Physical training improves cardiopulmonary functional capacity and increases cytokine IL-10 levels in individuals with Chagas disease

Purpose: To evaluate cardiopulmonary functional capacity and the production of cytokines in patients with and without Chagas disease, and with and without hypertension, after short and long-term exercise.Methods: In a case-controlled study, 56 participants who attended the Chagas Disease Laboratory at the State University of Maringa (LDC/UEM) and Basic Health Units (UBS) in Maringa that agreed to participate. The participants were divided into the following groups: 16 with Chagas disease (CHD group), 21 with systemic arterial hypertension (SAH group) and 19 normal individuals without these morbidities (NI group). Each participant performed the 6-min walk test (6MWT), and a 12-week physical training program. Pro-inflammatory and anti-inflammatory cytokines were measured before and after physical training.Results: The CHD group presented good performance in the 6MWT, with no significant differences in distance traveled or perceived exertion (p > 0.05) compared with the NI group. After physical training, the 6MWT results were significantly better, with significant decreases in systolic and diastolic blood pressure, in the SAH group (p = 0.0409; and p = 0.0377, respectively) and NI group (p = 0.0180; and p = 0.0431, respectively) and a significant increase in the levels of the anti-inflammatory cytokine interleukin-10 (IL-10; p < 0.05) in all three groups. The NI group exhibited a significant increase (p < 0.05) in the serum levels of the pro-inflammatory cytokines IL-6, IL-17 and tumor necrosis factor (all p< 0.05).Conclusion: All of the participants presented improvements in cardiopulmonary functional capacity and good prognosis, indicating the protective effect of IL-10 production and the benefits of physical training.Keywords: Chagas disease, Six-minute walk test, Physical training, Cytokines, Cardiopulmonary function capacity, Hypertensio

Avaliação cognitiva, comportamental e funcional : doença de Alzheimer

A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer’s disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The MiniMental State Examination has clinical utility as a screening test, as do the multifunctional batteries (CAMCOG-R, ADAS-COG, CERAD and MDRS) for brief evaluations of several cognitive domains. There was sufficient evidence to recommend the CDR scale for clinical and severity assessment of dementia. Tests for Brazilian Portuguese are recommended by cognitive domain based on available data.Este artigo apresenta revisão e ampliação das recomendações sobre os testes e baterias empregados no Brasil para o diagnóstico e avaliação cognitiva, funcional e comportamental da demência na doença de Alzheimer (DA). De modo sistemático foi revista a literatura disponível (nas bases MEDLINE, LILACS e SCIELO) e os artigos foram avaliados e classificados por níveis de evidência, para se estabelecerem as recomendações. Para a avaliação funcional a recomendação é o uso das escalas IQCODE, DAFS-R, DAD, ADL-Q e Bayer para avaliação das atividades instrumentais da vida diária e escala Katz para avaliação das atividades básicas. Para avaliação dos sintomas neuropsiquiátricos foram recomendadas as escalas NPI e CAMDEX e a Cornell para depressão em demência. Como instrumento de rastreio deve-se utilizar o Mini-Exame do Estado Mental; quanto às baterias multifuncionais, pode-se aplicar CAMCOG-R, ADAS-COG, CERAD e MDRS, que avaliam brevemente várias funções cognitivas. Para avaliação clínica da demência e classificação de acordo com a gravidade é recomendada a escala CDR. São recomendados os testes por domínio cognitivo baseados nas evidências disponíveis para uso na nossa língua

Abstracts

Resumos, em língua inglesa, dos artigos publicados nesta edição.Resumos, para a língua inglesa, dos artigos publicados nesta edição

New 99mTc-Labeled Digitoxigenin Derivative for Cancer Cell Identification

In recent years, cardiac glycosides (CGs) have been investigated as potential antiviral and anticancer drugs. Digitoxigenin (DIG) and other CGs have been shown to bind and inhibit Na+/K+-adenosinetriphosphatase (ATPase). Tumor cells show a higher expression rate of the Na+/K+-ATPase protein or a stronger affinity towards the binding of CGs and are therefore more prone to CGs than non-tumor cells. Cancer imaging techniques using radiotracers targeted at specific receptors have yielded successful results. Technetium-99m (99mTc) is one of the radionuclides of choice to radiolabel pharmaceuticals because of its favorable physical and chemical properties along with reasonable costs. Herein, we describe a new Na+/K+-ATPase targeting radiotracer consisting of digitoxigenin and diethylenetriaminepentaacetic acid (DTPA), a bifunctional chelating ligand used to prepare 99mTc-labeled complexes, and its evaluation as an imaging probe. We report the synthesis and characterization of the radiolabeled compound including stability tests, blood clearance, and biodistribution in healthy mice. Additionally, we investigated the binding of the compound to A549 human non-small-cell lung cancer cells and the inhibition of the Na+/K+-ATPase by the labeled compound in vitro. The 99mTc-labeled DTPA–digitoxigenin (99mTc-DTPA–DIG) compound displayed high stability in vitro and in vivo, a fast renal excretion, and a specific binding towards A549 cancer cells in comparison to non-tumor cells. Therefore, 99mTc-DTPA–DIG could potentially be used for non-invasive visualization of tumor lesions by means of scintigraphic imaging

Histomorphometric analysis of inflammatory response and necrosis in re-implanted central incisor of rats treated with low-level laser therapy

Low-level laser therapy is a tool employed in the management of post-operative inflammation process and in the enhancement of reparative process. The aim of the study was to perform histological evaluation of dental and periodontal ligament of rats central upper-left incisor teeth re-implanted and irradiated with low-level laser (InGaAl, 685 nm, 50 J/cm2) 15, 30, and 60 days after re-implantation. Seventy-two male rats had the central upper left incisor removed and kept for 15 min on dry gauze before replantation. Laser was irradiated over the root surface and empty alveolus prior replantation and over surrounding mucosa after the re-implantation. After histological procedures, all slices were analyzed regarding external resorption area and histological aspects. We observed an increase of root resorption (p < 0.05) in the control group compared to the laser group at 15, 30, and 60 days. These results showed that the laser groups developed less root resorption areas than the control group in all experimental periods. Additionally, histological analysis revealed less inflammatory cells and necrotic areas in laser groups

Indução da atividade fagocitária e produção de óxido nítrico numa população natural de Trypanosoma cruzi I e II do Estado do Paraná, Brasil

Twelve strains of Trypanosoma cruzi isolated from wild reservoirs, triatomines, and chronic chagasic patients in the state of Paraná, southern Brazil, and classified as T. cruzi I and II, were used to test the correlation between genetic and biological diversity. The Phagocytic Index (PI) and nitric-oxide (NO) production in vitro were used as biological parameters. The PI of the T. cruzi I and II strains did not differ significantly, nor did the PI of the T. cruzi strains isolated from humans, triatomines, or wild reservoirs. There was a statistical difference in the inhibition of NO production between T. cruzi I and II and between parasites isolated from humans and the strains isolated from triatomines and wild reservoirs, but there was no correlation between genetics and biology when the strains were analyzed independently of the lineages or hosts from which the strains were isolated. There were significant correlations for Randomly Amplified Polymorphic Deoxyribonucleic acid (RAPD) and biological parameters for T. cruzi I and II, and for humans or wild reservoirs when the lineages or hosts were considered individually.Doze cepas de Trypanosoma cruzi isoladas de reservatórios silvestres, triatomíneos e de pacientes chagásicos crônicos do Estado do Paraná, Brasil, classificadas como Tc I e II foram usadas para avaliar a correlação entre genética e diversidade biológica. Índice fagocítico (IF) e produção de óxido nítrico (ON) in vitro foram os parâmetros biológicos utilizados. O IF de cepas T. cruzi I e II não diferiram significativamente assim como o IF de cepas isoladas de humanos, triatomíneos ou de reservatórios silvestres. Há diferença estatística na inibição da produção de ON entre T. cruzi I e II e entre parasitos isolados de humanos e de cepas isoladas de triatomíneos e reservatórios silvestres, mas não foi observada correlação entre genética e biologia quando as cepas foram analisadas independentemente da linhagem ou hospedeiros das quais elas foram isoladas. Observou-se correlação significativa para amplificação aleatória do DNA polimórfico e parâmetros biológicos de Tc I ou II e para os seres humanos ou reservatório silvestre quando linhagens ou hospedeiros são consideradas separadamente

Freqüência de infecção por Toxocara em crianças atendidas em serviço público de Maringá, sul do Brasil

The lack of specific laboratorial diagnosis methods and precise symptoms makes the toxocariasis a neglected disease in Public Health Services. This study aims to determine the frequency of Toxocara spp. infection in children attended by the Health Public Service of Hospital Municipal de Maringá, South Brazil. To evaluate the association of epidemiological and clinical data, an observational and cross-section study was carried out. From 14,690 attended children/year aged from seven month to 12 years old, 450 serum samples were randomly collected from September/2004 to September/2005. A questionnaire was used to evaluate epidemiological, clinical and hematological data. An ELISA using Toxocara canis larval excretory-secretory products as antigen detected 130 (28.8%) positive sera, mainly between children from seven month to five years old (p = 0.0016). Significant correlation was observed between positive serology for Toxocara, and frequent playing in sandbox at school or daycare center (p = 0.011) and the presence of a cat at home (p = 0.056). From the families, 50% were dog owners which exposed soil backyards. Eosinophilia (p = 0.776), and signs and symptoms analyzed (fever p = 0.992, pneumonia p = 0.289, cold-like symptoms p = 0.277, cough p = 0.783, gastrointestinal problems p = 0.877, migraine p = 0.979, abdominal pain p = 0.965, joint pain p = 0.686 and skin rash p = 0.105) could not be related to the presence of anti-Toxocara antibodies. Therefore, two asthmatics children showed titles of 1:10,240 and accentuated eosinophilia (p = 0.0001). The authors emphasize the needs of prevention activities.A falta de métodos de diagnóstico laboratorial específico e sintomas específicos fazem da toxocaríase uma doença negligenciada nos serviços públicos de saúde. Este estudo teve por objetivo determinar a freqüência de infecção por Toxocara spp. em crianças atendidas no serviço público do Hospital Municipal de Maringá, sul do Brasil, e avaliar a associação com dados epidemiológicos e clínicos, em estudo observacional e transversal. De 14.690 crianças/ano atendidas, com idade entre sete meses a 12 anos, foram coletados 450 soros de setembro/2004 a setembro/2005. Um questionário foi utilizado para avaliar dados epidemiológicos, clínicos e hematológicos. Pelo teste ELISA, com antígeno de excreção/secreção de larvas de Toxocara canis, detectou-se 130 (28,8%) soros positivos, principalmente em crianças entre sete meses e cinco anos (p = 0,0016). Houve significante correlação entre sorologia positiva para Toxocara e freqüente recreação das crianças em caixas de areia da escola ou pré escola (p = 0,011) e presença do gato no domicilio (p = 0,056). Das famílias dessas crianças, 50% possuíam cachorros e o quintal com solo exposto. Eosinofilia (p = 0,776), sinais e sintomas (febre p = 0,992, pneumonia p = 0,289, resfriado p = 0,277, tosse p = 0,783, problema gastrointestinal p = 0877, dor de cabeça p = 0,979, dor abdominal p = 0,965, dores articulares p = 0,686, urticária p = 0,105) não se correlacionaram com a soropositividade. Todavia, duas crianças asmáticas apresentaram títulos de 1:10.240 (>; 1:320) e acentuada eosinofilia (p = 0.0001). Os autores enfatizam a necessidade de atividades preventivas

Perfil da mortalidade infantil em Petrolina (PE) entre os anos de 1994 a 2005

Infant mortality is a public health problem that has experienced reductions in recent years in Brazil, due to better conditions of life and investments to promote maternal and child health. The aim of this study was to evaluate the profile of infant mortality in Petrolina-PE, between the years 1994 to 2005. There has been research that are descriptive and quantitative, using indicators of live births and infant mortality, describing the profile of infant mortality in Petrolina. We applied the system DATASUS for data collection, and the income was through graphs and tables. In the data analysis, we observed that, in Petrolina over the 12 years studied was an average of 25 infant deaths per thousand live births. In an attempt to minimize the mortality public health policies need to be more effective actions, with focus to education in maternal and child health, and invest in the achievement of pre-natal to better quality.A mortalidade infantil é um problema de saúde pública que vem sofrendo reduções nos últimos anos no Brasil, devido às melhores condições de vida da população e investimentos de promoção à saúde materno-infantil. O objetivo deste estudo foi avaliar o perfil da mortalidade infantil em Petrolina (PE), entre os anos de 1994 a 2005. Foi desenvolvida uma pesquisa de caráter descritivo e quantitativo, utilizando-se os indicadores de nascidos vivos e mortalidade infantil e descrevendo-se o perfil da mortalidade infantil em Petrolina. Empregou-se o sistema DATASUS para a coleta de dados, e a demonstração dos resultados ocorreu através de gráficos e tabelas. Na análise dos dados, observou-se que, em Petrolina, durante os 12 anos estudados, ocorreu uma média de 25 mortes infantis por mil nascidos vivos. Na tentativa de minimizar a mortalidade infantil, as políticas públicas de saúde necessitam de ações mais efetivas, com enfoque para a educação em saúde materno-infantil, além de investimentos na realização de um pré-natal de melhor qualidade