Dual immune effect of iNKT cells considering human cutaneous and visceral leishmaniasis: An example of cell plasticity according to different disease scenarios.

Although the semi-invariant natural killer T cells (iNKT) are a small subpopulation of cells in the peripheral blood, they are presumed to play a role in early stages of infection against various pathogens, including protozoa. This work investigates the activation status and cytokine profile of iNKT cells during human Leishmania infantum and Leishmania braziliensis infection. We studied iNKT cells in patients with symptomatic active visceral leishmaniasis (AVL) (n = 8), patients with symptomatic active cutaneous leishmaniasis (ACL) (n = 13), negative endemic controls (NEC) (n = 6) and non-endemic controls (NonEC) (n = 6), with and without total Leishmania antigen stimulus (TLA). The number of iNKT cells in the peripheral blood of patients with ACL and AVL unaltered in relation to control groups. Moreover, the iNKT cells from ACL showed a hyperactivation profile compared to patients with AVL. Additionally, TLA induced IFN-gamma production in iNKT cells from patients with ACL, while in iNKT of patients with AVL, TLA induced a decrease in this cytokine. Higher IL-17 and IL-10 production by iNKT cells from patients with ACL were also observed compared to all other groups. There were no changes in iNKT IL-10-producing cells in AVL after TLA stimulation. However, TLA induced increase in IL-10 in iNKT cells in patients with ACL. These findings suggest that, although iNKT cells showed distinct profiles in patients with ACL and AVL, they play a dual role in immune modulation in both Leishmania infections.

NO production and potassium channels activation induced by Crotalus durissus cascavella underlie mesenteric artery relaxation.

Animal toxins are natural resources for pharmacological studies. The venom of Crotalus durissus cascavella (C.d. cascavella) may be a source in the bio-prospecting of new anti-hypertensive agents. The aim of this study was to investigate vascular effects of the venom of C.d. cascavella in normotensive rats. Studies were performed using isolated mesenteric artery segments and aortic endothelial cells. The cumulative administration of the venom of C.d. cascavella (0.001-30 µg/mL) on phenylephrine (Phe; 10 µM) pre-contracted rings induced a concentration-dependent vasorelaxation in the presence of vascular endothelium (Emax = 47.9 ± 5.0% n = 8), and its effect was almost abolished in the absence of endothelium (Emax = 5.8± 2.4% n = 5 (∗∗∗p < 0.001)). Tissue viability was maintained as there was no difference in the contractile capacity of rings before and after the administration of venom. The vasorelaxant effect of the venom was also abolished when arteries were pre-contracted with potassium chloride (KCl; 80 mM) (Emax = 6.4± 0.9% n = 5, ∗∗∗p < 0.001). When assessing the participation of endothelium-derived relaxing factors, it was noted that non-selective COX inhibition with indomethacin (10 µM) caused a significant reduction in the vasorelaxant effect of C.d. cascavella (*p < 0.05). When investigating the participation of NO released by endothelium, there was a significant reduction of the vasorelaxant effect of venom in rings treated with L-NAME (100 µM; Emax = 17.5± 2.2% n = 6; **p < 0.01). Similar results were noted in the presence of ODQ (10 µM), an inhibitor of soluble guanylyl cyclase (Emax = 11.2± 3.5%, n = 6) and PTIO (100 µM), a stable radical scavenger for nitric oxide (Emax = 10.77± 3.6%, n = 6). Moreover, the venom induced the release of NO by isolated aortic endothelial cells through amperometric studies. When assessing the participation of K+ channels on the vasodilatory response of the venom, tyrode solution with 20 mM of KCl caused a significant reduction in the relaxation response (p < 0.001) (Emax = 21.3 ± 8%, n = 7), as did inhibitor of delayed rectifier K+ channels (4-amynopiridine 1 mM; Emax = 9.5 ± 1.3, %, n = 5, ***p < 0.001), and vasorelaxation was almost abolished in the presence of Iberiotoxin (IbTx 100 nM). Therefore, these results suggest that the venom of C.d. cascavella induces vasorelaxation in superior mesenteric artery rings of normotensive rats in an endothelium-dependent manner. Specifically, the venom stimulates the generation of endothelium-derived relaxing factors, especially NO, and activates vascular smooth muscle hyperpolarization through K+ channels. These data illustrate that C.d. cascavella is a source of bioactive molecules and therefore has therapeutic potential in the treatment of cardiovascular diseases such as hypertension.

Endothelium-derived nitric oxide is involved in the hypotensive and vasorelaxant effects induced by discretamine in rats.

The aim of this study was to investigate the pharmacological effects of discretamine, an isoquinoline alkaloid isolated from Duguetia magnolioidea Maas, on the cardiovascular system, using a combined in vivo and in vitro approach. Blood pressure and heart rate measurements, as well as changes in isometric tension in rat superior mesenteric arterial rings, elicited by discretamine were recorded. In normotensive non-anaesthetized rats (n = 6), discretamine (0.01; 0.05; 0.1; 0.5; 1, 5 and 10 mg/kg i.v., randomly) injections produced hypotension (-5.2 +/- 1.7; -5.1 +/- 2.1; -7.7 +/- 2; -8.9 +/- 1.7; -9.6 +/- 2.2; -16.8 +/- 2.8 and -13.4 +/- 1.3 mmHg, respectively) accompanied by tachycardia (24.2 +/- 6.1; 36.8 +/- 11.3; 44.2 +/- 7.7; 45.9 +/- 6.4; 48.2 +/- 9.1; 72.1 +/- 14.5 and 64 +/- 17 bpm, respectively). Hypotensive and tachycardic responses were significantly attenuated after L-NAME (20 mg/kg, i.v.) administration. In isolated rat mesenteric artery rings, with endothelium intact, discretamine (10(-12) - 10(-5) M) induced concentration-dependent relaxation of the contractions induced by phenylephrine (10 microM) [pD2 = 6.8 +/- 0.1]. The effect of the discretamine on phenylephrine induced contractions was significantly attenuated after removal of the vascular endothelium [pD2 = 5.8 +/- 0.04]. Similar results were obtained after pre-treatment with L-NAME 100 microM [pD2 = 5.8 +/- 0.04], L-NAME 300 microM [pD2 = 5.9 +/- 0.06], Hydroxocobalamin 30 microM [pD2 = 5.8 +/- 0.06] or ODQ 10 microM [pD2 = 5.8 +/- 0.04]. In addition, in rabbit aorta endothelial cell line, discretamine significantly increased NO3- levels. These results suggest that the hypotensive effect induced by discretamine is probably due to a peripheral vasodilatation, at least, in part, due to the release of NO from vascular endothelium and consequent activation of soluble guanylyl cyclase (GC) in the vascular smooth muscle cells.

Functional and radiographic long-term results after bad split in orthognathic surgery.

Bilateral sagittal split osteotomy (BSSO) is a standard procedure in orthognathic surgery. The aim of the present study was to perform a matched pair analysis (bad sagittal split versus regular sagittal split) regarding the functional and radiographic long-term results after BSSO. Of 110 cases of mandibular hypoplasy treated with BSSO, 7 cases of bad sagittal splits (Group A) were selected, clinically examined and matched to 7 cases where no bad split occurred (Group B). The Research Diagnostic Criteria for Temporo Mandibular Disorders (RDC/TMD), condylar morphology scale (CMS) and ramus height measurements using orthopantomograms were carried out in the follow-up period to observe the clinical and functional status and condylar resorbtion or remodelling. The mean follow-up time was 28.6 months. The RDC/TMD examination did not show a higher incidence of temporomandibular dysfunction, including pain or clicking in the bad split group. Patients without a bad split showed statistically significant (p<0.05) better mouth opening. The CMS measurements were comparable in both groups. When compared with regular splits, bad splits, if treated in an appropriate manner, have a good chance of functional success, although, some mandibular movements can be compromised.

Weight reduction for primary prevention of stroke in adults with overweight or obesity.

BACKGROUND: Obesity is seen as a worldwide chronic disease with high prevalence that has been associated with increased morbidity from many conditions including stroke, which is the third leading cause of death in developed countries and a leading cause of severe long-term disability. The causal association between overweight or obesity and stroke is unclear and there is no definite study clarifying the role of obesity treatment in the prevention of a first stroke (primary prevention). Given the prevalence of stroke and the enormous health and economic cost of the disease, it is important to establish the possible impact of weight reduction per se on stroke incidence. OBJECTIVES: To assess the effects of weight reduction in people with overweight or obesity on stroke incidence. SEARCH STRATEGY: MEDLINE, EMBASE, The Cochrane Library, LILACS, databases of ongoing trials and reference lists were used to identify relevant trials. The last search was conducted in April 2006. SELECTION CRITERIA: Randomised controlled trials comparing any intervention for weight reduction (single or combined) with placebo or no intervention in overweight or obese people. DATA COLLECTION AND ANALYSIS: No trials were found in the literature for inclusion in this review. MAIN RESULTS: There are currently no results to be reported. AUTHORS' CONCLUSIONS: Obesity seems to be associated with an increased risk of stroke and it has been suggested that weight loss may lead to a reduction of stroke occurrence. However, this hypothesis is not based on strong scientific evidence resulting from randomised controlled clinical trials. This systematic review identified the urgent need for well-designed, adequately-powered, multi centre randomised controlled trials assessing the effects of weight reduction in persons with overweight or obesity on stroke occurrence.

A new Culicoides from the Amazonian region, Brazil (Diptera: Ceratopogonidae).

A new Neotropical species of biting midge Culicoides (Haematomyidium), C. kampa Felippe-Bauer, Veras & Castellon, is described and illustrated based on female specimens from the Amazonian Region.

[Capture-recapture methodology: an option for surveillance of non-communicable diseases in the elderly]. / Metodologia de captura-recaptura: uma opção para a vigilância das doenças não transmissíveis na população idosa.

Capture-recapture methodology is used in Ecology to estimate the total size of wild animal populations. This method can be used in Epidemiology to estimate the incidence and prevalence of communicable and non-communicable diseases in a relatively inexpensive and quick way. Surveillance systems based on the use of this methodology are a potential alternative for monitoring non-communicable diseases in Brazil. This paper presents a brief review of fundamental capture-recapture methodology and its applications to Epidemiology. We also present a theoretical model for implementation of a diabetes mellitus surveillance system in the elderly using publicly available morbidity and mortality data sources and the capture-recapture methodology.

[Quality assessment of drug use in the elderly]. / Avaliação da qualidade do uso de medicamentos em idosos.

INTRODUCTION: The objective is to evaluate the quality of medication utilization through the analysis of the pattern of usage, the degree of compliance to essential drug lists, therapeutic value and by drug interactions found among women over 60 years of age. METHODS: Six hundred thirty-four women enrolled at the Open University of the Third Age were studied. Data was collected through pattern-oriented, tested questionnaires. The variables examined were related to drugs and to drug utilization. The units of analysis used were the drugs and the individual. RESULTS: Of 634 women that participated in the study, 9,1% did not use drugs. The number of medications taken vary from 1 to 17. The average is 4,0 drugs/woman. Among the 2.510 pharmaceutical specialties mentioned by the interviewed, 538 different substances were identified. About 26% of the medications were in agreement with the recommendations of the World Health Organization and 17% with recommendations of the "Relação Nacional de Medicamentos Essenciais". Seventeen percent of the drugs are inappropriate for use in seniors; 14,1% of the women may suffer consequences for taking drugs of the same therapeutic class, and 15, 5% are exposed to interactions. CONCLUSIONS: The data suggest that the pattern of the medication utilization is considerably influenced by the medical prescription and that their quality is harmed by the low selectiveness of the pharmaceutical market

[Prevalence of organic brain syndrome in an elderly population in an metropolitan area of the southeastern region of Brazil]. / Prevalência da síndrome cerebral orgânica em população de idosos de área metropolitana da região sudeste do Brasil.

This paper is a summary of the main findings concerning organic brain syndrome (O.S.S.) in a prevalence study carried out among the elderly population of the city of Rio de Janeiro, Brazil. The project selected three districts of the city-Copacabana, Méier and Santa Cruz-in view of a set of indicators. The study for the validation and reliability of the diagnostic instrument was carried out in the district of Copacabana. Prevalence results for organic brain syndrome were 5.9% in Copacabana, 9.84% in Méier and 29.75% in Santa Cruz. Several hypotheses have been formulated in the attempt to explain such diverse results within a single city. Associations with a variety of socio-economic indicators are presented. Dependence and loss of autonomy in elderly people are closely associated with organic brain syndrome. The results are compared with national and international findings.

Brazil is getting older: demographic changes and epidemiological challenges.

Population ageing is currently a phenomenon not only in developed countries but also in third world countries. In this paper the features of a population's ageing and the process of epidemiological transition are discussed along with the worldwide changes in age-structure. Population statistics in Brazil and the characteristics of the elderly population are presented and analysed in the light of recent changes. The Brazilian elderly population is also discussed, particularly the issues relating to the social cost of the aged population, its urban and rural distribution, the elderly by sex, marital status and level of schooling, and emphasis is given to the imbalance of the sexes and the consequences of it for women.

[Prevalence of depression and organic cerebral syndrome in the elderly population, Brazil]. / Estudo de prevalência de depressão e síndrome cerebral orgânica na população de idosos, Brasil.

Data from a prevalence study of Organic Cerebral Syndrome and Depression in an elderly population living in three boroughs of Rio de Janeiro city are presented. The methodological issues related to interrater and test-retest reliability are discussed and the cut-off point for the instrument adapted (BOAS) established. The prevalence rates in the three boroughs were found, respectively, to be: 5.9%, 9.8% and 29.8% for Organic Cerebral Syndrome and 20.9%, 23.0% and 36.8% for Depression. The prevalence rats have been adjusted using information on sensitivity and specificity for both diagnosis. Aspects of these differences are discussed in the light of national and international literature.

[The elderly population in Rio de Janeiro (Brazil): a pilot-study of confiability and validity of the mental health segment of the BOAS questionnaire]. / População idosa no Rio de Janeiro (Brasil): estudo-piloto da confiabilidade e validação do segmento de saude mental do questionario BOAS.

A first step in the pilot-study undertaken as part of a research project on psychiatric morbidity--depression and organic brain syndrome--in the elderly population of Rio de Janeiro is described. The main objective is to "fine-tune" the instrument used (check list of DSM-III) and testing validity of the BOAS questionnaire (Brazilian version of Short-Care). The methodological aspects, and conceptual definitions are focused as well some procedures for the next stage of the project are suggested.

[Methodologic proposal for a domiciliary survey of the aged population in an urban center of the State of Rio de Janeiro (Brazil)]. / Proposta metodológica para inquérito domiciliar com populações idosas em um centro urbano do Estado do Rio de Janeiro (Brasil).

The methodology used by a project being carried out at the Institute of Social Medicine, Rio de Janeiro, concerning the epidemiology of the elderly and the stages of the community survey are presented. The sampling methods and the steps of the enumerator process are also detailed.

[The development of the medical school in Brazil]. / Notas sobre a evolução da escola médica no Brasil.

Since its beginnings in 1808, medical instruction in Brazil has evolved and changed as Brazilian society has done. Medical schools, at first a concern of government alone, between 1931 and 1960 began to attract private enterprise, which established six of the 19 schools founded during those years. Since then the share of the private sector has grown, and there was a veritable explosion between 1966 and 1970, when 30 new medical schools were set up, 25 of them in the private sector (more than half of the total of 76 schools in operation today are in the private sector). The authors note that the increase in the number of medical schools and courses has not made them less selective, diminished the importance of the government-operated schools--which are still the leading institutions--or made it more certain that the education imparted in the private schools is of satisfactory quality. The medical schools are clustered chiefly in the southeast, and they are partial to the industrial urban setting, especially the Rio-São Paulo axis (where half of the country's physicians are concentrated), which makes for yet another severe imbalance among regions.