ABSTRACT BACKGROUND AND OBJECTIVES: The type of questionnaire that aims to capture a patient’s perception/view of an aspect to be measured (e.g. pain intensity) is called Patient Reported Outcome Measure (PROM). One of the biggest challenges that clinicians and researchers often face is making a decision about which PROM to use for the assessment of their patient with pain, especially due to the lack of scientific literacy needed to understand the criteria and terms used in the field of measurement properties. Thus, the objectives of this narrative review (part I) were: (I) to introduce basic concepts about PROMs with a focus on the terminology and criteria defined through the COnsensus- based Standards for the selection of health Measurement INstruments (COSMIN), and (2) to describe the measurement properties of the reliability domain. METHODS: This study was produced using a search for articles from the COSMIN initiative. As the subject is very extensive, the authors divided the text into two parts. RESULTS: This study described basic concepts about PROMs (purposes and constructs), the process of cross-cultural adaptation and the measurement properties of the reliability domain (reliability, error measure and internal consistency). In general, an instrument with adequate reliability quality should meet certain criteria, such as: intraclass correlation coefficient ≥0.70, error measure < minimal clinically important change and Cronbach’s Cronbach’s α ≥ 0.70. CONCLUSION: The understanding on how to determine the quality of reliability can assist clinicians and researchers in choosing the best PROMs available. A checklist for assessing the quality of the measurement properties of PROMs is described in the part II of the manuscript.

RESUMO JUSTIFICATIVA E OBJETIVOS: O tipo de questionário que pretende captar a percepção/visão de um paciente sobre um aspecto a ser medido (ex: intensidade da dor) é chamado de Instrumento de Medida Baseado no Relato do Paciente (Patient Reported Outcome Measure - PROM). Um dos maiores desafios que clínicos e pesquisadores costumam enfrentar é quanto a tomar uma decisão sobre qual PROM utilizar para a avaliação de seu paciente com dor, especialmente devido à falta do letramento científico necessário para entender os critérios e termos empregados na área de propriedades de medida. Assim, os objetivos deste estudo (parte I) foram: (I) introduzir conceitos básicos sobre PROMs com enfoque na terminologia e critérios definidos através do COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), e (2) descrever as propriedades de medida do domínio confiabilidade. MÉTODOS: Utilizando uma busca voltada para os artigos da iniciativa COSMIN, foi elaborado este estudo. Sendo o assunto muito extenso, os autores dividiram o texto em duas partes. RESULTADOS: O presente artigo descreveu conceitos básicos sobre PROMs (propósitos e construtos), o processo de adaptação transcultural e as propriedades de medida do domínio confiabilidade (confiabilidade, medida de erro e consistência interna). De forma geral, um instrumento com qualidade adequada de confiabilidade deveria atender a alguns critérios, tais como: coeficiente de correlação intraclasse ≥ 0,70, medida de erro < mínima mudança clinicamente importante e α de Cronbach ≥ 0,70. CONCLUSÃO: O entendimento sobre como determinar a qualidade da propriedade de medida de confiabilidade pode auxiliar os clínicos e pesquisadores na escolha dos melhores PROMs disponíveis. Um checklist para avaliação da qualidade das propriedades de medida de PROMs está descrita na parte II do artigo.

Abstract Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi, whose treatment has remained unsatisfactory for over 50 years, given that it is limited to two drugs. Benznidazole (BZN) is an efficient antichagasic drug used as the first choice, although its poor water-solubility, irregular oral absorption, low efficacy in the chronic phase, and various associated adverse effects are limiting factors for treatment. Incorporating drugs with such characteristics into nanostructured lipid carriers (NLC) is a promising alternative to overcome these limiting obstacles, enhancing drug efficacy and bioavailability while reducing toxicity. Therefore, this study proposed NLC-BZN formulations in different compositions prepared by hot-melt homogenization followed by ultrasound, and the optimized formulation was characterized by FTIR, DRX, DSC, and thermogravimetry. Biological activities included in vitro membrane toxicity (red blood cells), fibroblast cell cytotoxicity, and trypanocidal activity against epimastigotes of the Colombian strain of T. cruzi. The optimized NLC-BZN had a small size (110 nm), negative zeta potential (-18.0 mV), and high encapsulation (1.64% of drug loading), as shown by infrared spectroscopy, X-ray diffraction, and thermal analysis. The NLC-BZN also promoted lower in vitro membrane toxicity (<3% hemolysis), and 50% cytotoxic concentration (CC50) for NLC-BZN in L929 fibroblast cells (110.7 µg/mL) was twice the value as the free BZN (51.3 µg/mL). Our findings showed that the NLC-BZN had higher trypanocidal activity than free BZN against the epimastigotes of the resistant Colombian strain, and this novel NLC-BZN formulation proved to be a promising tool in treating Chagas disease and considered suitable for oral and parenteral administration.

RESUMEN Introducción: Los extractos etanólico e hidroalcohólico de Ageratum fastigiatum se utilizan en la medicina popular como agentes antiinflamatorios y analgésicos. Objetivo: Evaluar la toxicidad en artemia salina y en las células del tejido conectivo de ratones (L929). Metodología: El extracto se fraccionó y se sometieron a la misma prueba sus fases hexano, diclorometano e hidroalcohólica. El tamizaje fitoquímico de las fases del extracto se realizó mediante pruebas dirigidas a la detección de metabolitos secundarios y GC-MS. En cuanto a A. salina, la fase hidroalcohólica presentó la mayor toxicidad (CL50, 1,33 mg/mL) y el extracto etanólico crudo fue el menos tóxico (CL50, 4,81 mg/mL). En el ensayo de células L929, la fase de diclorometano fue la más tóxica (95,48% de reducción de la viabilidad celular; CL50, 11,39 µg/mL), mientras que la fase hidroalcohólica fue la menos tóxica (porcentaje de muerte celular, 55,67-19,38 %; CL50, 174,20 µg/mL). Resultado: El estudio fitoquímico indicó la probable presencia de alcaloides, cumarinas, saponinas, triterpenos/esteroides y taninos. El análisis GC-MS identificó la presencia de terpenoides y un derivado de licopsamina (un alcaloide de pirrolizidina). Conclusión: Estos resultados sugieren que el extracto etanólico de A. fastigiatum tenía constituyentes (es decir, compuestos fenólicos) que corroboran su uso en la medicina popular como agente antiinflamatorio. Sin embargo, la toxicidad detectada y la presencia de 3'-acetil licopsamina (un marcador quimiotaxonómico del género que es hepatotóxico) indica que esta planta medicinal debe utilizarse con precaución.

SUMMARY Introduction: Ethanolic and hydroalcoholic extracts of Ageratum fastigiatum are used in folk medicine as anti-inflammatory and analgesic agents. Aim: To evaluate toxicity in Artemia salina and in the cells of the connective tissue of mice (L929). Methodology: The extract was partitioned and its hexane, dichloromethane and hydroalcoholic phases were submitted to the same test. The phytochemical screening of the phases of the extract was performed using tests aimed at the detection of secondary metabolites and GC-MS. Regarding A. salina, the hydroalcoholic phase exhibited the highest toxicity (LC50, 1.33 mg/mL) and the crude ethanolic extract was the least toxic (LC50, 4.81 mg/mL). In the assay of L929 cells, the dichloromethane phase was the most toxic (95.48% reduction in cell viability; LC50, 11.39 µg/mL), while the hydroalcoholic phase was the least toxic (cell death percentage, 55.67-19.38 %; LC50, 174.20 µg/mL). Result: The phytochemical study indicated the presence of alkaloids, coumarins, saponins, triterpenes/steroids and tannins. The GC-MS analysis identified the presence of terpenoids and a lycopsamine derivative (a pyrrolizidine alkaloid). Conclusion: These results suggest that the ethanolic extract of A. fastigiatum had constituents (i.e., phenolic compounds) that corroborate its use in folk medicine as an anti-inflammatory agent. However, the toxicity detected and the presence of 3'-acetyl lycopsamine (a chemotaxonomic marker of the genus that is hepatotoxic) indicates that this medicinal plant should be used with caution.

RESUMO Introdução: Os extratos etanólico e hidroalcoólico de Ageratum fastigiatum são usados na medicina popular como agentes antiinflamatório e analgésico. Objetivo: Avalidar quanto à sua toxicidade em Artemia salina e nas células do tecido conjuntivo de camundongos (L929). Metodologia: O extrato foi particionado e suas fases hexânica, diclorometânica e hidroalcoólica foram submetidas ao mesmo teste. A triagem fitoquímica das fases do extrato foi realizada por meio de testes visando a detecção de classes de metabólitos secundários e GC-MS. Resultados: Em relação a A. salina, a fase hidroalcoólica apresentou a maior toxicidade (CL50, 1,33 mg/mL) e o extrato etanólico bruto foi o menos tóxico (CL50_ 4,81 mg/mL). No ensaio de células L929, a fase de diclorometânica foi a mais tóxica (95,48% de redução na viabilidade celular; LC50, 11,39 µg/mL), enquanto a fase hidroalcoólica foi a menos tóxica (porcentagem de morte celular, 55,67-19,38 %; LC50, 174,20 µg/mL). O estudo fitoquímico indicou a provável presença de alcalóides, cumarinas, saponinas, triterpenos/ esteróides e taninos. A análise por GC-MS identificou a presença de terpenóides e um derivado de licopsamina (alcalóide pirrolizidínico). Conclusão: Esses resultados sugerem que o extrato etanólico de A. fastigiatum possui constituintes (ou seja, compostos fenólicos) que corroboram seu uso na medicina popular como agente antiinflamatório. No entanto, a toxicidade detectada e a presença da 3'-acetil licopsamina (um marcador quimiotaxonômico do gênero, que é hepatotóxico) indicam que essa planta medicinal deve ser usada com cautela.

Resumo Senna rugosa (Fabaceae) é uma espécie comum do território brasileiro, especialmente no Cerrado. É amplamente utilizado na medicina popular, embora ainda não tenha sido investigada quanto aos seus fitoconstituintes e atividades farmacológicas. Neste estudo, foram realizadas as análises fitoquímicas preliminares do extrato etanólico de folhas de S. rugosa e sua citotoxicidade, atividade antitumoral e antimicrobiana (antibacteriana, antifúngica, anti-Trypanosoma e anti-Leishmania). O extrato bruto foi analisado em HPLC-DAD e as frações foram caracterizadas usando técnicas de GC-MS e ESI-MS. Os resultados indicam a presença majoritária de compostos fenólicos, incluindo flavonóis, antraquinonas e derivados de antronas. Atividades antimicrobianas foram detectadas contra as espécies Staphylococcus aureus, Pseudomonas aeruginosa, Candida famata, Candida krusei e Candida tropicalis. Além disso, uma fraca atividade anti-tripanossomatídeos contra as cepas M2269 e BH46 de Leishmania sp. Uma atividade antitumoral foi identificada, porém também foi observada uma toxicidade sobre células de fibroblastos (L929). Fitoquimicamente, os resultados fornecem evidências de que compostos fenólicos nas folhas de S. rugosa podem ser os responsáveis pela sua atividade antimicrobiana e pela toxicidade celular observada em nosso estudo.

Abstract Senna rugosa (Fabaceae) is a common specie of the Brazilian territory, especially in the Cerrado biome. It is widely used in the popular medicine although not yet adequately investigated as to its phytoconstituents and pharmacological activities. In this study, the preliminary phytochemical analysis of ethanolic leaf extract of S. rugosa was performed and its cytotoxicity, antitumoral and antimicrobial activities (antibacterial, antifungal, anti-Trypanosoma and anti-Leishmania) were evaluated. The crude extract was analyzed in HPLC-DAD and fractions were also characterized using GC-MS and ESI-MS techniques. Results indicate phenolic compounds majority presence, including flavonol, anthraquinone and anthrones derivatives. Relative antimicrobial activities were detected against Staphylococcus aureus, Pseudomonas aeruginosa, Candida famata, Candida krusei and Candida tropicalis. As well as, a weak anti-trypanosomatids activity against M2269 strain and BH46 strain of Leishmania sp. A relative antitumoral activity was also identified but in counterpoint were also observed a toxicity in fibroblast cells (L929). Phytochemically, results provide evidence that phenolic compounds in S. rugosa leaves might be the responsible for its antimicrobial activity and cell toxicity inferred in our research.

ABSTRACT Introduction: Intestinal parasitosis by helminths and protozoa is still today a global public health problem mainly affecting people living in conditions of social vulnerability, including rural communities. Objective: Describe human intestinal parasitosis and environmental contamination with helminths and protozoa in the Quilombola community of Quartel do Indaiá (of African descent) in the State of Minas Gerais, Brazil. Methods: A cross-sectional study was conducted of stool and soil samples by spontaneous sedimentation, and of plant samples by centrifugation sedimentation, to detect intestinal helminths and protozoa. Water samples were analyzed for total and fecal coliforms. Results: Helminths and protozoa were found in 45.5% of the people (n = 66). The species detected were Ascaris lumbricoides (18.2 %), Entamoeba coli (18.2%), Endolimax nana (18.2 %), ancylostoma (6.1 %), Iodamoeba butschlii (4.6 %), Giardia duodenalis (3%) and Trichuris trichiura (1.5 %). More than one species were present in 19.7 % of the samples. In 18 of the 39 sites sampled, the soil was contaminated with E. coli, E. nana, A. lumbricoides, I. butschlii and/or Enterobius vermicularis. Vegetables (n = 135) were contaminated in 75 samples with 7 of the 8 species analyzed. The contaminants were E. coli cysts, A. lumbricoides eggs and ancylostoma. All water samples were contaminated with total and fecal coliforms. Conclusions: The Quilombola community of Quartel do Indaiá had high levels of human infection and high environmental contamination with intestinal parasites or protozoa, probably due to lack of appropriate sanitary conditions. It is necessary to improve the access to treated water and sanitation.

RESUMEN Introducción: El parasitismo intestinal por helmintos y protozoarios todavía es un problema de salud pública mundial, que afecta sobre todo personas en condiciones de vulnerabilidad social, incluso las comunidades rurales. Objectivo: Describir la infección humana y la contaminación ambiental por parásitos/comensales intestinales en una comunidade ‘quilombola’ Quartel do Indaiá (descendentes de esclavos) del Estado de Minas Gerais, Brasil. Métodos: Estudio de corte transversal con análisis de muestras fecales y de tierra por sedimentación espontánea, y de vegetales por sedimentación con centrifugación para detección de parásitos o comensales intestinales. Se analizaron muestras de agua para detección de coliformes totales y fecales. Resultados: Se observó la ocurrencia de parásitos o comensales en 45.5 % de las personas (n = 66). Las especies detectadas fueron Ascaris lumbricoides (18,2 %), Entamoeba coli (18,2 %), Endolimax nana (18,2 %), anquilostomas (6.1 %), Iodamoeba butschlii (4,6 %), Giardia duodenalis (3 %), and Trichuris trichiura (1,5 %). Para 19,7 % de las muestras se detectaron más de una especie. El suelo estuvo contaminado en 18 de los 39 sitios muestreados, con presencia de E. coli, E. nana, A. lumbricoides, I. butschlii y/o Enterobius vermicularis. Los vegetales (n = 135) presentaron contaminación en 75 muestras de 7, entre 8 especies analizadas. Sus contaminantes fueron quistos de E. coli y huevos de A. lumbricoides y anquilostoma. Todas las muestras de agua estaban contaminadas por coliformes totales y fecales. Conclusiones: La comunidad ‘quilombola’ Quartel do Indaiá presentó alta infección humana y alta contaminación ambiental por parásitos o comensales intestinales, lo que se debe probablemente a la falta de condiciones sanitarias. Se necesita mejorar el acceso para agua tratada y estructuras de saneamiento.

RESUMO Objetivo: O presente estudo teve como objetivo avaliar a presença de helmintos e protozoários intestinais em hortaliças comercializados em Diamantina, um município localizado no Vale do Jequitinhonha, uma das regiões mais pobres do mundo. Métodos: Cento e oito exemplares, incluindo alface, cebolinha e rúcula, foram mensalmente coletados em uma feira livre, uma quitanda e um supermercado do município. As amostras foram processadas por um método de concentração e avaliadas por microscopia óptica para pesquisa de estruturas parasitárias. Resultados: O percentual global de contaminação foi de 50,9% (55/108), com predominância de larvas de nematódeos (36,5%), cistos de Entamoeba coli e ovos de ancilostomídeos/Strongyloides spp. (12,9%). A alface demonstrou a maior taxa de contaminação (61,1%) e as amostras da feira livre foram as mais contaminadas (77,8%). Informações coletadas em cada ponto de venda apontaram o cultivo em campo como a etapa crítica para a contaminação. Conclusão: Hortaliças comercializadas em Diamantina apresentam uma ampla variedade de parasitas intestinais, o que representa um risco potencial à saúde dos consumidores da área.

ABSTRACT Objective: The present study aimed to evaluate the presence of helminthes and intestinal protozoa in vegetables commercialized in Diamantina, a municipality located at Jequitinhonha Valley, one of the poorest regions of the world. Methods: A total of 108 specimens, including lettuce, green onion and rocket, were monthly collected from the most popular open street market, green grocery and supermarket of the municipality. The samples were processed by a concentration method and evaluated by light microscopy for parasitological identification. Results: The percentage of contamination was 50.9% (55/108), with predominance of nematode larvae (36.5%), cysts of Entamoeba coli (26.0%) and eggs of hookworms/Strongyloides spp. (12.9%). Lettuce showed greater contamination rate (61.1%) and samples from the open street market were more contaminated (77.8%). Information collected at each point of sale pointed the field cultivation as the critical step for such contaminations. Conclusion: Vegetables marketed in Diamantina presents a wide variety of intestinal parasites, which may represent a potential risk to the health of consumers of fresh vegetables.

Reports of triatomine infestation in urban areas have increased. We analysed the spatial distribution of infestation by triatomines in the urban area of Diamantina, in the state of Minas Gerais, Brazil. Triatomines were obtained by community-based entomological surveillance. Spatial patterns of infestation were analysed by Ripley’s K function and Kernel density estimator. Normalised difference vegetation index (NDVI) and land cover derived from satellite imagery were compared between infested and uninfested areas. A total of 140 adults of four species were captured (100 Triatoma vitticeps, 25Panstrongylus geniculatus, 8 Panstrongylus megistus, and 7 Triatoma arthurneivai specimens). In total, 87.9% were captured within domiciles. Infection by trypanosomes was observed in 19.6% of 107 examined insects. The spatial distributions ofT. vitticeps, P. geniculatus, T. arthurneivai, and trypanosome-positive triatomines were clustered, occurring mainly in peripheral areas. NDVI values were statistically higher in areas infested by T. vitticeps and P. geniculatus. Buildings infested by these species were located closer to open fields, whereas infestations of P. megistus andT. arthurneivai were closer to bare soil. Human occupation and modification of natural areas may be involved in triatomine invasion, exposing the population to these vectors.

Candidíase vulvovaginal (CVV) em mulheres infectadas pelo HIV contribuiu substancialmente para a diminuição da sua qualidade de vida. O objetivo deste estudo foi avaliar o efeito do uso de terapia anti-retroviral altamente ativa (HAART) no isolamento de Candida spp. vaginais em mulheres HIV positivas comparado às não infectadas por HIV. Este estudo transversal incluiu 178 mulheres infectadas pelo HIV (grupo HIV) e 200 mulheres não infectadas (grupo controle) acompanhadas no Serviço de Assistência Especializada (SAE) para as doenças sexualmente transmissíveis (DST)/AIDS da cidade de Maringá/Brasil, de 1 abril a 30 de outubro de 2011. As leveduras foram isoladas e identificadas por métodos fenotípicos e moleculares. A susceptibilidade in vitro aos antifúngicos fluconazol, itraconazol, nistatina e anfotericina B foi avaliada pelo método de referência de microdiluição. Nós encontramos maior frequência de isolamento vaginal total de Candida spp. no grupo HIV do que no grupo controle. Entretanto, foi observada frequência similar de colonização e CVV entre os dois grupos. Apesar de C. albicans ser a mais frequente e sensível a azólicos e polienos em mulheres infectadas pelo HIV e não infectadas, foi detectada emergente resistência de C. glabrata a AMB nas mulheres infectadas pelo HIV. Embora tenha sido observada maior frequência de isolamento vaginal de Candida spp. nas mulheres infectadas pelo HIV do que nas não infectadas, colonização e CVV apresentaram frequência similar em ambos os grupos, o que indica que HAART parece proteger contra colonização vaginal e CVV.

 Vulvovaginal candidiasis (VVC) in HIV-infected women contributed to the impairment of their quality of life. The aim of this study was to evaluate the effect of highly active antiretroviral therapy (HAART) use on the vaginal Candida spp. isolation in HIV-infected compared to HIV-uninfected women. This cross-sectional study included 178 HIV-infected (HIV group) and 200 HIV-uninfected women (control) that were studied at the Specialized Assistance Service (SAE) for sexually transmitted diseases (STD)/AIDS of the city of Maringá, Brazil, from April 1 to October 30, 2011. The yeasts were isolated and identified by phenotypic and molecular methods. The in vitro antifungal susceptibility to fluconazole, itraconazole, nystatin and amphotericin B was tested by the reference microdilution method. Higher frequencies of total vaginal Candida spp. isolation were found in the HIV-infected group than in the control group. However, both groups showed a similar frequency of colonization and VVC. Although C. albicans was the most frequent and sensitive to azolics and polyenes in both HIV-infected and uninfected women, the emerging resistance of C. glabrata to amphotericin B in the HIV-infected women was observed. Although higher frequency of vaginal Candida spp. isolation had been observed in the HIV-infected than in HIV-uninfected women, colonization and VVC showed similar frequency in both groups, indicating that HAART appears to protect against vaginal colonization and VVC.

CONTEXTO: El alcohol de las drogas de abuso son las drogas psicoactivas más consumidas en el mundo. Lo II Nacional de Alcohol y Drogas de Encuesta, realizada en Brasil y publicado en 2013 muestra que la tasa de dependencia y / o abuso de alcohol entre la población es de 6,8% y 10,5% hombres y 3,6% mujeres. OBJETIVO(S): Este artículo tiene como objetivo presentar el patrón de consumo de alcohol y las intervenciones llevadas a cabo en una comunidad socialmente vulnerables, la ciudad de Belo Horizonte, Minas Gerais. METODOLOGÍA: Había un rastro de consumo de alcohol entre los 47 participantes, mayores de 18 años, a través del Alcohol Use Disorders Identification Test (AUDIT). Un estudio transversal se llevó a cabo para el análisis cuantitativo de los datos. En el contexto investigado, se adoptó la investigación-acción como metodología para realizar intervenciones de la clasificación del patrón de consumo de la población de estudio. Las intervenciones fueron guiados por los resultados de esa prueba. RESULTADOS: Los resultados del test se obtuvieron de acuerdo a las zonas de clasificación estándar de alcohol, lo que resulta en: zona I, el 61,7%; la zona II, 6,4; Zona III, 14,9% y la zona IV, 17,0%. Entre las personas clasificadas en las zonas III y IV 25,9% vivían con niños y adolescentes. CONCLUSIONES: Hacemos hincapié en la importancia de mantener las actividades para promover la salud y prevenir el uso y abuso de alcohol como parte de la asistencia grupo prestada por el personal de atención a la población estudiada.

CONTEXTO: O álcool, entre as drogas de abuso, é a substância psicoativa mais largamente consumida no mundo. O II Levantamento Nacional de Álcool e Drogas, feito no Brasil e publicado em 2013 aponta que a taxa de dependência e/ou abuso de álcool na população é de 6,8% sendo 10,5% homens e 3,6% mulheres. OBJETIVO(S): Neste artigo tem-se por objetivo apresentar o padrão de consumo de álcool e as intervenções realizadas em uma comunidade socialmente vulnerável, do município de Belo Horizonte, Minas Gerais. METODOLOGIA: Realizou-se um rastreamento do consumo de álcool entre 47 participantes, com idades superiores a 18 anos, por meio do Alcohol Use Disorders Identification Test. Foi feito um estudo transversal para a análise quantitativa dos dados. Diante do cenário pesquisado, adotou-se a pesquisa ação como uma estratégia metodológica, para fazer as intervenções a partir da classificação do padrão de consumo da população estudada. As intervenções realizadas foram norteadas pelos resultados do referido teste. RESULTADOS: Os escores do teste foram obtidos conforme as zonas de classificação do padrão de consumo de álcool, resultando: zona I, 61,7%; zona II, 6,4; zona III, 14,9% e zona IV, 17,0%. Dentre as pessoas classificadas nas zonas III e IV 25,9% residiam com crianças e adolescentes. CONCLUSÕES: Ressalta-se a importância da manutenção de atividades de promoção à saúde e prevenção ao uso e abuso de álcool como parte do cuidado de saúde prestado pela equipe que assiste a população estudada.

BACKGROUND: The alcohol, between drug abuse, is the most widely consumed psychoactive substance in the world. The II National Alcohol and Drug Survey, conducted in Brazil and published in 2013 shows that the rate of addiction and / or abuse of alcohol in the population is 6.8% and 10.5% men and 3.6% women. AIM: This paper aims to present the pattern of alcohol consumption and their interventions in a socially vulnerable community, the city of Belo Horizonte, Minas Gerais. METHODS: We conducted a trace of alcohol consumption among 47 participants, aged over 18 years, through the Alcohol Use Disorders Identification Test. A cross-sectional study was done for the quantitative analysis of the data. Against the backdrop researched, action research was adopted as a methodology to make interventions from the classification of the study population consumption pattern. RESULTS: The test scores were obtained depending on the zone classification of the pattern of alcohol consumption, resulting in: zone I, 61,7%, zone II, 6,4%, zone III,14,9%, zone IV, 17,0%. Among persons classified in zones III and IV 25,9% lived with children and adolescents. CONCLUSIONS: It emphasizes the importance of maintaining health promotion and prevention of alcohol use and abuse as part of the health care provided by thes team that assists the population studied.

Trypanosoma cruzi strains from distinct geographic areas show differences in drug resistance and association between parasites genetic and treatment response has been observed. Considering that benznidazole (BZ) can reduce the parasite burden and tissues damage, even in not cured animals and individuals, the goal is to assess the drug response to BZ of T. cruzi II strains isolated from children of the Jequitinhonha Valley, state of Minas Gerais, Brazil, before treatment. Mice infected and treated with BZ in both phases of infection were compared with the untreated and evaluated by fresh blood examination, haemoculture, polymerase chain reaction, conventional (ELISA) and non-conventional (FC-ALTA) serologies. In mice treated in the acute phase, a significant decrease in parasitaemia was observed for all strains. Positive parasitological and/or serological tests in animals treated during the acute and chronic (95.1-100%) phases showed that most of the strains were BZ resistant. However, beneficial effect was demonstrated because significant reduction (p < 0.05%) and/or suppression of parasitaemia was observed in mice infected with all strains (acute phase), associated to reduction/elimination of inflammation and fibrosis for two/eight strains. BZ offered some benefit, even in not cured animals, what suggest that BZ use may be recommended at least for recent chronic infection of the studied region.

CONTEXTO E OBJETIVO: Candidíase vulvovaginal (CVV) é causada pelo crescimento anormal de fungos do tipo leveduras na mucosa do trato genital feminino. Pacientes com diabetes mellitus (DM) são mais susceptíveis a infecções fúngicas, incluindo por espécies de Candida. O presente estudo investigou a frequência de isolamento total de Candida spp. vaginal, e diferentes quadros clínicos (CVV e CVV recorrente- CVVR) em mulheres com DM tipo 2 comparadas às não diabéticas. A razão de cura do tratamento com fluconazol também foi avaliada. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado no sistema público de saúde de Maringá, Paraná, Brazil. MÉTODO: O estudo envolveu 717 mulheres de 17-74 anos de idade e, destas, 48 (6,7%) tinham DM 2 (média de 53,7 anos), independentemente de sinais e sintomas de CVV. As leveduras foram isoladas e identificadas por métodos fenotípicos clássicos. RESULTADOS: No grupo de não diabéticas (controle), leveduras vaginais totais foram isoladas em 79 (11,8%) mulheres, e no grupo de diabéticas, em 9 (18,8%) (P = 0,000). O grupo de diabéticas mostrou mais mulheres sintomáticas (CVV + CVVR = 66,66%) do que colonizadas (33.33%), e significativamente mais colonização, CVV e CVVR, que as controle. A razão média de cura com fluconazol foi de 75.0% no grupo diabéticas e 86.7% no controle (P = 0.51). CONCLUSÃO: Nós encontramos que DM 2 em mulheres brasileiras associou-se com colonização vaginal por leveduras, CVV e CVVR, razão similar de isolamento de C. albicans e espécies não albicans. Boa taxa de cura foi obtida com fluconazol em ambos os grupos.

CONTEXT AND OBJECTIVE: Vulvovaginal candidiasis (VVC) is caused by abnormal growth of yeast-like fungi on the female genital tract mucosa. Patients with diabetes mellitus (DM) are more susceptible to fungal infections, including those caused by species of Candida. The present study investigated the frequency of total isolation of vaginal Candida spp., and its different clinical profiles - colonization, VVC and recurrent VVC (RVVC) - in women with DM type 2, compared with non-diabetic women. The cure rate using fluconazole treatment was also evaluated. DESIGN AND SETTING: Cross-sectional study conducted in the public healthcare system of Maringá, Paraná, Brazil. METHODS: The study involved 717 women aged 17-74 years, of whom 48 (6.7%) had DM type 2 (mean age: 53.7 years), regardless of signs and symptoms of VVC. The yeasts were isolated and identified using classical phenotypic methods. RESULTS: In the non-diabetic group (controls), total vaginal yeast isolation occurred in 79 (11.8%) women, and in the diabetic group in 9 (18.8%) (P = 0.000). The diabetic group showed more symptomatic (VVC + RVVC = 66.66%) than colonized (33.33%) women, and showed significantly more colonization, VVC and RVVC than seen among the controls. The mean cure rate using fluconazole was 75.0% in the diabetic group and 86.7% in the control group (P = 0.51). CONCLUSION: We found that DM type 2 in Brazilian women was associated with yeast colonization, VVC and RVVC, and similar isolation rates for C. albicans and non-albicans species. Good cure rates were obtained using fluconazole in both groups.

Introduction The biological diversity of Trypanosoma cruzi strains plays an important role in the clinical and epidemiological features of Chagas disease. Methods Eight T. cruzi strains isolated from children living in a Chagas disease vector-controlled area of Jequitinhonha Valley, State of Minas Gerais, Brazil, were genetically and biologically characterized. Results The characterizations demonstrated that all of the strains belonged to T. cruzi II, and showed high infectivity and a variable mean maximum peak of parasitemia. Six strains displayed low parasitemia, and two displayed moderate parasitemia. Later peaks of parasitemia and a predominance of intermediate and large trypomastigotes in all T. cruzi strains were observed. The mean pre-patent period was relatively short (4.2±0.25 to 13.7±3.08 days), whereas the patent period ranged from 3.3±1.08 to 34.5±3.52 days. Mortality was observed only in animals infected with strain 806 (62.5%). Histopathological analysis of the heart showed that strains 501 and 806 caused inflammation, but fibrosis was observed only in animals infected with strain 806. Conclusions The results indicate the presence of an association between the biological behavior in mice and the genetic characteristics of the parasites. The study also confirmed general data from Brazil where T. cruzi II lineage is the most prevalent in the domiciliary cycle and generally has low virulence, with some strains capable of inducing inflammatory processes and fibrosis.

INTRODUÇÃO: O objetivo foi desenvolver um método sorológico in-house de alta especificidade e sensibilidade para diagnosticar e monitorar a morbidade da doença de Chagas. MÉTODOS: Para tal, a reatividade sorológica de IgG e subclasses foi testada em soros de pacientes chagásicos de Berilo, Vale do Jequitinhonha/MG/Brasil. A reatividade sorológica foi também avaliada em amostras de pacientes com outras doenças infecto-contagiosas relevantes, incluindo o HIV, vírus da hepatite C (VHC), sífilis (SYP), leishmaniose visceral (LV), leishmaniose tegumentar americana (LTA) e controles não infectados (NI) para verificar o desempenho do método. Outras análises foram feitas para avaliar a aplicabilidade desta metodologia no monitoramento da morbidade da doença de Chagas. Com este propósito os pacientes com doença de Chagas foram anteriormente classificados em três grupos: indeterminados (IND), cardíacos (CARD) e digestivos/mistos (DIG/Mis) conforme seu estado clínico. RESULTADOS: A análise da reatividade sorológica de IgG total na diluição 1:40 mostrou ser uma abordagem importante no diagnóstico da doença de Chagas (100% de sensibilidade e especificidade e ausência de reação cruzada com as demais infecções). A análise das subclasses de IgG mostrou reação cruzada principalmente com NI, LV e LTA em todas as diluições. O grupo IND apresentou a maior reatividade para IgG3 e o grupo DIG/Mis apresentou nível mais elevado de IgG se comparados aos grupos IND e CARD. CONCLUSÕES: Estes achados demonstram que o método de ELISA in-house apresenta uma promissora aplicabilidade no diagnóstico diferencial e na avaliação da morbidade da doença de Chagas.

INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100% sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.