In vitro efficacy of isoflavonoids and terpenes against Leishmania (Leishmania) infantum and L. amazonensis.

The main form of control of leishmaniasis is the treatment, however various side effects and poor efficacy are associated with presently available drugs. The investigation of bioactive natural products for new antileishmanial drugs is a valid approach. The present study reports the in vitro efficacy of natural isoflavonoids and terpenes against Leishmania infantum and L. amazonensis and their cytotoxicity against HepG2 cells. L. infantum and L. amazonensis promastigotes were exposed to the terpenes kaurenoic acid, xylopic acid, and (-)-α-bisabolol and to the isoflavonoids (-)-duartin and (3R)-claussequinone for antileishmanial activity and to cytotoxicity to HepG2 cells. The most effective substance against both L. infantum and L. amazonensis species was (3R)-claussequinone (IC50 = 3.21 µg/mL and 2.47 µg/mL, respectively) that disclosed low cytotoxicity against HepG2 cells (CC50 = 387.79 µg/mL). The efficacy of (3R)-claussequinone against intracellular amastigotes of L. infantum and the externalization of phosphatidylserine in promastigotes of this isoflavanoid were investigated by infection of Raw 264.7 macrophages and marking with Annexin V-FITC and propidium Iodide for flow cytometry analysis. The results for amastigotes showed that (3R)-claussequinone was able to reduce the rate of infection with IC50 = 4.61 µg/mL and did not alter the externalization of phosphatidylserine. In conclusion it is presently reported, for the first time, the striking antileishmanial activity of (3R)-claussequinone against L. infantum and L. amazonensis associated to low cytotoxicity. Furthermore, these results suggest that (3R)-claussequinone is a new hit aiming to develop new therapeutic alternatives.

Conhecer para prevenir: complementação do conhecimento dos alunos do ensino fundamental sobre microbiologia e parasitologia em três escolas de Uberlândia-MG / Know to prevent: complementation of the knowledge of the students of fundamental education on microbiology and parasitology in three schools of Uberlândia-MG

O conhecimento sobre microbiologia e parasitologia é considerado abstrato, pois muitos agentes causadores de doenças não são vistos a olho nu, o que distancia os alunos da realidade. Assim, nossos objetivos foram promover ações educativas por meio de ferramentas didáticas lúdicas que possibilitassem a complementação do aprendizado dos alunos frente aos diferentes grupos de microorganismos e parasitos e das ações de profilaxia relacionadas aos mesmos, e avaliar se ao final eles tinham condições de discriminar os grupos e relacionar com as doenças e as formas de profilaxia. Para tanto, foram feitas entrevistas junto aos professores para levantamento das possíveis atividades a serem desenvolvidas. A ação foi definida e então dividida em três momentos (aula expositiva, jogo didático e mostra científica) realizados entre agosto e novembro de 2018, atingindo aproximadamente 350 alunos, de oitavos e nonos anos, de três escolas públicas da zona urbana e rural da cidade de Uberlândia-MG. Para avaliar o impacto da ação foi feita uma análise comparativa de questionários aplicados antes (pré-intervenção) e após a ação (pós-intervenção). O percentual das respostas corretas nos questionários pós-intervenção aumentou em duas escolas (p>0,005). Quanto à análise por questões, as menores porcentagens de acertos foram observadas em perguntas relacionadas à distinção entre doenças bacterianas e virais, o reconhecimento dos sintomas e a associação das formas de transmissão com a profilaxia. Assim, este estudo reforça a importância da educação em saúde para que os alunos se mobilizem frente ao combate das doenças.(AU)

The knowledge about microbiology and parasitology is considered abstract since causative agents of diseases cannot be seen with the naked eye, leading to students' detachment from reality. Therefore, this work aimed to promote educational actions through playful tools that could complement students' learning regarding the different groups of microorganisms and parasites and the prophylactic measures related to them. Furthermore, at the end of the actions it was evaluated if the students were able to discriminate the groups of microorganisms and relate them to the diseases they cause and the different forms of prophylaxis. To this end, interviews were conducted with teachers to survey the possible activities that could be used. The action was defined and then divided into three moments (expository class, didactic game and scientific show) held between August and November 2018, reaching approximately 350 students, from the eighth and ninth years, from three public schools in the urban and rural area of the city oftUberlândia-MG. To assess the impact of the action, a comparative analysis of questionnaires was applied before (pre-intervention) and after the action (post-intervention). The percentage of correct answers in the questionnaires post-intervention increased in two schools (p>0,005). Regarding the analysis by questions, the lowest percentages of correct answers were observed in questions related to the distinction between bacterial and viral diseases, the recognition of the symptoms and the association of transmission ways with prophylaxis. Thus, this study reinforces the importance of health education for students to mobilize in the fight against diseases.(AU)

Therapeutic Efficacy of a Mixed Formulation of Conventional and PEGylated Liposomes Containing Meglumine Antimoniate, Combined with Allopurinol, in Dogs Naturally Infected with Leishmania infantum.

The treatment of dogs naturally infected with Leishmania infantum using meglumine antimoniate (MA) encapsulated in conventional liposomes (LC) in association with allopurinol has been previously reported to promote a marked reduction in the parasite burden in the main infection sites. Here, a new assay in naturally infected dogs was performed using a novel liposome formulation of MA consisting of a mixture of conventional and long-circulating (PEGylated) liposomes (LCP), with expected broader distribution among affected tissues of the mononuclear phagocyte system. Experimental groups of naturally infected dogs were as follows: LCP plus Allop, receiving LCP intravenously as 2 cycles of 6 doses (6.5 mg Sb/kg of body weight/dose) at 4-day intervals plus allopurinol at 30 mg/kg/12 h per os (p.o.) during 130 days (LCP+Allop); LC plus Allop, receiving LC intravenously as 2 cycles of 6 doses (6.5 mg Sb/kg/dose) plus allopurinol during 130 days (LC+Allop); Allop, treated with allopurinol only; and a nontreated control. Parasite loads were evaluated by quantitative PCR in liver, spleen, and bone marrow tissue and by immunohistochemistry in the ear skin, before treatment, just after treatment, and 4 months later. The LCP+Allop and LC+Allop groups, but not the Allop group, showed significant suppression of the parasites in the liver, spleen, and bone marrow 4 months after treatment compared to the pretreatment period or the control group. Only LCP+Allop group showed significantly lower parasite burden in the skin in comparison to the control group. On the basis of clinical staging and parasitological evaluations, the LCP formulation exhibited a more favorable therapeutic profile than the LC one, being therefore promising for the treatment of canine visceral leishmaniasis.

Efficacy of lapachol on treatment of cutaneous and visceral leishmaniasis.

Leishmaniasis is one of the most important neglected diseases worldwide. It is a life-threatening disease and causes significant morbidity, long-term disability, and early death. Treatment involves disease control or use of intervention measures, although the currently used drugs require long-lasting therapy, and display toxicity and reduced efficacy. The use of natural products isolated from plants, such as lapachol, an abundant naphthoquinone naturally occurring in South American Handroanthus species (Tabebuia, Bignoniaceae), is a promising option for the treatment of leishmaniasis. In this study, we investigated the leishmanicidal activity of lapachol in vitro and in vivo against Leishmania infantum and L. amazonensis, causative agents of visceral and cutaneous leishmaniasis, respectively. Low cytotoxicity in HepG2 cells (3405.8 ±â€¯261.33 µM), good anti-Leishmania activity, and favorable selectivity indexes (SI) against promastigotes of both L. amazonensis (IC50 = 79.84 ±â€¯9.10 µM, SI = 42.65) and L. infantum (IC50 = 135.79 ±â€¯33.04 µM, SI = 25.08) were observed. Furthermore, anti-Leishmania activity assays performed on intracellular amastigotes showed good activity for lapachol (IC50 = 191.95 µM for L. amazonensis and 171.26 µM for L. infantum). Flow cytometric analysis demonstrated that the cytotoxic effect of lapachol in Leishmania promastigotes was caused by apoptosis-like death. Interestingly, the in vitro leishmanicidal effect of lapachol was confirmed in vivo in murine models of visceral and cutaneous leishmaniasis, as lapachol (25 mg/kg oral route for 24 h over 10 days) was able to significantly reduce the parasitic load in skin lesions, liver, and spleen, similar to amphotericin B, the reference drug. These results reinforce the therapeutic potential of lapachol, which warrants further investigations as an anti-leishmaniasis therapeutic.

In vitro antileishmanial activity of leaf and stem extracts of seven Brazilian plant species.

ETHNOPHARMACOLOGICAL RELEVANCE: Leishmaniasis is a parasitic disease that affects people all over the world. The number of cases of leishmaniasis is increasing and the drugs used for its treatment are toxic and not always effective. The recognition of the global nature of this disease and its direct or indirect effects on health economics and actions focuses attention on the development of new therapeutic options. In Brazil, this parasitic disease is endemic in many regions. The plants used by the population against leishmaniasis can be good starting points in the search of new lead compounds for antileishmanial drugs. AIM OF THE STUDY: The aim of the present study was to investigate the antileishmanial activity of extracts from leaves and stems of seven Brazilian plant species used by the population to treat leishmaniasis, and symptoms that might be related to Leishmania infections. MATERIALS AND METHODS: Twenty two extracts from seven plants belonging to five different botanical families were prepared by different methods and evaluated for their effect on the viability of promastigote forms of Leishmania infantum (MHOM/BR/1967/BH46) using the resazurin-based colorimetric assay. The extracts were considered active when they inhibited the growth of promastigotes in a percentage greater than or equal to 50% at 100 and 200 µg/mL. The active samples were further investigated to determine IC50, CC50 and SI values against promastigote forms of L. infantum. The active and non-cytotoxic extracts (SI> 10) were evaluated against amastigote forms of L. infantum. In addition, the active extracts against the amastigote forms were analyzed by TLC and HPLC, while the EtOAc extract of stems from Aspidosperma tomentosum was also evaluated by GC/MS. RESULTS: Among the twenty two extracts evaluated, two were considered active against L. infantum. The EtOH extract of leaves from Dyospiros hispida (IC50 55.48 ±â€¯2.77 µg/mL and IC50 80.63 ±â€¯13.17 µg/mL, respectively) and the EtOAc extract of stems from Aspidosperma tomentosum (IC50 9.70 ±â€¯2.82 µg/mL and IC50 15.88 ±â€¯1.53 µg/mL, respectively) inhibited significantly the growth of promastigote and amastigote forms of L. infantum. Some extracts, although active in the initial screening, were considered toxic since the SI was lower than 10. In TLC and HPLC analysis the leaf extract of Dyospiros hispida showed the presence of anthraquinones, terpenes and saponins, and in the EtOAc extract of stems from Aspidosperma tomentosum alkaloids and flavonoids were detected. In addition, in the latter extract the indole alkaloids uleine and dasycarpidone could be identified by GC/MS. CONCLUSIONS: The ethnopharmacological data of Aspidosperma tomentosum and Dyospiros hispida in part support the results found in the biological models used. Extracts of Aspidosperma tomentosum and Dyospiros hispida presented promising results against L. infantum.

O contexto formativo em uma instituição federal de ensino superior (IFES) em consolidação: visão dos alunos de fisioterapia / Physiotherapy students' view of the educational context in a federal higher education institution (IFES) in consolidation

Este estudo proporciona uma apreciação do perfil dos alunos de Fisioterapia da Universidade Federal dos Vales do Jequitinhonha e Mucuri, apurando possíveis causas de evasão, e analisa as opiniões destes em relação a sua formação e a esta nova Instituição Federal de Ensino Superior (Ifes) em expansão. Trata-se de um estudo observacional descritivo. Participaram 175 alunos. Os dados foram coletados por meio de um questionário com questões abertas, fechadas e do tipo Likert, que abordaram as áreas: pessoal, interpessoal, curso, carreira e institucional. Os alunos da cidade ou região representam 20% dos graduandos, e a renda familiar destes é variada. A maioria dos alunos escolheu estudar nesta Ifes por buscar um ensino superior de qualidade e gratuito. Após a conclusão do curso, 76% dos alunos pretendem fazer pós-graduação. Para a maioria, a estrutura física e o corpo docente são adequados ao aprendizado, mas a prestação de serviços não. Conhecendo as necessidades e expectativas dos alunos, podem-se propor soluções para melhoria e progresso de todos: alunos, curso, instituição e comunidade.

This study sought to provide an assessment of the profile of physiotherapy students at the Federal University of the Valleys of Jequitinhonha and Mucuri, investigating possible causes of student dropouts and analyzing student opinion on the course and a new Federal Higher Education Institution (Ifes) in expansion. It took the form of a descriptive observational study on 175 students. Data was collected via a questionnaire with open, closed and Likert questions, which addressed a range of personal, interpersonal, course, career and institutional topics. Students from the Ifes city or region accounted for 20% of the total and family income was varied. Most students chose to study in the university as they sought high-quality and free higher education, and after completing the course, 76% wished to study post-graduate courses. For most, the physical structure and the faculty foster learning, but the service provision does not. In light of the students' needs and expectations, solutions for improvement and ways to ensure progress for students, the course, the institution and the community may be offered.

Personas con diabetes mellitus tipo 2 y su capacidad de agencia de autocuidado, Cartagena / Patients with Type 2 Mellitus Diabetes and their Self-Care Agency Capacity, Cartagena / Pessoas com diabete mellitus tipo 2 e sua capacidade de agência de autocuidado, Cartagena

Contexto: La diabetes mellitus tipo 2 se constituye en un problema de salud pública por las repercusiones bio-psicosociales, la presencia de complicaciones neurovasculares y metabólicas en la persona que la padece. Enfermería cumple un papel importante a través de la educación y la capacitación. Objetivo: Identificar la capacidad de agencia de autocuidado de las personas con diagnóstico de diabetes mellitus tipo 2, inscritos en los programas de control de diabetes en 19 UPAS de Cartagena. Metodología: diseño descriptivo con abordaje cuantitativo, en una muestra de 225 adultos de ambos sexos, seleccionados en forma aleatoria. La capacidad de agencia de autocuidado se identificó con la escala de Valoración de las capacidades de autocuidado, desarrollada por Isenberg y Everest, traducida al español por Gallegos y adaptada por la Universidad Nacional de Colombia. Para presentar los datos se utilizó la estadística descriptiva, los resultados se presentan en tablas y gráficas. Resultados: Predominó el sexo femenino (68,4 %); la unión libre (59,1 %); escolaridad (50,6 % con básica primaria); bajos ingresos económicos (menos de un salario mínimo mensual vigente, 34.7 %). Al valorar la capacidad de agencia de autocuidado, el 73.8 % de los pacientes obtuvo una calificación de muy buena (76-100 %, según escala). Al valorar los aspectos comprendidos en la escala se encontró que más del 50 % de las personas siempre sacan tiempo para ellos, piden explicación sobre su salud, examinan su cuerpo para ver si hay cambios y conservan un ambiente limpio. Conclusiones: El apoyo social recibido por los pacientes con diabetes mellitus tipo 2 y las prácticas de higiene personal y del entorno, el conocimiento y la adherencia a la dieta, permiten a los pacientes una buena capacidad de agencia de autocuidado.

Background: Type 2 mellitus diabetes is a public health issue for the bio-psychosocial repercussions and the neurovascular and metabolic complications in the patient. Nursing plays an important role through education and training. Objective: Identify the self-care agency capacity of people diagnosed with type 2 mellitus diabetes registered in the diabetes control program in 19 primary care units (UPAs) of Cartagena. Methodology: Descriptive quantitative design in a population of 225 random adults of both sexes. The self-care agency capacity was identified with the self-care capacity appreciation scale developed by Isenberg and Everest, translated into Spanish by Gallegos and adapted by the Universidad Nacional de Colombia. Descriptive statistics were used to present the data, and results are shown in tables and charts. Results: The following features were predominant: Females (88.9 %), non-marital partners (59.1 %), schooling (50.6 % completed elementary education), low income (less than a valid minimum monthly salary, 59.6 %). Assessing the self-care agency capacity resulted in 73.8 % of patients with a very good score (76-100 %, according to the scale). By assessing the aspects included in the scale, more than 50 % of people were found to always find time for them, ask about their health, examine their bodies to see if there are changes and remain in a clean environment. Conclusions: The social support received by patients with type 2 mellitus diabetes and personal and environment hygiene practices, knowledge and adherence to the diet allow patients to have a good self-care agency capacity.

Contexto: A diabete mellitus tipo 2 se configura como um problema de saúde pública por conta das repercussões biopsicossociais e da presença de complicações neurovasculares e metabólicas na pessoa que a sofre. A enfermagem cumpre um papel importante através da educação e a capacitação. Objetivo: Identificar a capacidade de agência de autocuidado das pessoas com diagnóstico de diabete mellitus tipo 2, inscrito nos programas de controle da diabete em 19 UPAS de Cartagena. Metodologia: desenho descritivo com abordagem quantitativa em uma amostra de 225 adultos de ambos os sexos, selecionados aleatoriamente. A capacidade de agência de autocuidado foi identificada usando a escala de Valoração das capacidades de autocuidado, desenvolvida por Isenberg e Everest, traduzida ao espanhol por Gallegos e adaptada pela Universidade Nacional da Colômbia. Para a apresentação dos dados, foi utilizada a estatística descritiva. Os resultados foram apresentados em tabelas e gráficas. Resultados: Predominou o sexo feminino (88,9 %); a união livre (59,1 %); a escolaridade (50,6 % com básica primária); baixa renda económica (menos de um salário mínimo mensal em vigor, 59,6 %). Ao valorar a capacidade de agência de autocuidado, 73,8 % dos pacientes obteve uma qualificação de muito boa (76-100 %, conforme a escala). Ao valorar os aspetos contidos na escala verificou-se que mais de 50% das pessoas sempre procuram tempo para eles, pedem explicações sobre sua saúde, examinam seu corpo para ver qualquer mudança e conservam um ambiente limpo. Conclusões: O apoio social recebido pelos pacientes com diabete mellitus tipo 2 e as práticas de higiene pessoal e do entorno, o conhecimento e o cumprimento do regime fazem com que os pacientes tenham uma boa capacidade de agência de autocuidado.