Comparison of home-based rehabilitation and a centre-based exercise in terms of functional capacity, muscle oxygenation and quality of life in people with peripheral arterial disease: a protocol for a randomised controlled trial

INTRODUCTION

Peripheral arterial disease (PAD) is increasingly prevalent, and supervised physical exercise programmes are recommended as the first-line treatment. However, these programmes are underused. Alternative delivery models may be able to expand treatment coverage. The objective of this study was to compare a home-based exercise programme (HBEP) and a centre-based exercise (CBE) in terms of their effects on functional capacity, peripheral muscle oxygenation and quality of life in individuals with PAD.

METHODS AND ANALYSIS

This single-blind, parallel randomised clinical trial will consist of two groups: HBEP and CBE. A qualitative analysis will be carried out to investigate acceptability and satisfaction. The primary outcome will be functional capacity, assessed by the incremental shuttle walk test. Secondary outcomes will include functional capacity, assessed by a treadmill walking test; peripheral muscle oxygenation and quality of life; and self-reported functional impairment, risk factors, morbidity, level of physical activity, adherence, acceptability and satisfaction. The intervention protocols will consist of 12 weeks of intermittent walking until claudication symptoms, three times a week. Participants randomly assigned to the CBE group will participate in supervised face-to-face sessions. The HBEP group will perform exercises at home with remote supervision, monitored by a pedometer and heart rate monitor, and subjective perception of effort during each session will be recorded by participants in a training diary; follow-up will be conducted by telephone calls. Statistical analyses will follow the intention-to-treat principle. Participants allocated to the HBEP group will be interviewed about their experience of remote treatment using a qualitative approach.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Ethics Committee of the Universidade Federal de Minas Gerais. The results will be disseminated in a peer-reviewed journal and presented at international congresses. This research has the potential to improve the care of people with PAD because if home-based rehabilitation demonstrates effectiveness, it could be considered an alternative or support resource to the usual centre-based treatment models, expanding access, coverage and participation in vascular physiotherapy TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/rg/RBR-97vy9n7 on 14 April 2022.

Acute outcomes of acupuncture and dry needling over peripheral acute fatigue in untrained healthy volunteers: A randomized controlled clinical trial

Peripheral acute fatigue (PAF) is defined as when the skeletal muscle is incapable of generating power. We aimed to investigate the acute effects of traditional Chinese acupuncture (TCA) and dry needling (DN) over PAF induced on the biceps brachii of untrained healthy volunteers. We conducted a randomized, single-blind controlled clinical trial. All volunteers (n = 45) underwent fatigue induction protocols repeated before and after treatment with TCA (TCA group; TCAg; n = 15), DN (DN group; DNg; n = 15), and rest (control group; Cg; n = 15). Assessments of PAF, skin temperature, and exercise time occur before and after each event: 1st fatigue induction (FI), treatment, and 2nd FI. We used repeated measures ANOVA adjusted with Bonferroni post hoc test to determine any change in tested variables (PAF-VAS, PAF-EMG, and skin temperature) at different time points compared to the baseline. Paired Samples t-test was used for the variable exercise times. All statistical tests considered' the significance level at p ≤ 0,05. There was no difference between groups in acute fatigue recovery (p = 0.19). All intragroup analyses were significant (p ≤ 0.05) and all volunteers show a reduction in fatigue perception after treatment (p ≤ 0,05), however, exercise time did not ameliorate after TCA or DN (p > 0.77). A single session of TCA and, DN can equally reduce fatigue, temperature, and exercise time over PAF induced on biceps brachii of untrained healthy volunteers.

Variation in sociodemographic, clinical and functional characteristics of patients with chronic venous insufficiency in a single public health center

OBJECTIVES

Describe and analyze the sociodemographic, clinical and functional characteristics of individuals with chronic venous insufficiency (CVI) and compare the clinical severity with levels of mobility.

METHODS

Exploratory cross-sectional study in a single public health center. The study cohort comprised 99 individuals.

INTERVENTIONS

Clinical, sociodemographic and physical activity level questionnaires were applied; we also evaluated ankle amplitude and sural triceps function. Descriptive statistics, independent t test and one-way ANOVA with post hoc Least Significant Difference (LSD) were performed.

RESULTS

Ninety-nine participants (87.9% woman) with an average age with an average age of 60.6 ± 14 years who where recruited to the study. The cohort was composed of individuals were moderately active, 80% exhibited symptoms of the disease and approximately 40% reported reduced mobility. Individuals who had reduced mobility and less physical activity showed reduced ankle amplitude and muscle function (p <0.05).

CONCLUSION

CVI impacts on functional capacity, even in individuals with less severe disease.

Reference values for triceps surae tissue oxygen saturation by near-infrared spectroscopy

OBJECTIVE

To establish the reference values for peripheral tissue perfusion of the triceps surae muscle assessed by NIRS at rest and in progressive effort.

APPROACH

A total of 288 apparently healthy individuals of both sex were included; between 30 and 79 years of age; nonsmokers; without diagnosis of diabetes mellitus, systemic arterial hypertension, kidney disease, symptoms of angina and intermittent claudication, or any musculoskeletal alteration that would prevent physical exertion; and without diagnosis of PAD or other symptoms associated. All individuals performed anthropometric measurements, physical activity levels, and tissue oxygen saturation (StO2) assessments during and after arterial occlusion maneuver and incremental shuttle walking test by NIRS. The variables obtained by NIRS were presented in percentiles (P) for general comparison between sex and comparison between sexes according to age group. The relationship between the NIRS data and other variables was tested.

MAIN RESULTS

Considering P50 and p<0.05, men had lower StO2 values, higher deoxygenation and reoxygenation (Tx-reox) rates at rest, and higher Tx-reox during progressive effort. There were correlations (p<0.0001) of body composition with the lowest StO2 and Tx-reox values and functional capacity with Tx-reox in occlusion and Tx-reox.

SIGNIFICANCE

The percentiles presented can clinically assist in the diagnosis and monitoring of different health conditions; however, it is important to consider the individual's sex, body composition, and functional capacity.

Construction and validation of a booklet of perioperative orientation and patient safety

OBJECTIVE

To describe the development and validation process of a booklet with perioperative guidelines for surgical patients.

METHOD

This is a methodological, quantitative study, divided into three stages: narrative review, booklet preparation and validation with 23 judges, nurses specialized in patient safety/perioperative nursing, who answered the online Educational Content Validation Instrument. The booklet was considered valid when each item obtained a Content Validity Index equal to or greater than 0.8.

RESULTS

The elaborated material was divided into four items: surgical patient safety; preoperative guidelines; the surgical center; guidelines after surgery. The overall Content Validity Index in the validation with judges was 1.0, considered gold standard.

CONCLUSION

The booklet was validated by experts regarding objectives, structure/presentation and relevance.

The influence of nursing team’s behavior in adverse event following immunization surveillance

ABSTRACT Objectives: to analyze the effects of nursing professionals’ behavior in adverse event following immunization surveillance. Methods: a cross-sectional study of 384 participants who received vaccines. Information on vaccination history, administered vaccines and vaccination guidelines were analyzed. Descriptive and bivariate analyzes were performed using simple logistic regression (unadjusted Odds Ratio). Results: guidelines on events (PR=1.8; p=0.001) and conducts regarding their occurrence (PR=1.7; p=0.001) are activities that influence adverse event following immunization surveillance. More than half of participants did not receive guidance on the vaccines administered, the events and the conduct in case of an occurrence. Only 38.5% were instructed about the vaccines administered and 40.6% about adverse events. In the presence of an event, 29.9% reported that they sought services for notification. Conclusions: proper screening, providing guidance on vaccines and adverse events are essential preventive measures to strengthen adverse event following immunization surveillance.

Construção e validação de cartilha de orientação perioperatória e segurança do paciente

RESUMO Objetivo: Descrever o processo de elaboração e validação de uma cartilha com orientações perioperatórias para os pacientes cirúrgicos. Método: Estudo metodológico, quantitativo, dividido em três etapas: revisão narrativa, elaboração da cartilha e validação com 23 juízes, enfermeiros especialistas em segurança do paciente/enfermagem perioperatória, que responderam ao Instrumento de Validação de Conteúdo Educacional via online. A cartilha foi considerada válida quando cada item obteve Índice de Validade de Conteúdo igual ou superior a 0,8. Resultados: O material elaborado foi dividido em quatro itens: segurança do paciente cirúrgico; orientações pré-operatórias; o centro cirúrgico; orientações após a cirurgia. O Índice de Validade de Conteúdo global na validação com juízes foi 1,0, considerado padrão-ouro. Conclusão: A cartilha foi validada pelos especialistas em relação aos objetivos, estrutura/apresentação e relevância.

The Ancestry of Eastern Paraguay: A Typical South American Profile with a Unique Pattern of Admixture

Immigrants from diverse origins have arrived in Paraguay and produced important demographic changes in a territory initially inhabited by indigenous Guarani. Few studies have been performed to estimate the proportion of Native ancestry that is still preserved in Paraguay and the role of females and males in admixture processes. Therefore, 548 individuals from eastern Paraguay were genotyped for three marker sets: mtDNA, Y-SNPs and autosomal AIM-InDels. A genetic homogeneity was found between departments for each set of markers, supported by the demographic data collected, which showed that only 43% of the individuals have the same birthplace as their parents. The results show a sex-biased intermarriage, with higher maternal than paternal Native American ancestry. Within the native mtDNA lineages in Paraguay (87.2% of the total), most haplogroups have a broad distribution across the subcontinent, and only few are concentrated around the Paraná River basin. The frequency distribution of the European paternal lineages in Paraguay (92.2% of the total) showed a major contribution from the Iberian region. In addition to the remaining legacy of the colonial period, the joint analysis of the different types of markers included in this study revealed the impact of post-war migrations on the current genetic background of Paraguay.

Retrotransposons and multilocus sequence analysis reveals diversity and genetic variability in endophytic fungi-associated with Serjania laruotteana Cambess

The composition of endophytic communities is dynamic and demonstrates host specificity; besides, they have great intra- and interspecific genetic variability. In this work, we isolated leaf endophytic fungi from Serjania laruotteana, identify them using multilocus analysis, and evaluate the genetic variability using IRAP (inter-retrotransposon amplified polymorphism) and REMAP (retrotransposon-microssatellite amplified polymorphism). A total of 261 fungi were isolated and 58 were identified. Multilocus phylogenetic analysis using the partial sequences from the ITS1-5.8S-ITS2 regions, elongation factor 1-alpha, β-tubulin, actin, glyceraldehyde-3-phosphate dehydrogenase, and calmodulin genes identify that most strains belonged to the Colletotrichum and Diaporthe genera, other isolated genera were Xylaria, Phyllosticta, Muyocopron, Fusarium, Nemania, Plectosphaerella, Corynespora, Bipolaris, and Curvularia. The IRAP and REMAP analyzes were performed with Colletotrichum and Diaporthe genera and showed 100% of polymorphism and high intra- and interspecific variability. This is the first report of the diversity of endophytic fungi from S. laruotteana. In addition, it demonstrated that the IRAP and REMAP can be used to distinguish morphologically similar lineages, revealing differences even strains of the same species.

Behavioral aspects of waterbirds

Estuaries are used by waterbirds as foraging, resting and nesting sites, serving also as shelter for migratory birds. The dynamics of this avifauna in an aquatic environment may be associated with the differences of time of day, tide height, temperature, wind speed and use of the site by different species. This study had the objective of evaluating behavioral aspects of aquatic birds, relating the influence of environmental variables with their activities. Bird counts were performed at the mouth of two important rivers of the state of Santa Catarina, Brazil, during two-hour intervals throughout the day in monthly samplings between June (2015) and May (2016). A total of 44 species were recorded, ten of which were migratory. The most recorded behaviors were foraging and resting. The Kruskal-Wallis analysis indicated no significant difference in behavior between the sampling intervals. The Bray-Curtis similarity test resulted in three groups: 1) - species that foraged most of the time; 2) - species that rested most of the time; and 3) - same time in both activities. The Indicator Species Analysis showed that 17 species were associated with only one microhabitat and 15 species with more than one. The Canonical Correlation Analysis indicated that only tide height, temperature and rainfall variables were correlated with the behaviors performed and only the resting activity was positively correlated with all variables. This may be associated with thermoregulation and the ability of some species to stay in midlitoral at high tide. The results demonstrate that different waterbird species used the studied areas in different ways. Thus, the heterogeneity of microhabitats in an aquatic environment of extreme importance for the coexistence and maintenance of the diversity of waterbirds.

Challenges in recruitment and adherence to a randomized clinical trial in Brazil on the effects of transcutaneous nervous electrical stimulation on individuals with peripheral arterial disease: A feasibility study

OBJECTIVE

Describe the feasibility, barriers during the recruitment and intervention period, recruitment rate (success and efficiency), and the level of participation and adherence in the randomized clinical trial to verify the effects of transcutaneous electrical nerve stimulation (TENS) for the symptoms of intermittent claudication (IC) and its repercussions on functional capacity, cardiorespiratory fitness and cardiovascular autonomic function in individuals with sta II Fontaine classification, residing in Brazil.

DESIGN

Prospective, double-blind, randomized clinical trial.

SETTING

Level secondary.

PARTICIPANTS

A total of 63 participants were screened, of which 12.6% were included. Eight individuals with peripheral arterial disease (PAD) and IC underwent a protocol that lasted 8 weeks.

INTERVENTIONS

The experimental group received 45 minutes TENS 10 Hz, followed by 30 minutes of aerobic exercise, and the control group received a placebo TENS also followed by 30 minutes of exercise. Incremental walking test, gait impairment questionnaire, treadmill test, heart rate variability, and 4-second test were applied, considering adherence, success, and efficiency.

RESULTS

The most efficient recruitment sources were as follows: 1) referral by physician and 2) referral by a physiotherapist. Out of 63 participants, 8 (12.6%) were included in the clinical trial. Participants were excluded due to the following reasons: not meeting the criteria (41 participants (65%)), locomotion (6 participants (9.5%)), transportation (5 participants (7.9%)), work release (1 participant (1.6%)), and interest (2 participants (3.2%)). The overall participation was 99 participants (51.6%) in a total of 192 sessions offered.

CONCLUSION

It was not possible to succeed in recruitment and adherence rates. The results of this clinical trial reinforce that PAD is neglected, and strategies including a multidisciplinary approach with the effective participation of nursing, physiotherapy, medicine, and nutrition professionals, are necessary to optimize care for individuals with PAD need to be strengthened. Brazilian Registry of Clinical Trials (RBR-8RTZFN).

A new lipophilic amino alcohol, chemically similar to compound FTY720, attenuates the pathogenesis of experimental autoimmune encephalomyelitis by PI3K/Akt pathway inhibition

Experimental autoimmune encephalomyelitis (EAE) is one of the main animal models used for the study of Multiple Sclerosis (MS). Long-chain lipophilic amino alcohols with immunoregulatory activities have already been studied in some models of inflammatory diseases, but the action of these compounds in EAE and MS is still unknown. In this study, we investigated whether the lipophilic amino alcohol 4b would act to improve the clinical signs of EAE and reduce the demyelination process and the neuroinflammatory parameters in the spinal cord, as well as the inflammatory process in the inguinal lymph nodes, of C57Bl/6 mice induced with EAE after stimulation with MOG_35-55 and pertussis toxin. The 4b treatment (1.0 mg/kg/day) was orally administered, starting on the day of onset of clinical signs of the disease (10th) and ending on the 20th day after immunization. This treatment was able to reduce the cell count on the inguinal lymph nodes, the migration of inflammatory cells into the central nervous system (CNS), as well as the processes of microgliosis, astrogliosis, and the production of chemokines and pro-inflammatory cytokines, thus increasing the IL-10 anti-inflammatory cytokine levels in EAE mice. The inhibition of Akt phosphorylation in the CNS of EAE mice after treatment with 4b indicates that the immunoregulatory action of 4b is related to the PI3K/Akt signaling pathway. Our results indicate the immunoregulatory efficacy of the new compound 4b in the control of some inflammatory parameters and in the glial proliferation. In addition, 4b was able to reduce the demyelination of neurons and the worsening of clinical signs of EAE as effectively as the compound FTY720, the first oral drug approved by the FDA for the treatment of MS.

Correlates of HIV, STI and TB among sub-Saharan African migrants in Lisbon: a biobehavioral study

Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevention strategies. However, migrants are often underrepresented in national statistics and research. This study aimed to examine correlates of HIV, past STI and past TB among SAMs.

A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Uni- and multivariable logistic regression analyses were performed to examine factors associated with HIV, past STI and past TB.

Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive increased by age (OR 1.07, 95%CI 1.03-1.11) and were higher among those who experienced violence from a partner (OR 2.77, 95%CI 1.08-7.10). Increased odds of having a past STI were found among migrants with low income (OR 2.86, 95%CI 1.48-5.56), long-term migrants (&gt;25 years residing in Portugal: OR 2.16, 95%CI 1.06-4.38) and those who reported sexual risk behaviors (≥3 sexual partners: OR 2.06, 95%CI 1.14-3.70; inconsistent condom use: OR 2.61, 95%CI 1.32-5.17). In total, 4.1% of participants had TB in the past; these were more likely male (OR 3.42, 95%CI 1.29-9.06) and HIV positive (OR 11.48, 95%CI 4.55-28.94). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past.

Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

Key messages

High levels of HIV, STI and TB infection among SAMs were found to be strongly associated with socioeconomic disadvantage and poor living conditions in the host country. Social inequalities are persistently a major factor affecting risk for HIV, STIs and TB, and thus addressing social determinants of infectious diseases must remain a public health priority.

Validity of an instrument to evaluate the immunobiological cold chain

Objective: To develop and to test the validity of content and layout of a multidimensional tool to evaluate maintenance of the cold chain for immunobiological conservation.Method: A methodological study carried out in three steps: integrative review; development of theoretical and logical model for the development of the tool; implementation of the Delphi Technique to test the validity of content and layout. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated considering appropriate those values greater than or equal to 75% and 0.4, respectively.Results: The instrument consisted of 7 questions about structure and 20 about process, subdivided into three components: Transportation/Reception (n=3); Storage/Handling (n=13); Supervision/Permanent education (n=4). The CVI value was 87.4%, with values equal to 85.7% and 89% in the structure and process dimensions, respectively. The process components obtained CVI values equal to 88.9, 88.9 and 89.2%, respectively. The CVR was 0.8, with values equal to 0.7 and 0.8 in the structure and process dimensions. As for the layout validation, the questionnaire was considered intelligible.Conclusion: The study provides an instrument with validity of content and layout for health professionals in charge of the supervision of activities of immunobiological conservation, ensuring the maintenance of the immunogenic quality of the products offered to the population.

National Immunization Program Information System: implementation context assessment

BACKGROUND

The National Immunization Program Information System (SIPNI - Sistema de Informação do Programa Nacional de Imunização) in Brazil is a technological innovation management tool that enhances the performance of managers and health professionals in the evaluation and monitoring of immunization activities. In the country, the decentralization of the System is at an advanced stage, but it still faces challenges regarding its operation and use, impacting on its results. This study aims to evaluate the deployment of SIPNI in the state of Minas Gerais, in 2017.

METHOD

Cross-section study performed in Primary Healthcare vaccination rooms in 54 municipalities in the Brazilian state of Minas Gerais, in 2017. A multidimensional questionnaire was used with nursing professionals who work in vaccination rooms, containing questions about the structure (presence of an internet-connected computer, instruction manual, software version, IT professional for technical support, trained healthcare professional, use of communication channels to obtain system information) and the process (activities performed by the staff to operate the immunization information system) of their work. Those questions refer to the components of the information system: system management, immunized-patient records, and Movement of Immunobiological. Implementation Degree (ID) was defined by a score system with different weights for each criterion, according to the importance level observed in it, with a rating of: adequate, partially adequate, inadequate and critically inadequate. For data analysis, median was used as the summary measure, and Pearson's Chi-Squared Test was used for proportion comparison.

RESULTS

Municipal SIPNI is not adequately implemented and that results mainly from the actions performed in health service units, indicating problems in the use of technology by professionals working in vaccination rooms. The structure was better evaluated than the process, presenting IDs of 70.9 and 59.5%, respectively. Insufficient internet access, inadequate use of communication channels, and lack of professional qualification were some of the identified structural issues. "Movement of Immunobiological" was the best-ranked component (ID = 68.5%), followed by "immunized patient records" (ID = 59.3%) and "SIPNI management" (ID = 50.7%). Partial performance of SIPNI is independent of population size in the municipality and of FSH coverage.

CONCLUSIONS

SIPNI is still an underutilized technological innovation. There are challenges that must be overcome, such as implementation of the final web version, internet connectivity, and capabilities aimed at the use of information generated by technology. Nevertheless, perspectives regarding SIPNI are positive, with functionalities to optimize activities in vaccination rooms.

Disodium cromoglycate treatment reduces TH2 immune response and immunohistopathological features in a murine model of Eosinophilic Esophagitis

Eosinophilic esophagitis (EoE) is an emergent chronic disease of the esophagus. The immunopathological process in EoE is characterized by Th2 immune response and prominent eosinophilic influx, in response to common food allergens. The classical treatment consists of allergen elimination diet and systemic/topical corticosteroid therapy. Nevertheless, patients do not always comply to treatment, and the prolonged corticosteroid therapy can cause side effects, therefore, there is an immediate need for new therapeutic approach for EoE. Disodium cromoglicate (DSCG) is a substance broadly used in allergic asthma treatment, and a well-known mast cell activation stabilizer. However, its effect in EoE have not been evaluated yet. This study aimed to assess the effects of DSCG treatment in an EoE experimental model. Male Balb/C mice were subcutaneously sensitized for five days with OVA, and subsequently orally OVA-challenged, DSCG administration was performed between the OVA-challenges. DSCG treatment not only reduced eosinophilic and mast cell influx, as well as reduced fibrosis. In addition, tslp, GATA_3, IL-5, FoxP₃ and IL-10 mRNA expression were reduced in esophageal mucosa, associated with lower Th2 (CD3⁺CD4⁺GATA3⁺IL4⁺) and B cells (CD19⁺CD40⁺) number in peripheral lymphoid organs. In conclusion, the data demonstrate DSCG treatment was effective in reducing mast cell activation and Th2 immune response, important immunopathological EoE features. Therefore, the use of DSCG as an EoE treatment can be considered a promising therapeutic approach to treat this disease.

Ligas acadêmicas na educação médica: uma análise institucional sob a visão dos orientadores

Introdução: As Ligas Acadêmicas de Medicina (LAM) surgiram no Brasil no início do século XX como reuniões de alunos, na necessidade de combate à alta prevalência dos agravos de saúde pela tuberculose e pela hanseníase. Na década de 90, a criação de novas LAMs permitiu um ambiente de discussão e prática de atividades em área de saúde de interesse de um conjunto de alunos e foi, assim, ganhando cada vez mais espaço na formação médica. Todavia, ainda são poucas as evidências científicas que discutem as finalidades e contribuições das LAMs durante a graduação, seja do ponto de vista do aluno ou do orientador. Objetivo: Estudar o perfil das ligas acadêmicas do curso de medicina de uma instituição de ensino da cidade de Juiz de Fora – MG. Material e Métodos: Trabalho de natureza descritiva e transversal que teve como instrumento de pesquisa questionário estruturado com 12 perguntas fechadas, previamente definidas, que foi respondido pelos orientadores das LAMs. Resultados: Em 2018, havia na instituição 36 ligas oficialmente constituídas com 37 orientadores. Quanto a frequência de encontros, os mesmos são majoritariamente mensais (78,4%) e 78,4% contam com a participação dos orientadores. Quanto à participação científica, 70,3% fazem discussão de artigos científicos, 62,2% possuem práticas extra-curriculares, 10,8% realizaram projetos de extensão e 13,5% têm trabalhos vinculados ao Programa de Iniciação Científica. Ressalta-se que a percepção dos orientadores é que 56,8% dos alunos participam para pontuação em programas de residência médica. Finalmente, 89,2% consideram o modelo de gestão adequado. Conclusão: A percepção dos orientadores é importante para a análise das ligas de forma a garantir melhorias principalmente para a educação e extensão. Somente com a descrição e estudo da situação atual será possível imprimir sugestões e avanços nessa questão, que já é tema central dentro da educação médica.

High-fat diet-induced obesity worsens TH2 immune response and immunopathologic characteristics in murine model of eosinophilic oesophagitis

BACKGROUND

Eosinophilic oesophagitis (EoE) is an emergent chronic immune-mediated disease of the oesophagus, which affects both children and adults. It is clinically characterized by dysphagia, food impaction and oesophageal eosinophilia. Epidemiological studies indicate that obesity can worsen allergic symptoms; however, its effect on EoE immunopathological response has not been evaluated yet. This study aimed to assess the effect of obesity on allergic inflammation and T helper-2 profile in an EoE experimental model.

METHODS

Obesity was induced by high-fat feeding. After 7 weeks of diet, male BALB/c mice were subcutaneously sensitized and orally challenged with OVA.

RESULTS

Obesity itself induced a significant mast cell and eosinophil accumulation in the oesophagus, trachea, gut and lung. After allergy induction, this number was higher, when compared to lean-allergic mice. Moreover, obese-allergic mice showed higher remodelling area, in the oesophagus, associated with higher IL-5 and TSLP mRNA expression. In contrast, FoxP3 and IL-10 were less expressed in comparison with lean-allergic mice. In addition, the amount of CD11c⁺ MHCII⁺ PDL1⁺ dendritic cells was reduced, while the number of CD11c⁺ MHCII⁺ CD80⁺ DCs and CD3⁺ CD4⁺ GATA₃ ⁺ IL-4⁺ cells was increased in obese-allergic mice in the spleen and lymph nodes when compared to lean-allergic mice.

CONCLUSION

Obesity aggravated the immune histopathological characteristics in the EoE experimental model, which was associated with the reduction in the regulatory profile, and the increased inflammatory cells influx, related to the T_H 2 profile. Altogether, the data provide new knowledge about obesity as a risk factor, worsening EoE symptoms, and contribute for future treatment strategies for this specific profile.

Obesity affects peripheral lymphoid organs immune response in murine asthma model

Asthma and obesity present rising incidence, and their concomitance is a reason for concern, as obese individuals are usually resistant to conventional asthma treatments and have more exacerbation episodes. Obesity affects several features in the lungs during asthma onset, shifting the T helper type 2 (Th2)/eosinophilic response towards a Th17/neutrophilic profile. Moreover, those individuals can present reduced atopy and delayed cytokine production. However, the impact of obesity on follicular helper T (Tfh) cells and B cells that could potentially result in antibody production disturbances are still unclear. Therefore, we aimed to assess the peripheral response to ovalbumin (OVA) in a concomitant model of obesity and asthma. Pulmonary allergy was induced, in both lean and obese female BALB/c mice, through OVA sensitizations and challenges. Mediastinal lymph nodes (MLNs) and spleen were processed for immunophenotyping. Lung was used for standard allergy analysis. Obese-allergic mice produced less anti-OVA IgE and more IgG2a than lean-allergic mice. Dendritic cells (CD11c⁺  MHCII^high ) expressed less CD86 and more PDL1 in obese-allergic mice compared with lean-allergic mice, in the MLNs. Meanwhile, B cells (CD19⁺  CD40⁺ ) were more frequent and the amount of PDL1/PD1⁺ cells was diminished by obesity, with the opposite effects in the spleen. Tfh cells (CD3⁺  CD4⁺  CXCR5⁺  PD1⁺ ) expressing FoxP3 were more frequent in obese mice, associated with the predominance of Th (CD3⁺  CD4⁺ ) cells expressing interleukin-4/GATA3 in the MLNs and interleukin-17A/RORγT in the spleen. Those modifications to the main components of the germinal centers could be resulting in the increased IgG2a production, which - associated with the Th17/neutrophilic profile - contributes to asthma worsening and represents an important target for future treatment strategies.

Longitudinal follow-up of cardiac vagal activity in individuals undergoing endoscopic thoracic sympathectomy

OBJECTIVE

To conduct a longitudinal investigation of cardiac vagal activity (CVA) by measuring resting HR and calculating the cardiac vagal index (CVI) in individuals undergoing sympathectomy for the treatment of primary hyperhidrosis.

METHODS

This was a descriptive longitudinal study involving 22 patients, 13 of whom were female. The mean age was 22.5 ± 8.8 years. The palms, soles, and axillae were the most commonly affected sites. Resting HR was measured by an electrocardiogram performed 20 min before the 4-second exercise test (4sET), which was used in order to evaluate CVA at three different time points: before surgery, one month after surgery, and four years after surgery.

RESULTS

Resting HR (expressed as mean ± SE) was found to have decreased significantly at 1 month after surgery (73.1 ± 1.6 bpm before surgery vs. 69.7 ± 1.2 bpm at one month after surgery; p = 0.01). However, the HR values obtained at four years after surgery tended to be similar to those obtained before surgery (p = 0.31). The CVI (expressed as mean ± SE) was found to have increased significantly at one month after surgery (1.44 ± 0.04 before surgery vs. 1.53 ± 0.03 at one month after surgery; p = 0.02). However, the CVI obtained at four years after surgery tended to be similar to that obtained before surgery (p = 0.10).

CONCLUSIONS

At one month after sympathectomy for primary hyperhidrosis, patients present with changes in resting HR and CVA, both of which tend to return to baseline at four years after surgery.

Defining mtDNA origins and population stratification in Rio de Janeiro

The genetic composition of the Brazilian population was shaped by interethnic admixture between autochthonous Native Americans, Europeans settlers and African slaves. This structure, characteristic of most American populations, implies the need for large population forensic databases to capture the high diversity that is usually associated with admixed populations. In the present work, we sequenced the control region of mitochondrial DNA from 205 non-related individuals living in the Rio de Janeiro metropolitan region. Overall high haplotype diversity (0.9994 ± 0.0006) was observed, and pairwise comparisons showed a high proportion of haplotype pairs with more than one-point differences. When ignoring homopolymeric tracts, pairwise comparisons showed no differences 0.18% of the time, and differences in a single position were found with a frequency of 0.32%. A high percentage of African mtDNA was found (42%), with lineages showing a major South West origin. For the West Eurasian and Native American haplogroups (representing 32% and 26%, respectively) it was not possible to evaluate a clear geographic or linguistic affiliation. When grouping the mtDNA lineages according to their continental origin (Native American, European and African), differences were observed for the ancestry proportions estimated with autosomal ancestry-informative markers, suggesting some level of genetic substructure. The results from this study are in accordance with historical data where admixture processes are confirmed with a strong maternal contribution of African maternal ancestry and a relevant contribution of Native American maternal ancestry. Moreover, the evidence for some degree of association between mtDNA and autosomal information should be considered when combining these types of markers in forensic analysis.

Using Mobile Technologies in Education

The acquisition of reading skills is decisive for the academic achievement of students. However, learning to read is a complex process. With this in mind, several attempts have been made to find new educational approaches to enhance students' reading motivation. Considering the enormous potential of ICT for education and training, we have developed a digital repository of teaching and learning materials and a multiplatform application that runs on mobile devices: Letrinhas. This information system was designed to promote the development of reading and to provide tools for monitoring and assessing reading skills against the curricular targets set by the Ministry of Education. Letrinhas was evaluated by specialists and users and a high level of satisfaction was observed among students and teachers as time and effort spent to consolidate reading is considerably reduced with this application. This evaluation also enabled to identify features that will be available in the future.

Ferulic acid supresses Th2 immune response and prevents remodeling in ovalbumin-induced pulmonary allergy associated with inhibition of epithelial-derived cytokines

Asthma is characterized by intermittent airway obstruction and chronic inflammation, orchestrated primarily by Th2 cytokines. There is a strong rationale for developing new asthma therapies, since current treatment protocols present side effects and may not be effective in cases of difficult-to-control asthma. The purpose of this study was to evaluate the effect of ferulic acid, a phenolic acid commonly present in plants, in the ovalbumin-induced pulmonary allergy murine model.

METHODS

BALB/c mice were sensitized and challenged with ovalbumin, and treatments were provided by gavage. Six groups of mice (n = 6) were studied, labeled as: control, pulmonary allergy, dexamethasone, and 3 receiving ferulic acid (at 25, 50, and 100 mg/kg). Lung tissue, bronchoalveolar lavage fluid and serum were collected for analysis.

RESULTS

Ferulic acid treatment inhibited an established allergic Th2-response by decreasing the key features of pulmonary allergy, including lung and airway inflammation, eosinophil infiltration, mucus production and serum levels of OVA-specific IgE. These results were associated with lower levels of CCL20, CCL11 and CCL5 chemokines and IL-4, IL-5, IL-13, TSLP, IL-25 and IL-33 cytokines in lung tissue homogenate.

CONCLUSIONS

In this study it was demonstrated for the first time that ferulic acid treatment is able to suppress one of the main features of the airway remodeling, indicated by reduction of mucus production, besides the Th2 pathogenic response on ovalbumin-induced pulmonary allergy. Taken together, results shows that the immunopathological mechanism underlying these effects is linked to a reduction of the epithelial-derived chemokines and cytokines, suggesting that ferulic acid may be useful as a potential therapeutic agent for asthma.

Obesity promotes prolonged ovalbumin-induced airway inflammation modulating T helper type 1 (Th1), Th2 and Th17 immune responses in BALB/c mice

Clinical and epidemiological studies indicate that obesity affects the development and phenotype of asthma by inducing inflammatory mechanisms in addition to eosinophilic inflammation. The aim of this study was to assess the effect of obesity on allergic airway inflammation and T helper type 2 (Th2) immune responses using an experimental model of asthma in BALB/c mice. Mice fed a high-fat diet (HFD) for 10 weeks were sensitized and challenged with ovalbumin (OVA), and analyses were performed at 24 and 48 h after the last OVA challenge. Obesity induced an increase of inducible nitric oxide synthase (iNOS)-expressing macrophages and neutrophils which peaked at 48 h after the last OVA challenge, and was associated with higher levels of interleukin (IL)-4, IL-9, IL-17A, leptin and interferon (IFN)-γ in the lungs. Higher goblet cell hyperplasia was associated with elevated mast cell influx into the lungs and trachea in the obese allergic mice. In contrast, early eosinophil influx and lower levels of IL-25, thymic stromal lymphopoietin (TSLP), CCL11 and OVA-specific immunoglobulin (IgE) were observed in the obese allergic mice in comparison to non-obese allergic mice. Moreover, obese mice showed higher numbers of mast cells regardless of OVA challenge. These results indicate that obesity affects allergic airway inflammation through mechanisms involving mast cell influx and the release of TSLP and IL-25, which favoured a delayed immune response with an exacerbated Th1, Th2 and Th17 profile. In this scenario, an intense mixed inflammatory granulocyte influx, classically activated macrophage accumulation and intense mucus production may contribute to a refractory therapeutic response and exacerbate asthma severity.

Early IFN-γ production together with decreased expression of TLR3 and TLR9 characterizes EAE development conditional on the presence of myelin

Experimental autoimmune encephalomyelitis (EAE) is a model for the study of multiple sclerosis, which is an inflammatory and demyelinating disease of the central nervous system (CNS). Despite increased efforts to elucidate the function of toll-like receptors (TLRs) in autoimmune diseases of the CNS, the relative contribution of other factors, including the immunomodulatory properties of TLR signaling, role of the innate response and the presence or absence of myelin peptides remain unclear. The aim was to evaluate TLR expression in the CNS during EAE development by investigating the expression of TLRs in the initial phase of EAE and establishing correlations with the modulation of inflammatory factors. Mice were subcutaneously immunized at the tail base with 100 μg of myelin oligodendrocyte glycoprotein peptide (MOG35-55), emulsified in complete Freund's adjuvant (CFA) supplemented with 400 μg of attenuated Mycobacterium tuberculosis H37RA. Pertussis toxin (300 ng per animal) was intraperitoneally injected on the day of immunization and 48 h later. Another group (MOG(-)) received an equal emulsion of CFA and M. tuberculosis, without MOG35-55, and the same protocol of Pertussis toxin. The immunized mice presented signs of disease with increased IFN-γ production and presence of NK cells on Day 2 postimmunization and reduced the expression of TLR-3 and TLR-9. In the spinal cord, CCL5 and CCL20 were higher in EAE. This study establishes a correlation between TLR-3 and TLR-9 expression with the development of EAE. In addition, evidence of a role for the myelin peptide in targeting the innate inflammatory response to the CNS is presented.

Detection of IgG1 antibodies against Mycobacterium tuberculosis DosR and Rpf antigens in tuberculosis patients before and after chemotherapy

Diagnosis of tuberculosis (TB) remains challenging. Serum IgG1 antibodies against Mycobacterium tuberculosis active growth phase antigens (ESAT-6/CFP-10, Rv0717 and Rv3353), DosR regulon-encoded proteins (Rv1733, Rv1737, Rv2628 and Rv2029), and resuscitation-promoting factors (Rv0867 and Rv2389) were evaluated in TB patients using ELISA. Active TB patients showed elevated levels of IgG1 antibodies against ESAT-6/CFP-10, Rv0717, Rv3353, Rv1733, Rv2628, Rv2029 and Rv0867 in comparison to healthy controls (p < 0.001). These levels remained high after the initiation of treatment, while responses to Rv0717 and Rv1733 peaked early during treatment. IgG1 responses to ESAT-6/CFP-10, Rv3353, Rv2628, Rv2029 and Rv0867 declined to control levels after the completion of 6 months chemotherapy. ROC analysis confirmed the good diagnostic performance of Rv0717, Rv1733, Rv3353, Rv2628, Rv2029 and Rv0867antigens. These data suggest that detecting IgG1 antibodies against M. tuberculosis antigens, including DosR and Rpf proteins, may represent an additional tool in the diagnosis of tuberculosis.

SERUM CONCENTRATION OF NITRIC OXIDE IN WOMEN SMOKERS AND NONSMOKERS WITH OVERWEIGHT

AIM

to evaluate the serum concentration of NO in overweight women, smokers (SG) and nonsmokers (NSG).

METHODS

blood samples from smokers (n = 20) and nonsmokers (n = 18) were collected to obtain serum, and stored at -80 °C until analysis. NO was assessed by measuring total nitrite, determined by Greiss method. It was adopted as reference 24.4 μmol/L, mean value found in a study with healthy subjects without excess weight. We used the Student t test to compare the means of age and waist circumference, and the Mann-Whitney U test to compare the median of concentrations of nitrite, number of cigarettes/day and Body Mass Index. We adopted a significance level of p < 0.05.

RESULTS

the median nitrite in SG was 16.53 (2.79 - 69.72) μmol/L, whereas in NSG was 10.85 (1.44 - 43.25) μmol/L (p = 0.028). BMI median value to SG and NSG, was respectively 29.50 (25.00 - 38.14) kg/m2 and 30.68 (25.10 - 36.98) kg/m2 (p = 0.530), being classified as overweight. The data showing that the average nitrite was below the estimated value for healthy individuals.

CONCLUSION

the results indicate a decrease of NO metabolites in women with excess weight, independently of being smoker. Despite the significant difference found between groups, these women had values well below the reference value of NO for healthy women. Therefore, it seems that smoking does not interfere in nitrite levels in patients already compromised by obesity.

Acute cardiovascular responses to a session of Manual Lymphatic Drainage

Introduction Manual Lymphatic Drainage (MLD) creates pressure differentials to promote the movement of lymph and interstitial fluid, for their relocation into the bloodstream and can thus act on the variables responsible for determining blood pressure (BP). Objective To investigate the behavior of hemodynamic parameters, such as BP and Heart Rate (HR) during and immediately after a session of MLD. Materials and methods 23 healthy young volunteers with a mean age of 22 ± 2.97 years (18-29), underwent a session of MLD and evaluation of systolic BP, diastolic BP and HR after 10 minutes of initial rest, at the end of the implementation of the protocol in SP, PP and after 15 minutes of final rest. Results No changes were found in systolic BP or diastolic BP before, during and immediately after the MLD session (p = 0.57, p = 0.20, respectively). There was increased heart rate after the final 15 minute rest when compared to the HR after MLD in SP (72 ± 1.9 vs. 76 ± 1.9, p = 0.002), however, without clinical relevance. Conclusion During a session of MLD with healthy young women, no significant hemodynamic changes occurred, demonstrating that this technique is safe from the cardiovascular point of view.

Synthesis of genistein coupled with sugar derivatives and their inhibitory effect on nitric oxide production in macrophages

The isoflavone genistein 1 and some derivatives modulate IL-12, TNF-α and NO production by macrophages and lung cancer cell lines, and improve the clinical signs of experimental autoimmune encephalomyelitis (EAE). Seven genistein derivatives connected at C-6 position of a sugar, such as d-glucose and d-galactose, were synthesized. The ability to modulate macrophage response was evaluated, showing variable inhibition capacity of NO and TNF-α production in J774.A1 and RAW 264.7. Five of the seven compounds were non-cytotoxic; compound 8 was more effective to inhibit NO and TNF-α production, without affecting cell viability.

Hyoid bone position and vertical skeletal pattern--open bite/deep bite

The Hyoid Bone (HB) is a singular bone with no articulation, but is associated with some vital functions. The purpose of this study was to test the null hypotheses that there is no change in HB position in individuals with vertical jaw dysplasia.

METHODS

Eleven factors were used to determine the position of the HB. In this paper the ANOVA (two way analysis of variance) method was used to analyze the variability of the mean of each HB position according the factors facial type and gender. Comparisons with these procedures define which measurements were associated with facial type, gender; and the interactive associations between them.

RESULTS

The HB is related with vertical facial skeletal pattern being farther from mandible and a line joining it to the third cervical vertebra in deep bite, and from posterior nasal spine and sella turcica in open bite. There is sexual dimorphism in HB position. Men have a significant lower distance to the mandible and to the vertical pterigoidea; and higher values to the third cervical vertebra, to a line joining this vertebra to mandible, to the posterior nasal spine and to the sella turcica. Also, there is an association between HB position related group and gender.

CONCLUSION

In this research there is a relation between the position of HB and vertical skeletal pattern. The position of the HB is more related with deep bite. There is a possibility of including the HB in the differential diagnosis of this dysplasia.

Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

INTRODUCTION

Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age.

OBJECTIVE

This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment.

METHODS

The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years) and 10 adults (18-37 years) was recorded with the aid of a Visual Analog Scale (VAS), during 14 days--7 days with bonded brackets only and 7 days with the initial archwire inserted.

RESULTS

There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults.

CONCLUSIONS

In general, children reported pain less frequently than adults did, though with greater intensity.

Oral habits as risk factors for anterior open bite in the deciduous and mixed dentition - cross-sectional study

AIM

Anterior open bite (AOB) is an occlusal anomaly commonly associated with oral habits (OH). The aim of this study was to determine the prevalence of OH as a risk factor for the AOB.

MATERIALS AND METHODS

A group of children aged between 3 and 12 years were observed. The statistical methodology included independent chi-square test, Fisher's exact test and binary logistic regression.

RESULTS

The frequency of oral habits was of 43.5% in the deciduous dentition and 54.2% in the mixed dentition. There was a statistically significant association of pacifier sucking: 61.7 and 16.1 odd ratios (OR), and tongue thrust: 3.9 and 9.2 OR with AOB in both groups, respectively. Thumb sucking occurred only in the deciduous dentition with 5.6 OR.

CONCLUSION

OH and AOB have a high frequency in children. They hinder the normal development of dental and skeletal structures. As OH are risk factors for AOB, the damaging habits most frequently associated are: pacifier sucking, thumb sucking, and tongue thrust. Due to the correlation between the prevalence of AOB and OH, prevention strategies incorporating psychological data related to children should be integrated into a national public health programme.

Optical neuritis induced by different concentrations of myelin oligodendrocyte glycoprotein presents different profiles of the inflammatory process

Optical neuritis (ON) is characterized by inflammation of the optic nerve, and is one of the first clinical signs of multiple sclerosis (MS). Experimental autoimmune encephalomyelitis (EAE) is the animal model used to study MS and ON. The present study evaluated the induction, development and progression of ON using an EAE model induced by 100 μg or 300 μg of MOG35-55. An EAE model was induced in C57BL/6 mice by tail base injection of 100 μg or 300 μg of MOG35-55 in complete Freund's adjuvant, supplemented with Mycobacterium tuberculosis. On the day of injection and 48 h later, animals received intraperitoneally 300 ng of pertussis toxin. On days 7, 10, 14, 21 and 58 the optic nerve was dissected for histological analysis, production of CCL5 and immunohistochemical detection of CD4 and CD8. The histological changes observed in the optic nerves consisted of inflammatory cell infiltrates showing varying degrees of ON in the two groups. The onset of ON in the 300 μg of MOG35-55 group was coincident with higher production of CCL5, on day 10 after induction. However, the 100 μg MOG35-55 group showed more intense inflammatory infiltrate on day 14 after induction, with higher amounts of CD4 and CD8, reaching an excessive demyelination process on days 21 and 58 after induction. The results suggest that two different concentrations of MOG35-55 lead to different forms of evolution of optic neuritis.

[Serum levels of vitamin D and chronic periodontitis in patients with chronic kidney disease]

INTRODUCTION

Concomitance of chronic periodontitis (CP) in patients with chronic kidney disease (CKD) have been associated with adverse outcomes. Vitamin D (25(OH)D) deficiency my play a role in CP and inadequate vitamin D status is common among patients with CKD.

OBJECTIVE

To examine the relationship between vitamin 25(OH)D and CP in patients with CKD not yet on dialysis.

METHOD

A case-control study was conducted. Cases and controls were defined as patients with CKD with and without CP, respectively. The demographic, clinical and laboratory data were obtained when the patient was attended in the outpatient clinic. CKD was defined and staged according to the NKF QDOKI TM. Serum 25(OH) D levels were measured by chemiluminescence when assessing the CP, which was definined according to the American Academy of Periodontoly (1999). Serum 25(OH)D levels were stratified into deficient (< 14 ηg/mL), insufficient (15-29 ηg/mL) and sufficiency (> 30 ηg/ mL).

RESULTS

A total of 15 cases were compared with 14 controls. Cases had lower median 25(OH)D levels than controls (22.6 versus 28.6 ηg/mL, p < 0.01) and were more likely to be categorized as vitamin D insufficiency/deficiency (93,3% versus 57,1%, p < 0,004). On the other hand, the percentage of controls with vitamin D sufficiency was higher then cases (42,9% versus 6,7%, p < 0,004).

CONCLUSION

In patients with CKD not yet on dialysis, vitamin D deficiency is associated with CP.

Mosquito population dynamic (Diptera: Culicidae) in a eutrophised dam

This study observed the mosquito population in a rural eutrophised dam. Larvae of L3 and L4 stages and pupae were dipped out during twelve month collections and the reared to the adult stage for identification. The collections were done along nine metres from the edge of the dam divided in three parts (P1, P2 and P3), each part being 3 m long. P1 did not have vegetation (grass) along its edge,which would reach or sink into the water to promote some shade on the marginal water. A total of 217 adults of four species was identified with the following constancies and frequencies: Culex quinquefasciatus (Say, 1823) (83% and 40.6%), Anopheles (Nyssorhynchus) evansae (Brèthes, 1926) (92% and 26.7%), Anopheles (Nyssorhynchus) rangeli (Gabaldon, Cova Garcia and Lopez, 1940) (83% and 14.3%) and Culex nigripalpus (Theobald, 1901) (33% and 18.4%). C. quinquefasciatus, A. evansae, A. rangeli and C. nigripalpus were more frequent in the quarters Nov./Dec./Jan. (85.7%), May/June/July (75%), Aug./Sept./Oct. (29.4%) and Aug./Sept./Oct. (23.5%) particularly in the months of December (88.4%) Sept.tember (48.94), (38.3) and August (47.62) respectively. The presence of C. quinquefasciatus and the high incidence of Daphinia sp. and also the levels of Organic Nitrogen (0.28 mg/L) and of total Phosphorus (0.02 mg/L) are indications of the eutrophication of the dam. There was a difference regarding the total of Anopheles (A. avansae + A. rangeli) and Culex species (C. quinquefasciatus + C. nigripalpis) between P1 and P2 (χ(2) = 0.0097), P1 and P3 (χ(2) = 0.0005), but not between P2 and P3 (χ(2) = 0.2045).The high C. quinquefasciatus constancy and frequency were confirmed to be a good biological indicator for a eutrophised environment and A. evansae showed a good potential for this environment. Vegetation can be an important factor for anopheline population dynamic also in eutrophic breeding sites.

Expression of IL-1β, IL-6, TNF-α, and iNOS in pregnant women with periodontal disease

Periodontal disease is one of the most prevalent oral diseases. An association between this disease and pregnancy has been suggested, but available findings are controversial. We evaluated the expression levels of interleukins (IL-1β and IL-6), tumor necrosis factor-alpha (TNF-α), and inducible nitric oxide synthase (iNOS) in pregnant women with and without periodontal disease in comparison with non-pregnant women with and without periodontal disease since studies have suggested a relationship between periodontitis and the expression levels of these genes. The women in the sample were distributed into four groups: pregnant and non-pregnant women, with or without periodontal disease, a total of 32 women. The periodontal condition was evaluated according to the probing depth, clinical attachment level and bleeding on probing. Analysis of gene expression was performed by real-time PCR. Comparisons were made of the level of gene expression among the four groups. Expression of IL-1β in the non-pregnant women with periodontal disease was 12.6 times higher than in the non-pregnant women without periodontal disease (P < 0.01), while expression of TNF-α in the non-pregnant women without periodontal disease was 3.5 times higher than in the pregnant women with periodontal disease (P < 0.05). Despite these differences, our overall findings indicate no differences in the expression levels of the cytokines IL-1β, IL-6, TNF-α, and iNOS in pregnant women with and without periodontal disease in comparison with expression of the same genes in non-pregnant women with and without periodontal disease, suggesting that periodontal disease is not influenced by pregnancy.

Th2 responses in OVA-sensitized BALB/c mice are down-modulated by Mycobacterium bovis BCG treatment

Objective

This study aimed to determine whether Mycobacterium bovis Bacillus Calmette-Guérin (BCG) treatment can reverse an established allergic airway inflammation in a BALB/c mouse model of ovalbumin (OVA)-induced airway inflammation.

Methods

OVA sensitized BALB/c mice were challenged with aerosolized OVA on days 28 to 30, 34, 41 and 63. Mice were intranasal treated with BCG on days 35 and 42. Twenty-four hours after the last challenge, blood samples were collected to detect anti-OVA immunoglobulin isotypes, and bronchoalveolar lavage (BAL) was harvested for cell count. Additionally, lungs were collected for histological analysis, detection of the eosinophil peroxidase (EPO) activity and measurement of cytokines and CCL11. The expression of CTLA-4, Foxp3 and IL-10 was also determined in lung tissue by flow cytometry.

Results

BCG treatment was able to inhibit an established allergic Th2-response, by decreasing the allergen-induced eosinophilic inflammation, EPO activity, levels of CCL11 and IL-4, serum levels of IgE and IgG1. Mycobacteria treatment increased lung levels of IFN-γ, IL-10 and TGF-β, and expressions of Foxp3 and CTLA-4 in CD4⁺T cells. Additionally, an increased production of IL-10 by CD8⁺ T cells was observed, even though no detectable changes in CD4⁺IL-10⁺ was noticed.

Conclusion

BCG treatment inhibits features of allergic airway inflammation and the results suggest that the mechanism underlying the down-regulatory effects of BCG on OVA-induced airway inflammation appear to be associated with the induction of both Th1 and T regulatory immune responses.

Anthraquinone derivative O,O'-bis-(3'-iodopropyl)-1,4-dihydroxyanthraquinone modulates immune response and improves experimental autoimmune encephalomyelitis

The present study investigated the effects of the anthraquinone derivative (O,O'-bis-(3'-iodopropyl)-1,4-dihidroxyanthraquinone - DIPDHAQ), mitoxantrone analog, in an experimental autoimmune encephalomyelitis (EAE) model. The results showed that DIPDHAQ treatment improved the clinical signs of the disease (n=10; vehicle: 3.8 ± 0.3; DIPDHAQ: 1.4 ± 0.9). The improvement was associated with a decrease of inflammatory cells, demyelination, IL-17, IFN-γ, IL-12p40, IL-6, TGF-β, CCL5 and CCL20 levels in the spinal cord. DIPDHAQ presented a low cytotoxicity when in vitro assays were performed. Therefore, the findings suggest a major role for DIPDHAQ in multiple sclerosis, disease characterized as an autoimmune inflammatory disorder against myelin proteins of the brain and spinal cord. The attenuation of inflammation and consequently improvement of clinical signs, involving a decrease of pro-inflammatory cytokines and the low cytotoxicity of DIPDHAQ, suggest that this compound could be used as an alternative treatment for autoimmune diseases in the central nervous system.

Lower production of IL-17A and increased susceptibility to Mycobacterium bovis in mice coinfected with Strongyloides venezuelensis

The presence of intestinal helminths can down-regulate the immune response required to control mycobacterial infection. BALB/c mice infected with Mycobacterium bovis following an infection with the intestinal helminth Strongyloides venezuelensis showed reduced interleukin-17A production by lung cells and increased bacterial burden. Also, small granulomas and a high accumulation of cells expressing the inhibitory molecule CTLA-4 were observed in the lung. These data suggest that intestinal helminth infection could have a detrimental effect on the control of tuberculosis (TB) and render coinfected individuals more susceptible to the development of TB.

Assessment of heavy metals in Egretta thula: case study: Coroa Grande mangrove, Sepetiba Bay, Rio de Janeiro, Brazil

This study focuses on metals analysis in kidney and liver tissues of Egretta thula which were collected prostrate or newly dead in Coroa Grande mangrove, Sepetiba Bay, Rio de Janeiro, Brazil, between March 2005 and October 2008. Kidney and liver were collected and analysed to evaluate heavy metal pollution. High values and widest range were detected for all metals in liver and kidney tissues. Geometric mean differences from metals concentrations for Zn, Cd, Ni, Pb, Cu, and Cr, respectively, were found in both organs. Results from linear regression analysis were non-significant in kidney (r = -0.79975, P = 0.10428), and in liver (r = -0.53193, P = 0.35618). With ANOVA analysis for metal accumulation differences (kidney*liver), at the 0.05 level, the results were significantly different (F = 33.17676, P = 0.00000; F = 12.47880, P = 0.00000). These results indicate that Sepetiba Bay shows worrying levels of metals in this study with E. thula, showing potential power of widespread biological and mutagenic adverse effects in trophic levels, and therefore, signalling risk to human health.