Exploring promising minor natural phenolic compounds in neuroprotection-related preclinical models

Neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease, are characterised by the progressive loss of specific neuronal cell populations due to multifactorial factors, including neurochemical and immunological disturbances. Consequently, patients can develop cognitive, motor and behavioural dysfunctions, which lead to impairments in their quality of life. Over the years, studies have reported on the neuroprotective properties inherent in phenolic compounds. Therefore, this review highlights the most recent scientific findings regarding phenolic compounds as promising neuroprotective molecules against neurodegenerative diseases.

Assessment of antioxidant and antiparkinsonian potential of a new diterpene isolated from Croton argyrophylloides

Oxidative stress is related to health problems including neurological and neurodegenerativedisturbs, such as Parkinson's disease. Natural compounds are reported as source of antioxidant molecules. Therefore, this study aimed to analyze the antioxidant and neuroprotective potential of a new diterpene isolated from C. argyrophylloides (MP-1). Male Wistar rats (250-300 g) were used to evaluate MP-1 antiparkinsonian potential through neurodegenerative model induced by the neurotoxin 6-hydroxydopamine (21 μg). On the 14th day, animals were submitted to behavioral tests and on the 15th day, brain areas were dissected to neurochemical analyzes. MP-1 demonstrated a high antioxidant capacity in vitro and decreased the parkinsonian effects, such as behavioral changes, motor alterations, and body weight loss. MP-1 was also able to control the upregulated levels of nitrosative stress and lipid peroxidation. These findings suggest MP-1 as a diterpene with high antioxidant capacity which might be used to development of new approach against Parkinson's disease.

The association between statistical shape modeling-defined hip morphology and features of early hip osteoarthritis in young adult football players: Data from the femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

Objective

To explore the relationship between radiographic hip shape and features of early hip osteoarthritis (OA) on magnetic resonance imaging (MRI) in young male and female football players without radiographic hip OA.

Design

We used baseline data from a cohort of symptomatic and asymptomatic football players aged 18-50 years. Hip shape was assessed on anteroposterior radiographs with statistical shape modeling (SSM) for men and women separately. Cartilage defects and labral tears were graded using the Scoring Hip Osteoarthritis with MRI (SHOMRI) system. We used logistic regression with generalized estimating equations to estimate associations between each hip shape variant, called shape modes, and cartilage defects or labral tears.

Results

We included 229 participants (446 hips, 77.4% male). For each sex, 15 shape modes were analyzed. In men, three shape modes were associated with cartilage defects: adjusted odds ratios (aOR) 0.75 (95%CI 0.58-0.97) per standard deviation (SD) for mode 1; 1.34 (95%CI 1.05-1.69) per SD for mode 12; and 0.61 (95%CI 0.48-0.78) per SD for mode 15; and one also with labral tears: aOR 1.30 (95%CI 1.01-1.69) per SD for mode 12. These modes generally represented variations in the femoral neck and subtypes of cam morphology, with and without pincer morphology. For women, there was no evidence for associations with the outcomes.

Conclusions

Several hip shape variants were associated with cartilage defects on MRI in young male football players. Specifically, one subtype of cam morphology was associated with both cartilage defects and labral tears. Hip shape was not associated with early OA features in women.

Impact of eugenol on in vivo model of 6-hydroxydopamine-induced oxidative stress

Oxidative stress is involved in many pathological disturbs, such as neurodegenerative disorders. Eugenol (Eug) is a phenolic compound with antioxidant and neuroprotective activities. Then, this study was conducted to investigate the potential neuroprotective effects of Eug on oxidative stress model induced by 6-hydroxydopamine (6-OHDA) in rats. First, the in vivo oxidative stress model was performed by intrastriatal injection (int.) of 6-OHDA (21 µg), followed by the treatment of Eug (0.1, 1, and 10 mg/kg/7 d) per os (p.o.). On the 7 d, behavioral tests were performed. On the 8 d, all the animals were euthanasied and their cerebral areas were excised for neurochemical and transcriptional analyses. The results showed that the treatment with Eug promoted neuroprotective effects on in vivo through reducing of oxidative stress and modulation of genes related to antioxidant activity. Furthermore, animals treated with Eug demonstrated returning of behavioral performance and body weight gain to normal conditions. Thus, this study reports the neuroprotective effects of Eug against oxidative stress induced by 6-OHDA in rats.

Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

OBJECTIVE

To compare early hip osteoarthritis (OA) features on magnetic resonance imaging (MRI) in high-impact athletes with and without hip and/or groin pain, and to evaluate associations between early hip OA features, the International Hip Outcome Tool (iHOT33) and Copenhagen Hip and Groin Outcome Score (HAGOS).

DESIGN

This case-control study evaluated data of the femoroacetabular impingement and hip osteoarthritis cohort (FORCe). One hundred and eighty-two symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 pain-free high-impact athletes (soccer or Australian football (AF)) without definite radiographic hip OA underwent hip MRI. The Scoring Hip Osteoarthritis with MRI (SHOMRI) method quantified and graded the severity of OA features. Each participant completed the iHOT33 and HAGOS.

RESULTS

Hip and/or groin pain was associated with higher total SHOMRI (0-96) (mean difference 1.4, 95% CI: 0.7-2.2), labral score (adjusted incidence rate ratio (aIRR) 1.33, 95% CI: 1.1-1.6). Differences in prevalence of cartilage defects, labral tears and paralabral cysts between symptomatic and pain-free participants were inconclusive. There was a lower prevalence of effusion-synovitis in symptomatic participants when compared to pain-free participants (adjusted odds ratio (aOR) 0.46 (95% CI: 0.3-0.8). Early hip OA features were not associated with iHOT33 or HAGOS.

CONCLUSIONS

A complex and poorly understood relationship exists between hip and/or groin pain and early hip OA features present on MRI in high-impact athletes without radiographic OA. Hip and/or groin pain was associated with higher SHOMRI and labral scores.

Eugenol and its association with levodopa in 6-hydroxydopamine-induced hemiparkinsonian rats: Behavioural and neurochemical alterations

Parkinson's disease is a neurodegenerative disorder that affects the central nervous system and is mainly characterized by the loss of dopaminergic neurons and pro-oxidant mechanisms. Eugenol has been widely studied due to its anti-inflammatory and antioxidant activities, making it a promising neuroprotective agent. This study aimed to investigate the effects of eugenol and its combined action with levodopa in the 6-hydroxydopamine-induced Parkinson's disease model. Wistar rats were subjected to intrastriatal injection of 6-hydroxydopamine (21 μg) and then treated with eugenol (0.1, 1, or 10 mg/kg), levodopa (25 mg/kg) or their combination (eugenol 10 mg/kg + levodopa 12.5 mg/kg) orally for 14 days. On the 14th day, the animals were subjected to behavioural tests, and after euthanization and dissection of the brain areas, neurochemical analyses were performed. The results showed that eugenol reduced the oxidative stress and behavioural disturbances induced by 6-hydroxydopamine. The eugenol and levodopa combination was more effective in some behavioural parameters and body-weight gain in addition to promoting an increase in reduced glutathione levels compared to levodopa alone. Thus, the neuroprotective activity of eugenol was observed against motor and neurochemical disorders. Additionally, the eugenol and levodopa combination was promising when compared to conventional treatment.

Strontium Ranelate Elevates Expression of Heme Oxygenase-1 and Decreases Alveolar Bone Loss in Rats

Objectives

The purpose of this study was to determine the effects of strontium ranelate on ligature-induced periodontitis in rats and assess the putative involvement of heme oxygenase-1 (HO-1) pathway in these effects.

Material and Methods

Male Wistar rats underwent nylon ligature placement around maxillary molars and were treated (v.o.) with strontium ranelate (20 or 100 mg/kg) for 7 days. After that, rats were euthanized and histomorphometric/histopathological analyses and RT-PCR for HO-1 expression were performed.

Results

Strontium ranelate (20 or 100 mg/kg) prevented bone resorption by 28% and 38%, respectively. Strontium ranelate treatment (100 mg/kg) up-regulated (P < 0.05) heme oxygenase-1 mRNA levels in the gingival tissues in comparison to control groups.

Conclusions

Strontium ranelate prevented periodontal bone loss in experimental periodontitis in rats while heme oxygenase-1 mRNA levels increased after treatment.

In vitro activities of kappa-carrageenan isolated from red marine alga Hypnea musciformis: Antimicrobial, anticancer and neuroprotective potential

This study assessed the antioxidant, antimicrobial, anticancer and neuroprotective activities of the kappa(k)-carrageenan isolated from the red alga Hypnea musciformis (Hm-SP). The chemical spectrum of the k-carrageenan from Hm-SP was confirmed by Fourier transform infrared (FT-IR) spectroscopy. Hm-SP revealed an antibacterial and antifungal action against Staphylococcus aureus and Candida albicans, respectively. Hm-SP did not promoted cytotoxic effects against Human breast cancer (MCF-7) and Human neuroblastoma (SH-SY5Y) cell-lines. However, it was observed a significant reduction of the cellular proliferation capacity in these cancer cells in presence of the Hm-SP. Furthermore, Hm-SP showed neuroprotective activity in 6-hydroxydopamine-induced neurotoxicity on SH-SY5Y cells by modulation of the mitochondria transmembrane potential and reducing Caspase 3 activity. In addition, Hm-SP demonstrates low antioxidant potential and did not induce significant cytotoxic effects or changes in the cell proliferation on Balb/c 3T3 mouse fibroblast cell-line. In summary, our data suggest that Hm-SP shows antimicrobial, anticancer and neuprotective activities.

Heme oxygenase-1/biliverdin/carbon monoxide pathway downregulates hypernociception in rats by a mechanism dependent on cGMP/ATP-sensitive K+ channels

OBJECTIVE AND DESIGN

To investigate the role of heme oxygenase-1 (HO-1), carbon monoxide (CO), and biliverdin (BVD) in the zymosan-induced TMJ arthritis in rats.

MATERIALS AND METHODS

Mechanical threshold was assessed before and 4 h after TMJ arthritis induction in rats. Cell influx, myeloperoxidase activity, and histological changes were measured in the TMJ lavages and tissues. Trigeminal ganglion and periarticular tissues were used for HO-1, TNF-α, and IL-1β mRNA time course expression and immunohistochemical analyses. Hemin (0.1, 0.3, or 1 mg kg^-1), DMDC (0.025, 0.25, or 2.5 µmol kg^-1), biliverdin (1, 3, or 10 mg kg^-1), or ZnPP-IX (1, 3 or 9 mg kg^-1) were injected (s.c.) 60 min before zymosan. ODQ (12.5 µmol kg^-1; s.c.) or glibenclamide (10 mg kg^-1; i.p.) was administered 1 h and 30 min prior to DMDC (2.5 µmol kg^-1; s.c), respectively.

RESULTS

Hemin (1 mg kg^-1), DMDC (2.5 µmol kg^-1), and BVD (10 mg kg^-1) reduced hypernociception and leukocyte migration, which ZnPP (3 mg kg^-1) enhanced. The effects of DMDC were counteracted by ODQ and glibenclamide. The HO-1, TNF-α, and IL-1β mRNA expression and immunolabelling increased.

CONCLUSIONS

HO-1/BVD/CO pathway activation provides anti-nociceptive and anti-inflammatory effects on the zymosan-induced TMJ hypernociception in rats.

Neuroprotective Effects of Sulphated Agaran from Marine Alga Gracilaria cornea in Rat 6-Hydroxydopamine Parkinson's Disease Model: Behavioural, Neurochemical and Transcriptional Alterations

Parkinson's disease (PD) is a multifactorial disease associated with the degeneration of dopaminergic neurons and behavioural alterations. Natural bioactive compounds may provide new therapeutic alternatives for neurodegenerative disorders, such as PD. The sulphated polysaccharides isolated from marine algae are heterogenic molecules that show different biological activities. The red marine alga Gracilaria cornea has a sulphated polysaccharide (SA-Gc) with structure and anti-inflammatory and antinociceptive activities reported in the literature. Therefore, this study aimed to evaluate the neuroprotective effects of SA-Gc in rat model PD induced by 6-hydroxydopamine (6-OHDA). Firstly, we established the PD model in rats, induced by an intrastriatal injection (int.) of 6-OHDA, followed by a single administration of SA-Gc (15, 30 or 60 μg; int.). On the 14th day, behavioural tests were performed. After killing, brain areas were dissected and used for neurochemical and/or transcriptional analyses. The results showed that SA-Gc (60 μg, int.) promoted neuroprotective effects in vivo through reducing the oxidative/nitroactive stress and through alterations in the monoamine contents induced by 6-OHDA. Furthermore, SA-Gc modulated the transcription of neuroprotective and inflammatory genes, as well as returning behavioural activities and weight gain to normal conditions. Thus, this study reports the neuroprotective effects of SA-Gc against 6-OHDA in rats.

Mechanisms involved in the anti-inflammatory action of a polysulfated fraction from Gracilaria cornea in rats

The anti-inflammatory mechanisms of the sulfated polysaccharidic fraction obtained from red marine alga Gracilaria cornea (Gc-FI) were investigated using a paw edema model induced in rats by different inflammatory agents (carrageenan, dextran, serotonin, bradykinin, compound 48/80 or L-arginine). Gc-FI at the doses of 3, 9 or 27 mg/kg, subcutaneously--s.c., significantly inhibited rat paw edema induced by carrageenan and dextran, as confirmed by myeloperoxidase and Evans' blue assessments, respectively. Gc-FI (9 mg/kg, s.c.) inhibited rat paw edema induced by histamine, compound 48/80 and L-arginine. Additionally, Gc-FI (9 mg/kg, s.c.) inhibited Cg-induced edema in animals with intact mast cells but did not inhibit that with degranulated mast cells by compound 48/80, revealing a protective role on mast cell membranes. Gc-FI down-regulated the IL-1β, TNF-α and COX-2 mRNA and protein levels compared with those of the carrageenan group, based on qRT-PCR and immunohistochemistry analyses. After inhibition with ZnPP IX, a specific heme oxygenase-1 (HO-1) inhibitor, the anti-inflammatory effect of Gc-FI was not observed in Cg-induced paw edema, suggesting that the anti-inflammatory effect of Gc-FI is, in part, dependent on the integrity of the HO-1 pathway. Gc-FI can target a combination of multiple points involved in inflammatory phenomena.

Response of knee cartilage T1rho and T2 relaxation times to in vivo mechanical loading in individuals with and without knee osteoarthritis

OBJECTIVE

The objective of this study was to evaluate the effects of mechanical loading on knee articular cartilage T1ρ and T2 relaxation times in patients with and without osteoarthritis (OA).

DESIGN

Magnetic resonance (MR) images were acquired from 137 subjects with and without knee OA under two conditions: unloaded and loaded at 50% body weight. Three sequences were acquired: a high-resolution 3D-CUBE, a T1ρ relaxation time, and a T2 relaxation time sequences. Cartilage regions of interest included: medial and lateral femur (MF, LF); medial and lateral tibia (MT, LT), laminar analysis (superficial and deep layers), and subcompartments. Changes in relaxation times in response to loading were evaluated.

RESULTS

In response to loading, we observed significant reductions in T1ρ relaxation times in the MT and LT. In both the MF and LF, loading resulted in significant decreases in the superficial layer and significant increases in the deep layer of the cartilage for T1ρ and T2. All subcompartments of the MT and LT showed significant reduction in T1ρ relaxation times. Reductions were larger for subjects with OA (range: 13-19% change) when compared to healthy controls (range: 3-13% change).

CONCLUSIONS

Loading of the cartilage resulted in significant changes in relaxation times in the femur and tibia, with novel findings regarding laminar and subcompartmental variations. In general, changes in relaxation times with loading were larger in the OA group suggesting that the collagen-proteoglycan matrix of subjects with OA is less capable of retaining water, and may reflect a reduced ability to dissipate loads.

Quadriceps intramuscular fat fraction rather than muscle size is associated with knee osteoarthritis

OBJECTIVES

To compare thigh muscle intramuscular fat (intraMF) fractions and area between people with and without knee radiographic osteoarthritis (ROA); and to evaluate the relationships of quadriceps adiposity and area with strength, function and knee magnetic resonance imaging (MRI) lesions.

METHODS

Ninety six subjects (ROA: Kellgren-Lawrence (KL) > 1; n = 30, control: KL = 0, 1; n = 66) underwent 3-T MRI of the thigh muscles using chemical shift-based water/fat MRI (fat fractions) and the knee (clinical grading). Subjects were assessed for isometric/isokinetic quadriceps/hamstrings strength, function Knee injury and Osteoarthritis Outcome Score (KOOS), stair climbing test (SCT), and 6-minute walk test (6MWT). Thigh muscle intraMF fractions, muscle area and strength, and function were compared between controls and ROA subjects, adjusting for age. Relationships between measures of muscle fat/area with strength, function, KL and lesion scores were assessed using regression and correlational analyses.

RESULTS

The ROA group had worse KOOS scores but SCT and 6MWT were not different. The ROA group had greater quadriceps intraMF fraction but not for other muscles. Quadriceps strength was lower in ROA group but the area was not different. Quadriceps intraMF fraction but not area predicted self-reported disability. Aging, worse KL, and cartilage and meniscus lesions were associated with higher quadriceps intraMF fraction.

CONCLUSION

Quadriceps intraMF is higher in people with knee OA and is related to symptomatic and structural severity of knee OA, whereas the quadriceps area is not. Quadriceps fat fraction from chemical shift-based water/fat MR imaging may have utility as a marker of structural and symptomatic severity of knee OA disease process.

Differences between X-ray and MRI-determined knee cartilage thickness in weight-bearing and non-weight-bearing conditions

OBJECTIVE

Determine the effect of loading upon MRI-based mean medial femorotibial cartilage thickness (mMFT_th) and radiograph-based minimum joint space width (mJSW), and determine loading's effect on the relationship between these measures.

METHODS

MRI and radiographs were analyzed of 25 knees in weight-bearing and non-weight-bearing conditions. Eight subjects had a Kellgren-Lawrence (KL) grade of 0, indicating no evidence of radiographic OA. The rest were KL = 2 or KL = 3, indicating mild to moderate OA. The change from unloaded to loaded conditions was calculated.

RESULTS

Joint space measures decreased from unloaded to loaded conditions for both radiographs (mJSW = 3.29 mm unloaded to 3.16 mm loaded, P < 0.05) and MRI (mMFT_th = 2.70 mm unloaded to 2.55 mm loaded P < 0.001). The mean absolute difference measured from radiographs was larger for the OA group than the control group, at -0.20 mm for OA vs +0.01 mm for control. Loaded X-ray and loaded MRI joint space values from our study were no better correlated to one another than loaded X-ray and unloaded MRI.

CONCLUSION

Knee loading does not add a very significant value to the study of joint space on healthy knees, but loading may play a role in the study of OA knees. Unloaded MRI assessments of cartilage thickness are as correlated to loaded JSW as to loaded MRI measurements. More study is necessary to determine whether loaded MRI adds significant value to the study of OA progression.

Basilar artery aneurysm at a persistent trigeminal artery junction. A case report and literature review

The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature.

Local tissue properties of human osteoarthritic cartilage correlate with magnetic resonance T(1) rho relaxation times

The objective of this study is to examine the local relationship between T(1ρ) relaxation times and the mechanical behavior of human osteoarthritic articular cartilage using high-resolution magnetic resonance imaging (MRI) and local in situ microindentation. Seven human tibial plateaus were obtained from patients who underwent total knee arthroplasty due to severe osteoarthritis (OA). Three to six sites were selected from each sample for visual classification using the ICRS Outerbridge scale (a total of 36 sites). Samples were imaged by MR, and the local distribution of T(1ρ) relaxation times were obtained at these selected sites. The elastic and viscoelastic characteristics of the tissue were quantified nondestructively using dynamic microindentation to measure peak dynamic modulus, energy dissipation, and phase angle. Measured Outerbridge scores, MR T(1ρ) relaxation times, and mechanical properties were highly heterogeneous across each cartilage surface. Site-specific measures of T(1ρ) relaxation times correlated significantly with the phase angle (p < 0.001; R = 0.908), a viscoelastic mechanical behavior of the cartilage. The novel combination of high-resolution MR imaging and microindentation allows the investigation of the local relationship between quantitative MRI and biomechanical properties in highly heterogeneous OA cartilage. These findings suggest that MRI T(1ρ) can provide a functional assessment of articular cartilage.

The effects of acute loading on T1rho and T2 relaxation times of tibiofemoral articular cartilage

OBJECTIVE

To evaluate the effect of acute loading on healthy and osteoarthritic knee cartilage T(1ρ) and T(2) relaxation times.

DESIGN

Twenty subjects with radiographic evidence of osteoarthritis (OA) and 10 age-matched controls were enrolled. Magnetic resonance imaging (MRI) acquisition, including T(1ρ) and T(2) map sequences were performed unloaded and loaded at 50% body mass. Cartilage masks were segmented semi-automatically on registered high-resolution spoiled gradient-echo (SPGR) images for each compartment (medial and lateral). Cartilage lesions were identified using a modified Whole Organ Magnetic Resonance Imaging Score (WORMS) score. Statistical differences were explored using separate two-way (group×loading condition) Analysis of Variance (ANOVA) using age as a covariate to evaluate the effects of loading on T(1ρ) and T(2) relaxation times.

RESULTS

A significant decrease in T(1ρ) (44.5±3.8 vs 40.2±4.8ms for unloaded and loaded, respectively; P<0.001) and T(2) (31.8±3.8 vs 30.5±4.8ms for unloaded and loaded, respectively; P<0.001) relaxation times was observed in the medial compartment with loading while no differences were observed in the lateral compartment. This behavior occurred independent of WORMS score. Cartilage compartments with small focal lesions experienced greater T(1ρ) change scores with loading when compared to cartilage without lesions or cartilage with larger defects (P=0.05).

CONCLUSIONS

Acute loading resulted in a significant decrease in T(1ρ) and T(2) relaxation times of the medial compartment, with greater change scores observed in cartilage regions with small focal lesions. These data suggest that changes of T(1ρ) values with loading may be related to cartilage biomechanical properties (i.e., tissue elasticity) and may be a valuable tool for the scientist and clinician at identifying early cartilage disease.

Spatial analysis of egg distribution and geographic changes in the spawning habitat of the Brazilian sardine Sardinella brasiliensis

This paper establishes the spawning habitat of the Brazilian sardine Sardinella brasiliensis and investigates the spatial variability of egg density and its relation with oceanographic conditions in the shelf of the south-east Brazil Bight (SBB). The spawning habitats of S. brasiliensis have been defined in terms of spatial models of egg density, temperature-salinity plots, quotient (Q) analysis and remote sensing data. Quotient curves (Q(C)) were constructed using the geographic distribution of egg density, temperature and salinity from samples collected during nine survey cruises between 1976 and 1993. The interannual sea surface temperature (SST) variability was determined using principal component analysis on the SST anomalies (SSTA) estimated from remote sensing data over the period between 1985 and 2007. The spatial pattern of egg occurrences in the SBB indicated that the largest concentration occurred between Paranaguá and São Sebastião. Spawning habitat expanded and contracted during the years, fluctuating around Paranaguá. In January 1978 and January 1993, eggs were found nearly everywhere along the inner shelf of the SBB, while in January 1988 and 1991 spawning had contracted to their southernmost position. The SSTA maps for the spawning periods showed that in the case of habitat expansion (1993 only) anomalies over the SBB were zero or slightly negative, whereas for the contraction period anomalies were all positive. Sardinella brasiliensis is capable of exploring suitable spawning sites provided by the entrainment of the colder and less-saline South Atlantic Central Water onto the shelf by means of both coastal wind-driven (to the north-east of the SBB) and meander-induced (to the south-west of the SBB) upwelling.

[Heart surgery in Brazilian Indians]

PURPOSE

Our experience with surgical treatment of heart diseases in Indians living in the Amazon rain forest in primitive stages was reviewed.

METHODS

From 1988 to 1995, 18 patients underwent cardiovascular surgical procedures at the São Paulo Hospital of the Escola Paulista de Medicina. Seven patients had valvar disease, nine congenital heart defects, one submitral aneurysm and one arrhythmia. Thirteen Indians came from tribes of the Amazon rain forest area: three from the Xavante, two from Waiapi, two from Tucano, two from Macuxi, two from Mayoruna, and one of each tribe of Xikrin, Guajajara, Terena, Surui, Galibi, Cinta-Larga and Pataxó.

RESULTS

We performed 22 operations, with two hospital deaths. Follow-up was possible in 87.5% of cases, with one late death. The majority of cases were due to congenital heart defects and in this series it was noted the absence of operations to treat coronary artery disease. The incidence of valve disease was higher in accultured or semi-accultured Indians.

CONCLUSION

The surgical treatment of cardiovascular disease has made possible to the surviving indians to return to and be accepted by their fellow tribesmen.