The aim of this study was to characterize the role of local RAS (renin–angiotensin system) in the inflammatory response of normal (N) and diabetic (D) mice with periodontal disease (PD). Diabetes Mellitus (DM) was induced by peritoneal injection of streptozotocin in Balb/c mice. PD was induced by ligature around the first molar in both N and D, irrespective of whether they were treated with aliskiren (50 mg/kg, Alisk). Mandibles were harvested for histomorphometric analyses, and gingival tissue (GT) was collected to evaluate gene expression and extracellular matrix components (ECM). Immunohistochemical (IHC) analyses were used to localize RAS in GT. The production of C-reactive protein (CRP), IL-1β, CXCL2, and CCL8 was evaluated by enzyme-linked immunosorbent assay (ELISA). Renin was found to exacerbate the inflammation and periodontal bone loss at 14 days after PD, and Alisk inhibited this process in GT of N and D. PD increased CRP, CXCL2, CCL8, and IL-1β production in both animals. Alisk could inhibit CRP, CXCL2, and CCL8 primarily in D animals. However, only CCL8 was decreased in N animals after Alisk pretreatment. PD enhanced expression and production of AGT, ACE, AT1R, and AT2R in both N and D. AT1R expression was higher in D with PD, and AT2R expression was higher in N with PD. ACE2 and receptor Mas (MasR) expression and production was elevated in the control group of both animals. PD inhibited ACE2 in N but not in D. MasR expression was unaffected in both N and D with PD. Alisk reduced expression and production of all RAS components in GT of both animals, except for ACE2 in N. RAS staining was observed in all layers of epithelium, basal cell layer, and lamina propria and was higher in N with PD. Col1a1, Col1a2, Col3a1, and fibronectin (Fn1) were increased in both animals with PD. Alisk inhibited Col1a1 and Fn in both animals, Col1a2 was decreased only in D, while levels of Col3a1 remained unchanged in all animal groups. In conclusion, these data demonstrated the presence and functional role of local RAS in GT, exacerbating the inflammatory response, periodontal bone loss, and wound healing processes in both N and D animal groups. In addition, Alisk was able to significantly reduce gingival inflammation, excessive wound healing processes, and periodontal bone loss.
RESUMOInúmeros fatores estão associados aos distúrbios do sono ocasionando o aumento nos gastos com saúde. O objetivo do trabalho foi analisar a associação dos distúrbios do sono e doenças crônicas não transmissíveis em pacientes com idade superior a 50 anos atendidos por Unidades Básicas ABSTRACTMany factors are associated with sleep disorders causing an increase in health spending. The objective of this study was to analyze an association of sleep disorders and chronic diseases non-transmissible in patients older than 50 years attended by Basic Health Care Units of Presidente Prudente. Participated 363 patients. The history of diseases was self-reported through the use a questionnaire, the level of physical activity was evaluated by the Baecke questionnaire, and sleep quality was assessed using the Mini-Sleep Questionnaire. Anthropometric and body composition data were collected using stadiometer and scale, patients within the 75th percentile were considered obese. The statistical analysis was made by Student t test, chisquare, and binary logistic regression. The results showed that sleep disorders is associated with osteoporosis, arthritis / osteoarthritis, low back pain, depression and obesity. Additionally, obesity and physical inactivity influences the occurrence of chronic diseases non-transmissible. Keywords: Sleep disturbance. Chronic diseases. Brazilian national health system. IntroduçãoSono é um evento de grande complexidade que interfere diretamente no estado clínico do indivíduo 1 . Benefícios do sono são decorrentes de processos neurobiológicos 2 , como manutenção da saúde física e mental, que podem modificar a temperatura corporal, trabalho cardíaco e produção hormonal, levando ao estado restaurador essencial e ao funcionamento adequado do organismo 3 . Fernandes 4 em estudo de revisão, relata que as fases do sono levam em consideração os movimentos não rápidos dos olhos (NREM) e os movimentos rápidos dos olhos (REM), observados no traçado do eletrocardiograma, determinando assim a arquitetura do sono. O ciclo do sono é formado por cinco estágios com duração de 90 minutos cada um e é repetido de quatro a cinco vezes por noite. Cada fase apresenta estágios fisiológicos específicos.
resumo Esse texto se constitui de reflexões teóricas e vivenciais das autoras acerca da articu-lação entre pesquisa, ensino e serviços de saúde para a consolidação do Sistema Úni-co de Saúde. As pesquisas de enfermagem na saúde coletiva possuem como desafio romper com as formas tradicionais em que se separa quem pesquisa, aprende, ensi-na e cuida. É da produção investigativa e reflexiva que se processa o movimento de transformação do processo de cuidar e de ensinar. Assim, as pesquisas para a consoli-dação do Sistema Único de Saúde clamam por uma intensa articulação entre o ensi-no-serviço e a produção de conhecimento. Desafia-nos a constituir projetos de pes-quisa junto com os trabalhadores e isso im-plica em avançar da coleta de dados para a produção de dados, do levar estudantes para atividades e estágio para parceria e co-responsabilização pelas ações. Propo-mos assunção do não saber para criarmos práticas instituintes. descritores Enfermagem em saúde comunitária Educação em enfermagem Pesquisa em enfermagem Sistema Único de Saúde * paper presented at the roundtable "o ensino e a pesquisa de enfermagem em saúde coletiva frente a consolidação do sus", 2º simpósio internacional de políticas e práticas em saúde colectiva na perspectiva da enfermagem-sinpesc, school of nursing, university of são paulo, sao paulo, october 9 to 11 2011 1 nurse. ph.d. in nursing, professor at the ribeirão preto nursing school of the university of são paulo, ribeirão preto, sp, Brazil. fortuna@eerp.usp. br 2 nurse. ph.d. in nursing, professor at the ribeirão preto nursing school of the university of são paulo, ribeirão preto, sp, Brazil. smishima@eerp.usp.br
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