well, adrenal gland cholesterol and ascorbic acid concentrations were used as biomarkers. Serum corticosterone concentrations were higher after exercise in both M (1802,74±700,42) and AM (2027,96±724,94) groups when compared C group (467,11±262,12), but were not different as a function of exercise intensity. No difference in adrenal ascorbic acid (M=2,37±0,66; AM=2,11±0,50 and C=2,54±0,53) and cholesterol (M=1,04±0,12; AM=0,91±0,31 and C=1,15±0,40) levels were observed when the three groups were compared. Serum corticosterone concentrations showed to be sensitive to acute treadmill exercise intensity. On the other hand, ascorbic acid and cholesterol concentrations in adrenal were biomarkers not adequate to evaluate exercise stress in rats.

Polyethylene gel in the subcutaneous tissue of rats: Histopathologic and systemic evaluation

Purpose: To evaluate the histological and systemic response to subcutaneous injection of polyethylene gel in rats. Methods: Twenty-one white male rats were divided into 3 groups (G): G1 and G2 received subcutaneous polyethylene gel injection in the dorsal midline and were sacrificed at 30 and 60 postoperative days, respectively. G3 was not exposed to the polyethylene gel and was sacrificed after 60 days. Blood levels of lactate dehydrogenase (LDH), creatine kinase (CK), and alkaline phosphatase (ALP) were evaluated. The heart, kidney, liver, adrenal gland, injection site, and adjacent tissues were histologically examined. The results were submitted to statistical analysis. Results: There was no clinical evidence of extrusion, reduction of the injected volume, or abnormalities in the adjacent tissues. Blood levels of CK and LDH were normal and similar in all groups. ALP levels were significantly lower in G2 than in G1 and G3. The systemic organs were normal on histological examination in the 3 groups evaluated. Microscopically, the polyethylene gel was surrounded by a thin pseudocapsule formation and minimal inflammatory cell response, which decreased from G1 to G2. Conclusion: The subcutaneous injection of polyethylene gel in rats elicited minimal local inflammatory response and no systemic side effects. Copyright © 2008 Informa Healthcare USA, Inc.

Spatio-temporal distribution of fatty acid-binding protein 6 (fabp6) gene transcripts in the developing and adult zebrafish (Danio rerio)

We have determined the structure of the fatty acid-binding protein 6 (fabp6) gene and the tissue-specific distribution of its transcripts in embryos, larvae and adult zebrafish (Danio rerio). Like most members of the vertebrate FABP multigene family, the zebrafish fabp6 gene contains four exons separated by three introns. The coding region of the gene and expressed sequence tags code for a polypeptide of 131 amino acids (14 kDa, pI 6.59). The putative zebrafish Fabp6 protein shared greatest sequence identity with human FABP6 (55.3%) compared to other orthologous mammalian FABPs and paralogous zebrafish Fabps. Phylogenetic analysis showed that the zebrafish Fabp6 formed a distinct clade with the mammalian FABP6s. The zebrafish fabp6 gene was assigned to linkage group (chromosome) 21 by radiation hybrid mapping. Conserved gene synteny was evident between the zebrafish fabp6 gene on chromosome 21 and the FABP6/Fabp6 genes on human chromosome 5, rat chromosome 10 and mouse chromosome 11. Zebrafish fabp6 transcripts were first detected in the distal region of the intestine of embryos at 72 h postfertilization. This spatial distribution remained constant to 7-day-old larvae, the last stage assayed during larval development. In adult zebrafish, fabp6 transcripts were detected by RT-PCR in RNA extracted from liver, heart, intestine, ovary and kidney (most likely adrenal tissue), but not in RNA from skin, brain, gill, eye or muscle. In situ hybridization of a fabp6 riboprobe to adult zebrafish sections revealed intense hybridization signals in the adrenal homolog of the kidney and the distal region of the intestine, and to a lesser extent in ovary and liver, a transcript distribution that is similar, but not identical, to that seen for the mammalian FABP6/Fabp6 gene. © 2008 The Authors.

Localization of myosin-Va in subpopulations of cells in rat endocrine organs

Myosin-Va is a Ca 2+/calmodulin-regulated unconventional myosin involved in the transport of vesicles, membranous organelles, and macromolecular complexes composed of proteins and mRNA. The cellular localization of myosin-Va has been described in great detail in several vertebrate cell types, including neurons, melanocytes, lymphocytes, auditory tissues, and a number of cultured cells. Here, we provide an immunohistochemical view of the tissue distribution of myosin-Va in the major endocrine organs. Myosin-Va is highly expressed in the pineal and pituitary glands and in specific cell populations of other endocrine glands, especially the parafollicular cells of the thyroid, the principal cells of the parathyroid, the islets of Langerhans of the pancreas, the chromaffin cells of the adrenal medulla, and a subpopulation of interstitial testicular cells. Weak to moderate staining has been detected in steroidogenic cells of the adrenal cortex, ovary, and Leydig cells. Myosin-Va has also been localized to non-endocrine cells, such as the germ cells of the seminiferous epithelium and maturing oocytes and in the intercalated ducts of the exocrine pancreas. These data provide the first systematic description of myosin-Va localization in the major endocrine organs of rat. © 2008 Springer-Verlag.

A systematic review of anti-inflammatories for mild to moderate carpal tunnel syndrome

The purpose of this study was to evaluate anti-inflammatory drugs in the medium- and long-term management of mild to moderate carpal tunnel syndrome (CTS). The authors conducted a systematic review of the literature on the effectiveness of steroidal and nonsteroidal anti-inflammatory drugs for mild and moderate cases of CTS. There were included only randomized, double-blind clinical trials. Six publications referring to five trials were included in the review. No study on nonsteroidal anti-inflammatory drugs met our inclusion criteria. Although neurophysiological studies have not shown great differences resulting from the application of corticosteroids, the symptomatic benefit provided by such drugs is clear. In the short term, local infiltration provides better results than systemic administration of corticosteroids. Over a 1-year period, however, this difference does not persist. Further double-blind randomized trials evaluating therapeutic efficacy for a longer follow-up period are required to provide stronger evidence for both steroidal and nonsteroidal anti-inflammatories. © 2009 by Lippincott Williams & Wilkins.

Cellular localization of androgen synthesis in equine granulosa-theca cell tumors: Immunohistochemical expression of 17α-hydroxylase/17,20-lyase cytochrome P450

Elevated blood testosterone concentrations, often accompanied by male-typical behaviors, is a common signalment of mares with granulosa-theca cell tumors (GCTCs), but no definitive information exists regarding the cellular differentiation of tumors associated with androgen secretion. This study was conducted to localize and thereby define the cellular expression of 17α-hydroxylase/17,20-lyase cytochrome P450 (P450c17), the enzyme most directly responsible for androgen synthesis, in 30 GTCTs and control tissues (gonads and adrenal glands) using immuno-histochemistry (IHC). Immuno-reactivity for P450c17 was evident in approximately half of 30 specimens examined, was most consistent in the interstitial cells surrounding existing or developing cysts, and was less intense in cells within cysts in the smaller proportion of specimens where this was observed. In control tissues, the expression of P450c17 was localized primarily in theca interna of normal ovarian follicles, in theca-lutein cells of some corpora lutea, but not in granulosa-lutein cells. Testicular interstitial cells and islands of adreno-cortical cells located in the adrenal medulla of the adrenal cortex further established the specificity of the antisera used. These data provided the first substantive evidence that polyhedral cells identified previously in GTCTs by histopathology have the potential to synthesize and secrete androgens, similar to theca interna and theca lutein cells in normal equine ovaries. © 2010 Elsevier Inc.

Visceral mast cell tumor and mastocythemia in a dog

Mast cell tumor manifests as a localized proliferation of mast cells in the skin, or less frequently as a systemic disorder, which may be accompanied by the presence of neoplastic mast cells in the peripheral blood (mastocythemia). In some cases, the neoplastic circulating mast cells originate in the bone marrow, designated as mast cell leukemia, rarely observed in dogs, or the cells may arise from visceral mast cell tumors, characterizing systemic mastocytosis. The aim of this report was to describe a case of a six-year-old female German shepherd dog presenting with history of anorexia, hematemesis and diarrhea. The blood work revealed intense mastocythemia (43%), with degranulated mast cells, and anisocytosis. At necropsy, white nodular lesions in the thymic region and an infiltrative mass in mesenteric and abdominal lymph nodes were observed. Those lymph nodes were enlarged and off-white. Histopathological examination revealed neoplastic mast cells in the liver, spleen, lymph nodes, kidneys, lungs, gastric and enteric mucosae, and adrenal glands. The clinical, hematological and histopathological findings were compatible with mastocythemia, associated with a moderately differentiated visceral mast cell tumor.

Proactive management of extreme prematurity: Disagreement between obstetricians and neonatologists

Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.Study Design: Prospective cohort of 484 infants with 23 0/7 to 266/7 weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ≥1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.Conclusion: In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. © 2012 Nature America, Inc.

Some aspects of chicken behavior and welfare

Brazil is the world leader in broiler production and export. It achieved this position mainly to its excellent supply chain structure and climate, which favor poultry and grain production throughout its territory. Although Brazilian egg production is not as important as broiler production, this segment presents great potential of increasing its share in the global market. However, as elsewhere in the world, Brazilian poultry production faces the challenge to balance two elements within its supply chain: cruelty and productivity. The consumers of the European Union (EU) are very concerned with animal welfare issues. In order to increase its share in the European market, and eventually in the world market, Brazilian poultry producers must understand the effects of production systems on poultry welfare, and try to develop systems that are suited for its climate and other production conditions. There is a consensus that the natural behaviors performed by poultry in intensive production systems allow better welfare. This objective of this review is to present scientific research studies that relate different behaviors to chicken welfare. Poultry behavior is a reflex of their welfare status at a particular moment, and it is related to internal (physiological) and external (environmental) factors. Several natural behaviors that favor welfare, as well as undesirable behaviors, may be stimulated by environmental enrichment. The correct interpretation of the behaviors expressed by poultry, including their frequency, duration, and sequence, may be used to estimate their welfare. Animal production is an import sector of Brazilian economy. It significantly contributes to the Gross Domestic Product (GDP), in terms of products destined both to domestic consumption and exports. New technologies applied to products and management practices have been developed for field application, aiming at improving producers' productivity and profitability. In order to comply with the European Union's (EU) guidelines for animal protein production, Brazilian poultry production needs to undergo a process of adaptation. In May, 2007, the EU Commission established its new guidelines for animal welfare in poultry production, pressured by consumer demand. In the EU, there is a growing concern among consumers as to how poultry are reared and slaughtered. European consumers are in the fore front of the demand of high quality products produced with under better welfare conditions, and have spread this concern throughout the world. Beaumont et al. (2010) mentioned that European consumers frequently perceive that standard commercial poultry production has poor animal welfare practices. According to Nääs et al. (2008), Brazilian poultry production today needs to find a balance between cruelty and productivity. In fact, ensuring animal welfare may provide better financial results, as it increases the producer's profit margins and allows maintaining Brazilian chicken export quotas to the EU. França (2008) noted that biological studies that define ethical limits and guidelines for poultry production foster the development of new production practices that may ensure good product quality and productivity without putting bird welfare at risk. Gonyou (1994) states that, when animal welfare started to be studied, the only behavioral factors considered were those related to feeding and reproduction. These first studies used as indicators of animal welfare reduced life expectancy, impaired growth, impaired reproduction, body damage, disease, immunosuppression, adrenal activity, behavior anomalies, and self-narcotization (Broom, 1991). However, current studies evaluate additional indicators, such as natural behaviors, behavioral needs, preferences, behavioral problems, emotional state, cognitive abilities, etc. In the field of ethology, the expression of natural behavior is a frequently used tool used to estimate the welfare of poultry destined to human consumption. According to Bracke & Hopster (2006), natural behavior can be defined as the behavior the animal normaly presents when exposed to conditions similar to its natural habitat. Natural behaviors are pleasurable and promote biological functions that are meaningful to the animal's welfare. The definition of natural behavior, though, does not include the bird's behavior when sick, in flight or during aggression, since these are not considered pleasurable situations. Considering layer behavioral needs in the design of housing facilities optimize their welfare. Mishra et al. (2005) verified that ISA Brown layers spent, during 24 hours, around 97% of the time in the nest, feeding, walking, resting, or dust bathing, and that 57% of these behaviors did not depend on environmental enrichment. It was also observed that hens had preferred behavioral sequences, which included foraging and comfort behaviors, such as wing-stretching and preening. The present review aims at discussing, albeit not exhaustively, scientific research studies on the behavior of Gallusgallus domesticus and its relationship to welfare. The following behaviors are reviewed: feather pecking, scratching, dust bathing, nesting, locomotion activities, and aggressive behaviors. These behaviors are the most frequently observed in commercial broiler, broiler breeder, and layer farming, and therefore, monitoring their incidence may contribute to measure poultry welfare.

Influence of chronic exercise on serum cortisol levels in older adults

The circulating level of cortisol is regulated by the hypothalamic-pituitary-adrenal axis through a neuroendocrine feedback circuit. This circuit can be activated by physiological stimuli such as stress, diseases, and exercise. High levels of serum cortisol hormone normally occur as a byproduct of aging, and can cause several types of damage to the organism and exacerbate immunosenescence. There is a great deal of variability in the cortisol response with regard to type, intensity, volume, and frequency of exercise. However, these relationships have been extensively studied with respect to the acute effects of exercise. Despite the well-known effects of acute exercise on cortisol response, it is unclear how it is affected by chronic exercise and the aging process. Therefore, the aim of this study was to conduct a review of studies that attempt to analyze the influence of chronic exercise on serum cortisol hormone in older people. In order to accomplish this goal, a review from 1970 to June 2012 period was performed using the following databases: Biological Abstracts, PsycINFO, PubMed/Medline, and the Web of Science. Eight articles met the criteria used in this study. Based on the included articles, chronic exercise may influence the serum levels of cortisol levels in older people. Despite this evidence, these results may not be generalized to the entire population of older people, given the few number of studies and especially because the studies showed diversity in variables and methodologies. © 2013 European Group for Research into Elderly and Physical Activity (EGREPA).

Mechanisms in the bed nucleus of the stria terminalis involved in control of autonomic and neuroendocrine functions: A review

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