Phosphatidylserine Exposure by Toxoplasma gondii Is Fundamental to Balance the Immune Response Granting Survival of the Parasite and of the Host

Phosphatidylserine (PS) exposure on the cell surface indicates apoptosis, but has also been related to evasion mechanisms of parasites, a concept known as apoptotic mimicry. Toxoplasma gondii mimics apoptotic cells by exposing PS, inducing secretion of TGF-beta1 by infected activated macrophages leading to degradation of inducible nitric oxide (NO) synthase, NO production inhibition and consequently persisting in these cells. Here PS+ and PS− subpopulation of tachyzoites were separated and the entrance mechanism, growth and NO inhibition in murine macrophages, and mice survival and pathology were analyzed. Infection index in resident macrophages was similar for both PS subpopulations but lower when compared to the total T. gondii population. Growth in resident macrophages was higher for the total T. gondii population, intermediate for the PS+ and lower for the PS− subpopulation. Production of NO by activated macrophages was inhibited after infection with the PS+ subpopulation and the total populations of tachyzoites. However, the PS− subpopulation was not able to inhibit NO production. PS+ subpopulation invaded macrophages by active penetration as indicated by tight-fitting vacuoles, but the PS− subpopulation entered macrophages by phagocytosis as suggested by loose-fitting vacuoles containing these tachyzoites. The entrance mechanism of both subpopulations was confirmed in a non-professional phagocytic cell line where only the PS+ tachyzoites were found inside these cells in tight-fitting vacuoles. Both subpopulations of T. gondii killed mice faster than the total population. Clear signs of inflammation and no tachyzoites were seen in the peritoneal cavity of mice infected with the PS− subpopulation. Moreover, mice infected with the PS+ subpopulation had no sign of inflammation and the parasite burden was intense. These results show that PS+ and PS− subpopulations of T. gondii are necessary for a successful toxoplasma infection indicating that both subpopulations are required to maintain the balance between inflammation and parasite growth

Adherence To Diabetes Mellitus Treatments In Family Health Strategy Units


Estudo transversal que teve como objetivo analisar a adesão ao tratamento medicamentoso e não medicamentoso em 17 unidades da Estratégia Saúde da Família (ESF). Participaram 423 pacientes com diabetes mellitus tipo 2 selecionados por meio de amostragem aleatória estratificada, nas unidades da ESF de um município do interior de Minas Gerais, em 2010. Os resultados mostraram que a adesão ao tratamento medicamentoso foi superior a 60% nas 17 unidades investigadas; em relação à atividade física foi superior a 60% em 58,8% das unidades; entretanto, para o plano alimentar, foi nula em 52,9% das unidades. Conclui-se que a adesão ao tratamento medicamentoso foi alta na maioria das unidades; a prática de atividade física foi heterogênea e, em relação ao plano alimentar foi baixa em todas as unidades. Recomenda-se o fortalecimento das diretrizes institucionais e estratégias educativas, em consonância com as diretrizes do SUS, para o enfrentamento dos desafios impostos pela falta de adesão.
Estudio transversal, cuyo objetivo fue analizar la adherencia al tratamiento farmacológico y no farmacológico en 17 unidades de Estrategia Salud de la Familia (ESF). Participaron 423 pacientes con diabetes mellitus tipo 2 seleccionados mediante muestreo aleatorio estratificado en unidades de ESF de un municipio de Minas Gerais en el año 2010. Los resultados mostraron que la tasa de prevalencia de la adherencia al tratamiento farmacológico fue superior a 60% en las 17 unidades investigadas; en relación a la actividad física, ésta fue superior a 60% en el 58,8% de las unidades; y para el plan de alimentación, no tuvo efecto en 52,9% de las unidades. Se concluye que: la adherencia al tratamiento farmacológico fue alta en la mayoría de las unidades, la práctica de actividad física fue heterogénea y la adherencia a la dieta fue baja en todas las unidades. Se recomienda el fortalecimiento de las normas institucionales y estrategias educativas en consonancia con las directrices del SUS para hacer frente a los desafíos impuestos por la falta de adherencia.This cross-sectional study aimed to analyze the adherence to drug and non-drug treatments in 17 Family Health Strategy units. A total of 423 patients with type 2 diabetes mellitus were selected through stratified random sampling in Family Health Strategy units of a city in the state of Minas Gerais, Brazil, in 2010. The results showed that the prevalence rate of adherence to drug therapy was higher than 60% in the 17 units investigated; in relation to physical activity, adherence was higher than 60% in 58.8% units; and for the diet plan, there was no adherence in 52.9% units. Therefore, we concluded that adherence to drug therapy in most units was high and the practice of physical activity was heterogeneous, and in relation to diet adherence, it was low in all units. We recommend strengthening of institutional guidelines and educational strategies, in line with SUS guidelines, so that, professionals may face the challenges imposed by the lack of adherence.


Energy metabolism: gluconeogenesis and oxidative phosphorylation

Most animal cells are able to meet their energy needs from the oxidation of various types of compounds: sugars, fatty acids, amino acids, but some tissues and cells of our body depend exclusively on glucose and the brain is the largest consumer of all. That is why the body has mechanisms in order to keep glucose levels stable. As it decreases, the degradation of hepatic glycogen occurs, which maintains the appropriate levels of blood glucose allowing its capture continues by those tissues, even in times of absence of food intake. But this reserve is limited, so another metabolic pathway is triggered for glucose production, which occurs in the kidneys and liver and is called gluconeogenesis, which means the synthesis of glucose from non-glucose compounds such as amino acids, lactate, and glycerol. Most stages of glycolysis use the same enzymes as glycolysis, but it makes the opposite sense and differs in three stages or also called deviations: the first is the conversion of pyruvate to oxaloacetate and oxaloacetate to phosphoenolpyruvate. The second deviation is the conversion of fructose 1,6 biphosphate to fructose 6 phosphate and the third and last deviation is the conversion of glucose 6 phosphate to glucose

Overview of University Actions Aimed at The Nutrition of Two Indigenous Communities In The Interior of The State of Mato Grosso Do Sul – Brazil: Report of Experience In Public Policies

The diet composed of adequate food is reported in the literature as one of the aspects of health promotion and maintenance, and it is the duty and obligation of the State to promote public policies that seek to meet these needs of the population. However, due to a number of factors, the minority or vulnerable populations end up not benefiting from a good part of the projects in force in Brazil. Thus, this work aimed to conduct a case study with two indigenous communities living in the interior of the State of Mato Grosso do Sul, listing the main points related to food practices, evaluation of the state of health in force and measures that help adherence to good food practices. The largest target audience was children from 0 (zero) to 12 (twelve) years, totaling 190 (one hundred and ninety), followed by newborns and puerperals who totaled 14 (fourteen) family nuclei and the elderly population of the community, which totaled 15 (fifteen). The service team was composed of Nutritionist, Health Agent, Social Worker and Nutrition Intern professionals. Several activities were developed, occurring according to the public attended during the different days of visit in the villages, mainly home visits, community actions such as vaccination campaigns, lectures and collective guidance. It is concluded that the measures adopted in public policies related to feeding the indigenous community is a powerful tool to provide the benefits for a better quality of life, well-being and maintenance of the health of indigenous peoples

Food Science from the Perspective of the Nutrition Professional

This work had as thematic the study in analysis of foods from the perspective of the nutrition professional. The objective of the research was to seek the training of this professional for the then analysis of the performance in quality control and formulation of products, with the perspective of assistance to projects carried out on site. This research was conducted in a community cafeteria located in a university in the interior of the State of Mato Grosso do Sul - Brazil. As a data collection tool, preparation technical sheets were used in which costs were collected, the preparation order, and the nutritional value provided. Sensory observation was used as an analysis of the data in order to measure and analyze and interpret the reactions of food and material characteristics. It appears that with the identification, attributions and activities developed by a nutritionist in the area, it became possible to analyze the processing of raw material and industrialized food products, according to the needs presented by the site. As for the points not reached were not due to any other factors than those related to the specificities of the research site, which did not prevent the acquisition of theoretical, practical, scientific, social and environmental knowledge of the points concerning the area of action of the nutritionist professional within the field of food science

Nutritional Intervention in the Area of Clinical Nutrition in a Hospital Environment: A Report of Field Experience

The present experience report narrates a nutritional intervention in the area of individual and collective clinical nutrition that took place in a University Hospital (HU) in the interior of the State of Mato Grosso do Sul - Brazil. The main objective of this field work was the professional training for hospital and outpatient nutritional care through general and specific activities performed on site. The specific activities consisted in writing care protocols and standardization of hospital diets while the general activities consisted in the analysis of medical records, survey of clinical diagnoses, proposal of dietotherapic conduct, monitoring of nutritional status, prescription and dietary adequacy, preparation of nutritional guidelines and development, presentation and discussion of clinical cases. This work also reports on the difficulties in implementing and carrying out this intervention agenda and, given the results obtained, it was concluded that the field experience in the hospital area was a valid and beneficial opportunity in which it was possible to harmonize theory with practice

Abscesso hepático por Tuberculose em paciente com HIV: um relato de caso / Liver abscess by Tuberculosis IN HIV patient: a case report

A tuberculose é uma doença infectocontagiosa causada pelo Mycobacterium tuberculosis, comum em países em desenvolvimento. Os acomentimentos pulmonares são as principais manifestações da doença, embora existam, também, manifestações extrapulmonares, as quais são mais comuns em pacientes imunocomprometidos, a exemplo dos pacientes coinfectados com o HIV. O abscesso hepático é a forma menos comum de lesão. Entretanto, quando analisadas as taxas de mortalidade e os resultados dos tratamentos, é uma das manifestações extrapulmonares com pior prognóstico. O caso relatado segue com o diagnóstico através dos sinais e sintomas clínicos, além da realização dos exames laboratoriais e de imagem, a fim de diagnosticar e indicar os tratamentos cirúrgico e medicamentoso para tratar a infecção e sua consequente manifestação

AVALIAÇÃO DA ATIVIDADE ANTIFÚNGICA DOS FRUTOS VERDES E MADUROS DE Solanum lycocarpum FRENTE À Candida albicans e Candida krusei

A espécie Solanum lycocarpum é usada na medicina popular e possui atividade antibacteriana descrita na literatura. O objetivo do estudo foi avaliar a atividade antifúngica dos frutos de S. lycocarpum frente a Candida albicans (ATCC 18804) e Candida krusei (ATCC 20298). Os frutos maduros e verdes foram coletados, extraídos em Sohxlet, obtendo-se o extrato etéreo dos frutos verdes e o extrato etéreo dos frutos maduros, que assim como o antifúngico cetoconazol, a combinação (extratos e cetoconazol) foram testados em concentrações entre 15-2000 g/mL e determinada a Concentração Inibitória Mínima e a Concentração Fungicida Mínima. A combinação do extrato etéreo dos frutos verdes e cetoconazol e do extrato etéreo dos frutos maduros e cetoconazol exibiram atividade antifúngica frente as duas espécies de Candida, principalmente frente a C. albicans, destacando o efeito sinérgico entre o extrato etéreo dos frutos maduros e cetoconazol (CIM e CFM de 15 g/mL). Os resultados demonstram a ação antifúngica para os frutos verdes e maduros de S. lycocarpum.

AVALIAÇÃO DA ATIVIDADE ANTIFÚNGICA DOS FRUTOS VERDES E MADUROS DE Solanum lycocarpum FRENTE À Candida albicans e Candida krusei

A espécie Solanum lycocarpum é usada na medicina popular e possui atividade antibacteriana descrita na literatura. O objetivo do estudo foi avaliar a atividade antifúngica dos frutos de S. lycocarpum frente a Candida albicans (ATCC 18804) e Candida krusei (ATCC 20298). Os frutos maduros e verdes foram coletados, extraídos em Sohxlet, obtendo-se o extrato etéreo dos frutos verdes e o extrato etéreo dos frutos maduros, que assim como o antifúngico cetoconazol, a combinação (extratos e cetoconazol) foram testados em concentrações entre 15-2000 g/mL e determinada a Concentração Inibitória Mínima e a Concentração Fungicida Mínima. A combinação do extrato etéreo dos frutos verdes e cetoconazol e do extrato etéreo dos frutos maduros e cetoconazol exibiram atividade antifúngica frente as duas espécies de Candida, principalmente frente a C. albicans, destacando o efeito sinérgico entre o extrato etéreo dos frutos maduros e cetoconazol (CIM e CFM de 15 g/mL). Os resultados demonstram a ação antifúngica para os frutos verdes e maduros de S. lycocarpum.

Coxsackievirus A6 strains causing an outbreak of hand-foot-and-mouth disease in Northeastern Brazil in 2018

Hand-foot-and-mouth disease (HFMD) is a highly contagious viral disease commonly associated to Enteroviruses (EV). During 2018, Brazil faced massive HFMD outbreaks spread across the country. This study aimed to characterize the EV responsible for the HFMD outbreak that occurred in Paraiba State, Brazilian Northeastern region, in 2018, followed by a phylogenetic analysis to detail information on its genetic diversity. A total of 49 serum samples (one from each patient) collected from children ≤ 15 years old, clinically diagnosed with HFMD were tested for EV using conventional RT-PCR and RT-qPCR. EV infection was confirmed in 71.4% (35/49) of samples. The mean and median ages were 1.83 years and one year old, respectively. Twenty-two EV-positive samples were successfully sequenced and classified as EV-A species; 13 samples were also identified with the CV-A6 genotype. The phylogenetic analysis (VP1 region) of three samples revealed that the detected CV-A6 strains belonged to sub-lineage D3. The CV-A6 strains detected here clustered with strains from South America, Europe and West Asia strains that were also involved in HFMD cases during the 2017-2018 seasons, in addition to the previously detected Brazilian CV-A6 strains from 2012 to 2017, suggesting a global co-circulation of a set of different CV-A6 strains introduced in the country at different times. The growing circulation of the emerging CV-A6 associated with HFMD, together with the detection of more severe cases worldwide, suggests the need for a more intense surveillance system of HFMD in Brazil. In addition, this investigation was performed exclusively on serum samples, and the analysis of whole blood samples should be considered and could have shown advantages when employed in the diagnosis of enteroviral HFMD outbreaks