Association of vitamin D3, VDR gene polymorphisms, and LL-37 with a clinical form of Chagas Disease

Abstract INTRODUCTION: Chagas disease (CD) is an important public health problem in Brazil and worldwide. Aging and obesity are important matters in patients with CD, as is hypovitaminosis D3, which can decrease the quality of life of these patients. Immunomodulation mediated by vitamin D3, especially the production of antimicrobial peptides such as cathelicidin LL-37, might be related to the severity and symptoms of CD. This study aimed to determine the serum levels of vitamin D and LL-37 and VDR gene polymorphisms in patients with chronic CD. METHODS: This study included male patients with cardiac and indeterminate clinical forms of CD. Clinical, anthropometric, and blood parameters were obtained. Serum levels of 25(OH)D3 and LL-37 were determined by chemiluminescence and enzyme-linked immunosorbent assay respectively. Fok (rs731236), Bsm (rs1544410), Apa (rs7975232), and Taq (rs731236) polymorphisms of the VDR gene were investigated by PCR-RFLP. RESULTS: Sixty-four patients were included in the study: 18 of the cardiac form and 46 of the indeterminate form. No differences in age, ethnicity, BMI, arterial hypertension, diabetes mellitus, or dyslipidemias were observed between groups. However, the serum levels of 25(OH)D3, but not of LL-37, were lower in the cardiac form group. The association among polymorphisms, vitamin D, and clinical form was not significant. CONCLUSIONS: Decreased levels of vitamin D suggest an association with the cardiac form of CD. Studies investigating the roles of vitamin D and LL-37 in the immune response and their associations with VDR polymorphisms and disease susceptibility are necessary.

A lung image reconstruction from computed radiography images as a tool to tuberculosis treatment control

Background: Tuberculosis (TB) is an infectious lung disease with high worldwide incidence that severely compromises the quality of life in affected individuals. Clinical tests are currently employed to monitor pulmonary status and treatment progression. The present study aimed to apply a three-dimensional (3D) reconstruction method based on chest radiography to quantify lung-involvement volume of TB acute-phase patients before and after treatment. In addition, these results were compared with indices from conventional clinical exams to show the coincidence level. Methods: A 3D lung reconstruction method using patient chest radiography was applied to quantify lung-involvement volume using retrospective examinations of 50 patients who were diagnosed with pulmonary TB and treated with two different drugs schemes. Twenty-five patients were treated with Scheme I (rifampicin, isoniazid, and pyrazinamide), whereas twenty-five patients were treated with Scheme II (rifampicin, isoniazid, pyrazinamide, and ethambutol). Acute-phase reaction: Serum exams included C-reactive protein levels, erythrocyte sedimentation rate, and albumin levels. Pulmonary function was tested posttreatment. Results: We found strong agreement between lung involvement and serum indices pre- and posttreatment. Comparison of the functional severity degree with lung involvement based on 3D image quantification for both treatment schemes found a high correlation. Conclusions: The present 3D reconstruction method produced a satisfactory agreement with the acute-phase reaction, most notably a higher significance level with the C-reactive protein. We also found a quite reasonable coincidence between the 3D reconstruction method and the degree of functional lung impairment posttreatment. The performance of the quantification method was satisfactory when comparing the two treatment schemes. Thus, the 3D reconstruction quantification method may be useful tools for monitoring TB treatment. The association with serum indices are not only inexpensive and sensitive but also may be incorporated into the assessment of patients during TB treatment.(AU)

Pacientes com HIV/Aids em uso de inibidores de protease e a relação entre estado nutricional e hipertensão arterial sistêmica / Patients with HIV/Aids in use of protease inhibitors and relationship between nutritional status and hypertension

Objetivo Relacionar a hipertensão arterial com os fatores antropométricos e alterações metabólicas de pacientes com HIV/Aids em uso de inibidores de protease atendidos no Serviço de Ambulatórios Especializados de Infectologia Domingos Alves Meira, da Universidade Estadual Paulista Júlio de Mesquita Filho. Métodos Foram avaliados 34 pacientes quanto à aferição da pressão arterial, exames de colesterol total, lipoproteínas de baixa densidade, lipoproteínas de alta densidade, triglicérides e avaliação antropométrica (índice de massa corporal e circunferência da cintura). Na análise estatística foram realizados a média, o desvio-padrão e a correlação de Pearson. Resultados Os pacientes foram classificados, segundo o índice de massa corporal, com sobrepeso, ou seja, média de 26,9±5,7 kg/m², e, para circunferência da cintura, a média geral foi de 92,2±15,9 cm. A correlação entre esses indicadores foi forte (r= 0.88752; p<0,001). Os pacientes apresentaram pressão arterial média de 13,1±1,9 mm/Hg (sistólica) e 8,1±1,1 mm/Hg (diastólica), sendo que ambas tiveram correlação com a circunferência da cintura. Quanto aos níveis séricos de colesterol total, lipoproteínas de baixa densidade e triglicérides houve médias elevadas de: 208,5 mg/dL±39,0; 118,5 mg/dL±33,3 e 220,8 mg/dL±93,2, respectivamente, e níveis adequados de lipoproteínas de alta densidade, 47,0 mg/dL±19,4. Conclusão A correlação entre o índice de massa corporal e a circunferência da cintura foi forte e positiva, sendo apenas fraca e positiva entre esta última e os níveis de pressão arterial mostrando que, quanto maior a circunferência da cintura maior a pressão. Portanto há necessidade de uma avaliação precoce para prevenir a hipertensão arterial, as alterações antropométricas e metabólicas que podem contribuir para o aparecimento de síndrome metabólica e doenças cardiovasculares.

Objective To relate hypertension with anthropometric factors and metabolic changes in patients with HIV/Aids using protease inhibitors attending the Expert Infectology Outpatient Service Domingos Alves Meira, Universidade Estadual Paulista Júlio de Mesquita Filho. Methods We measured the blood pressure, total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, height, weight (to calculate body mass index) and waist circumference of 34 patients and calculated the means, standard deviations, and Pearson's correlations. Results The patients were overweight according to their mean body mass index (26.9±5.7 kg/m²) and waist circumference (92.2±15.9 cm). These indicators were strongly correlated (r=0.88752, p<0.001). The patients had mean systolic and diastolic blood pressures of 13.1±1.9 mm/Hg and 8.1±1.1 mm/Hg, respectively, and both correlated with waist circumference. The mean total cholesterol, low density lipoprotein, and triglycerides were 208.5 mg/dL±39.0, 118.5 mg/dL±33.3, and 220.8 mg/dL±93.2 respectively, all three considered high, and mean high density lipoproteinof 47.0 mg/dL±19.4, considered normal. Conclusion Waist circumference correlated strongly with body mass index but weakly with blood pressure, indicating that blood pressure increased with waist circumference. Early assessment is needed to prevent high blood pressure, metabolic changes, and anthropometric changes as these can promote the development of the metabolic syndrome and cardiovascular diseases.

THE RELEVANCE OF NUTRITIONAL STATUS AND HISTOPATHOLOGICAL FINDINGS ON THE INFECTIOUS PROCESS OF BALB/C MICE INOCULATED WITH Lacazia loboi / A relevância do estado nutricional e alterações histopatológicas no processo infeccioso de camundongos BALB/c inoculados com Lacazia loboi

SUMMARY The aim of this study was to evaluate the effects of the protein-calorie malnutrition in BALB/c isogenic mice infected with Lacazia loboi, employing nutritional and histopathological parameters. Four groups were composed: G1: inoculated with restricted diet, G2: not inoculated with restricted diet, G3: inoculated with regular diet, G4: not inoculated with regular diet. Once malnutrition had been imposed, the animals were inoculated intradermally in the footpad and after four months, were sacrificed for the excision of the footpad, liver and spleen. The infection did not exert great influence on the body weight of the mice. The weight of the liver and spleen showed reduction in the undernourished groups when compared to the nourished groups. The macroscopic lesions, viability index and total number of fungi found in the footpads of the infected mice were increased in G3 when compared to G1. Regarding the histopathological analysis of the footpad, a global cellularity increase in the composition of the granuloma was observed in G3 when compared to G1, with large numbers of macrophages and multinucleated giant cells, discrete numbers of lymphocytes were present in G3 and an increase was observed in G1. The results suggest that there is considerable interaction between Jorge Lobo's disease and nutrition.

RESUMO O objetivo do estudo foi avaliar os efeitos da desnutrição protéico-calórica em camundongos isogênicos da linhagem BALB/c inoculados com Lacazia loboi, empregando parâmetros nutricionais e histopatológicos. Foram constituídos quatro grupos: G1- inoculados com restrição dietética; G2- não inoculados com restrição dietética; G3- inoculados sem restrição dietética; G4- não inoculados sem restrição dietética. Após instalada a desnutrição, os animais foram inoculados via intradérmica no coxim plantar e após quatro meses foram sacrificados para remoção do coxim plantar, fígado e baço. A infecção não exerceu grande influência no peso corporal dos camundongos. O peso do fígado e baço apresentou redução nos grupos desnutridos em comparação aos grupos nutridos. A lesão macroscópica, a viabilidade e o número total de fungos dos coxins plantares dos camundongos inoculados revelaram aumento no G3 quando comparado com o G1. Em relação à análise histopatológica dos coxins plantares observou-se aumento da celularidade global na composição do granuloma no G3 em relação ao G1, com grande número de macrófagos e células gigantes multinucleadas, discretos números de linfócitos estavam presentes em G3 e aumentados no G1. Os resultados sugerem que existe grande interação entre nutrição e doença de Jorge Lobo.

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

Background Jorge Lobo's disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet.Methods DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet.Conclusion These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay.(AU)

DNA damage in BALB/c mice infected with Lacazia loboi and its relation to nutritional status

AbstractBackground Jorge Lobos disease, also known as lacaziosis, is a cutaneous-subcutaneous mycosis with chronic evolution. It is caused by the fungus Lacazia loboi. Herein we report a study that relates the genotoxicity caused by L. loboi in isogenic mice with nutritional status, through a normal or restricted diet.Methods DNA damage was assessed in the peripheral blood by the comet assay (tail intensity).Results The results for leukocytes showed increases in the mean tail intensity in mice under dietary restriction, in infected mice under dietary restriction and in infected mice ingesting a normal diet.Conclusion These results indicate that dietary restriction and L. loboi infection may increase DNA damage levels in mice, as detected by the comet assay.

Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs

Introduction Visceral leishmaniasis (VL) is caused by the intracellular protozoan Leishmania donovani complex. VL may be asymptomatic or progressive and is characterized by fever, anemia, weight loss and the enlargement of the spleen and liver. The nutritional status of the patients with VL is a major determinant of the progression, severity and mortality of the disease, as it affects the clinical progression of the disease. Changes in lipoproteins and plasma proteins may have major impacts in the host during infection. Thus, our goal was evaluate the serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose, albumin, globulin and total protein levels, as well as the body composition, of VL patients before and after treatment. Methods Nutritional evaluation was performed using the bioelectrical impedance analysis (BIA) to assess body composition. Biochemical data on the serum total cholesterol, HDL, LDL, triglycerides, glucose, albumin, globulin and total protein were collected from the medical charts of the patients. Results BIA indicated that both pre-treatment and post-treatment patients exhibited decreased phase angles compared to the controls, which is indicative of disease. Prior to treatment, the patients exhibited lower levels of total body water compared to the controls. Regarding the biochemical evaluation, patients with active VL exhibited lower levels of total cholesterol, HDL, LDL and albumin and higher triglyceride levels compared to patients after treatment and the controls. Treatment increased the levels of albumin and lipoproteins and decreased the triglyceride levels. Conclusions Our results suggest that patients with active VL present biochemical and nutritional changes that are reversed by treatment. .

Evaluation of fecal microorganisms of children with cleft palate before and after palatoplasty

This study isolated and quantified intestinal bacteria of children with cleft palate before and after palatoplasty. A prospective study was conducted from May 2007 to September 2008 on 18 children with cleft palate, aged one to four years, of both genders, attending a tertiary cleft center in Brazil for palatoplasty, to analyze the effect of surgical palate repair on the concentration of anaerobes Bacteroides sp, Bifidobacterium sp and microaerophiles Lactobacillus sp in feces of infants with cleft palate before and 24 hours after treatment with cefazolin for palatoplasty. There was significant reduction of Lactobacillus sp (p < 0.002), Bacteroides sp (p < 0.001) and Bifidobacterium sp (p = 0.021) after palatoplasty, revealing that surgery and utilization of cefazolin significantly influenced the fecal microbiota comparing collections before and after surgery. However, due to study limitations, it was not possible to conclude that other isolated factors, such as surgical stress, anesthetics and other medications used in palatoplasty might have a significant influence on the microbiota. Considering the important participation of the intestinal microbiota on both local and systemic metabolic and immunological activities of the host, professionals should be attentive to the possible influence of these changes in patients submitted to cleft repair.

Seroprevalence ff chagasic infection in young idividuals in a blood center in the state of sao paulo, Brazil / Soroprevalencia da infeccao chagasica em individuos jovens em Hemocentro no Estado de Sao Paulo, Brasil

SUMMARY This study aimed at estimating the number of cases of non-negative serological reactions to Chagas disease in blood donors at the Blood Center of Botucatu, São Paulo, Brazil, from 2003 to 2010 and at relating them to their cities of origin. Five hundred and seventy-four non-negative results for Chagas disease were evaluated. Of these, 371 (64.8%) were reagent, and 203 (35.4%) were inconclusive. The prevalence of Chagas disease in blood donors was 0.05%. There were, on average, 72 cases/year, and a prevalence of males was observed (64.8%). Forty-three (7.49%) individuals were 18 to 30 years old; 92 (16.02%) were 31 to 40; 147 (25.61%) 41 to 50, and 292 (50.87%) were older than 50 years. It was observed that 29.3% of females with reagent serology were at their fertile age (18 and 45 years). The majority of donors were originally from cities in the southwestern and central regions of São Paulo, but individuals from other states contributed with 20%. The provenance of most donors was the city of Botucatu/SP, followed by the city of Taquarituba/SP. Therefore, the profile of donors at this blood center favors the occurrence of a larger number of non-negative serological reactions. Although there has been a significant reduction in the number of new cases/year for this disease, it is still a public-health problem, and results suggest the need for new epidemiological assessments in the studied region. .

RESUMO Este estudo teve como objetivo estimar o número de casos de reações sorológicas não-negativas para doença de Chagas em doadores de sangue do Hemocentro de Botucatu, São Paulo - Brasil de 2003 a 2010 e, relaciona-las com as suas cidades de origem. Quinhentos e setenta e quatro reações sorológicas não-negativas para doença de Chagas foram avaliados. Destes, 371 eram reagentes (64,8%), e 203 inconclusivos (35,4%). A prevalência da doença de Chagas nos doadores de sangue foi de 0,05%. Houve, em média, 72 casos/ano, e uma prevalência do sexo masculino foi observada (64,8%). Quarenta e três indivíduos (7,49%) tinham entre 18 e 30 anos, 92 (16,02%) de 31 a 40; 147 (25,61%) 41 a 50, e 292 (50,87%) tinham mais de 50 anos. Observou-se que 29.3% das mulheres com sorologia reagente estavam em idade fértil (18 e 45 anos). A maioria dos doadores eram naturais de cidades das regiões sudoeste e central da cidade de São Paulo, mas os indivíduos de outros estados contribuíram com 20%. A procedência da maioria dos doadores era a cidade de Botucatu/SP, seguido pela cidade de Taquarituba/SP. Portanto, o perfil de doadores de sangue neste hemocentro favorece a ocorrência de um número maior de reações sorológicas não-negativas. Embora tenha havido uma redução significativa no número de casos novos/ano para esta doença, ainda é um problema de saúde pública, e os resultados sugerem a necessidade de novas avaliações epidemiológicas na região estudada. .

Challenges and perspectives of Chagas disease: a review

Chagas disease (CD), also known as American trypanosomiasis, is caused by the flagellated protozoan Trypanosoma cruzi, and affects an estimated 8 to 10 million people worldwide. In Latin America, 25 million people live in risk areas, while in 2008 alone, 10,000 CD-related deaths were reported. This review aimed to evaluate the challenges of CD control, future perspectives, and actions performed worldwide to control expansion of the disease and its impact on public health in Latin America.(AU)

Challenges and perspectives of Chagas disease: a review

Chagas disease (CD), also known as American trypanosomiasis, is caused by the flagellated protozoan Trypanosoma cruzi, and affects an estimated 8 to 10 million people worldwide. In Latin America, 25 million people live in risk areas, while in 2008 alone, 10,000 CD-related deaths were reported. This review aimed to evaluate the challenges of CD control, future perspectives, and actions performed worldwide to control expansion of the disease and its impact on public health in Latin America.

Perfil nutricional e dietético de indivíduos com hepatite C / Nutritional and dietetic profile of individuals with hepatitis C

O presente estudo avaliou a ingestão dietética e o estado nutricional de indivíduos com hepatite C com e sem tratamento antiviral. Os indivíduos participantes foram distribuídos em três grupos amostrais: Grupo Controle (G1) com 26 indivíduos saudáveis, Grupo 2 (G2) com 30 indivíduos com hepatite Csem tratamento antiviral, e Grupo 3 (G3) com 26 indivíduos com hepatite C em tratamento antiviral. Os indicadores antropométricos mostraram que a média de peso e porcentagem de gordura corpórea do G1 e G2 e o índice de massa corpórea do G2 e G3 estavam aumentados. Os valores séricos de ASTe ALT estiveram aumentados no G2 e G3 não sendo essa diferença significativa, considerando p < 0,05. A ingestão média energética (Kcal/dia) e de proteína (g/kg/d) estava adequada. O consumo médio de carboidrato foi acima do recomendado e a porcentagem média de lipídeo foi adequado, mas o G2consumiu mais lipídeo e fibras que o G3 sendo estatisticamente diferentes; entretanto a quantidade de fibras ingerida foi abaixo do recomendado nos três grupos. Conclui-se que o estado nutricional dos indivíduos com hepatite C é de sobrepeso. Uma vez tendo elevado percentual de gordura corpórea, esse diagnóstico pode ser fator de risco importante para doenças cardiovasculares e outras complicaçõesassociadas, além de afetar diretamente a qualidade de vida desses indivíduos.

The aim of this study was to evaluate the dietary intake and the nutritional status of individuals infected with Hepatitis C virus both with and without antiviral treatment. The individuals were consisted of data into three groups: The Control Group (G1): 26 healthy individuals, Group 2 (G2): 30 individualsinfected with hepatitis C without antiviral treatment and Group 3 (G3): 26 individuals with hepatitis C receiving antiviral treatment. The anthropometric index showed that the weight average and % of body fat from G1 and G2, as well as (BMI), Body Mass Index, from G2 and G3 were higher. The AST and ALT values in serum were enhanced at G2 and G3, though this is not a significant difference, considering p < 0,05. The mean energy intake (Kcal/day) and of protein (g/kg/d) was adequate. The carbohydrate mean intake was above the recommended, and % lipids mean was adequate, however G2 had a higher intake of lipids and fibers than G3 being statistically different, yet the amount of fibersintake was below the recommended in all three groups. In conclusion to that, the nutritional status of the individuals with hepatitis C is of overweight with high percent of body fat. This diagnosis can be an important risk factor to cardiovascular diseases and other associated complications besides directlyaffect the individual quality of life.

Microbiota intestinal de indivíduos que sofreram acidente ocupacional com materiais biológicos e que realizaram profilaxia anti-retroviral / Intestinal microbiota of individuals who suffered occupational accidents with biological materials and underwent antiretroviral prophylaxis

Avaliar a microbiota intestinal de indivíduos que sofreram acidente ocupacional com materiais biológicos e receberam anti-retrovirais foi o objetivo deste estudo. O grupo de estudo constou de 23 indivíduos com idade entre 18-45 anos, sendo 13 doadores de sangue e 10 que sofreram acidente ocupacional. Foram avaliados a microbiota intestinal, antropometria e exames laboratoriais pré, pós e 30 dias após o término da medicação. Zidovudina mais lamivudina foi utilizada em 70 por cento dos indivíduos associado ao nelfinavir, 20 por cento ao efavirenz e 10 por cento ao ritonavir. As alterações nutricionais e dietéticas-laboratoriais e de microbiota intestinal foram analisadas em três momentos. M1: até dois dias do início da profilaxia; M2: no último dia da profilaxia e M3: 30 dias após o término da profilaxia. Náuseas, vômitos e diarréia estiveram presentes em 50 por cento no segundo momento do estudo. Sobrepeso em 70 por cento, desnutrição e eutrofia em 10 por cento, dos indivíduos, não se modificaram durante o estudo. Transaminases, triglicérides, LDL-colesterol se elevaram no segundo momento e normalizaram 30 dias após término da medicação. Houve redução significativa dos Lactobacillus, Bifidobacterium e Bacteróides nos três momentos. Uso de anti-retrovirais provocou impacto significativo na microbiota intestinal dos indivíduos, sem recuperação em 30 dias.

The aim of this study was to evaluate the intestinal microbiota of individuals who had suffered occupational accidents and had received antiretrovirals. The study group consisted of 23 individuals between 18 and 45 years old, of whom 13 were blood donors and 10 had suffered occupational accidents. Intestinal microflora, anthropometry and laboratory tests were evaluated before, after and 30 days after discontinuation of the medication. Zidovudine plus lamivudine was used in association with nelfinavir for 70 percent of the individuals, with efavirenz for 20 percent and with ritonavir for 10 percent. Nutritional, diet, laboratory and intestinal microbiota abnormalities were analyzed at three times: M1, not more than two days after starting prophylaxis; M2, on the last day of prophylaxis; and M3, 30 days after ending prophylaxis. Nausea, vomiting and diarrhea were present in 50 percent at M2. Overweight in 70 percent, malnutrition and eutrophy in 10 percent of the individuals remained unchanged during the study. Transaminases, triglycerides and LDL-cholesterol because elevated at M2 and normalized 30 days after discontinuation of the medication. There were significant reductions in Lactobacillus, Bifidobacterium and Bacteroides at the three times. The use of antiretrovirals caused a significant impact on the individuals’ intestinal microbiota, without recovery after 30 days.

Clinical and nutritional profile of individuals with chagas disease

Chagas disease (CD), caused by the protozoan Trypanossoma cruzi, affects approximately 18 million individuals in the Americas, 5 million of which live in Brazil. Most chronic sufferers have either the indeterminate form of the disease, without organic compromise, or the cardiac or digestive forms. Despite the importance of this disease, there is no information on the effect of nutrition on CD evolution. We evaluated the clinical-nutritional profile of individuals with CD treated at the Tropical Diseases Nutrition Out-Patient Clinic of the Botucatu School of Medicine, UNESP. A retrospective cohort study was performed between 2002 and 2006, on 66 patients with serum and parasitological diagnosis of CD. Epidemiological, clinical, nutritional, and biochemical data were collected, including gender, age, skin color, smoking, alcoholism, physical activity, weight, stature, body mass index, abdominal circumference, glycemia, and lipid profile. Fifty-three percent were male and 47 percent female; 96 percent were white skinned. Mean age was 49.6±6.36 years. The predominant form was indeterminate in 71 percent; smoking and drinking were recorded in 23 percent and 17 percent, respectively. Sedentariness predominated in 83 percent, and 55 percent presented increased abdominal circumference. Most, 94 percent, were overweight or obese. The biochemical exams revealed hyperglycemia in 12 percent and dyslipidemia in 74 percent. These findings suggest that the Chagas population presents co-morbidities and risk factors for developing chronic non-transmissible diseases, including cardiovascular diseases, making CD evolution even worse.

Bezafibrate for the treatment of hypertriglyceridemia in HIV1-infected patients on highly active antiretroviral therapy

The use of highly active antiretroviral therapy (HAART) in HIV-infected patients has been associated with the development of risk factors for cardiovascular diseases (CD) including dyslipidemia and insulin resistance, hypertriglyceridemia being the most frequent metabolic disturbance in these patients. Fibrates are indicated when hypertriglyceridemia is accentuated and persists for over six months. We evaluated the efficacy and safety of bezafibrate for the treatment of hypertriglyceridemia in HIV-infected individuals on HAART. All patients received 400mg/day of bezafibrate and were evaluated three times: Mo (pre-treatment), M1 (one month after treatment), and M2 (six months after treatment). Fifteen adult individuals, eight males and seven females with mean age = 41.2 ± 7.97 years and triglyceride serum levels > 400mg/dL were included in the study. Smoking, alcohol ingestion and sedentarism rates were 50 percent, 6.66 percent and 60 percent, respectively. Family history of CD, hypertension and diabetes mellitus was reported in 33.3 percent, 40 percent and 46.7 percent of the cases, respectively, while dyslipidemia was reported by only 13.3 percent. More than half of the patients were using a protease inhibitor plus a nucleotide analog transcriptase inhibitor. Eutrophy and tendency toward overweight were observed at all three study time points. There were significant reductions in triglyceride serum levels from Mo to M1 and from Mo to M2. No significant changes were observed in the serum levels of creatine phosphokinase, hepatic enzymes, CD4+, CD8+ and viral load. Therefore, bezafibrate seems to be safe and effective for the reduction of hypertriglyceridemia in HIV-infected patients on HAART.

Intestinal microbiota of patients with bacterial infection of the respiratory tract treated with amoxicillin

The intestinal tract harbors a huge diversity of metabolically-active aerobic and anaerobic bacteria that interact, forming a complex ecosystem. This microbiota has an important role in human metabolism, nutrition, immunity, and protection against colonization by pathogenic microorganisms. Several factors can influence the intestinal microbiota; these include age, diet, inflammatory and infectious processes, and the use of antimicrobials. We investigated the influence of bacterial infection of the respiratory tract and of amoxicillin therapy on the normal intestinal microbiota of patients. Bacterial infectious processes affecting the respiratory tract were found to influence the intestinal microbiota, significantly decreasing the number of colony-forming units (CFUs) of Bacteroides spp. and Lactobacillus spp. per gram of feces. The use of amoxicillin also influenced the intestinal microbiota, significantly decreasing the CFU of Bifidobacterium spp. and Lactobacillus spp. /g of feces. Changes in the composition of the intestinal microbiota need to be observed, since a decrease in the normal microorganisms can pose a number of hazards for hosts, including decreased resistance to colonization. With proper follow-up, health-care teams can minimize such hazards by implementing suitable therapy- and diet-related measures, thus reducing the occurrence of detrimental effects on the gastrointestinal ecosystem.

Mal de Pott associado a meningoencefalite tuberculose / Pott's disease associated the tuberculous meningoencephalitis

Os autores relatam caso de tuberculose de coluna vertebral (mal de Pott) associado a meningoencefalite tuberculose em paciente de 51 anos, sexo masculino, com história crônica de confusao mental e dor em regiao lombar. Ressaltam o valor de tomografia computadorizada (TC), da ressonância nuclear magnética (RNM) e da cintilografia óssea (CO) como métodos diagnósticos auxiliares na avaliaçao do comprometimento do sistema nervoso central e coluna vertebral.