838 resultados para Serious injury
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Ischemic-reperfusion injury (IRI) triggers an inflammatory response involving neutrophils/macrophages, lymphocytes and endothelial cells. Galectin-3 is a multi-functional lectin with a broad range of action such as promotion of neutrophil adhesion, induction of oxidative stress, mastocyte migration and degranulation, and production of pro-inflammatory cytokines. The aim of this study was evaluate the role of galectin-3 in the inflammation triggered by IRI. Galectin-3 knockout (KO) and wild type (wt) mice were subjected to 45 min of renal pedicle occlusion. Blood and kidney samples were collected at 6, 24, 48 and 120 h. Blood urea was analyzed enzymatically, while MCP-1, IL-6 and IL-1 beta were studied by real-time PCR. Reactive oxygen species (ROS) was investigated by flow cytometry. Morphometric analyses were performed at 6, 24, 48 and 120 h after reperfusion. Urea peaked at 24 h, being significantly lower in knockout animals (wt = 264.4 +/- 85.21 mg/dl vs. gal-3 KO = 123.74 +/- 29.64 mg/dl, P = 0.001). Galectin-3 knockout animals presented less acute tubular necrosis and a more prominent tubular regeneration when compared with controls concurrently with lower expression of MCP-1, IL-6, IL-1 beta, less macrophage infiltration and lower ROS production at early time points. Galectin-3 seems to play a role in renal IRI involving the secretion of macrophage-related chemokine, pro-inflammatory cytokines and ROS production.
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Ischemia and reperfusion injury (IR) is an antigen independent inflammatory process that causes tissue damage. After IR, kidneys up-regulate leukocyte adhesion molecules and toll-like receptors (TLRs). Moreover, injured kidneys can also secrete factors (i.e. heat shock protein) which bind to TLRs and trigger intracellular events culminating with the increase in the gene expression of inflammatory cytokines. FTY720 is an immunomodulatory compound and protects at least in part kidneys submitted to IR. The mechanisms associated with FTY720`s beneficial effects on kidneys after IR remain elusive. We investigated whether FTY720 administration in mice submitted to kidney IR is associated with modulation of TLR2 and TLR4 expression. C57BL/6 mice submitted to 30 min of renal pedicles clamp were evaluated for serum parameters (creatinine, urea and nitric oxide), kidney histology, spleen and kidney infiltrating cells expression of TLR2 and TLR4, resident kidney cells expression of TLR2 and TLR4 and IL-6 protein expression in kidney. FTY720-treated mice presented decrease in serum creatinine, urea and nitric oxide, diminished expression of TLR2 and TLR4 both in spleen and kidney infiltrating cells, and reduced kidney IL-6 protein expression in comparison with IR non-treated mice. However, acute tubular necrosis was present both in IR non-treated and IR + FTY720-treated groups. Also, FTY720 did not prevent TLR2 and TLR4 expression in kidney resident cells. In conclusion, FTY720 can promote kidney function recovery after IR by reducing the inflammatory process. Further studies are needed in order to establish whether TLR2 and TLR4 down regulation should be therapeutically addressed as protective targets of renal function and structure after IR. (C) 2011 Elsevier B.V. All rights reserved.
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Lipopolysaccharides from gram-negative bacteria are amongst the most common causative agents of acute lung injury, which is characterized by an inflammatory response, with cellular infiltration and the release of mediators/cytokines. There is evidence that bradykinin plays a role in lung inflammation in asthma but in other types of lung inflammation its role is less clear. In the present study we evaluated the role of the bradykinin B(1) receptor in acute lung injury caused by lipopolysaccharide inhalation and the mechanisms behind bradykinin actions participating in the inflammatory response. We found that in C57BI/6 mice, the bradykinin B(1) receptor expression was up-regulated 24 h after lipopolysaccharide inhalation. At this time, the number of cells and protein concentration were significantly increased in the bronchoalveolar lavage fluid and the mice developed airway hyperreactivity to methacholine. In addition, there was an increased expression of tumor necrosis factor-alpha, interleukin-1 beta and interferon-gamma and chemokines (monocytes chemotactic protein-1 and KC) in the bronchoalveolar lavage fluid and in the lung tissue. We then treated the mice with a bradykinin B, receptor antagonist, R-954 (Ac-Orn-[Oic(2), alpha-MePhe(5), D-beta Nal(7), Ile(8)]desArg(9)-bradykinin), 30 min after lipopolysaccharide administration. We observed that this treatment prevented the airway hyperreactivity as well as the increased cellular infiltration and protein content in the bronchoalveolar lavage fluid. Moreover, R-954 inhibited the expression of cytokines/chemokines. These results implicate bradykinin, acting through B(1) receptor, in the development of acute lung injury caused by lipopolysaccharide inhalation. (C) 2010 Elsevier B.V. All rights reserved.
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Background: Sphincter injury is serious complication in connection to vaginal childbirth. Desire to avoid vaginal birth again is seen in women who previously suffered from a sphincter injury. Objective: To identify and evaluate obstetric guidelines in Sweden regarding sphincter injury in relation to childbirth Method: Content analysis with a combination of a deductive and inductive approach. Results: The most frequently occurring risk factors and prevention with help of perineal protection were described in the guidelines. The physician made diagnosis and repaired the sphincter injury at the theatre. Complications such as coital pain and anal incontinence were described in the guidelines. Paracetamol and diclofenac was most common analgesic regimen given for pain. Prophylaxis such as antibiotic treatment and laxative were common. Information given to women was described. Follow-up by physician, midwife and physiotherapist was recommended after four weeks to six months. For future birth a cesarean section was recommended. Conclusion: The guidelines were constructed in the same way and had to a large extent similar content. The authors of the present work recommend a national guideline.
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Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.
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Consideration of a wide range of plausible crime scenarios during any crime investigation is important to seek convincing evidence and hence to minimize the likelihood of miscarriages of justice. It is equally important for crime investigators to be able to employ effective and efficient evidence-collection strategies that are likely to produce the most conclusive information under limited available resources. An intelligent decision support system that can assist human investigators by automatically constructing plausible scenarios, and reasoning with the likely best investigating actions will clearly be very helpful in addressing these challenging problems. This paper presents a system for creating scenario spaces from given evidence, based on an integrated application of techniques for compositional modelling and Bayesian network-based evidence evaluation. Methods of analysis are also provided by the use of entropy to exploit the synthesized scenario spaces in order to prioritize investigating actions and hypotheses. These theoretical developments are illustrated by realistic examples of serious crime investigation.
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Serious games are a category of games which are designed for a specific purpose other than for pure entertainment. It is not a new concept but serious games using real data, coupled with real time modelling and combining model results with social and economic factors opens up a new paradigm for active stakeholder participation. DHI and UNEP-DHI Centre initiated a project called Aqua Republica where a virtual world is developed which allows participants to develop a river basin and visualise the consequences of their decisions. The aim of this project is to raise awareness of the interconnectivity of water and educate on integrated water resources management. Aqua Republica combines a game layer with a water allocation model, MIKE BASIN, to create an interactive, realistic virtual environment where players play the role of a catchment manager of an undeveloped river catchment. Their main objective is to develop the river catchment to be as prosperous as it can be. To achieve that, they will need to generate a good economy in the catchment to provide the funds needed for development, have a steady food supply for their population and enough energy and water for the catchment. Through these actions by the player, a meaningful play is established to engage players and to educate them about the complex relationships between developmental actions in a river basin and the natural environment as well as their consequences. The game layer also consists of a reward system to encourage learning. People can play and replay the game, get rewarded from performing the right principles and penalised from failures in the game. This abstract will explain the concept of the game and how it has been used in a stakeholder participation environment.
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Introdução - Os acidentes de trânsito são um grave problema de saúde pública universal, em países desenvolvidos e subdesenvolvidos, estando entre as primeiras causas de morte em quase todos os países do mundo (DEL CIAMPO & RICCO, 1996). No Brasil, assu-mem grande relevância, especialmente pela alta morbidade e mortalidade, predominância em populações jovens e/ou economicamente ativas, maior perda de anos de vida produtiva e ele-vado custo direto e indireto para a sociedade. Objetivo - Os objetivos deste trabalho foram descrever a magnitude da mortali-dade por acidentes de trânsito, avaliar sua correlação com indicadores sociais e proporção de jovens na população e testar a sua associação com adolescência, sexo masculino e consumo de álcool. Material e Métodos - Foi realizado, inicialmente, um estudo ecológico envolven-do todas as capitais das unidades da federação e Distrito Federal (exceto o município do Rio de Janeiro), com coleta de dados sobre acidentes de trânsito com vítimas no Departamento Nacional de Trânsito. Foram descritos os índices de acidentes de trânsito com vítimas p/ 1.000 veículos (IAT-V) e de feridos p/ 1.000 veículos (IF-V) referentes aos anos de 1995, 1997 e 1998 e o índice de mortos p/ 10.000 veículos (IM-V) referente ao período de 1995 a 1998. Em seguida, avaliou-se a existência de correlação entre o IM-V e taxa de mortalidade infantil (TMI), índice municipal de desenvolvimento humano (IDH-M), índice de condições de vida (ICV), proporção de condutores adolescentes envolvidos em acidentes de trânsito com vítimas (PCJ-ATV) e proporção de residentes jovens (PRJ) nas diferentes capitais. Em um segundo momento, realizou-se um estudo de caso controle, onde foram estudados 863 condu-tores envolvidos em acidentes de trânsito com vítimas atendidos no Departamento Médico Legal de Porto Alegre, no período de 1998 a 1999. Os condutores foram divididos em dois grupos: condutores envolvidos em acidentes de trânsito com vítima fatal (casos) e com vítima não fatal (controles). Os grupos foram comparados com relação a adolescência, sexo mascu-lino e consumo de álcool, através da razão de chances e seu intervalo de confiança, com signi-ficância determinada pelo teste de qui-quadrado. Resultados - No estudo ecológico, observou-se, no Brasil, uma tendência decres-cente quanto aos indicadores de eventos relacionados ao trânsito no período de 1995 a 1998. Nas capitais das unidades da federação e Distrito Federal, apesar da ampla variação apresenta-da, a maioria manteve a mesma tendência decrescente observada para o país como um todo. Na análise das correlações entre o IM-V e os indicadores sociais, observou-se forte correlação positiva com a TMI (r = 0,57; P = 0,002), ou seja, quanto maior a TMI, maior a mortalidade no trânsito, além de correlação negativa com o IDH-M (r = - 0,41; P = 0,038) e com o ICV (r = - 0,58; P = 0,02). Quando se avaliaram o IDH-M e o ICV separados em suas dimensões, a dimensão renda de ambos indicadores foi a única que não demonstrou correlação com o IM- -V. As demais dimensões do IDH-M e ICV demonstraram correlação negativa, sendo que a dimensão infância (r = - 0,62; P = 0,001) apresentou a maior correlação. A análise da asso-ciação entre o IM-V e a PCJ-ATV não demonstrou correlação, mas, quando avaliada a asso-ciação com a PRJ nas capitais, houve forte correlação positiva (r = 0,59; P = 0,002). No estudo de caso controle, quando avaliada a relação entre condutores envolvidos em acidentes com vítima fatal e adolescência, sexo masculino e consumo de álcool, não foi observada asso-ciação importante em nenhum dos fatores em estudo. Conclusões - Apesar de os indicadores de eventos relacionados ao trânsito (IAT- -V, IF-V e IM-V) terem apresentado uma tendência decrescente durante o período de estudo, acidentes de trânsito continuam sendo um grave problema de saúde pública. O estudo ecológico evidenciou a existência de relação entre o IM-V e os indicadores sociais (TMI, IDH-M e ICV), sendo que a dimensão renda não demonstrou correlação e a dimensão infância apresen-tou a correlação negativa de maior valor. Quanto à PCJ-ATV, não foi encontrada associação relevante entre este indicador e o IM-V. Entretanto, observou-se forte associação entre a PRJ e o IM-V. O estudo de caso controle não evidenciou associação entre adolescência e os de-mais fatores estudados e maior risco para acidente de trânsito fatal.
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To evaluate the effect of sildenafil, administered prior to renal ischemia/reperfusion (I/R), by scintigraphy and histopathological evaluation in rats. Methods: Twenty-four rats were divided randomly into two groups. They received 0.1 ml of 99mTechnetium-etilenodicisteine intravenous, and a baseline (initial) renal scintigraphy was performed. The rats underwent 60 minutes of ischemia by left renal artery clamping. The right kidney was not manipulated. The sildenafil group (n=12) received orally 1 mg/kg of sildenafil suspension 60 minutes before ischemia. Treatment with saline 0.9% in the control group (n=12). Half of the rats was assessed after 24 hours and half after seven days I/R, with new renal scintigraphy to study differential function. After euthanasia, kidneys were removed and subjected to histopathological examination. For statistical evaluation, Student t and Mann-Whitney tests were used. Results: In the control group rats, the left kidneys had significant functional deficit, seven days after I/R, whose scintigraphic pattern was consistent with acute tubular necrosis, compared with the initial scintigraphy (p<0.05). Sildenafil treatment resulted in better differential function of the left kidneys 24h after reperfusion, compared with controls. Histopathologically, the left kidney of control rats (24 hours after I/R) showed a higher degree of cellular necrosis when compared with the sildenafil treated rats (p<0.05). Conclusion: Sildenafil had a protective effect in rat kidneys subjected to normothermic I/R, demonstrated by scintigraphy and histomorphometry
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The genital HPV infection is very common between men and women worldwide, affecting particularly young women, constituting a serious public health problem in less developed regions, favored by the poor living conditions of population. The cytology and colposcopy have notorious importance in the diagnosis of precursor lesions of cervical cancer and therefore its prevention. However, even with such diagnostic tools, the number of women who develop cervical cancer is still high. This study aims to assess the prevalence of genital tract infection by HPV in pregnant and nonpregnant women, evaluating the profile of the immune response presented by the women of these two groups in order to establish correlations among profile of immune response, presence of virus and occurrence of lesions of the uterine cervix. We analyzed specimens obtained from the cervix of 221 patients, 91 pregnant and 130 non-pregnant, aged 14-72 years. The women were subjected to colposcopic and cytologic evaluation detect possible changes in the cervix and then samples were collected in order to perform HPV detection by PCR and real-time PCR for detection of mRNA of pro-inflammatory and anti-inflammatory cytokines. In the present study, the overall prevalence of HPV genital infection was 28.1%; of which 31.9% were pregnant patients and 25.4% in non-pregnant women. Young women under 30 years and those with low educational level education showed a higher risk of HPV infection. Colposcopy showed better correlation with detection of HPV DNA by PCR, when compared to cytology. Generally, HPV infected patients, pregnant or not, exhibited reduced mRNA expression of both pro-inflammatory (IFN-γ, TNF-α) and anti-inflammatory (IL -10) cytokines, when compared to patients not infected by HPV. Nonpregnant patients infected presented increase mRNA expression of IL-17 in patients without injury, whereas those with lesion showed higher mRNA expression of TGF-β. Pregnant women without injury infected exhibited increased mRNA expression of TGF-β. There was no difference in HPV prevalence between pregnant and nonpregnant women. There was a reduction of pro-inflammatory cytokines, except IL-17, in all women infected by HPV. Moreover, we observed an increase of TGF-β in HPV-infected women who are pregnant or not. The results suggest that, in women in this study, HPV infection promoted changes in the profile of cytokines necessary for activation of effective immune response, possibly favoring viral persistence
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Ulcerative colitis comprising an inflammatory bowel disease, whose most severe consequence is the development of intestinal neoplasia. The drugs currently used to treat the disease trigger a variety of serious adverse effects and are not effective in many cases. Recent studies demonstrated the effectiveness of natural products for the treatment of inflammatory processes. Seaweed extracts and their purified products have shown protective effects in models of inflammation and the association of traditional therapies with probiotics has significantly improved the clinical symptoms of ulcerative colitis. Therefore, the aims of this study include evaluating the potential effects of the use of probiotic strain Enterococcus faecium 32 (Ef32), the methanolic extract of the green seaweed Caulerpa mexicana (M.E.) and their concomitant administration in a murine model of colitis induced by dextran sodium sulfate (DSS). Accordingly, C57BL /6 mice were pretreated orally with Ef32 (109 CFU/ml) for seven days. In the seven days following, the colitis was induced by administration of 3% DSS (w/v) diluted in the animals drinking water. During this period, animals were treated daily with Ef32 and the M.E. (2.0 mg/kg) every other day by intravenous route. The development of colitis was monitored by the disease activity index (DAI), which takes into account the loss of body weight, consistency and presence of blood in stools. After euthanasia, the colon was removed, its length measured and tissue samples were destined for histological analysis and culture for cytokine quantification. The levels of cytokines in the culture supernatant of the colon were measured by ELISA. The treatments with the probiotic Ef32 or the M.E. alone or the combination of these two substances provoked significant improvement as to weight loss and DAI, and prevented the shortening of the colon in response to DSS. The isolated treatments triggered a slight improvement in intestinal mucosal tissue damage. However, their combination was able to completely repair the injury triggered by DSS. The association was also able to reduce the levels of all the cytokines analyzed (IFN-γ, IL-4, IL-6, IL-12, IL-17A and TNF-α). On the other hand, the treatment with Ef32 did not interfere with the levels of TNF-α, whereas treatment with M.E. did not alter the levels of IL-6. Moreover, the treatment with Ef32 not interferes in TNF-α levels, whereas treatment with M.E. did not alter the levels of IL-6. Therefore, the potential probiotic Ef32 and M.E. and especially when these samples were associated proved promising alternatives in the treatment of ulcerative colitis as demonstrated in an experimental model because of its beneficial effects on morphological and clinical parameters, and by reducing the production of proinflammatory cytokines of Th1, Th2 and Th17
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European corn borer (ECB) [Ostrinia nubilalis (Hubner)] (Lepidoptera: Crambidae) is known to infest Irish potato (Solanum tuberosum L.) but only causes economic damage during the first generation in East Coast potato producing areas. However, in Nebraska, second generation ECB infest potato plants during the bulking period and may reduce yield and/or potato quality. Experiments were conducted in 2001, 2002, and 2003 to examine physiological and yield effects of second generation ECB injury to potato in Nebraska. Pike, Atlantic, and three Frito Lay proprietary varieties (FL1867, FL1879, and FL1833) were used. Experimental plots were infested with four ECB egg masses per plant to simulate ECB infestation by second-generation larvae; controls received no egg masses. Photosynthetic rates, tuber weights, tuber size grades, solids, and fry quality were measured. Potato plants with ECB infestation had significantly reduced photosynthetic rates on ECB-infested stems and on uninfested stems on the same plant when larvae were in the fifth instar. When insects were in the fourth instar, photosynthetic rates were reduced only on ECB-infested stems. In 2001, ECB infestation reduced the average mass of large tubers and increased the amount of small tubers in FL1867 and FL1879. In 2002, significant yield reductions were not observed. Across both years, ECB-infested plots produced fewer large (65- to 100-mm diam.) tubers than control plots. Other tuber properties and chip qualities were unaffected. This study indicates that second generation ECB infestation of approximately 30% infested plants results in economic loss for some chipping varieties and affects tuber bulking. In contrast to east coast growers, Midwest potato farmers must be concerned with second generation ECB.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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The combinations of temperature and time which can cause chilling injuries in avocados 'Geada', 'Quintal' and 'Fortuna' were determined. The binomial 4 degrees C/ 28 days was selected to determine the activity of peroxidase (POD), polyphenoloxidase (PPO), polygalacturonase (PG) and methylesterase pectin (PME). The respiratory activity was also evaluated. The fruits were stored at this condition until being transferred to ambient conditions (22 degrees C and 77% RH) until maturity, when they were compared to fruits stored permanently at this environment, after being cleaned (control). In the second part of this work, different hydrothermal treatments were tested to prevent or minimize chilling injuries. Avocados 'Geada', 'Quintal' and 'Fortuna' were treated at 38 degrees C for 0, 30, 60 and 90 minutes before storage at 4 degrees C for 28 days. It was observed that the activity of enzymes associated to browning, POD and PPO, and to maturation, PG and PME, had become greater in fruits stored at 4 degrees C, or when they were transferred to environmental conditions. Fruits subjected to refrigeration, after transferred to environment, presented lower respiratory peak intensity and it occurred earlier than the others. Treatments using 38 degrees C for 60 and 90 min minimized the symptoms of chilling injury in avocados 'Geada' while for 'Quintal' the most efficient was 38 degrees C for 60 min. In 'Fortuna' these treatments did not minimize the damage by cold.