Atividade antimalárica de plantas medicinais da biorregião do Araripe-CE em modelo murino - Plasmodium berghei

Malaria, also popularly known as maleita , intermittent fever, paludism, impaludism, third fever or fourth fever, is an acute infectious febrile disease, which, in human beings, is caused by four species: Plasmodium falciparum, P. vivax, P. malariae and P. ovale. Malaria, one of the main infectious diseases in the world, is the most important parasitoses, with 250 million annual cases and more than 1 million deaths per year, mainly in children younger than live years of age. The prophylactic and therapeutic arsenal against malaria is quite restricted, since all the antimalarials currently in use have some limitation. Many plant species belonging to several families have been tested in vivo, using the murine experimental model Plasmodium berghei or in vitro against P. falciparum, and this search has been directed toward plants with antithermal, antimalarial or antiinflammatory properties used in popular Brazilian bolk medicine. Studies assessing the biological activity of medicinal plant essential oils have revealed activities of interest, such as insecticidal, spasmolytic and antiplasmodic action. It has also been scientifically established that around 60% of essential oils have antifungal properties and that 35% exhibit antibacterial properties. In our investigation, essential oils were obtained from the species Vanillosmopsis arborea, Lippia sidoides and Croton zethneri which are found in the bioregion of Araripe-Ceará. The chemical composition of these essential oils was partially characterized and the presence of monoterpenes and sesquiterpenes. The acute toxicity of these oils was assessed in healthy mice at different doses applied on a single day and on four consecutive days, and in vitro cytotoxicity in HeLa and Raw cell lines was determined at different concentrations. The in vivo tests obtained lethal dose values of 7,1 mg/Kg (doses administered on a single day) and 1,8 mg/Kg (doses administered over four days) for 50% of the animals. In the in vitro tests, the inhibitory concentration for 50% of cell growth in Hela cell lines was 588 μg/mL (essential oil from C. zethneri after 48 h), from 340-555 μg/mL (essential oil from L. sidoides, after 24 and 48 h). The essential oil from V. arborea showed no cytotoxicity and none of the essential oils were cytotoxic in Raw cell lines. These data suggest a moderate toxicity in the essential XVIII oils under study, a finding that does not impede their testing in in vivo antimalarial assays. Was shown the antimalarial activity of the essential oils in mice infected with P. berghei was assessed. The three species showed antimalarial activity from 36%-57% for the essential oil from the stem of V. arborea; from 32%-82% for the essential oil from the leaves of L. sidoides and from 40%-70% of reduction for the essential oil from the leaves of C. zethneri. This is the first study showing evidence of antimalarial activity with these species from northeast Brazil. Further studies to isolate the active ingredients of these oils are needed to determine if a single active ingredient accounts for the antimalarial activity or if a complex integration of all the compounds present occurs, a situation reflected in their biological activity

Talassoterapia para pacientes com fibromialgia: ensaio clínico radômico

Fibromyalgia (FM) is a chronic rheumatic syndrome characterized by diffuse muscle-skeletal pain, and aerobic exercises represent a fundamental portion in therapeutic approach. Objective of this study was to evaluate the effectiveness of aerobic exercises accomplished in the water of the sea (thalassotherapy) for women with FM and to compare with exercises accomplished in the swimming pool, involving a multidisciplinary team, composed by rheumatologists, physical therapists, students of physical therapy and students of physical education. Forty six (46) women with age between 18 and 60 years with FM were randomized in 2 groups: a swimming pool group (23 patients) and a sea group (23 patients). 80th groups trained a week with the same program of aerobic conditioning 3 times (60 minutes each) for 12 weeks. Ali the patients were evaluated, before and immediately after treatment, with Visual Analogical Scale (VAS) for pain and fatigue, number of tending points, Fibromyalgia Impact Ouestionnaire (FIO), Short Form 36 Health Survey (SF-36), Pittsburgh Sleep Ouality Index (PSOI) and Beck Oepression Inventory (BOI). For statistical analysis, it was used paired-t test for analysis intra-group and non-paired test for inter-groups analysis, significance levei of p <0,05. Four patients, of each group, didn't complete the training programo Groups were homogeneous and they were compared in initial evaluation, except for BOI (p <0,05). Both groups presented statistically significant improvement for ali appraised parameters in the post-treatment compared with initial evaluation, there were reduction of intensity of pain and fatigue, number of tending points, better functional capacity (FIO), life quality (SF-36), quality of sleep (PSQI) and depression indexes (BOI). However, in comparison among the groups, group of sea (thalassotherapy) presented better results for ali parameters, however with statistically significant difference just only for depression indexes (BOI). At the end, it was observed that accomplishment of aerobic exercises in sea water or swimming pool was effective as part of treatment for patients with FM. However, exercise programs with thalassotherapy seems to bring more benefits, mainly related to emotional aspects, could be a therapeutic option of low cost for patients with FM in our area

Efeito de um extrato de Artemísia Vulgaris L. marcação in vitro de constituintes sanguíneos com tecnécio-99m em ratos wistar

Artemisia vulgaris L..is used in folk medicine and in Traditional Chinese Medicine (TCM). This medicinal plant has been utilized as anticonvulsive, analgesic, antispasmodic effect, rheumatic pains, menstrual dyspepsia, asthenia, epilepsy, hepatitis, fevers, anemia and to expel parasites. In nuclear medicine, blood constituents are labeled with technetium-99m (99mTc) and used as radiopharmaceuticals (radiobiocomplexes). Authors have been described that synthetic and/or natural drugs could modify the labeling of blood constituents with 99mTc. The aim of this work was to evaluate the effects of an aqueous extract of Artemisia vulgaris L. on the labeling of blood constituents with 99mTc. Blood samples withdrawn of Wistar rats were incubated with Artemisia vulgaris L, stannous chloride and 99mTc, as pertechnetate ion. Aliquots of plasma (P) and blood cells (BC) were isolated. Aliquots of P and BC were also precipitated with trichloroacetic acid and soluble (SF) and insoluble (IF) fractions were separated. The radioactivity in each fraction was counted and the percentages of radioactivity (%ATI) were calculated. Artemisia vulgaris L. extract decreased significantly (p<0.05) the %ATI on BC and on IF-BC. The analysis of the results indicates that the extract could have substances that could interfere on the transport of stannous through the erythrocyte membrane altering the labeling of blood cells with 99mTc. Working in this study was a multidisciplinary group, with Phisical therapists, Biomedicals, Physicals, Pharmacists, Biologists, Statistics and Physicians.

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

Fisioterapia e sociedade: ações do Sistema Único de Saúde no Rio Grande do Norte

The work has objective to present actions of Physiotherapy, developed by SUS in the State of Rio Grande do Norte; discuss under the humanization point of view such actions of health; discuss the importance of physioterapy to the Norte-Riograndense, or maybe its role in the perpetuation of actions of health centered in the binomial cause/efect. The study was done in the State of Rio Grande do Norte. The data were obtained through public sources gathered in the health secretrary ship of this State. The collected data talks about physiotherapy sections developed by SUS in several areas of the State; such data was collected and analysed after the aproval of Ethic and Resarch Committee of Federal University of Rio Grande do Norte. Concerning the physiotherapy, along with the State Health Secretaryship of the State fo Rio Grande do Norte, there were only records of attending based on cure/rehabillitation, not being observed during the curse of study, any record or action of prevention, promotion and protection towards health. It s possible to notice that there is a highligth to the interventions focusing on the treatment of illness of rheumatic origin and general complaints related to the vertebral column. Such research evidenced that the Physiotherapy in the SUS in the State priorizes the individualized attending centered in the carteziano health/illness model, where the developde actions are turned to the curative and rehabilliting attention, with role fo some or no highligth in the primary attention

Impacto do abastecimento irregular de água nos altos índices de dengue

Dengue fever is an infectious disease that causes thousands of deaths each year in Brazil and other tropical countries. This work demonstrates that the irregularity in the supply of water by public water supply systems is a major factor that contributes to the proliferation of breeding sites of the mosquito that transmits dengue, due to the impossibility of removing water storage tanks. 31 points in the water supply network in thirteen districts of Natal, Brazil, were monitored by the installation of pressure gauges type Datalogger. The data about pressure showed deficiency in water supplies in many neighborhoods, forcing residents to accumulate water in tanks at ground level. In addition, It was observed that in neighborhoods with regular water supply, Infestation Index per type of container (ITR) of type A2 (Deposit ground level) was 0.00% and where there were failures in the supply of water , the ITR was high (above 50%). We believe that policies to combat dengue in Brazil should be reassessed so that more resources can be directed to the improvement of water supply systems and supply companies should be blamed for the problem too

Fisioterapia respiratória em crianças com pneumonia: revisão sistemática

Introduction: Pneumonia is an inflammatory lung disease and it is the greatest cause of deaths in children younger than five years of age worldwide. Chest physiotherapy is widely used in the treatment of pneumonia because it can help to eliminate inflammatory exudates and tracheobronchial secretions, remove airway obstructions, reduce airway resistance, enhance gas exchange and reduce the work of breathing. Thus, chest physiotherapy may contribute to patient recovery as an adjuvant treatment even though its indication remains controversial. Objectives: To assess the effectiveness of chest physiotherapy in relation to time until clinical resolution in children (from birth up to 18 years old) of either gender with any type of pneumonia. Methods: We searched CENTRAL 2013, Issue 4; MEDLINE (1946 to May week 4, 2013); EMBASE (1974 to May 2013); CINAHL (1981 to May 2013); LILACS (1982 to May 2013); Web of Science (1950 to May 2013); and PEDro (1950 to May 2013). We consulted the ClinicalTrials.gov and the WHO ICTRP registers to identify planned, ongoing and unpublished trials. We consulted the reference lists of relevant articles found by the electronic searches for additional studies. We included randomised controlled trials (RCTs) that compared chest physiotherapy of any type with no chest physiotherapy in children with pneumonia. Two review authors independently selected the studies to be included in the review, assessed trial quality and extracted data. Results: Three RCTs involving 255 inpatient children are included in the review. They addressed conventional chest physiotherapy, positive expiratory pressure and continuous positive airway pressure. The following outcomes were measured: duration of hospital stay, time to clinical resolution (observing the following parameters: fever, chest indrawing, nasal flaring, tachypnoea and peripheral oxygen saturation levels), change in adventitious sounds, change in chest X-ray and duration of cough in days. Two of the included studies found a significant improvement in respiratory rate and oxygen saturation whereas the other included study failed to show that standardised respiratory physiotherapy and positive expiratory pressure decrease the time to clinical resolution and the duration of hospital stay. No adverse effects related to the interventions were xvi described. Due to the different characteristics of the trials, such as the duration of treatment, levels of severity, types of pneumonia and the techniques used in children with pneumonia, as well as differences in their statistical presentation, we were not able to pool data. Two included studies had an overall low risk of bias whereas one included study had an overall unclear risk of bias. Conclusion: Our review does not provide conclusive evidence to justify the use of chest physiotherapy in children with pneumonia due to a lack of data. The number of included studies is small and they differed in their statistical presentation

Interações físicas e psicossociais em mulheres com fibromialgia

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome of unknown etiology, with symptoms of diffuse musculoskeletal pain and presence of specific anatomic sites called tender points. The symptoms are often associated with fatigue, sleep disturbances, morning stiffness, alterations in pain perception, anxiety and depression. Fibromyalgia exhibits a correlation between physical and behavioral symptoms, which have a negative influence on the quality of life of patients. Emotional skills are important factors since they are related to subjective well-being, personal productivity, social interaction and interpersonal relationships. We aim to describe the physical and psychosocial interactions in women with FM, showing the association between perceived social support and affect with symptoms of pain, functionality and mood. We will also describe a body representation of pain in women with FM. Data were collected over 3 years and the sample size ranged between studies. This is an exploratory cross-sectional study conducted with a convenience sample of 63 women with FM and 42 healthy women as a control group (CT), aged 20-76 years, recruited through spontaneous demand at Onofre Lopes University Hospital (HUOL) and the Clinical School of Physiotherapy of Universidade Potiguar (UNP). The Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Social Support Scale (MOS), Hamilton Anxiety Scale and Scale of Positive and Negative Affect Schedule (PANAS), in addition to pressure algometry were used. For data analysis, we used parametric and non-parametric tests and a general linear model with adjustment variables and analysis of variance. A significant difference was found between pain threshold and tolerance, functionality, depression, anxiety, social support, and positive and negative affect between the groups. Affective states and social support were associated with anxiety, depression and functionality. A body was drawn representing pain with higher incidences in trapeze, supraspinatus and second ribs. The reason for studying sensory aspects, affective behavior and social support in FM patients opens perspectives for scientific and clinical research of this syndrome. Women with chronic pain such as FM appear to have altered mood states, less social support and affective dysfunctions, influencing the other symptoms of the syndrome

Avaliação do cortisol, dehidroepiandrosterona sulfato e dos perfis lipídico e imunológico e suas correlações com a sensibilidade dolorosa, depressão e funcionalidade em mulheres com fibromialgia na pós-menopausa

Fibromyalgia (FM) is a non-inflammatory rheumatic syndrome characterized by widespread musculoskeletal pain with palpable tender points, muscle stiffness, fatigue, and sleep disturbances. Patients with FM have hormonal changes that are directly correlated with symptoms of the syndrome. The neuroendocrine regulation may be impaired, with abnormalities in the hypothalamus-pituitary-adrenal (HPA) axis with various hormones showing changes in their levels. In women in fertile period, various gonadal hormones are associated with symptoms of the syndrome, but studies focusing only a population of women in post-menopausal period who do not use hormone replacement are rare. We developed an analytical cross sectional study to assess the plasma levels of cortisol and dehidroepiandrosterona sulfate (DHEA-S) with quimioluminescence method in a group of 17 women with FM and 19 healthy women in post-menopause who do not use hormone replacement and observe the correlation with the symptoms of pain through algometry, depression and physical functional capacity measured from the Beck Depression Index (BDI) and the Fibromyalgia Impact Questionnaire (FIQ). Three blood samples were collected in the morning (between 8:00 9:30) with an interval of 24 hours for the measurements of hormonal levels and biochemical profile. There were no immunological or lipid changes in patients with FM. Comparing the two groups, there is no difference in levels of cortisol and a tangential effect for DHEA-S (p=0,094) with the lowest levels in the FM. DHEA-S also correlated with pain threshold (r=0,7) and tolerance (r=0,65) in group FM. We found the presence of depressive state and low physical functional capacity in FM. It was also evident that women in post-menopausal period, DHEA-S should influence the symptoms of increased sensitivity to pain, but not the presence of depressive status and low physical functional

Estudo teórico-bioclimático da potencialidade de desenvolvimento do Aedes aegypti no estado do Rio Grande do Norte

In the current climate of global public health there is the emergence of urban dengue, a disease regarded as acute infectious fever. The disease annually, has affected millions of people worldwide, mostly in the range of the intertropical globe. The disease's main vector in urban areas, the Aedes aegypti mosquito. Recent studies indicate that the distribution of the insect vector of dengue in the geographical area is directly tied to the behavior of environmental restrictions that area, especially among those, the air temperature and relative humidity. From that context, the work aims to estimate and spatializing, monthly, for each municipality in the state of Rio Grande do Norte, the potential of biophysical conditions conducive to the development of Aedes aegypti. Yet, made use of the following methodology: collection of epidemiological data and climatological, Normal climatological, descriptive statistics (measures of central tendency and scatter), uniform distribution, estimation geostatistics and sufer program, version 8.0. The results flagged for a behavior very heterogeneous, both in space and in time, in the case of the potential of biophysical conditions conducive to the development of Aedes aegypti in the state of Rio Grande do Norte. Still, he noted that there is a tendency for lifting the potential of development for the entire state, from the month of January, ending in the month of April mainly in central and western portions of the state. By contrast, there is the permanence of increased potential for development in the eastern portion of the state. The latter record maximum potential in the month of July, resulting probability of greater than 70% have been favorable conditions for the development of Aedes aegypti in that area. In the period between the months of August to December, it is small potential for development of Aedes aegypti in all parts of the state

A ocupação urbana do entorno de zonasde proteção ambiental de natal, suas condições de sustentabilidade e a relação com a ocorrência de insetos vetores

This study started from the hypothesis of the existence of a relation between the type of the urban occupation concerning to the sustainability conditions at the proximity of Environment Protected Zones and the occurrence of vectors insects in Natal, Rio Grande do Norte, Brazil. This research, which used data available by the City Administration Health and Urbanization Secretaries (respectively SMS and SEMURB), in the time period of 2006 to 2008, aimed to characterize the study site in terms of urban occupation, relating it to social environmental aspects of land occupation and the occurrence of vectors insects. This study is presented in two papers, the first one linking the occurrence of vectors insects and sustainable development indicators and the second relating the incidence of reported cases of Dengue and Dengue Hemorrhagic Fever (DHF) and the occurrence of larvae infection indexes of Aedes aegypti, in Natal, Rio Grande do Norte State. In the first paper, was made a correlation between Dengue Fever vectors and Visceral and Tegumentar Leishmaniasis vectors and sustainable development indicators, selected from IDS Brasil- 2008. Through factorial analysis a Sustainability Index (SI) was acquired for each region, the northern region of the municipality obtained lower numbers than southern region, which, in its turn, presented better sustainability conditions. Linking this index to vector infestation parameters shows a high significant correlation between the SI and the Breteau Index of Aedes aegypti (p=0,028) as well as with SI and sand flies infestation index (p=0,01). Higher rates in vectors infestation in regions with a lower Sustainable Development Index demonstrates that this index can be used to determine the increasing of probability of Aedes and sand flies occurrence in urban environment. The second paper analyzed the occurrence of the main vector of Dengue and DHF, the Aedes aegypti mosquito, and the relation between larvae infection indexes of this insect and reported cases of the diseases. This study revealed unexpected relation where areas with higher Breteau s Indexes showed lower infection rates of Dengue Fever, although showing high incidence of DHF

Coeficientes de incidência do dengue e sua relação com os diferenciais intra-urbanos segundo condições de vida no município do Natal, Rio Grande do Norte

This study sprang from the hypothesis that spatial variations in the morbidity rate for dengue fever within the municipality of Natal are related to intra-city socioeconomic and environmental variations. The objective of the project was to classify the different suburbs of Natal according to their living conditions and establish if there was any correlation between this classification and the incidence rate for dengue fever, with the aim of enabling public health planners to better control this disease. Data on population density, access to safe drinking water, rubbish collection, sewage disposal facilities, income level, education and the incidence of dengue fever during the years 2001 and 2003 was drawn from the Brazilian Demographic Census 2000 and from the Reportable Disease Notification System -SINAN. The study is presented here in the form of two papers, corresponding to the types of analysis performed: a classification of the urban districts into quartiles according to the living conditions which exist there, in the first article; and the incidence of dengue fever in each of these quartiles, in the second. By applying factorial analysis to the chosen socioeconomic and environmental indicators for the year 2000, a compound index of living condition (ICV) was obtained. On the basis of this index, it was possible to classify the urban districts into quartiles. On undertaking this grouping (paper 1), a heterogeneous distribution of living conditions was found across the city. As to the incidence rate for dengue fever (paper 2), it was discovered that the quartile identified as having the best living conditions presented incidence rates of 15.62 and 15.24 per 1000 inhabitants respectively in the years 2001 and 2003; whereas the quartile representing worst living conditions showed incidence rates of 25.10 and 10.32 for the comparable periods. The results suggest that dengue fever occurs in all social classes, and that its incidence is not related in any evident way to the chosen formula for living conditions