Physical Exercise Decreases Fasting Hyperglycemia in Diabetic Mice Through AMPK Activation

Introduction: The deficiency in glucose uptake in peripheral tissues and increased hepatic gluconeogenesis are physiopathological phenomena observed in type 2 diabetes patients. Physical exercise plays an important role in the improvement of glycemic profile in diabetic patients; however, the mechanisms involved in these processes have not been fully elucidated. Objective: to assess the role of AMPK protein in the glycemic control of diabetic mice after exercise. Methods: During fasting condition, the insulin tolerance test (ITT) and Western blot technique, were combined to assess the glucose homeostasis in diabetic mice (ob/ob and db/db) after a single swimming session. Results: Fasting hyperglycemia, severe insulin resistance and deficiency in the AMPk/ACC signaling in muscle and liver observed in the diabetic mice were reversed after the exercise session. The restoration of AMPK/ACC signaling reduced the expression of the gluconeogenic enzyme, PEPCk in the liver, and increased the translocation of GLUT4 in the skeletal muscle. These data indicate that the activation of AMPK/ACC pathway induced by physical exercise is important to reduce fasting glucose levels in experimental models of type 2 diabetes. These data open new insights for determination of physical activity control on the glucose homeostasis in diabetic patients.15317918

Methods of induction of labour: a systematic review

<p>Abstract</p> <p>Background</p> <p>Rates of labour induction are increasing. We conducted this systematic review to assess the evidence supporting use of each method of labour induction.</p> <p>Methods</p> <p>We listed methods of labour induction then reviewed the evidence supporting each. We searched MEDLINE and the Cochrane Library between 1980 and November 2010 using multiple terms and combinations, including labor, induced/or induction of labor, prostaglandin or prostaglandins, misoprostol, Cytotec, 16,16,-dimethylprostaglandin E2 or E2, dinoprostone; Prepidil, Cervidil, Dinoprost, Carboprost or hemabate; prostin, oxytocin, misoprostol, membrane sweeping or membrane stripping, amniotomy, balloon catheter or Foley catheter, hygroscopic dilators, laminaria, dilapan, saline injection, nipple stimulation, intercourse, acupuncture, castor oil, herbs. We performed a best evidence review of the literature supporting each method. We identified 2048 abstracts and reviewed 283 full text articles. We preferentially included high quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised or quasi-randomised trials.</p> <p>Results</p> <p>We included 46 full text articles. We assigned a quality rating to each included article and a strength of evidence rating to each body of literature. Prostaglandin E2 (PGE2) and vaginal misoprostol were more effective than oxytocin in bringing about vaginal delivery within 24 hours but were associated with more uterine hyperstimulation. Mechanical methods reduced uterine hyperstimulation compared with PGE2 and misoprostol, but increased maternal and neonatal infectious morbidity compared with other methods. Membrane sweeping reduced post-term gestations. Most included studies were too small to evaluate risk for rare adverse outcomes.</p> <p>Conclusions</p> <p>Research is needed to determine benefits and harms of many induction methods.</p

Therapeutic DNA Vaccine Encoding Peptide P10 against Experimental Paracoccidioidomycosis

Paracoccidioidomycosis (PCM), caused by Paracoccidioides brasiliensis, is the most prevalent invasive fungal disease in South America. Systemic mycoses are the 10th most common cause of death among infectious diseases in Brazil and PCM is responsible for more than 50% of deaths due to fungal infections. PCM is typically treated with sulfonamides, amphotericin B or azoles, although complete eradication of the fungus may not occur and relapsing disease is frequently reported. A 15-mer peptide from the major diagnostic antigen gp43, named P10, can induce a strong T-CD4+ helper-1 immune response in mice. The TEPITOPE algorithm and experimental data have confirmed that most HLA-DR molecules can present P10, which suggests that P10 is a candidate antigen for a PCM vaccine. In the current work, the therapeutic efficacy of plasmid immunization with P10 and/or IL-12 inserts was tested in murine models of PCM. When given prior to or after infection with P. brasiliensis virulent Pb 18 isolate, plasmid-vaccination with P10 and/or IL-12 inserts successfully reduced the fungal burden in lungs of infected mice. In fact, intramuscular administration of a combination of plasmids expressing P10 and IL-12 given weekly for one month, followed by single injections every month for 3 months restored normal lung architecture and eradicated the fungus in mice that were infected one month prior to treatment. The data indicate that immunization with these plasmids is a powerful procedure for prevention and treatment of experimental PCM, with the perspective of being also effective in human patients

PREVALENCE AND FACTORS ASSOCIATED WITH PRACTICE OF EPISIOTOMY AT A MATERNITY SCHOOL IN RECIFE, PERNAMBUCO, BRAZIL

PREVALENCE AND FACTORS ASSOCIATED WITH PRACTICE OF EPISIOTOMY AT A MATERNITY SCHOOL IN RECIFE, PERNAMBUCO, BRAZIL OBJECTIVE. To determine the prevalence and factors associated with episiotomy in a reference center of Pernambuco. METHODS. A retrospective cross-sectional study was carried out from January to December 2006 with 495 women who had a normal delivery at the Maternity Center Monteiro de Moraes Integrated Health Amaury de Medeiros (CISAM) University of Pernambuco. Assciated factors were issues preceeding birth, characteristics of labor and perinatal outcome. To verify the association between predictors and performance of episiotomy the Chi square, Fisher's exact and Student's t tests were used as appropriate, with a a significance level of 5%. The prevalence ratio and confidence intervals were calculated at 95%, in addition to logistic regression analysis. RESULTS. Prevalence of performing episiotomy was 29.1% (n = 144). After bivariate analysis, we found a significant association of episiotomy with adolescence (PR 1.74. 95% CI 1.33-2.28), age over 35 years (PR 0.35. 95% Cl 0.14-0.90), primiparity (PR 4.73, 95% CI 3.33-6.71), absence of previous vaginal delivery (PR 5.44, 95% CI 3.67-8.06) and related diseases at the time of delivery (RP 1.71, 95% Cl 1.30-2.25). There was no significant relation with gestational age at delivery, duration of labor over 6h and expulsion period of more than 30 minutes, use of misoprostol or oxytocin, abnormal fetal heart rate, presence of meconium, shift of completion of delivery (night or day), rate of Apgar score in 1 and 5 minutes and weight of the newborn. Presence of perineal lacerations was higher in the group not subject to episiotomy, however only 1(st) and 2(nd) degree lacerations were described. After logistic regression, the analyzed remaining factors associated with episiotomies were maternal diseases (RA 1.99, 95% CI 1.20-3.28) and absence of previous vaginal delivery (9.85 RA, 95% CI 6.04-16.06). CONCLUSION. Prevalence of episiotomies in the institution was 29%. Variables that remained related to episiotomy were maternal diseases and absence of previous vaginal delivery. [Rev Assoc Med Bras 2010; 56(3): 333-9]56333333