Improvement of Glycaemia and Endothelial Function by a New Low-Dose Curcuminoid in an Animal Model of Type 2 Diabetes.

Curcumin has been suggested as a promising treatment for metabolic diseases, but the high doses required limit its therapeutic use. In this study, a new curcuminoid is synthesised to increase curcumin anti-inflammatory and antioxidant potential and to achieve hypoglycaemic and protective vascular effects in type 2 diabetic rats in a lower dose. In vitro, the anti-inflammatory effect was determined through the Griess reaction, and the antioxidant activity through ABTS and TBARS assays. In vivo, Goto-Kakizaki rats were treated for 2 weeks with the equimolar dose of curcumin (40 mg/kg/day) or curcuminoid (52.4 mg/kg/day). Fasting glycaemia, insulin tolerance, plasma insulin, insulin signalling, serum FFA, endothelial function and several markers of oxidative stress were evaluated. Both compounds presented a significant anti-inflammatory effect. Moreover, the curcuminoid had a marked hypoglycaemic effect, accompanied by higher GLUT4 levels in adipose tissue. Both compounds increased NO-dependent vasorelaxation, but only the curcuminoid exacerbated the response to ascorbic acid, consistent with a higher decrease in vascular oxidative and nitrosative stress. SOD1 and GLO1 levels were increased in EAT and heart, respectively. Altogether, these data suggest that the curcuminoid developed here has more pronounced effects than curcumin in low doses, improving the oxidative stress, endothelial function and glycaemic profile in type 2 diabetes.

Management of Pipkin Fractures Using a Safe Surgical Hip Dislocation.

INTRODUCTION: Pipkin fractures are rare events and usually occur as a consequence for high-energy trauma. Surgery to obtain anatomical reduction and fixation is the mainstay treatment for the majority of these injuries; nonetheless, controversy exists regarding the best surgical approach. DESCRIPTION OF THE CASE: We present the case of a 41-year-old male, which sustained a type II Pipkin fracture following a motorcycle accident. In the emergency department, an emergent closed reduction was performed, followed by surgery five days later. Using a surgical hip dislocation, a successful anatomical reduction and fixation was performed. After three years of follow-up, the patient presented with a normal range of motion, absent signs for avascular necrosis or posttraumatic arthritis, but with a grade II heterotopic ossification. DISCUSSION: Safe surgical hip dislocation allows full access to the femoral head and acetabulum, without increasing the risk for a femoral head avascular necrosis or posttraumatic arthritis. Simultaneously, this surgical approach gives the opportunity to repair associated acetabular or labral lesions, which explains the growing popularity with this technique. CONCLUSION: Although technically demanding, safe surgical hip dislocation represents an excellent option in the reduction and fixation for Pipkin fractures.

Seroprevalence ff chagasic infection in young idividuals in a blood center in the state of sao paulo, Brazil / Soroprevalencia da infeccao chagasica em individuos jovens em Hemocentro no Estado de Sao Paulo, Brasil

SUMMARY This study aimed at estimating the number of cases of non-negative serological reactions to Chagas disease in blood donors at the Blood Center of Botucatu, São Paulo, Brazil, from 2003 to 2010 and at relating them to their cities of origin. Five hundred and seventy-four non-negative results for Chagas disease were evaluated. Of these, 371 (64.8%) were reagent, and 203 (35.4%) were inconclusive. The prevalence of Chagas disease in blood donors was 0.05%. There were, on average, 72 cases/year, and a prevalence of males was observed (64.8%). Forty-three (7.49%) individuals were 18 to 30 years old; 92 (16.02%) were 31 to 40; 147 (25.61%) 41 to 50, and 292 (50.87%) were older than 50 years. It was observed that 29.3% of females with reagent serology were at their fertile age (18 and 45 years). The majority of donors were originally from cities in the southwestern and central regions of São Paulo, but individuals from other states contributed with 20%. The provenance of most donors was the city of Botucatu/SP, followed by the city of Taquarituba/SP. Therefore, the profile of donors at this blood center favors the occurrence of a larger number of non-negative serological reactions. Although there has been a significant reduction in the number of new cases/year for this disease, it is still a public-health problem, and results suggest the need for new epidemiological assessments in the studied region. .

RESUMO Este estudo teve como objetivo estimar o número de casos de reações sorológicas não-negativas para doença de Chagas em doadores de sangue do Hemocentro de Botucatu, São Paulo - Brasil de 2003 a 2010 e, relaciona-las com as suas cidades de origem. Quinhentos e setenta e quatro reações sorológicas não-negativas para doença de Chagas foram avaliados. Destes, 371 eram reagentes (64,8%), e 203 inconclusivos (35,4%). A prevalência da doença de Chagas nos doadores de sangue foi de 0,05%. Houve, em média, 72 casos/ano, e uma prevalência do sexo masculino foi observada (64,8%). Quarenta e três indivíduos (7,49%) tinham entre 18 e 30 anos, 92 (16,02%) de 31 a 40; 147 (25,61%) 41 a 50, e 292 (50,87%) tinham mais de 50 anos. Observou-se que 29.3% das mulheres com sorologia reagente estavam em idade fértil (18 e 45 anos). A maioria dos doadores eram naturais de cidades das regiões sudoeste e central da cidade de São Paulo, mas os indivíduos de outros estados contribuíram com 20%. A procedência da maioria dos doadores era a cidade de Botucatu/SP, seguido pela cidade de Taquarituba/SP. Portanto, o perfil de doadores de sangue neste hemocentro favorece a ocorrência de um número maior de reações sorológicas não-negativas. Embora tenha havido uma redução significativa no número de casos novos/ano para esta doença, ainda é um problema de saúde pública, e os resultados sugerem a necessidade de novas avaliações epidemiológicas na região estudada. .

Co-infecção HIV/HCV em pacientes de Botucatu e região / HIV/HCV co-infection in patients from Botucatu and region (Brazilian cities)

Devido à similaridade nas rotas de transmissão, a co-infecção HIV/HCV é freqüente, afetando em média 30 a 50 por cento dos portadores de HIV. O presente estudo visou avaliar uma possível associação entre os subtipos do HIV e genótipos do HCV em pacientes co-infectados, com base na análise das freqüências em pacientes mono e co-infectados. Para determinação da freqüência dos subtipos HIV e genótipos HCV, foram analisados respectivamente 124 e 496 pacientes mono-infectados. O estudo da co-infecção foi realizado num grupo de 150 pacientes HIV positivos e esteve presente em 22 (14,7 por cento) dos pacientes. A freqüência dos subtipos do HIV-1 em mono-infectados foi: subtipo B (85,5 por cento), subtipo F (12,9 por cento) e recombinante B/F (1,6 por cento), enquanto nos genótipos HCV foi: 1a (25 por cento), 1b (29,4 por cento), 1a/1b (3,6 por cento), 3a (35 por cento), 2 (1,8 por cento) e 5 (0,4 por cento). Nos co-infectados o padrão de distribuição dos subtipos HIV-1 é semelhante aos mono-infectados, ou seja, subtipo B (85,0 por cento), seguido do subtipo F (15,0 por cento). A distribuição de freqüência de genótipos HCV nos co-infectados foi: 1a (36,3 por cento), 1b (27,3 por cento), 1a/1b (9,1 por cento) e 3a (27,3 por cento) mostrando um aumento de 10 por cento na freqüência do genótipo 1, queda de 7,7 por cento no genótipo 3 e ausência de outros genótipos. A análise estatística de associação entre os subtipos HIV e genótipos HCV (Goodman) mostrou que no genótipo 1 (HCV) ocorreu predominância do subtipo B, enquanto no genótipo 3 (HCV) a distribuição dos subtipos B e F (HIV-1) foi casual. Isto aponta para a necessidade de mais estudos desse grupo e um maior valor amostral.

HIV/HCV co-infection is a frequent event due to the similarity of the means of transmission of both viruses; 30-50 percent of HIV infected individuals are co-infected¹. This paper assesses the possible association among HCV and HIV genotypes in co-infected patients based on frequency distribution in mono and co-infected patients. To determine HIV and HCV genotype frequency 124 and 496 respectively, mono infected patients were analyzed. The study of co-infection was performed in 150 HIV positive patients and 22 (14.7 percent) patients were found. The frequency of HIV-1 subtypes was 106 B subtype (85.5 percent), 16 F (12.9 percent), and 2 B/F recombinant (1.6 percent); HCV genotypes were 1a (25 percent), 1b (29.4 percent), 1a/1b (3.6 percent), 3a (35 percent), 2 (1.8 percent) and 5 (0.4 percent). The HCV genotype could not be determined in 6.3 percent of samples using the technique. The HIV-1 subtype distribution standard was B subtype (85.0 percent) and F subtype (15.0 percent) in mono-infected as in co-infected. The frequency distribution of HCV genotypes in co-infected was 1a (36.4 percent), 1b (27.3 percent), 1a/1b (9.1 percent) and 3a (27.3 percent). These results showed a 10 percent increase in frequency of 1a genotype, 7.7 percent decrease in 3 genotype and lack of other genotypes. The statistical analysis of association of HCV genotypes and HIV-1 subtypes (Goodman Test) showed a predominance of the B HIV subtype among HCV genotype 1, and among HCV genotype 3 the distribution of B and F HIV subtypes was casual. These results suggest the need for further studies in this group and larger samples.

Using pegylated interferon alfa-2b and ribavirin to treat chronic hepatitis patients infected with hepatitis c virus genotype 1: are nonresponders and relapsers different populations?

The combination of pegylated interferon (PEG-INF) and ribavirin is currently the best treatment for chronic hepatitis C, providing a sustained virological response (SVR) in 54 percent-63 percent of patients. In patients infected with hepatitis C virus (HCV) genotype 1, the SVR rate is 42 percent-52 percent. To evaluate the treatment efficacy of this drug combination, we conducted an open, prospective study of 58 consecutive treatment-naïve patients infected with HCV genotype 1 and treated at a university hospital, comparing those presenting an SVR (SVRs), nonresponders (NRs), and relapsers (RELs). Among the intent-to-treat patients, an end-of-treatment virological response was achieved in 69 percent of the sample as a whole and in 52 percent of the SVRs. We found that being an SVR was significantly associated with mild fibrosis (p = 0.04) and with undetectable HCV RNA at weeks 12 and 24 of treatment (p < 0.0001). Comparing the SVR and REL groups, we observed that being older than 40 was significantly associated with being a REL (p = 0.04). Being an NR was found to be associated with severe fibrosis and moderate inflammatory infiltrates (portal or periportal). In the polytomous logistic regression, no independent factors were associated with the REL group when compared with the SVR group. We conclude that RELs and NRs differ in comparison with SVRs. The RELs accounted for 17 percent of the sample. The HCV RNA test results at weeks 12 and 24 of treatment, although independent predictors of non-response (OR: 4.8 and 8.2, respectively), did not differ between SVRs and RELs.

Using pegylated interferon alfa-2b and ribavirin to treat chronic hepatitis patients infected with hepatitis c virus genotype 1: are nonresponders and relapsers different populations?

The combination of pegylated interferon (PEG-INF) and ribavirin is currently the best treatment for chronic hepatitis C, providing a sustained virological response (SVR) in 54%-63% of patients. In patients infected with hepatitis C virus (HCV) genotype 1, the SVR rate is 42%-52%. To evaluate the treatment efficacy of this drug combination, we conducted an open, prospective study of 58 consecutive treatment-naïve patients infected with HCV genotype 1 and treated at a university hospital, comparing those presenting an SVR (SVRs), nonresponders (NRs), and relapsers (RELs). Among the intent-to-treat patients, an end-of-treatment virological response was achieved in 69% of the sample as a whole and in 52% of the SVRs. We found that being an SVR was significantly associated with mild fibrosis (p = 0.04) and with undetectable HCV RNA at weeks 12 and 24 of treatment (p < 0.0001). Comparing the SVR and REL groups, we observed that being older than 40 was significantly associated with being a REL (p = 0.04). Being an NR was found to be associated with severe fibrosis and moderate inflammatory infiltrates (portal or periportal). In the polytomous logistic regression, no independent factors were associated with the REL group when compared with the SVR group. We conclude that RELs and NRs differ in comparison with SVRs. The RELs accounted for 17% of the sample. The HCV RNA test results at weeks 12 and 24 of treatment, although independent predictors of non-response (OR: 4.8 and 8.2, respectively), did not differ between SVRs and RELs.

Distribuição dos genótipos de HCV em pacientes das regiões de Botucatu, Bauru e Assis, SP, Brasil / HCV genotypes distribution in patients from Botucatu, Bauru and Assis, São Paulo State, Brazil

Com objetivo de avaliar a distribuição dos genótipos do HCV em pacientes de Botucatu, Bauru, Assis e regiões, foram analisadas 1.018 amostras assim distribuídas: Botucatu (508), Bauru (415) e Assis (95)com sorologia anti-HCV reagente pela técnica ELISA (Enzyme - linked immunosorbent assay) e detectadas por Biologia Molecular RT-PCR (reverse transcription Polymerase Chain Reaction - Roche ). Genótipos foram determinados pela tecnologia LiPA (Line probe assay - Bayer) que permite detecção de 6 genótipos e subtipos mais comuns. Distribuição dos genótipos na região: genótipo 1 (62,9%) , genótipo 3 (34,5%),genótipo 2 presente nas regiões de Botucatu e Bauru (2,1%), genótipo 5 em Botucatu (0,2%). Distribuiçãodos subtipos: Região de Botucatu - subtipos: 1a (25,0%), 1b (29,3%), 1a/1b (3,5%), 2b (0,6%), 3a(35,0%), 5a (0,2%). Região de Bauru - subtipos: 1a (31,1%), 1b (27,2%),1a /1b (2,4%), 2 b (1,9%), 2 a/2c (0,2%), 3a (32,3%). Região de Assis - subtipos: 1a (26,3%), 1b (26,3%), 1a /1b (2,1%), 3a (41,1%). A técnica utilizada não permitiu a diferenciação dos subtipos em 5,1% das amostras. A distribuição dos genótipos nestas regiões foi similar às outras regiões do Brasil e do mundo ocidental (Europa Ocidental e Américas) apresentando algumas diferenças regionais relativas aos subtipos, como presença de genótipo africano (5) na região de Botucatu.

A razäo moldando o cidadäo: estratégias de política higienista e espaço urbano disciplinar - Belo Horizonte - 1907-1908 / The reason shapes the citizen: strategies for public health policy and disciplinary urban space - 1907-1908

Pretende desvendar o discurso higienista veiculado por um jornal na recém-fundada Belo Horizonte do início do século, situando dialeticamente discurso e palco como fundamento e reflexo da ordem republicana em Minas.(AU)