Venous ulcer: risk factors and the Nursing Outcomes Classification

Venous ulcer: risk factors and the Nursing Outcomes Classification Objective. To explore the relationship between the risk factors for the development of venous ulcers and the indicators of tissue integrity from the Nursing Outcomes Classification. Methodology. A cross-sectional study conducted in 2013 in a university hospital in Natal/RN (Brazil). Fifty individuals selected by consecutive sampling participated in an interview and physical examination. Results. The most important risk factors were: 44% presented with arterial hypertension, 26% allergy, 20% diabetes mellitus, 4% participated in some physical activity, 6% were smokers and 14% drank alcohol. There was a statistically significant association between diabetes mellitus and the texture of the lesion (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034); physical activity and hydration (p = 0.034); smoking and thickness (p = 0.018); and alcoholism and exudate of the ulcer (p=0.045). Conclusion. The relationship between risk factors and the nursing outcome indicators generated information relevant to the development of guidelines for the monitoring and treatment of venous ulcer information. Key words: venous ulcer; nursing; risk factors; nursing assessment Úlcera venosa: Relación entre los factores de riesgo y la clasificación de los resultados de enfermería Objetivo. Explorar la relación entre los factores de riesgo para el desarrollo de las úlceras venosas y los indicadores de integridad tisular de la clasificación de resultados de enfermería. Metodología. Estudio transversal realizado en 2013 en un hospital universitario de Natal / RN (Brasil). Participaron 50 individuos seleccionados por muestreo consecutivo; se les hizo entrevista y examen físico. Resultados. Los factores de riesgo más importantes fueron: 44% presentaba hipertensión arterial; 26%, alergia; 20%, Diabetes Mellitus; 4% realizaba alguna actividad física; 6%, fumadores y 14% bebía alcohol. Hubo asociación estadísticamente significativa entre la Diabetes Mellitus con la textura de la lesión (p=0.015) y la perfusión tisular (p=0.026), la alergia y la textura (p=0.034), la actividad física y la hidratación (p=0.034), el tabaquismo y el grosor (p=0.018); y el alcoholismo y el exudado de la úlcera Invest Educ Enferm. 2014;32(2) • 253 (p=0.045). Conclusión. La relación entre algunos factores de riesgo y los indicadores de resultado de enfermería genera información relevante para la elaboración de directrices para el seguimiento y tratamiento de las úlceras venosas. Palabras clave: úlcera venosa; enfermagem; fatores de risco; avaliação em enfermagem. Úlcera venosa: relação entre os fatores de risco e a classificação dos resultados de enfermagem Objetivo. Explorar a relação entre os fatores de risco para o desenvolvimento das úlceras venosas e os indicadores de integridade tissular da classificação de resultados de enfermagem. Metodologia. Estudo transversal realizado em 2013 num hospital universitário de Natal / RN (Brasil. Participaram 50 indivíduos selecionados por amostragem consecutiva, foi feita entrevista e exame físico. Resultados. Os fatores de risco mais importantes foram: 44% apresentavam hipertensão arterial, 26% alergia, 20% Diabete Mellitus, 4% realizava alguma atividade física, 6% eram fumantes e 14% bebiam álcool. Teve associação estatisticamente significativa entre a Diabete Mellitus com a textura da lesão (p=0.015) e a perfusão tissular (p=0.026), a alergia e a textura (p=0.034), a atividade física e a hidratação (p=0.034), o tabagismo e a gordura (p=0.018); e o alcoolismo e o exsudado da úlcera (p=0.045). Conclusão. A relação entre alguns fatores de risco e os indicadores de resultado de enfermagem gera informação relevante para a elaboração de diretrizes para o seguimento e tratamento das úlceras venosas. Palavras chave: úlcera venosa; enfermería; factores de riesgo; evaluación en enfermería. Venous ulcer: risk factors and the Nursing Outcomes Classificatio

Fine-Tuning Roles of Endogenous Brain-Derived Neurotrophic Factor, TrkB and Sortilin in Colorectal Cancer Cell Survival

International audienceBACKGROUND: Neurotrophin receptors were initially identified in neural cells. They were recently detected in some cancers in association with invasiveness, but the function of these tyrosine kinase receptors was not previously investigated in colorectal cancer (CRC) cells. METHODS AND FINDINGS: We report herein that human CRC cell lines synthesize the neural growth factor Brain-derived neurotrophic factor (BDNF) under stress conditions (serum starvation). In parallel, CRC cells expressed high- (TrkB) and low-affinity (p75(NTR)) receptors at the plasma membrane, whereas TrkA and TrkC, two other high affinity receptors for NGF and NT-3, respectively, were undetectable. We demonstrate that BDNF induced cell proliferation and had an anti-apoptotic effect mediated through TrkB, as assessed by K252a, a Trk pharmacologic inhibitor. It suppressed both cell proliferation and survival of CRC cells that do not express TrkA nor TrkC. In parallel to the increase of BDNF secretion, sortilin, a protein acting as a neurotrophin transporter as well as a co-receptor for p75(NTR), was increased in the cytoplasm of primary and metastatic CRC cells, which suggests that sortilin could regulate neurotrophin transport in these cells. However, pro-BDNF, also detected in CRC cells, was co-expressed with p75(NTR) at the cell membrane and co-localized with sortilin. In contrast to BDNF, exogenous pro-BDNF induced CRC apoptosis, which suggests that a counterbalance mechanism is involved in the control of CRC cell survival, through sortilin as the co-receptor for p75(NTR), the high affinity receptor for pro-neurotrophins. Likewise, we show that BDNF and TrkB transcripts (and not p75(NTR)) are overexpressed in the patients' tumors by comparison with their adjacent normal tissues, notably in advanced stages of CRC. CONCLUSION: Taken together, these results highlight that BDNF and TrkB are essential for CRC cell growth and survival in vitro and in tumors. This autocrine loop could be of major importance to define new targeted therapies

Nongenomic actions of thyroid hormones: focus on membrane transport systems.

Extranuclear or nongenomic effects of thyroid hormones are unaffected by inhibitors of protein synthesis, and their rapid time course cannot be explained by interaction of the hormone molecule with nuclear receptors. Their origin has been localized at the plasma membrane, but also at organelles such as the endoplasmatic reticulum and mitochondria. Thyroid hormone has been reported to activate, by both genomic and non genomic mechanisms, the Ca2+-ATPase that stores calcium from the cytosol in the sarcoplasmic reticulum; the decrease in intracellular Ca2+ leads to muscle relaxation. Considering the important effects on the cardiovascular system, T3 can actually be envisaged as a potent inotropic drug. T3 is also a major regulator of the plasma membrane Na+/K+-ATPase activity; T3 and its analog 3,5-diiodothyronine rapidly inhibits Na+/K+-ATPase in chick embryo hepatocytes, whereas the activity is up-regulated in alveolar epithelial cells. Also the ubiquitous plasma membrane Na+/H+ exchanger, that regulates cell volume and pH by exchanging extracellular Na+ with cytoplasmic H+ according to the concentration gradient, is activated by T3 via both genomic and nongenomic mechanisms. A growing number of natural and synthetic thyroid hormone analogs are available to study the physiological importance of extranuclear effects; this may lead to compounds that selectively target either genomic or nongenomic receptors. Such drugs may make it possible to activate separately only a part of the complex effects normally induced by thyroid hormones, this could be of clinical relevance for the cardiovascular system, bone tissue and the Central Nervous System