Increased intestinal production of α-defensins in aged rats with acute pancreatic injury.

Acute pancreatitis is a life-threatening situation, frequently associated with uncontrolled local and systemic inflammation, and aging is associated with a worst prognosis. Antimicrobial peptides are ancient molecules that belong to innate immunity, produced by epithelial and immune cells, and are able to trigger a myriad of effector responses. We have hypothesized that antimicrobial peptides could play an important role during serious pancreatic injury. To investigate our hypothesis, α-defensin-5, α-defensin-7 and CRAMP gene expression levels were measured in the intestinal tissue of old and young rats submitted to chemical pancreatic damage. We found significantly higher levels of α-defensin-5 and α-defensin-7, but not CRAMP, in the samples from old mice. This increase was not associated with a worse systemic inflammatory response. We conclude that α-defensins may have a pivotal role during acute pancreatitis and that the elderly develops a more severe local, but not systemic inflammatory process.

Perfil epidemiológico dos pacientes com hanseníase atendidos em Centro de Saúde em São Luís, MA / Epidemiological profile of leprosy patients treated at health Center in São Luís, MA

JUSTIFICATIVA E OBJETIVOS: O estado do Maranhão é classificado em relação à prevalência de hanseníase como o 2º do Brasil com maior prevalência da doença. O objetivo deste estudo foi caracterizar o perfil epidemiológico dos pacientes atendidos em centro de saúde de referência.MÉTODO: Realizou-se estudo retrospectivo e descritivo, em que foram revisados os prontuários de 183 pacientes, atendidos no período de janeiro de 2007 a dezembro de 2008, analisando-se os seguintes parâmetros: idade, sexo, classificação operacional, forma clínica, grau de incapacidade e motivo de saída dos pacientes. RESULTADOS: Entre os prontuários analisados não houve diferença significativa entre homens e mulheres, com 51% e 49%, respectivamente. A idade média dos pacientes afetados foi prevalente nos pacientes entre 16 e 30 anos com 35,5%. A maioria dos pacientes (78%) teve classificação operacional multibacilar com a forma clínica dimorfa predominante. A problemática da hanseníase não se limita apenas ao grande número de casos, deve ser considerado também o seu alto potencial incapacitante. Essas incapacidades têm sido responsáveis pelo estigma e discriminação dos pacientes. Neste estudo 33% dos pacientes apresentam grau I e 9% grau II de incapacidade. Entretanto, 68% tiveram êxito em seu tratamento chegando à cura. CONCLUSÃO: Os resultados desta análise apontam que o serviço de hanseníase está realizando o diagnóstico predominantemente de maneira tardia, devido ao fato da maioria dos pacientes ser diagnosticados na forma multibacilar, associada aos números elevados de casos com algum grau de incapacidade. O grau de incapacidade acentuado pode ser reflexo de uma procura tardia pelo serviço de saúde por parte do paciente.

BACKGROUND AND OBJECTIVES: The state of Maranhão located in Northern Brazil, is ranked second as for the prevalence of hanseniasis within that country. This study has as its main goal to epidemiologically profile the patients treated at a public hanseniasis specialty hospital in São Luís, MA, capital and largest city. METHOD: In order to support this study, a retrospective-descriptive research was made, in which 183 patients? medical records were evaluated according to the parameters of age, sex, operational classification, clinical presentation, disability degree and reasons for dropping treatment. RESULTS: There was no significant difference between men and women in the analyzed records (49% versus 51%, respectively). The most affected age span was that of 16-30 years old, being 35.5% of the charts analyzed. The majority of the patients (78%) were operationally classified multibacilar, and the dimorph clinical presentation was the most predominant one. When talking about hanseniasis, not only the number of cases must be taken into account, but also the high disability potential each case has. These disabilities are blamed responsible for the stigma and discrimination of the patients. In this study, 33% of the patients treated were reported disability stage I, and 9% were reported stage II; however, 68% of the patients were successfully cured. CONCLUSION: This analysis results point that the public control service of hanseniasis dissemination is late diagnosing the cases, due to the facts that the majority of the patients were first diagnosed with multibacilar operational classification and the high rate of cases with some disability degree. Chances are that the higher the disability level is the later patients are being referenced to the specialty healthcare center.