Skeletal muscle synthesizes, stores, and releases body L-glutamine (GLN). Muscle atrophy due to disabling diseases triggers the activation of proteolytic and pro-apoptotic cell signaling, thus ...impairing the body's capacity to manage GLN content. This situation has a poor therapeutic prognosis.
Evaluating if oral GLN supplementation can attenuate muscle wasting mediated by elevated plasma cortisol and activation of caspase-3, p38MAPK, and FOXO3a signaling pathways in soleus and gastrocnemius muscles of rats submitted to 14-day bilateral hindlimbs immobilization.
Animals were randomly distributed into six groups: non-immobilized rats (Control), control orally supplemented with GLN (1 g kg
) in solution with L-alanine (ALA: 0.61 g kg
; GLN+ALA), control orally supplemented with dipeptide L-alanyl-L-glutamine (DIP; 1.49 g kg
), hindlimbs immobilized rats (IMOB), IMOB orally GLN+ALA supplemented (GLN+ALA-IMOB), and IMOB orally DIP supplemented (DIP-IMOB). Plasma and muscle GLN concentration, plasma cortisol level, muscle caspase-3 activity, muscle p38MAPK and FOXO3a protein content (total and phosphorylated forms), and muscle cross-sectional area (CSA) were measured.
Compared to controls, IMOB rats presented: a) increased plasma cortisol levels; b) decreased plasma and muscle GLN concentration; c) increased muscle caspase-3 activity; d) increased total and phosphorylated p38MAPK protein content; e) increased FOXO3a and decreased phosphorylated FOXO3a protein content; f) reduced muscle weight and CSA befitting to atrophy. Oral supplementation with GLN+ALA and DIP was able to significantly attenuate these effects.
These findings attest that oral GLN supplementation in GLN+ALA solution or DIP forms attenuates rats' skeletal muscle mass wasting caused by disuse-mediated muscle atrophy.
Skeletal muscle disuse results in myofibrillar atrophy and protein degradation, via inflammatory and oxidative stress-mediated NF-kB signaling pathway activation. Nutritional interventions, such as ...l-glutamine (GLN) supplementation have shown antioxidant properties and cytoprotective effects through the modulation on the 70-kDa heat shock protein (HSP70) expression. However, these GLN-mediated effects on cell signaling pathways and biochemical mechanisms that control the myofibrillar protein content degradation in muscle disuse situations are poorly known yet. This study investigated the effects of oral GLN plus l-alanine (ALA; GLN + ALA-solution) supplementation, either in their free or dipeptide (L-alanyl-l-glutamine-DIP) form, on GLN-glutathione (GSH) axis and cytoprotection mediated by HSP70 protein expression in the slow-twitch soleus and fast-twitch gastrocnemius skeletal muscle of rats submitted to 14-days of hindlimb immobilization-induced disuse muscle atrophy. Forty-eight Wistar rats were distributed into 6 groups: hindlimb immobilized (IMOB group) and hindlimb immobilized orally supplemented with either GLN (1 g kg−1) plus ALA (0.61 g kg−1) (GLN + ALA-IMOB group) or 1.49 g kg−1 of DIP (DIP-IMOB group) and; no-immobilized (CTRL) and no-immobilized supplemented GLN + ALA and DIP baselines groups. All animals, including CTRL and IMOB rats (water), were supplemented via intragastric gavage for 14 days, concomitantly to immobilization period. Plasma and muscle GLN levels, lipid (thiobarbituric acid reactive substances-TBARS) and protein (carbonyl) peroxidation, erythrocyte concentration of reduced GSH and GSH disulfide (GSSG), plasma and muscle pro-inflammatory TNF-α levels, muscle IKKα/β-NF-kB signaling pathway and, the myofibrillar protein content (MPC) were measured. The MPC was significantly lower in IMOB rats, compared to CTRL, GLN + ALA, and DIP animals (p < 0.05). This finding was associated with reduced plasma and muscle GLN concentration, equally in IMOB animals. Conversely, both GLN + ALA and DIP supplementation restored plasma and muscle GLN levels, which equilibrated GSH and intracellular redox status (GSSG/GSH ratio) in erythrocytes and skeletal muscle even as, increased muscle HSP70 protein expression; attenuating oxidative stress and TNF-α-mediated NF-kB pathway activation, fact that reverberated on reduction of MPC degradation in GLN + ALA-IMOB and DIP-IMOB animals (p < 0.05). In conclusion, the findings shown herein support the oral GLN + ALA and DIP supplementations as a therapeutic and effective nutritional alternative to attenuate the deleterious effects of the skeletal muscle protein degradation induced by muscle disuse.
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•Disuse periods are characterized by skeletal muscle protein degradation (MPD).•MPD is associated to oxidative stress-mediated NF-kB signaling pathway activation.•Glutamine (GLN) supplementation has antioxidant and anti-inflammatory properties.•GLN supplementation induced HSP70 protein expression.•GLN supplementation attenuates oxidative stress-mediated NF-kB activation.
Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter ...data on this condition in Brazil.
To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up.
This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted.
The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality.
The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216).
Resumo Fundamento A síndrome de takotsubo (takotsubo) é uma forma de cardiomiopatia adquirida. Dados nacionais sobre essa condição são escassos. O Registro REMUTA é o primeiro a incluir dados ...multicêntricos dessa condição no nosso país. Objetivo Descrever as características clínicas, prognóstico, tratamento intra-hospitalar e mortalidade hospitalar e em 1 ano de seguimento. Métodos Estudo observacional, retrospectivo, tipo registro. Incluídos pacientes internados com diagnóstico de takotsubo ou que desenvolveram esta condição durante internação por outra causa. Os desfechos avaliados incluíram fator desencadeador, análise dos exames, uso de medicações, complicações e óbito intra-hospitalar e em 1 ano de seguimento. O nível de significância adotado foi de 5%. Resultados Foram incluídos 169 pacientes, em 12 centros no Estado do Rio de Janeiro. A idade média foi de 70,9 ± 14,1 anos e 90,5% eram do sexo feminino; 63% dos casos foram de takotsubo primário e 37% secundário. Troponina I foi positiva em 92,5% dos pacientes e a mediana de BNP foi de 395 (176,5; 1725). Supradesnivelamento do segmento ST esteve presente em 28% dos pacientes. A fração de ejeção do ventrículo esquerdo teve mediana de 40 (35; 48)%. Observamos taxa de 25,7% de ventilação mecânica invasiva e 17,4% de choque. Suporte circulatório mecânico foi utilizado em 7,7%. A mortalidade intra-hospitalar foi de 10,6% e a mortalidade ao final de 1 ano foi de 16,5%. Takotsubo secundário e choque cardiogênico foram preditores independentes de mortalidade. Conclusão Os resultados do REMUTA mostram que takotsubo não se trata de patologia benigna como se pensava, especialmente no grupo de takotsubo secundário que acarreta elevada taxa de complicações e de mortalidade. (Arq Bras Cardiol. 2020; 115(2):207-216)
Seismic analysis of about 3,000 km of sparker seismic lines allowed us to address a first order stratigraphic and stratal architecture scenario encompassing the shallow sedimentary record (~ 300 ...milliseconds) of the southern continental shelf of Campos Basin, Brazil. Five major seismic sequences were identified (sequences Sq1 to Sq5), bounded by large margin-scale unconformities (horizons S1-S5). These seismic sequences were interpreted as a succession of depositional sequences induced by repeated glacio eustatic cycles limited by seismic horizons interpreted as master sequence boundaries, representing diachronous periods of erosion originated at times of deepest sea-level lowstands, related to periods of most extensive subaerial exposure of the shelf. These surfaces were reworked during subsequent times of sea level rise. Sequences Sq1-Sq4 are essentially composed of seaward-thickening stacks of forced-regression wedges, implying periods of declining accommodation space for sediments; whereas sequence Sq5 exhibit architectural elements of mostly transgressive units. Comparison between seismic lines and available chronostratigraphic data from the oil industry's exploratory wells made it possible to place the stratigraphic sequences Sq1-Sq5 within the Middle Pleistocene-Holocene interval (last ~ 500 kyr). Correlation of chronostratigraphic data and ?18O-derived information on glaciation-related global sea level variations (Marine Isotope Stages, MIS), also supports the hypothesis that sequences Sq1-Sq4 are fourth-order forced-regression sequences that record 100-120 kyr glacioeustatic cycles and high amplitude sea-level variations (± 100-145 m) for the last ~ 500 kyr, while deposits labeled as Sq5 are mostly represented by Latest Pleistocene-Holocene transgressive and highstand units
Professionals face various environmental, physical, mental risks, accidents and occupational diseases, and often face inadequate working conditions. The aim of this study is to describe the ...multiprofessional role in workers' health. The methodology is a narrative review of literature with an approach of exploratory, observational, retrospective studies that were searched in the literature 23 articles between 2010 to 2022. Results: Within an organization, the presence of nurses, doctors, physiotherapists, biochemists and other professionals can give employees greater security and better performance in their functions, as they must be monitored and must gain confidence where they can count on a professional nurse always available. Professionals face various environmental, physical, mental risks, accidents and occupational diseases, and often face inadequate working conditions. The health of the worker started to be seen in a worrying way when men realized the link between work and illness, which has existed since antiquity. Occupational nursing focuses on caring for workers, especially those who care about work. It is concluded that the ideas presented in this study lead to the conclusion that the multidisciplinary work of occupational health is extremely important in promoting the health and well-being of workers, as it has the technical knowledge and can act in the prevention of accidents and occupational diseases.
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