O papel dos novos antidiabéticos orais (iSGLT2) no tratamento da doença renal crónica

A Diabetes Mellitus tipo 2 (DM2) é um importante problema de saúde pública com um impacto significativo na mortalidade e representa um fator de risco na doença renal crónica. Recentemente, os inibidores dos Co-transportador sódio-glicose-2 (SGLT2), representados pela empagliflozina, dapagliflozina e canagliflozina têm exibido resultados satisfatórios em diversos ensaios clínicos, nomeadamente na proteção renal. O benefício dos inibidores SGLT2 tem por base o seu mecanismo de ação, que ocorre ao nível do túbulo proximal promovendo a glicosúria e assim reduzindo a glicemia. Além disso, esta classe de fármacos apresenta um perfil de segurança adequando, sendo que a complicação mais frequente está relacionada com o aumento de incidência de infeções genitourinárias. Ao longo do tempo, os inibidores SGLT2 foram ganhando espaço nas recomendações práticas no controlo da DM2, sendo que a abordagem terapêutica inicial desta doença deve passar pela sua utilização. O objetivo desta dissertação passa por avaliar os efeitos para além do controlo glicémico, nomeadamente no que diz respeito aos efeitos renoprotetores nos principais ensaios, avaliando a consistência dos resultados. Apesar de todas as opções terapêutica para o controlo da glicemia, os inibidores dos SGLT2 conseguiram melhorar os resultados renais, sendo que os mecanismos propostos na renoproteção serão abordados e posteriormente explicados, ao longo da dissertação.Type 2 Diabetes Mellitus (DM2) is an important problem in public health issues, with a significant impact on mortality rates and represents a risk factor on chronic renal disease. Recently, sodium-glucose Cotransporter-2 (SGLT2) inhibitors, represented by empagliflozina, dapagliflozina and canagliflozina, have shown satisfactory results in multiple clinical trials, namely on renal protection. The benefit of SGLT2 inhibitors is based on its action mechanism, which occurs at the level of the proximal tubule promoting glucosuria and therefore reducing blood glucose. Furthermore, this class of drugs presents an adequate safety profile, since its most frequent complication is related to an increase in incidence of genitourinary infections. Over time, SGLT2 inhibitors have been gaining relevance in practical recommendations for control of DM2 disease, being that the initial therapeutic approach should involve the use of these inhibitors. The objective of this thesis consists of evaluating the effects other than glycemic control, in particular with regard to the renoprotective effects in the main trials, evaluating the consistency of the results. Despite all theurapeutical options for blood glucose control, SGLT2 inhibitors have succeeded in improving renal results, being that the proposed mechanisms in renoprotection will be approached and explained throughout this thesis

Una visión geoarqueológica general del yacimiento musteriense de El Salt (Alcoy, Alicante) a partir de la micromorfología

En aquest article es ressalten algunes de les aportacions principals de la micromorfologia de sòls a l’estudi del jaciment mosterià del Salt, amb la finalitat de destacar el paper tan important que ha tingut aquesta disciplina per a resoldre i caracteritzar aspectes tan importants com els processos de formació (deposicionals i postdeposicionals) geogènics, biogènics i antròpics de jaciments arqueològics, així com la identificació i descripció de sòls d’ocupació i estructures de combustió. Paraules clau: Micromorfologia. Processos de formació. Geoarqueologia. Mosterià. Estructures de combustió.In this article, we highlight some of the main contributions of an ongoing micromorphological study of sediments from the Mousterian site of El Salt (Alcoy, Alicante, Spain) in order to emphasize the important role played by this discipline in the reconstruction of geogenic, biogenic and anthropogenic site formation processes (depositional and postdepositional), as well as in the characterization of human occupation floors and combustion structures. Keywords: Micromorphology. Formation processes. Geoarchaeology. Mousterian. Combustion structures.En el presente artículo se resaltan algunas de las principales aportaciones de la micromorfología de suelos al estudio del yacimiento musteriense de El Salt, con el fin de destacar el importante papel que juega esta disciplina para resolver y caracterizar aspectos tan importantes como los procesos de formación (deposicionales y postdeposicionales) geogénicos, biogénicos y antrópicos de yacimientos arqueológicos así como la identificación y descripción de suelos de ocupación y estructuras de combustión. Palabras clave: Micromorfología. Procesos de formación. Geoarqueología. Musteriense. Estructuras de combustion

Diseño de estrategias educativas que permitan la sensibilización del buen uso del agua potable en Sabanalarga Atlántico

The design of educational strategies to raise awareness of the proper use of drinking water focuses on promoting knowledge and awareness of the importance of conserving this vital resource and encouraging responsible behavior. Water is an essential resource to maintain life in the ecosystem, but unfortunately it is being wasted in a worrying way. This form of waste has serious consequences for both nature and future generations. For this reason, we have developed an initiative with the aim of sensitizing the community about the negative impact that this has on our planet and fostering greater awareness to promote its improvement. The study used a research methodology with a qualitative approach that involved conducting surveys on a representative sample of 20 individuals from the population. In order to determine the use they give to drinking water from their homes. As a result of the surveys and interviews carried out, it was possible to verify that in the homes there was a notable waste of water in daily activities and in unauthorized vehicle washing practices. In addition, it was detected that some households resorted to fraudulent methods to avoid paying excessive bills related to water consumption.El diseño de estrategias educativas para la sensibilización del buen uso del agua potable se centra en promover el conocimiento y la conciencia sobre la importancia de conservar este recurso vital y fomentar comportamientos responsables. El agua es un recurso esencial para mantener la vida en el ecosistema, pero lamentablemente se está malgastando de manera preocupante. Esta forma de desperdicio tiene graves consecuencias tanto para la naturaleza como para las futuras generaciones. Por esta razón, hemos desarrollado una iniciativa con el objetivo de sensibilizar a la comunidad acerca del impacto negativo que esto tiene en nuestro planeta y fomentar una mayor conciencia para promover su mejora. En el estudio se empleó una metodología de investigación con enfoque cualitativa que involucró la realización de encuestas, entrevistas a una muestra representativa de 20 individuos de la población. Con el fin de determinar el uso que le dan al agua potable desde sus hogares. Como resultado de las encuestas y entrevistas realizadas, se pudo constatar que en los hogares se presentaba un notable derroche de agua en actividades cotidianas y en prácticas de lavado de vehículos no autorizadas. Además, se detectó que algunos hogares recurrían a métodos fraudulentos para eludir el pago de facturas excesivas relacionadas con el consumo de agua

Acute effects of isotonic eccentric exercise on the neuromuscular function of knee extensors vary according to the motor task: impact on muscle strength profiles, proprioception and balance

IntroductionEccentric exercise has often been reported to result in muscle damage, limiting the muscle potential to produce force. However, understanding whether these adverse consequences extend to a broader, functional level is of apparently less concern. In this study, we address this issue by investigating the acute and delayed effects of supramaximal isotonic eccentric exercise on neuromuscular function and motor performance of knee extensors during tasks involving a range of strength profiles, proprioception, and balance.MethodsFifteen healthy volunteers (23.2 ± 2.9 years old) performed a unilateral isotonic eccentric exercise of the knee extensors of their dominant lower limb (4 × 10 reps at 120% of one Repetition Maximum (1RM)). The maximum voluntary isometric contraction (MVC), rate of force development (RFD), force steadiness of the knee extensors, as well as knee joint position sense and mediolateral (MLI) and anteroposterior stability (API) of the dominant lower limb, were measured pre-, immediately, and 24 h after the eccentric exercise. The EMG amplitude of the vastus medialis (VM) and biceps femoris (BF) were concomitantly evaluated.ResultsMVC decreased by 17.9% immediately after exercise (P < 0.001) and remained reduced by 13.6% 24 h following exercise (P < 0.001). Maximum RFD decreased by 20.4% immediately after exercise (P < 0.001) and remained reduced by 15.5% at 24 h (P < 0.001). During the MVC, EMG amplitude of the VM increased immediately after exercise while decreasing during the RFD task. Both values returned to baseline 24 h after exercise. Compared to baseline, force steadiness during submaximal isometric tasks reduced immediately after exercise, and it was accompanied by an increase in the EMG amplitude of the VM. MLI and knee joint position sense were impaired immediately after isotonic eccentric exercise (P < 0.05). While MLI returned to baseline values 24 h later, the absolute error in the knee repositioning task did not.DiscussionImpairments in force production tasks, particularly during fast contractions and in the knee joint position sense, persisted 24 h after maximal isotonic eccentric training, revealing that neuromuscular functional outputs were affected by muscle fatigue and muscle damage. Conversely, force fluctuation and stability during the balance tasks were only affected by muscle fatigue since fully recovered was observed 24 h following isotonic eccentric exercise

Acute effects of isotonic eccentric exercise on the neuromuscular function of knee extensors vary according to the motor task: impact on muscle strength profiles, proprioception and balance

[EN] Introduction: Eccentric exercise has often been reported to result in muscle damage, limiting the muscle potential to produce force. However, understanding whether these adverse consequences extend to a broader, functional level is of apparently less concern. In this study, we address this issue by investigating the acute and delayed effects of supramaximal isotonic eccentric exercise on neuromuscular function and motor performance of knee extensors during tasks involving a range of strength profiles, proprioception, and balance. Methods: Fifteen healthy volunteers (23.2 ± 2.9 years old) performed a unilateral isotonic eccentric exercise of the knee extensors of their dominant lower limb (4 × 10 reps at 120% of one Repetition Maximum (1RM)). The maximum voluntary isometric contraction (MVC), rate of force development (RFD), force steadiness of the knee extensors, as well as knee joint position sense and mediolateral (MLI) and anteroposterior stability (API) of the dominant lower limb, were measured pre-, immediately, and 24 h after the eccentric exercise. The EMG amplitude of the vastus medialis (VM) and biceps femoris (BF) were concomitantly evaluated. Results: MVC decreased by 17.9% immediately after exercise (P < 0.001) and remained reduced by 13.6% 24 h following exercise (P < 0.001). Maximum RFD decreased by 20.4% immediately after exercise (P < 0.001) and remained reduced by 15.5% at 24 h (P < 0.001). During the MVC, EMG amplitude of the VM increased immediately after exercise while decreasing during the RFD task. Both values returned to baseline 24 h after exercise. Compared to baseline, force steadiness during submaximal isometric tasks reduced immediately after exercise, and it was accompanied by an increase in the EMG amplitude of the VM. MLI and knee joint position sense were impaired immediately after isotonic eccentric exercise (P < 0.05). While MLI returned to baseline values 24 h later, the absolute error in the knee repositioning task did not. Discussion: Impairments in force production tasks, particularly during fast contractions and in the knee joint position sense, persisted 24 h after maximal isotonic eccentric training, revealing that neuromuscular functional outputs were affected by muscle fatigue and muscle damage. Conversely, force fluctuation and stability during the balance tasks were only affected by muscle fatigue since fully recovered was observed 24 h following isotonic eccentric exercise.SIThe author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Portuguese Foundation for Science and Technology, IP, under project UID04045/2020. The Polytechnic of Guarda partly supported the research reported in this publication.ARB and AB are part of the Highly Qualified Human Resources Project, reference number CENTRO-04-3559-FSE-000162. MR-A acknowledges the financial support received from the Spanish Ministry of Universities through the Grants for the Requalification of the Spanish University System under the Postdoctoral Margarita Salas Programme (RSUC.UDC.MS09), funded by the European Union – Next Generation

Neoplasias benignas e malignas em 261 necropsias de pacientes HIV positivos no período de 1989 a 2008

Considering that there are some studies with autopsies from AIDS describing only malignant neoplasias and that changes can occur after the introduction of Highly Active Antiretroviral Therapy (HAART), our objectives were to analyze the frequency of benign and malignant neoplasms in AIDS patients in the periods of both pre- and post-HAART. This is a retrospective study with 261 autopsies of HIV-positive patients between 1989 and 2008 in Uberaba, Brazil. Sixty-six neoplasms were found (39 benign, 21 malignant and six premalignant) in 58 patients. The most frequent malignant neoplasms were lymphoid, in 2.7% (four Non-Hodgkin lymphoma, one Hodgkin, one multiple myeloma and one plasmablastic plasmacytoma), and Kaposi's Sarcoma, in 2.3% (six cases). The most frequent benign neoplasms were hepatic hemangiomas in 11 (4.2%) of 261 cases and uterine leiomyoma in 11 (15.7%) of 70 woman. In the pre-HAART period eight (9.8%) benign neoplasias and four (4.9%) malignant occurred in 82 patients; in the post-HAART period, 29 (16.2%) benign and 17 (9.5%) malignant were present; however, the differences were not significant. We conclude that the introduction of HAART in our region doesn't look to have modified the frequency of neoplasms occurring in patients with HIV.Tendo em vista que trabalhos sobre necropsias de AIDS analisam apenas neoplasias malignas e que ocorreram alterações após a terapia antiretroviral altamente eficaz (HAART), este estudo foi feito com objetivo de avaliar a frequência de neoplasias benignas e malignas nos períodos pré e pós-HAART. Estudo retrospectivo de 261 necropsias de HIV positivos entre 1989 e 2008 em Uberaba - Brasil. Foram encontradas 66 neoplasias (39 benignas, 21 malignas e seis lesões pré-invasivas) em 58 pacientes. As neoplasias malignas mais frequentes foram linfóides, em 2,7% (quatro linfomas não Hodgkin, um Hodgkin, um mieloma múltiplo e um plasmocitoma plasmoblástico) e, sarcoma de Kaposi, em 2,3% (seis casos). As benignas mais frequentes foram hemangiomas hepáticos em 11 (4,2%) dos 261 casos e leiomiomas uterinos em 11 (15,7%) das 70 mulheres. No período pré-HAART ocorreram oito (9,8%) neoplasias benignas e quatro (4,9%) malignas em 82 pacientes; no pós-HAART, 29 (16,2%) benignas e 17 (9,5%) malignas; entretanto, essas diferenças não foram estatisticamente significantes. Concluímos que a introdução da HAART em nossa região não parece ainda ter alterado a frequência de neoplasias em pacientes HIV

VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad

Acta de congresoLa conmemoración de los cien años de la Reforma Universitaria de 1918 se presentó como una ocasión propicia para debatir el rol de la historia, la teoría y la crítica en la formación y en la práctica profesional de diseñadores, arquitectos y urbanistas. En ese marco el VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad constituyó un espacio de intercambio y reflexión cuya realización ha sido posible gracias a la colaboración entre Facultades de Arquitectura, Urbanismo y Diseño de la Universidad Nacional y la Facultad de Arquitectura de la Universidad Católica de Córdoba, contando además con la activa participación de mayoría de las Facultades, Centros e Institutos de Historia de la Arquitectura del país y la región. Orientado en su convocatoria tanto a docentes como a estudiantes de Arquitectura y Diseño Industrial de todos los niveles de la FAUD-UNC promovió el debate de ideas a partir de experiencias concretas en instancias tales como mesas temáticas de carácter interdisciplinario, que adoptaron la modalidad de presentación de ponencias, entre otras actividades. En el ámbito de VIII Encuentro, desarrollado en la sede Ciudad Universitaria de Córdoba, se desplegaron numerosas posiciones sobre la enseñanza, la investigación y la formación en historia, teoría y crítica del diseño, la arquitectura y la ciudad; sumándose el aporte realizado a través de sus respectivas conferencias de Ana Clarisa Agüero, Bibiana Cicutti, Fernando Aliata y Alberto Petrina. El conjunto de ponencias que se publican en este Repositorio de la UNC son el resultado de dos intensas jornadas de exposiciones, cuyos contenidos han posibilitado actualizar viejos dilemas y promover nuevos debates. El evento recibió el apoyo de las autoridades de la FAUD-UNC, en especial de la Secretaría de Investigación y de la Biblioteca de nuestra casa, como así también de la Facultad de Arquitectura de la UCC; va para todos ellos un especial agradecimiento

Criopreservação das células estaminais do sangue do cordão umbilical

A célula estaminal caracteriza-se por ser uma célula indiferenciada com capacidade de proliferação e de diferenciação em células especializadas com diversas funções de acordo com o tecido ou órgão onde estão localizadas. Podem classificar-se quanto à sua origem ou potência de diferenciação. As células estaminais hematopoiéticas, devido às suas propriedades tem apresentado uma vasta gama de utilizações em múltiplas doenças e investigações face a outras estratégias terapêuticas. O sangue do cordão umbilical, pelo facto de ser rico nestas células, tem-se sobreposto a outras fontes e tem sido já aplicado em cerca de 80 patologias, como por exemplo, na anemia de Fanconi, na leucemia linfoblástica aguda e na síndrome de Hunter. O processo de criopreservação permite o armazenamento destas células por longos períodos de tempo até que sejam necessárias, não alterando as características e a viabilidade celular. Assim, inúmeros bancos, públicos e privados têm surgido em todo o mundo, tal como a BebéVida. No entanto, o potencial de cada amostra, avaliado por diversos parâmetros laboratoriais, pode ser influenciado por fatores neonatais e obstétricos, como o género e o tipo de parto, bem como pelo processamento aplicado para o isolamento destas células a partir do sangue. Portanto, este trabalho teve como objetivo entender o modo como todos estes indicadores podem afetar a qualidade da amostra criopreservada. Consoante o género observou-se diferenças significativas em parâmetros como no número total de células nucleadas inicial e na percentagem da taxa de recuperação. Pelo tipo de parto observou-se diferenças significativas no número total de células nucleadas iniciais e na percentagem do hematócrito inicial. Pela correlação entre os diversos parâmetros laboratoriais avaliados, antes e após o processamento, também se observaram que alguns estavam correlacionados, por exemplo o volume de sangue colhido e o número inicial de células nucleadas ou a taxa recuperação celular, o número inicial de células nucleadas, o número final de células nucleadas e o número de células expressas por CD34+. Pode concluir-se que apesar do género e do tipo de parto serem fatores extrínsecos ao processamento, estas podem afetar a qualidade da unidade a criopreservar. Contudo, esta também se encontra dependente do método empregue pelo laboratório e da eficiência de todo o processamento