Early mobilization: Why, what for and how? Miranda Rocha, A R; Martinez, B P; Maldaner da Silva, V Z ...
Medicina intensiva,
10/2017, Letnik:
41, Številka:
7
Journal Article
Recenzirano
Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital ...stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results. The main techniques used were kinesitherapy, transfer and locomotion training, as well as neuromuscular electrical stimulation and cycle ergometry. Although two trials and a meta-analysis found no positive results with mobilization, programs that focus on specific populations, such as patients with weakness due to immobility and with preserved neuromuscular excitability can derive more positive effects from such treatment.
prostaglandin E(2), by ligation of its receptor EP4, suppresses the production of inflammatory cytokines and chemokines in macrophages in vitro. Thus, activation of EP4 may constitute an endogenous ...anti-inflammatory pathway. This study investigated the role of EP4 in atherosclerosis in vivo, and particularly its impact on inflammation.
Ldlr(-/-) mice transplanted with EP4(+/+) or EP4(-/-) bone marrow consumed a high-fat diet for 5 or 10 weeks. Allogenic bone marrow transplantation promoted exacerbation of atherosclerosis irrespective of EP4 genotype, compatible with prior observations of exacerbated atherogenesis by allogenicity. EP4 deficiency had little effect on plaque size or morphology in early atherosclerosis, but at the later time point, mice deficient in EP4 displayed enhanced inflammation in their atherosclerotic plaques. Expression of monocyte chemoattractant protein-1 and interferon-γ inducible protein 10 increased, and there was a corresponding increase in macrophage and T-cell infiltration. These plaques also contained fewer smooth muscle cells. Despite these changes, mice deficient in EP4 in bone marrow-derived cells at an advanced stage had similar lesion size (in both aorta and aortic root) as mice with EP4.
this study shows that in advanced atherosclerosis, EP4 deficiency did not alter atherosclerotic lesion size, but yielded plaques with exacerbated inflammation and altered lesion composition.
Atherosclerosis is the biological basis of ischemic heart disease and ischemic stroke, the leading causes of death in the world. After decades of studies, the understanding of atherosclerosis has ...evolved dramatically, and inflammation has been recognized as one of the most relevant pillars in all phases of atherosclerotic disease. Nevertheless, only recently, the trial CANTOS, and subsequent outcome studies with colchicine, finally provided proof-of-concept evidence that anti-inflammatory therapies were able to reduce cardiovascular events with no influence on lipid levels. These landmark studies inaugurated an era of clinical and pre-clinical studies of immunomodulatory strategies focused on reduction of cardiovascular risk. Although there are promising results in the field, selection of the most appropriate immunomodulatory therapy and identification of patients who could benefit the most, are still enormous challenges. Further research is imperative before we can finally advance towards regular use of anti-inflammatory agents to reduce atherosclerotic events in our clinical practice.
The white rot fungus, Pleurotus ostreatus, metabolized four soil adsorbed polycyclic aromatic hydrocarbons: 50% of pyrene (0.1 mg g^sup -1^ dry soil), 68% of anthracene and 63% of phenanthrene were ...mineralized after 21 d. Biodegradation was increased to 75%, 80% and 75%, respectively of the initial concentration when 0.15% Tween 40 was added. Biodegradation of pyrene in the presence of surfactant and H^sub 2^O^sub 2^ (1.0 mM) was 90%. Benzapyrene was also oxidized by Pleurotus ostreatus but it is not mineralized.PUBLICATION ABSTRACT
Cutaneous superficial mycoses appear as lesions on the skin, hair and nails. The highest prevalence is of fungal infections caused by the fungi of the genus Microsporum, Epidermophyton, Trichophyton, ...Candida and Malassezia. These mycoses are common in tropical regions and are commonly neglected due to lack of patient knowledge, difficult diagnosis and lack of access to health facilities, which makes them a public health problem. In research, mycological examination of patients using Basic Health Units (BHU) was carried out in order to diagnose mycoses. Through this action, it was possible to diagnose and refer to the appropriate treatment 5359 patients, seeking to improve their quality of life. From the results of the mycological exams of these patients during the period from 2011 to 2016, it was possible to trace the epidemiological profile of the State of Rio Grande do Sul and the most prevalent species, contributing to the accomplishment of measures in public health.
Cutaneous superficial mycoses appear as lesions on the skin, hair and nails. The highest prevalence is of fungal infections caused by the fungi of the genus Microsporum, Epidermophyton, Trichophyton, ...Candida and Malassezia. These mycoses are common in tropical regions and are commonly neglected due to lack of patient knowledge, difficult diagnosis and lack of access to health facilities, which makes them a public health problem. In research, mycological examination of patients using Basic Health Units (BHU) was carried out in order to diagnose mycoses. Through this action, it was possible to diagnose and refer to the appropriate treatment 5359 patients, seeking to improve their quality of life. From the results of the mycological exams of these patients during the period from 2011 to 2016, it was possible to trace the epidemiological profile of the State of Rio Grande do Sul and the most prevalent species, contributing to the accomplishment of measures in public health.
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