Satisfação corporal e características de lipodistrofia em crianças e adolescentes com HIV/AIDS em uso de terapia antirretroviral de alta potência Body satisfaction and lipodystrophy characteristics in HIV/AIDS children and teenagers undergoing highly active antiretroviral therapy

OBJETIVO: Verificar a presença de alterações metabólicas e corporais e satisfação corporal em crianças e adolescentes em uso de terapia antirretroviral. MÉTODOS: Estudo transversal de 38 jovens entre seis e 18 anos infectados por HIV e atendidos entre dezembro de 2009 e maio de 2010. A satisfação corporal foi avaliada por escala de silhuetas, composta por 11 figuras. O estado nutricional foi avaliado por meio de mensurações de peso, altura, circunferências e pregas cutâneas. A presença de características de lipodistrofia foi avaliada pelo exame físico e o perfil lipídico e glicêmico foi solicitado no dia da consulta. Na análise estatística, aplicou-se o teste t e do qui-quadrado, sendo significante p<0,05. RESULTADOS: A maioria dos 38 jovens era eutrófica, com estatura adequada para idade, e 26% apresentavam sobrepeso/obesidade. O colesterol total esteve adequado em 29% dos pacientes. As mudanças corporais mais expressivas foram a lipo-hipertrofia na face e na região abdominal. A prevalência de insatisfação corporal foi de 84%. Crianças e adolescentes apresentaram níveis de insatisfação semelhantes; no entanto, as insatisfeitas com o excesso de peso mostravam valores médios mais elevados de índice de massa corporal e prega cutânea tricipital do que os satisfeitos, porém sem relação com a presença de lipodistrofia. CONCLUSÕES: A prevalência de insatisfação corporal nesta amostra não se associou com a lipodistrofia e foi semelhante à de indivíduos saudáveis. No entanto, as alterações morfológicas e bioquímicas requerem atenção das equipes multiprofissionais, de modo que se possam diminuir os riscos de novas enfermidades nos pacientes avaliados.<br>OBJECTIVE: To verify the presence of body and metabolic alterations as well as body satisfaction in children and teenagers undergoing antiretroviral therapy. METHODS: This cross-sectional study enrolled 38 HIV infected young individuals (aged six to 18 years old) treated from December 2009 to May 2010). The body satisfaction was assessed by the silhouette rating scale with 11 figures. The nutritional status was assessed by weight, height, circumferences and skinfolds. The presence of lipodystrophy characteristics was determined by the physical exam, and lipid profile and glycemia were requested during consultation. The statistical analysis used t-test and chi-square test, being significant p<0.05. RESULTS: Most of the 38 patients were eutrophic with length adequate for age; 26% of them presented overweight/obesity. The total cholesterol was within the normal range in 29% of the sample. The most expressive changes were cheek and abdominal lipohypertrophy. The body dissatisfaction prevalence was 84%. Children and teenagers had similar dissatisfaction levels; however, those dissatisfied by an excessive body weight had higher mean body mass index and tricipital skinfold thickness than the satisfied ones. The dissatisfaction was not associated with the presence of lipodystrophy. CONCLUSIONS: The prevalence of body dissatisfaction in these patients was not associated with lipodystrophy and was similar to the reported by healthy individuals. However, the morphological and biochemical alterations need multi-professional attention in order to decrease the risk of new diseases in HIV patients

Cyclotides: Macrocyclic peptides with applications in drug design and agriculture

Cyclotides are disulfide-rich peptides from plants that are exceptionally stable as a result of their unique cyclic cystine knot structural motif. Their natural role is thought to be as plant defence agents, most notably against insect pests, but they also have potential applications in drug design and agriculture. This article identifies gaps in current knowledge on cyclotides and suggests future directions for research into this fascinating family of ultra-stable mini-proteins. © Springe

Anaerobes as sources of bioactive compounds and health promoting tools

Aerobic microorganisms have been sources of medicinal agents for several decades and an impressive variety of drugs have been isolated from their cultures, studied and formulated to treat or prevent diseases. On the other hand, anaerobes, which are believed to be the oldest life forms on earth and evolved remarkably diverse physiological functions, have largely been neglected as sources of bioactive compounds. However, results obtained from the limited research done so far show that anaerobes are capable of producing a range of interesting bioactive compounds that can promote human health. In fact, some of these bioactive compounds are found to be novel in their structure and/or mode of action. Anaerobes play health-promoting roles through their bioactive products as well as application of whole cells. The bioactive compounds produced by these microorganisms include antimicrobial agents and substances such as immunomodulators and vitamins. Bacteriocins produced by anaerobes have been in use as preservatives for about 40 years. Because these substances are effective at low concentrations, encounter relatively less resistance from bacteria and are safe to use, there is a growing interest in these antimicrobial agents. Moreover, several antibiotics have been reported from the cultures of anaerobes. Closthioamide and andrimid produced by Clostridium cellulolyticum and Pantoea agglomerans, respectively, are examples of novel antibiotics of anaerobe origin. The discovery of such novel bioactive compounds is expected to encourage further studies which can potentially lead to tapping of the antibiotic production potential of this fascinating group of microorganisms. Anaerobes are widely used in preparation of fermented foods and beverages. During the fermentation processes, these organisms produce a number of bioactive compounds including anticancer, antihypertensive and antioxidant substances. The well-known health promoting effect of fermented food is mostly due to these bioactive compounds. In addition to their products, whole cell anaerobes have very interesting applications for enhancing the quality of life. Probiotic anaerobes have been on the market for many years and are receiving growing acceptance as health promoters. Gut anaerobes have been used to treat patients suffering from severe Clostridium difficile infection syndromes including diarrhoea and colitis which cannot be treated by other means. Whole cell anaerobes are also studied to detect and cure cancer. In recent years, evidence is emerging that anaerobes constituting the microbiome are linked to our overall health. A dysfunctional microbiome is believed to be the cause of many diseases including cancer, allergy, infection, obesity, diabetes and several other disorders. Maintaining normal microflora is believed to alleviate some of these serious health problems. Indeed, the use of probiotics and prebiotics which favourably change the number and composition of the gut microflora is known to render a health promoting effect. Our interaction with the microbiome anaerobes is complex. In fact, not only our lives but also our identities are more closely linked to the anaerobic microbial world than we may possibly imagine. We are just at the beginning of unravelling the secret of association between the microbiome and human body, and a clear understanding of the association may bring a paradigm shift in the way we diagnose and treat diseases and disorders. This chapter highlights some of the work done on bioactive compounds and whole cell applications of the anaerobes that foster human health and improve the quality of life