ABSTRACT The effect of glutamine dipeptide (GDP) supplementation in patients with diabetic foot syndrome was evaluated. A total of 22 patients took part in the study. GDP was supplied in 10 g sachets, and was dissolved in water immediately before use, with ingestion once a day, after lunch or after dinner (20 g/day) over a period of 30 days. Quantification of foot insensitive areas, oxidative stress, blood cytokines, and biochemical, hematological and toxicological parameters was performed before and after GDP supplementation. We observed an increase in blood levels of interferon-α (P=0.023), interferon-γ (P=0.038), interleukin-4 (P=0.003), interleukin-6 (P=0.0025), interleukin-7 (P=0.028), interleukin-12 p40 (P=0.017), interleukin-13 (P=0.001), leukocytes (P=0.037), eosinophils (P=0.049), and typical lymphocytes (P<0.001) due to GDP administration. In addition, we observed a reduced number (P=0.048) of insensitive areas on the foot, and reduction (P=0.047) of fasting hyperglycemia. Patients also showed increased blood high density lipoprotein (P<0.01) and protein thiol groups (P=0.004). These favorable results were associated with the absence of renal and hepatic toxicity. These results are of clinical relevance, since supplementation with GDP over 30 days improved clinical responses in patients with diabetic foot syndrome.

INTRODUÇÃO: A doença de Chagas é uma infecção causada pelo Trypanosoma cruzi que afeta oito milhões de pessoas na América Latina. Um fator ligado ao estilo de vida que interfere significativamente na resposta à infecção é o exercício físico, dependendo do tipo, intensidade e frequência da atividade praticada. OBJETIVO: Avaliar a influência do exercício físico aeróbio moderado crônico pré-infecção na evolução da infecção experimental pelo T. cruzi em camundongos de duas linhagens distintas pertencentes aos dois sexos. MÉTODOS: Camundongos Swiss e BALB/c (machos e fêmeas) com 30 dias de idade foram divididos em quatro grupos para cada linhagem e sexo (total de 16) e nomeados como segue: SM (Swiss machos), SF (Swiss fêmeas), BM (BALB/c machos) e BF (BALB/c fêmeas). Os grupos foram: NT+NI (não treinado+não infectado), T+NI (treinado+não infectado), NT+I (não treinado+infectado) e T+I (treinado+infectado). O programa de exercício físico aeróbio moderado crônico pré-infecção foi realizado durante oito semanas, com uma sessão diária de treinamento, cinco vezes na semana. O inóculo foi de 1.400 tripomastígotas sanguíneos da cepa Y do T. cruzi, via intraperitoneal. Foi avaliado o pico de parasitos, parasitemia total média e as medidas das atividades séricas de CK e CK-MB. RESULTADOS E CONCLUSÃO: O treinamento físico promoveu nas duas linhagens e em ambos os sexos redução no pico de parasitos e na parasitemia total média em animais infectados pelo T. cruzi. O treinamento físico promoveu redução nas atividades séricas de CK e CK-MB em animais infectados pelo T. cruzi, de ambos os sexos, das duas linhagens, exceto para fêmeas Swiss na atividade de CK e CK-MB.

BACKGROUND: Chagas disease is an infection caused by Trypanosoma cruzi that affects eight million people in Latin America. One factor linked to the lifestyle that significantly interferes in the response to infection is physical exercise, depending on the kind, intensity and frequency of the activity practiced. OBJECTIVE: To evaluate the influence of pre-infection chronic moderate aerobic exercise in the development of experimental infection with T. cruzi in mice of two distinct lineages from both sexes. METHODS: 30-day old Swiss and BALB/c mice (male and female) were divided into four groups for each strain and sex (total 16) and named as follows: SM (Swiss males), SF (Swiss females) BM (BALB/c mice) and BF (BALB/c mice). The groups were: NT NI (untrained uninfected) T NI (trained not infected); NT I (untrained infected), TI (trained infected). The aerobic exercise pre-moderate chronic infection training was performed with one daily session for eight weeks, five times a week. The inoculum was 1,400 blood trypomastigotes of Y strain of T. cruzi intraperitoneally. The peak of parasites, parasitemia total and average measurements of the serum activities of CK and CK-MB were evaluated. RESULTS AND CONCLUSIONS: The physical training promoted reduction in peak, parasitemia parasites and total average in animals infected with T. cruzi in both strains and sexes. Physical training induced reduction in serum activities of CK and CK-MB in animals infected with T. cruzi of both sexes and from the two strains, except for females in the Swiss CK activity.

The aim of this work was to evaluate the prevalence of metabolic syndrome, diabetes mellitus, and obesity among a Brazilian indigenous population. A cross-sectional study was carried out in 2008 among Kaingang native Americans from the central region of the state of Paraná, Brazil. Eighty two of the inhabitants aged 15 or older were selected. Height, weight, blood pressure, waistline circumference, and hip circumference were measured. After fasting, the blood was collected for the measurement of glucose, HDL cholesterol, triglyceride, total cholesterol, AI and B apolipoprotein, and hemoglobin. The prevalences found were: fasting hyperglycemia (9.8%), hypercholesterolemia (4.9%), reduced HDL cholesterol (13.4%), hypertriglyceridemia (11%), abdominal obesity (37.8%), generalized obesity (26.8%), arterial hypertension (26.8%), and anemia (46.3%). The prevalence of Metabolic Syndrome among the Kaingang was 11%, all in females 20 to 49 years of age. The results suggested that the changes in the indigenous lifestyle, especially in eating habits and physical activity, have occurred.

Although most recent publications focus on Ventilator-associated Pneumonia, Non-Ventilator-associated Hospital-acquired pneumonia (NVHAP) is still worrisome. We studied risk factors for NVHAP among patients admitted to a small teaching hospital. Sixty-six NVHAP case patients and 66 controls admitted to the hospital from November 2005 through November 2006 were enrolled in a case-control study. Variables under investigation included: demographic characteristics, comorbidities, procedures, invasive devices and use of medications (Sedatives, Antacids, Steroids and Antimicrobials). Univariate and multivariable analysis (hierarchical models of logistic regression) were performed. The incidence of NVHAP in our hospital was 0.68% (1.02 per 1,000 patients-day). Results from multivariable analysis identified risk factors for NVHAP: age (Odds Ratio[OR]=1.03, 95% Confidence Interval[CI]=1.01-1.05, p=0.002), use of Antacids (OR=5.29, 95%CI=1.89-4.79, p=0.001) and Central Nervous System disease (OR=3.13, 95%CI=1.24-7.93, p=0.02). Although our findings are coherent with previous reports, the association of Antacids with NVHAP recalls a controversial issue in the physiopathology of Hospital-Acquired Pneumonia, with possible implications for preventive strategies.

OBJETIVOS: avaliar a distribuição de espécies de leveduras isoladas da vagina em duas localidades do sul do Brasil e comparar o perfil de suscetibilidade in vitro destas leveduras a antifúngicos usados na prática clínica. MÉTODOS: todas as mulheres atendidas entre janeiro e junho de 2004 para exames rotineiros de amostras vaginais, independente de serem sintomáticas ou não, foram incluídas neste estudo. Foram excluídas as que apresentavam imunodeficiências como AIDS ou outras infecções genitais. Amostras de conteúdo vaginal dessas mulheres (Jaraguá do Sul - SC (n=130) e Maringá - PR (n=97)) foram cultivadas. As leveduras isoladas foram identificadas e submetidas ao teste de suscetibilidade aos antifúngicos fluconazol, nistatina e anfotericina B. RESULTADOS: a freqüência de cultura positiva para levedura foi semelhante nas duas localidades, aproximadamente 24%. Candida albicans foi a espécie prevalente, mas sua freqüência diferiu: em SC correspondeu a 77,4% das leveduras e foi a mais freqüente tanto nas mulheres sintomáticas quanto nas assintomáticas. Já no PR foi 50,0%, com predomínio mais evidente nos casos sintomáticos. Observamos altos índices de suscetibilidade ao fluconazol e anfotericina B, porém 51,1% das leveduras apresentaram suscetibilidade dependente da dose (S-DD) para nistatina. C. albicans mostrou maior tendência de resistência à nistatina (52,8% de S-DD) do que as espécies não-albicans (44,4%). CONCLUSÕES: nossos dados mostram diferenças regionais quanto à espécie de levedura em amostras vaginais. Sugerem que a determinação da espécie pode ter implicação clínica, considerando as diferenças quanto à suscetibilidade, principalmente à nistatina, e que poderiam ter importância no manejo da candidíase vulvovaginal.

PURPOSE: to evaluate the distribution of yeast species isolated from the vagina in two cities of the South of Brazil and compare the in vitro susceptibility profile of these yeasts against some antifungals, which are used in clinical routine. METHODS: all women attended from January to June 2004 for vaginal routine examinations, independent of being symptomatic or not were included in the study. Only those who presented immunodeficiency like AIDS or any other genital infection were excluded. Samples of vaginal discharge from the women (Jaraguá do Sul - SC (n=130) and Maringá - PR (n=97)) were cultivated. The yeasts were identified and submitted to the susceptibility test against the antifungals fluconazole, nystatin and amphotericin B. RESULTS: the frequency of positive cultures for yeasts was the same in both cities; C. albicans was the most prevalent species (about 24%), but its frequency was different: in SC it corresponded to 77.4% of the yeasts both in symptomatic and asymptomatic women and in PR it was 50.0% with predominance in symptomatic women. We observed high rates of susceptibility to fluconazole and amphotericin B, but 51.1% of the yeasts presented dose-dependent susceptibility (DDS) to nystatin. C. albicans showed a higher tendency to be nystatin resistant (52.8% DDS) than non-albicans species (44.4%). CONCLUSIONS: our data showed geographic differences among the species of yeasts isolated from the vagina and suggest that this fact has clinical relevance considering the differences in susceptibility, especially regarding nystatin, which could be important for the management of vulvovaginal candidiasis.