Application of Lactose-Free Whey Protein to Greek Yogurts: Potential Health Benefits and Impact on Rheological Aspects and Sensory Attributes.

The application of ß-galactosidase in the fermentation of milk enables the acquirement of lower levels of lactose that are tolerated by lactose maldigesters and can reduce the nutritional consequences of avoiding dairy products. The present study evaluated the viability of the fortification of lactose-free prebiotic Greek yogurt formulas with whey protein concentrate (WPC). Two rotational central composite designs (RCCDs) were applied: one to perform the hydrolysis of the whey protein concentrate and another for the yogurt formulations (α = 2 with 2 central points and 4 axial points). Two ß-galactosidase enzymes obtained from Kluyveromyces lactis were used. The content of lactose, glucose, galactose, and lactic acid were determined in the WPC, milk (pasteurized and powdered), and yogurts. The three best formulations regarding the attributes' viscosity, syneresis, firmness, and elasticity were sensorially evaluated by using a nine-point hedonic scale. A microbiological analysis was performed after 48 h of yogurt production. The characterization of the products and the comparison of the results obtained were evaluated using the Student's T test and the analysis of variance with Tukey's test (p-values < 0.05). The application of a lactose-free WPC promoted viscosity, firmness, and elasticity. The syneresis was reduced, and whey increased the protein and calcium content. Lactose-free WPC can be used as a partial substitute for skimmed powdered milk in yogurts. The obtained results are encouraging with respect to the production of lactose-free Greek yogurts by the dairy industry.

Antileishmanial activity of fullerol and its liposomal formulation in experimental models of visceral leishmaniasis.

Visceral leishmaniasis (VL) is a systemic parasitic disease that leads to high rates of morbidity and mortality in humans worldwide. There is a great need to develop new drugs and novel strategies to make chemotherapy for this disease more efficacious and well tolerated. Recent reports on the immunomodulatory effects and the low toxicity of the spherical carbon nanostructure fullerol led us to investigate in vitro and in vivo antileishmanial activity in free and encapsulated forms in liposomes. When assayed against intramacrophagic Leishmania amastigotes, fullerol showed a dose-dependent reduction of the infection index with IC50 of 0.042 mg/mL. When given daily by i.p. route for 20 days (0.05 mg/kg/d) in a murine model of acute VL, fullerol promoted significant reduction in the liver parasite load. To improve the delivery of fullerol to the infection sites, liposomal formulations were prepared by the dehydration-rehydration method. When evaluated in the acute VL model, liposomal fullerol (Lip-Ful) formulations given i.p. at 0.05 and 0.2 mg/kg with 4-days intervals were more effective than the free form, with significant parasite reductions in both liver and spleen. Lip-Ful at 0.2 mg/kg promoted complete parasite elimination in the liver. The antileishmanial activity of Lip-Ful was further confirmed in a chronic model of VL. Lip-Ful was also found to induce secretion of pro-inflammatory TNF-α, IFN-γ and IL-1ß cytokines. In conclusion, this work reports for the first time the antileishmanial activity of fullerol and introduces an innovative approach for treatment of VL based on the association of this nanostructure with liposomes.

Análise do perfil de usuários atendidos em um centro de atenção psicossocial / Analysis of the profile of users assisted in a psychosocial care center / Análisis del perfil de usuarios atendidos en un centro de atención psicosocial

Objetivo: caracterizar o perfil de usuários de um Centro de Atenção Psicossocial (CAPS) do tipo II. Método: estudo documental e quantitativo, realizado de agosto a dezembro de 2016, em Fortaleza, Ceará. A amostra constituiu-se de 240 prontuários de usuários ativos nos anos de 2014 e 2015. Realizou-se associação entre variáveis com aplicação do teste qui-quadrado de Pearson. Respeitaram-se os critérios éticos. Resultados: concernente ao gênero e sua associação às psicopatologias, a esquizofrenia foi a mais frequente em ambos os sexos, porém com maior prevalência entre os homens. Para o sexo feminino teve destaque o transtorno afetivo bipolar (23,3%) e a depressão (24,1%). Obteve-se significância estatística ao associar tipo de transtorno com faixa etária (p=0,002), sexo (p=0,001), suicídio (p=0,001) e nº de internações (p=0,001). Conclusão: as psicopatologias mais prevalentes nesse estudo influenciam a qualidade de vida dos usuários do serviço. Desse modo, a caracterização do perfil dos usuários do CAPS gera subsídios para elaboração de medidas que ampliem o cuidado em saúde mental.

Objective: to characterize the profile of users of a type II Psychosocial Care Center (PSCC). Method: documentary and quantitative study, carried out from August to December 2016, in Fortaleza, Ceará. The sample consisted of 240 records of active users in the years 2014 and 2015. A form was used to collect data that investigated variables such as age, sex, schooling, type of disorder and number of hospitalizations. An association was made between variables with Pearson's Chisquare test. Results: the results showed that when the type of disorders and the gender were related, schizophrenia was more frequent in males (47.3%) and bipolar disorder (23.3%) and depression (24.1%) were more frequent in females. Statistical significance was obtained by correlating variables, such as: age group and type of disorder (p = 0.002); Sex and disorder (p = 0.001); Suicide and disorder (p = 0.001) and number of hospitalizations and type of disorder (p = 0.001). Conclusion: the most prevalent psychopathologies in this study influence the quality of life of service users. Thus, the characterization of the profile of the users of the PSCC generates subsidies for elaboration of measures that extend the care in mental health.

Objetivo: Caracterizar el perfil de usuarios de un Centro de Atención Psicosocial del tipo II. Método: estudio documental y cuantitativo, realizado de agosto a diciembre de 2016, en Fortaleza, Ceará. La muestra se constituyó de 240 prontuarios de usuarios activos en los años 2014 y 2015. Celebró la asociación entre variables con la aplicación de la prueba chi-cuadrado de Pearson. Respete los criterios éticos. Resultados: en relación con el género y su asociación con Psychopathologies, la esquizofrenia fue la más frecuente en ambos sexos, pero con mayor prevalencia entre los hombres. En el caso de las hembras, había puesto de relieve el trastorno afectivo bipolar (23,3%) y depresión (24,1%). Obtuvimos significación estadística para asociar el tipo de trastorno con la edad (p=0,002), el sexo (p=0,001), el suicidio (p=0,001) y no las hospitalizaciones (p=0,001). Conclusion: las psicopatologías más prevalentes en este estudio influencian la calidad de vida de los usuarios del servicio. De este modo, la caracterización del perfil de los usuarios del CAPS genera subsidios para la elaboración de medidas que amplíen el cuidado en salud mental.

Inserção profissional de Egressos da Licenciatura: avaliação quantitativa / Employability of teaching credential in nursing program alumni: a quantitative evaluation / Inserción profesional de Egresados de la Licenciatura: evaluación cuantitativa

Objetivos: Caracterizar os egressos da Licenciatura em Enfermagem da Escola de Enfermagem da Universidade de São Paulo e sua inserção no mercado de trabalho e conhecer as perspectivas sobre o curso. Trata-se de um estudo exploratório, de natureza descritiva e quantitativa. Resultados: Participaram da pesquisa 66 egressos do curso de Licenciatura, no período de 2002 a 2017. A coleta de dados foi realizada por meio de questionário eletrônico. Houve predominância do sexo feminino, solteiros, sem fi lhos, e de renda entre 7 a 10 salários mínimos. A maioria concluiu a licenciatura em 4 a 5 anos (69,7%). Parte dos egressos teve inserção profissional na Licenciatura (38%) e sete (10,6%) afirmaram exercer docência como atividade principal.Conclusão: Na fala dos participantes, percebeu-se algumas fragilidades em relação ao estágio curricular, bem como falta de articulação entre as disciplinas. A autonomia gerada durante o curso de licenciatura é citada como um fortalecedor da profissão. Foi possível observar que a docência é a segunda atividade mais exercida pelos egressos, contudo o curso é considerado fundamental para o crescimento pessoal e profissional.

Objective: To describe the alumni of the teaching credential in nursing program from the School of Nursing of the University of São Paulo and their employability, and to explore their perspectives about the course. This is an exploratory, descriptive, and quantitative study. Results: A total of 66 alumni from the teaching credential in nursing program who graduated between 2002 and 2017 participated in the study. Data collection were performed by using an electronic form. Participants were mainly female, single, childless, with an income between 7 to 10 minimum wages. The majority of the alumni concluded the course in 4 to 5 years (69.7%). Some of the alumni experienced teaching activities (38%) and seven (10.6%) participants described teaching as being their main current professional activity. Conclusion: Participants reported weaknesses regarding the clinical internship, as well as the lack of articulation among the disciplines. According to the alumni, the program generates professional autonomy, which empowers the profession. Although teaching was described as the second most commonly professional activity performed by the alumni, the program is considered fundamental for personal and professional development.

Objetivos: Caracterizar a los egresados de la Licenciatura en Enfermería de la Escola de Enfermagem da Universidade de São Paulo y su inserción en el mercado de trabajo, y conocer las perspectivas sobre el curso. Es un estudio exploratorio, de naturaleza descriptiva y cuantitativa. Resultados: Participaron de la investigación 66 egresados del curso de Licenciatura, en el periodo de 2002 a 2017. La recolección de los datos fue realizada por medio de un cuestionario electrónico. Hubo predominancia del sexo femenino, solteros, sin hijos, y de ingresos económicos entre 7 a 10 salarios mínimos (37,9%). La mayoría concluyó la licenciatura en 4 o 5anos (69,7%). Parte de los egresados tuvo inserción profesional en la Licenciatura (38%) y siete (10,6%) afirmaron ejercer la docencia como actividad principal.Conclusión: En el relato de los participantes se perciben algunas fragilidades con relación a la pasantía curricular, así como la falta de articulación entre las disciplinas. La autonomía generada durante el curso de licenciatura es citada como un fortalecedor de la profesión. Fue posible observar que la docencia es la segunda actividad más ejercida por los egresados, sin embargo, el curso es considerado fundamental para el crecimiento personal y profesional.

Nurses in the labor market: professional insertion, competencies and skills / El enfermero en el mercado de trabajo: inserción, competencias y habilidades / O enfermeiro no mercado de trabalho: inserção, competências e habilidades

ABSTRACT Objective: to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work. Method: an exploratory, descriptive study with a qualitative approach. Results: out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population. Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills. Conclusion: the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.

RESUMEN Objetivo: caracterizar enfermeros egresos de la Escuela de Enfermería de la Universidade de São Paulo (EEUSP), período de 2006 a 2012; verificar la inserción, a las facilidades y dificultades de esos egresos en el mercado de trabajo y asimilar sus habilidades y competencias en el mundo del trabajo. Método: estudio exploratorio, descriptivo, de naturaleza cuantitativa. Resultados: de los 505 egresos, 172 (34,1%) participaron de la pesquisa. La inserción en el mercado de trabajo se dio mayoritariamente en instituciones hospitalarias públicas, en la región Sureste, en el área de asistencia. La mayor parte permaneció en los primeros empleos de uno a dos años. La mayoría concordó que fue preparada para el atendimiento a las necesidades de salud de la población, que fue estimulada a buscar perfeccionamiento sistemático y continuo, de forma crítica, reflexiva y creativa, aliando conocimiento técnico-científico y habilidades personales. Conclusión: los resultados evidencian que EEUSP viene preparando enfermeros para actuar en el mundo del trabajo, según preceptos de las Directrices Curriculares Nacionales.

RESUMO Objetivo: caracterizar enfermeiros egressos da Escola de Enfermagem da Universidade de São Paulo (EEUSP), período de 2006 a 2012; verificar a inserção, as facilidades e dificuldades desses egressos no mercado de trabalho e apreender suas habilidades e competências no mundo do trabalho. Método: estudo exploratório, descritivo, de natureza quantitativa. Resultados: dos 505 egressos, 172 (34,1%) participaram da pesquisa. A inserção no mercado de trabalho se deu majoritariamente em instituições hospitalares públicas, na região Sudeste, na área da assistência. A maior parte permaneceu nos primeiros empregos de um a dois anos. A maioria concordou que foi preparada para o atendimento às necessidades de saúde da população, que foi estimulada a buscar aperfeiçoamento sistemático e contínuo, de forma crítica, reflexiva e criativa, aliando conhecimento técnico-científico e habilidades pessoais. Conclusão: os resultados evidenciam que a EEUSP vem preparando enfermeiros para atuar no mundo do trabalho, conforme preceitos das Diretrizes Curriculares Nacionais.

Nurses in the labor market: professional insertion, competencies and skills.

OBJECTIVE: to characterize nurses graduated from the School of Nursing of the University of São Paulo, from 2006 to 2012; verify their entry, facilitating factors and difficulties of these graduates in the labor market and to consider their skills and competences in the world of work. METHOD: an exploratory, descriptive study with a qualitative approach. RESULTS: out of 505 graduates, 172 (34.1%) participated in the research. Entry into the labor market was mainly via public hospital institutions, in the SE of Brazil, in the caregiving sectors. The greater part remained from one to two years in their first job. Most agreed that they were prepared to meet the health needs of the population.  Furthermore, they had been encouraged to seek systematic and continuous improvement in a critical, reflexive and creative way, while combining technical-scientific knowledge and personal skills. CONCLUSION: the results show that the University of São Paulo has been preparing nurses for work in the labor market, in accordance with the provisions of the National Curricular Guidelines.

Validação da versão brasileira do Quality of Life Index Spinal Cord Injury - version III / Validation of the Brazilian version of quality of life index spinal cord injury - version III

A validação da versão brasileira do Quality of Life Index Spinal Cord Injury - version III (QLI version SCI-III) defende a seguinte tese: o QLI version SCI- III é um instrumento válido e confiável para a língua portuguesa, proporciona um embasamento para a compreensão de saúde por ter como base a satisfação e importância de fatores que influenciam na qualidade de vida das pessoas com lesão medular. Tem como objetivo validar a versão brasileira do QLI version SCI-III, verificar as propriedades psicométricas, associar os escores do índice com as variáveis socioeconomicodemográficas e clínicas das pessoas com lesão medular e com o instrumento Short Form-36. Para tanto procedeu-se um estudo metodológico com abordagem quantitativa, no domicílio de cinquenta pessoas com lesão medular em fase crônica, de outubro de 2016 a março de 2017, que atenderam aos aspectos de inclusão e exclusão, por amostragem aleatória simples dos indivíduos com lesão medular cadastrados no Núcleo de Pesquisa e Extensão em Enfermagem Neurológica da Universidade Federal do Ceará. Efetuou-se a coleta de dados em quatro momentos, por dois avaliadores distintos. A validação é fundamentada no referencial proposto pelo Comitê Executivo para os Data Sets Internacionais de Lesão Medular conforme Biering-Sorensen 2011, por meio da confiança intraexaminador e interexaminador. Utilizaram-se também, para validação do constructo, grupos contrastados e aplicação do padrão ouro Short Form-36 e propriedades psicométricas de confiabilidade (homogeneidade: alfa de Cronbach e correlação de Pearson; estabilidade: coeficiente de correlação inter e intraclasses). O intervalo entre as quatro coletas ocorrem com a realização da segunda coleta imediatamente após a primeira por dois examinadores diferentes, e a terceira e quarta coletas após quinze dias da primeira pelos mesmos examinadores anteriores, sendo a quarta imediatamente após a terceira. Para o cálculo dos escores obtidos utilizau-se o programa SPSS-PC, e os testes exigidos na metodologia descrita. Respeitaram-se os aspectos éticos em consonância com as exigências da Resolução 466/2012 do Conselho Nacional de Saúde e obteve-se parecer nº 2.022.574. A validade de constructo efetuada pelo alfa de Cronbach sugeriu a exclusão de onze itens da parte de satisfação e importância; assim seu valor passou de 0,835 para 0,942, resultando em um índice com 52 itens. Conforme revela a validade de constructo por meio da comparação dos grupos contrastados as pessoas que residem sozinhas nos domicílios possuem melhor qualidade de vida. O QLI version SCI-III apresentou correlação convergente em cinco domínios do SF - 36. O ICC teve média inter 0,955 e intra 0,945, correlação de Pearson média inter 0,915 e intra 0,897, dados estatisticamente relevantes. Segundo se conclui, obteve-se um instrumento confiável, válido e capaz de avaliar a qualidade de vida de pessoas com lesão medular. Recomenda-se que a QLI version SCI-III seja aplicada tanto em pesquisas como na prática neurológica, por possibilitar o planejamento, intervenções e avaliação de cuidados direcionados às necessidades peculiares destes pacientes, os quais agora recorrem a uma tecnologia que mensura muitas relações subjetivas e que não são observadas ou reveladas na prática dos cuidados de enfermagem, principalmente por mensurar satisfação e importância dos domínios de qualidade de vida. (AU)

Biophysical and Pharmacological Characterization of Energy-Dependent Efflux of Sb in Laboratory-Selected Resistant Strains of Leishmania (Viannia) Subgenus.

The growing resistance of leishmaniasis to first-line drugs like antimonials in some regions limits the control of this parasitic disease. The precise mechanisms involved in Leishmania antimony resistance are still subject to debate. The reduction of intracellular SbIII accumulation is a common change observed in both laboratory-selected and field isolated resistant Leishmania strains, but the exact transport pathways involved in antimony resistance have not yet been elucidated. In order to functionally characterize the antimony transport routes responsible for resistance, we performed systematic transport studies of SbIII in wild-type and resistant strains of L. (Viannia) guyanensis and L. (V.) braziliensis. Those include influx and efflux assays and the influence of ABC transporters and metabolism inhibitors: prochlorperazine, probenecid, verapamil, BSO, and sodium azide. The mRNA levels of genes associated with antimony resistance (MRPA, GSH1, ODC, AQP1, ABCI4, and ARM58) were also investigated in addition to intracellular thiol levels. A strong reduction of Sb influx was observed in L. guyanensis resistant mutant (LgSbR), but not in L. braziliensis (LbSbR). Both mutants showed increased energy-dependent efflux of SbIII, when compared to their respective parental strains. In LgSbR, BSO and prochlorperazine inhibited antimony efflux and resistance was associated with increased MRPA and GSH1 mRNA levels, while in LbSbR antimony efflux was inhibited by probenicid and prochlorperazine in absence of resistance-associated gene modulation. Intracellular thiol levels were increased in both Sb-resistant mutants. An energy-dependent SbIII efflux pathway sensitive to prochlorperazine was clearly evidenced in both Sb-resistant mutants. In conclusion, the present study allowed the biophysical and pharmacological characterization of energy-dependent Sb efflux pathway apparently independent of MRPA, ABCI4, and ARM58 upregulation, in Leishmania (Vianna) mutant selected in vitro for resistance to SbIII. Prochlorperazine has also been identified as an effective chemosensitizer in both Sb resistant mutants, which acts through inhibition of the active efflux of Sb.

Alterações metabólicas e estimativa de risco cardiovascular em pessoas vivendo com HIV/AIDS doze meses após o início da TARV / Metabolic changes and estimating cardiovascular risk of people living with HIV/AIDS twelve months after the start of HAART

A incidência de doenças cardiovasculares (DCV) chega a ser duas vezes maior em pessoas vivendo com HIV/AIDS (PVHA) devido aos danos pró-inflamatório causado pelo vírus e efeitos tóxicos de antirretrovirais incluindo as dislipidemias. O objetivo deste trabalho foi acompanhar o risco de DCV e marcadores metabólicos em PVHA. Trata-se de estudo longitudinal realizado antes e após 12 meses de inicio de antirretrovirais. Coletou-se variáveis socioeconômicas, clínicas, antropométricas e laboratoriais, e calculou-se escores de Framingham e PROCAM. Utilizaram-se os testes de Wilcoxon, T-Student e Qui-Quadrado na comparação das variáveis. A amostra basal deste estudo foi composta por 91 PVHA. Desses, 85% eram homens com mediana de idade igual a 31 anos e 94,5% declararam não ter história pregressa de dislipidemias. Foi observado aumento nos níveis de colesterol total (p0,05). Portanto, para a definição de risco real de DCV nesta população temos que considerar a inclusão de outras variáveis como alguns biomarcadores e, ainda, a mensuração ultrassonográfica da camada íntima carotídeas. Sendo assim, o cuidado compartilhado com outras áreas da saúde como nutricionistas e educadores físicos visando estimular a mudança de estilo de vida, pode qualificar o acompanhamento de PVHA reduzindo a incidência de eventos não infecciosos. (AU)

The incidence of cardiovascular disease (CVD) is up to twice as high in people living with HIV / AIDS (PLWHA) because of the proinflammatory damage caused by the virus and antiretroviral toxicities including dyslipidemias. The objective of this study was to monitor the risk of CVD and metabolic markers in PLWHA. This is a longitudinal study before and after 12 months of antiretroviral beginning. They were collected socioeconomic, clinical, anthropometric and laboratory variables, and calculated scores of Framingham and PROCAM. They used the Wilcoxon paired tests, T-Student and Chi-square partition in the comparison of variables. The baseline sample was composed of 91 PLWHA. Of these, 85% were male with median age 31 years and 94.5% did not have a history of dyslipidemia. There was an increase in total cholesterol levels (p 0.05). Therefore, to define real risk of CVD in this population we have to consider the inclusion of other variables as some biomarkers, and also ultrasound measurement of carotid intima layer. Thus, the shared care with other health areas as physical nutritionists and educators to stimulate the change of lifestyle, can qualify PLWHA monitoring reducing the incidence of non-infectious events. (AU)

Urban upgrading and its impact on health: a "quasi-experimental" mixed-methods study protocol for the BH-Viva Project.

There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a "quasi-experimental", multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents' health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the "formal city", increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

Urban upgrading and its impact on health: a “quasi-experimental” mixed-methods study protocol for the BH-Viva Project / Intervenciones de renovación urbana y el impacto en la salud: protocolo de un estudio cuasi-experimental con métodos mixtos – Proyecto BH-Viva / Intervenções de requalificação urbana e o impacto na saúde: protocolo de estudo “quasi-experimental” com métodos mistos – Projeto BH-Viva

Abstract There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a “quasi-experimental”, multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents’ health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the “formal city”, increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.

Resumen Hay poca evidencia científica de que las estrategias de regeneración urbana contribuyen a mejorar la salud y reducir las inequidades. En este trabajo se presenta el diseño del Proyecto BH-Viva, estudio “cuasi-experimental”, de múltiples fases, con métodos mixtos, incluidos los componentes cuantitativos y cualitativos, que propone un modelo de análisis para el seguimiento de los efectos de las intervenciones en el entorno urbano puede tener en la salud residentes de las aldeas y los barrios marginales en Belo Horizonte, Minas Gerais, Brasil. En el análisis preliminar hubo diferencias intra-urbanas en la mortalidad proporcional por grupos de edad, al comparar las zonas con y sin la intervención; las tendencias de la mortalidad de 2002 hasta 2012 se mantuvieron estables en la ciudad formal, el aumento en el pueblo sin ninguna intervención y disminuyen de que con la intervención. El BH-Viva es un esfuerzo para avanzar en cuestiones metodológicas, proporcionando el aprendizaje y la base teórica de los métodos de investigación y de investigación en salud urbana, lo que permite la aplicación y la extensión en otros contextos urbanos.

Resumo Há poucas evidências científicas de que estratégias de requalificação urbana contribuam para a melhoria da saúde e redução das iniquidades. Este artigo apresenta o delineamento do Projeto BH-Viva – estudo “quasi-experimental”, multifásico, com métodos mistos, incluindo componentes quantitativos e qualitativos, propondo um modelo de análise para monitoramento dos efeitos que intervenções no ambiente urbano possam ter sobre a saúde de moradores de vilas e favelas em Belo Horizonte, Minas Gerais, Brasil. Em análise preliminar observou-se diferenças intraurbanas na mortalidade proporcional por grupos etários, ao comparar áreas com e sem intervenção; a tendência de mortalidade de 2002 a 2012 mostrou estabilidade na cidade formal, aumento na vila sem intervenção e decréscimo naquela com intervenção. BH-Viva representa um esforço no avanço de questões metodológicas, fornecendo aprendizado e subsídios teóricos para a pesquisa e métodos de investigação em Saúde Urbana, possibilitando a aplicação e extensão em outros contextos urbanos.

[Cross-cultural adaptation of the Quality of Life Index Spinal Cord Injury - Version III]. / Adaptação transcultural do Quality of Life Index Spinal Cord Injury ­ Version III.

OBJECTIVE: To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. METHOD: A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. RESULTS: An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. CONCLUSION: After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury.

Cross-cultural adaptation of the Quality of Life Index Spinal Cord Injury - Version III / Adaptación Transcultural Del Quality Of Life Index Spinal Cord Injury - Version III / Adaptação transcultural do Quality of Life Index Spinal Cord Injury - Version III

OBJECTIVE To translate and culturally adapt to Portuguese the Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III and characterize the sample in relation to sociodemographic and clinical aspects. METHOD A methodological study with view to cross-cultural adaptation, following the particular steps of this method: initial translation, translation synthesis, back-translation (translation back to the original language), review by a committee of judges and pretest of the final version. The pretest was carried out with 30 patients with spinal cord injury. RESULTS An index of 74 items divided into two parts (satisfaction/importance) was obtained. The criteria of semantic equivalence were evaluated as very adequate translation, higher than 87%, and vocabulary and were grammar higher than 86%. Idiomatic equivalence was higher than 74%, experimental greater than 78% and conceptual was greater than 70%. CONCLUSION After cross-cultural adaptation, the instrument proved semantic, idiomatic, experimental and conceptual adequacy, in addition to helping the evaluation of the quality of life of people with spinal cord injury. .

OBJETIVO Traducir y adaptar culturalmente a la lengua portuguesa el Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III y caracterizar la muestra en cuanto a los aspectos sociodemográficos y clínicos. MÉTODO Estudio metodológico con vistas a la adaptación transcultural, siguiendo las etapas propias de ese método: traducción inicial, síntesis de la traducción, traducción de vuelta a la lengua original (back-translation), revisión por un comité de jueces y pre prueba de la versión final. Se llevó a cabo una pre prueba con 30 pacientes con lesión medular. RESULTADOS Se logró índice con 74 puntos, divididos en dos partes (satisfacción/importancia). Los criterios de equivalencia semántica fueron evaluados como traducción muy adecuada, superior al 87%, vocabulario y gramática superior al 86%, idiomática superior al 74%, experimental superior al 78% y conceptual superior al 70%. CONCLUSIÓN Después de adaptado transculturalmente, el instrumento se mostró adecuado semántica, idiomática, experimental y conceptualmente, además de facilitar la evaluación de la calidad de vida de personas con lesión medular. .

OBJETIVO Traduzir e adaptar culturalmente para a língua portuguesa o Ferrans and Powers Quality of Life Index Spinal Cord Injury - Version III e caracterizar amostra quanto aos aspectos sociodemográficos e clínicos. MÉTODO Estudo metodológico com vistas à adaptação transcultural, seguindo as etapas própias deste método: tradução inicial, síntese da tradução, tradução de volta à língua original (back-translation), revisão por um comitê de juízes e pré-teste da versão final. Realizou-se pré-teste com 30 pacientes com lesão medular. RESULTADOS Obteve-se índice com 74 itens, divididos em duas partes (satisfação/importância). Os critérios de equivalência semântica foram avaliados como tradução muito adequada, superior a 87%, vocabulário e gramática superior a 86%. Idiomática superior a 74%, experimental superior a 78% e conceitual superior a 70%. CONCLUSÃO Após adaptado transculturalmente o instrumento mostrou-se adequado semântica, idiomática, experimental e conceitualmente, além de facilitar a avaliação da qualidade de vida de pessoas com lesão medular. .

Synthesis and characterization of bismuth(III) and antimony(V) porphyrins: high antileishmanial activity against antimony-resistant parasite.

Two bismuth(III) porphyrins-5,10,15,20-tetrakis(phenyl)porphyrinatobismuth(III) nitrate, [Bi(III)(TPP)]NO3, and the unprecedent 5,10,15,20-tetrakis(4-carbomethoxyphenyl)porphyrinatobismuth(III) nitrate, [Bi(III)(T4CMPP)]NO3, and two unprecedented antimony(V) porphyrins dichlorido(5,10,15,20-tetrakis(phenyl)porphyrinato)antimony(V) bromide, [Sb(V)(TPP)Cl2]Br, and dibromido(5,10,15,20-tetrakis(4-carbomethoxyphenyl)porphyrinato)antimony(V) bromide, [Sb(V)(T4CMPP)Br2]Br,-were synthesized by reacting the corresponding porphyrin ligand with Bi(NO3)3·5H2O or SbCl3. All compounds were characterized by UV-vis, (1)H NMR spectroscopy, and mass spectrometry. The new compounds were also characterized by elemental analysis. Because antimony and bismuth compounds have been widely applied in medicine, the activity of these complexes was tested against Sb-sensitive and -resistant Leishmania amazonensis parasites. [Sb(V)(T4CMPP)Br2]Br was more active against the promastigote form of Sb-resistant mutant strain as compared to the sensitive parental strain, with IC50 in the micromolar range. These data contrasted with those obtained using the Sb(III) drug potassium antimony tartrate, which displayed IC50 of 110 µmol L(-1) against the Sb-sensitive parasite and was almost inactive against the Sb-resistant strain. The H2T4CMPP ligand also showed antileishmanial activity against Sb-resistant and -sensitive strains, but with IC50 at least tenfold greater than that of the complex. The Sb(V)-porphyrin complex was also active against intracellular amastigotes and showed a higher selectivity index than the conventional Sb(V) drug glucantime, in both Sb-sensitive and -resistant strains. The greater antileishmanial activity of this complex could be attributed to an increased cellular uptake of Sb. Thus, [Sb(V)(T4CMPP)Br2]Br constitutes a new antileishmanial drug candidate.

Domínios de qualidade de vida de crianças com paralisia cerebral: estudo transversal / Domains of quality of life of children suffering from cerebral palsy: a cross-sectional study / Dominios de calidad de vida de niños con parálisis cerebral: estudio transversal

OBJETIVO: Avaliar a correlação entre os domínios de qualidade de vida de crianças com paralisia cerebral a partir da CP QoL Child ­ aplicação com pais. MÉTODO: Estudo descritivo e transversal realizado na cidade de Fortaleza, em duas instituições de referência, com 100 pais de crianças com paralisia cerebral. A coleta de dados ocorreu por meio da aplicação da escala Cerebral Palsy Quality of Children. RESULTADOS: Identificou-se uma correlação moderada estatisticamente significante entre o domínio família e amigos e os domínios atividade coletiva (r=0,5145), comunicação (r=0,2585) e saúde da criança (r=0,3277). Também percebeu-se uma correlação entre moderada e fraca estatisticamente significante entre o domínio atividade coletiva e os domínios saúde da criança (r=0,4669) e equipamento especial (r=0,2120), respectivamente. CONCLUSÃO: O domínio família e amigos afeta diretamente outros, sendo necessária intervenção de forma precoce nesse aspecto influenciador, a fim de alcançar melhoria na qualidade de vida dessas crianças

AIM: To evaluate the correlation between domains for the quality of life of children with cerebral palsy from the CP QoL Child-application and their parents. METHOD: This is a descriptive and cross-sectional study, conducted in two reference institutions in the city of Fortaleza, and involved one hundred parents of children suffering from cerebral palsy. Data collection occurred through the application of the Cerebral Palsy scale, Quality of Children. RESULTS: We identified a statistically significant moderate correlation between the family and friends' domain and the domain's collective activity (r=0.5145), communication (r=0.2585) and child health (r=0.3277). We also noticed a statistically significant correlation of moderate and weak, between the collective activity domain and the domain of child health (r=0.4669) and special equipment (r=0.2120), respectively. CONCLUSION: The family and friends domain directly affects others, requiring early intervention in this influential aspect, in order to achieve an improved quality of life for these children.

OBJETIVO: Evaluar la correlación entre los dominios de calidad de vida de niños con parálisis cerebral a partir de la CP QoL Child ­ aplicación con padres. MÉTODO: Estudio descriptivo y transversal realizado en la ciudad de Fortaleza, en dos instituciones de referencia, con 100 padres de niños con parálisis cerebral. La colecta de datos ocurrió por medio de la aplicación de la escala Cerebral Palsy Quality of Children. RESULTADO: Se identificó una correlación moderada estadísticamente significante entre el dominio familia y amigos y los dominios actividad colectiva (r=0,5145), comunicación (r=0,2585) y salud del niño (r=0,3277). También se percibió una correlación entre moderada y débil estadísticamente significante entre el dominio actividad colectiva y los dominios salud del niño (r=0,4669) y equipo especial (r=0,2120), respectivamente. CONCLUSIÓN: El dominio familia y amigos afecta directamente otros, siendo necesaria intervención de forma precoz en ese aspecto influyente, con el fin de alcanzar mejoría en la calidad de vida de esos niños.

Complexes of different nitrogen donor heterocyclic ligands with SbCl3 and PhSbCl2 as potential antileishmanial agents against Sb(III)-sensitive and -resistant parasites.

Novel trivalent antimony complexes with the nitrogen donor heterocyclic ligand 2,2'-bipyridine (bipy), 1,10-phenanthroline (phen) or dipyrido[3,2-d:2',3'-f]quinoxaline (dpq) have been synthesized by the reaction with SbCl3 or PhSbCl2. The crystal structures of [Sb(phen)Cl3] and [PhSb(phen)Cl2]CH3COOH were determined and shown to adopt a distorted square pyramid geometry with a five-coordinated Sb center. Surprisingly, all the complexes, the ligands and PhSbCl2 showed very high antileishmanial activities, with IC50 in the nanomolar range against Sb(III)-sensitive and -resistant Leishmania infantum (syn. Leishmania chagasi) and Leishmania amazonensis strains. These compounds were much more active against these Leishmania strains than the old trivalent drug potassium antimonyl tartrate. [PhSb(phen)Cl2]CH3COOH complex was found to be the most active compound and the lack of cross-resistance of PhSbCl2 suggests that the transport pathways of this compound across the cell membrane differ from those responsible for the resistance of Leishmania to Sb(OH)3. In the case of the complexes with PhSbCl2, our data supports the model that both ligand and metal contributed to the overall activity of the complex. Furthermore, among the complexes with SbCl3, only bipy showed an improved activity upon complexation. Cytotoxicity evaluations of these compounds against murine peritoneal macrophages showed high selective indexes in the range of 7-70 for [Sb(phen)Cl3], [Sb(bipy)Cl3] and [Sb(dpq)Cl3] complexes, being much more selective than potassium antimonyl tartrate. In conclusion, this study presents a set of new antileishmanial agents including one of the most active Sb-based compounds ever reported, which can contribute to the development of new chemotherapeutic strategies against leishmaniasis including Sb-resistant cases.

Antimony transport mechanisms in resistant leishmania parasites.

Antimonial compounds have been used for more than a century in the treatment of the parasitic disease leishmaniasis. Although pentavalent antimonials are still first-line drugs in several developing countries, this class of drugs is no longer recommended in the Indian sub-continent because of the emergence of drug resistance. The precise mechanisms involved in the resistance of leishmania parasites to antimony are still subject to debate. It is now well documented that drug resistance in leishmania parasites is a multifactorial phenomenon involving multiple genes whose expression pattern synergistically leads to the resistance phenotype. The reduction of intracellular antimony accumulation is a frequent change observed in resistant leishmania cells; however, no comprehensive transport model has been presented so far to explain this change and its contribution to Leishmania resistance. The present review firstly covers the actual knowledge on the metabolism of antimonial drugs, the mechanisms of their transmembrane transport and intracellular processing in Leishmania. It further describes both the functional and molecular changes associated with Sb resistance in this organism. Possible transport models based on the actual knowledge are then presented, as well as their functional implications. Biophysical and pharmacological strategies are finally proposed for the precise identification of the transport pathways.

Hepatotoxicity of pentavalent antimonial drug: possible role of residual Sb(III) and protective effect of ascorbic acid.

Pentavalent antimonial drugs such as meglumine antimoniate (Glucantime [Glu; Sanofi-Aventis, São Paulo, Brazil]) produce severe side effects, including cardiotoxicity and hepatotoxicity, during the treatment of leishmaniasis. We evaluated the role of residual Sb(III) in the hepatotoxicity of meglumine antimoniate, as well as the protective effect of the antioxidant ascorbic acid (AA) during antimonial chemotherapy in a murine model of visceral leishmaniasis. BALB/c mice infected with Leishmania infantum were treated intraperitoneally at 80 mg of Sb/kg/day with commercial meglumine antimoniate (Glu) or a synthetic meglumine antimoniate with lower Sb(III) level (MA), in association or not with AA (15 mg/kg/day), for a 20-day period. Control groups received saline or saline plus AA. Livers were evaluated for hepatocytes histological alterations, peroxidase activity, and apoptosis. Increased proportions of swollen and apoptotic hepatocytes were observed in animals treated with Glu compared to animals treated with saline or MA. The peroxidase activity was also enhanced in the liver of animals that received Glu. Cotreatment with AA reduced the extent of histological changes, the apoptotic index, and the peroxidase activity to levels corresponding to the control group. Moreover, the association with AA did not affect the hepatic uptake of Sb and the ability of Glu to reduce the liver and spleen parasite loads in infected mice. In conclusion, our data supports the use of pentavalent antimonials with low residue of Sb(III) and the association of pentavalent antimonials with AA, as effective strategies to reduce side effects in antimonial therapy.

Development and validation of an analytical method for quantification of arsenic and antimony in liposomes using inductively coupled plasma-optical emission spectrometry.

Arsenic and antimony compounds are used to treat endemic diseases, such as cancer, leishmaniasis, and schistosomiasis, in spite of their toxicity. Several studies seeking the development and characterization of nanocarrier systems such as liposomes are being carried out with the aim of developing new drug delivery systems and minimizing the toxicity of these drugs. However, the lack of reference methods to quantify these semimetals within a liposomal matrix hinders the QC of these formulations. Therefore, the validation of an analytical method for arsenic and antimony quantification in liposomal matrix by inductively coupled plasma-optical emission spectrometry is presented here. The linearity, specificity, LOD, LOQ, accuracy, and precision were determined according to the International Conference on Harmonization norms and the Brazilian Health Surveillance Agency (Resolution 899). The LOD values were 0.02 and 0.06 mg/L for antimony and arsenic, respectively. The LOQ for both was 3.0 mg/L, with an adequate accuracy within 98.26 and 101.32% for different levels of antimony and 99.98 and 100.36% for arsenic. Precision (CV) was lower than 5.0%. The developed and validated method was shown to be reproducible for quantification of arsenic and antimony in liposome pharmaceutical dosage forms.

Molecular characterization of the MRPA transporter and antimony uptake in four New World Leishmania spp. susceptible and resistant to antimony.

ATP-binding cassette (ABC) transporters have been associated with drug resistance in various diseases. The MRPA gene, a transporter of ABCC subfamily, is involved in the resistance by sequestering metal-thiol conjugates in intracellular vesicles of Leishmania parasite. In this study, we performed the molecular characterization of the MRPA transporter, analysis of P-glycoprotein (Pgp) and aquaglyceroporin-1 (AQP1) expression, and determination of antimony level in antimony-susceptible and -resistant lines of L. (V.) guyanensis, L. (L.) amazonensis, L. (V.) braziliensis and L. (L.) infantum. PFGE analysis revealed an association of chromosomal amplification of MRPA gene with the drug resistance phenotype in all SbIII-resistant Leishmania lines analyzed. Levels of mRNA from MRPA gene determined by real-time quantitative RT-PCR showed an increased expression of two fold in SbIII-resistant lines of Leishmania guyanensis, Leishmania amazonensis and Leishmania braziliensis. Western blot analysis revealed that Pgp is increased in the SbIII-resistant L. guyanensis and L. amazonensis lines. The intracellular level of antimony quantified by graphite furnace atomic absorption spectrometry showed a reduction in the accumulation of this element in SbIII-resistant L. guyanensis, L. amazonensis and L. braziliensis lines when compared to their susceptible counterparts. Interestingly, a down-regulation of AQP1 protein was observed in the SbIII-resistant L. guyanensis and L. amazonensis lines, contributing for decreasing of SbIII entry in these lines. In addition, efflux experiments revealed that the rates of SbIII efflux are higher in the SbIII-resistant lines of L. guyanensis and L. braziliensis, that may explain also the low SbIII concentration within of these parasites. The BSO, an inhibitor of γ-glutamylcysteine synthetase enzyme, reversed the SbIII-resistance phenotype of L. braziliensis and caused an increasing in the Sb intracellular level in the LbSbR line. Our data indicate that the mechanisms of antimony-resistance are different among species of Leishmania analyzed in this study.