Vitamin D deficiency and seasonal variation over the years in São Paulo, Brazil.

Brazil is a tropical/subtropical geographic area with elevated ultraviolet (UV) radiation. We report very high prevalence of vitamin D deficiency in a large database of Brazilian subjects and show seasonal and reciprocal relationship between vitamin D and parathyroid hormone (PTH) over the years in this tropical area. INTRODUCTION: We aim to examine the prevalence of vitamin D deficiency, characterize the temporal relationship between 25-hydroxyvitamin D levels (25(OH)D) and intact PTH (iPTH) according to seasons, and investigate potential associations between 25(OH)D levels and extra-skeletal outcomes in a Brazilian population. METHODS: We retrospectively determined population weekly mean concentrations of unpaired 25(OH)D and iPTH using 39,004 laboratory results of Brazilian individuals of both genders aged 2 to 95 years. The 25(OH)D and iPTH distributions were normalized, and the means fit with a sinusoidal function. Potential associations between 25(OH)D serum levels and inflammatory markers, fasting glucose, HbA1c and Homeostasis Model Assessment index (HOMA) were examined. RESULTS: Of the samples, 33.9 % had 25(OH)D serum concentrations lower than 20 ng/mL, while the vast majority (70.7 %) were found to be vitamin D deficient or insufficient (<30 ng/mL). Vitamin D deficiency was significantly higher during the winter as compared to the summer (38.4 % <20 ng/mL and 75.5 % <30 ng/mL versus 23.3 % <20 ng/mL and 62.5 % <30 ng/mL, respectively; p < 0.001). Seasonal variation was observed for both 25(OH)D and iPTH. 25(OH)D peaks occurred in March and troughs in September. iPTH levels showed an inverted pattern of peaks and troughs with a delay of 1 ± 5 week. 25(OH)D was significantly associated with inflammatory markers but not with glucose homeostasis. CONCLUSIONS: A sinusoidal interrelationship has been detected between vitamin D and PTH in this tropical population. A large percentage of the individuals showed vitamin D deficiency. Public health strategies are needed to better understand and manage this very high and apparently contradictory prevalence of vitamin D deficiency.

Physicochemical characteristics and pollen spectra of organic and non-organic honey samples of Apis mellifera L.

The aim of this research was to analyze and compare 17 honey samples, 11 organic and six non-organic Apis mellifera honey. The samples were analyzed concerning moisture, hydroxymethylfurfural, diastase index, water activity, color, total sugar, reducing sugar, sucrose, ash, viscosity, electrical conductivity, pH, acidity, and formol index. With the exception of acidity, reducing sugar and diastase index, the averages of other parameters were different between the two groups. All samples of organic honey presented moisture values between 23.50 and 24.40%. Among the nonorganic honey samples, two presented apparent sucrose amount upper the maximum limit established by the Brazilian Legislation. According to the quantitative analysis of pollen sediments in the honey samples and frequency of pollen types in 17 honey samples, 41.20% were classified as unifioral, and the remainder as polifioral.

Phenotypic screening of nonsteroidal anti-inflammatory drugs identified mefenamic acid as a drug for the treatment of schistosomiasis.

BACKGROUND: Treatment and control of schistosomiasis, one of the most insidious and serious parasitic diseases, depend almost entirely on a single drug, praziquantel. Since the funding for drug development for poverty-associated diseases is very limited, drug repurposing is a promising strategy. In this study, 73 nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used in medical and veterinary fields were evaluated for their anti-schistosomal properties. METHODS: The efficacy of NSAIDs was first tested against adult Schistosoma mansoni ex vivo using phenotypic screening strategy, effective drugs were further tested in a murine model of schistosomiasis. The disease parameters measured were worm and egg burden, hepato- and splenomegaly. FINDINGS: From 73 NSAIDs, five (mefenamic acid, tolfenamic acid, meclofenamic acid, celecoxib, and diclofenac) were identified to effectively kill schistosomes. These results were further supported by scanning electron microscopy analysis. In addition, the octanol-water partition coefficient, both for neutral and ionized species, revealed to be a critical property for the ex vivo activity profile. Compounds were then tested in vivo using both patent and a prepatent S. mansoni infection in a mouse model. The most effective NSAID was mefenamic acid, which highly reduced worm burden, egg production, and hepato- and splenomegaly. INTERPRETATION: The treatment regimen used in this study is within the range for which mefenamic acid has been used in clinical practice, thus, it is demonstrated the capacity of mefenamic acid to act as a potent anti-schistosomal agent suitable for clinical repurposing in the treatment of schistosomiasis.

Antischistosomal agents: state of art and perspectives.

Praziquantel has remained the drug of choice for schistosomiasis chemotherapy for almost 40 years. The pressing need to develop a new antischistosomal drug may necessitate exploring and filtering chemotherapeutic history to search for the most promising ones. In this context, this review attempts to summarize all progress made in schistosomiasis chemotherapy from the early 20th century (mid-1910s) to 2016. We gathered almost 100 compounds providing information on therapeutic action, specifically covering at least first in vivo studies in animal model and in vitro. Pharmacokinetic and toxicity profiles of antischistosomal agents were also described. Preclinical studies indicate a handful of promising future candidates.

Antiparasitic, structural, pharmacokinetic, and toxicological properties of riparin derivatives.

Schistosomiasis, caused by helminth flatworms of the genus Schistosoma, is one of the most important parasitic diseases in the world, affecting over 200 million people in developing countries. Riparins are natural alkamides found in Aniba riparia (Lauraceae) fruits that possess several pharmacological properties. In this study, we reported the synthesis, characterization and structural analysis of six riparin derivatives (A-F), as well as their schistosomicidal activity against S. mansoni worms together with a biological, pharmacokinetic and toxicological in silico evaluation. Firstly, these compounds were synthesized, purified and characterized by elemental analysis, FT-IR spectroscopy, X-ray diffraction and theoretical calculations to evaluate their stability and conformation. Next, the schistosomicidal activity of the riparins was tested against S. mansoni worms. Bioassays revealed that Riparins E and F were the most active compounds, showing half-maximum inhibitory concentration at low micromolar ranges (IC50 values ~10 µM). Also, confocal laser scanning microscopy studies revealed tegumental damage in parasites after exposition with Riparins B, E and F. Additionally, based on MTT assay, all tested riparins showed no cytotoxic potential toward mammalian cells. Finally, in silico analyses were used to predict the absorption, distribution, metabolism, elimination and toxicity (ADMET) of the compounds. Taken together, the results revealed a promising ADMET profile and suggested that riparins could be starting points for lead optimization programs for natural products with antischistosomal properties.

Field-induced columnar transition of biocompatible magnetic colloids: An aging study by magnetotransmissivity.

The field dependence of the optical transmission of tartrate-coated and polyaspartate-coated magnetite-based aqueous colloids was studied. The colloidal stock samples were diluted to prepare a series of samples containing different particle volume fractions ranging from 0.17% up to 1.52% and measured at distinct times after preparation (1, 30, 120, 240, and 1460 days). We show that the magneto-transmissivity behavior is mainly described by the rotation of linear chains, at the low-field range, whereas the analysis of the data provided the measurement of the average chain length. Results also reveal that the optical transmissivity has a minimum at a particular critical field, whose origin is related to the onset of columns of chains built from isolated particle chains, i.e., due to a columnar phase transition. We found the critical field reducing as the particle volume fraction increases and as the sample's aging time increases. To investigate the origin of this phenomenon we used phase condensation models and Mie's theory applied to a chain of spheres and to an infinite cylinder. Possible implications for magnetophotonic colloidal-based devices and biomedical applications were discussed.

Physicochemical characteristics and pollen spectra of organic and non-organic honey samples of Apis mellifera L.

The aim of this research was to analyze and compare 17 honey samples, 11 organic and six non-organic Apis mellifera honey. The samples were analyzed concerning moisture, hydroxymethylfurfural, diastase index, water activity, color, total sugar, reducing sugar, sucrose, ash, viscosity, electrical conductivity, pH, acidity, and formol index. With the exception of acidity, reducing sugar and diastase index, the averages of other parameters were different between the two groups. All samples of organic honey presented moisture values between 23.50 and 24.40 percent. Among the nonorganic honey samples, two presented apparent sucrose amount upper the maximum limit established by the Brazilian Legislation. According to the quantitative analysis of pollen sediments in the honey samples and frequency of pollen types in 17 honey samples, 41.20 percent were classified as unifioral, and the remainder as polifioral.

O objetivo deste trabalho foi analisar e comparar 17 amostras de Apis mellifera mel, sendo 11 orgânicos e seis não orgânicos. As amostras foram analisadas quanto à umidade, hidroximetilfurfural, índice de diastase, atividade de água, cor, açúcares totais, açúcares redutores, sacarose, cinzas, viscosidade, condutividade elétrica, pH, acidez e índice de formol. Com exceção da acidez, açúcar redutor e índice de diastase as médias dos demais parâmetros analisados diferiram entre os dois grupos. Todas as amostras de mel orgânico analisadas apresentaram valores de umidade entre 23,50 to 24,40 por cento. Das amostras de mel não orgânico analisadas, duas apresentaram quantidades de sacarose aparente acima do limite máximo estabelecido pela legislação brasileira. De acordo com as análises quantitativas dos sedimentos polínicos e a frequência dos tipos polínicos observados nas 17 amostras de mel analisadas, 41,20 por cento foram classificadas como monofloral e o restante como polifloral.

A nalbufina em neuroleptoanestesia: drobufina / Nalbuphine in neuroleptoanesthesia: drobufina

O cloridrato de nalbufina (Nubain) é um analgésico agonista-antagonista que tem uma potência analgésica semelhante à da morfina sem, no entanto, produzir depressäo respiratória pós-operatória. Foi usado neste ensaio clínico associado ao droperidol na técnica de neuroleptoanestesia. Foram estudados 21 padientes de ambos os sexos, com idade média de 41,5 ñ 10,1 anos, pêso corporal de 56,7 ñ 8,9 kg, estado físico I ou II (ASA), escalados para cirurgia abdominal na quase totalidade dos casos. Imediatamente antes da induçäo da anestesia eram medidas a freqüência resperatória, o volume minuto, a pressäo arterial e a freqüência cardíaca. Os parâmetros respiratórios serviram de controle para a avaliaçäo do comportamento respiratório ao final da cirurgia. A pressäo arterial foi medida a cada 5 minutos; os batimentos cardíacos e o eletrocardiograma foram monitorizados continuamente durnate a cirurgia. Para avaliaçäo hemodinâmica dos pacientes foram registradas as pressöes arteriais sistólicas e diastólicas e a freqüência cardíaca nas seguintes etapas: vista pré-operatória (controle), imediatamente antes da induçäo da anestesia (inicial), durante a intubaçä ortotraqueal (IOT), no início da cirurgia e daí em diante de 15 em 15 minutos durante o restante da 1ª hora, de 30 em 30 minutos até completar a 3ª hora e a úlrima, ao final da cirurgia. Os mesmos parâmetros eram verificados juntamente com os parâmetros respiratórios no pós-operatório imediato. A induçäo da anestesia foi realizada com 12,38 ñ 2,06 ml da mistura nalbufina/droperidol (Ddrobufina) em todos os casos. A IOT foi realizada sob a açäo do brometo de pancurônio na dose de 0,1 mg.kg elevado a menos um. A anestesia foi mantida com nalbufina em doses intermitentes, óxido nitroso 66 por cento em oxigênio e brometo de pancurônio. A duraçäo média das anestesias foi 208,8 ñ 69,5 minutos. A dose média de nalbufina foi de 359,0 ñ 154,8 mg o que equivale a 6,20 ñ 2,33 mg.kg elevado a menos um ou 0,03 ñ 0,051 µg.kg elevado a menos um. Ao final da cirurgia, depois da reversäo do efeito do relaxante muscular confirmada com a obtençäo de tétano muscular com corrente de 100HZ aplicada através de estimulador de nervo periférico, foi iniciada a avaliaçäo do comportamento hemodinâmico e respiratório no pós-operatório. Gases sangüíneos foram coletados em 10 pacientes. A análise estatística dos resultados foi feita através do teste "t" de Student

Distrofia muscular miotônica / Muscular Myothonic Distrophy

A Distrofia Miotônica é um distúrbio miopática herdado de forma dominante que, em geral, manifesta-se na terceira ou quarta década de vida, embora possa aparecer na infância. Apresenta-se caso de Distrofia Muscular Miotônica, discutindo-se as características clínicas e laboratoriais, diagnóstico diferencial e evoluçäo

Lisencefalia / Lissencephaly

A lisencefalia ou Agiria faz parte das mal-formaçöes cerebrais congênitas hemisféricas e relacioandas, sendo de ocorrência rara. O quadro clínico é inespecífico, confundindo-se com inúmeras patologias que cursam com retardo no desenvolvimento neuropsicomotor, hiperatividade e crises epilépticas

Hipertrofia ou alargamento benigno do espaço subaracnóide / Hyphertrophy or benign lenghtening of subaracnoidal space

Relata-se caso de macrocefalia relacionada ao alargamento benigno do espaço subaracnóide. Discutem-se os achados clínicos, etiopatogenia e manuseio dessa condiçäo. Salienta-se a importância do diagnóstico radiológico (tomografia computadorizada) e evoluçäo caracteristicamente favorável dos pacientes

Síndrome de Rett / Rett's syndrome

Relata-se caso de síndrome de Rett, patologia relativamente comum, sendo mais freqüente que a Fenilcetonúria. Consiste em demenciamento progressivo, estereotipias manuais, retardo no desenvolvimento motor e crises epilépticas

Empiema epidural lombar / Lumbar epidural empyema

Relata-se dois casos de Empiema Epidural Lombar, resultantes da disseminaçao por continuidade de lesoes de partes moles, com subseqüente comprometimento de raízes nervosas. Comenta-se a fisiopatologia e os fatores de risco, importância do diagnóstico precoce, exames complementares e conduta terapêutica.

Demência / Dementia

Freqüentemente o médico é consultado devido à alteraçöes mentais que resultam na reduçäo da capacidade produtiva do trabalho ou de liderança familiar. Este fato pode indicar o início de tumores cerebrais, hematomas subdurais crônicos ou o desenvolvimento de intoxicaçäo crônica por drogas, meningoencefalite crônica (Sífilis), doença degenerativa cerebral, hidrocefalia de pressäo normal ou doença psiquiátrica. Na maioria das vezes, o diagnóstico näo oferece grandes perspectivas. Mas, a medicina moderna oferece os meios para o tratamento de muitas destas condiçöes e, em muitos casos, o restabelecimento da saúde e da capacidade produtiva. Modernas tecnologias diagnósticas permitem o reconhecimento e entendimento precoce dos processos patológico, aumentando as possibilidades de recuperaçäo com tratamento apropriados

Complicaçöes neurológicas na síndrome da imunodeficiência adquirida / Neurological problems in acquired immunodeficiency syndrome

Dos pacientes portadores da SIDA, 75 por cento desenvolveräo sintomas e sinais neurológicos. Em cerca de 10 por cento dos pacientes com SIDA, as primeiras manifestaçöes estäo relacionadas com complicaçöes neurológicas. Analisam-se as complicaçöes neurológicas mais comuns com os respectivos meios diagnósticos. a incidência da SIDA em homossexuais e nos toxicômanos com uso endovenoso é extremamente alto. A suspeita de diagnóstico da SIDA, sempre deve ser uscitada quando uma pessoa apresentar uma infecçäo oportunista

Paracoccidioidomicose do sistema nervoso central / Paracoccidioidomycosis of central nervous sistem

Relata-se dois casos de infecçäo fúngica dos Sistema Nervoso Central (Paracoccidioidomicose) envolvendo o cerebele e determinando hidrocefalia obstrutiva. O manuseio dos casos é apresentado, revisando-se a literatura pertinente