Food insecurity and symptoms of anxiety and depression disorder during the COVID- 19 pandemic: COVID-Inconfidentes, a population-based survey.

This study aimed to investigate the association between adult food insecurity (FI) and symptoms of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in two Brazilian cities during the coronavirus disease (COVID-19) pandemic. This study used data derived from a cross-sectional survey of 1693 adults. Interviews were conducted using an electronic questionnaire. The FI was measured using the Brazilian Food Insecurity Scale. The Generalized Anxiety Disorder-7 was used to measure the symptoms of GAD. The Patient Health Questionnaire-9 was used for MDD symptoms. The association between FI, GAD, and MDD symptoms was investigated using a Poisson regression model with robust variance to estimate the prevalence ratio and 95% confidence interval (95% CI). In regression models, a linear association between FI levels and outcomes was observed, with severe food insecurity having a 3.56 higher prevalence of GAD symptoms (95% CI: 2.23, 5.68) and a 3.03 higher prevalence of MDD (95% CI: 1.55, 5.90). In the stratified analyses, worse results were observed for females and males, individuals with non-white race/skin color, those without children, and those with lower monthly family income. In conclusion, the FI was associated with symptoms of GAD and MDD, and the sociodemographic characteristics interfered in this association. Therefore, we recommend the improvement of public health and social protection policies for food-insecure people.

Analysis of the chemerin and resistin adipokines in children and adolescents.

OBJECTIVES: To compare the serum concentrations of adipokines resistin and chemerin in children and adolescents with eutrophic and overweight and to evaluate their relationship with anthropometric, biochemical, and blood pressure variables. METHODS: a cross-sectional epidemiological study was conducted with 234 students enrolled in public elementary schools in the city of Juiz de Fora / MG. Anthropometric evaluation, biochemistry, and blood pressure measurement were performed. Statistical analyzes included the Student-t or Mann-Whitney tests, Pearson or Spearman correlation, used according to the distribution of the variables, and linear regression analysis, by means of the evaluation of the effect of the independent variables on the serum levels of chemerin and resistin, adjusted for age and sex. For the data analysis, SPSS® software version 21.0 and STATA® version 10.1 were used, assuming a significance level of 5%. RESULTS: the concentrations of chemerin were higher in eutrophic individuals than in those with excess weight (p> 0.05). In contrast, levels of resistin were higher in the young with excess weight than in the eutrophic ones (p <0.05). In the multiple linear regression analysis, the levels of chemerin were associated with the values of resistin, systolic, and diastolic blood pressure. Resistance levels maintained association only with BMI and chemerin values. CONCLUSION: the adipokines analyzed presented a distinct profile in the groups of children and adolescents with eutrophic and overweight.

Analysis of the chemerin and resistin adipokines in children and adolescents

SUMMARY OBJECTIVES To compare the serum concentrations of adipokines resistin and chemerin in children and adolescents with eutrophic and overweight and to evaluate their relationship with anthropometric, biochemical, and blood pressure variables. METHODS a cross-sectional epidemiological study was conducted with 234 students enrolled in public elementary schools in the city of Juiz de Fora / MG. Anthropometric evaluation, biochemistry, and blood pressure measurement were performed. Statistical analyzes included the Student-t or Mann-Whitney tests, Pearson or Spearman correlation, used according to the distribution of the variables, and linear regression analysis, by means of the evaluation of the effect of the independent variables on the serum levels of chemerin and resistin, adjusted for age and sex. For the data analysis, SPSS® software version 21.0 and STATA® version 10.1 were used, assuming a significance level of 5%. RESULTS the concentrations of chemerin were higher in eutrophic individuals than in those with excess weight (p> 0.05). In contrast, levels of resistin were higher in the young with excess weight than in the eutrophic ones (p <0.05). In the multiple linear regression analysis, the levels of chemerin were associated with the values of resistin, systolic, and diastolic blood pressure. Resistance levels maintained association only with BMI and chemerin values. CONCLUSION the adipokines analyzed presented a distinct profile in the groups of children and adolescents with eutrophic and overweight.

RESUMO OBJETIVOS Comparar as concentrações séricas das adipocinas resistina e quemerina em crianças e adolescentes com eutrofia e excesso de peso e avaliar sua relação com as variáveis antropométricas, bioquímicas e a pressão arterial. MÉTODOS Estudo epidemiológico transversal realizado com 234 estudantes matriculados em escolas públicas do ensino fundamental no município de Juiz de Fora/MG. Realizou-se avaliação antropométrica, bioquímica e aferição da pressão arterial. As análises estatísticas compreenderam os testes t de Student ou Mann-Whitney, correlação de Pearson ou Spearman, utilizados de acordo com a distribuição das variáveis, e análise de regressão linear, realizada por meio da avaliação do efeito das variáveis independentes nos níveis séricos de quemerina e resistina, ajustado por idade e sexo. Para a análise dos dados foram utilizados os softwares SPSS® versão 21.0 e Stata® versão 10.1, admitindo-se nível de significância de 5%. RESULTADOS As concentrações de quemerina foram maiores nos indivíduos eutróficos do que nos com excesso de peso (p>0,05). Em contrapartida, os níveis de resistina estiveram maiores nos jovens com excesso ponderal do que nos eutróficos (p<0,05). Na análise de regressão linear múltipla, os níveis de quemerina apresentaram associação com os valores de resistina, pressão arterial sistólica e diastólica. Os níveis de resistina mantiveram associação apenas com os valores de IMC e quemerina. CONCLUSÃO As adipocinas analisadas apresentaram perfil distinto nos grupos de crianças e adolescentes com eutrofia e com excesso de peso.

Time and dose-dependence evaluation of nitroheterocyclic drugs for improving efficacy following Trypanosoma cruzi infection: A pre-clinical study.

Benznidazole and nifurtimox-treatments regimens currently used in human are supported by very limited experimental data. This study was designed to evaluate the time and dose dependence for efficacy of the most important nitroheterocyclic drugs in use for Chagas disease. In order to evaluate time dependence, Y strain-infected mice received benznidazole for a total of 1, 3, 7, 10, 20, and 40 days. Treatment courses of 3-10-day were effective in clearing parasitaemia and suppressing mortality, but parasitological cure was not achieved. Extending the treatments to 20 or 40 days clearly improved benznidazole efficacy. The 20-day treatment induced cure in 57.1% of Y strain infections (partially drug resistant) but failed to cure Colombian strain infections (full drug resistant), while the 40-day treatment resulted in cure of 100% of Y and 50% of Colombian strain infected mice. The increased cure rates in T. cruzi infected animals that received nifurtimox for 40 days confirm the relationship between the length of treatment and efficacy. An improvement in efficacy was observed with increasing benznidazole doses; cure was verified in 28.6% (75 mg/kg), 57.1% (100 mg/kg) and 80% (300 mg/kg). Overall, these nonclinical study data provide evidence that the efficacy of benznidazole is dose and time dependent. These findings may be relevant for optimizing treatment of human Chagas disease.

Physical activity is associated with malignant and benign breast diseases in low-income Brazilian women.

We compared the relationships among percentage of body fat (%BF) and physical activity with breast cancer (BC) and benign breast diseases (BBD) in low-income Brazilian women. A case-control study including 106 incident BC cases, 178 incident BBD cases, and 181 control women recruited from a public hospital-based screening center was conducted. Logistic regression models showed that sedentary women have a higher odds of developing BC in the age adjusted model [odds ratio (OR) = 2.39, 95% confidence interval (CI) 1.43-3.99]. After adjusting for hormonal-related risk factors and family history of breast cancer (OR = 2.94, 95% CI 1.50-5.79) and also for the % BF (OR = 2.71, 95% CI 1.36-5.37) the odds remained high. Independent of the adjustments made, %BF did not affect the odds for developing BC. When the same models were tested for women with BBD, we found a significant association with sedentary lifestyle in all models tested, with an OR = 3.03 (95% CI 1.69-5.42) in the fully adjusted model. In the same way, in the fully adjusted model %BF was significantly associated to risk for BBD (OR = 0.54, 95% CI 0.30-0.98). Similar to results found in other populations, our data suggest that physical activity is an important, independent protective factor for the risk of developing BC and BBD in low-income women from an admixed population.

Associação entre estado nutricional, hábitos alimentares e nível de atividade física em escolares / Association between nutritional status, food habits and physical activity level in schoolchildren

OBJETIVO: Analisar a relação entre estado nutricional, hábitos alimentares e nível de atividade física em escolares. MÉTODOS: Realizou-se estudo transversal com 661 escolares de 6-14 anos de idade, matriculados nas escolas públicas e privadas da área urbana da cidade. Um questionário semiestruturado foi aplicado para coleta das variáveis demográficas, socioeconômicas, antropométricas e nível de atividade física. Os escolares foram classificados segundo critérios para índice de massa corporal por idade, percentual de gordura corporal e nível de atividade física, respectivamente. Os dados dietéticos foram obtidos por meio de questionário de frequência alimentar validado e específico para crianças e adolescentes, a partir do qual o consumo alimentar foi avaliado segundo o Recommended Foods Score adaptado, cuja finalidade é a avaliação da qualidade global da dieta com enfoque no consumo de alimentos saudáveis. RESULTADOS: Elevadas frequências de excesso de peso segundo índice de massa corporal por idade (20,1%) e percentual de gordura corporal (22,8%), bem como inatividade física (80,3%), foram observadas entre os escolares. Baixas pontuações no escore de consumo foram encontradas para 77,2% dos escolares. Não foi observada associação significativa entre o excesso de peso e inatividade física ou consumo alimentar (p > 0,05). CONCLUSÃO: Os escolares apresentaram elevada frequência de excesso de peso, que de forma isolada não foi associada a alta inatividade física e baixa qualidade da dieta. Assim, mais estudos devem ser realizados para identificar outros fatores além dos descritos que possam estar influenciando a presença do excesso de peso nessa população.

OBJECTIVE: To analyze the relation between nutritional status, food habits and physical activity level in schoolchildren. METHODS: A cross-sectional study was carried out with 661 schoolchildren, from 6 to 14 years old, enrolled in public and private schools located in the urban area of Ouro Preto, state of Minas Gerais, Brazil. A semi-structured questionnaire was applied to collect data on demographic, socio-economic, anthropometric and level of physical activity variables. Schoolchildren were classified according to criteria for body mass index by age, body fat percentage and physical activity level, respectively. Dietary data were collected through a validated food frequency questionnaire specific for children and adolescents. Food consumption was evaluated according to an adaptation of the Recommended Foods Score, whose objective is the assessment of overall diet quality with a focus on healthy food consumption. RESULTS: We observed high frequency of overweight according to body mass index per age (20.1%) and body fat percentage (22.8%), as well as physical inactivity (80.3%) among schoolchildren. We also found low scores on the Recommended Foods Score in 77.2% of students. There was no significant relation between overweight and physical inactivity or food consumption (p > 0.05). CONCLUSION: Schoolchildren had a high frequency of overweight, which, alone, was not associated with the high physical inactivity and the low quality diet observed. Therefore, more studies should be performed to identify other factors besides those already described, which may be influencing overweight in this population.

Association between nutritional status, food habits and physical activity level in schoolchildren.

OBJECTIVES: To analyze the relation between nutritional status, food habits and physical activity level in schoolchildren. METHODS: A cross-sectional study was carried out with 661 schoolchildren, from 6 to 14 years old, enrolled in public and private schools located in the urban area of Ouro Preto, state of Minas Gerais, Brazil. A semi-structured questionnaire was applied to collect data on demographic, socio-economic, anthropometric and level of physical activity variables. Schoolchildren were classified according to criteria for body mass index by age, body fat percentage and physical activity level, respectively. Dietary data were collected through a validated food frequency questionnaire specific for children and adolescents. Food consumption was evaluated according to an adaptation of the Recommended Foods Score, whose objective is the assessment of overall diet quality with a focus on healthy food consumption. RESULTS: We observed high frequency of overweight according to body mass index per age (20.1%) and body fat percentage (22.8%), as well as physical inactivity (80.3%) among schoolchildren. We also found low scores on the Recommended Foods Score in 77.2% of students. There was no significant relation between overweight and physical inactivity or food consumption (p > 0.05). CONCLUSION: Schoolchildren had a high frequency of overweight, which, alone, was not associated with the high physical inactivity and the low quality diet observed. Therefore, more studies should be performed to identify other factors besides those already described, which may be influencing overweight in this population.

SLCO1B1 rs4149056 polymorphism associated with statin-induced myopathy is differently distributed according to ethnicity in the Brazilian general population: Amerindians as a high risk ethnic group.

BACKGROUND: Recent studies reported the association between SLCO1B1 polymorphisms and the development of statin-induced myopathy. In the scenario of the Brazilian population, being one of the most heterogeneous in the world, the main aim here was to evaluate SLCO1B1 polymorphisms according to ethnic groups as an initial step for future pharmacogenetic studies. METHODS: One hundred and eighty-two Amerindians plus 1,032 subjects from the general urban population were included. Genotypes for the SLCO1B1 rs4149056 (c.T521C, p.V174A, exon 5) and SLCO1B1 rs4363657 (g.T89595C, intron 11) polymorphisms were detected by polymerase chain reaction followed by high resolution melting analysis with the Rotor Gene 6000® instrument. RESULTS: The frequencies of the SLCO1B1 rs4149056 and rs4363657 C variant allele were higher in Amerindians (28.3% and 26.1%) and were lower in African descent subjects (5.7% and 10.8%) compared with Mulatto (14.9% and 18.2%) and Caucasian descent (14.8% and 15.4%) ethnic groups (p<0.001 and p<0.001, respectively). Linkage disequilibrium analysis show that these variant alleles are in different linkage disequilibrium patterns depending on the ethnic origin. CONCLUSION: Our findings indicate interethnic differences for the SLCO1B1 rs4149056 C risk allele frequency among Brazilians. These data will be useful in the development of effective programs for stratifying individuals regarding adherence, efficacy and choice of statin-type.

Anthropometric measurements and obesity diagnosis in schoolchildren.

AIM: To evaluate whether anthropometric methods such as arm muscle area, arm fat area, Rohrer index, conicity index, and waist-to-height ratio and the commonly used body mass index method are suitable for obesity screening in a multiethnic paediatric population. METHOD: A cross-sectional population study was carried out in the city of Ouro Preto, Brazil, in 2006. Schoolchildren (n = 788) aged 6-15 years were selected by the stratified random sampling procedure by the proportion of students according to age and gender in all schools. Nonparametric receiver-operating characteristic analysis was used to define the cut-off for obesity for each method studied, using the tetrapolar bioelectrical impedance technique as the reference method. RESULTS: Arm fat area measurements and Rohrer index were most suitable for adiposity screening in prepubertal and pubertal boys and in pubertal and prepubertal girls, respectively. In postpubertal period, the Rohrer index was the most suitable body fat assessment method in both genders. CONCLUSION: Body mass index presented the best balance between sensitivity and specificity only in the prepubertal period and postpubertal boys. Anthropometric measurements, especially arm fat area measurements and Rohrer index, are useful for screening of adiposity in a multiethnic paediatric population.

Benznidazole alters the pattern of Cyclophosphamide-induced reactivation in experimental Trypanosoma cruzi-dependent lineage infection.

The factors involved in the reactivation of chronic Chagas disease infection are not clear enough and may be related to host immune unbalance and/or parasite genetic diversity. To evaluate the role of the Trypanosoma cruzi genetic background in the Chagas disease reactivation, we inoculated Cyclophosphamide-immunosupressed (CyI) Swiss mice with clonal stocks from T. cruzi I (Cuica cl1, P209 cl1, Gamba cl1, SP104 cl1), T. cruzi II (IVV cl4, MVB cl8) and T. cruzi (Bug2148 cl1, MN cl2) lineages. We used the parasitemia as the parameter for Chagas disease reactivation and observed that CyI animals infected with T. cruzi stocks showed no reactivation and those infected with T. cruzi II stocks showed only 5% of reactivation. In contrast, immunosuppressed mice infected with stocks from T. cruzi I lineage showed 77.5 and 51.25% reactivation of the infection when Cyclophosphamide treatment was performed 60 and 180 days after inoculation, respectively. Next, we evaluated the efficacy of the Benznidazole (Bz) pre-treatment in reducing or preventing the recurrence of the infection in these CyI animals. In general, the percentage of the parasite recurrence was not altered among the CyI mice that received the Bz pre-treatment during the acute phase of the infection. Interestingly, when pre-Bz treatment was performed during the chronic phase, we observed two different patterns of response: (i) an increased protection among the animals inoculated with the SP104 cl1 (genotype 19) and Cuica cl1 (genotype 20) stocks; (ii) an increased percentage of parasitemia reactivation among mice inoculated with Gamba cl1 (genotype 19) and P209 cl1 (genotype 20) T. cruzi stocks. Our results corroborate our hypothesis by showing that the T. cruzi genetic background in combination with specific Bz treatment has an important role in the Chagas disease reactivation in immunosuppressed animals.

Cardiovascular risk factors in children and adolescents living in an urban area of Southeast of Brazil: Ouro Preto Study.

This study aims to identify risk factors for cardiovascular disorders in schoolchildren living in Ouro Preto City, Brazil. A cross-sectional study was carried out in a population-based sampling of schoolchildren (6-14 years old), randomly selected and stratified by the proportion of students according to age and gender in each schools of the city. Biochemical, clinical and anthropometric variables as well as physical activity and family history were used in a logistic regression model for obesity or arterial hypertension. Out of 780 schoolchildren sampled, the risk of obesity was greater in subjects presenting high triglyceride and low high density lipoprotein-cholesterol levels, and those whose parents were obese, while the risk of hypertension was high in obese subjects and those who presented low birth weight. It was observed that 44.4% of the schoolchildren were exposed to two or three cardiovascular disease (CVD) risk factors and 8.2% were exposed to four or six factors. These findings should be considered in preventive measures to reduce the future risk for CVD among schoolchildren in Brazil.

Trypanosoma cruzi: blood parasitism kinetics and their correlation with heart parasitism intensity during long-term infection of Beagle dogs.

The goals of the present study were to evaluate the kinetics of blood parasitism by examination of fresh blood, blood culture (BC) and PCR assays and their correlation with heart parasitism during two years of infection in Beagle dogs inoculated with the Be-78, Y and ABC Trypanosoma cruzi strains. Our results showed that the parasite or its kDNA is easily detected during the acute phase in all infected animals. On the other hand, a reduced number of positive tests were verified during the chronic phase of the infection. The frequency of positive tests was correlated with T. cruzi strain. The percentage of positive BC and blood PCR performed in samples from animals inoculated with Be-78 and ABC strains were similar and significantly larger in relation to animals infected with the Y strain.Comparison of the positivity of PCR tests performed using blood and heart tissue samples obtained two years after infection showed two different patterns associated with the inoculated T. cruzi strain: (1) high PCR positivity for both blood and tissue was observed in animals infected with Be-78 or ABC strains; (2) lower and higher PCR positivity for the blood and tissue, respectively, was detected in animals infected with Y strains. These data suggest that the sensitivity of BC and blood PCR was T. cruzi strain dependent and, in contrast, the heart tissue PCR revealed higher sensitivity regardless of the parasite stock.

Trypanosoma cruzi: Induction of benznidazole resistance in vivo and its modulation by in vitro culturing and mice infection.

Through a continuous in vivo drug pressure protocol, using mice as experimental model, we induced benznidazole resistance in Trypanosoma cruzi stocks. Full resistance was obtained for four out of five T. cruzi stocks analyzed. However, the number of benznidazole doses (40-180), as well as the time (4-18 months) necessary to induce resistance varied among the different T. cruzi stocks. The resistance phenotype remained stable after T. cruzi stocks has been maintained by 12 passages in mice (six months) and in acellular culture for the same time. However, the maintenance of resistant parasite for 12 months in acellular culture induces a reduction in its level of benznidazole resistance, while no alteration was detected in parasite maintained for the same time in mice. The data showed the stability of the resistance acquired by drug pressure, but suggest the possibility of reversible changes in the resistance levels after maintenance for long time in acellular culture.

Trypanosoma cruzi: blood parasitism kinetics and their correlation with heart parasitism intensity during long-term infection of Beagle dogs

The goals of the present study were to evaluate the kinetics of blood parasitism by examination of fresh blood, blood culture (BC) and PCR assays and their correlation with heart parasitism during two years of infection in Beagle dogs inoculated with the Be-78, Y and ABC Trypanosoma cruzi strains. Our results showed that the parasite or its kDNA is easily detected during the acute phase in all infected animals. On the other hand, a reduced number of positive tests were verified during the chronic phase of the infection. The frequency of positive tests was correlated with T. cruzi strain. The percentage of positive BC and blood PCR performed in samples from animals inoculated with Be-78 and ABC strains were similar and significantly larger in relation to animals infected with the Y strain.Comparison of the positivity of PCR tests performed using blood and heart tissue samples obtained two years after infection showed two different patterns associated with the inoculated T. cruzi strain: (1) high PCR positivity for both blood and tissue was observed in animals infected with Be-78 or ABC strains; (2) lower and higher PCR positivity for the blood and tissue, respectively, was detected in animals infected with Y strains. These data suggest that the sensitivity of BC and blood PCR was T. cruzi strain dependent and, in contrast, the heart tissue PCR revealed higher sensitivity regardless of the parasite stock.

Trypanosoma cruzi: acute and long-term infection in the vertebrate host can modify the response to benznidazole.

We analyzed the influence of Trypanosoma cruzi maintenance in different hosts (dog and mouse) on its susceptibility to benznidazole treatment. Five T. cruzi stocks were isolated from dogs inoculated with Be-62 or Be-78 strain (both sensitive to benznidazole) 2-10 years ago, and the benznidazole sensitivity was then determined using the mouse as experimental model. The different T. cruzi stocks obtained from long-term infected dogs showed 50-90% drug resistance right after isolation. However, maintenance of these T. cruzi stocks in mice, by successive blood passages (2.5 years), led to either a decrease or stability of the drug resistance pattern and an increase in parasite virulence. We also demonstrated the effectiveness of the induction of parasitemia reactivation by cyclophosphamide immunosuppression in the evaluation of the response to the specific drug treatment.

Comparison of polymerase chain reaction with other laboratory methods for the diagnosis of American cutaneous leishmaniasis: diagnosis of cutaneous leishmaniasis by polymerase chain reaction.

An evaluation of 5 laboratory methods for diagnosing American cutaneous leishmaniasis (ACL) was carried out on patients from an endemic area of Brazil. From 164 patients presenting cutaneous lesions, and suspected to have ACL, 133 (81.1%) were confirmed for the disease by Montenegro skin test (MST) and/or parasitologic examination (PE). In both groups of patients, the positivity of polymerase chain reaction (PCR) was similar to that of immunofluorescence assay and enzyme-linked immunosorbent assay, and higher than that of MST and PE (P < .05). In the group of patients suspected to have ACL, PCR presented the same positivity as PE and MST together. No correlation between positivity of the laboratory methods and clinical or epidemiologic aspects was observed. Our data confirmed the value of PCR as an alternative laboratory method for diagnosing ACL, especially for those patients with negative PE and MST.

Importance of Lutzomyia longipalpis in the dynamics of transmission of canine visceral leishmaniasis in the endemic area of Porteirinha Municipality, Minas Gerais, Brazil.

A study of Lutzomyia longipalpis (Lutz and Neiva, 1912) (Diptera: Psychodidae), the primary vector of American visceral leishmaniasis (AVL), and the canine form of the disease, was carried out in Porteirinha. The city is situated in the northern part of the Brazilian State of Minas Gerais and is an endemic area of AVL. Systematic phlebotomine captures were performed in seven districts with previously reported cases of canine visceral leishmaniasis, during 2 years (January 2000--December 2001). A total of 2328 specimens of L. longipalpis were captured. The association between the local climate variables and the population density of L. longipalpis was evaluated and rainfall was determined to be a major factor, with increased populations during the rainy season (October--March). At the same time period, blood samples from every dog domiciled in the same seven districts, in total 14,077 animals, were analyzed for infection by viscerotropic Leishmania using indirect immunofluorescence assay (IFA). Accumulated incidence rates of canine VL per district varied from 3.40 to 14.34 for the 2-year period. A positive correlation between the population density of L. longipalpis and the canine cases of visceral leishmaniasis in Porteirinha was observed.

Risk factors for mucosal manifestation of American cutaneous leishmaniasis.

A case-comparison study was carried out to identify risk factors for mucosal manifestations of American cutaneous leishmaniasis (ACL) in southeast Brazil, using a series of 2820 patients, diagnosed with ACL between 1966 and 1999. The significant factors independently associated with mucosal leishmaniasis were: gender, age, nutritional status and length of disease. Mucosal leishmaniasis occurred 1.7 times more frequently among males than females; twice as often in individuals older than 22 years compared with the younger group; almost four times as often in individuals with severe malnutrition compared with those who were well nourished; and almost four times more frequently in individuals reporting the disease for more than 4 months compared with those reporting a shorter duration of the disease. Among individuals older than 22 years the risk of mucosal leishmaniasis increased significantly (from 1.9 to 9.6) as the nutritional status decreased, when compared with younger and well-nourished patients. The characteristics herein described and correlated with severe forms could be used as diagnostic markers as part of clinical screening in areas endemic for ACL.

Activity of the new triazole derivative albaconazole against Trypanosoma (Schizotrypanum) cruzi in dog hosts.

Albaconazole is an experimental triazole derivative with potent and broad-spectrum antifungal activity and a remarkably long half-life in dogs, monkeys, and humans. In the present work, we investigated the in vivo activity of this compound against two strains of the protozoan parasite Trypanosoma (Schizotrypanum) cruzi, the causative agent of Chagas' disease, using dogs as hosts. The T. cruzi strains used in the study were previously characterized (murine model) as susceptible (strain Berenice-78) and partially resistant (strain Y) to the drugs currently in clinical use, nifurtimox and benznidazole. Our results demonstrated that albaconazole is very effective in suppressing the proliferation of the parasite and preventing the death of infected animals. Furthermore, the parasitological, PCR, serological, and proliferative assay results indicated parasitological cure indices of 25 and 100% among animals inoculated with T. cruzi strain Y when they were treated with albaconazole at 1.5 mg/kg of body weight/day for 60 and 90 days, respectively. On the other hand, although albaconazole given at 1.5 mg/kg/day was very effective in suppressing the proliferation of the parasite in animals infected with the Berenice-78 T. cruzi strain, no parasitological cure was observed among them, even when a longer treatment period (150 doses) was used. In conclusion, our results demonstrate that albaconazole has trypanocidal activity in vivo and is capable of inducing radical parasitological cure, although natural resistance to this compound was also indicated. Furthermore, the compound can be used in long-term treatment schemes (60 to 150 days) with minimal toxicity and thus represents a potentially useful candidate for the treatment of human Chagas' disease.

Use of the Trypanosoma cruzi recombinant complement regulatory protein to evaluate therapeutic efficacy following treatment of chronic chagasic patients.

One of the greatest concerns in Chagas' disease is the absence of reliable methods for the evaluation of chemotherapy efficacy in treated patients. The tests available to evaluate cure after the specific treatment are the complement-mediated lysis (CoML) and flow cytometry tests, but they are not feasible for routine clinical use. In this study, we evaluated an enzyme-linked immunosorbent assay (ELISA) based on the recombinant Trypanosoma cruzi complement regulatory protein (rCRP) as a method to determine parasite clearance in comparison to the CoML and other methods such as conventional serology, hemoculture, and PCR in serum samples of 31 patients collected before and after the treatment, monitored for an average of 27.7 months after chemotherapy. The results showed that the percentage of patient samples that were positive by rCRP ELISA was reduced from 100 to 70.3, 62.5, 71.4, and 33.4% in the first, second, third, and fourth years after treatment, respectively, while the samples positive by CoML were reduced to 85.2, 81.2, 71.4, and 33.4% during the same period, demonstrating the same significant tendency in the reduction of positive samples. On the other hand, the conventional serology (CS) tests did not present this reduction. The percentage of samples positive by PCR was initially 77.4% and decreased to 55.5, 68.7, 47.7, and 50.0% at the fourth year after treatment, confirming the drastic clearance of circulating parasites after treatment. Our results strongly suggest that the rCRP ELISA was capable of detecting the early therapeutic efficacy in treated patients and confirmed its superiority over the CS tests and parasitologic methods.