Determinantes socioeconômicos e ambientais do declínio das hospitalizações por diarréias em lactentes no Rio Grande do Norte - 1992 a 2001

There was a significant decline in hospitalizations for acute diarrhea in children younger than 1 year of age in Brazil between 1992 to 2001. The less economically developed state of Rio Grande do Norte is a case example of the national trend. In this work, we show a significant association between improvements in socioeconomic variables as well as increased access to sanitation and the decreased rate of hospitalization. Additionally, we observed a positive, seasonal correlation between rainfall and hospitalizations. Most notably, however, we show that improvements in income and inflation were positively correlated with a decline in hospitalizations. Improvements in public health infrastructure, socioeconomic variables like education and literacy, and increased investment in health services were important in reducing severe early childhood diarrheas. However, the data suggests that increased buying power and reductions in poverty played an equally crucial role in reducing hospitalizations for acute diarrhea in infants in Brazil. The work includes elements of the demography of the period for the age groups involved, children under one year, women in fertile age and fertility rate

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

Ecotoxicological assessment of sediments from the Santos and São Vicente estuarine system- Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Acute and chronic toxicity of sediment samples from Guanabara Bay (RJ) during the rainy period

A Baía de Guanabara é um ambiente marinho-estuarino de grande relevância ecológica e sócio-econômica, e sujeita a uma ampla gama de impactos ambientais. O sedimento é o principal destino para a maioria das substâncias introduzidas nos corpos d'água, podendo fornecer uma medida integrada da qualidade ambiental, a qual pode ser avaliada por várias abordagens. Neste projeto, a qualidade de sedimentos da Baía de Guanabara foi por uma abordagem ecotoxicológica, por meio de testes de toxicidade aguda de sedimento integral, utilizando Tiburonella viscana, e testes de toxicidade crônica de água intersticial, elutriato e interface sedimento-água, utilizando embriões de Lytechinus variegatus. Os sedimentos foram coletados em 14 estações de amostragem. Nos testes crônicos houve efeitos significativos na maioria das amostras, enquanto os sedimentos coletados nas estações 1, 2, 3, 6, 8, 10, 11, 12 e 15 apresentaram também toxicidade aguda. Houve grande concordância entre os resultados dos diferentes testes, e sua integração mostrou que os sedimentos analisados encontram-se inadequados à vida aquática, indicando degradação ambiental na baía da Guanabara. Nesse contexto, o controle das fontes poluidoras e o gerenciamento dos múltiplos usos da baía devem ser implementados, no sentido da melhora da qualidade ambiental.

Suplementação oral de zinco pode diminuir o perfil sérico de ferro em crianças saudáveis

Conselho Nacional de Desenvolvimento Científico e Tecnológico

IL-10 na patogênese da infecção por Leishmania infantum

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Estudo epidemiológico das parasitoses oculares na população de escolares da cidade de Natal-RN, Brasil

The objective of this study is to estimate the prevalence of Ocular Toxocariasis, Diffuse Unilateral Subacute Neuroretinitis (DUSN), Toxoplasma gondii infection and Ocular Toxoplasmosis in a student population in Natal-RN/Brazil and relate it to demographic, epidemiologic and socio-economic risk factors. The incidence of DUSN was observed in patients at the Federal University of Rio Grande do Norte Ophthalmology Service and the Prontoclinica de Olhos Ophthalmology clinic in Natal. In cases where a worm was found in the subretinal space, the result of treatment with photocoagulation using Green Laser (Eye Light ALCON) was evaluated in relation to final visual result. The sample was randomly selected among the schools of the four districts of Natal, according to the type of institution (public or private), its level (elementary or secondary), and study period (morning, afternoon or evening). The school population was studied from March to May, 2001. Initially, the students answered a questionnaire to evaluate demographic, epidemiologic and socio-economic risk factors. Afterwards, the following procedures were carried out: blood samples were taken for Toxoplasmosis (IgG, IgM) serology, hemogram, ophthalmological examination, consisting of clinical history, measurement of visual acuity, refraction under cycloplegia, biomicroscopy of the anterior segment and annexa, funduscopy and examination of extrinsic motility. The prevalence of Toxocariasis was 0.2% or 2 per one thousand students. The sample was insufficient to estimate the prevalence of DUSN. Seventy patients with DUSN diagnosis were examined from January, 2001 to January, 2003. A live worm was found in the subretinal space of all four patients in the acute phase, and these were treated with laser photocoagulation. After follow-up (average = 11.5 months), visual acuity improved in three eyes and remained unaltered in one eye. Worms were found in 22 of the 66 patients in the chronic phase, and these also were treated with laser photocoagulation. After a follow-up period of 13.1 months, on average, visual acuity improved in two of the patients, remained unchanged in 19 and worsened in one. The comparison of visual result before and after treatment was not statistically significant (p = 0.302). The diagnosis of DUSN in the acute phase, followed by prompt localization and destruction of the worm by photocoagulation, can improve the patient s vision. However, destruction of the worm by laser photocoagulation in eyes with DUSN in the chronic phase does not improve visual acuity. Seroprevalence for IgG was 46% (Confidence Interval CI 95%-42.9-49.2%) and for IgM it was 1.4% (CI 95% = 0.8-2.4%). The prevalence of ocular lesion was 1.15% (CI 95% = 0.6 - 2.0%). Socio-economic conditions were determinants in the prevalence of Systemic and Ocular Toxoplasmosis in the bivaried analysis and confirmed in the multivaried analysis (mother s scholarity illiterate/ OR = 2.9 and p < 0.001). The T. gondii infection prevalence, although high, was less than that found in studies performed in the South and Southeast of Brazil and that of Ocular Toxoplasmosis was completely discrepant, varying from 5 to 17 times less. Although important epidemiological variables such as owning a cat, drinking unfiltered water, and coming into contact with rivers or lakes showed an association in the preliminary analysis, they lost their influence when included in the logistic model. Future studies are scheduled to begin in March, 2004, in collaboration with other Brazilian and American universities in an attempt to discover the reason for these findings, as well as identifying the different strains of Toxoplasma gondii, and studying the sources of water utilized by the population of Natal Brazil

Efeitos da deficiência de vitamina A na função pulmonar de crianças após infecção respiratória viral

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Anfotericina b pré-aquecida: um novo sistema terapêutico para infecções fúngicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Influência da laparoscopia e da laparotomia na gasometria, leucometria diferencial e citocinas em modelo de sepse abdominal em ratos

Laparoscopic surgery is associated with reduced surgical trauma, and less acute phase response, as compared with open surgery. Cytokines are important regulators of the biological response to surgical and anesthetic stress. The aim of this study was to determine if CO2 pneumoperitoneum would change cytokine expression, gas parameters and leukocyte count in septic rats. Methods: Wistar rats were randomly assigned to five groups: control (anesthesia only), laparotomy, CO2 pneumoperitoneum, cecum ligation and puncture by laparotomy, and laparoscopic cecum ligation and puncture. After 30 min of the procedures, arterial blood samples were obtained to determine leukocytes subpopulations by hemocytometer. TNFα, IL-1β, IL-6 were determined in intraperitoneal fluid (by ELISA). Gas parameters were measured on arterial blood, intraperitoneal and subperitoneal exsudates. Results: Peritoneal TNFα, IL-1β and IL-6 concentrations were lower in pneumoperitoneum rats than in all other groups (p<0.05). TNFα, IL-1β and IL-6 expression was lower in the laparoscopic than in laparotomic sepsis (p<0.05). Rats from laparoscopic cecum ligation and puncture group developed significant hypercarbic acidosis in blood and subperitoneal fluid when compared to open procedure group. Total white blood cells and lymphocytes were significantly lower in laparoscopic cecum ligation and puncture rats than in the laparotomic (p<0.01). Nevertheless, the laparotomic cecum ligation rats had a significant increase in blood neutrophils and eosinophils when compared with controls (p<0.05). Conclusions: This study demonstrates that the CO2 pneumoperitoneum reduced the inflammatory and immune response in an animal model of peritonitis with respect to intraperitoneal cytokines, white blood cell count and clinical correlates of sepsis. The pneumoperitoneum produced hypercarbic acidosis in septic animals

FERRITINA: intervalos de referência para adultos no Estado do Rio Grande do Norte

Ferritin is a protein composed of heavy and light chains, non-covalently linked and which accommodates, in its core, thousands of atoms of iron. Furthermore, this protein represents the stock of iron in the body and it is characterized as an acute marker and predictor of diseases, such as iron deficiency anemia, hereditary hemochromatosis and others. Considering the variability of reference values and the analytical methods currently available, the aim of this work was to propose 95% confidence intervals for adults in the State of Rio Grande do Norte, Brazil, after determining the average concentration of serum ferritin for both sexes, beyond its correlation with the age. We analyzed 385 blood samples, collected by venipuncture from individuals residing in the State, after 12-14 hours of fast. The populational sample had 169 men and 216 women between 18-59 years old, which filled a questionnaire on socioeconomic, food habits and accounts about previous and current diseases. The sample collections were itinerant and the results of erythrogram, fasting glucose, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, urea, creatinine, leukocyte count and platelets, beyond C-reactive protein, were issued to each participant, so that, after selection of the apparently healthy individuals, the dosage of serum ferritin was carried out. Statistical analysis was performed using the softwares SPSS 11.0 Windows version, Epi Info 3.3.2 and Graf instant pad (version 3.02), and the random population sample was single (finite population), for which the test of linear correlation and diagram of dispersion were also made. After selection of individuals and determination of serum ferritin, the most discrepant outliers were disregarded (N = 358, Men = 154/Women = 207) and the average value determined for the masculine sex individuals was 167,18 ng / dL; for the feminine sex individuals, the average value obtained was 81,55 ng / dL. Moreover, we found that 25% of men had values < 90,30 ng / dL; 50% ≤ 156,25 ng / dL and 75% ≤ 229,00 ng / dL. In the group of women, 25% had values < 38,80 ng / dL; 50% ≤ 65,00 ng / dL and 75% ≤ 119,00 ng / dL. Through the correlation coefficient (r = 0,23 with p = 0,003), it is possible to suggest the existence of positive linear correlation between age and serum ferritin for men. The correlation coefficient for women (r = 0,16 with p = 0,025) also confirms the existence of positive linear correlation between serum ferritin and age. Considering the analysis carried out and specific methods corroborating with the proposed benchmarks, we concluded that the average value found for men is higher than that found for women. Furthermore, this scenario rises with age for both sexes, and the 95% confidence intervals obtained were 74 ng/dL ≤ μ ≤ 89 ng/dL and 152ng/dL ≤ μ ≤183ng/dL for the feminine and masculine sex individuals respectively

Avaliação histológica da próstata de cães adultos sexualmente intactos

Avaliou-se histologicamente a próstata de 30 cães adultos e idosos sexualmente intactos que apresentavam ou não sintomatologia clínica de doença prostática, e verificou-se a incidência de possíveis alterações da glândula. Dentre as alterações encontradas, a hiperplasia prostática benigna constituiu o diagnóstico mais comum, 85,6% (n=24), seguida por prostatite crônica, 64,3% (n=18), displasia do epitélio glandular, 42,8% (n=12), atrofia do epitélio glandular, 39,3% (n=11), infiltrado inflamatório focal, 25% (n=7), dilatação glandular focal, 21,4% (n=6), prostatite aguda, 7,1% (n=2), metaplasia escamosa, 3,6%, (n=1), metástase de neoplasia sistêmica, 3,6% (n=1) e abscesso prostático, 3,6% (n=1). Como em muitos casos os cães são assintomáticos, ressalta-se a importância da realização rotineira de exames clínicos específicos, como o toque retal e a ultrassonografia, para o diagnóstico precoce e o tratamento das afecções prostáticas.

Avaliação da composição química, atividade antioxidante, antibacteriana, antinoceptiva, antiinflamatória e toxicidade do extrato metanólico e frações de folhas de Spondias sp. (Anacardiaceae)

Spondias sp. (Anacardiaceae), popularly known as cajá-umbu, is an endemic plant from Northeastern Brazil, where their leaves are widely used in folk medicine to treat inflammatory processes, while their fruits have a great agro industrial potential. This study was designed to evaluate hepatoprotective, antinociceptive, antioxidant, antimicrobial and anti-inflammatory properties, as well as the acute toxicity and repeated dose 28, using a methanolic extract (MES), a fraction rich in flavonoids (FRF) and a precipitate from Spondias sp.leaves. The antioxidant activity of them was valued to evaluate their free radical scavenger capacity by DPPH test, whereas MES and FRF were used to evaluate while the preventive action on carbon tetrachloride (CCl4)-induced hepatotoxicity. Seven groups (n=5) of female Wistar rats were used as follows: control group, CCl4-intoxicated group treated with EMS (500 mg/kg) for 7 days, three CCl4-intoxicated groups treated with FRF (25, 50 and 75 mg/kg) for 7 days and the CCl4-intoxicated group treated with Legalon ® (silimarina; (phytotherapeutic reference) (50 mg/kg; 7 days). MES and FRF showed a protective action against liver injury induced by CCl4, being observed a significant reduction of serum enzyme activity marker of liver damage (alanine transaminase and aspartate transaminase). On the other hand, the lipid peroxidation (SRAT) decrease, as well as the increase of glutathione content and enzyme activity of antioxidant defense system (SOD, CAT, GPx) toward near normal values indicated the ability of EMS to restore the oxidative imbalance induced by CCl4. The histological analysis confirmed the hepatoprotection, compared to degenerative changes in CCl4-treated group. This hepatoprotetor effect was similar to that shown by Legalon®. The in vitro high antioxidant capacity of extract (93.16 ± 1.00%) showed analogous results to those obtained by Carduus marianus BHT (reference standard). This fact explains the obtained results in vivo. Although no antimicrobial activity was detected, EMS and FRF promoted the antinociceptive effect induced in the second phase by the intraplantar formalin test, evidencing the anti-inflammatory action; confirmed by the carrageenan-induced peritonitis model. The evaluation of the mechanical allodynia (CFA a 80%) demonstrated the involvement of the Spondias sp. chemical composition in the anti-inflammatory activity toward the acute processes. The acute exposure and repeated dose during 28 days did not produce significant changes in the parameters that evaluate toxicity. Together the experimental results reveal, that Spondias sp. leaf extracts have a promising potential in pharmaceutical area, and due to its non-toxic condition present efficiency and security

Caracterização dos marcadores químicos e avaliação de atividades biológicas do extrato de Spondias mombim

Spondias mombin is a fruitful species dispersed in tropical regions of America, Africa and Asia. In Brazil, the species can be found mainly in the northern and northeastern regions. Scarce chemical and pharmacological studies have been reported for S. mombin and until this moment studies about chemical markers were not developed. In this context, the aims of this study were to characterize the chemical markers from S. mombin leaves and evaluate their anti-inflammatory, antioxidant and antiproliferative potentials. The chemical profile of the hydroethanolic extract from S. mombin leaves analyzed by HPLC-DAD, through a validated method, allowed the identification and quantification of ellagic acid and chlorogenic acid. This extract showed anti-inflammatory potential in acute peritonitis model induced by carrageenan. The hydroethanolic extract from S. mombin leaves was subjected to a liquid-liquid partition with the solvents: n-hexane, dichloromethane, ethyl acetate and n-butanol. Regarding the anti-inflammatory potential of the fractions obtained they were active; however, ethyl acetate fraction at 200 mg/kg showed highlighted results. The compounds ellagic acid and chlorogenic acid also inhibited the leukocyte migration to the site of inflammation at 2.5, 5 and 10 mg/kg. The hydroethanolic extract, fractions and the chemical markers showed significant antioxidant potential when evaluated in different assays: DPPH Free-Radical Scavenging, Superoxide Radical Scavenging, Hydroxyl Radicals Scavenging and Reducing Power. Taken together our results showed that hydroethanolic extract of S. mombin leaves has ellagic acid and chlorogenic acid as bioactive markers and it demonstrated antiinflammatory and antioxidant properties besides no cytotoxicity against 3T3 cells. It enables us to suggest S. mombin as an important species to develop herbal drugs

Casearia sylvestris na permeabilidade gástrica à sacarose em equinos submetidos a protocolo de indução de úlcera gástrica

Estudos em animais de laboratório sugerem um efeito antiulcerogênico do extrato de Casearia sylvestris. Esse extrato ainda não foi estudado para a profilaxia e/ou o tratamento de úlceras gástricas em equinos. Para avaliar a influência do extrato de C. sylvestris na permeabilidade gástrica à sacarose, seis equinos adultos foram submetidos a modelo de indução de úlceras gástricas. Os animais foram submetidos ao teste de permeabilidade à sacarose antes e ao término do protocolo de restrição alimentar intermitente, para detecção de ulceração gástrica. Durante os sete dias da indução, os animais foram submetidos a tratamentos diários via sondagem nasogástrica com extrato de C. sylvestris (9mg kg-1 de peso corpóreo) ou veículo (ágar). Após intervalo de 32 dias em piquete, para permitir a cicatrização das úlceras induzidas, cada animal foi submetido novamente ao protocolo de indução de úlcera gástrica, e os tratamentos foram alternados. Dessa forma, cada animal foi submetido a ambos os tratamentos em períodos distintos. A concentração de sacarose na urina foi determinada para cada amostra obtida, por cromatografia líquida de alto desempenho e detecção amperométrica pulsátil. Não foram observadas alterações nos exames clínicos e hemogramas. O tratamento com o extrato de C. sylvestris evitou o aumento da concentração de sacarose urinária (P<0,05) quando comparado ao veículo, sugerindo um efeito antiulcerogênico gástrico em equinos. Estudos mais amplos incluindo gastroscopia são necessários para avaliar a possibilidade de usar o extrato para a profilaxia e/ou o tratamento das úlceras gástricas em equinos.