Nanostructured Lipid Carriers as Robust Systems for Lupeol Delivery in the Treatment of Experimental Visceral Leishmaniasis.

Leishmaniasis is a neglected tropical disease that affects millions of people around the world. Available therapy causes severe side effects, has unacceptable prices for some specific formulations, and the existence of drug-resistant parasites limits the use of the currently available arsenal of antiparasitic drugs. Therefore, natural products serve as one of the main sources to develop new and effective alternative drugs against leishmaniasis. In this sense, the present study evaluated the potential of the triterpene Lupeol (Lu) entrapped in nanostructured lipid carriers (NLCs) for the treatment of experimental visceral leishmaniasis. The therapeutic efficacy of Lu or Lu entrapped in NLC (Lu-NLC) was investigated in golden hamsters infected with Leishmania (Leishmania) infantum. Lu-NLC presented a mean particle size of 265.3 ± 4.6 nm, a polydispersity index of <0.25 and a zeta potential of -37.2 ± 0.84 mV; the efficacy of encapsulation was 84.04 ± 0.57%. Studies on hamsters showed that Lu-NLC (5 mg/kg) administered intraperitoneally for 10 consecutive days caused a reduction of 99.9% in the number of parasites in the spleen and liver compared to the untreated infected control. On the contrary, Lu-treated animals (5 mg/kg) had 94.4 and 90.2% less parasites in the spleen and liver, respectively, than the infected group. Additionally, a significant preservation of splenic and hepatic tissues was observed in animals treated with Lu-NLC or Lu. Furthermore, Lu-NLC-treated animals produced high levels of anti-Leishmania IgG2 isotype. These data indicate that NLC potentialized Lu efficacy in experimental visceral leishmaniasis. This work suggests that Lu and nanoformulations carrying this compound may be considered as an important tool to be included in the alternative therapy of leishmaniasis.

Role of antigen-presenting cells in non-ulcerated skin lesions caused by Leishmania (Leishmania) infantum chagasi.

In Central America, infection by Leishmania (Leishmania) infantum chagasi causes visceral leishmaniasis and non-ulcerated cutaneous leishmaniasis (NUCL). This work aimed to evaluate the participation of subpopulations of antigen-presenting cells in skin lesions of patients affected by NUCL through double-staining immunohistochemistry using cellular and intracellular markers. Twenty-three skin biopsies from patients affected by NUCL were used. Histological sections stained by HE were used for histopathological study. Immunohistochemical studies were performed using primary antibodies against Langerhans cells, dermal dendritic cells, T lymphocytes, and the cytokines IL-12, IFN-γ, TNF-α, iNOS, and IL-10. The histopathological lesions were characterized by an inflammatory infiltrate, predominantly lymphohistiocytic, of variable intensity, with a diffuse arrangement associated with epithelioid granulomas and discreet parasitism. Double-staining immunohistochemistry showed higher participation of dendritic cells producing the proinflammatory cytokine IL-12 in relation to the other evaluated cytokines. Activation of the cellular immune response was marked by a higher density of CD8 Tc1-lymphocytes followed by CD4 Th1-lymphocytes producing mainly IFN-γ. The data obtained in the present study suggest that antigen-presenting cells play an important role in the in situ immune response through the production of proinflammatory cytokines, directing the cellular immune response preferentially to the Th1 and Tc1 types in NUCL caused by L. (L.) infantum chagasi.

Leishmania (L.) infantum chagasi isolated from skin lesions of patients affected by non-ulcerated cutaneous leishmaniasis lead to visceral lesion in hamsters.

In Central America, Leishmania (L.) infantum chagasi infection causes visceral leishmaniasis (VL) and non-ulcerated cutaneous leishmaniasis (NUCL). The aim of the present study was to evaluate the course of an experimental infection in hamsters caused by L. (L.) infantum chagasi isolated from patients affected by NUCL compared with a strain isolated from a patient with VL. Stationary phase parasites in culture were inoculated through subcutaneous and intraperitoneal routes in hamsters. Following the post-infection times, a histopathological study, parasite load and cytokine determination in skin from the cutaneous inoculation site and viscera were performed. Animals subcutaneously infected with the different strains did not develop macroscopic lesions at the inoculation site, and the histopathological changes in the dermis were very slight. Regarding the histopathological study of the viscera, we observed the portal mononuclear inflammatory infiltrate, the presence of nodules in the hepatic parenchyma and the proliferation of macrophages in the spleen, which increased over the infection course. Overall, the parasite load in the liver and spleen and in the total IgG titres in the sera of infected hamster showed an increase with the time of infection, regardless of the route of inoculation. Regarding cellular immunity, we did not observe an increase or decrease in pro- and anti-inflammatory cytokines compared to the healthy control, except for IL-10, which was evident in the infected animals. The data showed that strains isolated from NUCL cause visceral lesions in the hamsters regardless of the route of inoculation, and they were similar to parasites isolated from VL humans.

A pandemia na vida cotidiana: reflexões sobre os impactos sociais e psicológicos à luz da perspectiva crítica / The pandemic in everyday life: reflections on the social and psychological impacts in the light of a critical perspective

A proposta deste artigo é apresentar uma reflexão sobre o impacto da pandemia de Coronavirus Disease 2019 na vida cotidiana de pessoas de diferentes classes sociais, culturas e instituições no Brasil, destacando o aumento das desigualdades sociais agravadas pelo contexto da pandemia. Toma como aporte teórico a psicologia histórico-cultural, em sua potência, para orientar e organizar práticas sociais voltadas ao coletivo e favorecer a criação de políticas públicas que se instituam como ferramenta de enfrentamento e superação das condições de vida atuais das pessoas. Questiona-se, em especial, o papel da psicologia escolar no contexto da pandemia com a proposição de questões a serem enfrentadas pela disciplina, como a ampliação de ameaças que afetam o desenvolvimento humano, principal objeto de ação da área. O texto se encerra destacando o papel do meio na promoção do desenvolvimento e os desafios da área em se expandir para outros contextos e culturas, além de oferecer conhecimentos e práticas que possam enfrentar essas novas ameaças. Coloca a psicologia escolar como central nesse processo e momento histórico, em que deve assumir o compromisso de transformar a realidade por meio de ações coletivas e colaborativas.

The purpose of this article is to present a reflection on the impact of the Coronavirus Disease 2019 pandemic on the everyday life of Brazilians from different social classes, cultures, and institutions, highlighting the increase in social inequalities aggravated by the context of the pandemic. Critical psychology was used as a theoretical support, in its power to guide and organize social practices aimed at the collective and favor the creation of public policies that are instituted as a tool for confronting and overcoming their current conditions. Particularly, it questions the role of school psychology in the context of the pandemic with the proposition of issues to be faced by the discipline, such as the expansion of threats that affect human development, the main object of action in the area. The text ends by highlighting the role of the environment, especially the school environment, in promoting the development of children and youths so that they can face these new threats, placing school psychology as central in this process and historical moment, in which it must commit to transform reality through collective and collaborative actions.

Preclinical Assessment of Ursolic Acid Loaded into Nanostructured Lipid Carriers in Experimental Visceral Leishmaniasis.

Ursolic acid, a triterpene produced by plants, displayed leishmanicidal activity in vitro and in vivo; however, the low solubility of this triterpene limits its efficacy. To increase the activity of ursolic acid (UA), this triterpene was entrapped in nanostructured lipid carriers (UA-NLC), physical-chemical parameters were estimated, the toxicity was assayed in healthy golden hamsters, and the efficacy of UA-NLC was studied in experimental visceral leishmanisis. UA-NLC exhibited a spherical shape with a smooth surface with a size of 266 nm. UA-NLC displayed low polydispersity (PDI = 0.18) and good colloidal stability (-29.26 mV). Hamsters treated with UA-NLC did not present morphological changes in visceral organs, and the levels of AST, ALT, urea and creatinine were normal. Animals infected with Leishmania (Leishmania) infantum and treated with UA-NLC showed lower parasitism than the infected controls, animals treated with UA or Amphotericin B (AmB). The therapeutic activity of UA-NLC was associated with the increase in a protective immune response, and it was associated with a high degree of spleen and liver preservation, and the normalization of hepatic and renal functions. These data indicate that the use of lipid nanoparticles as UA carriers can be an interesting strategy for the treatment of leishmaniasis.

Sintomas de ansiedade e indicativos de depressão em idosas praticantes do método pilates no solo / Symptoms of anxiety and indicative of depression in elderly women practicing the mat pilates method / Los sintomas de ansiedad e indicativo de depresión en las mujeres de más edad practicantes del método pilates en el suelo

Este estudo analisou sintomas de ansiedade e indicativos de depressão em idosas praticantes do Método Pilates (MP) no solo e seus fatores associados. Participaram desta pesquisa transversal 90 idosas praticantes do MP no solo. Como instrumentos, foram utilizados a Escala de Depressão Geriátrica e o Inventário de Ansiedade Geriátrica. A análise de dados foi conduzida por meio dos testes de Qui-Quadrado e Exato de Fisher (p < 0,05). Os resultados evidenciaram associação significativa dos sintomas de ansiedade com a presença de osteoartrite (p = 0,0004), depressão (p = 0,005) e quantidade de doenças associadas (p = 0,012). Não foi encontrada associação significativa (p > 0,05) dos indicativos de depressão com nenhuma das variáveis sociodemográficas e de saúde. Concluiu-se que a presença de doenças nos idosos deste estudo, como a osteoartrite e a depressão, e o acúmulo de comorbidades podem levar ao aumento do nível de ansiedade de idosas praticantes do MP no solo.

This study analyzed symptoms of anxiety and indicative of depression in elderly women practicing the Mat Pilates Method (MPM) and its associated factors. A cross-sectional study of 90 elderly women practicing MPM. The Geriatric Depression Scale and the Geriatric Anxiety Inventory were used as instruments. Data analysis was performed using Chi-Square and Fisher's Exact tests (p < 0.05). The results showed a significant association of anxiety symptoms with osteoarthritis (p = 0.0004), depression (p = 0.005), and number of associated diseases (p = 0.012). There was no significant association (p > 0.05) of the indicators of depression with none of the sociodemographic and health variables. It was concluded that the presence of diseases in the elderly of this study, such as osteoarthritis and depression, and the accumulation of comorbidities may lead to an increase in the level of anxiety of elderly MPM.

Este estudio analizó síntomas de ansiedad e indicativo de depresión en las mujeres de más edad que practican el método Pilates (MP) en el suelo y sus factores asociados. Participaron del estudio transversal 90 mujeres mayores practicantes del MP suelo. Se utilizaron la Escala de Depresión Geriátrica y el Inventario de Ansiedad Geriátrica. El análisis de datos se realizó mediante las pruebas de Chi-Cuadrado y Exacto de Fisher (p < 0.05). Los resultados obtenidos evidenciaron una asociación significativa de síntomas de ansiedad con osteoartritis (p = 0.0004), depresión (p = 0.005) y el número de enfermedades asociadas (p = 0,012). No hubo una asociación significativa (p > 0.05) de los indicadores de la depresión con ninguno de las variables socioeconómicas e de la salud. Se concluyó que la presencia de enfermedades en los ancianos de este estudio, como la osteoartritis y la depresión, y la acumulación de comorbilidades pueden conducir al aumento del nivel de ansiedad de las personas mayores practicantes del MP en el suelo.

O nível de atividade física como um fator interveniente no estado cognitivo de idosos da atenção básica à saúde / The level of physical activity as an intervening factor in the cognitive state of primary care older adults

Resumo Este estudo propôs a avaliar o nível de atividade física e o estado cognitivo de idosos usuários das Unidades Básicas de saúde (UBS) do Município de Maringá, Paraná. Trata-se de um estudo epidemiológico descritivo, de corte observacional e transversal, realizado com 654 idosos, de ambos os sexos, usuários das UBS. Foi utilizado um questionário sociodemográfico, o Mini exame do estado mental e o International Activity Questionnaire (IPAQ), versão curta. A análise dos dados foi realizada mediante o teste Kolmogorov-Smirnov, Qui quadrado, Kruskal-Wallis e "U" de Mann-Whitney, adotando significância quando p < 0,05. Os idosos não realizam atividades físicas vigorosas e poucas atividades moderadas durante a semana. Porém, apresentaram alto escore na orientação temporal (Md = 5,0), Orientação espacial (Md = 5,0), memória imediata (Md = 3,0), evocação (Md = 3,0) e linguagem (Md = 8,0). Ao comparar o estado mental em função do nível de atividade física dos idosos verificou-se que os Muito ativo/ativo possuem melhor atenção e cálculo (p = 0,036), evocação (p = 0,001) e estado cognitivo geral (p = 0,002), se comparado aos irregularmente ativos e sedentários. Níveis adequados de atividade física podem estar relacionados a melhores escores de funções cognitivas de sujeitos idosos.

Abstract This study proposed to evaluate the level of physical activity and the cognitive state of elderly users of Primary Care Facilities (UBS) of the Municipality of Maringá, State of Paraná, Brazil. This is a descriptive, cross-sectional, epidemiological study with 654 elderly men and women UBS users. A sociodemographic questionnaire, the Mini Mental State Examination (MMSE) and the short version of the International Physical Activity Questionnaire (IPAQ) were employed. Data was analyzed using the Kolmogorov-Smirnov, Chi-square, Kruskal-Wallis and Mann-Whitney "U" tests, with a significance level of p<0.05. However, they evidenced a high score in temporal orientation (Md = 5.0), spatial orientation (Md = 5.0), immediate memory (Md = 3.0), recall (Md = 3.0) and language (Md = 8.0). When comparing the mental state according to the level of physical activity of the elderly, we observed that very active/active individuals had better attention and calculation (p = 0.036), recall (p = 0.001) and general cognitive status (p = 0.002) against irregularly active and sedentary elderly. Adequate levels of physical activity may be related to better scores of cognitive functions of elderly subjects.

The level of physical activity as an intervening factor in the cognitive state of primary care older adults. / O nível de atividade física como um fator interveniente no estado cognitivo de idosos da atenção básica à saúde.

This study proposed to evaluate the level of physical activity and the cognitive state of elderly users of Primary Care Facilities (UBS) of the Municipality of Maringá, State of Paraná, Brazil. This is a descriptive, cross-sectional, epidemiological study with 654 elderly men and women UBS users. A sociodemographic questionnaire, the Mini Mental State Examination (MMSE) and the short version of the International Physical Activity Questionnaire (IPAQ) were employed. Data was analyzed using the Kolmogorov-Smirnov, Chi-square, Kruskal-Wallis and Mann-Whitney "U" tests, with a significance level of p<0.05. However, they evidenced a high score in temporal orientation (Md = 5.0), spatial orientation (Md = 5.0), immediate memory (Md = 3.0), recall (Md = 3.0) and language (Md = 8.0). When comparing the mental state according to the level of physical activity of the elderly, we observed that very active/active individuals had better attention and calculation (p = 0.036), recall (p = 0.001) and general cognitive status (p = 0.002) against irregularly active and sedentary elderly. Adequate levels of physical activity may be related to better scores of cognitive functions of elderly subjects.

Este estudo propôs a avaliar o nível de atividade física e o estado cognitivo de idosos usuários das Unidades Básicas de saúde (UBS) do Município de Maringá, Paraná. Trata-se de um estudo epidemiológico descritivo, de corte observacional e transversal, realizado com 654 idosos, de ambos os sexos, usuários das UBS. Foi utilizado um questionário sociodemográfico, o Mini exame do estado mental e o International Activity Questionnaire (IPAQ), versão curta. A análise dos dados foi realizada mediante o teste Kolmogorov-Smirnov, Qui quadrado, Kruskal-Wallis e "U" de Mann-Whitney, adotando significância quando p < 0,05. Os idosos não realizam atividades físicas vigorosas e poucas atividades moderadas durante a semana. Porém, apresentaram alto escore na orientação temporal (Md = 5,0), Orientação espacial (Md = 5,0), memória imediata (Md = 3,0), evocação (Md = 3,0) e linguagem (Md = 8,0). Ao comparar o estado mental em função do nível de atividade física dos idosos verificou-se que os Muito ativo/ativo possuem melhor atenção e cálculo (p = 0,036), evocação (p = 0,001) e estado cognitivo geral (p = 0,002), se comparado aos irregularmente ativos e sedentários. Níveis adequados de atividade física podem estar relacionados a melhores escores de funções cognitivas de sujeitos idosos.

Evaluating the muscular strength, functional capacity, and risk of sarcopenia in elderly women who practice Mat Pilates / Avaliação da força muscular, capacidade funcional e indicativo de sarcopenia em idosas que praticam Pilates no solo / Evaluación de la fuerza muscular, capacidad funcional e indicativo de sarcopenia en mujeres de edad avanzada que practican Pilates en el suelo

Abstract Introduction: Despite the importance of appropriate levels of muscular strength to maintain the functional capacity and a healthy life in old age, the current literature still lacks studies that investigate the profile of elderly women who practice Mat Pilates regarding these variables. Objective: This study aimed to analyze muscular strength, functional capacity, and risk of sarcopenia in elderly women who practiced Mat Pilates. Method: This is a cross-sectional study carried out with 50 elderly women who practice Mat Pilates in the city of Maringá, Paraná. Sociodemographic and health questionnaires were used, in addition to tests created by a Latin American development group for maturity called Grupo de Desenvolvimento Latino Americano para a Maturidade (GDLAM), sitting-rising test, arm curl test, and SARC-F questionnaire. For data analysis, Shapiro-Wilk and Mann-Whitney U tests, as well as Spearman's Rank Correlation Coefficients, were used. The level of significance was p < 0.05. Results: The 70-79-year-old elderly women showed worse results in the functional capacity and muscular strength tests of the upper limbs and a higher risk of sarcopenia than the individuals who were under 70 years of age. Muscular strength was inversely related to the reduction of the risk of sarcopenia, and functional capacity was directly associated with this risk. Conclusion: A good functional capacity seems to be related to the reduction of the risk of sarcopenia. Age seems to be an intervening factor for reducing muscular strength levels and functional capacity and increasing the risk of sarcopenia.

Resumo Introdução: Apesar da importância de níveis adequados de força muscular para manter a capacidade funcional e uma vida saudável na velhice, a literatura atual ainda carece de estudos que investiguem o perfil de idosas que praticam o Pilates no solo em relação a essas variáveis. Objetivo: Este trabalho teve como objetivo investigar a força muscular, a capacidade funcional e o indicativo de sarcopenia em idosas praticantes de Pilates no solo. Método: Trata-se de um estudo transversal realizado com 50 idosas que praticam Pilates no solo na cidade de Maringá-PR. Utilizaram-se questionários sociodemográficos e de saúde, além de testes realizados pelo grupo de desenvolvimento latino-americano para maturidade do chamado Grupo de Desenvolvimento Latino-americano para a Maturidade (GDLAM), p teste de levantar e sentar, teste de flexão de cotovelo e o Questionário SARC-F. Para análise dos dados, foram utilizados os testes Shapiro-Wilk e Mann-Whitney U, bem como os Coeficientes de Correlação de Spearman. O nível de significância foi estabelecido em p < 0,05. Resultados: As idosas de 70 a 79 anos apresentaram piores resultados nos testes de capacidade funcional e força muscular dos membros superiores e maior indicativo de sarcopenia do que os indivíduos com menos de 70 anos de idade. A força muscular foi inversamente relacionada à redução do indicativo de sarcopenia, e a capacidade funcional esteve diretamente associada a esse indicativo. Conclusão: Uma boa capacidade funcional parece estar relacionada à redução do indicativo de sarcopenia. A idade parece ser um fator interveniente para reduzir os níveis de força muscular e a capacidade funcional, além de aumentar o indicativo de sarcopenia

Resumen Introducción: A pesar de la importancia de los niveles apropiados de fuerza muscular para mantener la capacidad funcional y una vida saludable en la vejez, la literatura actual aún carece de estudios que investiguen el perfil de las mujeres ancianas que practican Pilates en el suelo en relación con estas variables. Objetivo: Este trabajo tuvo como objetivo investigar la fuerza muscular, la capacidad funcional y el indicio de sarcopenia en mujeres ancianas que practican Pilates en el suelo. Método: Este es un estudio transversal realizado con 50 mujeres ancianas que practican Pilates en el suelo en la ciudad de Maringá-PR. Se utilizaron cuestionarios sociodemográficos y de salud, además de las pruebas realizadas por un grupo de desarrollo de América Latina para el llamado Grupo de Desarrollo Latino Americano para una Muerte (GDLAM), la prueba de aumento de la sesión, la prueba de flexión del brazo y la Cuestionario SARC-F. Para el análisis de los datos, se utilizaron las pruebas Shapiro-Wilk y Mann-Whitney U, así como los coeficientes de correlación de rango de Spearman. El nivel de significación se estableció en p < 0.05. Resultados: Las mujeres de 70 a 79 años de edad mostraron peores resultados en la capacidad funcional y las pruebas de fuerza muscular de las extremidades superiores y un mayor indicio de sarcopenia en comparación con las personas menores de 70 años. La fuerza muscular se relacionó inversamente con la reducción del indicativo de sarcopenia, y la capacidad funcional se asoció directamente con este indicativo. Conclusión: Una buena capacidad funcional parece estar relacionada con la reducción del indicativo de sarcopenia. La edad parece ser un factor que interviene para reducir los niveles de fuerza muscular y la capacidad funcional, y también para aumentar el indicativo de sarcopenia.

Histopathological features of skin lesions in patients affected by non-ulcerated or atypical cutaneous leishmaniasis in Honduras, Central America.

In Honduras visceral leishmaniasis and non-ulcerated or atypical cutaneous leishmaniasis (NUCL) are caused by the species Leishmania (L.) infantum chagasi. NUCL is the most common clinical form in the southern regions of the country, mainly affecting the young. In view of the lack of knowledge about the pathogenesis of the disease pattern caused by L. (L) infantum chagasi in individuals affected by NUCL, the aim of the present study was to describe in detail the histopathological features of the skin lesion caused by the parasite. Biopsies from human NUCL lesions with a positive parasitological diagnosis were collected and processed using standard histological techniques. Paraffin sections stained by haematoxylin and eosin were used to examine the histopathological alterations seen in the skin. The lesions varied between 3 and 5 mm, and the majority of the patients (60%) had a single lesion. Lesions were more frequently seen in females (65%), with an average age of 33.4 years. Microscopically, the skin lesions were characterized by mononuclear inflammatory infiltrate in the dermis composed of lymphocytes, macrophages and a few plasma cells. The intensity of the infiltration varied from discrete to intense. In both cases, the parasitic infection was discrete. Granulomas were present in 60% of cases and were associated with intense inflammation. The data revealed by the histopathological alterations in the skin of individuals affected by NUCL suggest activation of a cellular immune response that potentially controls parasite spreading.

Elder abuse in Brazil: an integrative review / Maus-tratos a idosos no Brasil: uma revisão integrativa

Objective: the present study aimed to carry out an integrative review of literature on the scientific knowledge relating to the occurrence of elder abuse produced in Brazil between the years of 2013 to 2017. Method: a bibliographic survey was carried out through publications indexed in the Virtual Health Library (VHL) database: the Scientific Electronic Library Online (SCIELO), Latin American Literature in Health Sciences (LILACS) and the CAPES Portal of Periodicals (CAPES). The data collection instrument, created by the authors, included characteristics such as: year of publication, main journals, research design, topics covered, main areas of knowledge, sampling and study objectives. Results: 28 publications were analyzed. The main types of violence were psychological (28%), physical (28%), unspecified (16%), financial (12%), self-abandonment (8%), neglect and verbal violence (4%). The majority of the victims were female (64%), of unspecified gender (28%) and male (8%). Conclusion: the present integrative review found that the main violence suffered was psychological together with physical, with the elderly the main victims. The main place of maltreatment was in the home. The research also found that there are gaps in information about the reasons that triggered the aggressions. It is therefore necessary to investigate this subject further and carry out new studies that seek to identify these factors.

Objetivo: o presente estudo objetivou a realização de uma revisão integrativa da literatura sobre o conhecimento científico produzido no Brasil entre os anos de 2013 a 2017, enfatizando a ocorrência de maus-tratos contra idosos. Método: o levantamento bibliográfico foi realizado através de publicações indexadas na base de dados da Biblioteca Virtual de Saúde (BVS): Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana em Ciências de Saúde (LILACS) e Portal de Periódicos CAPES (CAPES). O instrumento de coleta de dados, elaborado pelos autores, abrangeu características como: ano de publicação, principais periódicos, delineamento de pesquisa, temas abordados, principais áreas de conhecimento, amostragem e objetivos dos estudos. Resultados: foram analisadas 28 publicações. Os principais tipos de violência evidenciados foram: psicológica (28%), física (28%), não especificou (16%), financeira (12%), autoabandono (8%), negligência e violência verbal (4%), sendo o principal gênero da vítima do sexo feminino (64%), não especificou o gênero (28%) e do sexo masculino (8%). Conclusão: a presente revisão integrativa evidenciou que as principais violências sofridas foram à psicológica juntamente com a física, sendo as idosas as principais vítimas. O principal local de ocorrência de maus-tratos foi na própria residência. A pesquisa concluiu ainda que há lacunas de informação quanto aos motivos que desencadearam as agressões. Diante disso, faz-se necessária uma maior investigação nesse contexto e realização de novos estudos que busquem identificar esses fatores.

Histopathological characteristics of cutaneous lesions caused by Leishmania Viannia panamensis in Panama.

Cutaneous leishmaniasis (CL) is an endemic disease in the Republic of Panama, caused by Leishmania (Viannia) parasites, whose most common clinical manifestation is the presence of ulcerated lesions on the skin. These lesions usually present a chronic inflammatory reaction, sometimes granulomatous, with the presence of lymphocytes, plasma cells and macrophages. This study describes the histopathological characteristics found in the skin lesions of patients with CL caused by Leishmania (V.) panamensis in Panama. We analyzed 49 skin biopsy samples from patients with clinical suspicion of CL, by molecular tests (PCR for subgenus Viannia and HSP-70) and by Hematoxylin-Eosin staining. Samples were characterized at the species level by PCR-HSP-70/RFLP. From the 49 samples studied, 46 (94%) were positive by PCR and were characterized as Leishmania (V.) panamensis. Of these, 48% were positive by Hematoxylin-Eosin staining with alterations being observed both, in the epidermis (85%) and in the dermis (100%) of skin biopsies. The inflammatory infiltrate was characterized according to histopathological patterns: lymphohistiocytic (50%), lymphoplasmacytic (61%) and granulomatous (46%) infiltration, being the combination of these patterns frequently found. The predominant histopathological characteristics observed in CL lesions caused by L. (V.) panamensis in Panama were: an intense inflammatory reaction in the dermis with a combination of lymphohistiocytic, lymphoplasmacytic and granulomatous presentation patterns and the presence of ulcers, acanthosis, exocytosis and spongiosis in the epidermis.

Therapeutic effect of ursolic acid in experimental visceral leishmaniasis.

Leishmaniasis is an important neglected tropical disease, affecting more than 12 million people worldwide. The available treatments are not well tolerated and present diverse side effects in patients, justifying the search for new therapeutic compounds. In the present study, the therapeutic potential and toxicity of ursolic acid (UA), isolated from the leaves of Baccharis uncinella C. DC. (Asteraceae), were evaluated in experimental visceral leishmaniasis. To evaluate the therapeutic potential of UA, hamsters infected with L. (L.) infantum were treated daily during 15 days with 1.0 or 2.0 mg UA/kg body weight, or with 5.0 mg amphotericin B/kg body weight by intraperitoneal route. Fifteen days after the last dose, the parasitism of the spleen and liver was stimated and the main histopathological alterations were recorded. The proliferation of splenic mononuclear cells was evaluated and IFN-γ, IL-4, and IL-10 gene expressions were analyzed in spleen fragments. The toxicity of UA and amphotericin B were evaluated in healthy golden hamsters by histological analysis and biochemical parameters. Animals treated with UA had less parasites in the spleen and liver when compared with the infected control group, and they also showed preservation of white and red pulps, which correlate with a high rate of proliferation of splenic mononuclear cells, IFN-γ mRNA and iNOS production. Moreover, animals treated with UA did not present alterations in the levels of AST, ALT, creatinine and urea. Taken together, these findings indicate that UA is an interesting natural compound that should be considered for the development of prototype drugs against visceral leishmaniasis.

The significance of teaching in indigenous teacher education: The role of language mediation / Os sentidos da docência para estudantes do magistério indígena: o papel da língua como mediação

This paper presents the results of a PhD research that investigated the role of language mediation in the training of professionals to teach indigenous people, seeking to investigate its influence on the changes and preservation of indigenous culture. This study was based on theoretical and methodological assumptions of cultural-historical Psychology. The present study investigated a teacher training course, Tamî'kan - Indigenous Teacher Education, in the State of Roraima, and the data were collected through classroom observations and semi-structured interviews that were conducted with 10 students and 3 course coordinators. The results indicate difficulties undergone by the indigenous students resulting from previous teaching experiences by non-indigenous teachers, especially regarding the Portuguese language. This relationship leads to contradictions in terms of indigenous culture and can influence the students' character and professional life.(AU)

O presente artigo apresenta os resultados de uma pesquisa que teve por objetivo analisar o papel da linguagem na mediação da constituição da docência indígena, buscando compreender sua influência na transformação e manutenção da cultura. Adotaram-se os pressupostos teórico-metodológicos da Psicologia Histórico-cultural. O contexto da pesquisa foi o Curso Magistério Indígena Tamî'kan, no estado de Roraima, e as informações foram construídas por meio de observações de aulas e entrevistas semiestruturadas com 10 estudantes e três dirigentes do curso em questão. Os resultados indicam que os sentidos configurados por esses alunos indígenas sobre a docência, além de diferentes, revelam forças tensionais vividas em seu processo de escolarização, já mediado desde o princípio por professores não indígenas e, consequentemente, pela língua portuguesa. Essa vivência constitui-se fonte de contradições no modo de se relacionar com a cultura indígena e de se constituir como sujeito e profissional.(AU)

The significance of teaching in indigenous teacher education: the role of language mediation / Os sentidos da docência para estudantes do magistério indígena: o papel da língua como mediação

This paper presents the results of a PhD research that investigated the role of language mediation in the training of professionals to teach indigenous people, seeking to investigate its influence on the changes and preservation of indigenous culture. This study was based on theoretical and methodological assumptions of cultural-historical Psychology. The present study investigated a teacher training course, Tamî'kan - Indigenous Teacher Education, in the State of Roraima, and the data were collected through classroom observations and semi-structured interviews that were conducted with 10 students and 3 course coordinators. The results indicate difficulties undergone by the indigenous students resulting from previous teaching experiences by non-indigenous teachers, especially regarding the Portuguese language. This relationship leads to contradictions in terms of indigenous culture and can influence the students' character and professional life.

O presente artigo apresenta os resultados de uma pesquisa que teve por objetivo analisar o papel da linguagem na mediação da constituição da docência indígena, buscando compreender sua influência na transformação e manutenção da cultura. Adotaram-se os pressupostos teórico-metodológicos da Psicologia Histórico-cultural. O contexto da pesquisa foi o Curso Magistério Indígena Tamî'kan, no estado de Roraima, e as informações foram construídas por meio de observações de aulas e entrevistas semiestruturadas com 10 estudantes e três dirigentes do curso em questão. Os resultados indicam que os sentidos configurados por esses alunos indígenas sobre a docência, além de diferentes, revelam forças tensionais vividas em seu processo de escolarização, já mediado desde o princípio por professores não indígenas e, consequentemente, pela língua portuguesa. Essa vivência constitui-se fonte de contradições no modo de se relacionar com a cultura indígena e de se constituir como sujeito e profissional.

Comparação entre a pressão inspiratória máxima aferida pelo manovacuômetro digital e pelo dispositivo eletrônico de treinamento muscular inspiratório / Comparison between maximum inspiratory pressure measured by a digital manometer and by an electronic inspiratory muscle training device

OBJETIVOS: Comparar valores de pressão inspiratória máxima (PImáx) aferidos por um manovacuômetro digital e por um dispositivo eletrônico de treinamento muscular inspiratório e avaliar as repercussões hemodinâmicas após as medidas. MÉTODOS: A amostra foi composta por indivíduos acima de 18 anos, de ambos os sexos, internados na unidade de terapia intensiva, hemodinamicamente estáveis, sem uso de drogas vasoativas ou de sedação, intubados ou traqueostomizados, em processo de desmame da ventilação mecânica. Foram feitas três medidas de PImáx pelos dois equipamentos, com tempo de oclusão de 20 segundos e tempo entre as medidas de cinco minutos. Foram analisados frequência respiratória, pressão arterial média e frequência respiratória antes e após cada medida para cada equipamento utilizado. A análise estatística usou os programas Statistical Analysis System e R Project for Statistical Computing V. 3.1.2, aplicando os testes ANOVA e Wilcoxon. RESULTADOS: Foram incluídos no estudo 58 pacientes. A média das PImáx obtidas com o manovacuômetro digital foi -46,22 centímetros de água (cmH2O), enquanto a média obtida com o dispositivo de TMI foi -13,15 cmH2O (p<0,001). A frequência cardíaca apresentou aumento na comparação antes e após todas as medidas em ambos os dispositivos (p<0,0001). A pressão arterial média apresentou diferença estatisticamente significativa somente entre antes e após a primeira medida obtida pelo manovacuômetro digital, e entre antes e após a segunda medida obtida com o dispositivo de treinamento muscular inspiratório (p<0,001). A frequência respiratória apresentou variação significativa entre antes e após as três medidas em ambos dispositivos (p<0,0001). Os valores das variáveis hemodinâmicas após as medidas de PImáx permaneceram dentro dos limites da normalidade. CONCLUSÕES: O manovacuômetro digital registrou uma PImáx superior à registrada pelo dispositivo eletrônico de treinamento muscular inspiratório. Ambos os dispositivos alteraram os valores das variáveis hemodinâmicas, que entretanto permaneceram dentro da normalidade e sem repercussão clínica.

AIMS: To compare maximum inspiratory pressure (MIP) measured by a digital manometer and by an inspiratory muscle training (IMT) device and to evaluate hemodynamic changes after measurements. METHODS: The sample included male and female individuals older than 18 years admitted to an intensive care unit who were hemodynamically stable, not being treated with vasoactive drugs or sedated, intubated or tracheostomized, and who were in the process of being weaned from mechanical ventilation. MIP was measured by both devices on three different occasions, with an occlusion time of 20 seconds and a 5-minute interval between measurements. The following parameters were assessed: respiratory rate, mean arterial pressure, and respiratory rate before and after each measurement by each device. The statistical analysis was made in the Statistical Analysis System and the R Project for Statistical Computing V. 3.1.2 softwares, using the ANOVA and the Wilcoxon tests. RESULTS: Fifty-eight patients were included in the study. The mean value obtained for MIP was -46.22 centimeters of water (cmH2O) in the digital manometer and -13.15 cmH2O (p<0.001) in the IMT device. Heart rate showed a significant increase (p<0.0001) both before and after all measurements in both devices. Mean arterial pressure showed a statistically significant difference only before and after the first measurement by the digital manometer and before and after the second measurement by the IMT device (p<0.001). The respiratory rate oscillated significantly before and after the three measurements by both devices (p<0.0001). The hemodynamic parameters remained within reference values after MIP measurements. CONCLUSIONS: The digital manometer recorded a higher MIP than that measured by the IMT device. The hemodynamic parameter values oscillated in both devices, but they remained within the normal range and were not clinically significant.

Lung pathology in fatal novel human influenza A (H1N1) infection.

RATIONALE: There are no reports of the systemic human pathology of the novel swine H1N1 influenza (S-OIV) infection. OBJECTIVES: The autopsy findings of 21 Brazilian patients with confirmed S-OIV infection are presented. These patients died in the winter of the southern hemisphere 2009 pandemic, with acute respiratory failure. METHODS: Lung tissue was submitted to virologic and bacteriologic analysis with real-time reverse transcriptase polymerase chain reaction and electron microscopy. Expression of toll-like receptor (TLR)-3, IFN-gamma, tumor necrosis factor-alpha, CD8(+) T cells and granzyme B(+) cells in the lungs was investigated by immunohistochemistry. MEASUREMENTS AND MAIN RESULTS: Patients were aged from 1 to 68 years (72% between 30 and 59 yr) and 12 were male. Sixteen patients had preexisting medical conditions. Diffuse alveolar damage was present in 20 individuals. In six patients, diffuse alveolar damage was associated with necrotizing bronchiolitis and in five with extensive hemorrhage. There was also a cytopathic effect in the bronchial and alveolar epithelial cells, as well as necrosis, epithelial hyperplasia, and squamous metaplasia of the large airways. There was marked expression of TLR-3 and IFN-gamma and a large number of CD8(+) T cells and granzyme B(+) cells within the lung tissue. Changes in other organs were mainly secondary to multiple organ failure. CONCLUSIONS: Autopsies have shown that the main pathological changes associated with S-OIV infection are localized to the lungs, where three distinct histological patterns can be identified. We also show evidence of ongoing pulmonary aberrant immune response. Our results reinforce the usefulness of autopsy in increasing the understanding of the novel human influenza A (H1N1) infection.

Escalas de avaliação aplicadas à espondilite anquilosante pertinentes à fisioterapia / Ankylosing spondylitis evaluation scale related to physical therapy

A espondilite anquilosante (EA) é uma doença inflamatória crônica que acomete preferencialmente o esqueleto axial. A patologia evolui de forma insidiosa e é potencialmente debilitante, levando a redução da qualidade de vida dos indivíduos acometidos. Este estudo teve como objetivo realizar uma revisão literária das escalas de avaliação em EA (BASFI - Bath Ankylosing Spondylitis Functional Index, DFI - Dougado´s Functional Index, EVA – Escala Visual Analógica e BASDAI - Bath Ankylosing Spondylitis Disease Activity Index) pertinentes à fisioterapia, especificamente dos domínios: função, dor, mobilidade da coluna, rigidez e avaliação global do paciente, presentes na área SM-ARD/Fisioterapia. Foi abordada também uma escala de avaliação radiológica, SASSS (Stoke Ankylosing Spondylitis Spine Score). A revisão estendeu-se de outubro a dezembro de 2006, mediante pesquisas em livros de acervos particulares e públicos e em base de dados. Constatou-se neste estudo a necessidade da realização de pesquisas, metodologias ou complementos visando à validação de instrumentos no Brasil que sirvam de esclarecimento sobre o dinamismo e comportamento da EA diante da intervenção fisioterapêutica.

The Ankylosing Spondylitis (AS) is a chronic inflammatory disease that affects the axial skeleton. The pathology develops in an insidious way and it is potentially debilitated, taking reduction of the life quality. The objective of this study was to make a literature review of the evaluation scales in AS (BASFI - Bath Ankylosing Spondylitis Functional Index, DFI - Dougado´s Functional Index, VAS – Visual Analog Scale e BASDAI - Bath Ankylosing Spondylitis Disease Activity Index) related with physical therapy, specifically of the domains: function, pain, mobility of the column, rigidity and the patient's global evaluation, present in SM-ARD/ physical therapy area. This review showed also a scale of radiologic evaluation, SASSS (Stoke Ankylosing Spondylitis Spine Score). The literature revision was performed from October to December 2006, using books of private and public collections and data basis. It was verified, in this study, the need of researches, methodologies or complements aiming at the validation of instruments in Brazil in order to explain the dynamism and behavior of AS with physical therapy intervention.

Spastic paraplegia, optic atrophy, and neuropathy: new observations, locus refinement, and exclusion of candidate genes.

SPOAN is an autosomal recessive neurodegenerative disorder which was recently characterized by our group in a large inbred Brazilian family with 25 affected individuals. This condition is clinically defined by: 1. congenital optic atrophy; 2. progressive spastic paraplegia with onset in infancy; and 3. progressive motor and sensory axonal neuropathy. Overall, we are now aware of 68 SPOAN patients (45 females and 23 males, with age ranging from 5 to 72 years), 44 of which are presented here for the first time. They were all born in the same geographic micro region. Those 68 patients belong to 43 sibships, 40 of which exhibit parental consanguinity. Sixty-one patients were fully clinically evaluated and 64 were included in the genetic investigation. All molecularly studied patients are homozygotes for D11S1889 at 11q13. This enabled us to reduce the critical region for the SPOAN gene from 4.8 to 2.3 Mb, with a maximum two point lod score of 33.2 (with marker D11S987) and of 27.0 (with marker D11S1889). Three genes located in this newly defined critical region were sequenced, but no pathogenic mutation was detected. The gene responsible for SPOAN remains elusive.