Antibioticoterapia e sua Automedicação: Prática Comum entre Estudantes do Curso de Biomedicina de Instituto de Ensino Superior

Self-medication habit of antibiotics contributes to the bacterial resistance mechanism, which is a global public health problem that must be prevented. The university student, as a future health professional, is summoned to guide a conduct and report on the use of antimicrobials regarding the casual agent, the site of infection and the severity of the disease. In this study, it has been verified, through a questionnaire, the profile of freshmen and academic students who are majoring in Biomedical Science in an institution of higher education, comparing the results obtained. It is a descriptive study with quantitative data approach (relative frequency – %) through a self-administered questionnaire, and containing 13 multiple choice questions stored in the database in Excel. The sample consisted of 132 undergraduate students from the Biomedical Science course from this University Center. Among the freshmen, the purchase of antibiotic is mainly influenced by previous experiences with the drug, what is not repeated by the students that are graduating and prefer to seek and follow medical advice. Thus, 91.8% of trainees believe that self-medication may be harmful to health. Regarding the use of anti-inflammatory, analgesic and antipyretic before the use of antibiotics, 67% of the entering students said that they take these medications, against 70% of the senior students that also do it. Therefore, we may conclude that information on the danger of self-medication is provided in the disciplines of microbiology and pharmacology, which have not been studied by the freshmen and is unknown by the general population, that appeals to self-medication due to the lack of knowledge. To reverse this situation, it is necessary a greater media exposure on educational practices regarding the risks, the benefits, and elucidation about multi-resistant bacteria.O hábito da automedicação de antibióticos contribui para o mecanismo de resistência bacteriana, sendo um problema de saúde pública mundial que deve ser prevenido. O universitário, como futuro profissional da saúde, é cobrado no sentido de orientar uma conduta e informar quanto ao uso de antimicrobianos no que se refere ao agente causal, ao sítio de infecção e à gravidade da doença. Neste estudo, verificou-se, através de um questionário, o perfil dos acadêmicos ingressantes e concluintes do curso de biomedicina de uma instituição de nível superior, comparando-se os resultados obtidos. Trata-se de um estudo descritivo com abordagem quantitativa dos dados (frequência relativa – %) através de questionário autoaplicável, e contendo 13 questões de múltipla escolha armazenadas no banco de dados no programa Excel. A amostra foi composta por 132 alunos de graduação do curso de Biomedicina desse centro universitário. Dentre os acadêmicos ingressantes, a compra do antibiótico é influenciada principalmente pela experiência própria com o fármaco, o que não se repete com concluintes, que preferem procurar e seguir orientação médica. Assim, 91,8% dos concluintes acreditam que a automedicação pode trazer danos à saúde. Em relação ao consumo de anti-inflamatórios, analgésicos e antitérmicos antes do uso do antibiótico, 67% dos iniciantes disseram que fazem a utilização destes medicamentos, contra 70% dos concluintes que também a fazem. Portanto, conclui-se que informações sobre os perigos da automedicação são fornecidos nas disciplinas de microbiologia e farmacologia, disciplinas estas ainda não cursadas pelos ingressantes e desconhecidas pela população em geral, que recorre à automedicação devido à falta de conhecimento. Para reverter este quadro, é necessária uma maior exposição na mídia sobre práticas educativas, riscos, benefícios, e explicações sobre bactérias multirresistentes

Circulating MicroRNAs as biomarkers of gestational diabetes mellitus: Updates and perspectives

Gestational diabetes mellitus (GDM) is defined as any degree of carbohydrate intolerance, with onset or first recognition during second or third trimester of gestation. It is estimated that approximately 7% of all pregnancies are complicated by GDM and that its prevalence is rising all over the world. Thus, the screening for abnormal glucose levels is generally recommended as a routine component of care for pregnant women. However, additional biomarkers are needed in order to predict the onset or accurately monitor the status of gestational diabetes. Recently, microRNAs, a class of small noncoding RNAs demonstrated to modulate gene expression, have been proven to be secreted by cells of origin and can be found in many biological fluids such as serum or plasma. Such feature renders microRNAs as optimal biomarkers and sensors of in situ tissue alterations. Furthermore, secretion of microRNAs via exosomes has been reported to contribute to tissue cross talk, thus potentially represents, if disrupted, a mechanistic cause of tissue/cell dysfunction in a specific disease. In this review, we summarized the recent findings on circulating microRNAs and gestational diabetes mellitus with particular focus on the potential use of microRNAs as putative biomarkers of disease as well as a potential cause of GDM complications and β cell dysfunction

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

GLP-1 receptor agonists in type 1 diabetes: a proof-of-concept approach

Aims: To test potential efficacy of liraglutide, a GLP-1 receptor agonist, in subjects with type 1 diabetes (T1DM). Methods: We have recruited nine T1DM patients (age 40.1 ± 6.4 years, duration of diabetes 19.2 ± 8.8 years, BMI 24.3 ± 3.5 kg/m2, HbA1c 8.2 ± 1.0 %–66 ± 11 mmol/mol, daily insulin dose: 0.6 ± 0.1 IU/kg) on continuous subcutaneous insulin therapy with undetectable C-peptide. In addition to existing treatment was administered in single-blind (a) therapy subcutaneously with 0.1 ml of saline solution for 3 days and (b) 0.1 ml of liraglutide (0.6 mg/day) for a further 3 days with daily glucose excursions recorded by continuous glucose monitoring. Results: Adding liraglutide resulted in a significant reduction in mean blood glucose (138 ± 29 vs. 163 ± 29 mg/dl, p < 0.0001) and standard deviation (42 ± 9 vs. 60 ± 15 mg/dl, p < 0.0001). The area under the curve (AUC) for blood glucose >140 mg/dl was also significantly reduced (22.2 ± 16.4 vs. 41.1 ± 19.7 mg/dl h, p < 0.05) with no difference in AUC for blood glucose <70 mg/dl (liraglutide 0.7 ± 0.9 mg/dl h; placebo: 0.8 ± 1.4 mg/dl h, p = NS). Finally, adding liraglutide reduced daily insulin requirement (37.5 ± 17.2 vs. 42.9 ± 22.4 UI/day, p < 0.01). Conclusions: Short-term treatment with liraglutide, in T1DM, reduces average blood glucose, blood glucose variability and daily insulin requirement without increasing risk of hypoglycemia

Neuron-Astroglia Cell Fate Decision in the Adult Mouse Hippocampal Neurogenic Niche Is Cell-Intrinsically Controlled by COUP-TFI In Vivo

Summary: In the dentate gyrus (DG) of the mouse hippocampus, neurogenesis and astrogliogenesis persist throughout life. Adult-born neurons and astrocytes originate from multipotent neural stem cells (NSCs) whose activity is tightly regulated within the neurogenic niche. However, the cell-intrinsic mechanisms controlling neuron-glia NSC fate choice are largely unknown. Here, we show COUP-TFI/NR2F1 expression in DG NSCs and its downregulation upon neuroinflammation. By using in vivo inducible knockout lines, a retroviral-based loss-of-function approach and genetic fate mapping, we demonstrate that COUP-TFI inactivation in adult NSCs and/or mitotic progenitors reduces neurogenesis and increases astrocyte production without depleting the NSC pool. Moreover, forced COUP-TFI expression in adult NSCs/progenitors decreases DG astrogliogenesis and rescues the neuro-astrogliogenic imbalance under neuroinflammation. Thus, COUP-TFI is necessary and sufficient to promote neurogenesis by suppressing astrogliogenesis. Our data propose COUP-TFI as a central regulator of the neuron-astroglia cell fate decision and a key modulator during neuroinflammation in the adult hippocampus. : The adult hippocampal dentate gyrus contains multipotent neural stem cells (NSCs) and neuronal committed progenitors. Bonzano et al. demonstrate that the nuclear receptor COUP-TFI cell-intrinsically drives NSCs/progenitors toward neurogenesis by repressing astrogliogenesis. Notably, COUP-TFI downregulation occurs in inflamed hippocampi, and its overexpression rescues the hippocampal neurogenesis-astrogliogenesis imbalance due to neuroinflammation. Keywords: adult neurogenesis, dentate gyrus, neuroinflammation, NR2F1, neural stem cells, neural progenitors, astrogliogenesi

RBC levels of analytes involved in Arginine/NO pathway.

<p>(A) L-arginine (Arg), L-citrulline (Cit), L-ornithine (Orn) were simultaneously determined by LC-MS/MS. (B) Arg bioavailability and the relative activity of arginase and RBC-NOS enzymes are expressed as Arg/(Orn+Cit) and Orn/Cit ratios, respectively. (C) The endogenous inhibitors asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) were determined by LC-MS/MS. (D) Tetrahydrobiopterin (BH₄) and oxidized biopterins (Box) were detected by HPLC after selective oxidation with iodine. Data are presented as age and sex adjusted geometric means and 95% C.I. Comparisons between groups (CAD, n = 22; Ctrl, n = 20) were performed by covariance analysis, adjusting for age and sex.</p