Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Determinantes envolvidos na resposta imune celular humana à infecção por Leishmania infantum chagasi

Visceral leishmaniasis (VL) is a disease caused by protozoa of the Leishmania donovani complex, whose infection has clinical spectrum ranging from asymptomatic infection to active disease characterized by fever, cachexia, hepatosplenomegaly, and immunosuppression. The healing or protective immunity require an antigen-specific type 1. The Montenegro skin test (DTH) has been interpreted as a marker of protective immunity. However, there is no known correlation between the DTH response to type 1 and DTH and immunity of type 1 are maintained in the long term. Thus, a longitudinal study of 8 years, nested in a cohort family held in Brazil, documented the status of DTH and cytokine production by peripheral blood mononuclear cells in response to antigen-specific stimulation. This study was the interdisciplinary approach of physicians, biochemists, nutritionists, veterinary medicine, biology and statistics. The results show that 46.2% of subjects were analyzed DTH positive at baseline. The prevalence of positive and DTH induration size increased with age (p = 0.0021). 15.7% of individuals positive DTH "retro-converted" the negative and 50.4% (64) of individuals negative DTH became positive. The size of DTH induration was correlated significantly with the antigen-induced production of IFN-γ (r = 0.6186, p = 0.0001). IL-6 was secreted at higher levels in peripheral blood mononuclear cells of individuals who "retro-converted" DTH positive to negative than individuals who remained stable DTH status (p = 0.005). Thus, IFN-γ produced by peripheral blood mononuclear cells, may be a surrogate marker for protective immunity instead of the DTH response. In addition, differences in innate immune response may determine whether individuals maintain or eliminate the infection by Leishmania infantum chagasi in asymptomatic patients

Risco de doença cardiovascular em mulheres com história de distúrbio hipertensivo da gravidez

OBJECTIVE: Preeclampsia is a disease that can lead to a high maternal and infant morbidity. Worldwide, the incidence of this disease is highly variable and there is no data on this disorder in the Brazilian population. This study aimed at determining incidence and risk factors in the hypertensive disorders during pregnancy in a neighborhood of Natal, in addition to observing the evolution of these disorders one year and five years after delivery. METHODS: Prospective cohort study to assess the outcome of pregnancies of 242 women who became pregnant between 2004-2007 in the neighborhood of Bom Pastor in the city of Natal, state of RN, Brazil. Five years after delivery, there was an active search of thirty-nine (39) women who became pregnant and had a hypertensive disorder during pregnancy and/or pré-eclâmpsia, out of the total of 242 participants in the initial study. We administered a structured questionnaire to obtain basic information about the current clinical situation of patients and occurrences of subsequent pregnancy and presence of hypertensive disorders during pregnancy. We also searched for information on the use of hypotensive drugs and contraceptives. The following characteristics were checked and recorded: a) current weight, b) blood pressure c) body mass index - BMI, and we collected biological samples (blood and urine) for measurement of biochemical parameters and evaluation of microalbuminúria. Finally, we monitored the ambulatory blood pressure (ABP), which uses the method of automatic measurement of heart rate, systolic and diastolic blood pressure and an average of the two for the period of 24 hours. RESULTS: Out of 218 women who completed the study, the incidence of hypertensive disorders was of 16.9% (37 out of 218), while the incidence of preeclampsia was 13.8% (30 of 218). Women with preeclampsia had a BMI (body mass index) averaged of 25.3 (± 4.8) while this ratio in normotensive women was of 23.5 (± 3.7), p = 0.02. The risk of preeclampsia rises with age (OR 1084 p = 0.0034) and with a family history of hypertension (OR 2.6 p = 0.01). The follow-up one year after delivery revealed that 50% of women with hypertensive disorders in pregnancy remained hypertensive. High BMI was also observed after 5 years of delivery. CONCLUSIONS: an elevated BMI, age above 35 years and excessive weight gain during pregnancy were associated with hypertension in the long term in patients with prior preeclampsia. History of preeclampsia increases the risk of chronic hypertension

Doença cardiovascular em mulheres com histórico de pré-eclâmpsia e seguimento no sistema único de saúde

The aim of the present study was to analyze cardiovascular risk of women with a history of preeclampsia, as well as its follow-upin the National Health System.This is a cross-sectional quantitative research conducted at the Januário Cicco Maternity School. The study population was composed of 573 women selected from a databank belonging to the Women s Health Research Group of the Gynecology Department at Universidade Federal do Rio Grande do Norte, with a history of preeclampsia, and normotensives who gave birth at this institution five years before. The final sample consisted of 147 women, 64 in the group with a history of PE and 83 normotensives. Data were collected on a questionnaire containing the following: sociodemographic aspects, anthropometric measures, life habits, personal and family history of pregnancy-induced hypertension, family history of cardiovascular diseases and frequency of measuring current blood pressure levels. In relation to the association between cardiovascular risk and altered blood pressure (≥130x85 mmHg), the likelihood of exhibiting the latter condition was significantly higher in women with a history of preeclampsia (CI 95% 4.12-38.92), the overweight and obese (CI 95% 1.70-20.75), and in those with a family historyof CVD and personal history of PIH (CI 95% 0.78-47.07 and CI 95% 3.20-25.39) respectively. Likewise, the probability of having altered blood pressure was higher in women with fasting glycemia ≥100mg/dL (CI 95% 2.09-24.73), as well as in those with triglycerides ≥150mg/dl (CI 95% 1.72-9.66). After fitting the logistic model, diagnosis previous preeclampsia and altered triglycerides remained as explanatory variables.The women with a history of preeclampsia five years before exhibited altered blood pressure levels, clinical and laboratory manifestations suggestive of elevated risk for cardiovascular disease, as well as family and personal history of hypertension. There is no differential treatment or adequate outpatient follow-up for this population in basic health care units

Avaliação dos parâmetros de estresse oxidativo no lúpus eritematoso

OBJECTIVE: The aim of this work was to analyse some oxidative stress parameters in patients of Systemic Lúpus Erythematosus. PATIENTS AND METHODS: Determinations of reduced glutathione content in whole blood were carried out. The activity of superoxide dismutase, gluthatione peroxidase and catalase in erythrocytes and the concentration of reactive substances of acid thiobarbituric in plasma of patients female (n =19) with SLE no activity of disease (Mex-SLEDAI < 2), with average ages of 32 ± 11 years, through the spectrophotometrical methods and from healthy individuals (n =30). Statistical data were analyzed by student t-test, p<0,05. RESULTS: Our data indicated a significant decrease on the activity of catalase and significant increase on the concentration of reactive substances of acid thiobarbituric in patients with SLE comparing with healthy individuals. There was no significant difference in other parameters. CONCLUSION: The results showed that oxidative stress has a role in the pathogenesis of the disease in SLE, even in patients without active disease.

Extração, caracterização e atividades biológicas de proteínas da espécie cnidoscolus urens (L.) Arthur

The extraction, chemical and structural characterization of a wide variety of compounds derived from plants has been a major source of bioactive molecules. Several proteases have been isolated in the plant kingdom, with numerous pharmacological and biotechnological applications. Among the proteases isolated from plants, are the fibrinogenolytic, with relevant application in the treatment of disorders in the coagulation cascade, in addition to potential use as a tool in clinical laboratories. In this study, in addition to evaluating the effects of the protein extract of Cnidoscolus urens (L.) Arthur (Euphorbiaceae) in the coagulation cascade also investigates the presence of antimicrobial activity and characterizes the proteolytic activity detected in this extract, aiming to determine their potential pharmacological and biotechnological application. In this way, crude protein extracts obtained from the leaves of C. urens in Tris-HCl 0.05M, NaCl 0.15M, pH 7.5, were precipitated in different concentrations of acetone, and assessed for the presence of proteolytic activity in azocaseína and fibrinogen. The most active fraction (F1.0) in these tests was chosen for assessment of biological activity and biochemical characterization. The Aα chain and Bβ of fibrinogen were completely cleaved at a concentration of 0.18 μg/μL of protein fraction in 4 minutes. Fibrinogenolytic activity presented total inhibition in the presence of E-64 and partial in the presence of EDTA. The fraction demonstrated coagulant activity in plasm and reduced the APTT, demonstrating acting on the factors coagulation of the intrinsic pathway and common, not exerting effects on the PT. Fibrinolytic activity on plasma clot was detected only in SDS-PAGE in high concentrations of fraction, and there were no defibrinating. Although several proteases isolated from plants and venomous animals are classically toxic, the fraction F1.0 of C. urens not expressed hemorrhagic nor hemolytic activities. Fraction F1.0 also showed no antimicrobial activity. In proteolytic activity on the azocasein, the optimal pH was 5.0 and optimum temperature of 60ºC. The enzyme activity has been shown to be sensitive to the presence of salts tested, with inhibition for all compounds. The surfactant triton did not influence the enzyme activity, but the tween-20 and SDS inhibited the activity. In the presence of reducing agents increase in enzyme activity occurred, a typical feature of enzymes belonging to the class of cysteine proteases. Several bands with proteolytic activity were detected in zymogram, in the region of high-molecular-weight, which were inhibited by E-64. In this study, we found that C. urens presents in its constitution cysteine proteases with fibrinogenolytic and procoagulant activity, which may be isolated, with potential application in treatment of bleeding disorders, thrombolytic and clinical laboratory

Poéticas de um saber brincar: a vez e a voz do fandango

The present thesis aims to get to know and to analyze the elements which make up the poetical performance of the Fandango from Canguaretama confirming/corroborating an eminently theatrical model. It still highlights the producers´ history, its asset production and its insertion in community where we had contact with two other types of performances: the daily and the ritualistic. Such actions both combine and present different meanings and objectives, promoting distinct readings and experiences. Looking at these three ways of performances poetic, daily, and ritual enabled to go deeper in cultural aspects of the studied community and, thus, check over what is going on in these events, how they accord with and conceive a popular performance context. The research could substantiate the existence of a theatrical model whose performance by means of the voice and active presence of playful bodies, implied in getting to know the consolidation of a cultural patrimony which reveals us the past, but, especially, the present, its people and its place

Estrutura econômica, mercado de trabalho e evolução sócio-ocupacional no Rio Grande do Norte 2001 a 2008: reflexo de uma condição mercantil e estruturalmente periférica

The aim of this thesis was to investigate the evolution of the socio-occupational status in Rio Grande do Norte from 2001 to 2008, based on the characterization of the socio-economic status of this State from the analysis of labor market norte-rio-grandense . The study, specifically, drew a comparison between the dynamics of the labor market in Rio Grande do Norte and the capital city, Natal. From this perspective, the purpose was to make a relationship between the social division of labor and its effects on the socio-spatial division, represented in the "macro scale" by the federal unit and the "micro level" for the capital; locus of economic and population concentration. The collection of data on the labor market had as a major source PNAD/IBGE, characterizing the labor market in many ways: people of working age, economically active population and employed and unemployed people, classified by age, sex, color, education, income and social protection condition. However, as for the socio-occupational division, we follow the methodology used by the research group on national television, based in IPPUR /UFRJ, called Monitoring of the Metropolis," which rallied twenty-four groups that aggregate the occupations found in the PNAD/IBGE, in eight groups of socio-occupational categories, according to the similarity between them. It was used in the socio-spatial cutting two relevant discussions, which are inter-related and were characterized as crucial points in developing the research problem: the former was related to the influence of the hegemony of merchant capital in the labor market in Rio Grande North and, the latter, it referred the socio-economic relations between the territory and the variable occupation. Lastly, the results all indicated that in Rio Grande do Norte, as a peripheral state, has suffered the devastating influence of the hegemony of capital purely commercial basis, where "wealth" of capitalism is generated through the sphere of mere movement of goods and services rather than a productive process due to the social relations of production more advanced. We have a little advanced economic structure, with a tertiary sector that has propagated under-employment or disguised unemployment. Similarly, the agricultural sector has been presented as an example of greater social degradation of working conditions in the state. The secondary sector, in turn, also was not behind this uncertainty; on the contrary, confirmed that condition, with poor levels of income, low education of the workforce and a high degree of social helplessness, even in the state capital, space full urban area, which although always appear with a favorable condition compared to Province, in practically most of the variables studied, was also reflected at the same time the author of a structurally underdeveloped condition

Relações de poder, fragmentação e gestão do território no semi-árido nordestinho: um outro olhar sobre o Cariri paraibano

This study aims to analize the Cariri Paraibano territory, as a product of relations of power that were being established along its historic process of territory formation. In this process, the fragmentation and the territory management are fundamental elements to socioterritorial reality comprehension. The theoretical-conceptual basis is based on notions of territory, region, power and territory management, which are articulated to the opinions and empiric confirmations origined from interviews made with several social actions. They also were made photographical records and researches on books, newspapers and magazines, as well on other information sources related to the object of studying. Obtained data confirm the pressuposement on which the relations of dominations and the used methods by the power s owners in the region created a little fruitful political practice and little adequate to the process of active participation of the local population on the territory management, even being on disagreement with the new political-institutional mechanisms, which take to political-administrative more democratic and participative in the country

A construction como método concretizador de direitos fundamentais: aplicação na jurisdição constitucional brasileira

The way of organization of the constitutional jurisdiction implies the possibility to extend the democratization of the same one in function of the popular participation in the active legitimacy to constitutional process (procedimentalist model) e, at the same time, to assure technical viable decisions fast and to the complex problems of the constitucional law (substancialist model). The comparison with the constitutional jurisdiction of U.S.A. becomes interesting from the knowledge of the wide power to decide experience of Supreme the Court that for a methodology of construction of rights and not simply of interpretation of the Constitution, brought up to date and reconstructed throughout its historical evolution the direction of the norms of basic rights and the North American principles constitutional. Construction while constitutional hermeneutic method of substancialist matrix works with techniques as the measurement of principles, the protection of interests of minorities and the entailing of the basic rights with values politicians, what it can be brought to evidence of the Brazilian constitutional jurisdiction in order to improve the construction of basic rights that comes being carried through for the judicial ativism in control of the diffuse and abstract constitutionality. To define the limits of construction is to search, on the other hand, a dialogue with the procedimentalists thesis, aiming at the widening of the participation of the citizen in the construction of the basic rights for the constitutional process and to argue forms of the society to evaluate the pronounced decisions activist in the controls diffuse and abstract of constitutionality

A aplicações dos trataos internacionais de direitos humanos pela jurisdição brasileira

O Brasil, apesar de ter uma participação ativa nos fóruns internacionais de debates sobre a proteção dos direitos humanos, ainda não atua de forma eficiente no adimplemento das obrigações livremente pactuadas, fato este que o levou a ser acionado e condenado pela Corte Interamericana de Direitos Humanos, em virtude da prática de atos violatórios aos ditos direitos, praticados no âmbito dos três Poderes, bem como por todos os Entes Federativos. Diante dessa realidade que se apresenta, o nosso objeto de estudo será investigar a efetivação dos direitos humanos previstos em tratados internacionais pela Jurisdição brasileira. Na esteira desse raciocínio, nossa problemática consiste em demonstrar que os tratados internacionais de direitos humanos, apesar de serem claramente fontes do direito estatal, não vêm sendo devidamente aplicados pelos órgãos que exercem a função jurisdicional em nosso país. Fixada à problemática, nosso objetivo no presente estudo consiste em: 1) descrever a competência constitucional do Poder Judiciário para proteção dos direitos humanos e aplicação dos tratados internacionais; 2) definir o controle jurisdicional de convencionalidade como instrumento de proteção dos direitos humanos a ser utilizados pelos magistrados; e, 3) analisar quase um século de decisões do Supremo Tribunal Federal no que toca a aplicação dos tratados internacionais de direitos humanos. Espera-se efetivamente demonstrar que compete a todos os órgãos estatais o dever de aplicar diretamente os instrumentos internacionais de proteção aos direitos humanos devidamente internalizados. Essa obrigação inegavelmente também recai sobre os que exercem a função jurisdicional. Desta maneira, todos os juízes incumbidos do exercício da jurisdição convertem-se no âmbito estatal em verdadeiros concretizadores dos direitos humanos, sejam eles advindos do sistema global ou do regional de proteção. Dessa forma, devem servir-se do controle de convencionalidade para afastar as manifestações estatais que estejam em dissintonia com o teor dos tratados internacionais de direitos humanos, bem como da interpreção a eles conferida pelas Cortes e Tribunais internacionais

A Dimensão objetiva dos direitos fundamentais: conceito e sistematização

This paper is about the objective dimension of fundamental rights, aiming to present a concept well-designed for this dimension, and establish a systematic teaching of the subject, presenting the developments of this dimension of fundamental rights. The objective dimension of fundamental rights arises related to the idea of linking the state of fundamental rights, transforming these rights as the foundation and purpose of the state. It is distinguished from that perspective of the subjective dimension of fundamental rights, which includes the fundamental rights in an individual-state relationship. Under the subjective prism, rights are seen as limits required by the individual, the state intervention in the lives of individuals. A new dimension goes beyond the perspective of the rights of the individual as a mere resistance in the face of the state, assigning those rights also an active mission, which generates a series of legal repercussions. These developments or "effectiveness" the objective dimension are studied. The first consists of Binding Effectiveness, and demonstrated a new respect for fundamental rights within the state structure, which creates concepts such as "linkage of state functions fundamental rights" and "state s duty to protect". There is also the Radiant Effectiveness in which are examined topics such as the "constitutionalization of Law" and the "application of fundamental rights to particular relationships". Studies are still Procedure Effectiveness, in the case of "objectification of the mechanisms of protection of fundamental rights" and "opening of the processes of state protection of fundamental rights to public participation"

A mediação como instrumento concretizador do direito fundamental à saúde: uma alternativa à judicialização de conflitos Natal 2013

In Brazil, the 1946 Constitution enshrined the right to health, having it defined as the possession of the best state of health that the individual can achieve. Already the Federal Constitution of 1988 lifted that right to the status of fundamental social right, which transcends the effectiveness and cure of the disease is based on the joint liability of public entities for the provision of a quality service, efficient and prioritize human dignity and comprehensive evaluation of patients. According to the World Health Organization, the definition of health, first characterized as the mere absence of disease, has become recognized as the need to search for preventive mechanisms to ensure the welfare and dignity of the population. Garantista this context, the growing seem lawsuits that deal with the implementation of public policies, especially in the area of the right to health, the omission of which the Government can result in the risk of death. Hence the concern of law professionals about whether or not the intervention of the judiciary in cases that deal with providing material benefits of health care. It claims to break the principle of separation of powers, disobedience to the principle of equality and the impossibility of judicial intervention in the formulation of public policy to try and exclude the liability of public entities. In contrast, the judiciary has repeatedly guardianships granted injunctions or merit determining the supply of materials indicated by the medical benefits that accompany the treatment of patients who resort to a remedy. In this context, mediation, object of study and resolution presented in this work, is presented as an instrument conciliator between the reserve clause and the right to financially possible existential minimum, as it seeks to serve all through rationalization of health services , avoidance of negativistic influence of the pharmaceutical industry, with prioritizing the welfare of the individual and the quality of relationships. This is alternative way to judicialization that in addition to encouraging and developing active citizen participation in public policy formulation also allows the manager to public knowledge of community needs. It is in this sense that affirms and defends the right to health is no longer the mere provision of medical care and prescription drugs, but a dialogue conscious existential minimum to guarantee a dignified life

O direito coletivo prestacional à saúde e o poder judiciário: a concretização do art. 196 da Constituição de 1988 pela via jurisdicional

During the ninth century, owing to the process of industrialization, new social conflicts were showed, forcing the Government not to remain inert. The necessity of answer to these new demands requires from the State some actions that assure the new economic, cultural and social rights, able to exceed the formal equality, according to the principles of redistributive equality and well-being. Among the social rights, the right to health is showed up, which is placed at the Universal Declaration of Human Rights and the International Treaty for the Economic, Social and Cultural Rights, as a necessary term to promote the dignity and the free development of the human personality. Under the Constitutional Law, it is clear that the implementation of the right to health, placed at the 6th article of the Brazilian Constitution, demands a government activity, which usually requires a provision of material goods, depending on budgetary resources. The Legislative and Executive Branches have a very important role in compliance with the constitutional regulations about the satisfactory offer of health care services, besides the correct use of the resources at this area. The adoption of public policies is the way of Government action to the planning and realization of this right. Though, some public policies are usually made apart from the social compromises, to the detriment of the basic social rights. The government has a discretionary competence to manage the health services. That is the reason it is necessary the control of the political choices, through the popular control, the extrajudicial control by the Account Courts, or the judicial review. Owed to the constitutionalization of social rights, the constitutional justice has a very relevant role, concerning to the constitutional jurisdiction, in a way the Judiciary Branch assume your position as a player that transforms the society. On the control of the public health policies, there is a cast of official instruments, judicial or not, to the guarantee of the collective right to the public health services, and to allow the citizens to reach the real implementation of the right to health

A diversidade de lagartos na Caatinga é mediada pelos térmitas?

Intending to explain the extraordinary lizard coexistence levels found in Australian deserts, Morton & James (1988) figured out a hypothesis which defends that the termite diversity would bring about lizard radiation. This study aims to verify the validation of that hypothesis in Caatinga lizard assemblages. This study also objectives verifying if the termite defense mechanisms influence their consuming levels by lizards and if this pattern differs between different lizard lineages. Termites were collected using a standardized sampling protocol of termites. Besides using haphazard sampling, we collect lizards with 108 pitfall traps in each area. Intending to check the linkage between the termite and lizard assemblages, the lizard stomach contents were analyzed and then a canonical correspondence analysis was performed. The presence of nonrandom patterns of diet overlap among the lizard species was also examined. Aiming to check if the defense mechanisms of termite influence their consuming pattern by lizards it was performed a laboratory experiment where termite with different defense mechanisms were offered to lizards of two different lineages. We verified that lizard assemblages do not consume termites according to termite abundance in ecosystems. Furthermore, mean niche overlap lizard species did not differ significantly from that expected by chance. We found that termite chemical defense mechanism does influence the termite s pattern consuming by lizards. These results do not corroborate premises which support Morton & James hypothesis (1988) and point out that lizard do not chose termites based on their abundance, but, trying to avoid consuming termites which exhibit chemical defense mechanisms. This defense mechanism, however, may not be the only explanation to patterns of termite s consuming by lizards.