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  • ItemEditorial
    Editorial: Peritoneal dialysis: Recent advances and state of the art
    (2023-01-01) Larkin, John; Barretti, Pasqual [UNESP]; de Moraes, Thyago Proença; Global Medical Office; Universidade Estadual Paulista (UNESP); Pontifícia Universidade Católica do Paraná
  • ItemCarta
    Role of sulfonylurea administration in sepsis and septic shock patients: A systematic review
    (2023-01-01) Lazzarin, Taline [UNESP]; Ballarin, Raquel Simões [UNESP]; Pereira, Filipe Welson Leal [UNESP]; Azevedo, Paula Schmidt [UNESP]; Tanni, Suzana Erico [UNESP]; Minicucci, Marcos Ferreira [UNESP]; Universidade Estadual Paulista (UNESP)
  • ItemArtigo
    RNA-seq reveals that anti-obesity irisin and triiodothyronine (T3) hormones differentially affect the purinergic signaling transcriptomics in differentiated human adipocytes
    (2023-04-01) Mathias, Lucas Solla [UNESP]; Herman-de-Sousa, Carina; Cury, Sarah Santiloni [UNESP]; Nogueira, Célia Regina [UNESP]; Correia-de-Sá, Paulo; de Oliveira, Miriane [UNESP]; Universidade Estadual Paulista (UNESP); Universidade do Porto (ICBAS-UP); ICBAS-UP
    The anti-obesity thyroid hormone, triiodothyronine (T3), and irisin, an exercise- and/or cold-induced myokine, stimulate thermogenesis and energy consumption while decreasing lipid accumulation. The involvement of ATP signaling in adipocyte cell function and obesity has attracted increasing attention, but the crosstalk between the purinergic signaling cascade and anti-obesity hormones lacks experimental evidence. In this study, we investigated the effects of T3 and irisin in the transcriptomics of membrane-bound purinoceptors, ectonucleotidase enzymes and nucleoside transporters participating in the purinergic signaling in cultured human adipocytes. The RNA-seq analysis revealed that differentiated adipocytes express high amounts of ADORA1, P2RY11, P2RY12, and P2RX6 gene transcripts, along with abundant levels of transcriptional products encoding to purine metabolizing enzymes (ENPP2, ENPP1, NT5E, ADA and ADK) and transporters (SLC29A1, SCL29A2). The transcriptomics of purinergic signaling markers changed in parallel to the upsurge of “browning” adipocyte markers, like UCP1 and P2RX5, after treatment with T3 and irisin. Upregulation of ADORA1, ADORA2A and P2RX4 gene transcription was obtained with irisin, whereas T3 preferentially upregulated NT5E, SLC29A2 and P2RY11 genes. Irisin was more powerful than T3 towards inhibition of the leptin gene transcription, the SCL29A1 gene encoding for the ENT1 transporter, the E-NPP2 (autotaxin) gene, and genes that encode for two ADP-sensitive P2Y receptors, P2RY1 and P2RY12. These findings indicate that anti-obesity irisin and T3 hormones differentially affect the purinergic signaling transcriptomics, which might point towards new directions for the treatment of obesity and related metabolic disorders that are worth to be pursued in future functional studies.
  • ItemArtigo
    Impact of unplanned peritoneal dialysis start on patients' outcomes—A multicenter cohort study
    (2022-11-23) Hangai, Kellen Thayanne; Pecoits-Filho, Roberto; Blake, Peter G.; da Silva, Daniela Peruzzo; Barretti, Pasqual [UNESP]; de Moraes, Thyago Proença; Programa de Pós- Graduação em Ciências da Saúde-Pontifícia Universidade Católica do Paraná (PUCPR); University of Western Ontario; Universidade Estadual Paulista (UNESP)
    Background: Patients with end-stage kidney disease (ESKD) who start unplanned dialysis therapy are more likely to be treated with hemodialysis (HD) using a central venous catheter, which has been associated with a greater risk of infections and other complications, as well as with a higher long-term risk of death. Urgent-start PD is an alternative that has been suggested as an option for starting dialysis in these cases, with potentially better patient outcomes. However, the definition of urgent-start PD is not homogeneous, and no study, to our knowledge, has compared clinical outcomes among urgent start, early start, and conventional start of PD. In this study, we aimed to compare these types of initiation of dialysis therapy in terms of a composite outcome of patient survival and technique failure. Methods: This is a retrospective, multicenter, cohort study, involving data from 122 PD clinics in Brazil. We used the following: Urgent-start groups refer to patients who initiated PD within 72 h after the PD catheter insertion; early-start groups are those starting PD from 72 h to 2 weeks after the catheter insertion; and conventional-start groups are those who used the PD catheter after 2 weeks from its insertion. We analyzed the composite endpoint of all causes of patient's mortality and technique failure (within the initial 90 days of PD therapy) using the following three different statistical models: multivariate Cox, Fine and Gay competing risk, and a multilevel model. Results: We included 509 patients with valid data across 68 PD clinics. There were 38 primary outcomes, comprising 25 deaths and 13 technique failures, with a total follow-up time of 1,393.3 months. Urgent-start PD had no association with the composite endpoint in all three models. Conclusion: Unplanned PD seems to be a safe and feasible option for treatment for patients with non-dialysis ESKD in urgent need of dialysis.
  • ItemEditorial
    The new Brazilian Dialysis Census
    (2022-01-01) Barretti, Pasqual [UNESP]; Universidade Estadual Paulista (UNESP)
  • ItemArtigo
    The high-intensity interval training mitigates the cardiac remodeling in spontaneously hypertensive rats
    (2022-11-01) Engel, Letícia Estevam; de Souza, Francilene Lima Agostinho; Giometti, Ines Cristina; Okoshi, Katashi [UNESP]; Mariano, Thaoan Bruno; Ferreira, Natalia Zamberlan; Pinheiro, Dyovana Gomes; Floriano, Rafael Stuani; Aguiar, Andreo Fernando; Cicogna, Antônio Carlos [UNESP]; Vechetti, Ivan José; Pacagnelli, Francis Lopes; University of Western São Paulo (UNOESTE); Universidade Estadual Paulista (UNESP); University of Northern Paraná (UNOPAR); University of Nebraska-Lincoln
    Aim: To evaluate the influence of high-intensity interval training (HIIT) on cardiac structural and functional characteristics and myocardial mitogen-activated protein kinase (MAPK) signaling in hypertensive rats. Methods: Male rats (12 months old) were divided into three groups: Wistar Kyoto rats (WKY, n = 8); sedentary spontaneously hypertensive rats (SED-SHR, n = 10), and trained spontaneously hypertensive rats (HIIT-SHR, n = 10). Systolic blood pressure (SBP), functional capacity, echocardiography, isolated papillary muscle, and gene expression of MAPK gene-encoding proteins associated with Elk1, cJun, ATF2, MEF2 were analyzed. Key findings: HIIT decreased SBP and increased functional capacity, left ventricular diastolic diameter, posterior wall thickness-left ventricle, relative wall thickness-left ventricle, and resting tension of the papillary muscle. In hypertensive rats, we observed a decrease in the gene-encoding ATF2 protein; this decrease was reversed by HIIT. Significance: The influence of HIIT in the SHR model in the compensated hypertension phase generated an increase in cardiac hypertrophy, attenuated myocardial diastolic dysfunction, lowered blood pressure, improved functional capacity, and reversed the alteration in gene-encoding ATF2 protein.
  • ItemArtigo
    Intermittent fasting combined with exercise training reduces body mass and alleviates hypothalamic disorders induced by high-fat diet intake
    (2023-09-01) Oliveira, Luciana da Costa; Morais, Gustavo Paroschi; de Oliveira, Franciane Pereira; Mata, Milene Montavoni; Veras, Allice Santos Cruz [UNESP]; da Rocha, Alisson Luiz; Elias, Lucila Leico Kagohara; Teixeira, Giovana Rampazzo [UNESP]; de Moraes, Camila; Cintra, Dennys E.; Ropelle, Eduardo R.; de Moura, Leandro P.; Pauli, José R.; de Freitas, Ellen C.; Rorato, Rodrigo; da Silva, Adelino Sanchez R.; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
    High-fat diet consumption causes hypothalamic inflammation, dysregulating the leptin pathway, which, in turn, compromises the modulation of hypothalamic neuronal activities and predisposes obesity development. Intermittent fasting (IF) and exercise training (ET) have been demonstrated as efficient interventions to modulate hypothalamic inflammation and neuronal activity. However, no studies have evaluated whether combining these interventions could induce better results in reestablishing hypothalamic homeostasis disrupted by high-fat diet intake. The 8-week-old male C57BL/6 mice were randomly assigned into 2 groups: sedentary mice fed a standard diet (CT), and sedentary mice fed a high-fat diet (HF). After 8 weeks of an HF diet, part of the HF group (now 16 weeks old) was randomly subjected to different interventions for 6 weeks: HF-IF = HF diet mice submitted to IF; HF-T = HF diet mice submitted to ET; HF-IFT = HF diet mice submitted to IF and ET. All interventions decreased the body weight gain induced by high-fat diet intake, associated with reduced calorie consumption in week 14. Only the HF-IFT group presented improved serum insulin, leptin, resistin, and Tnf-alpha levels concomitantly with decreased hypothalamic inflammation. The HF-IFT group also demonstrated increased Pomc mRNA expression associated with enhanced pSTAT3 expression in the hypothalamic arcuate and ventromedial hypothalamic nuclei. Our data indicate that the beneficial effects of the combination of IF and ET on energy homeostasis are associated with increased leptin sensitivity in the hypothalamic arcuate nucleus and ventromedial hypothalamic nucleus, which is likely due to an improvement in hypothalamic inflammatory pathways in these nuclei.
  • ItemResenha
    Missing links in preeclampsia cell model systems of endothelial dysfunction
    (2023-07-01) Viana-Mattioli, Sarah [UNESP]; Fonseca-Alaniz, Miriam Helena; Pinheiro-de-Sousa, Iguaracy; Krieger, José Eduardo; Sandrim, Valéria Cristina [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); European Bioinformatics Institute
    Preeclampsia, one of the main hypertensive disorders of pregnancy, is associated with circulating factors released by the ischemic placenta accompanied by systemic endothelial dysfunction. The etiology of preeclampsia remains poorly understood although it is associated with high maternal and fetal mortality and increased cardiovascular disease risk. Most cell model systems used for studying endothelial dysfunction have not taken into account hemodynamic physical factors such as shear-stress forces which may prevent extrapolation of cell data to in vivo settings. We overview the role of hemodynamic forces in modulating endothelial cell function and discuss strategies to reproduce this biological characteristic in vitro to improve our understanding of endothelial dysfunction associated with preeclampsia.
  • ItemResenha
    Absence of Effects of L-Arginine and L-Citrulline on Inflammatory Biomarkers and Oxidative Stress in Response to Physical Exercise: A Systematic Review with Meta-Analysis
    (2023-04-01) Porto, Andrey A. [UNESP]; Gonzaga, Luana A. [UNESP]; Benjamim, Cicero Jonas R.; Valenti, Vitor E. [UNESP]; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP)
    Background: The repercussions on oxidative and inflammatory stress markers under the effects of arginine and citrulline in response to exercise are not fully reached. We completed a systematic review to investigate the effects of L-Citrulline or L-Arginine on oxidative stress and inflammatory biomarkers following exercise. EMBASE, MEDLINE (PubMed), Cochrane Library, CINAHL, LILACS, and Web of Science databases were used to record the trials. This study includes randomized controlled trials (RCTs) and non-RCTs with subjects over 18 years old. Those under the intervention protocol consumed L-Citrulline or L-Arginine, and the controls ingested placebo. We recognized 1080 studies, but only 7 were included (7 studies in meta-analysis). We observed no difference between pre- vs. post-exercise for oxidative stress (subtotal = −0.21 [CI: −0.56, 0.14], p = 0.24, and heterogeneity = 0%. In the sub-group “L-Arginine” we found a subtotal = −0.29 [−0.71, 0.12], p = 0.16, and heterogeneity = 0%. For the “L-Citrulline” subgroup we observed a subtotal = 0.00 [−0.67, 0.67], p = 1.00, and heterogeneity was not applicable. No differences were observed between groups (p = 0.47), and I² = 0%) or in antioxidant activity (subtotal = −0.28 [−1.65, 1.08], p = 0.68, and heterogeneity = 0%). In the “L-Arginine” sub-group, we found a subtotal = −3.90 [−14.18, 6.38], p = 0.46, and heterogeneity was not applicable. For the “L-Citrulline” subgroup, we reported a subtotal = −0.22 [−1.60, 1.16], p = 0.75, and heterogeneity was not applicable. No differences were observed between groups (p = 0.49), and I² = 0%), inflammatory markers (subtotal = 8.38 [−0.02, 16.78], p = 0.05, and heterogeneity = 93%. Tests for subgroup differences were not applicable, and anti-inflammatory markers (subtotal = −0.38 [−1.15, 0.39], p = 0.34 and heterogeneity = 15%; testing for subgroup differences was not applicable). In conclusion, our systematic review and meta-analysis found that L-Citrulline and L-Arginine did not influence inflammatory biomarkers and oxidative stress after exercise.
  • ItemArtigo
    Negligible Effects of Nutraceuticals from Beetroot Extract on Cardiovascular and Autonomic Recovery Response following Submaximal Aerobic Exercise in Physically Active Healthy Males: A Randomized Trial
    (2023-03-01) Benjamim, Cicero Jonas R.; de Sousa Júnior, Francisco Welington; Porto, Andrey Alves [UNESP]; Andrade, Camila Venancia Guerra; de Figueiredo, Maria Íris L. Saraiva; Benjamim, Cicera Josilânia R. [UNESP]; da Silva Rodrigues, Guilherme; Rocha, Elida M. Braga [UNESP]; Cavalcante, Taisy Ferro; Garner, David M.; Valenti, Vitor Engracia [UNESP]; Bueno Júnior, Carlos R.; Universidade de São Paulo (USP); University Center of the Juazeiro do Norte; Universidade Estadual Paulista (UNESP); University of Pernambuco; Oxford Brookes University
    Background: There is little evidence that nutraceuticals from beetroot extract are beneficial with regards to recovery of the cardiovascular parameters and the autonomic nervous system (ANS) after submaximal aerobic exercise, though this formulation is employed widely for this purpose. Objective: To study the effects of beetroot extract supplementation on the recovery of cardiorespiratory and autonomic parameters after a session of submaximal aerobic exercise. Methods: Sixteen healthy male adults commenced a cross-over, randomized, double-blind and placebo-controlled trial. Beetroot extract (600 mg) or placebo (600 mg) were ingested 120 min prior to evaluation on randomized days. We assessed systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and HR variability (HRV) indexes at Rest and during 60 min of recovery from submaximal aerobic exercise. Results: Beetroot extract ingestion slightly accelerated HR, SBP, DBP and MAP reduction following exercise associated to the placebo protocol (vs. rest). Yet no group effect (p = 0.99) was identified between the beetroot and placebo protocols on HR mean, in addition to interaction (group vs. time) (p = 0.60). No group effect was attained between the SBP (p = 0.90), DBP (p = 0.88), MAP (p = 0.73) and PP (p = 0.99) protocols and no significant differences (group vs. time) were observed between the values of SBP (p = 0.75), DBP (p = 0.79), MAP (p = 0.93) and PP (p = 0.63) between placebo and beetroot protocols. Similarly, the reoccurrence of cardiac vagal modulation after exercise via the HF (ms2) was enhanced, but not with regards to the RMSSD index. No group effect (p = 0.99) was identified for the HF (p = 0.90) and RMSSD (p = 0.67) indices. Likewise, we observed no significant differences (group vs. time) amongst the values of HF (p = 0.69) and RMSSD (p = 0.95) between the placebo and beetroot protocols. Conclusion: Whilst beetroot extract might assist the recovery of the cardiovascular and autonomic systems following submaximal aerobic exercise in healthy males, these results seem insignificant owing to minor differences between interventions and are weak clinically.
  • ItemArtigo
    Nitrate-rich beet juice intake on cardiovascular performance in response to exercise in postmenopausal women with arterial hypertension: study protocol for a randomized controlled trial
    (2023-12-01) Benjamim, Cicero Jonas R.; Sousa, Yaritza Brito Alves; Porto, Andrey Alves [UNESP]; de Moraes Pontes, Yasmim Mota; Tavares, Simone Sakagute; da Silva Rodrigues, Guilherme; da Silva, Leonardo Santos Lopes; da Silva Goncalves, Leonardo; Guimaraes, Carolina Scoqui; Rebelo, Macário Arosti; da Silva Sobrinho, Andressa Crystine; Tanus-Santos, Jose E.; Valenti, Vitor Engracia [UNESP]; Gualano, Bruno; Bueno Júnior, Carlos Roberto; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Universidade Estadual de Campinas (UNICAMP)
    Background: There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH). Methods: We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65–70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them. Discussion: The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health. Trial registration: ClinicalTrials.gov NCT05384340. Registered on May 20, 2022.
  • ItemArtigo
    Melatonin receptors and Per1 expression in the inferior olivary nucleus of the Sapajus apella monkey
    (2022-12-20) Granado, Marcos Donizete Junior; Pinato, Luciana [UNESP]; Santiago, Jeferson; Barbalho, Sandra Maria; Parmezzan, Jessica Ellen Lima; Suzuki, Lenita Mayumi; Cabrini, Mayara Longui; Spressão, Daniele Raineri Mesquita Serva; Carneiro de Camargo, Ana Letícia; Guissoni Campos, Leila Maria; University of Marilia (UNIMAR); Universidade Estadual Paulista (UNESP)
    Melatonin is a transducer of photic environmental information and participates in the synchronization of various physiological and behavioral phenomena. Melatonin can act directly in several areas of the central nervous system through its membrane receptors coupled to G protein, called MT1 and MT2 receptors. In some structures, such as the retina, hypothalamus and pars tuberalis, the expression of both melatonin receptors shows circadian variations. Melatonin can act in the synchronization of the clock proteins rhythm in these areas. Using the immunohistochemistry technique, we detected the immunoexpression of the melatonin receptors and clock genes clock protein Per1 in the inferior olivary nucleus (ION) of the Sapajus apella monkey at specific times of the light-dark phase. The mapping performed by immunohistochemistry showed expressive immunoreactivity (IR) Per1 with predominance during daytime. Both melatonin receptors were expressed in the ION without a day/night difference. The presence of both melatonin receptors and the Per1 protein in the inferior olivary nucleus can indicate a functional role not only in physiological, as in sleep, anxiety, and circadian rhythm, but also a chronobiotic role in motor control mechanisms.
  • ItemArtigo
    Proposing Specific Neuronal Epithelial-to-Mesenchymal Transition Genes as an Ancillary Tool for Differential Diagnosis among Pulmonary Neuroendocrine Neoplasms
    (2022-12-01) Prieto, Tabatha Gutierrez; Baldavira, Camila Machado; Machado-Rugolo, Juliana [UNESP]; Olivieri, Eloisa Helena Ribeiro; da Silva, Eduardo Caetano Abilio; Ab’ Saber, Alexandre Muxfeldt; Takagaki, Teresa Yae; Capelozzi, Vera Luiza; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); AC Camargo Cancer Center; Barretos Cancer Hospital; Fundação Oncocentro do Estado de São Paulo (FOSP)
    Pulmonary neuroendocrine neoplasms (PNENs) are currently classified into four major histotypes, including typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC), and small cell lung carcinoma (SCLC). This classification was designed to be applied to surgical specimens mostly anchored in morphological parameters, resulting in considerable overlapping among PNENs, which may result in important challenges for clinicians’ decisions in the case of small biopsies. Since PNENs originate from the neuroectodermic cells, epithelial-to-mesenchymal transition (EMT) gene expression shows promise as biomarkers involved in the genotypic transformation of neuroectodermic cells, including mutation burden with the involvement of chromatin remodeling genes, apoptosis, and mitosis rate, leading to modification in final cellular phenotype. In this situation, additional markers also applicable to biopsy specimens, which correlate PNENs subtypes with systemic treatment response, are much needed, and current potential candidates are neurogenic EMT genes. This study investigated EMT genes expression and its association with PNENs histotypes in tumor tissues from 24 patients with PNENs. PCR Array System for 84 EMT-related genes selected 15 differentially expressed genes among the PNENs, allowing to discriminate TC from AC, LCNEC from AC, and SCLC from AC. Functional enrichment analysis of the EMT genes differentially expressed among PNENs subtypes showed that they are involved in cellular proliferation, extracellular matrix degradation, regulation of cell apoptosis, oncogenesis, and tumor cell invasion. Interestingly, four EMT genes (MAP1B, SNAI2, MMP2, WNT5A) are also involved in neurological diseases, in brain metastasis, and interact with platinum-based chemotherapy and tyrosine–kinase inhibitors. Collectively, these findings emerge as an important ancillary tool to improve the strategies of histologic diagnosis in PNENs and unveil the four EMT genes that can play an important role in driving chemical response in PNENs.
  • ItemArtigo
    Latex–collagen membrane: an alternative treatment for tibial bone defects
    (2022-12-01) de Paiva, Marcela Britto; Pegorin Brasil, Giovana Sant’Ana [UNESP]; Chagas, Ana Laura Destro [UNESP]; Macedo, Ana Paula; Ramos, Júnia; Issa, João Paulo Mardegan; Gangrade, Ankit; Floriano, Juliana Ferreira [UNESP]; Caetano, Guilherme Ferreira; Li, Bingbing; Farhadi, Neda; Mandal, Kalpana; Dokmeci, Mehmet Remzi; Jucaud, Vadim; Herculano, Rondinelli Donizetti [UNESP]; Shimano, Antonio Carlos; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Terasaki Institute for Biomedical Innovation; Imperial College London; University Center of Hermínio Ometto Foundation (FHO); California State University
    Due to the difficulty of consolidation, the risk of fractures, and the high cost of therapy, the orthopedic field views the restoration of bony defects or post-traumatic diseases as a significant issue. In recent years, efforts have been made toward guided bone regeneration as a viable solution. In this study, natural rubber latex (NRL) and latex–collagen (NRL-COL) membranes were developed and characterized, and their effects on bone regeneration in rat tibial lesions were assessed. According to the physicochemical findings, the hydrolyzed COL was effectively incorporated into the NRL membrane to produce a more robust membrane (348% increase in stress) and showed good biocompatibility for human dermal fibroblast cells and in hemolytic activity assay. According to bone analysis using computed microtomography, a substantial difference in bone volume (BV) was found among NRL, control (CONT), and NRL-COL. NRL-COL exhibited the greatest value for the bone volume/total volume ratio (BV/TV). The presence of NRL and COL was significant for the analysis of BV and BV/TV, respectively. All the experimental groups demonstrated a higher bone quality and fracture resistance, as shown by the mechanical properties of the bone. In the COL group, both neoformation of bone and total collagen levels were greater, indicating that treated defects had been closed and mature bone cells were present. Due to its angiogenic properties and the low cost of NRL membrane production, the NRL-COL membrane could be a good substitute for upcoming bone regeneration applications. Graphical Abstract: [Figure not available: see fulltext.]
  • ItemArtigo
    Modeling extracellular matrix through histo-molecular gradient in NSCLC for clinical decisions
    (2022-11-14) Baldavira, Camila Machado; Prieto, Tabatha Gutierrez; Machado-Rugolo, Juliana [UNESP]; de Miranda, Jurandir Tomaz; de Oliveira, Lizandre Keren Ramos; Velosa, Ana Paula Pereira; Teodoro, Walcy Rosolia; Ab’Saber, Alexandre; Takagaki, Teresa; Capelozzi, Vera Luiza; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
    Lung cancer still represents a global health problem, being the main type of tumor responsible for cancer deaths. In this context, the tumor microenvironment, and the extracellular matrix (ECM) pose as extremely relevant. Thus, this study aimed to explore the prognostic value of epithelial-to-mesenchymal transition (EMT), Wnt signaling, and ECM proteins expression in patients with non–small-cell lung carcinoma (NSCLC) with clinical stages I-IIIA. For that, we used 120 tissue sections from patients and evaluated the immunohistochemical, immunofluorescence, and transmission electron microscopy (TEM) to each of these markers. We also used in silico analysis to validate our data. We found a strong expression of E-cadherin and β-catenin, which reflects the differential ECM invasion process. Therefore, we also noticed a strong expression of chondroitin sulfate (CS) and collagens III and V. This suggests that, after EMT, the basal membrane (BM) enhanced the motility of invasive cells. EMT proteins were directly associated with WNT5A, and collagens III and V, which suggests that the WNT pathway drives them. On the other hand, heparan sulfate (HS) was associated with WNT3A and SPARC, while WNT1 was associated with CS. Interestingly, the association between WNT1 and Col IV suggested negative feedback of WNT1 along the BM. In our cohort, WNT3A, WNT5A, heparan sulfate and SPARC played an important role in the Cox regression model, influencing the overall survival (OS) of patients, be it directly or indirectly, with the SPARC expression stratifying the OS into two groups: 97 months for high expression; and 65 for low expression. In conclusion, the present study identified a set of proteins that may play a significant role in predicting the prognosis of NSCLC patients with clinical stages I-IIIA.
  • ItemArtigo
    A Single Dose of Beer after Moderate Aerobic Exercise Did Not Affect the Cardiorespiratory and Autonomic Recovery in Young Men and Women: A Crossover, Randomized and Controlled Trial
    (2022-10-01) Santana, Milana R. Drumond; Pontes, Yasmim M. de Moares; Benjamim, Cicero Jonas R.; Rodrigues, Guilherme da Silva; Liberalino, Gabriela A.; Mangueira, Luana B.; Feitosa, Maria E.; Leal, Jessica; Akimoto, Amanda [UNESP]; Garner, David M. [UNESP]; Valenti, Vitor E. [UNESP]; School of Juazeiro do Norte; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP); Oxford Brookes University
    Background: Beer is a choice beverage worldwide and is often consumed after sports for social interaction. Beer has been suggested for hydration after exercise, but the effects on cardiovascular and autonomic systems in men and women after effort are unknown. Objectives: We assessed the effect of beer absorption immediately after moderate exercise on heart rate (HR) variability (HRV) and cardiovascular recovery after effort in women and men separately. Methods: This is a crossover, randomized and controlled trial performed on 15 healthy female and 17 male adults submitted to two protocols on two randomized days: (1) Water (350 mL) and (2) Beer (350 mL). The subjects underwent 15 minutes seated at rest, followed by aerobic exercise on a treadmill (five minutes at 50–55% of maximum HR and 25 min 60–65% of maximum HR) and then remained 3 min stood on treadmill and 57 min seated for recovery from the exercise. Water or beer was consumed between four and ten minutes after exercise cessation. Blood pressure, HR and HRV were evaluated before exercise, during exercise and during recovery from exercise. Results: Systolic and diastolic blood pressure, HRV and HR changes during and following recovery from exercise were similar when women consumed beer or water. HR, systolic and diastolic blood pressures also returned to baseline levels in the beer and water protocols in males. Yet, parasympathetic indices of HRV recovery from exercise were comparable between protocols in males. Conclusions: Ingestion of 300 mL of beer did not significantly affect HRV and cardiovascular parameters following effort. Our data indicate that beer was safe for this population.
  • ItemArtigo
    ISPD guidelines: Peritoneal dialysis for acute kidney injury
    (2014-01-01) Cullis, Brett; Abdelraheem, Mohamed; Abrahams, Georgi; Balbi, Andre; Cruz, Dinna N.; Frishberg, Yaacov; Koch, Vera; McCulloch, Mignon; Numanoglu, Alp; Nourse, Peter; Pecoits-Filho, Roberto; Ponce, Daniela; Warady, Bradley; Yeates, Karen; Finkelstein, Fredric O.; Renal Unit Greys Hospital; Royal Devon and Exeter Hospital; University of Khartoum; Pondicherry Institute of Medical Sciences and Madras Medical Mission; Botucatu School of Medicine; University of California; Shaare Zedek Medical Center; Universidade de São Paulo (USP); University of Cape Town; Pontificia Universidade Catolica do Parana; University of Missouri-Kansas City School of Medicine; Queen's University; Yale University
  • ItemCarta
    Use of anticoagulants in patients with COVID-19: an update of a living systematic review and meta-analysis
    (2023-06-05) Batista, Diane R. [UNESP]; Floriano, Idevaldo; Silvinato, Antonio; Bacha, Hélio A; Barbosa, Alexandre Naime [UNESP]; Tanni, Suzana E. [UNESP]; Bernardo, Wanderley M.; Universidade Estadual Paulista (UNESP); Associação Médica Brasileira; Cooperativa Baixa Mogiana; Hospital Israelita Albert Einstein; Universidade de São Paulo (USP)
  • ItemArtigo
    Exercise intolerance in post-coronavirus disease 2019 survivors after hospitalisation
    (2023-05-01) Lafetá, Mariana L.; Souza, Vitor C.; Menezes, Thaís C. F.; Verrastro, Carlos G. Y.; Mancuso, Frederico J.; Albuquerque, André Luis P.; Tanni, Suzana E. [UNESP]; Izbicki, Meyer; Carlstron, Júlio P.; Nery, Luiz Eduardo; Oliveira, Rudolf K. F.; Sperandio, Priscila A.; Ferreira, Eloara V. M.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Sírio-Libanês Teaching and Research Institute; Universidade Estadual Paulista (UNESP)
    Rationale Post-coronavirus disease 2019 (COVID-19) survivors frequently have dyspnoea that can lead to exercise intolerance and lower quality of life. Despite recent advances, the pathophysiological mechanisms of exercise intolerance in the post-COVID-19 patients remain incompletely characterised. The objectives of the present study were to clarify the mechanisms of exercise intolerance in post-COVID-19 survivors after hospitalisation. Methods This prospective study evaluated consecutive patients previously hospitalised due to moderate-tosevere/ critical COVID-19. Within mean±SD 90±10 days of onset of acute COVID-19 symptoms, patients underwent a comprehensive cardiopulmonary assessment, including cardiopulmonary exercise testing with earlobe arterialised capillary blood gas analysis. Measurements and main results 87 patients were evaluated; mean±SD peak oxygen consumption was 19.5±5.0 mL·kg− 1·min− 1, and the tertiles were ≤17.0, 17.1–22.2 and ≥22.3 mL·kg− 1·min− 1. Hospitalisation severity was similar among the three groups; however, at the follow-up visit, patients with peak oxygen consumption ≤17.0 mL·kg− 1·min− 1 reported a greater sensation of dyspnoea, along with indices of impaired pulmonary function, and abnormal ventilatory, gas-exchange and metabolic responses during exercise compared to patients with peak oxygen consumption >17 mL·kg− 1·min− 1. By multivariate logistic regression analysis (receiver operating characteristic curve analysis) adjusted for age, sex and prior pulmonary embolism, a peak dead space fraction of tidal volume ≥29 and a resting forced vital capacity ≤80% predicted were independent predictors of reduced peak oxygen consumption. Conclusions Exercise intolerance in the post-COVID-19 survivors was related to a high dead space fraction of tidal volume at peak exercise and a decreased resting forced vital capacity, suggesting that both pulmonary microcirculation injury and ventilatory impairment could influence aerobic capacity in this patient population.
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    Peritoneal Dialysis in Acute Kidney Injury: Prescribing Acute PD
    (2021-01-01) Ponce, Daniela; Balbi, André Luís [UNESP]; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
    Decades ago, peritoneal dialysis was widely accepted as treatment for acute kidney injury (AKI); however, its usage declined in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited, and PD now frequently is used in developing countries because of its lower cost and minimal requirements for infrastructure. Studies from Brazil, India, and Africa have shown that with careful thought and planning, critically ill patients can be successfully treated with PD. To overcome some of the classic limitations in the use of PD for AKI, such as increased risk of infectious and mechanical complications and poorer control of urea, potassium, and bicarbonate levels, the use of cyclers, flexible catheters, and a high volume of dialysis fluid has been proposed. However, in developing countries, the setup for quality research is often lacking, thereby resulting in limited evidence regarding standardized treatment regimens including indications, dosing, technical failure, and mortality. The recent publication of the International Society for Peritoneal Dialysis (ISPD) guidelines for PD in AKI has tried to address these issues and provide an evidence-based standard by which to provide therapy. In this chapter, the advances in technical aspects, advantages, and limitations of PD and the key prescriptions and strategies for PD use in AKI are discussed, and we will review recent literature on clinical experience with PD for the treatment of AKI.