Doença cardiovascular: contribuição do Vascepa®, medicamento de origem marinha, no combate à hipertrigliceridemia

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

A alfarroba como fonte de ingredientes bioactivos: fibra alimentar, polifenóis e ciclitóis

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

Efeitos pleiotrópicos das estatinas

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

Terapêutica antiretroviral e metabolismo lipídico

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

Prevalência da síndrome metabólica e seus componentes nos estágios pubertários de escolares do sexo feminino norte-rio-grandenses

The diagnosis of nutritional status is extremely re levant in clinical practice and population assessment, due to the association betwe en body fat and metabolic alterations. The aim of this study is to analyze th e prevalence of metabolic syndrome (MS) and its components in the pubertal stages of f emale students in Rio Grande do Norte state, Brazil, in accordance with Internation al Diabetes Federation criteria. This is a cross-sectional study with 449 students aged betw een 8 and 19 years, stratified into pubertal stages systematized by Marshal and Tanner (1969), as follows: 27.6% prepubertal, 44.3% pubertal and 28.1% postpubertal, with mean ages of 9.4±1.27, 12.4±2.23 and 15.1±1.88 years, respectively. Preval ences were analyzed using distribution of frequencies and their respective 95 % confidence intervals, while the chi- square test and odds ratio were applied to analyze the associations between variables. The general prevalence of MS was 3.3% (CI: 2% - 5%) , without occurrences in the prepubertal stage, observing that it emerges from t he pubertal stage onwards with a prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95% 0.4% - 2.3%) of cases with overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes e individuals, while in the postpubertal stage the prevalence is 7.9% (CI 95% 3 .2% - 12.6%), 0.8% (CI 95% -0.8% - 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4% ) overweight and 3.1% (CI 0.1% - 6.2%) obese individuals. There was an association (p<0.02) between pubertal stages and MS ( x 2 =5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha t postpubertal adolescents are more prone to SM than pubertals, while the OR i n obese individuals was 2.1 (CI: 2– 2.2) compared to the overweight. Body mass index (B MI) ( x 2 = 29.4; p<0.001) and age range ( x 2 = 13.1; p<0.001) showed a significant linear assoc iation with MS. Of the adolescents with MS, those aged ten years or younge r exhibited higher %G. The most prevalent components in all the stages were altered waist circumference (27.2% [CI 23% - 31%]) and low HDL cholesterol (39.6% [CI 35% – 44%]), which, coupled with hypertension, displayed significant differences in the postpubertal stage in relation to the other stages. The results show that MS emerges from the pubertal stage onwards in proportion to excess childhood body fat, a fact tha t calls for prevention strategies using an educational approach, reducing the large demand on the National Health System. Keywords: Metabolic syndrome, pubertal stages, risk factors.

Parâmetros bioquímicos e níveis de IgE total e específicas para aeroalérgenos em mulheres obesas com síndrome dos ovários policísticos

Introduction: Polycystic ovary syndrome (PCOS) whose classic features (menstrual irregularity of oligo/ amenorrhea type, chronic anovulation, infertility and hyperandrogenism clinical and/ or biochemical), is associated with aspects of metabolic syndrome (MS), as obesity and insulin resistance. The level of obesity determines different levels of inflammation, increasing cytokines participants of metabolic and endocrine functions, beyond modulate the immune response. Metabolic changes, added to the imbalance of sex hormones underlying irregular menstruation observed in (PCOS) can trigger allergic processes and elevation of total and specific IgE antibodies indicate that a sensitization process was started. Objective: To evaluate the influence of PCOS on biochemical parameters and levels of total and specific IgE to aeroallergens in obese women. Methods: After approval by the Committee of Ethics in Research, were recruited 80 volunteers with BMI ≥ 30 kg/m2 and age between 18 and 45 years. Among these, 40 with PCOS according to the Rotterdam criteria and 40 women without PCOS (control group). All participants were analysed with regard to anthropometric, clinical, gynecological parameters, interviewed using a questionnaire, and underwent blood sampling for realization of laboratory tests of clinical biochemistry: Total cholesterol, LDL-cholesterol, HDL- cholesterol, Triglycerides, Fasting glucose, Urea, Creatinine, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and immunological: total and specific IgE to Dermatophagoides pteronyssinus, Blomia tropicalis, Dermatophagoides farinae and Dermatophagoides microceras.Statistical analysis was performed using SPSS 15.0 software through the chi-square tests, Fisher, Student t test and binary logistic regression, with significance level (p <0.05). Results: It was observed in the group of obese women with PCOS that 29 (72.5%) had menstrual cycle variable and 27 (67.5%) had difficulty getting pregnant. According to waist-hip ratio, higher average was also observed in obese PCOS (0.87). Blood level of HDL (36.9 mg/dL) and ALT (29.3 U/L) were above normal levels in obese women with PCOS, with statistically significant relationship. In the analysis of total and specific IgE to D. pteronyssinus high results were also prevalent in obese PCOS, with blood level (365,22 IU/mL) and (6.83 kU/L), respectively, also statistically significant. Conclusions: Observed predominance of cases with high levels of total IgE in the group of obese women with PCOS, 28 (70%) of the participants, whose mean blood concentration of the group was 365.22 IU/mL. In the analysis of Specific IgE between the groups, the allergen Dermatophagoides pteronyssinus showed greater dispersion and average the results of sensitization in the group of obese PCOS, whose mean blood concentration was 6.83 kU/l. Keywords: Obesity, Allergens and Polycystic Ovary Syndrome

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.

Efeito do exercício físico na estabilidade de membrana de eritrócitos

CHAPTER II - This study evaluated the effects of two different types of acute aerobic exercise on the osmotic stability of human erythrocyte membrane and on different hematological and biochemical variables that are associated with this membrane property. The study population consisted of 20 healthy and active men. Participants performed single sessions of two types of exercise. The first session consisted of 60 min of moderate-intensity continuous exercise (MICE). The second session, executed a week later, consisted of high-intensity interval exercise (HIIE) until exhaustion. The osmotic stability of the erythrocyte membrane was represented by the inverse of the salt concentration (1/H50) at the midpoint of the sigmoidal curve of dependence between the absorbance of hemoglobin and the NaCl concentration. The values of 1/H50 changed from 2.29 ± 0.1 to 2.33 ± 0.09 after MICE and from 2.30 ± 0.08 to 2.23 ± 0.12 after HIIE. In MICE has occurred an increase in the mean corpuscular volume, probably due to in vivo lysis of older erythrocytes, with preservation of cells that were larger and more resistant to in vitro lysis. The study showed that a single bout of acute exercise affected the erythrocyte osmotic stability, which increased after MICE and decreased after HIIE.

Proteína C reactiva, índice de conicidad y factores de riesgo cardiovascular en pacientes con diabetes tipo 2

La Diabetes tipo 2, forma parte del clúster de componentes que integran el Síndrome metabólico, y constituye una enfermedad tremendamente prevalente en el mundo, con disfunciones metabólicas que incrementan la morbimortalidad. Objetivo. Con la finalidad de definir las características de una población amplia de pacientes diabéticos de la Comunidad de Madrid diagnosticados por el Hospital Infanta Leonor de Madrid, su contribución al síndrome metabólico, tipo de tratamiento, años de evolución y riesgo cardiovascular, se procedió a realizar un estudio transversal en una población de 735 diabéticos, seleccionados de una base de datos de 1135 diabéticos del Servicio de Endocrinología del Hospital de los que se disponían de datos sobre edad, género, parámetros antropométricos, glucosa, hemoglobina glicosilada, lípidos, lipoproteínas, consumo de tabaco, alcohol y actividad física. En muchos de ellos también se disponía de marcadores emergentes de afectaciones relacionadas con la diabetes y la enfermedad cardiovascular como PCR-us, microalbuminuria y fibrinógeno. Descripción de la muestra. La selección se realizó garantizando confidencialidad y que todos tuvieran datos de edad, sexo, y de los marcadores clásicos, y de la mayoría de los nuevos marcadores emergentes. Como quiera que contar absolutamente con todos los marcadores en el mismo individuo supondría perder en tal selección un número no despreciable de pacientes, se procedió a respetar la selección de 735 en donde 716 tenía información de la mayoría de los marcadores. A partir de los datos primarios se calcularon los cocientes colesterol/total /HDL-c, LDL-c/HDL-c que informan del riesgo cardiovascular, el cociente molar TG/HDL-c indicativo del tamaño de las LDL, y la relación de triglicérido- glucosa como marcador de resistencia a la insulina y riesgo de síndrome metabólico. Se procedió a calcular el riesgo cardiovascular según los algoritmos del estudio Framingham...

Condicionantes nutricionales que influyen sobre los factores de riesgo de síndrome metabólico en niños de la Comunidad de Madrid

El Síndrome Metabólico (SM) es un conjunto de factores de riesgo asociados con el incremento del riesgo de enfermedad cardiovascular y diabetes mellitus de tipo 2 (DM2). Dichos factores son obesidad (OB), resistencia a la Insulina (RI), hiperglucemia, dislipidemia e hipertensión (HTA) e interactúan entre sí sobre las anomalías vasculares, el estrés oxidativo, la grasa visceral, la inflamación y el cortisol en un entorno de OB y RI y bajo la influencia de las predisposiciones genéticas y condiciones ambientales, tales como hábitos de alimentación y actividad física. Según una hipótesis, la RI y la OB son los factores que más contribuyen en la manifestación de anormalidades metabólicas y las manifestaciones más tempranas del desarrollo de SM en niños. Mientras el páncreas compensa adecuadamente la RI mediante una mayor secreción de insulina, las concentraciones de glucosa en sangre se mantienen normales. Sin embargo, en algunos pacientes la capacidad de las células β del páncreas disminuye con el tiempo, lo que conduce al desarrollo de DM2. Otro factor a tener en cuenta en el diagnóstico del SM es la dislipidemia, caracterizada por el aumento de los triglicéridos (TG) y del VLDL‐colesterol, bajas cifras de HDL‐colesterol, así como por la presencia de partículas de LDL‐colesterol más pequeñas y densas de lo normal. Otro factor de riesgo de padecimiento de SM es la presión arterial elevada, que suele aparecer ligada a la presencia de OB, ya que el aumento de algunas adipoquinas que en esta se produce, entre las que se encuentran el AGE, PAI‐1, IL‐6, TNF‐α y leptina, pueden llevar a disfunción endotelial a través de la ruta del óxido nítrico. Debido a que el sobrepeso y el incremento de los valores de insulina plasmática son componentes clave del SM, es importante tener en cuenta los hábitos alimentarios y otros estilos de vida que influyen en los mismos...

Influência das alturas iniciais de pasto diferido na recria de cordeiros sobre o desempenho na terminação em confinamento

The objective of this study was to evaluate the productive performance, metabolic and feeding behavior of sheep after ninety days deferred pasture at different heights. The experiment was conducted at Capim Branco experimental farm of the Universidade Federal de Uberlândia. During the period of 90 days, from June to September 2013, forty-eight crossbred lambs Santa Inês x Dorper, divided into groups of four animals, occupied twelve pickets deferred pasture with four initial heights (15 cm, 25 cm, 35 cm and 45 cm). During this period we evaluated the structural characteristics of pasture. For confinement, from September to December 2013, 32 of these animals were used (16 males and 16 females), divided into four bays, separated as pasture were using. The consumption was assessed daily, while biometric measurements were made every 21 days. In relation to gender, there were differences in average daily gain weight. Reviews of feeding behavior occurred at the beginning, middle and end of the experiment for 24 hours. The rumination and leisure activities do not present statistical differences, both initial height of pasture and by period. The time spent on intake was higher during the daytime both treatments starting height as the experimental periods, however, rumination activity was more intense at night. Blood glucose was achieved in five periods of the day, while other metabolites have been obtained with a collection made fortnightly. The different initial heights not promoted effects on blood glucose. The harvesting times were not affected. However, there was a reduction of basal blood glucose of animals throughout the experimental period. There was a significant interaction between the initial pasture heights and periods of evaluation of basal glucose. Cholesterol and triglyceride levels were below recommended levels, however the final phase of confinement cholesterol level increased significantly. The values of VLDL and GGT were above the reference range. FA and AST showed average values within the recommended values. Total protein was influenced by different initial heights of pasture. The creatinine and albumin had values below the recommended range. Moreover, the albumin decreased during the confinement time. Uric acid showed close to the recommended maximum. There was stabilization of compensatory growth, with modification of consumption and weight gain at 45 days of experiment.

Manipulação gênica do protozoário Neospora caninum como ferramenta para o estudo das interações parasito-hospedeiro

Neospora caninum is an obligate intracellular parasite classified in the phylum Apicomplexa, characterized by the presence of the apical complex composed by micronemes proteins, rhoptries and dense granules, used by parasite during the adhesion and invasion process of the host cell. This is the mean event in infection pathogenesis generated by N. caninum and other parasites from the phylum Apicomplexa, promoting influence in the parasite biology and the interface between the parasite and its host. Therefore, molecular tools have been developed in order to identify and characterize these possible virulence factors. Thus, the present study sought to establish a specific system of genetic manipulation of N. caninum, searching for the improvement of the genetics manipulation of this parasite. So, we developed genetically depleted N. caninum to Rop9 rhoptry using the pU6-Universal CRISPR-Cas9 plasmid of T. gondii modified by the insertion of Ku80. The Rop9 depleted parasite showed important during initial phase of invasion and replication of the parasite, however it was not characterized as a potential virulence fator for N. caninum. Furthermore, T. gondii proteins were expressed in N. caninum by the use of specific vectors for this parasite, showing an heterologous system for the study of Toxoplasma proteins, due to the fact that Gra15 or Gra24 of type II T. gondii and Rop16 of type I T. gondii were expressed in N. caninum tachyzoites in a stable way and keept its biological phenotype, as already presented the former parasite, that naturaly expresses these proteins. In addition, it was observed that N. caninum induced an inflammasome activation through NLRP3, ASC and Caspase-1. IL-1R/MyD88 demonstrated an indirect pathway in the control of parasite replication. Furthermore, it was observed that this activation is dependent of the potassium efflux and that different strains of N. caninum keep this activation profile. However, T. gondii strains block this activation, making necessary a prior signal in order to active the inflamosome pathway. Type I T. gondii Rop16 was identified as responsible for blocking this activation, in a dependent way to the STAT3 activation. Therefore, the development of molecular tools and their application in N. caninum may prove to be useful to identify and characterize virulent factors involved in the pathogenesis by these two protozoans.

Efecto de diferentes programas de entrenamiento en sujetos con sobrepeso sedentarios

El propósito de este estudio es comprobar los efectos de diferentes planes de entrenamiento en la composición corporal y sobre factores de riesgo cardiovascular en sujetos con sobrepeso. La muestra está compuesta por 6 hombres sedentarios con sobrepeso. Considerando así, a aquellos sujetos con un IMC >25, un perímetro de cintura >88 cm y una ? de los 3 pliegues >57 (subescapular, abdominal y supraespinal). Es condición que no hayan realizado ejercicio sistemáticamente en los últimos 6 meses. Se pide a los participantes que no realicen cambios significativos en sus dietas. Todos adultos de entre 22 y 45 años de edad. La intervención dura 8 semanas, con una frecuencia de 3 veces por semana (lunes, miércoles y viernes). Se realizó a todos una evaluación de los siguientes parámetros de salud cardiovascular: colesterol total, perfil lipídico, tensión arterial, VO 2 máx., IMC, CCi/Ca, ? 3 pliegues cutáneos del tronco, antes y después de finalizar la intervención. Los 6 participantes fueron divididos aleatoriamente en 4 grupos: el grupo control que no realiza ningún plan de entrenamiento; el grupo de ejercicios de fuerza que realizó las primeras 2 semanas 8 ejercicios al 55 de la MR estimativa y las posteriores 6 semanas 10 ejercicios entre el 60 a 65 de la MR estimativa; el grupo de ejercicios aeróbicos que trabajó al 55 - 60 1del VO 2 máx. caminando de forma continua con un volumen de 30 a 40 minutos de duración por sesión; y por último, el grupo de entrenamiento mixto que alternó un día de trabajo de fuerza y un día aeróbico con la misma metodología descripta anteriormente

Efecto de diferentes programas de entrenamiento en sujetos con sobrepeso sedentarios

El propósito de este estudio es comprobar los efectos de diferentes planes de entrenamiento en la composición corporal y sobre factores de riesgo cardiovascular en sujetos con sobrepeso. La muestra está compuesta por 6 hombres sedentarios con sobrepeso. Considerando así, a aquellos sujetos con un IMC >25, un perímetro de cintura >88 cm y una ? de los 3 pliegues >57 (subescapular, abdominal y supraespinal). Es condición que no hayan realizado ejercicio sistemáticamente en los últimos 6 meses. Se pide a los participantes que no realicen cambios significativos en sus dietas. Todos adultos de entre 22 y 45 años de edad. La intervención dura 8 semanas, con una frecuencia de 3 veces por semana (lunes, miércoles y viernes). Se realizó a todos una evaluación de los siguientes parámetros de salud cardiovascular: colesterol total, perfil lipídico, tensión arterial, VO 2 máx., IMC, CCi/Ca, ? 3 pliegues cutáneos del tronco, antes y después de finalizar la intervención. Los 6 participantes fueron divididos aleatoriamente en 4 grupos: el grupo control que no realiza ningún plan de entrenamiento; el grupo de ejercicios de fuerza que realizó las primeras 2 semanas 8 ejercicios al 55 de la MR estimativa y las posteriores 6 semanas 10 ejercicios entre el 60 a 65 de la MR estimativa; el grupo de ejercicios aeróbicos que trabajó al 55 - 60 1del VO 2 máx. caminando de forma continua con un volumen de 30 a 40 minutos de duración por sesión; y por último, el grupo de entrenamiento mixto que alternó un día de trabajo de fuerza y un día aeróbico con la misma metodología descripta anteriormente

Efecto de diferentes programas de entrenamiento en sujetos con sobrepeso sedentarios

El propósito de este estudio es comprobar los efectos de diferentes planes de entrenamiento en la composición corporal y sobre factores de riesgo cardiovascular en sujetos con sobrepeso. La muestra está compuesta por 6 hombres sedentarios con sobrepeso. Considerando así, a aquellos sujetos con un IMC >25, un perímetro de cintura >88 cm y una ? de los 3 pliegues >57 (subescapular, abdominal y supraespinal). Es condición que no hayan realizado ejercicio sistemáticamente en los últimos 6 meses. Se pide a los participantes que no realicen cambios significativos en sus dietas. Todos adultos de entre 22 y 45 años de edad. La intervención dura 8 semanas, con una frecuencia de 3 veces por semana (lunes, miércoles y viernes). Se realizó a todos una evaluación de los siguientes parámetros de salud cardiovascular: colesterol total, perfil lipídico, tensión arterial, VO 2 máx., IMC, CCi/Ca, ? 3 pliegues cutáneos del tronco, antes y después de finalizar la intervención. Los 6 participantes fueron divididos aleatoriamente en 4 grupos: el grupo control que no realiza ningún plan de entrenamiento; el grupo de ejercicios de fuerza que realizó las primeras 2 semanas 8 ejercicios al 55 de la MR estimativa y las posteriores 6 semanas 10 ejercicios entre el 60 a 65 de la MR estimativa; el grupo de ejercicios aeróbicos que trabajó al 55 - 60 1del VO 2 máx. caminando de forma continua con un volumen de 30 a 40 minutos de duración por sesión; y por último, el grupo de entrenamiento mixto que alternó un día de trabajo de fuerza y un día aeróbico con la misma metodología descripta anteriormente