A Parallel between the Physicians Portrayed in Luigi Pirandello’s Novels and Contemporary Brazilian Physicians

The characters within Luigi Pirandello’s novels portray real people whose topicality is undeniable. As such, the purpose of this article is to establish a comparison between the physician in Pirandello’s novels and the physician in Brazilian society nowadays, highlighting their professional conduct. The novels “The Doctor’s Duty”, “The Fly”, and “The Other Son” were analyzed in the light of the current Medical Ethics Code, conveying old problems that still remain these days. Reading Pirandello induces critical thinking of the medical practice, prompting the establishment of a physician-patient relationship based on exchanging experiences and sharing decisions

Dectin-1 Activation Exacerbates Obesity and Insulin Resistance in the Absence of MyD88

This work was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, grant numbers 11/15682-4, 12/02270-2, 15/18121-4), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Regenera INCT Process Grant 465656/2014-5). JL is funded by the NIH/NIDDK R01DK106210. GDB is funded by the Wellcome Trust and the MRC Centre for Medical Mycology. Open access journalPeer reviewedPublisher PD

Protective role of adenosine monophosphate activated kinase (AMPK) on the progression and severity of experimental tubulointerstitial nephritis.

Objetivamos investigar o papel da quinase ativada por adenosina monofosfato (AMPK) na doença renal crônica. Induzimos nefrite túbulo-intersticial (NTI) em camundongos C57BL/6 e LyzM-cre AMPKflox/flox através de ração com adenina, e tratamos com metformina (Met) 200 mg/kg/dia. Avaliamos ainda o efeito da Met sobre a transição epitélio-mesenquimal (TEM) em células tubulares epiteliais renais murinas (linhagem MM55.K). Os C57BL/6 tratados apresentaram preservação da função renal; maior frequência de macrófagos (MØ) M1, em detrimento dos M2; e redução de marcadores de fibrose. Os LyzM-cre AMPK-/- não diferiram dos LyzM-cre AMPK+/+ quanto à intensidade da lesão, por a molécula já se encontrar infrarregulada na NTI. Contudo, ao serem tratados com Met, os LyzM-cre AMPK+/+ evoluíram melhor do que os não tratados, o mesmo não se verificando nos LyzM-cre AMPK-/-, sugerindo que a ação da Met nos MØ é dependente de AMPK. As MM55.K, após estímulo com Met, exibiram maior captação de glicose, expressão do transportador Glut-2, ativação da glicólise, e resistência à TEM.We aimed to investigate the role of adenosine monophosphate activated kinase (AMPK) on chronic kidney disease. We induced tubulointerstitial nephritis (TIN) in C57BL/6 and LyzM-cre AMPKflox/flox mice by feeding them adenine diet, and then treating with metformin (Met) 200 mg/kg/day. We also evaluated the effect of Met on epithelium-to-mesenchyma transition (EMT) of murine epithelial renal tubular cells (lineage MM55.K). Met-treated C57BL/6 mice presented preserved kidney function, greater frequency of M1 macrophages (MØ) compared to M2 ones, and reduced markers of fibrosis. Disease severity on LyzM-cre AMPK-/- and AMPK+/+ mice did not differ, since the molecule was already downregulated on TIN. However, by treating them with Met, LyzM-cre AMPK+/+ improved in comparison to the non-treated mice. The same did not happen with LyzM-cre AMPK-/- mice, suggesting that Met effect on MØ is AMPK-dependent. MM55.K cells, after stimulus with Met, showed increased glucose uptake, greater expression of the transporter Glut-2, activation of glycolysis, and resistance to EMT

Protective role of adenosine monophosphate activated kinase (AMPK) on the progression and severity of experimental tubulointerstitial nephritis.

Objetivamos investigar o papel da quinase ativada por adenosina monofosfato (AMPK) na doença renal crônica. Induzimos nefrite túbulo-intersticial (NTI) em camundongos C57BL/6 e LyzM-cre AMPKflox/flox através de ração com adenina, e tratamos com metformina (Met) 200 mg/kg/dia. Avaliamos ainda o efeito da Met sobre a transição epitélio-mesenquimal (TEM) em células tubulares epiteliais renais murinas (linhagem MM55.K). Os C57BL/6 tratados apresentaram preservação da função renal; maior frequência de macrófagos (MØ) M1, em detrimento dos M2; e redução de marcadores de fibrose. Os LyzM-cre AMPK-/- não diferiram dos LyzM-cre AMPK+/+ quanto à intensidade da lesão, por a molécula já se encontrar infrarregulada na NTI. Contudo, ao serem tratados com Met, os LyzM-cre AMPK+/+ evoluíram melhor do que os não tratados, o mesmo não se verificando nos LyzM-cre AMPK-/-, sugerindo que a ação da Met nos MØ é dependente de AMPK. As MM55.K, após estímulo com Met, exibiram maior captação de glicose, expressão do transportador Glut-2, ativação da glicólise, e resistência à TEM.We aimed to investigate the role of adenosine monophosphate activated kinase (AMPK) on chronic kidney disease. We induced tubulointerstitial nephritis (TIN) in C57BL/6 and LyzM-cre AMPKflox/flox mice by feeding them adenine diet, and then treating with metformin (Met) 200 mg/kg/day. We also evaluated the effect of Met on epithelium-to-mesenchyma transition (EMT) of murine epithelial renal tubular cells (lineage MM55.K). Met-treated C57BL/6 mice presented preserved kidney function, greater frequency of M1 macrophages (MØ) compared to M2 ones, and reduced markers of fibrosis. Disease severity on LyzM-cre AMPK-/- and AMPK+/+ mice did not differ, since the molecule was already downregulated on TIN. However, by treating them with Met, LyzM-cre AMPK+/+ improved in comparison to the non-treated mice. The same did not happen with LyzM-cre AMPK-/- mice, suggesting that Met effect on MØ is AMPK-dependent. MM55.K cells, after stimulus with Met, showed increased glucose uptake, greater expression of the transporter Glut-2, activation of glycolysis, and resistance to EMT

The Emerging Role of Mitochondrial Dysfunction in the Pathogenesis of Idiopathic Inflammatory Myopathies

Increasing evidence points towards mitochondria as crucial players in the initiation and progression of auto-immune and degenerative disorders, to which impaired cell metabolism is but a facet of the subjacent etiopathogenesis. This review aims to introduce the reader to essential concepts of mitochondrial abnormalities in idiopathic inflammatory myopathy (IIM), underscoring inclusion-body myositis and dermatomyositis. Far surpassing the initial simplistic view of being responsible for energy generation, mitochondria have gathered attention regarding their role in inflammatory processes, being able to fuel autoimmunity, as shown by the presence of anti-mitochondrial antibodies (AMAs) in up to 10% of IIM patients. As cellular respiration takes place, mitochondrial metabolites might help to shape the pro-inflammatory milieu in affected muscle, beyond generating reactive oxygen species, which are well-recognized inducers of damage-associated molecular patterns. A series of mitochondrial components might facilitate the sterile activation of pro-inflammatory cells and the production of several cytokines responsible for enhancing auto-immune responses. Marked variation in the mitochondrial genome has also been reported in IIM patients. As such, we summarize key historical and recent advances linking aberrations and instabilities of mitochondrial DNA to impaired muscle function. Besides discussing mitochondrial dysfunction as an essential part of IIM development, we also highlight possible associations between presence of AMAs and a particular phenotype of IIM, with its own characteristic clinical and radiological pattern. Finally, we present promising treatment approaches targeting mitochondria, while briefly discussing experimental models for gaining deeper insight into the disease process, and ultimately leading to novel drug development

Lingual osteoma as a fortuitous finding on a boy with post-adenoidectomy inflammatory pseudotumor

Lingual osteoma is a very rare clinical entity. There are less than 100 cases reported in the literature, and the occurrence is even rarer in males. It is a benign lesion with a yet unknown pathogenesis. Lingual osteoma is usually a slow-growing tumor that can be incidentally detected after physical or radiological examination. The location of this tumor in the oral cavity is most commonly in the posterior third of the dorsum of the tongue. Treatment of choice is surgical excision, and definitive diagnosis is provided by histopathological analysis. We report a case of osteoma at the base of the tongue presenting as an incidental concurrent finding of a post-adenoidectomy inflammatory pseudotumor in a 9-year-old male patient, while briefly reviewing the literature. Keywords: Lingual osteoma, Osseous choristoma, Inflammatory pseudotumor, Adenoidectom

Emergency cricothyrotomy: temporary measure or definitive airway? A systematic review.

ABSTRACT Being a fast and safe method in the hands of well trained professionals in both prehospital and intrahospital care, Cricothyrotomy has been broadly recommended as the initial surgical airway in the scenario "can't intubate, can't ventilate", and is particularly useful when the obstruction level is above or at the glottis. Its prolonged permanence, however, is an endless source of controversy. In this review we evaluate the complications of cricothyrotomy and the need of its routine conversion to tracheotomy through a search on PubMed, LILACS and SciELO electronic databases with no restriction to the year or language of the publication. In total, we identified 791 references, retrieved 20 full text articles, and included nine studies in our review. The incidence of short-term complications ranged from zero to 31.6%, and the long-term complications, from zero to 7.86%. Subglotic stenosis was the main long-term reported complication, even though it was quite infrequent, occurring only in 2.9 to 5%. The frequency of conversion to tracheostomy varied from zero to 100%. Although a small frequency of long-term complications was found for emergency cricothyrotomy, the studies' low level of evidence does not allow the recommendation of routine use of cricothyrotomy as a secure definitive airway

Curso de Odontología de la UFPI: 50 años de interacción con la educación y la salud en Piauí

La Odontología, como es propio de cualquier profesión, tiene peculiaridades en lo que toca a su desarrollo que, al ser revisadas por medio de una retrospectiva en la Historia, es un valioso instrumento para comprender su actual papel dentro de la sociedad contemporánea. Así, el presente trabajo se propone rememorar la historia de la creación del curso de Odontología en el Estado del Piauí, tercero curso superior de este Estado, desde la época de la Facultad de Odontología, cuya origen es de 15/07/1960, hasta cuando tal curso fue incorporado a la UFPI, en 1971. Intentase, por otra parte, hacerse un breve panorama acerca del ingreso de estudiantes en el curso, basándose en una escala temporal, y centrarse también en la calificación del cuadro docente de la Facultad entre las últimas décadas del siglo XX y la primera década del siglo XXI, considerando la importancia del cuerpo docente como un preeminente contribuyente para el nivel de calidad del curso. En 2010, el curso contaba con 19 doctores y 11 maestros, entre los 32 docentes, con 80 clases concluyentes y cerca de 1500 alumnos graduados. La conclusión general del análisis crítica de los indicadores y parámetros abordados es que las actividades académicas, científicas e culturales pueden influir decisivamente en el cambio de las estructuras sociales, contribuyendo para el desarrollo y el progreso

Obstetric profile of perinatal deaths on a capital of the Northeast of Brazil

Abstract Objectives: to analyze the obstetric and sociodemographic profile on perinatal deaths in Teresina the capital of Piauí, from data obtained from the Sistema de Informação de Mortalidade e Sistema de Informação de Nascidos Vivos (Brazilian Mortality Information System and Livebirth Information System). Methods: this is a retrospective cohort on perinatal deaths of mothers whose babies were born and resided in Teresina between 2010 and 2014. The analyzed variables were age and the mother´s schooling, gestational age, type of pregnancy (singleton or multiple), route of delivery (vaginal or cesarean), place of death (in and out hospital), time of death in relation to the delivery (prior, during or after), and birth weight. Results: the perinatal mortality coefficient (PMC) varied from 17.5 to 19.3 per 1,000 births. We found similarities in the sociodemographic profile and in the obstetric fetal and non-fetal deaths, both with a great incidence on 20 to 27 years-old mothers, vaginal delivery and singleton pregnancy. Low birth weight was positively related to early neonatal deaths. Conclusions: perinatal mortality presented a statistical correlation in gestational age, birth weight, and type of delivery. The PMC in our study was higher than other Brazilian capitals