Differences in responses to the intracellular macrophage environment between Mycobacterium bovis BCG vaccine strains Moreau and Pasteur

BACKGROUND The Bacille Calmette-Guérin (BCG) vaccine comprises a family of strains with variable protective efficacy against pulmonary tuberculosis (TB) and leprosy, partly due to genetic differences between strains. OBJECTIVES Previous data highlighting differences between the genomes and proteomic profiles of BCG strains Moreau and Pasteur led us to evaluate their behaviour in the macrophage microenvironment, capable of stimulating molecular responses that can impact the protective effect of the vaccine. METHODS Strain infectivity, viability, co-localisation with acidified vesicles, macrophage secretion of IL-1 and MCP-1 and lipid droplet biogenesis were evaluated after infection. FINDINGS We found that BCG Moreau is internalised more efficiently, with significantly better intracellular survival up to 96 h p.i., whereas more BCG Pasteur bacilli were found co-localised in acidified vesicles up to 6 h p.i. IL-1β and MCP-1 secretion and lipid droplet biogenesis by infected macrophages were more prominent in response to BCG Pasteur. MAIN CONCLUSION Overall, our results show that, compared to Pasteur, BCG Moreau has increased fitness and better endurance in the harsh intracellular environment, also regulating anti-microbial responses (lower IL-1b and MCP-1). These findings contribute to the understanding of the physiology of BCG Moreau and Pasteur in response to the intraphagosomal environment in a THP-1 macrophage model.

Heterogeneous persistence of Mycobacterium leprae in oral and nasal mucosa of multibacillary patients during multidrug therapy

BACKGROUND Leprosy is curable by multidrug therapy (MDT) treatment regimen ranging from six to 12 months. The variable levels of tolerance and adherence among patients can, however, result in treatment failure and the emergence of drug-resistant strains. OBJECTIVES Describe the impact of MDT over Mycobacterium leprae viability in patient's oral and nasal mucosa along treatment. METHODS Mycobacterium leprae viability was monitored by quantitative polymerase chain reaction (qPCR) quantification of 16S rRNA in lateral and contralateral scrapings of oral and nasal mucosa of 10 multibacillary patients along the initial five months of treatment. FINDINGS The results demonstrated high heterogenicity of M. leprae viability among patients and between nasal and oral samples. Of six patients who presented good adherence and tolerance to the treatment, only four displayed absence of M. leprae viability in both samples three months after the first MDT dose, while for the other two, the absence of M. leprae viability in the oral and nasal cavities was only detected five months after the first dose. MAIN CONCLUSIONS We concluded that qPCR of 16S rRNA for the determination of M. leprae viability in nasal and oral scraping samples could represent an interesting approach to monitor treatment efficacy.

Association of CD209 (DC-SIGN) rs735240 SNV with paucibacillary leprosy in the Brazilian population and its functional effects

BACKGROUND Leprosy, caused by Mycobacterium leprae, is a public health problem in Brazil that affects peripheral nerves, resulting in physical disabilities. During host-pathogen interactions, the immune response determines leprosy outcomes from a localised (paucibacillary) form to a disseminated (multibacillary) form. The recognition of M. leprae involves the DC-SIGN receptor, which is present on the dendritic cells (DCs) and participates in immune activation. OBJECTIVES To evaluate the association of polymorphisms in the promoter region of the gene encoding DC-SIGN (CD209) and the clinical form of leprosy, and to investigate its functional effects. METHODS The study population included 406 leprosy patients from an endemic area in Brazil [310 multibacillary (MB); 96 paucibacillary (PB)]. A functional evaluation based on the effects of the single nucleotide variant (SNV) associated with PB leprosy on the specific immune response was also performed. RESULTS The GA genotype and the presence of the A allele of rs735240 (-939G>A) were associated with PB leprosy [OR: 2.09 (1.18-3.69) and 1.84 (1.07-3.14), respectively]. Carriers of the A allele showed reduced expression of CD209 and TGF-β1 in leprosy lesions in comparison with individuals with GG genotype, in addition to a higher response to the Mitsuda test. CONCLUSION These data suggest that rs735240 influences the immune response against M. leprae and clinical presentation of leprosy.

Relapse in leprosy and drug resistance assessment in a tertiary hospital of the state of Espírito Santo, Brazil

Abstract INTRODUCTION: Leprosy recurrence is the reappearance of the disease after treatment with current schemes and discharged for cure and may have variable incubation periods. METHODS: This is a descriptive observational study of leprosy recurrence in Espírito Santo diagnosed between January 2018 and January 2020. RESULTS: One hundred and ninety-two cases were available, of which 30 were diagnosed with leprosy recurrence. CONCLUSIONS: In 25 cases, the incubation period was 5-15 years after the first treatment, favoring bacillary persistence. In the remaining 5 cases, the disease had recurred after 15 years, pointing to reinfection as none of them exhibited drug resistance.

Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease

Abstract INTRODUCTION: Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy. METHODS: We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates: age, sex, and trypanocidal treatment. RESULTS: A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04). CONCLUSIONS: Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.

Association between MBL2 haplotypes and dengue severity in children from Rio de Janeiro, Brazil

BACKGROUND Dengue is an arthropod-borne viral disease with a majority of asymptomatic individuals and clinical manifestations varying from mild fever to severe and potentially lethal forms. An increasing number of genetic studies have outlined the association between host genetic variations and dengue severity. Genes associated to viral recognition and entry, as well as those encoding mediators of the immune response against infection are strong candidates for association studies. OBJECTIVES The aim of this study was to investigate the association between MBL2, CLEC5A, ITGB3 and CCR5 genes and dengue severity in children. METHODS A matched case-control study was conducted and 19 single nucleotide polymorphisms (SNPs) were investigated. FINDINGS No associations were observed in single SNP analysis. However, when MBL2 SNPs were combined in haplotypes, the allele rs7095891G/rs1800450C/ rs1800451C/rs4935047A/rs930509G/rs2120131G/rs2099902C was significantly associated to risk of severe dengue under α = 0.05 (aOR = 4.02; p = 0.02). A second haplotype carrying rs4935047G and rs7095891G alleles was also associated to risk (aOR = 1.91; p = 0.04). MAIN CONCLUSIONS This is the first study to demonstrate the association between MBL2 haplotypes and dengue severity in Brazilians including adjustment for genetic ancestry. These results reinforce the role of mannose binding lectin in immune response to DENV.

Single nucleotide polymorphisms of cytokine-related genes and association with clinical outcome in a Chagas disease case-control study from Brazil

BACKGROUND The severity of chronic chagasic cardiomyopathy (CCC), the most frequent clinical outcome of Chagas disease (CD), has been associated with cytokine-enriched heart tissue inflammation, and high serum levels of transforming growth factor (TGFβ), interferon-gamma (IFNγ), and tumour necrosis factor (TNF). Conversely, increased interleukin (IL)-10 serum concentrations have been associated with asymptomatic CD. Cytokines and cytokine-related gene polymorphisms may control cytokine expression and have been proposed to contribute to CCC outcomes. OBJECTIVES We evaluated the association of 13 cytokine-related genes (TGFB: rs8179181, rs8105161, rs1800469; IL10: rs1800890, rs1800871, rs1800896; IFNG: rs2430561; TNF: rs1800629; BAT1: rs3853601; LTA: rs909253, rs2239704; TNFR1: rs767455; TNFR2: rs1061624) with risk and progression of CCC. FINDINGS Four hundred and six seropositive patients from CD endemic areas in the state of Pernambuco, north-eastern Brazil, were classified as non-cardiopathic (A, 110) or cardiopathic (mild, B1, 163; severe, C, 133). We found no evidence of TGFB, IL10, TNF, or TNFR1/2 gene polymorphisms associated with CCC risk or progression. Only BAT1 rs3853601 −22G carriers (B1 vs. C: OR = 0.5; p-value = 0.03) and IFNG rs2430561 +874AT (A vs. C: OR = 0.7; p-value = 0.03; A vs. B1+C: OR = 0.8; p-value = 0.02) showed a significant association with protection from cardiopathy in a logistic regression analysis with adjustment for gender and ethnicity; however, the association disappeared after performing adjustment for multiple testing. A systematic review of TNF rs1800629 −308G>A publications included five studies for meta-analysis (534 CCC and 472 asymptomatic patients) and showed no consensus in pooled odds ratio (OR) estimates for A allele or A carriers (OR = 1.4 and 1.5; p-values = 0.14 and 0.15, respectively). In CD patients, TNF serum levels were increased, but not affected by the TNF rs1800629 −308A allele. MAIN CONCLUSIONS Our data suggest no significant contribution of the analysed gene variants of cytokine-related molecules to development/severity of Chagas' heart disease, reinforcing the idea that parasite/host interplay is critical to CD outcomes.

Treinamento de Força Moderado Atenua o Aumento da Pressão Arterial e Diminui o Número de Núcleos em Cardiomiócitos de Ratos Hipertensos / Moderate Resistance Training Attenuates the Increase in Blood Pressure and Decreases the Cardiomyocyte Nuclei Number in Hypertensive Rats

O treinamento de força (TF) é uma estratégia que diminui a pressão arterial (PA) em pacientes com hipertensão arterial (HA) estágio 1 e atenua a progressão da PA em ratos hipertensos (estágio 3). A influência do TF na remodelação cardíaca na HA não controlada ainda não está estabelecida. Objetivo: O objetivo deste estudo foi avaliar os efeitos a longo prazo do TF em intensidade moderada na remodelação cardíaca em ratos espontaneamente hipertensos (SHRs) sem tratamento. Métodos: Dez SHRs machos com HA estágio 3 (PA sistólica ≥ 180 mmHg) e cinco ratos Wistar-Kyoto (WKY) normotensos (PA sistólica < 120 mmHg) foram divididos em três grupos: sedentários normotensos (SED-WKY), sedentários hipertensos (SED-SHR) e hipertensos TF (TF-SHR). O TF foi realizado em uma escada vertical (3 dias / semana por 12 semanas, em dias não consecutivos) com 70% da carga máxima. A PA e a frequência cardíaca foram registradas. Ao final do protocolo, os animais foram sacrificados e tiveram o ventrículo esquerdo seccionado para análise histológica (hematoxilina e eosina e picrosirius red). Resultados: O TF não atenuou o ganho de peso absoluto e relativo do coração e do ventrículo esquerdo no grupo TF-SHR em comparação ao grupo SED-SHR. Não houve nenhuma diferença no volume nuclear nos cardiomiócitos e conteúdo de colágeno entre os grupos. No entanto, o TF diminuiu o número de núcleos nos cardiomiócitos e atenuou o aumento da PA sistólica no grupo TF-SHR em relação ao grupo SED-SHR. O Δ do duplo produto foi menor no grupo TF-SHR em comparação aos grupos SED-WKY e SED-SHR. Conclusões: Os dados obtidos demonstram que o TF não atenuou a hipertrofia cardíaca, mas reduziu a proliferação nuclear nos cardiomiócitos e a progressão da PA em SHR com HA severa.

Resistance training (RT) is a strategy that decreases blood pressure (BP) in patients with stage 1 hypertension and attenuates BP progression in hypertensive rats (stage 3). The influence of RT in cardiac remodeling in uncontrolled hypertension is not yet established. Objective: The aim of this study was to evaluate the long-term effects of RT in moderate intensity in cardiac remodeling in spontaneously hypertensive rats (SHRs) without treatment. Methods: Ten male SHRs with stage 3 hypertension (systolic BP ≥ 180 mmHg) and five normotensive Wistar-Kyoto (WKY) rats (systolic BP < 120 mmHg) were divided into three groups: sedentary normotensive (SED-WKY), sedentary hypertensive (SED-SHR), and RT hypertensive (RT-SHR). The RT was conducted in a vertical ladder (3 days/week for 12 weeks, on nonconsecutive days) at 70% of the maximum load. BP and heart rate were recorded. At the end of the protocol, the animals were euthanized and had their left ventricles sectioned for histological analysis (hematoxylin and eosin and picrosirius red). Results: RT did not attenuate the absolute and relative weight gains of the heart and left ventricle in the RT-SHR group compared with the sedentary group (SED-SHR). There was no difference in nuclear cardiomyocyte volume and collagen content between groups. However, RT decreased the number of nuclei in the cardiomyocytes and attenuated the increase in systolic BP in the RT-SHR when compared with the SED-SHR group. The Δ of the rate-pressure product was lower in the RT-SHR group compared with the groups SED-WKY and SED-SHR. Conclusions: The data obtained demonstrate that RT did not attenuate the cardiac hypertrophy, but reduced the nuclear proliferation in cardiomyocytes and the BP progression in SHRs with severe hypertension.

Resistance Training in Spontaneously Hypertensive Rats with Severe Hypertension / Treinamento de Força em Ratos Espontaneamente Hipertensos com Hipertensão Arterial Grave

Abstract Background: Resistance training (RT) has been recommended as a non-pharmacological treatment for moderate hypertension. In spite of the important role of exercise intensity on training prescription, there is still no data regarding the effects of RT intensity on severe hypertension (SH). Objective: This study examined the effects of two RT protocols (vertical ladder climbing), performed at different overloads of maximal weight carried (MWC), on blood pressure (BP) and muscle strength of spontaneously hypertensive rats (SHR) with SH. Methods: Fifteen male SHR ENT#091;206 ± 10 mmHg of systolic BP (SBP)ENT#093; and five Wistar Kyoto rats (WKY; 119 ± 10 mmHg of SBP) were divided into 4 groups: sedentary (SED-WKY) and SHR (SED-SHR); RT1-SHR training relative to body weight (~40% of MWC); and RT2-SHR training relative to MWC test (~70% of MWC). Systolic BP and heart rate (HR) were measured weekly using the tail-cuff method. The progression of muscle strength was determined once every fifteen days. The RT consisted of 3 weekly sessions on non-consecutive days for 12-weeks. Results: Both RT protocols prevented the increase in SBP (delta - 5 and -7 mmHg, respectively; p > 0.05), whereas SBP of the SED-SHR group increased by 19 mmHg (p < 0.05). There was a decrease in HR only for the RT1 group (p < 0.05). There was a higher increase in strength in the RT2 (140%; p < 0.05) group as compared with RT1 (11%; p > 0.05). Conclusions: Our data indicated that both RT protocols were effective in preventing chronic elevation of SBP in SH. Additionally, a higher RT overload induced a greater increase in muscle strength.

Resumo Fundamentos: O treinamento de força (TF) tem sido recomendado como tratamento não farmacológico para hipertensão arterial moderada. Apesar do papel importante que a intensidade do exercício desempenha sobre a prescrição do treinamento, ainda não há nenhum dado avaliando os efeitos da intensidade do TF sobre a hipertensão arterial grave (HAG). Objetivo: Este estudo analisou os efeitos de dois protocolos do TF(subida em escada vertical), realizados com diferentes sobrecargas do peso máximo carregado (PMC), sobre a pressão arterial (PA) e a força muscular de ratos espontaneamente hipertensos (SHR) com HAG. Métodos: Quinze SHR machos (206 ± 10 mmHg de PA sistólica (PAS)) e cinco ratos Wistar Kyoto (WKY; 119 ± 10 mmHg de PAS) foram divididos em 4grupos:sedentários: (SED-WKY) e SHR (SED-SHR); treinados: TF1-SHR conforme o peso corporal (~40% do PMC); e TF2-SHR conforme o teste de PMC (~70% do PMC). Foram coletadas medidas de PAS e a frequência cardíaca (FC) semanalmente usando o método de pressão arterial caudal. A progressão da força muscular foi determinada a cada 15 dias. O TF consistiu de 3 sessões semanais em dias não consecutivos durante 12 semanas. Resultados: Os dois protocolos de TF preveniram o aumento da PAS(respectivamente, delta - 5 e -7 mmHg; p > 0, 05), enquanto que a PAS do grupo SED-SHR aumentou em 19 mmHg (p < 0, 05). Houve queda na FC apenas para o grupo TF1 (p < 0, 05). Foi observado um aumento mas significativo de força no grupo do protocolo TF2 (140%; p < 0, 05) em comparação com o TF1 (11%; p>0, 05). Conclusões: Nossos dados indicam que ambos os protocolos de TF foram efetivos na prevenção da elevação crônica da PAS na HAG. Além disso, sobrecargas maiores de TF induziram a um maior aumento de força muscular.

Diagnostic challenges of single plaque-like lesion paucibacillary leprosy

The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR) results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP), medium (MP) or low (LP) probability of leprosy or other dermatopathy (OD). Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19), two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.

HIV-associated tuberculous lymphadenitis: the importance of polymerase chain reaction (PCR) as a complementary tool for the diagnosis of tuberculosis - a study of 104 patients / Linfadenite tuberculosa associada ao HIV: a importância da reação em cadeia de polimerase (PCR) como ferramenta complementar para o diagnóstico da tuberculose - estudo de 104 pacientes

BACKGROUND: Lymphadenitis is common in HIV-positive patients. Diagnosis of the infections associated with this condition is complex, particularly in the case of tuberculosis. Rapid and specific detection of Mycobacterium tuberculosis (M. tuberculosis) is fundamental in ensuring adequate treatment. In addition, frequent causes of lymphadenitis such as those associated with lymphoma and histoplasmosis, among others, must be eliminated as possible causes. OBJECTIVES: To evaluate the accuracy of polymerase chain reaction as a tool for the diagnosis of lymphadenitis resulting from M. tuberculosis. METHODS: In this study, a protocol was developed using the following procedures: direct microscopy using Ziehl-Neelsen staining, culture in Lowenstein-Jensen medium, histology and polymerase chain reaction. RESULTS: A total of 104 patients were included in the study. According to histopathology, 38 patients (36 percent) were found to have nonspecific chronic lymphadenitis, 27 (26 percent) had tuberculous lymphadenitis, 11 patients (10.5 percent) had lymphoma and 9 (8.7 percent) had histoplasmosis. When Lowenstein-Jensen culture was performed, positive tests for tuberculous lymphadenitis increased by 30 percent. With polymerase chain reaction, M. tuberculosis DNA was detected in 6 out of 38 samples of non-specific chronic lymphadenitis. Three of these patients were followed up, developed symptoms of tuberculosis and were cured following specific treatment. CONCLUSION: The data obtained in this study suggest that all cases of lymphadenopathies should be submitted to histopathology, Lowenstein-Jensen or Ogawa culture and polymerase chain reaction. Polymerase chain reaction may prove to be useful in providing an early and accurate detection of cases of extrapulmonary tuberculosis in HIV-positive patients with lymphadenopathies, avoiding empirical treatment and the possible development of resistant strains.

FUNDAMENTOS: A linfadenite é comum em pacientes HIV-positivos. O diagnóstico das infecções associadas a essa condição é complexo, especialmente em relação à tuberculose. A detecção rápida e específica do Mycobacterium tuberculosis (M. tuberculosis) é essencial para o tratamento adequado. Além disso, frequentes causas de linfadenites tais como as relacionadas a linfoma, histoplasmose, e outras, devem ser afastadas. OBJETIVOS: Avaliar a importância da biópsia cirúrgica excisional das linfadenites e realização dos exames histopatológicos, exames baciloscópicos (Ziehl-Neelsen), cultura (Lowenstein-Jensen) e reação em cadeia da polimerase (PCR) com finalidade diagnostica MÉTODOS: Desenvolveu-se um protocolo para biópsias excisionais de linfonodos, adotando-se os seguintes procedimentos: exame direto de esfregaços corados pelo método de Ziehl-Neelsen, cultura em meio de Lowenstein-Jensen, exame anátomo-patológico e PCR. RESULTADOS: Ao todo foram incluídos 104 pacientes, e o exame histopatológico evidenciou 36 por cento (n = 38 pacientes) de casos de linfadenite crônica inespecífica, 26 por cento (n = 27) de linfadenite tuberculosa, 10,5 por cento (n =11) de linfoma e 8,7 por cento (n = 9) de histoplasmose. Através da cultura no meio de Lowenstein-Jensen, os casos positivos para linfadenite tuberculosa aumentaram para 30 por cento. A PCR detectou M. tuberculosis em 6 das 38 amostras de linfadenite crônica inespecífica. Três desses pacientes foram acompanhados, exibiram sintomas de tuberculose e foram curados após tratamento específico. CONCLUSÃO: Os dados obtidos neste trabalho sugerem que em todos os casos de linfadenopatia deve-se realizar exame histopatológico, cultura em Lowenstein-Jensen ou Ogawa e reação em cadeia da polimerase. A reação em cadeia da polimerase pode ser útil na detecção precoce e acurada de casos de TB extrapulmonar nos pacientes HIV-positivos com linfadenopatias, evitando-se o uso de tratamentos empíricos e o eventual desenvolvimento de cepas resistentes.

Suplementação proteica não aumenta a concentração plasmática de óxido nítrico em homens saudáveis / Protein supplementation does not increase nitric oxide plasmatic concentration in healthy men

Suplementos nutricionais, supostamente, capazes de potencializar a produção endógena de óxido nítrico (NO) têm experimentado crescente popularidade entre os indivíduos fisicamente ativos. Diante da carência de informações sobre o assunto, o objetivo do presente estudo foi avaliar o efeito de um suplemento comercial à base de proteínas e aminoácidos sobre a produção endógena de NO. MÉTODOS: A amostra foi constituída de 12 homens sedentários, mas sem fatores de risco para doenças cardiovasculares. O protocolo de suplementação foi conduzido conforme o arranjo experimental duplo-cego cruzado. Os participantes receberam, aleatoriamente, placebo (PLA) ou suplemento proteico (SP), em dois momentos diferentes, separados por uma semana. Com o intuito de determinar a concentração plasmática de NO, amostras de sangue foram coletadas antes (24h e imediatamente antes) e depois (30 e 60 minutos) do consumo da substância PLA ou do SP. RESULTADOS: Não foi observada alteração na concentração plasmática de NO após a ingestão do SP em comparação com o PLA (pós- suplementação 30min - PLA: 19,3 ± 4,7µmol.L- 1 vs. SP: 18,9 ± 4,4µmol.L-1 e pós-suplementação 60min - PLA: 21,3 ± 6,5µmol.L-1 vs. SP: 20,3 ± 4,9µmol.L-1). Também não foi verificada alteração da pressão arterial. CONCLUSÃO: O suplemento nutricional à base de proteínas e aminoácidos, testado no presente estudo, não potencializou a produção endógena de NO.

Nutritional supplements, theoretically able to increase endogenous nitric oxide (NO) production have experienced great popularity among physically active individuals. AIM: scientific evidence available regarding this issue is scarce. Therefore, the purpose of this study was to evaluate the effect of a dietary supplement commercialized as a nitric oxide booster. MATERIALS AND METHODS: twelve sedentary men with no risk factors for cardiovascular diseases were supplemented with placebo or protein in two different occasions. The present study was conducted in a cross double-blind design. In order to assess plasmatic NO concentration, blood samples were obtained before (24hs and immediately before) and after (30 and 60 minutes) consumption of placebo (PLA) or protein supplement (SP). RESULTS: there was no difference in plasmatic nitric oxide concentration between both trails (Post-supplementation 30 min - PLA: 19.3±4.7 µmol.L-1 vs. SP: 18.9±4.4 µmol.L-1 and Post-supplementation 60 min - PLA: 21.3±6.5 µmol.L-1 vs. SP: 20.3±4.9 µmol.L-1). In addition, no difference was detected for arterial blood pressure. CONCLUSION: the dietary supplement analyzed in the present study failed to increase nitric oxide endogenous production.

Perda de nitrogênio pela Brachiaria decumbens após a antese: relação com a umidade do solo / Nitrogen loss through Brachiaria decumbens after anthesis stage: relation with soil moisture

Com o objetivo de avaliar a perda de N por plantas de Brachiaria decumbens no estádio da pós-antese relacionada com a umidade do solo, realizou-se um experimento em casa-de-vegetação, em delineamento inteiramente casualizado, com três tratamentos e seis repetições. Os tratamentos do estudo constaram da colheita de plantas nos seguintes estádios e condições de umidade do solo: (a) A60: estádio de antese e com umidade do solo mantida a 60 por cento da capacidade máxima de retenção de água; (b) PA60: estádio de pós-antese ou maturidade com umidade do solo mantida a 60 por cento da capacidade máxima de retenção de água; e (c) PA20: pós-antese com umidade estabelecida após a antese de 20 por cento da capacidade máxima de retenção de água do solo. As plantas de Brachiaria decumbens, cultivadas em vasos preenchidos com solo arenoso, foram fertilizadas com sulfato de amônio-15N (800mg vaso-1 de N). As plantas dos tratamentos pós-antese (PA60 e PA20) foram colhidas após 17 dias do início do florescimento. O balanço de N do sulfato de amônio (15N) no sistema solo-planta indicou perdas de N, presumivelmente pela parte aérea das plantas de Brachiaria decumbens, no estádio de pós-antese (tratamento PA60), da ordem de 25 por cento em relação ao de antese (A60). A perda de N na pós-antese avaliada no tratamento com déficit hídrico (PA20) foi reduzida comparativamente ao PA60, sendo da ordem de 11 por cento em relação ao tratamento A60.

The objective of this research work was to evaluate the N loss through Brachiaria decumbens in the stage of post-anthesis related to the soil moisture. The experiment was carried out in green-house condition and the experimental design was a completely randomized, with three treatments and six replications. Plants of grass-Brachiaria were cultivated in pots filled out with sandy soil. The soil of each pot was fertilized with ammonium sulfate-15N (800mg vaso-1 of N). The treatments consisted of harvest of plants in the stages and soil moisture conditions, as following: (a) A60: stage of anthesis and with soil moisture maintained to 60 percent of the maximum water retention capacity; (b) PA60: post-anthesis stage or maturity with soil moisture maintained to 60 percent of the maximum retention capacity, and (c) PA20: post-anthesis stage with soil moisture of 20 percent of the maximum water retention capacity established after the anthesis stage. The plants of the treatments post-anthesis (PA60 and PA20) were harvested after 17 days beginning of the flowering stage. The balance of N from ammonium sulfate (15N) in the soil-plant system indicated losses of N, presumably from the aerial part of grass-Brachiaria plants in the post-anthesis stage (treatment PA60). These values were of the order of 25 percent in relation to the anthesis treatment (A60). The N loss in the post-anthesis stage as evaluated in the treatment with water deficits (PA20), it was minimized comparatively to the PA60 and it was of the order of 11 percent in relation to the treatment A60.

Resposta cardiovascular materna e fetal ao exercício isométrico / Maternal and Fetal Cardiovascular Responses to Isometric Exercise

O objetivo do presente trabalho foi verificar o efeito do exercício isométrico com variação no percentual da contração voluntária máxima e no tamanho dos grupos musculares recrutados sobre a resposta cardiovascular materna e fetal. Materiais e métodos: A amostra foi constituída de 37 mulheres saudáveis, sedentárias que foram divididas em dois grupos, grávidas (n=13) e não grávidas (n=24). No primeiro dia foi determinada a contração voluntária máxima (CVM) nos dinamômetros de preensão manual e no de extensão de costas e pernas. No dia seguinte foram realizados testes a 30% e 50% dos valores previamente obtidos em ambos os dinamômetros. Resultados: O percentual da contração voluntária máxima não afetou a freqüência cardíaca materna e fetal quando uma menor massa muscular foi recrutada (dinamômetro de preensão manual). Quando uma grande massa muscular foi acionada (dinamômetro de extensão de costas e pernas) o principal fator na determinação da freqüência cardíaca materna e fetal não foi o percentual da contração voluntária máxima, mas a própria quantidade de massa muscular. Conclusão: Em atividades isométricas a quantidade de músculos recrutados é mais importante que a intensidade da contração para o aumento da freqüência cardíaca materna e fetal. O aumento para a freqüência cardíaca fetal, entretanto, não ultrapassou o limite considerado seguro de 160 batimentos por minuto.

Aim: The aim of present study was verify the effect of isometric exercise with different intensities of contraction and quantity of muscle mass recruited upon maternal e fetal cardiovascular response. Materials and methods: Thirty-seven women were divided in pregnant (n=13) and non-pregnant (n=24). Initially was determined the maximal voluntary contraction to hand-grip dynamometer and to back-leg extension dynamometer. After that, tests were performed at 30% and 50% of maximal voluntary contraction using the two dynamometers. Results: The percentage of maximal voluntary contraction did not affect maternal and fetal cardiovascular response when a small amount of muscle (handgrip) was recruited. When a great amount of muscle mass was activated maternal and fetal heart rate increased independently of the percentage of maximal voluntary contraction (30% or 50% MVC). Conclusion: To isometric contractions the size of muscle mass recruited is more important in determine maternal and fetal cardiovascular response than the percentage of maximal voluntary contraction.

Detection of Mycobacterium leprae DNA by polymerase chain reaction in the blood and nasal secretion of Brazilian household contacts

DNA samples from blood and nasal swabs of 125 healthy household contacts was submitted to amplification by polymerase chain reaction (PCR) using a Mycobacterium leprae-specific sequence as a target for the detection of subclinical infection with M. leprae.All samples were submitted to hybridization analysis in order to exclude any false positive or negative results. Two positive samples were confirmed from blood out of 119 (1.7 percent) and two positive samples from nasal secretion out of 120 (1.7 percent). The analysis of the families with positive individuals showed that 2.5 percent (n = 3) of the contacts were relatives of multibacilary patients while 0.8 percent of the cases (n = 1) had a paucibacilary as an index case. All positive contacts were followed up and after one year none of them presented clinical signs of the disease. In spite of the PCR sensitivity to detect the presence of the M. leprae in a subclinical stage, this molecular approach did not seem to be a valuable tool to screen household contacts, since we determined a spurious association of the PCR positivity and further development of leprosy.

Stannous chloride participates in the generation of reactive oxygen species

A genotoxic potentiality to stannous salts has been reported. The relevance of these data is due to the wide application of this metal in our society. The biological effect of these salts might depend on the physicochemical conditions and the route of their administration. There are situations in which stannous salts can be directly administered to human beings endovenously and there is not doubt about their absorption into the body. The disparate and largely unexplained differences suggest that stannous salts as a simple poisoning and/or a remarkable genotoxic agent might be a fertile field for additional investigation. Reactive oxygen species scavengers and metal ion chelators can abolish, at least in part, the effect of stannous salts. This suggests that the generation of free radicals by the reducing agent is involved in the biological effect induced by this metal.

Aprenda a controlar sua hipertensäo / Learn to control your hypertension

O curso sobre controle da hipertensäo tem por objetivo transmitir à populaçäo informaçöes sobre a doença, permitir a troca de experiências entre os indivíduos hipertensos e destes com a equipe de saúde, bem como incentivar os profissionais de saúde e educaçäo no desenvolvimento das atividades educativas sobre a hipertensäo à comunidade

Incentivo ao aleitamento materno no Município do Rio de Janeiro: avaliaçäo das condiçöes de eficiência dos serviços

O presente trabalho tem como objetivo comunicar a experiência do comitê de aleitamento Materno da Sóperj (Cam/Soperj), na aplicaçäo de um novo instrumento de avaliaçäo das práticas de saúde vinculadas a promoçäo e facilitaçäo do aleitamento materno no âmbito hospitalar do Município do Rio de Janeiro. Foram analisadas as práticas ligadas a Assistência Pré-Natal, Assistência ao Parto e Puerpério Imediato e Assistência Pós-Parto atribuindo pontos aos itens de planta física, equipamento, pessoal, procedimentos, interaçäo entre os Serviços e atividades programadas. Os autores concluíram que em relaçäo ao incentivo ao Aleitamento, a Assitência Pré-Natal foi considerada deficiente (85%) dos serviços) devido, principalmente ao despreparo da Equipe de Saúde. A Assistência ao Parto foi considerada regular (50% dos serviços). A Assistência Pós-Natal foi considerada deficiente (75% dos serviços). De todas as instituiçöes analisadas, as de pior desempenho foram as Universitárias