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Uncaria tomentosa is a plant native to the Amazon that has immunomodulatory and antitumor properties due to the alkaloids found in the plant, being able to modify the immune response by potentiating or suspending the action of cytokines secreted by macrophages that induce the immune response, either by the classical route (M1) or through the alternative route (M2). Macrophages activated by M1 convert L-arginine into L-citrulline and nitric oxide (NO), whereas macrophages activated by the M2 pathway use the enzymatic activity of arginase to convert the same substrate into L-ornithine and urea. The aim of this work was to evaluate the immunostimulating activity of the crude hydroalcoholic extract from the bark of the U. tomentosa stem in RAW 264.7 macrophages. Concentrations of 0.2, 0.1 and 0.05 mg/mL of U. tomentosa extract associated with LPS, INF-γ and IL-4 inducers were tested by determining NO production and arginase enzyme activity. Nitric oxide production was enhanced by the extract when associated with LPS and LPS + INF-γ inducers. In the activity of the arginase enzyme, the extract decreased the stimulation of IL-4 on the enzyme, mainly at 0.2 mg/mL concentration. Therefore, it is concluded that the crude hydroalcoholic extract of the stem bark of U. tomentosa in RAW 264.7 cells, at a concentration of 0.2 mg/mL, showed considerable pro-inflammatory activity.

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BACKGROUND: The Brazilian Cohort of Asthma São Paulo (BRASASP) had a well-characterized severe asthmatic in Brazil, with 12 years of follow-up under standard treatment. METHODS: Sequential assessment of patients with uncontrolled asthma from BRASASP cohort was carried out with 12 years of follow-up, performing exams and comparing with previous measurements. RESULTS: 50 from the 60 initial patients were reevaluated. Twelve years later, FEV1 and the FEV1/FVC ratio have significantly decreased, with a rate of loss of lung function of 11.8 and 14%, respectively, and worsening in small airway parameters such as RV/TLC. BMI, The Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) scores haven't changed. However, exacerbations decreased by 56%. Mean daily inhaled corticosteroid use was similar over time, but daily oral corticosteroid use decreased, in addition to a significant reduction in induced sputum eosinophilic and neutrophilic profile and serum IgE. Rhinitis, sinusitis, and GERD were the main comorbidities. In quality of life according to respiratory questionnaire SGRQ, total score showed a huge improvement (62% of patients). CONCLUSIONS: There was significant decrease in FEV1 and FEV1/FVC. Data of pulmonary functional small airway characteristics show globally affected airways. Although higher doses of medications, patients were still uncontrolled, but with reduction of exacerbations, daily use of oral corticosteroid, less eosinophils and neutrophils in induced sputum and lower levels of IgE. Improvement in quality of life in 62% of patients.

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Abstract Uncaria tomentosa is a plant native to the Amazon that has immunomodulatory and antitumor properties due to the alkaloids found in the plant, being able to modify the immune response by potentiating or suspending the action of cytokines secreted by macrophages that induce the immune response, either by the classical route (M1) or through the alternative route (M2). Macrophages activated by M1 convert L-arginine into L-citrulline and nitric oxide (NO), whereas macrophages activated by the M2 pathway use the enzymatic activity of arginase to convert the same substrate into L-ornithine and urea. The aim of this work was to evaluate the immunostimulating activity of the crude hydroalcoholic extract from the bark of the U. tomentosa stem in RAW 264.7 macrophages. Concentrations of 0.2, 0.1 and 0.05 mg/mL of U. tomentosa extract associated with LPS, INF-γ and IL-4 inducers were tested by determining NO production and arginase enzyme activity. Nitric oxide production was enhanced by the extract when associated with LPS and LPS + INF-γ inducers. In the activity of the arginase enzyme, the extract decreased the stimulation of IL-4 on the enzyme, mainly at 0.2 mg/mL concentration. Therefore, it is concluded that the crude hydroalcoholic extract of the stem bark of U. tomentosa in RAW 264.7 cells, at a concentration of 0.2 mg/mL, showed considerable pro-inflammatory activity.

Resumo A Uncaria tomentosa é uma planta nativa da Amazônia que possui propriedades imunomoduladoras e antitumorais devido aos alcaloides encontrados no vegetal, sendo capaz de modificar a resposta imune ao potencializar ou suspender a ação de citocinas secretadas por macrófagos que induzem a resposta imune, seja pela via clássica (M1) ou pela via alternativa (M2). Macrófagos ativados pela M1 converte L-arginina em L-citrulina e óxido nítrico (NO), já os macrófagos ativados pela via M2 utilizam a atividade enzimática da arginase para converter o mesmo substrato em L-ornitina e ureia. O trabalho teve como objetivo avaliar a atividade imunoestimuladora do extrato hidroalcoólico bruto da casca do caule da U. tomentosa em macrófagos RAW 264.7. Foram testadas as concentrações 0.2, 0.1 e 0.05 mg/mL do extrato de U. tomentosa associadas aos indutores LPS, INF-γ e IL-4, por meio da determinação da produção de NO e atividade da enzima arginase. A produção de óxido nítrico foi potencializada pelo extrato quando associado aos indutores LPS e LPS + INF-γ. Na atividade da enzima arginase, o extrato diminuiu a estimulação da IL-4 sobre a enzima, principalmente na concentração 0.2 mg/mL. Portanto, conclui-se que o extrato hidroalcoólico bruto da casca do caule de U. tomentosa em células RAW 264.7, na concentração 0.2 mg/mL, demostrou atividade pró-inflamatória considerável.

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BACKGROUND: Patients with asthma present structural and inflammatory alterations that are believed to play a role in disease severity. However, airway remodeling and inflammation have not been extensively investigated in relation to both symptom control and airflow obstruction in severe asthmatics. We aimed to investigate several inflammatory and structural pathological features in bronchial biopsies of severe asthmatics that could be related to symptom control and airflow obstruction after standardized treatment. METHODS: Fifty severe asthmatics received prednisone 40 mg/d for 2 weeks and maintenance therapy with budesonide/formoterol 400/12 µg twice daily + budesonide/formoterol 200/6 µg as needed for 12 weeks. Endobronchial biopsies were performed at the end of 12 weeks. We performed extensive immunopathological analyses of airway tissue inflammation and remodeling features in patients stratified by asthma symptom control and by airflow obstruction. RESULTS: Airway tissue inflammation and remodeling were not associated with symptom control. Asthmatics with persistent airflow obstruction had greater airway smooth muscle (Asm) area with decreased periostin and transforming growth factor beta-positive cells within Asm bundles, in addition to lower numbers of chymase-positive mast cells in the submucosa compared to patients with nonpersistent obstruction. CONCLUSIONS: Symptom control in severe asthmatics was not associated with airway tissue inflammation and remodeling, although persistent airflow obstruction in these patients was associated with bronchial inflammation and airway structural changes.

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AIM: To analyze possible factors associated with the quality of life (QoL) of mothers of preterm infants with very low birth weight (VLBW) during the first 3 years after delivery. METHODS: The World Health Organization Quality of Life (WHOQOL)-bref scores were compared and correlated with maternal and infant-related sociodemographic and clinical variables at maternal discharge (T0) and at 6 (T1), 12 (T2), 24 (T3), and 36 (T4) months after delivery. Multiple linear regression models were fitted to investigate the effect of these variables on the mothers' QoL. RESULTS: The WHOQOL-BREF physical domain scores were higher at T1 and T2 compared to T0 (p = 0.013). Maternal variables that contributed to maternal QoL scores (p < 0.05) were stable marital union (b = 13.60; T0), family income (b = -12.75; T3), Evangelical religion (b = 8.11; T4), and beck depression inventory (BDI) score (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3, and T4). Infants' variables that most affected maternal QoL (p < 0.05) were posthemorrhagic hydrocephalus (PHH) (-18.84 ≤ b ≤ -10.05; T1, T2, and T4), bronchopulmonary dysplasia (BPD) (b = -7.41; T2), female gender (b = 8.09; T2), and SNAPPE severity score (b = -0.23; T3). CONCLUSION: Mothers of preterm infants with VLBW exhibited transient improvements in physical well-being during the first year after delivery. The presence of depressive symptoms in mothers and the diagnosis of PHH or BPD were negatively associated with QoL. Social, religious, and economic aspects were also important factors for the QoL of mothers of preterm infants with VLBW.

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Entre os meses de março de 2000 e dezembro de 2005, 87 espécimes de L. gastrophysus foram obtidos de supermercados e empresas de exportação localizadas nos municipios de Cabo Frio, Niteroi, Duque de Caxias e Rio de Janeiro. Os peixes foram necropsiados, filetados e seus órgãos investigados para presença de helmintos. Dois espécimes (2,3 por cento) estavam parasitados por plerocecoides de Diphyllobothrium Cobbold, 1858 na cavidade abdominal e serosa do intestino, com intensidade média de um parasito por peixe e abundância média de 0,02, mostrando baixo potencial infectivo. Este é o primeiro registro de plerocercoides de Diphyllobothrium sp. no peixe sapo-pescador.(AU)

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Entre os meses de março de 2000 e dezembro de 2005, 87 espécimes de L. gastrophysus foram obtidos de supermercados e empresas de exportação localizadas nos municipios de Cabo Frio, Niteroi, Duque de Caxias e Rio de Janeiro. Os peixes foram necropsiados, filetados e seus órgãos investigados para presença de helmintos. Dois espécimes (2,3 por cento) estavam parasitados por plerocecoides de Diphyllobothrium Cobbold, 1858 na cavidade abdominal e serosa do intestino, com intensidade média de um parasito por peixe e abundância média de 0,02, mostrando baixo potencial infectivo. Este é o primeiro registro de plerocercoides de Diphyllobothrium sp. no peixe sapo-pescador.

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From December 2006 to March 2008, 60 specimens of Paralichthys isosceles and 25 specimens of P. patagonicus were investigated for helminths. One hundred and sixty-nine digeneans were recovered and parasites were identified as juvenile didymozoids of two types. Torticaecum and Neotorticaecum were found in 48 of the 60 P. isosceles (80%) and 10 of the 25 P. patagonicus (40%). Torticaecum and Neotorticaecum are reported for the first time in fish in South America (Brazil), found in the Atlantic Ocean. Morphometrics and illustrations are presented.

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Sixty specimens of Paralichthys isosceles captured in the southeastern Brazilian coast were investigated for helminths from October 2006 to March 2008. One thousand eight hundred and twenty larvae (third and fourth stages) of Hysterothylacium sp. were recovered from the abdominal cavity, free or inserted in the mesentery, intestine, stomach, stomach wall, liver, spleen, ovaries, and serosas of heart, kidneys, ovaries and abdominal musculature. Gross lesions appeared as nodules in the stomach mucosa and intestinal serosa. Histological examination of these nodules revealed sections of Hysterothylacium sp. larvae inserted in the abdominal musculature, in the submucosa, muscular and serosa layers of the stomach and intestine. Associated granulomas consisted of fibrous connective tissue, macrophages and lymphocytes that surrounded, besides the larvae, necrotic material and tunnels with acidophilic lining, sometimes devoid of inflammatory reaction. The pathological alterations as well as the occurrence of Hysterothylacium sp. are reported for the first time in this host. The parasitic indexes refer to a prevalence of 100%, mean intensity of 30.3, mean abundance of 32 and range of intensity variation from 1 to 596.

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Adherence is integral to improving and maintaining the health and quality of life of people living with HIV. Two-hundred HIV-positive adults recruited from teaching hospitals and non-governmental organizations (NGOs) in Rio de Janeiro City were assessed on socio-demographic factors, adherence to antiretroviral therapy (ART) and psychosocial factors hypothesized to be associated with ART. Predictors of non-adherence were analyzed using bivariate and multivariate analyses. Self-reported medication adherence was high (82% had adherence >90%). Non-adherence was associated with personal factors (i.e. sexual orientation, self-efficacy), physical factors (i.e. loss of appetite) and interpersonal factors (i.e. doctor-patient relationship). Adherence in Brazil is as good, if not better, than that seen in the US and western Europe, which is noteworthy since the sample was derived predominantly from public healthcare settings. It is possible that the connection to NGOs in Rio de Janeiro City played a helpful role in achieving high levels of adherence in this sample of people living with HIV and AIDS. Recommendations, based on study findings, include enhancing and sustaining supportive services for NGOs, promoting patient self-efficacy and behavioral skills for adherence, increasing social network support and having healthcare providers directly address patients' medication beliefs, attitudes and experience with side effects.

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