Somatostatina e seu análogo sintético octreotida são as drogas mais amplamente utilizadas para tratar fístulas enterocutâneas. Todavia, as evidências suportando seu uso ainda são insuficientes. Objetivo: Investigar os efeitos terapêuticos de octreotida em um modelo experimental de fístula enterocutânea. Métodos: Em trinta ratos machos Wistar com peso 210± 17g foi confeccionada cirurgicamente uma fístula jejunocutânea. Os animais foram aleatoriamente divididos em três grupos de dez. No grupo A, administrou-se uma dose única diária de octreotida (4 mig/kg/peso corporal/SC) enquanto no grupo B injetou-se por via SC solução salina a 0,9% em quantidade idêntica à utilizada para veicular octreotida. O grupo C serviu de controle. Os roedores foram inspecionados a respeito do volume diário do débito das fístulas, tempo necessário para sua cicatrização espontânea, avaliação clínico-bioquímica, hematológica e nutricional. Resultados: Os ratos tratados com octreotida não tiveram significantes alterações clínico-bioquímicas ou ponderais quando comparados ao controle (sem fístula) e cicatrizaram as fístulas espontaneamente em um tempo significativamente menor (3,8 ± 1,6 dias) que os do grupo B (15,3 ± 4,5 dias) (p < 0,05). No grupo B verificou-se queda ponderal média de 60% ao final da pesquisa, com 40% dos animais exibindo caquexia, anemia, hipoglobulinemia e hipoalbuminemia. Conclusão: A octreotida foi superior ao placebo e permitem afirmar que, segundo as estritas condições do experimento, o fármaco foi eficaz na cicatrização de fístulas enterocutâneas não complicadas de ratos.
Polycystic ovary syndrome (PCOS) is a growing worldwide public health problem that affects millions of women in their reproductive age. Despite being a very common disorder among women, there are still gaps regarding knowledge of disease mechanisms. In this respect, it was recently reported that acetaldehyde (ACD) is endogenously formed during normal ovarian steroidogenesis. The researchers demonstrated that in physiological concentrations ACD caused no detrimental effect on ovarian tissue. Contrariwise, in supraphysiological levels, ACD impairs granulosa cell differentiation, reduces ovulation, and decreases oocyte quality. Gut microbiota of patients with nonalcoholic fatty liver disease (NAFLD) produces significant quantities of endogenous ethanol (EE) and ACD. Because PCOS is closely linked to NAFLD, an ethanol-producing disorder, we hypothesize that it can be an endogenous alcoholic polycystic ovary syndrome (EAPCOS). The main findings of this study were that (i) the odds ratio of having polycystic ovaries is 30-fold greater in alcohol-exposed women than among unexposed controls; (ii) NAFLD/PCOS patients produce gonadotoxic quantities of EE; (iii) NAFLD/PCOS and alcoholic hepatitis individuals share similar liver expression levels of genes regulating high-km ethanol-metabolizing enzymes; (iv) NAFLD/PCOS and alcohol-tolerant drinkers share similar high-capacity to metabolize ethanol in the gut-liver axis; and (v) low blood alcohol concentration (BAC) in NAFLD/PCOS and alcohol-tolerant individuals stem from extensive alcohol degradation in gut-liver axis and significant fecal loss of ethanol. In summary, we provide mechanistic insights supporting the hypothesis that PCOS can be indeed an EAPCOS.
Objetivos: Avaliar a usabilidade entre médicos de um aplicativo móvel, Endometriosis Intelligent Application (ENIA), criado para facilitar o diagnóstico da endometriose. Métodos: O estudo envolveu 15 médicos especialistas e 21 residentes em Ginecologia e Obstetrícia de uma maternidade localizada no Estado do Rio Grande do Norte, Brasil, no período de julho a novembro de 2020, contando como instrumento de avaliação o mHealth App Usability Questionnaire (MAUQ). Resultados: Acerca da confiabilidade geral, a escala apresentou boa consistência interna determinada por um alfa de Cronbach de 0,871. Sobre a facilidade de uso e satisfação, organização das informações no sistema e utilidade, os valores de alfa foram 0,80, 0,65 e 0,87, respectivamente. Verifica-se concordância máxima acima de 70% na maioria das questões da subescala de utilidade. Conclusão: Satisfação e utilidade foram relatadas pela maioria dos médicos que avaliaram o ENIA, indicando que o aplicativo, após validação, poderá ser usado na prática destes profissionais.
Nonalcoholic fatty pancreas disease (NAFPD) is closely linked to nonalcoholic steatohepatitis (NASH), suggesting that the two conditions share a common etiopathogenetic background. In Addition, growing evidence indicates that endogenous ethanol (EE) plays a fundamental role in NASH pathogenesis. Accordingly, it is intuitively appealing to assume that EE plays also a causative role in NAFPD development. This connection is further supported by the finding that NAFPD shares with alcoholic fatty pancreas disease (AFPD) similar metabolic signaling pathways and histopathological features. However, low blood alcohol concentrations (BAC) along with the alleged inability of gut microbiota to produce toxic amounts of ethanol are the main obstacles to validate the idea of an endogenous alcoholic fatty pancreas disease (EAFPD). Here, we provide a mechanistic explanation reconciling the EAFPD hypothesis with these apparently conflicting observations. The key conclusions of our investigation are as follows. First, ethanol is a prodrug, implicating that under extensive presystemic metabolism BACs can be low and/ or absent. Second, oro-gastrointestinal microbiota may produce higher amounts of ethanol than those required to cause AFPD. Last, livers of NASH/NAFPD individuals overexpress all genes encoding alcohol-metabolizing enzymes identically to livers of patients with alcoholic hepatitis. Even more importantly, the upregulation of these genes is higher in the early steatotic stage of nonalcoholic fatty liver disease than in alcoholic hepatitis. This suggests a greater exposure of the liver, and by extension, of the pancreas, to ethanol in the former than in the latter condition. In summary, this paper provides a mechanistic framework for how NAFPD indeed may be an EAFPD.
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