Epidemiologic Study of Charcot-Marie-Tooth Disease: A Systematic Review.

BACKGROUND: Charcot-Marie-Tooth disease (CMT) is the most common inherited neuropathy. CMT is classified into 2 main subgroups: CMT type 1 (CMT1; demyelinating form) and CMT type 2 (CMT2; axonal form). The objectives of this study were to systematically review and assess the quality of studies reporting the incidence and/or prevalence of CMT worldwide. SUMMARY: A total of 802 studies were initially identified, with only 12 meeting the inclusion criteria. CMT prevalence was reported in 10 studies and ranged from 9.7/100,000 in Serbia to 82.3/100,000 in Norway. The frequency of the main subtypes varied from 37.6 to 84% for CMT1 and from 12 to 35.9% for CMT2; the country with the lowest prevalence of CMT1 was Norway, and the country with the highest prevalence of CMT1 was Iceland; on the other hand, CMT2 was least prevalent in the United Kingdom and most prevalent in Norway. KEY MESSAGES: This review reveals the gaps that still exist in the epidemiological knowledge of CMT around the world. Published studies are of varying quality and utilise different methodologies, thus precluding a robust conclusion. Additional research focusing on epidemiological features of CMT in different nations and different ethnic groups is needed.

Nutrient Allocation and Growth Responses of Senegalia polyphylla under Varied Fertilizer Regimes for Effective Forest Recovery.

To restore invaded areas, planting fast-growing native species such as Senegalia polyphylla (DC.) Britton & Rose (Fabaceae) is widely used. However, invasive grasses reduce light availability, alter fire regimes, and compete for water and nutrients, hindering the growth of native trees. Fertilization practices influence the competition dynamics between natives and invasives by altering soil fertility. Therefore, this study investigated the effects of mineral and organic fertilization on the nutritional status and growth of S. polyphylla cultivated during the first 120 days after transplanting. The experiment was conducted in a completely randomized design comprising five treatments and four replications, along with the unfertilized control (0-0%) as an additional treatment. Dystrophic red latosol and different proportions of mineral and organic fertilizers were used. The variables evaluated included dry mass of aboveground parts and roots, nutrient content in leaves, and nutrient use efficiency. The results showed that fertilizations with high nutrient concentrations (100-0% and 75-25%) resulted in greater accumulation of N, P, and K in the leaves, while balanced fertilization (50-50% and 25-75%) led to greater root dry mass. These results emphasize the importance of strategically choosing fertilizer formulations to promote the healthy development of seedlings in areas subject to interference from invasive grasses.

Qualidade de vida de mulheres com excesso de peso / Quality of life of overweight women / Quality of life of overweight women

Objetivo: Identificar características sociodemográficas e clínicas de mulheres com excesso de peso e descrever a associação entre qualidade de vida e estado nutricional. Método: estudo transversal, com 82 mulheres de ambulatório público, na Bahia. Utilizou-se formulários sociodemográfico e clínico, o SF-36, a estatística descritiva, o teste de Kruskal Wallis e significância estatística de 5%. Resultados: A maioria era negra (92,7%), tinha de 40 a 59 anos (85,4%), companheiro (51,2%), até o ensino médio (61,0%), trabalho remunerado (52,4%) e renda mensal ≤ 3 salários-mínimos (86,6%). Tinha obesidade grau I 34,1% e III 31,7% e duas comorbidades 32,9%. Os domínios dor, estado geral de saúde e vitalidade foram mais comprometidos, com medianas de 51, 52, e 55, respectivamente. Mulheres com obesidade III apresentaram pior qualidade de vida nos domínios capacidade funcional, aspectos físicos e dor (p≤0,05). Considerações finais: O excesso de peso afeta a qualidade de vida, especialmente, em mulheres com obesidade III.

Objetivo: Identificar características sociodemográficas y clínicas de mujeres con sobrepeso y describir la asociación entre calidad de vida y estado nutricional Método: estudio transversal, con 82 mujeres de ambulatorio público, en Bahía. Se utilizó formularios sociodemográfico y clínico, el SF-36, la estadística descriptiva, el test de Kruskal Wallis y significación estadística del 5%. Resultados: La mayoría era negra (92,7%), tenía de 40 a 59 años (85,4%), compañero (51,2%), hasta la enseñanza media (61,0%), trabajo remunerado (52,4%) e ingreso mensual 3 salarios-mínimos (86,6%). Tenía obesidad grado I 34,1% y III 31,7% y dos comorbilidades 32,9%. Los dominios dolor, estado general de salud y vitalidad fueron más comprometidos, con medianas de 51, 52, y 55, respectivamente. Mujeres con obesidad III presentaron peor calidad de vida en los dominios capacidad funcional, aspectos físicos y dolor (p 0,05). Consideraciones finales: El sobrepeso afecta la calidad de vida, especialmente en mujeres con obesidad III.

Objective: To identify overweight women's sociodemographic and clinical characteristics and describe the association between quality of life and nutritional status. Method: a cross-sectional study with 82 women from a public outpatient clinic in Bahia. We used sociodemographic and clinical forms, the SF-36, descriptive statistics, the Kruskal Wallis test, and a statistical significance of 5%. Results: The majority were black (92.7%), had 40 to 59 years (85.4%), had a partner (51.2%), up to high school (61.0%), paid work (52.4%) and had monthly income 3 minimum wages (86.6%). She had obesity grade I 34.1%, III 31.7%, and two comorbidities 32.9%. The domains of pain, general health status, and vitality were more compromised, with medians of 51, 52, and 55, respectively. Women with obesity III had worse quality of life in the functional capacity, physical aspects and pain domains (p 0.05). Final considerations: Overweight affects quality of life, especially in women with obesity III.

Infectivity of seropositive dogs, showing different clinical forms of leishmaniasis, to Lutzomyia longipalpis phlebotomine sand flies.

Visceral leishmaniasis (VL) is a growing zoonosis with an increasing number of new cases and a rapid geographical spreading of the disease. In the present study, a canine survey was carried out in the city of Montes Claros (320,000 inhabitants), an endemic area of American visceral leishmaniasis in the state of Minas Gerais, Brazil. A total number of 4795 dogs were examined by serology, which showed a rate of seropositivity of 5%. Isoenzymatic analysis confirmed Leishmania infantum chagasi as the local aetiological agent of CVL. Canine tissues were assayed for the presence of Leishmania parasite DNA using different techniques. The infectivity of asymptomatic, oligosymptomatic and symptomatic seropositive dogs was tested by xenodiagnosis using laboratory reared Lutzomyia longipalpis. Rates of infection of 5.4%, 5.1% and 28.4% were found for the phlebotomine sand flies that fed in asymptomatic, oligosymptomatic and symptomatic dogs, respectively. Our results indicate that, under experimental conditions, symptomatic dogs are about four times more infective to VL vectors than oligosymptomatic or asymptomatic animals. The lower infectivity rates of dogs displaying any of the last two clinical forms of leishmaniasis, however, must be taken into account in the epidemiology of CVL.

Síndrome de Burnout e sofrimento em atletas de alto rendimento no esporte brasileiro / Burnout syndrome and suffering in high performance athletes in brazilian sports / Síndrome de Burnout y sufrio en atletas de alto rendimiento en el deporte brasileñomient

A Síndrome de Burnout é considerado um problema que afeta profissionais de diferentes áreas, com interferências físicas, psicológicas e sociais, podendo gerar no indivíduo incapacidade para atividades físicas ou cognitivas. Quando ocorre em atletas, além de interferir na vida pessoal e na saúde, podem acarretar impactos ao rendimento esportivo e gerar abandono do esporte. Dessa forma, o objetivo da pesquisa foi analisar como a Síndrome de Burnout e o sofrimento são compreendidos no esporte de alto rendimento em artigos de origem brasileira. Foi utilizado como método de pesquisa uma revisão da literatura com busca em cinco bases de dados bibliográficos: PubMed, SciELO, Web of Science, EMBASE e LILACS. O artigo destacou algumas questões relevantes e sugestões de cada um dos temas (Síndrome de Burnout e sofrimento no esporte) sugeridos pela literatura analisada. Entender como os atletas sofrem e lidam com estas questões é importante para podermos manter maior quantidade e qualidade de atletas no esporte brasileiro, pois muitos deles desistem do esporte praticado devido ao sofrimento e exigências externas.

Burnout Syndrome is considered to be a problem that affects professionals of different areas, interfering physically, psychologically and socially and can generate an inability to perform physical or cognitive activity. When it happens with athletes, in addition to interfering with the personal life and health, it can have an impact on sports performance and lead to sport abandonment. Thus, the objective of the research was to analyze in articles of Brazilian origin, how Burnout Syndrome and suffering in high performance sports are understood. The research method used was to review five bibliographic databases: PubMed, SciELO, Web of Science, EMBASE and LILACS. The article highlights some relevant issues and suggestions for each theme (Burnout Syndrome and sport suffering) suggested by this literature. Understanding how athletes suffer and deal with these issues is important so that we can maintain Brazilian athletes practicing in a greater quantity and quality. Given that, many of them give up sports due to suffering and external demands.

El Síndrome de Burnout es considerado un problema que afecta a profesionales de diferentes áreas, con interferencia física, psicológica y social; lo que puede causar que el individuo quede incapacitado para la actividad física o cognitiva. Cuando ocurre con los deportistas, además de interferir en la vida y la salud personal, pueden tener un impacto en el rendimiento deportivo y llevar al abandono del deporte. Así, el objetivo de la investigación fue analizar cómo son comprendidos el Síndrome de Burnout y el sufrimiento en los deportes de alto rendimiento, en artículos de origen brasileño. Se utilizó como método de investigación una revisión de la literatura con búsquedas en cinco bases de datos bibliográficas: PubMed, SciELO, Web of Science, EMBASE y LILACS. El artículo destacó algunas cuestiones y sugerencias relevantes para cada uno de los temas (Síndrome de Burnout y sufrimiento deportivo) sugeridos por la literatura analizada. Comprender cómo sufren los deportistas y afrontar estos problemas es importante para que podamos mantener una mayor cantidad y calidad de deportistas en el deporte brasileño, ya que muchos de ellos lo abandonan por el sufrimiento y las exigencias externas.

Canine Cutaneous Leishmaniasis: Dissemination and Tissue Tropism of Genetically Distinct Leishmania (Viannia) braziliensis Populations.

Little is known regarding the internal dissemination of initial cutaneous lesions and tissue tropism of Leishmania (Viannia) braziliensis populations in naturally infected dogs. The aim of this study was to investigate genetic polymorphisms of L. (V.) braziliensis populations in different anatomic sites of naturally infected dogs by using polymerase chain reaction (PCR) and low-stringency single specific primer-PCR (LSSP-PCR) techniques. The amplified products were analyzed by LSSP-PCR to investigate the genetic variability of the parasite populations present in different anatomical sites. Twenty-three out of the 52 samples gave PCR-positive results. The existence of L. (V.) braziliensis strains that remained restricted to cutaneous lesions and others showing characteristics of dissemination to internal organs and healthy skin was observed. LSSP-PCR and numerical analyses revealed that parasite populations that do not disseminate were genetically similar and belonged to a separate phenetic cluster. In contrast, populations that showed spreading to internal organs displayed a more polymorphic genetic profile. Despite the heterogeneity, L. (V.) braziliensis populations with identical genetic profiles were observed in popliteal and cervical lymph nodes of the same animal. Our results indicate that infection in dogs can be manifested by dissemination and tissue tropism of genetically distinct populations of L. (V.) braziliensis.

Reversible pulmonary trunk banding: IX. G6PD activity of adult goat myocardium submitted to ventricular retraining.

OBJECTIVE: Increased glucose 6-phosphate dehydrogenase activity has been demonstrated in heart failure. This study sought to assess myocardial glucose 6-phosphate dehydrogenase activity in retraining of the subpulmonary ventricle of adult goats. METHODS: Eighteen adult goats were divided into three groups: traditional (fixed banding), sham, and intermittent (adjustable banding, daily 12-hour systolic overload). Systolic overload (70% of systemic pressure) was maintained during a 4-week period. Right ventricle, pulmonary artery and aortic pressures were measured throughout the study. All animals were submitted to echocardiographic and hemodynamic evaluations throughout the protocol. After the study period, the animals were killed for morphological and glucose 6-phosphate dehydrogenase activity assessment. RESULTS: A 55.7% and 36.7% increase occurred in the intermittent and traditional right ventricle masses, respectively, when compared with the sham group (P<0.05), despite less exposure of intermittent group to systolic overload. No significant changes were observed in myocardial water content in the 3 groups (P=0.27). A 37.2% increase was found in right ventricle wall thickness of intermittent group, compared to sham and traditional groups (P<0.05). Right ventricle glucose 6-phosphate dehydrogenase activity was elevated in the traditional group, when compared to sham and intermittent groups (P=0.05). CONCLUSION: Both study groups have developed similar right ventricle hypertrophy, regardless less systolic overload exposure of intermittent group. Traditional systolic overload for adult subpulmonary ventricle retraining causes upregulation of myocardial glucose 6-phosphate dehydrogenase activity. It may suggest that the undesirable "pathologic systolic overload" is influenced by activation of penthose pathway and cytosolic Nicotinamide adenine dinucleotide phosphate availability. This altered energy substrate metabolism can elevate levels of free radicals by Nicotinamide adenine dinucleotide phosphate oxidase, an important mechanism in the pathophysiology of heart failure.

Genetic polymorphism in Leishmania (Viannia) braziliensis detected in mucosal leishmaniasis of HIV-infected and non-HIV-infected patients.

The genetic polymorphism of Leishmania (Viannia) braziliensis detected in cases of mucosal leishmaniasis (ML) from HIV-infected and non HIV-infected patients was evaluated. Nine samples from three HIV-infected patients and five samples from five non HIV-infected patients were analysed by polymerase chain reaction (PCR), low-stringency single-specific primer PCR (LSSP-PCR) and phenetic analysis. The presence of L. (V.) braziliensis DNA was detected in all samples by specific PCR assay. The intraspecific polymorphism of the variable region of L. (V.) braziliensis kDNA minicircles was investigated by LSSP-PCR. Phenetic analysis grouped the genetic profiles into two distinct clusters, which discriminated between samples obtained from HIV-infected and non HIV-infected patients. In two HIV-infected patients, identical genetic profiles were detected in lesions biopsied at different times after the treatment of the initial lesion. Interestingly, genetically divergent profiles were detected in the cutaneous and mucosal lesions of the same HIV-infected patient collected at the same time. This is the first work comparing genetic polymorphism of L. (V.) braziliensis in cases of mucosal leishmaniasis from HIV-infected and non HIV-infected patients.

Eco-epidemiology of visceral leishmaniasis in the urban area of Paracatu, state of Minas Gerais, Brazil.

The present study was developed in the urban area of Paracatu, an endemic city for the American visceral leishmaniasis in Brazil. A six-month canine survey was performed with 6295 domiciled dogs in 28 districts in that area and showed that 4.2% of those (267 dogs) were positive for VL by ELISA and IFAT serum assays. Prevalence ratios for canine VL varied between 1.2% and 16.1%, depending on the district under investigation. Fifteen dogs - 80% of which were clinically asymptomatic for VL - were submitted to a more detailed study that comprised direct parasitological examination and Leishmania kDNA amplification of tissue samples as well as two PCR-RFLP methods using myelocultures. Leishmania amastigotes or Leishmania DNA were detected in all dogs but one. The infecting species of Leishmania was identified in about 50% (7/15) of the sample dogs: Leishmania (Leishmania) chagasi in two of them and, unexpectedly, Leishmania (Leishmania) amazonensis in the remaining five. Three months after the end of confiscation and elimination of the VL-seropositive dogs in the 28 districts of Paracatu, a systematic entomological survey was performed in five of them. Six hundred and sixty five (665) phlebotomine sand flies were captured in total, from which 89.5% were identified as Lutzomyia longipalpis. The population density of that species increased during the rainy season. Other thirteen (13) species of phlebotomine sand flies were captured at varying percentages from 0.2 to 5.0%. It is worth noting that L. longipalpis females were predominantely intradomicile when compared to males, suggesting that the VL transmission cycle in Paracatu may be occurring inside home.

kDNA minicircle signatures of Leishmania (Viannia) braziliensis in oral and nasal mucosa from mucosal leishmaniasis patients.

Polymerase chain reaction (PCR) and low-stringency single-specific primer PCR (LSSP-PCR) analyses were used to detect Leishmania (Viannia) braziliensis DNA and investigate kDNA signatures of parasite populations present in oral and nasal mucosa lesions from mucosal leishmaniasis patients. A total of 25 samples from 22 patients were processed by specific PCR/hybridization assays. Parasite DNA was detected in all samples analyzed. The intraspecific polymorphism of the variable region of L. (V.) braziliensis kDNA minicircles was also investigated by LSSP-PCR. Similar kDNA signatures were observed in parasites recovered from nasal and oral mucosa lesions of the same patient. In contrast, genetically divergent profiles were detected in lesions from patients biopsied at different times within a period of 1 year. This is the first work to report genetic typing of L. (V.) braziliensis directly from human oral and nasal mucosal lesions.

Intermittent systolic overload promotes better myocardial performance in adult animals.

BACKGROUND: Corrected transposition of great arteries often evolves with right ventricular dysfunction. The ventricular preparation for anatomic correction in adult patients has produced disappointing results. OBJECTIVE: To assess right ventricular hypertrophy (RV) induced by conventional and intermittent pulmonary banding (PB) in adult animals. METHODS: Nineteen adult goats were divided into three groups: conventional (six animals), intermittent (six animals) and control (seven animals). The Conventional group underwent fixed PB with cardiac tape, while the intermittent group received PB adjustable device, which generated systolic overload for 12 hours, alternated with 12 hours of rest of RV. The pressures of the RV, pulmonary artery and aorta were measured throughout the study. Echocardiography was performed weekly. After four weeks, the animals were euthanized for morphological evaluation of the ventricles. The Control group was put to euthanasia for analysis at baseline. RESULTS: Pressure overload was lower in the intermittent group (p = 0.001), compared to the conventional group. There was an increase in the thickness of the RV of the Intermittent group measured by echocardiography compared to their baseline values (p < 0.05). The myocardial performance index in the RV group was better in the Intermittent group (p = 0.024), compared to the Conventional group. The groups stimulated showed increased muscle mass compared to the Control group (p = 0.001). There was no difference in myocardial water content. CONCLUSION: The intermittent BP developed hypertrophy of better performance, suggesting this protocol as the preferred method of ventricular preparation.

Bandagem ajustável do tronco pulmonar: IX: atividade da G6PD do miocárdio de cabras adultas submetido ao treinamento ventricular / Reversible pulmonary trunk banding: IX. G6PD activity of adult goat myocardium submitted to ventricular retraining

OBJETIVO: O aumento da atividade miocárdica da Glicose 6-Fosfato Desidrogenase tem sido demonstrado na insuficiência cardíaca. Este estudo avalia a atividade miocárdica da Glicose 6-Fosfato Desidrogenase no treinamento do ventrículo subpulmonar de cabras adultas. MÉTODOS: Foram utilizadas 18 cabras adultas, divididas em três grupos: convencional (bandagem fixa), sham e intermitente (bandagem ajustável; 12 horas diárias de sobrecarga). A sobrecarga sistólica (70% da pressão sistêmica) foi mantida durante quatro semanas. As avaliações hemodinâmica e ecocardiográfica foram realizadas durante todo o estudo. Depois de cumprido o protocolo, os animais foram mortos para avaliação morfológica e da atividade da Glicose 6-Fosfato Desidrogenase dos ventrículos. RESULTADOS: Apesar de haver sobrecarga sistólica proporcionalmente menor no ventrículo subpulmonar do grupo intermitente (P=0,001), ambos os grupos de estudo apresentaram aumento da massa muscular de magnitude similar. Os grupos intermitente e convencional apresentaram aumento da massa de 55,7% e 36,7% (P<0,05), respectivamente, em comparação ao grupo sham. O conteúdo de água do miocárdio não variou entre os grupos estudados (P=0,27). O ecocardiograma demonstrou maior aumento (37,2%) na espessura do ventrículo subpulmonar do grupo intermitente, em relação aos grupos sham e convencional (P<0,05). Foi observada maior atividade da Glicose 6-Fosfato Desidrogenase na hipertrofia miocárdica do ventrículo subpulmonar do grupo convencional, comparada aos grupos sham e intermitente (P=0,05). CONCLUSÃO: Ambos os grupos de treinamento ventricular desenvolveram hipertrofia ventricular, a despeito do menor tempo de sobrecarga sistólica no grupo intermitente. A maior atividade de Glicose 6-Fosfato Desidrogenase observada no grupo convencional pode refletir um desequilíbrio redox, com maior produção de fosfato de dinucleotídeo de nicotinamida e adenina e glutationa reduzida, um mecanismo importante da fisiopatologia da insuficiência cardíaca.

OBJECTIVE: Increased glucose 6-phosphate dehydrogenase activity has been demonstrated in heart failure. This study sought to assess myocardial glucose 6-phosphate dehydrogenase activity in retraining of the subpulmonary ventricle of adult goats. METHODS: Eighteen adult goats were divided into three groups: traditional (fixed banding), sham, and intermittent (adjustable banding, daily 12-hour systolic overload). Systolic overload (70% of systemic pressure) was maintained during a 4-week period. Right ventricle, pulmonary artery and aortic pressures were measured throughout the study. All animals were submitted to echocardiographic and hemodynamic evaluations throughout the protocol. After the study period, the animals were killed for morphological and glucose 6-phosphate dehydrogenase activity assessment. RESULTS: A 55.7% and 36.7% increase occurred in the intermittent and traditional right ventricle masses, respectively, when compared with the sham group (P<0.05), despite less exposure of intermittent group to systolic overload. No significant changes were observed in myocardial water content in the 3 groups (P=0.27). A 37.2% increase was found in right ventricle wall thickness of intermittent group, compared to sham and traditional groups (P<0.05). Right ventricle glucose 6-phosphate dehydrogenase activity was elevated in the traditional group, when compared to sham and intermittent groups (P=0.05). CONCLUSION: Both study groups have developed similar right ventricle hypertrophy, regardless less systolic overload exposure of intermittent group. Traditional systolic overload for adult subpulmonary ventricle retraining causes upregulation of myocardial glucose 6-phosphate dehydrogenase activity. It may suggest that the undesirable "pathologic systolic overload" is influenced by activation of penthose pathway and cytosolic Nicotinamide adenine dinucleotide phosphate availability. This altered energy substrate metabolism can elevate levels of free radicals by Nicotinamide adenine dinucleotide phosphate oxidase, an important mechanism in the pathophysiology of heart failure.

Sobrecarga sistólica intermitente promove melhor desempenho miocárdico em animais adultos / Intermittent systolic overload promotes better myocardial performance in adult animals / Sobrecarga sistólica intermitente promueve mejor desempeño miocárdico en animales adultos

FUNDAMENTO: A transposição corrigida das grandes artérias frequentemente evolui com disfunção ventricular direita. O preparo ventricular para a correção anatômica em pacientes adultos apresenta resultados desapontadores. OBJETIVO: Analisar a hipertrofia do ventrículo direito (VD) induzida por dois tipos de bandagem pulmonar (BP), convencional e intermitente em animais adultos. MÉTODOS: Dezenove cabras adultas foram divididas em três grupos: Convencional (seis animais), Intermitente (seis animais) e Controle (sete animais). O grupo Convencional foi submetido à BP fixa com fita cardíaca, enquanto no grupo Intermitente foi usado dispositivo de BP ajustável, que gerava sobrecarga sistólica por 12 horas, alternada com 12 horas de descanso do VD. As pressões de VD, tronco pulmonar e aorta foram medidas durante todo o estudo. Ecocardiograma foi realizado semanalmente. Após quatro semanas, os animais foram eutanasiados para avaliação morfológica dos ventrículos. O grupo Controle foi submetido a eutanásia para análise em condições basais. RESULTADOS: A sobrecarga pressórica foi menor no grupo Intermitente (p=0,001), comparada ao grupo Convencional. Houve aumento na espessura do VD do grupo Intermitente, medida pelo ecocardiograma, comparado ao seu momento basal (p<0,05). O índice de performance miocárdica do VD foi melhor no grupo Intermitente (p=0,024), comparado ao Convencional. Os grupos estimulados apresentaram aumento da massa muscular em comparação ao grupo Controle (p=0,001). Não houve diferença no conteúdo de água miocárdica. CONCLUSÃO: A BP intermitente desenvolveu hipertrofia de melhor desempenho funcional, sugerindo este protocolo como método preferencial de preparo ventricular.

BACKGROUND: Corrected transposition of great arteries often evolves with right ventricular dysfunction. The ventricular preparation for anatomic correction in adult patients has produced disappointing results. OBJECTIVE: To assess right ventricular hypertrophy (RV) induced by conventional and intermittent pulmonary banding (PB) in adult animals. METHODS: Nineteen adult goats were divided into three groups: conventional (six animals), intermittent (six animals) and control (seven animals). The Conventional group underwent fixed PB with cardiac tape, while the intermittent group received PB adjustable device, which generated systolic overload for 12 hours, alternated with 12 hours of rest of RV. The pressures of the RV, pulmonary artery and aorta were measured throughout the study. Echocardiography was performed weekly. After four weeks, the animals were euthanized for morphological evaluation of the ventricles. The Control group was put to euthanasia for analysis at baseline. RESULTS: Pressure overload was lower in the intermittent group (p = 0.001), compared to the conventional group. There was an increase in the thickness of the RV of the Intermittent group measured by echocardiography compared to their baseline values (p < 0.05). The myocardial performance index in the RV group was better in the Intermittent group (p = 0.024), compared to the Conventional group. The groups stimulated showed increased muscle mass compared to the Control group (p = 0.001). There was no difference in myocardial water content. CONCLUSION: The intermittent BP developed hypertrophy of better performance, suggesting this protocol as the preferred method of ventricular preparation.

FUNDAMENTO: La transposición corregida de las grandes arterias frecuentemente evoluciona con disfunción ventricular derecha. La preparación ventricular para la corrección anatómica en pacientes adultos presenta resultados desalentadores. OBJETIVO: Analizar la hipertrofia del ventrículo derecho (VD) inducida por dos tipos de vendaje pulmonar (VP), convencional e intermitente en animales adultos. MÉTODOS: Diecinueve cabras adultas fueron divididas en tres grupos: Convencional (seis animales), Intermitente (seis animales) y Control (siete animales). El grupo Convencional fue sometido al VP fijo con cinta cardíaca, mientras que en el grupo Intermitente fue usado dispositivo de VP ajustable, que generaba sobrecarga sistólica por 12 horas, alternada con 12 horas de descanso del VD. Las presiones de VD, tronco pulmonar y aorta fueron medidas durante todo el estudio. Ecocardiograma fue realizado semanalmente. Después de cuatro semanas, los animales fueron eutanasiados para evaluación morfológica de los ventrículos. El grupo Control fue sometido a eutanasia para análisis en condiciones basales. RESULTADOS: La sobrecarga presórica fue menor en el grupo Intermitente (p=0,001), comparada al grupo Convencional. Hubo aumento en el espesor del VD del grupo Intermitente, medida por el ecocardiograma, comparado a su momento basal (p<0,05). El índice de performance miocárdica del VD fue mejor en el grupo Intermitente (p=0,024), comparado al Convencional. Los grupos estimulados presentaron aumento de la masa muscular en comparación al grupo Control (p=0,001). No hubo diferencia en el contenido de agua miocárdica. CONCLUSIÓN: EL VP intermitente desarrolló hipertrofia de mejor desempeño funcional, sugiriendo este protocolo como método preferencial de preparación ventricular.

Estudo clínico-molecular na Leishmaniose mucocutânea diagnóstico e rastreamento de subpopulações de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes

O presente estudo teve como principal objetivo avaliar a diversidade genética de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes, diretamente em lesões cutâneas e mucosas de indivíduos com leishmanioses mucocutânea (LMC), disseminada (LD) e mucosa (LM), incluindo indivíduos coinfectados pelo vírus da imunodeficiência humana (HIV). Um total de 61 amostras procedentes de 38 pacientes foi analisado pelas técnicas da reação em cadeia da polimerase (PCR), da reação em cadeia da polimerase com primer único em condições de baixa estringência (LSSP-PCR) e da análise fenética, tendo como alvo molecular a região variável do minicírculo do DNA do cinetoplasto (kDNA). Neste estudo, predominaram indivíduos do sexo masculino e com acometimento mucoso nasal. A presença de DNA do parasita foi evidenciada pela banda diagnóstica de 750 pb, em todas as amostras analisadas, possibilitando o diagnóstico específico. Na investigação do perfil genotípico de subpopulações de L. (V.) braziliensis, através da LSSP-PCR, foi revelado o polimorfismo genético intrafragmento traduzido como uma assinatura do kDNA do parasito para cada amostra. Assinaturas de kDNAs similares em amostras de paciente coletadas ao mesmo tempo (mucosa oral e nasal), e a divergência nos perfis genéticos em amostras coletadas em tempos diferentes na mesma localização (mucosa nasal) sugerem a clonalidade do inóculo inicial, como consequência da estrutura populacional clonal de Leishmania No estudo da variabilidade genética de L. (V.) braziliensis nos níveis inter e intrapacientes foram evidenciadas similaridades genotípicas entre as amostras de lesões cutânea e mucosa intrapacientes. As análises fenética e estatística possibilitaram afirmar que a diversidade genética no nível intrapacientes é menor do que a observada entre os pacientes. Nenhuma associação pode ser observada entre os perfis genéticos de L. (V.) braziliensis e as formas clínicas da doença (LM, LMC, LD), e nem em relação à localização da lesão cutânea ou mucosa (nasal ou oral). O polimorfismo genético de L. (V.) braziliensis também foi evidenciado nos pacientes coinfectados pelo HIV, cuja análise fenética reuniu os perfis genéticos em dois grupos distintos, os quais discriminaram entre as amostras obtidas de pacientes com coinfecção Leishmania/ HIV daquelas obtidas de pacientes não coinfectados. A discriminação de perfis genéticos diferenciados de L. (V.) braziliensis em pacientes coinfectados pelo HIV sugere que a imunossupressão tem impacto na estrutura populacional do parasita. Os nossos resultados corroboram a complexidade genética existente nos parasitos do gênero Leishmania, reforçando a diversidade na dinâmica populacional e na plasticidade genética de L. (V.) braziliensis

Estudo clínico-molecular na Leishmaniose mucocutânea: diagnóstico e rastreamento de subpopulações de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes / Clinical and molecular study in mucocutaneous leishmaniasis: Diagnoses and screening of subpopulation of Leishmania (Viannia) braziliensis in the inter and intrapatient levels

O presente estudo teve como principal objetivo avaliar a diversidade genética de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes, diretamente em lesões cutâneas e mucosas de indivíduos com leishmanioses mucocutânea (LMC), disseminada (LD) e mucosa (LM), incluindo indivíduos coinfectados pelo vírus da imunodeficiência humana (HIV). Um total de 61 amostras procedentes de 38 pacientes foi analisado pelas técnicas da reação em cadeia da polimerase (PCR), da reação em cadeia da polimerase com primer único em condições de baixa estringência (LSSP-PCR) e da análise fenética, tendo como alvo molecular a região variável do minicírculo do DNA do cinetoplasto (kDNA). Neste estudo, predominaram indivíduos do sexo masculino e com acometimento mucoso nasal. A presença de DNA do parasita foi evidenciada pela banda diagnóstica de 750 pb, em todas as amostras analisadas, possibilitando o diagnóstico específico. Na investigação do perfil genotípico de subpopulações de L. (V.) braziliensis, através da LSSP-PCR, foi revelado o polimorfismo genético intrafragmento traduzido como uma assinatura do kDNA do parasito para cada amostra. Assinaturas de kDNAs similares em amostras de paciente coletadas ao mesmo tempo (mucosa oral e nasal), e a divergência nos perfis genéticos em amostras coletadas em tempos diferentes na mesma localização (mucosa nasal) sugerem a clonalidade do inóculo inicial, como consequência da estrutura populacional clonal de Leishmania. No estudo da variabilidade genética de L. (V.) braziliensis nos níveis inter e intrapacientes foram evidenciadas similaridades genotípicas entre as amostras de lesões cutânea e mucosa intrapacientes. As análises fenética e estatística possibilitaram afirmar que a diversidade genética no nível intrapacientes é menor do que a observada entre os pacientes.

Nenhuma associação pode ser observada entre os perfis genéticos de L. (V.) braziliensis e as formas clínicas da doença (LM, LMC, LD), e nem em relação à localização da lesão cutânea ou mucosa (nasal ou oral). O polimorfismo genético de L. (V.) braziliensis também foi evidenciado nos pacientes coinfectados pelo HIV, cuja análise fenética reuniu os perfis genéticos em dois grupos distintos, os quais discriminaram entre as amostras obtidas de pacientes com coinfecção Leishmania/ HIV daquelas obtidas de pacientes não coinfectados. A discriminação de perfis genéticos diferenciados de L. (V.) braziliensis em pacientes coinfectados pelo HIV sugere que a imunossupressão tem impacto na estrutura populacional do parasita. Os nossos resultados corroboram a complexidade genética existente nos parasitos do gênero Leishmania, reforçando a diversidade na dinâmica populacional e na plasticidade genética de L. (V.) braziliensis. (AU)

The present study has as its main objective to evaluate the genetic diversity of Leishmania (Viannia) braziliensis in the inter and intrapatient levels, directly from cutaneous and mucosal lesions of individuals with mucocutaneous (MCL), disseminated (DL) and mucosal (ML) leishmaniasis, including individuals with the human immunodeficiency virus (HIV) infection. A total of 61 samples recovered from 38 patients was analyzed by the techniques ofpolymerase chain reaction (PCR), low-stringency single-specific-primer PCR (LSSP-PCR) and phenetic analysis, directed to the variable region of the kinetoplast DNA (kDNA) minicircles. In this study, male individuals with nasal mucosa involvement predominated. Thepresence of the parasites DNA was revealed by the diagnosis band of 750 bp, in all analyzed samples, making the specific diagnosis possible. In the investigation of the genotypic profile of the subpopulations of L. (V.) braziliensis, through LSSP-PCR, it was revealed theintrafragment genetic polymorphism translated as a kDNA signature for each sample. Similar kDNAs signatures in patients samples collected simultaneously (oral and nasal mucosa), and the divergence in the genetic profiles in samples collected at different times on the same location (nasal mucosa) suggest the clonality of the initial inoculum, as a consequence of the clonal population structure of Leishmania. In the study of the genetic variability of L. (V.)braziliensis in the inter and intrapatient levels, genotypic similarities were observed among the cutaneous and mucosal lesions intrapatients. The statistic and phenetic analyzes made it possible to assure that the genetic diversity in the intrapatient level is lower than the observed among the patients.

No association could be observed between the genetic profiles of L. (V.)braziliensis and the clinical forms of the disease (ML, MCL, DL) and neither in relation to the location of the cutaneous or mucosal lesion (nasal or oral). The genetic polymorphism of L. (V.) braziliensis was also detected in the HIV-infected patients. The phenetic analysis has grouped the genetic profiles into two different clusters, which discriminated between samplesfrom patients with Leishmania/ HIV co-infections from that of non-HIV-infected patients. The discrimination of L. (V.) braziliensis divergent genetic profiles in patients co-infected with HIV suggests that the immunosupression has some impact on the parasites populationalstructure. Our results corroborate the genetic complexity in parasites of the genus Leishmania reinforcing the diversity in the populacional dynamics and genetic plasticity of L. (V.) braziliensis. (AU)

Estudo clínico-molecular na leishmaniose mucocutânea: diagnóstico e rastreamento de subpopulações de leishmania (Viannia) braziliensis nos níveis inter e intrapacientes / Clinical and molecular study in mucocutaneous leishmaniasis: Diagnoses and screening of subpopulation of leishmania (Viannia) braziliensis in the inter and intrapatient levels

O presente estudo teve como principal objetivo avaliar a diversidade genética de Leishmania (Viannia) braziliensis nos níveis inter e intrapacientes, diretamente em lesões cutâneas e mucosas de indivíduos com leishmanioses mucocutânea (LMC), disseminada (LD) e mucosa (LM), incluindo indivíduos coinfectados pelo vírus da imunodeficiência humana (HIV). Um total de 61 amostras procedentes de 38 pacientes foi analisado pelas técnicas da reação em cadeia da polimerase (PCR), da reação em cadeia da polimerase com primer único em condições de baixa estringência (LSSP-PCR) e da análise fenética, tendo como alvo molecular a região variável do minicírculo do DNA do cinetoplasto (kDNA). Neste estudo, predominaram indivíduos do sexo masculino e com acometimento mucoso nasal. A presença de DNA do parasita foi evidenciada pela banda diagnóstica de 750 pb, em todas as amostras analisadas, possibilitando o diagnóstico específico. Na investigação do perfil genotípico de subpopulações de L. (V.) braziliensis, através da LSSP-PCR, foi revelado o polimorfismo genético intrafragmento traduzido como uma assinatura do kDNA do parasito para cada amostra. Assinaturas de kDNAs similares em amostras de paciente coletadas ao mesmo tempo (mucosa oral e nasal), e a divergência nos perfis genéticos em amostras coletadas em tempos diferentes na mesma localização (mucosa nasal) sugerem a clonalidade do inóculo inicial, como consequência da estrutura populacional clonal de Leishmania. No estudo da variabilidade genética de L. (V.) braziliensis nos níveis inter e intrapacientes foram evidenciadas similaridades genotípicas entre as amostras de lesões cutânea e mucosa intrapacientes. As análises fenética e estatística possibilitaram afirmar que a diversidade genética no nível intrapacientes é menor do que a observada entre os pacientes...

The present study has as its main objective to evaluate the genetic diversity of Leishmania(Viannia) braziliensis in the inter and intrapatient levels, directly from cutaneous and mucosallesions of individuals with mucocutaneous (MCL), disseminated (DL) and mucosal (ML)leishmaniasis, including individuals with the human immunodeficiency virus (HIV) infection.A total of 61 samples recovered from 38 patients was analyzed by the techniques ofpolymerase chain reaction (PCR), low-stringency single-specific-primer PCR (LSSP-PCR)and phenetic analysis, directed to the variable region of the kinetoplast DNA (kDNA)minicircles. In this study, male individuals with nasal mucosa involvement predominated. Thepresence of the parasite’s DNA was revealed by the diagnosis band of 750 bp, in all analyzedsamples, making the specific diagnosis possible. In the investigation of the genotypic profileof the subpopulations of L. (V.) braziliensis, through LSSP-PCR, it was revealed theintrafragment genetic polymorphism translated as a kDNA signature for each sample. SimilarkDNAs signatures in patient’s samples collected simultaneously (oral and nasal mucosa), andthe divergence in the genetic profiles in samples collected at different times on the samelocation (nasal mucosa) suggest the clonality of the initial inoculum, as a consequence of theclonal population structure of Leishmania. In the study of the genetic variability of L. (V.)braziliensis in the inter and intrapatient levels, genotypic similarities were observed amongthe cutaneous and mucosal lesions intrapatients...