2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Valores de referência para plumbemia em uma população urbana do Sul do Brasil Reference values for lead in blood in an urban population in southern Brazil

Objetivo. Descrever os valores de referência para chumbo em sangue em uma população urbana do Município de Londrina, Estado do Paraná, Brasil. Métodos. A população de referência foi constituída por 520 voluntários adultos avaliados de novembro de 1994 a dezembro de 1996. Os critérios de exclusão foram: exposição ocupacional ao chumbo, exposição através de hábitos, fumar mais de 10 cigarros por dia e morar perto de indústrias ou de locais que utilizam o chumbo em seus processos produtivos. Também foram excluídos indivíduos com valores de exames clínicos e laboratoriais fora da normalidade, doenças crônicas e distúrbios cardiovasculares. Os teores de chumbo em sangue foram determinados por espectrofotometria de absorção atômica com chama de ar-acetileno. O limite de detecção obtido foi 1,23 mig/dL. Após as análises de chumbo em sangue, foram determinados valor mínimo, primeiro quartil, mediana, terceiro quartil e valor máximo; média geométrica; intervalo de confiança de 95%; intervalo experimental; e valor de referência. Resultados. Os valores de referência para plumbemia variaram de 1,20 a 13,72 mig/dL. A média geométrica foi igual a 5,5 mig/dL. Conclusões. Em geral, os valores obtidos no presente estudo são mais baixos do que aqueles obtidos em outros países. Estudos adicionais deveriam enfocar a obtenção de valores de referência em outras populações brasileiras que vivem em regiões mais industrializadas.<br>Objective. To describe the reference values for lead in blood in an urban population in the city of Londrina, in the state of Paraná, Brazil. Materials and methods. The reference population was composed of 520 adult volunteers who were assessed from November 1994 to December 1996. Exclusion criteria were: occupational exposure to lead, exposure through personal habits or practices, smoking more than 10 cigarettes per day, and living near industrial plants or other places that use lead in their production processes. Also excluded were individuals with abnormal clinical or laboratory results or with chronic diseases or cardiovascular disorders. Lead blood levels were determined using air-acetylene flame atomic absorption spectrophotometry. The detectable limit was 1.23 mug/dL. After the analyses of lead in blood, the following values were determined: minimum value, first quartile, median, third quartile, and maximum value; geometric mean; 95% confidence interval; experimental interval; and reference value. Results. The reference values for lead in blood ranged from 1.20 mug/dL to 13.72 mug/ dL. The geometric mean was 5.5 mug/dL. Conclusions. In general, the values found in this study are lower than those that have been reported for other countries. Additional data should be gathered from Brazilian populations living in more-industrialized areas

A 'teoria da práxis': retomando o referencial marxista para o enfrentamento do capitalismo no campo da saúde The 'theory of praxis: ' retrieving the marxist framework to confront capitalism in the health field

Este ensaio tem a intenção de recolocar o marxismo - como corpo epistemológico, teórico, metodológico e político voltado para a superação do capitalismo - na pauta do debate conceitual e político do campo da Saúde Coletiva. Discute o campo simbólico como campo de expressão de ideologias que sustentam o capitalismo e que utiliza, dentre outras estratégias, o silenciamento sobre o marxismo, e mesmo sobre o capitalismo, para esvaziar a crítica e o questionamento político. Relaciona estes mecanismos à saúde, identificando alguns campos onde o capitalismo opera nesta área. Apresenta alguns fundamentos filosóficos, teóricos e metodológicos da 'teoria da práxis', destacando a unidade indissolúvel entre teoria crítica e ação transformadora. Por fim, conclama os profissionais, pesquisadores e educadores do campo sanitário a se (re)engajarem na luta contra o capitalismo, retomando a bandeira do socialismo, rumo à conquista do efetivo direito à saúde.<br>This essay is intended to retrieve Marxism - as an epistemological, theoretical, methodological and political body aimed toward overcoming Capitalism - in the political and conceptual debate agenda in field of Collective Health. It discusses the symbolic field as a field for the expression of ideologies that underpin capitalism and which uses, among other strategies,the silencing of Marxism, and even of capitalism, to eliminate criticism and political questioning. It relates these mechanisms to health, identifying some fields in which capitalism operates in this area. It presents a few philosophical, theoretical and methodological foundations of the 'theory of praxis,' highlighting the indissoluble unity between critical theory and transformative action. Finally, it urges health care practitioners, researchers and educators to (re)engage in the struggle against Capitalism, taking up the banner of Socialism aiming to achieve the actual right to health

Xylitol inhibits J774A.1 macrophage adhesion in vitro

The aim of this work was to evaluate the effect of xylitol on J774A.1 macrophage adhesion. Adhesion consisted of a three-hour interval, at room temperature, followed by washing and cell incubation at 37ºC/5% CO2/ 48h. Xylitol was used to treat the cells either before (for 24h) or after the cell incubation (for 48h) at 5% as final concentration in both the situations. It was found that xylitol was effective in preventing the adhesion in both the conditions in spite of the former being 100-fold greater and significant (p < 0.001). The results pointed to an important xylitol action on macrophage adhesion, which should be further investigated as an inflammatory control