Nutritonal evaluation of pemphigus foliaceus patients on long term glucocorticoid therapy

Our objective was to compare food intake and nutritional status of Pemphigus Foliaceus patients (PG) on long term glucocorticoid therapy to a Control Group (CG). Fourteen PG female inpatients receiving prednisone (0.33 ± 0.22mg/kg) for at least 12 months and twelve CG subjects were submitted to nutritional evaluation, including anthropometry, urinary creatinine determination and serum biochemical measurements, besides 48-h-based food intake records. Groups were compared by Chi-square, Mann-Whitney and "t" tests. PG patients and CG were paired, respectively, in relation to age (24.7 ± 14.1 vs. 22.0 ± 12.0 years), body mass index (25.8 ± 6.4 vs. 24.0 ± 5.6kg/m2), daily protein intake (132.9 ± 49.8 vs. 95.2 ± 58.9g), and serum albumin (median; range) (3.8; 3.5-4.1 vs. 3.8; 3.6-5.0g/dl). However, PG patients had lower height-creatinine index (64.8 ± 17.6 vs. 90.1 ± 33.4%), and higher daily energy (3080 ± 1099 vs. 2187 ± 702kcal) and carbohydrate (376.8 ± 135.8 vs. 242.0 ± 80.7g) intakes. Despite high food, protein and energy consumption, PG patients on long term glucocorticoid therapy had lower body muscle mass than controls, while showing high body fat stores. These findings are possibly related to combined metabolic effects of long term corticotherapy and inflammatory disease plus corticosteroid-induced increased appetite.

Seroprevalence of Helicobacter pylori infection in chronic chagasic patients, and in the rural and urban population from Uberlândia, Minas Gerais, Brazil

As patients with chronic Chagas disease exhibit morphological and functional changes of the stomach (hypomotility and hypochlorhydria), malnutrition, immunological deficiency and high prevalence of peptic disease associated to Helicobater pylori infection, the purpose of this study was to evaluate if the prevalence of H. pylori infection in chronic chagasic is higher than in non-chagasic individuals in the urban and rural population from Uberlândia, MG, Brazil. Serological determination of IgG antibodies to H. pylori was performed using a second-generation ELISA. Thus, 598 people were evaluated: 128 chagasic (CG), 222 non-chagasic living in urban area (U-NCG) and 248 non-chagasic living in rural area (R-NCG). Regarding the age range from 21 to 50 years, the prevalence of H. pylori infection in the CG (85.1%) was significantly higher than in the U-NCG (56.3%, p < 0.01) and the R-NCG (67.4%, p < 0.05). In the patients over 50 years, the prevalence in the CG (86.4%) was similar to the U-NCG (78.8%) and R-NCG (86.1%). Similar results were also found between the U-NCG and R-NCG for all age ranges, with prevalence rates of 29.1% and 35.3% for the age range from 5 to 13 years, and 47.2% and 40% for that from 14 to 20 years, respectively. We conclude that chagasic patients showed a higher seroprevalence of H. pylori infection than non-chagasic individuals, in the age range from 21 to 50 years, and that the prevalence of this infection was similar in the studied urban and rural non-chagasic population.

Avaliação do efeito da esplenectomia e auto-implante esplênico sobre algumas funções de monócitos em crianças com esquistossomose mansônica

Investigamos em portadores de esquistossomose hepatoesplênica após esplenectomia com ou sem auto-implante esplênico: índice de aderência, produção de superóxido (SP) e de TNF-alfa em monócitos, tratados ou não com tuftsina. Avaliamos três grupos: voluntários sadios CG (grupo controle) (n=12); esplenectomizados com auto-implante AG (n=18) e esplenectomizados sem auto-implante WAG (n=9). Índice de aderência e TNF-alfa não diferiram entre os grupos. SP foi semelhante em CG e AG na 1ª hora após estimulação celular. SP foi maior em todos intervalos de tempo nos grupos CG e AG, comparados ao WAG. O tratamento com tuftsina recuperou o padrão de normalidade de SP em AG, com aumento da 1ª para a 2ª hora nos níveis do CG. O tratamento com tuftsina não alterou SP em WAG, permanecendo reduzida em todos intervalos. O auto-implante esplênico parece recuperar e manter os parâmetros imunológicos avaliados, que têm participação importante na resposta do hospedeiro às infecções.

Accidents caused by Bothrops and Bothropoides in the State of Paraiba: epidemiological and clinical aspects

INTRODUCTION: Bothrops and Bothropoides snakes cause 70% of the ophidic accidents in Brazil. The species that cause ophidic accidents in State of Paraíba are Bothropoides erythromelas, Bothrops leucurus and Bothropoides neuwiedi. METHODS: This is a prospective and transverse study, following a quantitative approach of accidents involving Bothrops and Bothropoides admitted to the Toxicological Assistance and Information Centers of Campina Grande and João Pessoa (Ceatox-CG and Ceatox-JP), aimed at identifying the epidemiological and clinical profile of such accidents. All of the patients admitted had medical diagnoses and were monitored at Ceatox-CG or Ceatox-JP. RESULTS: The genera Bothrops and Bothropoides caused 91.7% of the ophidic accidents reported. Snake bites were frequent in men (75.1%), rural workers (65.1%), literate individuals (69%) between 11 and 20 years-old (21.7%), and toes the most common area attacked (52.7%). Most (86.6%) patients were admitted within 6 hours after the accident/bite, with a predominance of mild cases (64.6%). The annual occurrence in Paraíba was 5.5 accidents/100,000 inhabitants and lethality was 0.2%. CONCLUSIONS: Positive changes in the profiles of these accidents were verified, such as the non-application of inadequate solutions, including the use of tourniquet, coffee grounds, garlic, suction and/or cutting the bitten area. Moreover, the Itinerant Laboratory project, linked to Paraíba State University in partnership with Ceatox-CG, has contributed positively, providing several cities of the state with information regarding the prevention of accidents involving venomous animals. The local press has also contributed, reporting the educational work developed by the centers.

Larval control of Anopheles (Nyssorhinchus) darlingiusing granular formulation of Bacillus sphaericus in abandoned gold-miners excavation pools in the Brazilian Amazon Rainforest

INTRODUCTION: Use of a Bacillus sphaericus based mosquito larvicide was evaluated as an intervention for malaria vector control at a mining site in Amapá, Brazil. Impacts on larval and adult densities of the primary vector Anopheles darlingi were measured over the course of a 52 week study period.METHODS: In Calçoene, State of Amapá, gold mining activity occurs in 19 mining sites in gold-miners of Lourenço. Large pools are formed in mining sites and naturally colonized by Anopheles darlingi. During one year, the impact of applications of VectoLex(r) CG to these larval sources was evaluated. Applications of 20kg/ha were made as needed, based on 10 immature (3rd, 4th instars and pupae) surveillance of health and established thresholds. RESULTS: One hundred percent initial control was observed 48h after each treatment. The pools received from 2-10 (5.3±1.6) treatments during the year. The average re-treatment interval in productive pools was 9.4±4.3 weeks. During weeks 3-52 of the study, mean density of late stage larvae was 78% and pupae were 93% lower in the treated pools than in untreated pools (p< 0.0001, n=51) while reduction of adult mosquitoes was 53% in comparison to the untreated area during the last five months of the study, which were the rainy season (p<0.001).CONCLUSIONS:VectoLex(r) CG reduced immature Anopheles darlingi infestation levels during the entire study period, and reduced adult mosquito populations during the rainy season.

Constituintes voláteis dos frutos de Licania tomentosa Benth

O aroma dos frutos de Licania tomentosa foi obtido por hidrodestilação e extração com pentano, e seus constituintes voláteis identificados através de cromatografia de gás acoplada à espectrometria de massas (CG/EM). Os principais componentes identificados foram l-hexanol (11,1%), 4-heptanol (10,5%), butanoato de 3-metilbutila (7,4%), hexanal (7,1%) e mirceno (6,4%).

Constituintes voláteis das folhas e dos galhos de Cinnamomum zeylanicum Blume (Lauraceae)

Os óleos essenciais das folhas e dos galhos de Cinnamomum zeylanicum coletada no município de Manaus, estado do Amazonas, foram obtidos por hidrodestilação e analisados através de CG-EM. Vinte e três constituintes foram identificados nas folhas, dos quais o eugenol foi o que apresentou maior porcentagem (60%). Nos galhos foram identificados trinta e seis componentes, com predominância dos monoterpenos alfa- e beta-pineno (9,9%; 3,5%), alfa-felandreno (9,2%), p-cimeno (6,2%), limoneno (7,9%), linalol (10,6%); os sesquiterpenos alfa-copaeno (3,3%), (beta )-cariofileno (6,7%), óxido de cariofileno (3,1%) e os alilbenzenos (E)-cinamaldeído (7,8%) e acetato de (E)-cinamila (9,7%).

Efeito do óleo essencial de pimenta longa (Piper hispidinervum C. DC) e do emulsificante Tween® 80 sobre o crescimento micelial de Alternaria alternata (Fungi: Hyphomycetes)

Este trabalho objetivou avaliar o efeito do óleo essencial de folhas de pimenta longa (Piper hispidinervum C. DC), sobre o crescimento micelial de Alternaria alternata e a análise da influência da concentração do emulsificante Tween® 80 no controle deste fitopatógeno. O óleo essencial foi obtido pela técnica "arraste a vapor d'água", utilizando-se aparelho de Clevenger modificado, e posteriormente submetido, à análise por cromatografia em fase gasosa acoplada a espectrômetro de massas CG-EM a CG. Para os ensaios biológicos, o método foi o bioanalítico in vitro observando-se o crescimento ou inibição do micélio de A. alternata no meio de cultura BDA na presença de diferentes concentrações do óleo essencial (0, 100, 250, 500 e 1000 mgL-1 ) sob diferentes concentrações de Tween® 80. Adotou-se esquema fatorial com quatro repetições, em delineamento inteiramente casualizado (DIC). Observou-se que o óleo essencial de pimenta longa apresentou inibição sobre o crescimento micelial do fungo A. alternataem todas as concentrações analisadas, sendo que na concentração de 1000 mgL-1 esta inibição foi de 100% , e a porcentagem de emulsificante (Tween® 80), influenciou na atividade fungitóxica das concentrações de 250 mgL -1 e 500 mgL -1 do óleo essencial.

Atividade inseticida do óleo essencial de pimenta longa (Piper hispidinervum C. DC.) sobre lagarta-do-cartucho do milho Spodoptera frugiperda (J. E. Smith, 1797) (Lepidoptera: Noctuidae)

Os objetivos desta pesquisa foram a obtenção e caracterização do óleo essencial de folhas de pimenta longa Piper hispidinervum, e avaliação de seu efeito no comportamento e/ou mortalidade da lagarta-do-cartucho do milho Spodoptera frugiperda. O óleo essencial foi obtido pela técnica "arraste a vapor d'água", utilizando-se de um aparelho de Clevenger modificado, e posteriormente submetido, à análise por CG-EM e CG. Foram realizados testes de ingestão e contato tópico em lagartas de 1º e 3º ínstar. Os resultados constataram que o óleo essencial de pimenta-longa possui atividade inseticida sobre S. frugiperda, causando redução alimentar e mortalidade, sendo o safrol (82%) seu constituinte majoritário. Verificou-se mortalidade no teste de ingestão em lagartas de 1º ínstar com CL50 = 16,2 mg/mL e para lagartas de 3º ínstar a CL50 = 9,4 mg/mL com redução alimentar CD50 = 0,72 mg/mL; e de toxicidade aguda no teste de contato tópico com DL50 = 277,91 μg/lagarta, após o intervalo de tempo de 96 horas, sendo também observados sintomas de neurotoxicidade, como o efeito knock-down.

Estudo da adaptação da espécie Piper hispidinervum C. DC. (pimenta longa) à região do Vale do Itajaí - SC, através da composição química do óleo essencial obtido por hidrodestilação por micro-ondas e convencional

Neste trabalho, a espécie Piper hispidinervum (pimenta longa), endêmica do estado do Acre, foi cultivada na região do Vale do Itajaí - SC, e sua adaptação foi avaliada em relação à composição química do óleo essencial obtido pelos processos de hidrodestilação convencional e por micro-ondas. O safrol foi identificado como o constituinte majoritário do óleo essencial desta espécie, o qual foi empregado como parâmetro de avaliação da capacidade de adaptação desta planta à região sul do Brasil, já que a proposta abrange avaliar a utilização desta espécie como fonte alternativa de safrol, em substituição a Canela Sassafrás (Ocotea odorifera), espécie muito explorada até a década de 90 nesta região. As amostras da planta foram obtidas de diferentes regiões do Acre e foram cultivadas na estação experimental da EPAGRI - Itajaí-SC. O óleo essencial das folhas forneceu um teor médio de safrol entre 76,6% e 89,9%. A análise por CG-DIC e CG-EM do óleo com maior concentração de safrol, apresentou os seguintes constituintes: safrol (89,93%), α-terpineno (0,35%), (E)-β-ocimeno (0,54%), terpinoleno (3,10%), valenceno (0,21%), (Z)-β-bisaboleno (1,70%) e guaiol (0,29%).

Estudo químico de duas plantas medicinais da amazônia: Philodendron scabrum k. Krause (araceae) e Vatairea guianensis aubl. (fabaceae)

Este trabalho relata o estudo químico de duas plantas medicinais da Amazônia: Philodendron scabrum K. krause (Araceae) e Vatairea guianensis Aubl. (Fabaceae). As composições dos óleos essenciais dos cipós de P. scabrum e dos frutos de V. guianensis, respectivamente, foram analisadas em CG-DIC e CG-EM. Os constituintes majoritários dos cipós de P. scabrum foram óxido de cariofileno (19,42%), α-copaeno (16,08%) e β-bisaboleno (10,01%); e nos frutos de V. guianensis foram o ácido (9Z)-octadecenoico (24,95%) e o ácido docosahexaenoico (24,17%). β-sitosterol e o alquilresorcinol 1-hexadecanoil-2,6-dihidroxibenzeno foram isolados do extrato etanólico dos cipós de P. scabrum; e do extrato etanólico dos frutos de V. guianensis, foram isoladas as antraquinonas crisofanol e fisciona. As determinações estruturais foram baseadas em dados de RMN de ¹H e 13C. RMN, uni e bidimensional e comparação com dados da literatura.

Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

Background: Heart rate variability (HRV) is a marker of autonomic dysfunction severity. The effects of physical training on HRV indexes in Chagas heart disease (CHD) are not well established. Objective: To evaluate the changes in HRV indexes in response to physical training in CHD. Methods: Patients with CHD and left ventricular (LV) dysfunction, physically inactive, were randomized either to the intervention (IG, N = 18) or control group (CG, N = 19). The IG participated in a 12-week exercise program consisting of 3 sessions/week. Results: Mean age was 49.5 ± 8 years, 59% males, mean LVEF was 36.3 ± 7.8%. Baseline HRV indexes were similar between groups. From baseline to follow-up, total power (TP): 1653 (IQ 625 - 3418) to 2794 (1617 - 4452) ms, p = 0.02) and very low frequency power: 586 (290 - 1565) to 815 (610 - 1425) ms, p = 0.047) increased in the IG, but not in the CG. The delta (post - pre) HRV indexes were similar: SDNN 11.5 ± 30.0 vs. 3.7 ± 25.1 ms. p = 0.10; rMSSD 2 (6 - 17) vs. 1 (21 - 9) ms. p = 0.43; TP 943 (731 - 3130) vs. 1780 (921 - 2743) Hz. p = 0.46; low frequency power (LFP) 1.0 (150 - 197) vs. 60 (111 - 146) Hz. p = 0.85; except for high frequency power, which tended to increase in the IG: 42 (133 - 92) vs. 79 (61 - 328) Hz. p = 0.08). Conclusion: In the studied population, the variation of HRV indexes was similar between the active and inactive groups. Clinical improvement with physical activity seems to be independent from autonomic dysfunction markers in CHD.

An Equation for the Prediction of Oxygen Consumption in a Brazilian Population

Background: The equations predicting maximal oxygen uptake (VO2max or peak) presently in use in cardiopulmonary exercise testing (CPET) softwares in Brazil have not been adequately validated. These equations are very important for the diagnostic capacity of this method. Objective: Build and validate a Brazilian Equation (BE) for prediction of VO2peak in comparison to the equation cited by Jones (JE) and the Wasserman algorithm (WA). Methods: Treadmill evaluation was performed on 3119 individuals with CPET (breath by breath). The construction group (CG) of the equation consisted of 2495 healthy participants. The other 624 individuals were allocated to the external validation group (EVG). At the BE (derived from a multivariate regression model), age, gender, body mass index (BMI) and physical activity level were considered. The same equation was also tested in the EVG. Dispersion graphs and Bland-Altman analyses were built. Results: In the CG, the mean age was 42.6 years, 51.5% were male, the average BMI was 27.2, and the physical activity distribution level was: 51.3% sedentary, 44.4% active and 4.3% athletes. An optimal correlation between the BE and the CPET measured VO2peak was observed (0.807). On the other hand, difference came up between the average VO2peak expected by the JE and WA and the CPET measured VO2peak, as well as the one gotten from the BE (p = 0.001). Conclusion: BE presents VO2peak values close to those directly measured by CPET, while Jones and Wasserman differ significantly from the real VO2peak.

South American Guidelines for Cardiovascular Disease Prevention and Rehabilitation

In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.

Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

Background: Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP) of hypertensive patients. Objective: To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients. Methods: Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt) and Control Group (CG - receiving regular salt). Systolic BP (SBP) and diastolic BP (DBP) were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM), and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks. Results: The study evaluated 35 patients (65.7% women), 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%), had a family income of up to US$ 600 (n = 17; 48.6%) and practiced regular physical activity (n = 19; 54.3%). Two patients (5.7%) were smokers and 40.0% consumed alcohol regularly (n = 14). The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05) and in sodium excretion (p = 0.016). The CG showed a significant reduction only in casual SBP (p = 0.032). Conclusions: The light salt substitution for regular salt significantly reduced BP of hypertensive patients.