RESUMO
To evaluate the effect of yoga on the frequency of MetS and its impact on cardiovascular risk markers in climacteric women. We recruited 84 sedentary women between 40 and 65 years diagnosed with MetS. Participants were randomly assigned to a 24-week yoga intervention or control group. We evaluated the frequency of MetS and changes in the individual components of MetS at baseline and after 24 weeks. We also assessed the impact of yoga practices on cardiovascular risk through the following markers: High-sensitivity C-reactive Protein (hs-CRP), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), and Atherogenic Index of Plasma (AIP). The frequency of MetS reduced significantly after 24 weeks of yoga practice (- 34.1%; p < 0.001). Statistical analysis showed that the frequency of MetS was significantly lower in the yoga group (65.9%; n = 27) than in the control group (93.0%; n = 40) after 24 weeks (p = 0.002). Regarding the individual components of MetS, yoga practitioners had statistically lower waist circumference, systolic blood pressure, triglycerides, HDLc, and glucose serum concentrations than the control group after 24 weeks. Yoga practitioners also had a significant decrease in hs-CRP serum concentrations (3.27 ± 2.95 mg/L vs. 2.52 ± 2.14 mg/L; p = 0.040) and a lower frequency of moderate or high cardiovascular risk (48.8% vs. 34.1%; p = 0.001) after 24 weeks of practice. The yoga group had LAP values significantly lower than the control group after the intervention period (55.8 ± 38.04 vs. 73.9 ± 40.7; p = 0.039). Yoga practice demonstrated to be an effective therapeutic to manage MetS and reduce cardiovascular risk in climacteric women.
Assuntos
Doenças Cardiovasculares , Climatério , Síndrome Metabólica , Yoga , Feminino , Humanos , Adiposidade , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco de Doenças Cardíacas , Síndrome Metabólica/prevenção & controle , Fatores de Risco , Adulto , Pessoa de Meia-Idade , IdosoRESUMO
Este estudo teve o objetivo de promover interseção entre direito e saúde e refletir sobre o papel do operador do direito perante as políticas de saúde. Foram realizados um estudo de caso com base em análise documental da petição inicial de uma Ação de Improbidade Administrativa sobre Saúde Mental e pesquisa bibliográfica sobre as políticas de saúde mental, o bloco carnavalesco Os Conspirados e conceitos de saúde relacionados. A ação judicial desconsiderou o bloco de carnaval dos usuários da saúde mental como ação de saúde, reprovando a destinação de verbas do Fundo Municipal de Saúde de Ouro Preto (MG) para sua manutenção. Observou-se, a partir desse caso, uma necessidade de maior aproximação entre as áreas e os atores do direito e da saúde para melhorar a técnica, o diálogo e a racionalização da judicialização da saúde.
This study aimed to promote the intersection between law and health and reflect on the role of the law operator in relation to health policies. A case study was conducted based on documentary analysis of the initial petition of an Administrative Misconduct Action on Mental Health, and a bibliographic research was also conducted on Mental Health policies, the carnival block Os Conspirados and related health concepts. The lawsuit disregarded the carnival block of mental health users as a health action, disapproving the allocation of funds from Ouro Preto's Municipal Health Fund for its maintenance. It was observed, from this case, that is a need for closer approximation between the areas and the actors of law and health, to improve the technique, dialogue and rationalization of the judicialization of health.
RESUMO
Chagas disease, caused by the protozoan Trypanosoma cruzi, is considered to be a multifactorial disease associated with host and parasite genetics, which influence clinical aspects of the disease and other host conditions. In order to understand better the evolution of the disease, this study intended to evaluation of parasite and host genetics in two generations of a family with Chagas disease from the Alto Paranaiba region, Minas Gerais, Brazil, comprising a mother and her five daughters. Several features were evaluated, including the characterization of T. cruzi directly from the blood of patients, host polymorphisms of genes related to cardiomyopathy (TNF, WISP1, CCR5, and TGF-ß1) and clinical aspects of the patients. To verify the intraspecific variability of the parasite, the characterization was done directly from human blood using the PCR-LSSP technique and analyzed based on Dice coefficient and unweighted pair group analysis (UPGMA). The host polymorphism was evaluated by PCR-RFLP. The global results showed low variability of the parasites characterized from blood of patients, through Shannon index (0.492) and mean heterozygosity value per locus (0.322). All six patients presented the same genetic polymorphism profile for TNF, WISP1, and TGF-ß1, and only one patient was homozygous to CCR5, which suggests that there is no association between the clinical aspects of the patients and their genetic profiles. In conclusion, the findings confirm that the understanding of the clinical evolution of Chagas disease goes beyond the genetic aspects of the parasite and the host.
Assuntos
Proteínas de Sinalização Intercelular CCN/genética , Doença de Chagas/genética , Doença de Chagas/patologia , Proteínas Proto-Oncogênicas/genética , Receptores CCR6/genética , Fator de Crescimento Transformador beta1/genética , Trypanosoma cruzi/genética , Fator de Necrose Tumoral alfa/genética , Idoso , Idoso de 80 Anos ou mais , Animais , Brasil , Doença de Chagas/parasitologia , DNA de Protozoário/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo Genético/genética , Polimorfismo de Fragmento de RestriçãoRESUMO
We developed a novel murine model of long-term infection with Trypanosoma cruzi with the aim to elucidate the pathogenesis of megacolon and the associated adaptive and neuromuscular intestinal disorders. Our intent was to produce a chronic stage of the disease since the early treatment should avoid 100% mortality of untreated animals at acute phase. Treatment allowed animals to be kept infected and alive in order to develop the chronic phase of infection with low parasitism as in human disease. A group of Swiss mice was infected with the Y strain of T. cruzi. At the 11th day after infection, a sub-group was euthanized (acute-phase group) and another sub-group was treated with benznidazole and euthanized 15 months after infection (chronic-phase group). Whole colon samples were harvested and used for studying the histopathology of the intestinal smooth muscle and the plasticity of the enteric nerves. In the acute phase, all animals presented inflammatory lesions associated with intense and diffuse parasitism of the muscular and submucosa layers, which were enlarged when compared with the controls. The occurrence of intense degenerative inflammatory changes and increased reticular fibers suggests inflammatory-induced necrosis of muscle cells. In the chronic phase, parasitism was insignificant; however, the architecture of Aüerbach plexuses was focally affected in the inflamed areas, and a significant decrease in the number of neurons and in the density of intramuscular nerve bundles was detected. Other changes observed included increased thickness of the colon wall, diffuse muscle cell hypertrophy, and increased collagen deposition, indicating early fibrosis in the damaged areas. Mast cell count significantly increased in the muscular layers. We propose a model for studying the long-term (15 months) pathogenesis of Chagasic megacolon in mice that mimics the human disease, which persists for several years and has not been fully elucidated. We hypothesize that the long-term inflammatory process mediates neuronal damage and intramuscular and intramural denervation, leading to phenotypic changes in smooth muscle cells associated with fibrosis. These long-term structural changes may represent the basic mechanism for the formation of the Chagasic megacolon.
Assuntos
Doença de Chagas/patologia , Modelos Animais de Doenças , Sistema Nervoso Entérico/patologia , Megacolo/patologia , Neurônios/patologia , Animais , Doença de Chagas/complicações , Denervação , Feminino , Megacolo/complicações , Camundongos , Músculo Liso/inervaçãoRESUMO
Este trabalho foi composto por um estudo transversal, feito em Ouro Preto, Minas Gerais, Brasil, para avaliar os fatores associados à qualidade de vida em mulheres no climatério. Foram usados o questionário de qualidade de vida SF36 e uma entrevista sobre dados socioeconômicos, demográficos, uso de medicamentos e hábitos de vida. A média de idade das 113 participantes foi de 53,3 ± 4,4 anos. Dessas, 49,6% conviviam com companheiro e 77,4% eram usuárias exclusivas do Sistema Único de Saúde. Foi observado que a renda de 54% delas era menor ou igual a um salário mínimo e 69% tinham baixa escolaridade. Na avaliação da associação entre as variáveis da entrevista e os oito domínios do questionário SF36, observouse diferença significativa na qualidade de vida em relação a: (i) idade no domínio saúde mental; (ii) viver com ou sem companheiro nos domínios estado geral de saúde e limitação por aspecto emocional; (iii) presença de alguma doença crônica nos domínios estado geral de saúde e saúde mental; (iv) uso de medicamento contínuo no domínio saúde mental. Concluise que o aumento da idade, a presença de doenças crônicas e o uso de medicamentos agrava a qualidade de vida dessas mulheres. Entretanto, a convivência com parceiro modifica positivamente alguns domínios associados à qualidade de vida.
A crosssectional study was conducted in Ouro Preto, Minas Gerais, Brazil to evaluate the factors associated with quality of life in climacteric women. It was used for this evaluation the questionnaire SF36 of quality of life and one interview about socioeconomic, demographic, medicines used and living habits. The average age of the 113 participant was 53.3±4.4 years, 49.6% living with a partner and 77.4% using the public health system as the exclusive health insurance. It was observed that the income of 54% of them were less than or equal to the minimum wage and 69% had low education. Assessing the association between the variables of the interview and the eight domains of the SF36, there was significant difference in the quality of life in relation to: (i) age, in the mental health domain; (ii) living with or without a partner, related to general health and limitation by emotional aspect; (iii) the presence of any chronic disease correlated to general health and mental health; (iv) continuoususe medication in the mental health domain. Concluding, the higher the age, in association with chronic diseases and medicines intake, the worse the quality of life of these women. Moreover, living with a partner positively modifies some areas associated with quality of life.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Climatério , Uso de Medicamentos , Menopausa , Qualidade de Vida , Inquéritos e Questionários/estatística & dados numéricosRESUMO
BACKGROUND: Trypanosoma cruzi is classified into six discrete taxonomic units (DTUs). For this classification, different biological markers and classification criteria have been used. The objective was to identify the genetic profile of T. cruzi samples isolated from patients of two municipalities of Jequitinhonha Valley, MG, Brazil. METHODS: Molecular characterization was performed using two different criteria for T. cruzi typing to characterize 63 T. cruzi samples isolated from chronic Chagas disease patients. The characterizations followed two distinct methodologies. Additionally, the RAPD technique was used to evaluate the existence of genetic intragroup variability. RESULTS: The first methodology identified 89% of the samples as TcII, but it was not possible to define the genetic identity of seven isolates. The results obtained with the second methodology corroborated the classification as TcII of the same samples and defined the classification of the other seven as TcVI. RAPD analysis showed lower intra-group variability in TcII. CONCLUSIONS: The results confirmed the preliminary data obtained in other municipalities of the Jequitinhonha Valley, showing a predominance of TcII, similar to that verified in northeast/south axis of Brazil and the first detection of TcVI in the study region. The second protocol was more simple and reliable to identify samples of hybrid character.
Assuntos
Doença de Chagas/parasitologia , Tipagem Molecular/métodos , Trypanosoma cruzi/classificação , Trypanosoma cruzi/isolamento & purificação , Brasil , Doença Crônica , Cidades , Genótipo , Humanos , Trypanosoma cruzi/genéticaRESUMO
The present study aims at establishing whether the diversity in pathogenesis within a genetically diverse host population infected with a single polyclonal strain of Trypanosoma cruzi is due to selection of specific subpopulations within the strain. For this purpose we infected Swiss mice, a genetically diverse population, with the polyclonal strain of Trypanosoma cruzi Berenice-78 and characterized via LSSP-PCR the kinetoplast DNA of subpopulations isolated from blood samples collected from the animals at various times after inoculation (3, 6 and 12 months after inoculation). We examined the biological behavior of the isolates in acellular medium and in vitro profiles of infectivity in Vero cell medium. We compared the characteristics of the isolates with the inoculating strain and with another strain, Berenice 62, isolated from the same patient 16 years earlier. We found that one of the isolates had intermediate behavior in comparison with Berenice-78 and Berenice-62 and a significantly different genetic profile by LSSP-PCR in comparison with the inoculating strain. We hereby demonstrate that genetically distinct Trypanosoma cruzi isolates may be obtained upon experimental murine infection with a single polyclonal Trypanosoma cruzi strain.
Assuntos
Doença de Chagas/parasitologia , Interações Hospedeiro-Parasita , Trypanosoma cruzi/genética , Animais , Chlorocebus aethiops , DNA de Cinetoplasto , Modelos Animais de Doenças , Variação Genética , Humanos , Camundongos , Reação em Cadeia da Polimerase/métodos , Células VeroRESUMO
Trypanosoma cruzi infection may be caused by different strains with distinct discrete typing units (DTUs) that can result in variable clinical forms of chronic Chagas disease. The present study evaluates the immune response and cardiac lesions in dogs experimentally infected with different T. cruzi strains with distinct DTUs, namely, the Colombian (Col) and Y strains of TcI and TcII DTU, respectively. During infection with the Col strain, increased levels of alanine aminotransferase, erythrocytes, haematocrit and haemoglobin were observed. In addition, CD8+ T-lymphocytes isolated from the peripheral blood produced higher levels of interleukin (IL)-4. The latter suggests that during the acute phase, infection with the Col strain may remain unnoticed by circulating mononuclear cells. In the chronic phase, a significant increase in the number of inflammatory cells was detected in the right atrium. Conversely, infection with the Y strain led to leucopoenia, thrombopoenia, inversion of the ratio of CD4+/CD8+ T-lymphocytes and alterations in monocyte number. The Y strain stimulated the production of interferon-γ by CD4+ and CD8+ T-lymphocytes and IL-4 by CD8+ T-cells. In the chronic phase, significant heart inflammation and fibrosis were observed, demonstrating that strains of different DTUs interact differently with the host.
Assuntos
Animais , Cães , Doença de Chagas/imunologia , Miocárdio/patologia , Trypanosoma cruzi/imunologia , Alanina Transaminase/sangue , /metabolismo , /metabolismo , Doença Crônica , Doença de Chagas/sangue , Doença de Chagas/patologia , Modelos Animais de Doenças , Contagem de Eritrócitos , Citometria de Fluxo , Fibrose/imunologia , Fibrose/parasitologia , Hematócrito , Hemoglobinas/análise , /metabolismo , Contagem de Linfócitos , Leucócitos Mononucleares/química , Miocárdio/química , Miocárdio/imunologia , Fenótipo , Trypanosoma cruzi/metabolismoRESUMO
Chagasic megaoesophagus and megacolon are characterised by motor abnormalities related to enteric nervous system lesions and their development seems to be related to geographic distribution of distinct Trypanosoma cruzi subpopulations. Beagle dogs were infected with Y or Berenice-78 (Be-78) T. cruzi strains and necropsied during the acute or chronic phase of experimental disease for post mortem histopathological evaluation of the oesophagus and colon. Both strains infected the oesophagus and colon and caused an inflammatory response during the acute phase. In the chronic phase, inflammatory process was observed exclusively in the Be-78 infected animals, possibly due to a parasitism persistent only in this group. Myenteric denervation occurred during the acute phase of infection for both strains, but persisted chronically only in Be-78 infected animals. Glial cell involvement occurred earlier in animals infected with the Y strain, while animals infected with the Be-78 strain showed reduced glial fibrillary acidic protein immunoreactive area of enteric glial cells in the chronic phase. These results suggest that although both strains cause lesions in the digestive tract, the Y strain is associated with early control of the lesion, while the Be-78 strain results in progressive gut lesions in this model.