2,039 research outputs found
Cuidados de higiene - baño: significados y perspectivas de los enfermeros
Enquadramento: Como cuidado direto à pessoa, o banho, na sua execução ou supervisão, exalta-se como espaço/tempo de
interação e conhecimento entre enfermeiro/pessoa. Porém, por vezes, é entendido como a tarefa de manter apenas a pessoa
limpa.
Objetivos: Compreender o significado que os enfermeiros atribuem aos cuidados de higiene - banho; identificar os focos,
relativos à pessoa no seu todo, que os enfermeiros consideram aquando da prestação do banho; e descrever o cuidado
desenvolvido durante o banho.
Metodologia: Qualitativa. Estudo descritivo-exploratório, transversal, com recurso à entrevista e observação, com 18 participantes.
Resultados: Orientam-nos para a prestação dos cuidados de higiene - banho, como um cuidado de Enfermagem essencial à
limpeza e conforto do corpo, sendo uma oportunidade para comunicação, presença e relação com a pessoa, onde se pode ter
em conta focos que orientem a prestação de cuidados face às suas necessidades.
Conclusão: Um cuidado que potencia um espaço direcionado à pessoa, que deve ser efetuado pelo enfermeiro, incentivando-a
na participação ativa do seu plano de cuidados.Background: As direct care to the person, the bath, in its
performance or supervision, is emphasised as a space/time of
interaction and knowledge between the nurse and the person.
However, it is sometimes regarded as merely the task of keeping
a person clean.
Objectives: To understand the meaning assigned by nurses to
hygiene care - bath; identify Nursing foci, related to the provision
of Nursing care to the person as a whole, considered during
hygiene care - bath; and describe the care provided during the
bath.
Methodology: Qualitative. A descriptive-exploratory, crosssectional
study was conducted with 18 participants using
interviews and observation.
Results: The results indicate that the provision of health care -
bath is a type of nursing care essential to body cleanliness and
comfort, and offers an opportunity for communication, presence
and relationship with the person. Different foci may be taken into
account to guide the provision of care with a view to meeting the
person’s needs.
Conclusion: A type of care that promotes a space directed to
the person and that must be provided by the nurse, who should
encourage the person to have an active role in the care plan.Antecedentes: Como atención directa a la persona, el
baño, es decir, su ejecución o supervisión, se muestra
como el espacio/tiempo de interacción y conocimiento
entre el enfermero y la persona. Sin embargo, a veces, solo
se considera como la tarea de mantener a la persona limpia.
Objetivos: Comprender el significado que los enfermeros
atribuyen a los cuidados de higiene - baño; identificar los
focos de la persona como un todo que los enfermeros
consideran al dar el baño, y describir el cuidado llevado a
cabo durante el baño.
Metodología: Cualitativa; estudio descriptivo-exploratorio
y transversal en el que se recurrió a la entrevista y la
observación con 18 participantes.
Resultados: Nos orientan a considerar que la prestación
de los cuidados de higiene - baño es una atención de
enfermería esencial para la limpieza y la comodidad del
cuerpo y es una oportunidad para la comunicación, la
presencia y la relación con la persona, en la que se pueden
tener en cuenta focos que orienten la prestación de
cuidados frente a las necesidades.
Conclusión: Una atención que potencia un espacio dirigido
a la persona, que el enfermero debe realizar, fomentando
que esta participe activamente en su plan de atención.info:eu-repo/semantics/publishedVersio
Effect of denture-related stomatitis fluconazole treatment on oral Candida albicans susceptibility profile and genotypic variability
Denture-related stomatitis (DRS) is the most common condition affecting removable-denture wearers, and Candida albicans the most frequent pathogenic agent. Systemic antifungal treatment is indicated but recurrences are frequent. The aim of this study was to characterize the oral load, fluconazole susceptibility profile and genotypic variability of oral C. albicans isolates from patients with DRS before (T0), immediately after fluconazole treatment (Tat) and after 6-months follow-up (T6m). Eighteen patients presenting DRS and treated with fluconazole were followed at the Faculty of Dentistry of Oporto University. Seventy C. albicans isolates were obtained and identified using standard cultural and biochemical multi-testing. Fluconazole susceptibility was tested by E-test®. Microsatellite-primed PCR was performed to assess the genotypic variability of C. albicans isolates. The patientsâ mean age was 58.0±3.2 years, and 55.6%/44.4% had total/partial dentures. Before treatment, 22.2%, 44.4% and 33.3% of the patients presented DRS type I, II or III, respectively. Fluconazole treatment healed or improved DRS in 77.8% of the patients, accompanied by an 83.5% reduction in oral C. albicans load. However, after 6-months, oral C. albicans load increased significantly and DRS severity was similar to the one observed before treatment. Moreover, the prevalence of patients presenting fluconazole resistant isolates of C. albicans increased significantly throughout the study: T0-5.6%, Tat-10.0% and T6m-42.9%. A change in the genotypic variability of C. albicans isolates was also verified, being mostly associated to fluconazole susceptibility profile change. In conclusion, fluconazole presents a good short-term DRS treatment efficiency, but may be associated to a long-term emergence of C. albicans fluconazole resistance. © Figueiral et al.; Licensee Bentham Open
Estrogen receptor, progesterone receptor, and bcl-2 are markers with prognostic significance in CIN III
There are no known biological markers or technologies to predict the natural history of an individual CIN III. The probability of progression is considered greater with the persistence of high-risk human papillomavirus (HPV) infection and age. p53 polymorphism has been associated with cervical carcinogenesis. Hormone-induced cervical cancer is mediated by estrogen receptor (ER) and progesterone receptor (PR). In cervical cancer, increased bcl-2 and Bax immunoreactivity is generally associated with a better prognosis. The purpose of this study was to evaluate the value of HPV 16 and HPV 18 typing and p53 codon polymorphism genotyping by polymerase chain reaction and ER, PR, bcl-2, and Bax expression by immunohistochemistry in predicting the CIN III clinical behavior of CIN III lesions. We studied the expression of these prognostic factors in the CIN III adjacent to squamous cell microinvasive carcinomas of the cervix (MIC) from 29 patients with FIGO stage IA1 cervical cancer and in 25 patients with CIN III and no documented focus of invasion. In the MIC group, only the CIN III was considered at least 2 mm away from the microinvasive complex. The ER, PR, bcl-2, and Bax immunoreactivity was scored as positive (>10% staining cells) and negative (<10% staining cells). No significant difference was observed between MIC and CIN III group concerning HPV infection and p53 polymorphism. The ER, PR, bcl-2, and Bax immunohistochemical expression was stronger and more frequent in the CIN III group. After multivariable analysis, coexpression of ER, PR, and bcl-2 was the only independent factor in defining low risk of progression for CIN III. Our study suggests that coexpression of ER, PR, and bcl-2 may be a useful tool in identifying the CIN III lesions with low risk of progression to cervical cance
Safety and Family-Centered Care during Restriction of Hospital Visits due to COVID-19: The Experience of Family Members
Background: Person and Family Centered Care (PFCC) has demonstrated important contributions to health care outcomes. However, in response to the need for safety due to the pandemic COVID-19, measures were taken to restrict hospital visits. So, the aim of this study was to understand the healthcare experience of family members of patients hospitalized during the pandemic period regarding safety and person- and family-centered care. Methods: Qualitative interpretative study, conducted through semi-structured interviews with six family members of people hospitalized during the pandemic period. Content analysis was performed using Atlas.ti software version 22 (Berlin, Germany) and Bardin’s methodology. Results and Conclusions: Restrictions on hospital visits due to the pandemic of COVID-19 have led to a distancing of families from the hospital setting and influenced healthcare practice, making it difficult to involve families in the care process. In some cases, healthcare professionals made efforts to provide PFCC, attempting to minimize the impact of the visitation restriction. However, there were reported experiences of care delivery that did not consider social and psychological factors and did not place the person and family at the center of the care process, relying instead on the biomedical model. These practices left out important factors for the provision of safe care. It is crucial, even in pandemic settings, that healthcare professionals provide person- and family-centered care to the extent possible, promoting the safety of care. The family should be involved in the care of the person in the inpatient setting.info:eu-repo/semantics/publishedVersio
Lipid profile with eslicarbazepine acetate and carbamazepine monotherapy in adult patients with newly diagnosed focal seizures: post hoc analysis of a phase III trial and open-label extension study
BACKGROUND: Antiseizure medications can have negative effects on plasma lipid levels. OBJECTIVES: To evaluate plasma lipid changes in patients with newly diagnosed focal epilepsy treated with eslicarbazepine acetate (ESL) or controlled-release carbamazepine (CBZ-CR) monotherapy during a phase III, randomized, double-blind (DB) trial and 2 years of ESL treatment in an open-label extension (OLE). DESIGN: Post hoc analysis of a phase III trial and OLE study. METHODS": Proportions of patients with elevated levels of total cholesterol and low-density lipoprotein (LDL) cholesterol were assessed at DB baseline, OLE baseline (last visit of DB trial), and end of OLE. RESULTS: A total of 184 patients received ESL monotherapy during the OLE: 96 received ESL monotherapy in the DB trial and 88 patients received CBZ-CR monotherapy. The proportions of patients with elevated total cholesterol and LDL cholesterol increased significantly during the DB trial in those treated with CBZ-CR monotherapy [total cholesterol, +14.9% (p < 0.001); LDL cholesterol, +11.5% (p = 0.012)] but decreased significantly after switching to ESL monotherapy in the OLE [total cholesterol, −15.3% (p = 0.008); LDL cholesterol, −11.1% (p = 0.021)]. No significant changes were observed in those treated with ESL monotherapy during the DB trial and OLE. At the end of the DB trial, between-group differences (ESL–CBZ-CR) in the proportions of patients with elevated total and LDL cholesterol were −13.6% (p = 0.037) and −12.3% (p = 0.061), respectively; at the end of the OLE, these between-group differences were −6.0% (p = 0.360) and −0.6% (p = 1.000), respectively. CONCLUSION:A lower proportion of patients with newly diagnosed focal epilepsy had increased levels of total and LDL cholesterol, compared to baseline, following monotherapy with ESL versus CBZ-CR; after switching from CBZ-CR to ESL, the proportions of patients with increased levels decreased significantly. REGISTRATION: ClinicalTrials.gov NCT01162460/NCT02484001; EudraCT 2009-011135-13/2015-001243-36
Factores relacionados con la fragilidad multidimensional en personas mayores
Objective: to analyze the sociodemographic and health factors related to multidimensional frailty in elderly people
living at home. Method: descriptive, exploratory and cross-sectional study, which evaluated 300 elderly enrolled in
a Health Unit in the Northern Region of Portugal. The sociodemographic and health conditions of the old people
were analyzed, with application of the Tilburg Frailty Index, Falls Efficacy Scale International – 7 items, Barthel
Index and Lawton and Brody Scale. Results: in the elderly in the study, with a mean age of 81.34±6.75 years, frailty
was identified in 60.33%. The related factors were: gender, marital status, self-perceived health, pathological history,
severe disease in the last year, polymedication, falls, fear of falling and higher level of dependence. Conclusion:
multidimensional frailty of the elderly living at home is a prevalent condition. When predictor factors in primary
health care are analyzed early, it is possible to intervene in order to delay this syndrome.Objetivo: analisar os fatores sociodemográficos e de saúde relacionados com a fragilidade multidimensional em
idosos que vivem no domicílio. Método: estudo descritivo, exploratório e transversal, que avaliou 300 idosos inscritos
numa Unidade de Saúde da Região Norte de Portugal. Foram analisadas as condições sociodemográficas e de saúde
das pessoas idosas, com aplicação do Índice de Fragilidade de Tilburg, Falls Efficacy Scale International – 7 itens,
Índice de Barthel e Escala Lawton & Brody. Resultados: nos idosos do estudo, com idade média de 81,34±6,75 anos,
a fragilidade foi identificada em 60,33%. Os fatores relacionados foram: género, estado civil, autopercepção de
saúde, antecedentes patológicos, doença grave no último ano, polimedicação, quedas, medo de cair e maior nível de dependência. Conclusão: a fragilidade multidimensional dos idosos que vivem no domicílio é uma condição
prevalente. Quando analisados precocemente os fatores preditores na atenção primária à saúde, é possível intervir
de forma a retardar essa síndrome.Objetivo: analizar los factores sociodemográficos y de salud relacionados con la fragilidad multidimensional en
personas mayores que viven en el hogar. Método: estudio descriptivo, exploratorio y transversal, que evaluó a 300
ancianos matriculados en una Unidad de Salud de la Región Norte de Portugal. Se analizaron las condiciones
sociodemográficas y de salud de los ancianos, con aplicación del Tilburg Frailty Index, Falls Efficacy Scale
International – 7 items, Barthel Index y Lawton and Brody Scale. Resultados: en los ancianos del estudio, con una
edad media de 81,34±6,75 años, se identificó fragilidad en el 60,33%. Los factores relacionados fueron: género,
estado civil, salud autopercibida, antecedentes patológicos, enfermedad grave en el último año, polimedicación,
caídas, miedo a caerse y mayor nivel de dependencia. Conclusión: la fragilidad multidimensional de los ancianos
que viven en el hogar es una condición prevalente. Cuando los factores predictores en la atención primaria de salud
se analizan temprano, es posible intervenir para retrasar este síndrome.info:eu-repo/semantics/publishedVersio
Effect of the Active Aging-in-Place–Rehabilitation Nursing Program: A Randomized Controlled Trial
Abstract: (1) Background: It is of great importance to promote functional capacity and positive
lifestyles, since they contribute to preventing the progression of frailty among the older adults. The
aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program
(AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was
a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a
Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks,
and the sessions took place at the participants’ homes. We used as instruments the Tilburg Frailty
Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip
strength measurement; Tinetti Index; Individual lifestyle profile; and Borg’s perception of effort.
(3) Results: Post-program, there was an improvement in multidimensional and physical frailty,
functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the
older adults’ lifestyles, we observed significant improvements in physical activity habits, relational
behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the
AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults.info:eu-repo/semantics/publishedVersio
Attitudes of specialist nurses towards death: particularities of specialist nurses in rehabilitation nursing
Objetivo: analisar as diferenças no perfil de atitudes face à morte entre enfermeiros especialistas em enfermagem de reabilitação e enfermeiros especialistas em outras áreas. Método: estudo comparativo, quantitativo, transversal, com participação de 223 enfermeiros especialistas de um hospital do norte de Portugal. Como instrumento de colheita de dados usou-se o questionário. Para análise dos dados recorreu-se a estatística descritiva e analítica. Resultados: quanto às atitudes face à morte, nos enfermeiros especialistas em enfermagem de reabilitaçãopredominaram as de aproximação, neutralidade, medo, evitamento e escape. Nos enfermeiros com especializaçãoem outras áreas prevaleceram as atitudes de aproximação, medo, neutralidade, evitamento e escape. Conclusão: embora as atitudes positivas dos enfermeiros especialistas em enfermagem de reabilitação face à morte, adquirissem um valor percentual superior, a diferença não foi significativa. Além disso, as atitudes negativas sinalizam para a necessidade de ser repensarem as estratégias de formação no contexto académico, mas também no contexto profissional.
Descritores: Atitude Frente à Morte; Morte; Enfermeiras Especialistas; Especialidades de Enfermagem; Enfermagem em Reabilitação; Hospitais.Objective: to analyse the differences in the profile of attitudes towards death between specialist nurses in rehabilitation nursing and specialist nurses in other areas. Method: comparative, quantitative, cross-sectional study, with the participation of 223 specialist nurses from a hospital in northern Portugal. A questionnaire was applied as a data collection instrument. For data analysis, descriptive and analytical statistics were used.
Results: as for attitudes towards death, in nurses who specialize in rehabilitation, those of approach, neutrality, fear, avoidance and escape predominated. In nurses with expertise in other areas, attitudes of approach, fear, neutrality, avoidance and escape prevailed.
Conclusion: although the positive attitudes towards death, of nurses specializing in rehabilitation, acquired a higher percentage value, the difference was not significant. In addition, negative attitudes signal the need to rethink training strategies in the academic, but also in the professional context.Objetivo: analizar las diferencias en el perfil de actitudes hacia la muerte entre enfermeros especializados en enfermería de rehabilitación y enfermeros especializados en otras áreas. Método: estudio comparativo, cuantitativo, transversal, con la participación de 223 enfermeros especializadas de un hospital del norte de Portugal. Como instrumento de recolección de datos, se utilizó el cuestionario. Para el análisisde datos, se utilizaron estadísticas descriptivas y analíticas. Resultados: en cuanto a las actitudes hacia la muerte, en los enfermeros especializados en enfermería de rehabilitación, predominaron las de enfoque, neutralidad, miedo, evitación y escape. En los enfermeros con experiencia en otras áreas, prevalecieron las actitudes de acercamiento, miedo, neutralidad, evitación y escape. Conclusión: aunque las actitudes positivas de los enfermeros especializados en enfermería de rehabilitación hacia la muerte adquirieron un mayor valor porcentual, la diferencia no fue significativa. Además, las actitudes negativas señalan la necesidad de repensar las estrategias de aprendizaje en el contexto académico, pero tambiénen el contexto profesional.info:eu-repo/semantics/publishedVersio
Actitudes de los enfermeros frente a la muerte en el contexto hospitalario: diferenciación por unidades de cuidados
Objetivo: identificar a ocorrência da morte nas unidades de cuidados, bem como analisar os registros e as atitudes dos enfermeiros
frente à morte no contexto hospitalar. Método: estudo quantitativo, descritivo, transversal, com participação de 900 enfermeiros
de um hospital do Norte de Portugal. Com recurso à triangulação de fontes de dados, a coleta realizou-se de fevereiro a março
de 2018 através de questionário e observação de registros efetuados pelos enfermeiros. Para análise dos dados, usou-se
estatística descritiva e analítica. Resultados: são as unidades de medicina que apresentam maior número de mortes, sendo
no turno da noite que se registra um valor mais elevado de ocorrências. Com relação às atitudes dos enfermeiros frente à morte,
à exceção do evitamento, todas as outras evidenciam tendência semelhante entre o grupo profissional, independentemente
da sua área de atuação. Os registros de enfermagem apresentam maior incidência ao nível da função ao invés de focados no
domínio da pessoa. Conclusão e implicações para a prática: além da aquisição de conhecimentos através da participação
em formações sobre a morte e o processo de morrer, o acompanhamento e apoio dos profissionais, poderão desempenhar um
papel fundamental na preparação dos enfermeiros para cuidar das pessoas em fim de vida.Objective: to identify the occurrence of death in the care units, as well as to analyze the nurses’ records and attitudes towards
death in the hospital context. Method: quantitative, descriptive, cross-sectional study, with the participation of 900 nurses from
a hospital in northern Portugal. Using data source triangulation, the collection took place from February to March 2018 through
a questionnaire and observation of records made by nurses. For data analysis, descriptive and analytical statistics were used.
Results: it is the medical units that present the highest number of deaths, with the highest number of occurrences taking place
in the night shift. Regarding the nurses’ attitudes towards death, with the exception of avoidance, all the others show a similar
trend among the professional group, regardless of their area of activity. Nursing records have a higher incidence at the function
level rather than focusing on the person’s domain. Conclusion and implications for the practice: in addition to the acquisition
of knowledge, through participation in training on death and the dying process, the monitoring and support of professionals, may
play a fundamental role in preparing nurses to care of people at the end of life.Objetivo: identificar la ocurrencia de la muerte en unidades de cuidados y analizar registros y actitudes de los enfermeros
frente a la muerte en el contexto hospitalario. Método: estudio cuantitativo, descriptivo, transversal, con participación de
900 enfermeros de un hospital en el Norte de Portugal. Utilizando la triangulación de fuentes de datos, la recopilación se realizó
de febrero a marzo de 2018 a través de cuestionario y observación de registros de enfermeros. Para el análisis, se utilizaron
estadísticas descriptivas y analíticas. Resultados: las unidades médicas presentan mayor número de muertes, con mayor
número de ocurrencias en el turno nocturno. Con respecto a las actitudes de los enfermeros frente a la muerte, con excepción
de la evitación, todas las demás muestran una tendencia similar entre el grupo profesional, independientemente de su área de
especialización. Los registros de enfermería tienen una mayor incidencia a nivel de función, en lugar de centrarse en el dominio
de la persona. Conclusión e implicaciones para la práctica: además de la obtención de conocimiento sobre la muerte y el
morir, el seguimiento y el apoyo de profesionales puede desempeñar un papel fundamental en la preparación de los enfermeros
para cuidar a los enfermos en final de vida.info:eu-repo/semantics/publishedVersio
A
Abstract:
Non-Alcoholic Fatty Liver Disease (NAFLD) is considered a clinical manifestation of Metabolic Syndrome (MS). The hepatic lipid overload generates an excesive production of reactive oxygen species inducing oxidative stress (OS), there are still no standardized studies on effective treatments or consensus on the appropriate drug for each patient. Assess in MS the pharmacological response of atorvastatin and metformin on levels of inflammatory and OS biomarkers and possible liver modifications. 40 Male Wistar rats were used (8 per group): (A)Control, (B)MS, C) MS+Atorvastatin, D) MS+Metformin, E) MS+Atorvastatin+Metformin. MS was induced by 10% fructose for 6 week. The inflammatory and OS state were verify by Fibrinogen (mg/dL), Nitric oxide (NO)(µM) and superoxide dismutase (SOD)(U/mL) by means of spectrophotometry. The liver tissue was analyzed by optical microscopy(OM). ANOVA and hotelling as a post hoc test, p significance level<0.05. Fibrinogen concentration increased in (B)(288.83±6.8) with respect to (A)(203.33±6.8)(p<0.001), and in groups (C)(196±7.45), (D)(242±7.45) and (E)(104,33±6,8) showed significant regression of hyperfibrinogenemia (p<0.001). Levels of NO significantly decreased in (B)(14.76±1.86) compared to (A)(27.09±1.95)(p<0.001) and normalized their levels in the groups (C)(25.48±2.06), (D)(22.2±2,33) and (E)(31.25±2,18)(p<0,001). SOD activity in (B)(178.64±10.23) increased significantly contrasted with (A)(134.5±10.73)(p<0.001), (D)(195.71±12,82) and (E)(222,17±15.17)(p<0.001), however in group (C)(145.71±12.82) there was a significant decreased from (B)(p<0.001). In the hepatic OM (B), centrilobular and sinusoidal congestion with the presence of binucleated hepatocytes and vacuolization phenomena was evidenced. Our results indicated a pro-oxidative and inflammatory state with hepatic repercussion in (B). Atorvastatin normalizing biomarkers and retrograde the liver injury. Metformin achieves the reversal of inflammation and OS with restoration of liver tissue by showing the absence of cellular and inflammatory lesions. The pharmacological combination demonstrated superior efficacy than monotherapy, each drug acting on its biological targets, achieving greater effectiveness in normalizing biochemical variables and in regression of histological lesions. The current evidence on MS shows that in the face of a complex etiopathogenic mechanism, therapeutic approaches with multiple objectives are necessary such as the implementation of these drugs instead of waiting for an ideal drug that includes all the altered molecular pathways.Resumen:
Enfermedad del hígado graso asociada a disfunción metabólica(MAFLD, siglas inglés),es considerada una manifestación clínica del Síndrome Metabólico(SM). La sobrecarga hepática de lípidos genera producción excesiva de especies reactivas de oxígeno induciendo Estrés Oxidativo(EO), aún no hay estudios estandarizados sobre tratamientos efectivos ni consenso sobre el fármaco adecuado para cada paciente. Valorar en SM la respuesta farmacológica de atorvastatina y metformina sobre niveles de biomarcadores inflamatorios, de EO y las posibles modificaciones hepáticas. Utilizamos 40 ratas machos Wistar (n=8 por grupo): A)Control, B)SM, C)SM+Atorvastatina, D)SM+Metformina y E)SM+Atorvastatina+Metformina. SM inducido mediante fructuosa al 10% diluida en agua durante 6 semanas. Atorvastatina 0,035mg/día/rata y 1,78mg/día/rata de metformina durante 45 días. El estado inflamatorio y EO se constató por Fibrinógeno (mg/dL), óxido nítrico (NO)(µM) y superóxido dismutasa(SOD)(U/mL) por espectrofotometría. Se analizó histología hepática por microscopía óptica(MO). ANOVA y Hotelling como test post-hoc, significación p<0.05. Fibrinógeno aumentó en (B)(288,83±6,8) respecto a (A)(203,33±6,8)(p<0,001), los grupos (C)(196±7,45), (D)(242±7,45) y (E)(104,33±6,8) evidenciaron una regresión significativa de hiperfibrinogenemia(p<0,001). Los niveles de NO disminuyeron en (B)(14,76±1,86) comparado con (A)(27,09±1,95)(p<0,001), su concentración se normalizó en los grupos (C)(25,48±2,06), (D)(22,2±2,33) y (E)(31,25±2,18)(p<0,001). SOD aumentó en (B)(178,64±10,23), (D)(195,71±12,82) y (E)(222,17±15,17)(p<0,001) contrastado con (A)(134,5±10,73)(p<0,001), sin embargo en (C)(145,71±12,82) evidenció disminución significativa respecto a (B)(p<0,001). MO hepática en (B) evidencio congestión centrolobulillar y leve congestión sinusoidales con presencia de hepatocitos binucleados y fenómenos de vacuolización. Los grupos (C), (D) y (E) demostraron regresión de las lesiones descriptas en (B). Nuestros resultados indicaron un estado prooxidativo e inflamatorio con repercusión hepática en (B).Atorvastatina normalizando los biomarcadores analizados y retrogradando las lesiones hepáticas. Metformina logra una reversión de inflamación y EO, con restitución del tejido hepático al evidenciar ausencia de lesiones celulares e inflamatorias. La combinación farmacológica demostró eficacia superior que la monoterapia, actuando cada fármaco en sus blancos biológicos logrando una mayor efectividad en la normalización de las variables bioquímicas y en la regresión de lesiones histológicas. La evidencia actual sobre MAFLD demuestra que ante un mecanismo etiopatogénico complejo es necesario enfoques terapéuticos con múltiples objetivos, la implementación de estos fármacos en lugar de esperar un fármaco ideal que contemple todas las vías moleculares alteradas.
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