Follow-up of patients diagnosed with and treated for tuberculosis in Brazil: financial burden on the household / Acompanhamento de pacientes com diagnóstico e tratamento de tuberculose no Brasil: ônus financeiro para a família

ABSTRACT Objective: To evaluate the implications of the proportion of annual family income spent in the pre- and post-diagnosis periods in tuberculosis patients followed for after at least one year after completing tuberculosis treatment in Brazil. Methods: This was a cross-sectional study of tuberculosis patients followed for at least one year after completing tuberculosis treatment in five Brazilian capitals (one in each region of the country). Results: A total of 62 patients were included in the analysis. The overall average cost of tuberculosis was 283.84 Brazilian reals (R$) in the pre-diagnosis period and R$4,161.86 in the post-diagnosis period. After the costs of tuberculosis disease, 71% of the patients became unemployed, with an overall increase in unemployment; in addition, the number of patients living in nonpoverty decreased by 5%, the number of patients living in poverty increased by 6%, and the number of patients living in extreme poverty increased by 5%. The largest proportion of annual household income to cover the total costs of tuberculosis was for the extremely poor (i.e., 40.37% vs. 11.43% for the less poor). Conclusions: Policies to mitigate catastrophic costs should include interventions planned by the health care system and social protection measures for tuberculosis patients with lower incomes in order to eliminate the global tuberculosis epidemic by 2035-a WHO goal in line with the United Nations Sustainable Development Goals.

RESUMO Objetivo: Avaliar as implicações da proporção da renda familiar anual gasta nos períodos pré e pós-diagnóstico em pacientes com tuberculose acompanhados durante pelo menos um ano após o término do tratamento da tuberculose no Brasil. Métodos: Estudo transversal com pacientes com tuberculose acompanhados durante pelo menos um ano após o término do tratamento da tuberculose em cinco capitais brasileiras (uma em cada região do país). Resultados: Foram incluídos na análise 62 pacientes. O custo médio global da tuberculose foi de R$ 283,84 no período pré-diagnóstico e de R$ 4.161,86 no período pós-diagnóstico. Após os custos da doença tuberculosa, 71% dos pacientes ficaram desempregados, com um aumento global do desemprego; além disso, o número de pacientes não pobres diminuiu 5%, o número de pacientes pobres aumentou 6% e o número de pacientes extremamente pobres aumentou 5%. A maior proporção de renda familiar anual para cobrir os custos totais da tuberculose foi observada nos pacientes extremamente pobres (40,37% vs. 11,43% nos menos pobres). Conclusões: As políticas para mitigar os custos catastróficos devem incluir intervenções planejadas pelo sistema de saúde e medidas de proteção social para pacientes de baixa renda com tuberculose, a fim de eliminar a epidemia global de tuberculose até 2035, uma meta da OMS alinhada com os Objetivos de Desenvolvimento Sustentável propostos pela Organização das Nações Unidas.

Antiproliferative Effect of Urera baccifera Leaves Against Ovarian Carcinoma Cell Line (OVCAR-3)

Abstract Natural products, especially phytochemicals, have been extensively studies and have exhibited important antiproliferative effects. The American native species Urera baccifera (L.) Gaudich. ex Wedd. (Urticaceae) is widely distributed in Brazil, where it is known as urtiga-vermelha or urtigão. The leaves are popularly used as anti-inflammatory, antirheumatic and in the treatment of gastric disorders. However, the antiproliferative potential of this plant against human tumor cells remain to be elucidated. In this study, we evaluated the antiproliferative effects of U. baccifera leaves extracts and fractions against a panel of human tumor cell lines in vitro besides a chemical evaluation of the most active sample by mass spectrometry (ESI-IT-MSn). The hydroalcoholic extract was inactive while dichloromethane extract showed moderate cytostatic activity against ovarian carcinoma cell line (OVCAR-3, GI50 = 1.5 μg/mL). More, the ethyl acetate and n-butanol fractions did not show important activity against tumour cell while the dichloromethane and hexane fractions showed moderate cytostatic activity against ovarian tumor cell line (OVCAR-3, GI50 = 12.7 and 9.4 μg/mL, respectively). Finally, the chemical profile evaluated by mass spectrometry (ESI-IT-MSn) allowed the detection of flavonoids in the HEU and hydroxylated fatty acid in DEU that can explain partially the biological effects observed. This is the first report of the antiproliferative effects of U. baccifera, and DEU has shown potential as a promising source of bioactive compounds.

Antiproliferative potential of solidagenone isolated of Solidago chilensis

ABSTRACT Plants are considered among the main sources of biologically active chemicals. The species Solidago chilensis Meyen, Asteraceae, is native to the southern parts of South America, where the aerial parts of the plant are commonly used for the treatment of inflammatory conditions. However, the effects of S. chilensis on human cancer cells remain to be elucidated. In this study, we evaluated the antiproliferative effects of the hydroalcoholic and dichloromethane extracts of S. chilensis, as well as their chemical constituents quercitrin and solidagenone against the five human tumor cell lines in vitro. The dichloromethane extract showed a promisor antiproliferative effects in vitro, especially against glioma cell line. Besides, the hydroalcoholic extract and quercitrin were inactive. The diterpene solidagenone showed highly potent antiproliferative effects against breast (MCF-7), kidney (786-0), and prostate cancer (PC-3) cells (total growth inhibition: TGI < 6.25 µg/ml). Solidagenone meets the theoretical physico-chemical criteria for bioavailability of drugs, according to the "Rule of Five" and, by theorical studies, the observed biological effects were probably related to the interaction of the molecule with nuclear receptors and as an enzymatic inhibitor. This study contributes to chemical study and to the identification of antiproliferative molecules in S. chilensis.

É melhor prevenir do que remediar: a doença imaginária no jornalismo / Es mejor prevenir que remediar: la enfermedad imaginaria en el periodismo / An ounce of prevention is worth a ton of cure: imaginary diseases in journalism

Utilizamos as teorias do imaginário para compreender como o jornalismo tende a redefinir o estatuto do que é ser ou sentir-se doente a partir da disseminação da cultura do risco. O dispositivo jornalístico promove a doença em potencial ou imaginária e intervém no cotidiano, constituindo-se uma "tecnologia do imaginário". Sofremos por antecipação, receosos do futuro que pode ser portador de alguma patologia. Devemos nos prevenir, seja por meio do regramento de nossos hábitos ou por meio da descoberta de tendências genéticas que nos predisponham a desenvolver doenças. Prolongar a existência e viver com qualidade tornaram-se quase um dever moral. O corpus é composto por oito matérias da Folha de S. Paulo. O jornalismo emprega recursos considerados racionais, mas mobiliza os leitores pela emoção, produzindo um imaginário que tende a se disseminar na sociedade.(AU)

Utilizamos las teorías de lo imaginario para entender cómo el periodismo tiende a redefinir el estatuto de lo que es estar o sentirse enfermo a partir de la difusión de la cultura del riesgo. El dispositivo periodístico promueve la enfermedad en potencia o imaginaria e interviene en el cotidiano, constituyéndose una "tecnología de lo imaginario". Sufrimos por anticipado, recelosos del futuro que puede ser portador de alguna patología. Debemos prevenirnos, sea por medio de reglar nuestros hábitos o por medio del descubrimiento de tenencias genéticas que nos predispongan a desarrollar enfermedades. Prolongar la existencia y vivir con calidad se convirtieron en casi un deber moral. El corpus se compone de ocho artículos del periódico Folha de S. Paulo. El periodismo emplea recursos considerados racionales, pero moviliza a los lectores por la emoción, produciendo un imaginario que tiende a diseminarse en la sociedad.(AU)

We use the theories of the imaginary to understand how journalism tends to redefine the status of what it is to be or to feel sick through the dissemination of the culture of risk. The journalistic devices promote the potential or imaginary disease, acting on the daily practices, thus becoming a "technology of the imaginary". We suffer in anticipation, afraid of the future that may carry a disease. We should be aware, either through the regulation of our habits or the discovery of genetic tendencies that predispose us to development of diseases. Prolonging existence and living with quality have evolved into an almost a moral duty. The corpus is composed of eight stories from Folha de S. Paulo. Journalism employs resources considered rational, but mobilizes readers by emotion, producing an imaginary that tends to spread in society.(AU)

Effects of hydroalcoholic extract of Celtis iguanaea on markers of cardiovascular diseases and glucose metabolism in cholesterol-fed rats

ABSTRACT Celtis iguanaea (Jacq.) Sarg., Cannabaceae, is popularly used in the treatment of diabetes mellitus. However, chemical and pharmacological investigations are lacking. In this study, we investigated the effects of the hydroalcoholic extract from C. iguanaea on markers of cardiovascular diseases and the glucose metabolism in cholesterol-fed rats. Therefore, hypercholesterolemic rats (1% cholesterol) were orally treated with C. iguanaea extract (C-150, CI-300, or CI-600 mg/kg) or simvastatin (4 mg/kg) (n = 6) once a day (30 days) with a hypercholesterolemic diet. A control group (C) was given saline. C. iguanaea extract showed significant decreases in serum levels of total cholesterol, LDL-cholesterol, HMG-CoA-reductase, interleukin-1 and 6, TNF-α and IFN-γ when compared to group C (p < 0.001). Hypoglycemic effects were observed along with a decrease of the activity of sucrase (CI-600), maltase (CI-150, CI-300), and an increase in muscle glycogen levels (CI-300). Antioxidant effects were observed in plasma by the decrease of TBARS and increase of nonprotein thiols levels (CI-600). The histopathological analysis showed a significant decrease in the liver fat area for C. iguanaea extract compared to group C (p < 0.001). Our results suggest that the biological effects of C. iguanaea extract could be related to the flavonoids that possibly exert antioxidant, enzymatic inhibitory, and insulin-mimetic effects.

A study of intestinal parasites in children of an urban region with excellent sanitary condition reveals high occurrence of Blastocystis spp

Intestinal parasites are among the major causative agents of diseases that affect animals and humans, especially children. In view of this, the current study evaluated the occurrence of these parasitic agents in 737 children in an urban region with excellent sanitation condition of the city of Pedreira, São Paulo, Brazil. Fecal samples from the children were processed with the use of a technique of high diagnostic efficiency (TF-Test®). The diagnosis of these samples resulted in the detection of 557 parasitic structures among eleven genera of parasites, and of 46.4% (342/737) infected children. Blastocystis spp. was found in 69.6% (238/342) of the positive samples and the monoparasitism was accompanied by symptoms in 44 children. Furthermore, 67.8% (232/342) of the infected children had close contact with pets, suggesting a possible zoonotic transmission. Lastly, this study allowed to perform health education to the children, aiming the reduction of new intestinal parasitic infections.

Antiproliferative effects of pinostrobin and 5,6-dehydrokavain isolated from leaves of Alpinia zerumbet

Abstract Natural products are a major source of drugs for the treatment of cancer. The species Alpinia zerumbet (Pers.) B.L. Burtt & R.M. Sm, Zingiberaceae, is widely distributed in Brazil where it is known as "colônia". The leaves are commonly used in the treatment of hypertension and dyspepsia, however, the effects of A. zerumbet extracts and isolated substances on human cancer cells remain to be elucidated. This study was designed to identify the chemical constituents of hydroalcoholic and dichloromethane extracts from A. zerumbet leaves and to investigate their in vitro antiproliferative activity. The isolated phytochemicals included kaempferol, dihydro-5,6-dehydrokavain, 5,6-dehydrokavain, and pinostrobin. The hydroalcoholic extract inhibited cellular proliferation only at high concentrations, while the dichloromethane extract showed a moderate antiproliferative effect against leukemia and lung tumor cell lines. 5,6-Dehydrokavain showed potent cytostatic activity against glioblastoma cells and a moderate effect on all other tumor cell lines. Pinostrobin showed potent activity against leukemia and breast tumor cell lines and moderate cytostatic effect against ovarian cell. Furthermore, this is the first report on the isolation of kaempferol and pinostrobin from A. zerumbet leaves. Moreover, the purification process described in this study was effective. These results suggest that A. zerumbet leaves are a promising source of anticancer compounds.

Hypolipidemic and antiatherogenic effects of Cynara scolymus in cholesterol-fed rats

ABSTRACT Cynara scolymus L., Asteraceae, are traditionally used to treat dyspepsia. This study evaluated the hypolipidemic and antiatherogenic effects of an aqueous extract prepared from the leaves of C. scolymus in rat's model. Hypercholesterolemic rats (1% cholesterol and 0.5% cholic acid for 15 days) were treated (0.5 ml/200 g) with extract of C. scolymus (150, 300, or 600 mg/kg p.o.; n = 6) or simvastatin (4 mg/kg p.o.; n = 6) once per day for 30 days along with hypercaloric diet. A control group (C) was given water (0.5 ml/200 g; n = 6). A high-cholesterol diet was maintained throughout the treatment period. Rats treated with extract of C. scolymus (150, 300, or 600 mg/kg) and simvastatin showed significant decreases in serum levels of total cholesterol (−46.9%, −51.9%, −44%, and −41.9%, respectively) and low-density lipoprotein-cholesterol (LDL-C; −52.1%, −54.8%, −51.9%, and −46.7%, respectively), compared with group C (p < 0.005). Biochemical analyses revealed significant decrease in the concentration of IL-1, IL-6, TNF-α, IFN-γ, C-reactive protein, oxidized-LDL, and antioxidized-LDL in rats treated with extract of C. scolymus (150, 300, or 600 mg/kg). There were no differences in serum ALT enzyme activity between the groups. Our results suggest that hypolipidemic and antiatherogenic effects could be related with the presence of polar substances present in aqueous extract of C. scolymus.

Coronal microleakage of endodontically treated teeth with intracanal post exposed to fresh human saliva

OBJECTIVE: The aim of this study was to investigate the coronal microleakage of endodontically treated teeth prepared to receive an intracanal post and teeth with an intracanal post but without a prosthetic crown and exposed to contamination by fresh human saliva. MATERIAL AND METHODS: A mechanical-chemical preparation following the step-back technique was carried out in 35 extracted single-rooted human teeth. The teeth were randomly divided into five groups: G1=root canals instrumented, obturated, and prepared to receive an intracanal post (N=10); G2=root canals with cemented posts but without coronal sealing (N=10); PC1=positive control root canals instrumented and open (N=5); PC2=positive control 2 root canals without instrumentation and open (N=5); and NC=negative control healthy teeth (N=5). The crowns were removed except for the control group of intact teeth. The root canals were obturated and sterilized with cobalt 60 gamma irradiation and were then adapted in an apparatus using a Brain Heart Infusion (BHI) medium and fresh human saliva for contamination. Microbial growth was indicated by the presence of turbidity in the BHI liquid medium. RESULTS: Data were submitted to the Kaplan-Meier Survival Analysis and the Holm-Sidak statistic method, which observed an index of 90% of microleakage in root canals after 24 hours for G1 and 70% of microleakage in samples at the end of 40 days for G2. CONCLUSION: The results show that root canals with an intracanal post but without a prosthetic crown can be recontaminated when exposed to fresh human saliva in a short period. .

Psicologia da Religião no Brasil: a produção em periódicos e livros / Psychology of Religion in Brazil: the production in journals and books

Apresenta-se apreciação crítica da Psicologia da Religião no Brasil, no período de 1956 a 2005, realizada com base em artigos publicados principalmente em periódicos nacionais de Psicologia. Avaliaram-se 125 artigos, segundo o tema, a teoria e a metodologia. Observou-se tendência de aumento gradativo do número de publicações. Os temas preferidos foram saúde, experiência religiosa, vocação, identidade e relações entre psicologia e religião. A produção revela utilização de teorias, conceitos e métodos da linha-mestra da Psicologia. A apreciação crítica é contextualizada em termos da origem da Psicologia da Religião no Brasil, da sua institucionalização acadêmica e dos eventos que resultaram numa literatura científica específica.

A critical evaluation of Psychology of Religion in Brazil, from 1956 to 2005, based mainly on articles published in Brazilian journals of Psychology, is presented. One hundred and twenty five articles were evaluated according to their subject matter, and their theoretical and methodological dimensions. It was observed an increasing trend in the number of publications. The subject matters most studied were health, religious experience, vocation, identity and relationship between psychology and religion. The production demonstrates preference for theories, concepts and methods of Psychology mainstream. The critical evaluation is placed in the context of the history of Psychology of Religion in Brazil, its academic institutionalization and the events that resulted in a specific scientific literature.

Processos psicológicos da conversão religiosa: imaginário e simbólico, categorização e prototipicalidade / Psychological processes of religious conversion: the imaginary and the symbolic, categorization and prototypicality

Este estudo teve como objetivos 1)estudar o processo da mudança religiosa, à luz de um instrumento da análise inspirado nos conceitos lacanianos de imaginário e de simbólico; 2)discutir essa mesma mudança à luz da teoria da identidade social da Escola de Bristol; 3) procurar possíveis convergências entre as análises ensejadas pelo instrumento e pela teoria mencionada. Os Sujeitos foram 5 adultos do sexo feminino, de origem religiosa católica, filiados há pelo menos 5 anos à Seicho-no–iê ou à PL, religiões de origem japonesa. Os dados foram coletados por meio de entrevista semidirigida, relacionada com o processo de adesão à nova religião. Os principais resultados indicam que a mudança religiosa ocorrida nos entrevistados foi a do tipo simbólico e que a mudança simbólica no nível do indivíduo encontra correspondência, no nível psicossocial, com as noções de categorização, autocategorização e prototipicalidade das teorias da identidade social.

Studies on the effectiveness of diarylheptanoids derivatives against Leishmania amazonensis

In a previous work we demonstrated that diarylheptanoids extracted from Centrolobium sclerophyllum are very active against Leishmania amazonensis promastigotes. In order to continue our studies with these class of compounds, we decided to evaluate the activity of several diarylheptanoids derived from curcumin (diferuloyl methane) against the extracellular form (promastigotes) of L. amazonensis. Furthermore, an experiment against the intracellular form of the parasite (amastigotes) was carried out, comparing the most active compound among the curcumin derivatives (the methylcurcumin) with des-O-methylcentrolobine, the most active diarylheptanoid derived from C. sclerophyllum

Síndrome fetal do warfarin: relato de um caso / Fetal warfarin syndrome: a case report

Os autores relatam o caso de uma paciente portadora de próteses valvulares cardíacas que fez uso de anticoagulantes orais durante toda a gestaçäo e deu a luz um recém-nascido com a síndrome Fetal do Warfarin (embriopatia por warfarin). Baseados neste caso e em outros da literatura mundial, os autores discutem a síndrome e enfatizam o risco teratogênico associado ao uso deste fármaco