Hemoglobin polymorphism and hematological profile of Geoffroy's side-necked turtle (Phrynops geoffroanus, Testudines) in the northwestern region of São Paulo State, Brazil

Complete blood counts and hemoglobin isoform data were gathered from 36 specimens of the turtle species Phrynops geoffroanus from the northwestern region of São Paulo State, Brazil. They were collected in an urban area. The hemoglobin profiles were obtained after red blood cell lysis and by electrophoretic migration in alkaline pH, acid pH, and neutral pH buffer. The hemoglobin components were confirmed using high-performance liquid chromatography (HPLC). Erythrogram analysis included hematocrit, total hemoglobin concentration, total red blood cell count, and red blood cell indices. The leukogram included a total white blood cell count and a calculation of the percent values of neutrophils, lymphocytes, monocytes, basophils, eosinophils, heterophils, and azurophils. HPLC analysis revealed three hemoglobin components; the first with a concentration of 5.5%, the second was a major component with an average concentration of 67.1%, and the third with a concentration of 28.5%. The hematological profile obtained for these specimens allowed us to establish a pattern for P. geoffroanus in São Paulo State Northwestern region. The average hematocrit values were 22.5% for females and 24.0% for males. For total hemoglobin, we found average values of 6.66 g/dL in females and 7.22 g/dL in males. The number of white blood cells was 2725 x 103/μL for females and 2775 x 103/μL for males. There was a predominance of heterophils, eosinophils, and monocytes in both sexes. No significant differences were found between males and females for hematological profile. The hematological results were compared to literature data for other Chelonia. They were similar to what is known for fresh water turtles. © FUNPEC-RP.

Improvement in clinical signs and cellular immunity of dogs with visceral leishmaniasis using the immunomodulator P-MAPA

This study investigated the immunotherapeutic potential of the protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride immuno-modulator (P-MAPA) on canine visceral leishmaniasis. Twenty mongrel dogs presenting clinical symptoms compatible with leishmaniasis and diagnosis confirmed by the detection of anti-leishmania antibodies were studied. Ten dogs received 15 doses of the immunomodulator (2.0mg/kg) intramuscularly, and 10 received saline as a placebo. Skin and peripheral blood samples were collected following administration of the immunomodulator. The groups were followed to observe for clinical signals of remission; parasite load in the skin biopsies using real-time PCR, the cytokines IL-2, IL-10 and IFN-γ in the supernatant of peripheral blood mononuclear cells stimulated in vitro with either total promastigote antigen or phytohemagglutinin measured by capture ELISA, and changes in CD4+ and CD8+ T cell subpopulations evaluated by flow cytometry. Comparison between the groups showed that treatment with the immunomodulator promoted improvement in clinical signs and a significant reduction in parasite load in the skin. In peripheral blood mononuclear cell cultures, supernatants showed a decrease in IL-10 levels and an increase in IL-2 and IFN-γ. An increase in CD8+ T cells was observed in peripheral blood. In addition, the in vitro leishmanicidal action of P-MAPA was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and no leishmanicidal activity was detected. These findings suggest that P-MAPA has potential as an immunotherapeutic drug in canine visceral leishmaniasis, since it assists in reestablishing partial immunocompetence of infected dogs. © 2013 Elsevier B.V.

Avaliação do efeito de derivados de parede celular de levedura de cana-de-açúcar (Saccharomyces cerevisiae) sobre a resposta imune de cães adultos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação da transferência de imunidade passiva em bezerros de vacas da raça Canchim

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Associações entre marcadores nutricionais e inflamação em pacientes renais crônicos tratados por hemodiálise

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Enteroparasitoses em indivíduos HIV/aids: aspectos epidemiológicos, nutricionais e imunológicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Characterization of polymorphisms in the mannose-binding lectin gene promoter among human immunodeficiency virus 1 infected subjects

ABSTRACT: The present study investigated the prevalence of mutations in the -550 (H/L) and -221 (X/Y) mannose-binding lectin (MBL) gene promoter regions and their impact on infection by human immunodeficiency virus 1 (HIV-1) in a population of 128 HIV-1 seropositive and 97 seronegative patients. The allele identification was performed through the sequence-specific primer polymerase chain reaction method, using primer sequences specific to each polymorphism. The evolution of the infection was evaluated through CD4+ T-lymphocyte counts and plasma viral load. The allele and haplotype frequencies among HIV-1-infected patients and seronegative healthy control patients did not show significant differences. CD4+ T-lymphocyte counts showed lower levels among seropositive patients carrying haplotypes LY, LX and HX, as compared to those carrying the HY haplotype. Mean plasma viral load was higher among seropositive patients with haplotypes LY, LX and HX than among those carrying the HY haplotype. When promoter and exon 1 mutations were matched, it was possible to identify a significantly higher viral load among HIV-1 infected individuals carrying haplotypes correlated to low serum levels of MBL. The current study shows that haplotypes related to medium and low MBL serum levels might directly influence the evolution of viral progression in patients. Therefore, it is suggested that the identification of haplotypes within the promoter region of the MBL gene among HIV-1 infected persons should be further evaluated as a prognostic tool for AIDS progression.

Estado nutricional e marcadores clínico-bioquímicos em indivíduos portadores de carcinoma gastrointestinal

O estado nutricional de indivíduos portadores de carcinoma gastrointestinal é frequentemente afetado, sendo agravado em função da carcinogênese promover ativação do processo inflamatório e consequente ativação do sistema imunológico, com produção de citocinas e proteínas de fase aguda, como proteína C- reativa, que resulta no hipermetabolismo, acelerando a perda de peso e progredindo para o quadro de caquexia. Este trabalho teve como objetivo analisar o estado nutricional e os marcadores clínico-bioquímicos em indivíduos portadores de carcinoma gastrointestinal, atendidos no Hospital Universitário João de Barros Barreto (HUJBB), em Belém-PA. Foi realizado estudo transversal, descritivo, observacional com pacientes adultos e idosos, portadores de carcinoma gastrointestinal atendidos na Unidade de Alta Complexidade em Oncologia e na clínica cirúrgica do HUJBB, no período de dezembro de 2013 a julho de 2014. Realizou-se avaliação nutricional por meio de parâmetros antropométricos, que incluíram índice de massa corporal (IMC), percentual de perda de peso (%PP), circunferência do braço (CB), circunferência muscular do braço (CMB), área muscular do braço corrigida (AMBc), prega cutânea triciptal (PCT) e músculo adutor do polegar (MAP), parâmetros bioquímicos, por meio da classificação da hemoglobina, contagem total de linfócitos (CTL), albumina, transferrina, índice de prognóstico inflamatório-nutricional (IPIN) e parâmetros subjetivos, utilizando-se a avaliação subjetiva global produzida pelo paciente (ASG-PPP), além da identificação e classificação da caquexia. Foram avaliados 44 pacientes, sendo 63,30% do sexo masculino com idade média de 61,2 anos (±13,3). 95,50% eram naturais do Pará, 45,50% residentes no interior, 50,00% apresentavam escolaridade em ensino fundamental incompleto e 52,30% não possuíam renda familiar. Do total de pacientes avaliados, 63,60% possuíam neoplasia de estômago; destes, 50,00% estavam em estádio clínico IV e 73,30% em tratamento cirúrgico, com tempo médio de internação de 45,85 dias (±32,97). Na avaliação nutricional, verificou-se 20,50% de eutrofia para adultos e 42,30% para idosos, por meio do IMC, porém, em avaliação isolada dos compartimentos muscular e adiposo, verificou-se 59,10% de depleção grave por meio da AMBc, 54,50% por meio da PCT e 75,00% com presença de depleção em algum grau em CB e 68,18% em CMB. A perda de peso grave foi verificada em 61,36% dos pacientes avaliados e no MAP, obteve-se maior prevalência de depleção moderada (30,20%). Nos parâmetros bioquímicos, observou-se redução grave em hemoglobina em 61,40% dos pacientes, depleção leve em CTL em 56,80%, de albumina em 47,70% e depleção moderada de transferrina em 45,50%. Na avaliação do IPIN, verificou-se médio risco de complicação para 56,80% dos pacientes avaliados. Na ASG-PPP, 63,60% dos pacientes foram classificados em desnutrição grave e a presença de caquexia sintomática foi de 54,50%. No que se refere à análise de correlação, constatou-se que houve correlação positiva e significativa de IMC com CMB, CB, PCT, AMBc, MAP e Hemoglobina; CMB com CB e AMBc; CB com PCT, AMBc, MAP, e hemoglobina; PCT com AMBc; AMBc com MAP. Na análise de componente principal, verificou-se como métodos mais sensíveis para a detecção de desnutrição a avaliação de CB, AMBc, CMB, IMC, PCT, MAP, IPIN e avaliação da caquexia. Desta forma, os resultados obtidos no presente estudo evidenciam o comprometimento nutricional em pacientes portadores de carcinoma gastrointestinal, por diferentes parâmetros, demonstrando assim que a desnutrição ocorre de forma global, com perdas tanto de tecido adiposo quanto de tecido muscular, assim como alterações a nível bioquímico.

A longer time of exposure to antiretroviral therapy improves selenium levels

Background &aims: Selenium is an essential mineral for immunological function, performing crucial functions at the cellular level. This micronutrient has been determined to be frequently deficient in HIV infected patients, with correlations between reduced immunological function and greater susceptibility to opportunistic infections. Our aim was to evaluate the influence of time of exposure to antiretroviral therapy (ART) on the biochemical profile of selenium in HIV-infected patients.Methods: We performed a cross-sectional study on 50 HIV-positive men with different quantitations of viral load and CD4+ T cells, who were either receiving or not receiving ART. Dual energy X-ray absorptiometry (DXA) to determine body composition, biochemical analysis of selenium and albumin, anthropometric measurements were performed. The subjects were divided into groups according to the use of ART or not: The Control Group (CG) was 10 treatment-nave volunteers, Group G < 2 was 20 volunteers on ART for less than 2 years, and Group G > 2 was 20 volunteers on ART for >2 years.Results: The body mass index showed that all subjects were of normal weight. The group with a longer time of exposure to ART (G > 2) had undetectable viremia and a higher CD4+ T cell count: 593.1 +/- 234.6 mm(3). Selenium values (mu g/L) were 55.9 +/- 11.9 for CG, 52.1 +/- 10.5 for G < 2, and 66.9 +/- 20.8 for G > 2, with a significant difference between groups G < 2 and G > 2 (p < 0.05), and only G > 2 showed normal selenium values.Conclusions: Most of the men studied showed selenium deficiency, except for the subjects with a longer exposure to antiretroviral treatment. Thus, an adequate selenium concentration is related to better control of virology and of immunologic function. (C) 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Production of autoantibodies associated with polyclonal activation in Yersinia enterocolitica 0:8-infected mice

Polyclonal lymphocyte stimulation is one of the immunomodulatory mechanisms induced by arthritogenic pathogens. In this study we examined the polyclonal activation potential of a virulent strain of Y. enterocolitica serotype O:8 (WA 2707+) and its plasmidless isogenic pair (WA 2707-). SPF Swiss mice were infected intragastrically and spleen cells were obtained on days 7, 14, 21, 28, 35 and 42 after infection. The number of cells secreting nonspecific immunoglobulins of IgG, IgM and IgA isotypes was determined by the ELISPOT technique. The presence of serum-specific antibodies was investigated by ELISA and the presence of autoantibodies by dot-blot assay. Although the patterns of infection of the two bacterial strains were almost the same, only the animals infected with the virulent strain presented clinical anomalies. Neither arthritic nor inflammatory signs were observed in the joints of the infected animals. The greatest activation observed was that of the nonspecific IgM-secreting cells, and their peak of secretion occurred between the 28th and the 42nd day after infection, for both strains of Y. enterocolitica O:8. Only the animals infected with the virulent strain (WA 2707+) produced IgG-specific antibodies in the serum, from the 28th day after infection. The serum of animals infected with either strain showed reactivity to all the autologous constituents tested, mainly on the 28th and 42nd day after infection. It was concluded that infection of mice with either the virulent strain of Y. enterocolitica O:8 or with its plasmidless isogenic pair resulted in the polyclonal activation of the splenic B lymphocytes including some autoreactive clones.

Resultados da atenção farmacêutica no Brasil: uma revisão

The practice of pharmaceutical care (PC) is recent in Brazil and little is known about its impact on the health system or patients. The aim of this review was thus to identify the clinical, humanistic and economic outcomes achieved by the practice of PC in Brazil. In order to assess those outcomes, data published in studies from 1997 to 2011 were collected from Lilacs and MEDLINE databases, using the technique of content analysis. Original studies on PC that included pharmacotherapeutic follow-up were considered eligible for this descriptive review. A total of 306 articles were identified through the chosen descriptors. Of those, ten studies were eligible for this review and only two did not report significant results. The others reported increased adherence to pharmacotherapy, resolution of pharmacotherapeutic issues and control of clinical parameters of diseases (such as maintenance or reduction of blood pressure, reduction in HIV viral load and increase in lymphocyte count), promoting improvements in the general state of health and behavioral changes. However, economic impact was not assessed in any article analyzed, nor was a direct measurement of life quality performed. Although there are few studies on the outcomes of pharmaceutical care services in Brazil, it is demonstrated in this review that positive results were obtained when the pharmacist acted as a provider of optimized pharmacotherapy. This may be considered a result of the actions that followed the Brazilian Pharmaceutical Care Consensus of 2002, such as the restructuring of the curricular basis of pharmacy courses. From this point on, Brazilian researchers and pharmacists should think of a strategy to expand the offer of pharmaceutical care beyond academia and reach people in general who need this type of health care.

The impact of late diagnosis on the survival of patients following their first AIDS-related hospitalization in Belo Horizonte, Brazil

The purpose of this study is to estimate the survival probability of patients following their first admission for the treatment of AIDS to an infectious disease reference hospital in Belo Horizonte, Brazil, during 2005. Study subjects were monitored during a 12-month period to identify factors associated with survival probability. Late diagnosis was recorded among many of the 250 study subjects: almost half (44.8%) were diagnosed less than 30 days prior to or during their hospitalization. A high mortality rate was also detected: 39.6% of the subjects died during the 12 months of monitoring. The cumulative survival probability of the cohort group was estimated at 68.0% after 3 months and at 61.2% after 12 months. However, certain patient subgroups analyzed had even lower cumulative survival probabilities after 12 months of monitoring: if diagnosed during hospitalization, it was estimated at only 48.0% and those with no record of antiretroviral treatment had a 48.5% cumulative survival probability. Patients with severe anemia had the lowest survival probability, similar among the two lymphocyte count groups (<1000 mm(3) and >= 1000 mm(3)), the former with a 45.5% survival probability and the latter with a 46.7% one. The proportional death risk was 2.5-fold higher for men residing in other area than the capital city of the State of Minas Gerais and greater metropolitan region when compared with women residing there. The findings of this study highlight the importance of early diagnosis for predicting patient survival and reinforce the necessity off acilitating HIV diagnosis.

Recognition of enteroinvasive Escherichia coli and Shigella flexneri by dendritic cells: distinct dendritic cell activation states

The innate and adaptive immune responses of dendritic cells (DCs) to enteroinvasive Escherichia coli (EIEC) infection were compared with DC responses to Shigella flexneri infection. EIEC triggered DCs to produce interleukin (IL)-10, IL-12 and tumour necrosis factor (TNF)-alpha, whereas S. flexneri induced only the production of TNF-alpha. Unlike S. flexneri, EIEC strongly increased the expression of toll like receptor (TLR)-4 and TLR-5 in DCs and diminished the expression of co-stimulatory molecules that may cooperate to inhibit CD4(+) T-lymphocyte proliferation. The inflammation elicited by EIEC seems to be related to innate immunity both because of the aforementioned results and because only EIEC were able to stimulate DC transmigration across polarised Caco-2 cell monolayers, a mechanism likely to be associated with the secretion of CC chemokine ligands (CCL) 20 and TNF-alpha. Understanding intestinal DC biology is critical to unravelling the infection strategies of EIEC and may aid in the design of treatments for infectious diseases.

Late entry into HIV care: lessons from Brazil, 2003 to 2006

Background: To ascertain the population rates and proportion of late entry into HIV care, as well as to determine whether such late entry correlates with individual and contextual factors. Methods: Data for the 2003-2006 period in Brazil were obtained from public health records. A case of late entry into HIV care was defined as one in which HIV infection was diagnosed at death, one in which HIV infection was diagnosed after the condition of the patient had already been aggravated by AIDS-related diseases, or one in which the CD4(+) T-cell count was <= 200 cells/mm(3) at the time of diagnosis. We also considered extended and stricter sets of criteria (in which the final criterion was <= 350 cells/mm(3) and <= 100 cells/mm(3), respectively). The estimated risk ratio was used in assessing the effects of correlates, and the population rates (per 100,000 population) were calculated on an annual basis. Results: Records of 115,369 HIV-infected adults were retrieved, and 43.6% (50,358) met the standard criteria for late entry into care. Diagnosis at death accounted for 29% (14,457) of these cases. Late entry into HIV care (standard criterion) was associated with certain individual factors (sex, age, and transmission category) and contextual factors (region with less economic development/increasing incidence of AIDS, lower local HIV testing rate, and smaller municipal population). Use of the extended criteria increased the proportion of late entry by 34% but did not substantially alter the correlations analyzed. The overall population rate of late entry was 9.9/100,000 population, specific rates being highest for individuals in the 30-59 year age bracket, for men, and for individuals living in regions with greater economic development/higher HIV testing rates, collectively accounting for more than half of the cases observed. Conclusions: Although the high proportion of late entry might contribute to spreading the AIDS epidemic in less developed regions, most cases occurred in large cities, with broader availability of HIV testing, and in economically developed regions.

Faster HIV-1 Disease Progression among Brazilian Individuals Recently Infected with CXCR4-Utilizing Strains

Introduction: Primary HIV infection is usually caused by R5 viruses, and there is an association between the emergence of CCXR4-utilizing strains and faster disease progression. We characterized HIV-1 from a cohort of recently infected individuals in Brazil, predicted the virus's co-receptor use based on the env genotype and attempted to correlate virus profiles with disease progression. Methods: A total of 72 recently infected HIV patients were recruited based on the Serologic Testing Algorithm for Recent HIV Seroconversion and were followed every three to four months for up to 78 weeks. The HIV-1 V3 region was characterized by sequencing nine to twelve weeks after enrollment. Disease progression was characterized by CD4+ T-cell count decline to levels consistently below 350 cells/mu L. Results: Twelve out of 72 individuals (17%) were predicted to harbor CXCR4-utilizing strains; a baseline CD4,350 was more frequent among these individuals (p = 0.03). Fifty-seven individuals that were predicted to have CCR5-utilizing viruses and 10 individuals having CXCR4-utilizing strains presented with baseline CD4.350; after 78 weeks, 33 individuals with CCR5 strains and one individual with CXCR4 strains had CD4.350 (p = 0.001). There was no association between CD4 decline and demographic characteristics or HIV-1 subtype. Conclusions: Our findings confirm the presence of strains with higher in vitro pathogenicity during early HIV infection, suggesting that even among recently infected individuals, rapid progression may be a consequence of the early emergence of CXCR4-utilizing strains. Characterizing the HIV-1 V3 region by sequencing may be useful in predicting disease progression and guiding treatment initiation decisions.