[Consumption of nutrients among the elderly living in Porto Alegre in the State of Rio Grande do Sul, Brazil: a population-based study]. / Consumo de nutrientes em idosos residentes em Porto Alegre (RS), Brasil: um estudo de base populacional.

A cross-sectional, population-based study was conducted on a random sample of 427 elderly individuals living in Porto Alegre, Brazil, to establish the nutrient consumption profile and verify its association with sociodemographic and health variables. Dietary intake was assessed using the 24-hour Food Recall Survey and the Dietetic Research Investigation technique. Seventy percent of the elderly respondents were women: 48.5% were between 60 and 69 years old; 68.8% had less than 8 years of schooling; 39% had a family income of between 2 and 5 minimum wages and 58.4% took no physical exercise. Hypertension was the most prevalent disease among the elderly and 54.9% were underweight. Men consumed more calories, protein, fiber, minerals and vitamins than women. Carbohydrate and calcium intake increases with advancing age, while zinc intake decreases. Physical exercise increased the intake of calories, magnesium, potassium and phosphorus. The higher the schooling the greater the intake of vitamins B6 and B12; the higher the family income, the greater the consumption of vitamin B6 and folic acid. The results show that there are nutritional deficiencies in the daily diet of the Brazilian elderly population, especially among women and individuals over 80 years of age.

The association between the chronic use of non-steroidal anti- inflammatory drugs and oxidative and inflammatory markers in the elderly.

OBJECTIVES: Investigate the association between the chronic or occasional use of nonsteroidal anti-inflammatory drugs (NSAIDs) and plasma levels of oxidative and inflammatory markers in elderly at the Family Health Strategy in Brazil. METHODS: It was a cross-sectional study of data collected from random elderly volunteers. A questionnaire including sociodemographic, health and medicine use data was administered. The blood levels of FRAP (ferric reducing ability of plasma), AOPP (plasma advanced oxidation protein products), MDA (malondialdehyde) and insulin were measured. RESULTS: The study sample comprised 758 elderly patients, of which 121 (15.96%) used NSAIDs. The mean age was 68.53 years and 68.41 for individuals who used NSAIDs occasionally and chronically, respectively. Gastric problems may be associated with the chronic or occasional use of NSAIDs (P = 0.042). Which indicates mean plasma levels of Insulin and HOMA-IR (Homeostasis Model Assessment Insulin Resistance) are increased in chronic use of NSAIDs and describes a statistical trend (P = 0.065) for the association of chronic NSAIDs use with the BMI (body mass index) of the subjects studied. CONCLUSION: This study suggests that there is no association between the chronic or occasional use of NSAIDs and oxidative and inflammatory markers. It is known that NSAIDs have innumerable adverse effects, but they can have some benefits. So, additional studies are needed to clarify whether NSAIDs are associated with these markers and whether they are related with their real consequences.

Soroepidemiologia de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família, Porto Alegre, Rio Grande do Sul, Brasil / Seroepidemiology of Toxoplasma gondii in elderly individuals treated under the Family Health Strategy, Porto Alegre, Rio Grande do Sul, Brazil

O objetivo desse estudo foi avaliar a soroprevalência para Toxoplasma gondii e a relacionar com as condições socioeconômicas, higiênicas, sanitárias e de saúde nos idosos da Estratégia Saúde da Família - ESF, do município de Porto Alegre, Rio Grande do Sul, Brasil. A pesquisa realizada foi um estudo transversal, no qual foi aplicado um questionário de inquérito epidemiológico e realizada coleta de sangue. A avaliação de IgG e IgM anti-T. gondii foi realizada pela técnica de ELISA. Foram avaliados 599 idosos com soroprevalência para IgG anti-T. gondii de 88,0% e de 0,8% para IgM. Na análise multivariada, as variáveis que se associaram de forma independente para IgG positivo foram: faixa etária, renda pessoal e uso de óculos; e para IgM positivo: faixa etária, autopercepção de saúde e uso de óculos. Os resultados obtidos chamam a atenção pela alta prevalência de IgG anti-T. gondii nos idosos da ESF de Porto Alegre, gerando uma preocupação no caso de ocorrência de reativação da toxoplasmose e desenvolvimento dos sintomas mais graves dessa infecção.

The aim of this study was to evaluate the seroprevalence of Toxoplasma gondii and relate it to the socioeconomic, hygienic, sanitary and health conditions of the elderly of the Family Health Strategy (FHS) in the city of Porto Alegre, Rio Grande do Sul, Brazil. The research involved a cross-sectional study in which a questionnaire with epidemiologic questions was applied and blood samples were taken. The assessment of IgG and IgM anti-T. gondii was performed using the ELISA technique. Seroprevalence was evaluated among 599 elderly individuals with 88% for IgG anti-T. gondii and with 0.8% for IgM. In the multivariate analysis, the variables that associated themselves independently with positive IgG were age range, personal income and wearing spectacles. Those associated with positive IgM were age, self-rated health and wearing spectacles. The results call attention to the high prevalence of IgG anti-T. gondii in elderly individuals in the FHS in Porto Alegre, generating concern in the event that the reactivation of toxoplasmosis and the development of more severe symptoms of this infection occur.

Prevalência de obesidade associada à ingestão calórica, glicemia e perfil lipídico em uma amostra populacional de idosos do Sul do Brasil / Obesity prevalence associated with caloric intake, glycemia, and serum lipides in a sample population of elderly adults from Southern Brazil

OBJETIVO: Determinar a prevalência de obesidade associada ao consumo de macronutrientes, às alterações do perfil lipídico, à glicemia e à prática de atividade física em idosos. MÉTODOS: Foi realizado estudo transversal com 304 idosos do município de Porto Alegre, RS, Brasil. Medidas antropométricas de peso e altura foram utilizadas para o cálculo do índice de massa corporal (IMC) e foram analisados o perfil lipídico, a glicemia, a ingestão diária de macronutrientes e a prática de atividade física. RESULTADOS: A prevalência de obesidade foi de 30,6%, sofrendo redução com o aumento da idade. As idosas obesas apresentaram maior frequência de hipertrigliceridemia, cujos valores aumentaram conforme o aumento do IMC. Nesse grupo, a prática de atividade física foi menor. Entre os homens, houve maior consumo de proteína na dieta. CONCLUSÃO: Os resultados mostraram que a obesidade é um importante problema de saúde na Região Sul do Brasil, sofrendo influência de fatores socioculturais e econômicos que prejudicam a manutenção de uma alimentação saudável. Políticas públicas devem ser direcionadas a fim de controlar esse problema, já que a obesidade é um fator limitante para a longevidade.

OBJECTIVE: To determine the prevalence of obesity in elderly adults associated with macronutrient consumption, lipid profile, blood glucose and physical activity. METHODS: A cross-sectional-study was made with 304 elderly patients from Porto Alegre, State of Rio Grande do Sul, Brazil. Anthropometric measures of weight and height were used to calculate body mass index (BMI), and lipid profile, blood glucose, daily intake of nutrients, and physical activity were analyzed. RESULTS: The prevalence of obesity was 30.6%, decreasing with increased age. Obese women had higher frequency of hypertriglyceridemia and these values increased with increasing BMI. In this group, physical activity was lower. Among men, there was higher intake of dietary protein. CONCLUSION: The results show that obesity is an important health problem in Southern Brazil, being influenced by socio-cultural and economic factors that make it difficult to keep a healthy diet. Public policies should be adopted to control that problem, since obesity is a limiting factor for longevity.

Hematological parameters and prevalence of anemia among free-living elderly in south Brazil.

OBJECTIVE: The aims of this study were to analyze the hematological parameters, the prevalence of anemia and the association between anemia and socioeconomic conditions in an elderly community-based population. METHODS: A population-based study was performed as part of the Multidimensional Study of the Elderly in Porto Alegre, Brazil (EMIPOA). An initial total of 1058 community residents aged 60 years and older were interviewed. Of these, 392 agreed to have a physical evaluation and a blood sample was taken from each. The hematological parameters analyzed in the blood samples included the hemoglobin concentration, mean cell volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW). The association between the variables and the diagnosis of anemia was assessed using the chi-squared test and a multiple logistic regression model. RESULTS: The overall prevalence of anemia was 12.8%. Anemia was present in 13.7% of women and in 10.4% of men. Normocytic normochromic anemia without anisocytosis was the most common type of anemia (46%). The assessment of erythrocyte morphology showed significant differences between anemic and non-anemic individuals (microcytosis = 12% vs. 1.5%, hypochromia = 40% vs. 8.8%, and anisocytosis = 26% vs. 7%). In the analysis of socioeconomic conditions, significant differences were found in respect to age and race. CONCLUSION: The prevalence of anemia increases with age and is associated with race, microcytosis, hypochromia and anisocytosis. Anemia is not a condition that should be associated only with the aging process, as it may be due to pathological conditions that occur most frequently in this age group. As a result, a diagnosis of anemia warrants adequate clinical attention.

Intestinal parasitism and socio-environmental factors among Mbyá-Guarani Indians, Porto Alegre, Rio Grande do Sul, Brazil.

Disturbing data reveal the prevalence of intestinal parasites and their relationship with socio-environmental factors among Mbyá-Guarani Indians. The prevalence was determined by spontaneous sedimentation in water, centrifugation-floatation, and Kato-Katz. A socioeconomic questionnaire was submitted to each family. The overall prevalence of intestinal parasites was 88.7%, and 45.5% were polyparasitized. There was 90.5% prevalence of enteric parasites in children (1-12- year-old), and 85% among 13-65-year-old individuals, indicating that both age groups are extensively parasitized. The parasite load was low to moderate for geohelminths and 75% of the families did not have latrine, thus the practice of defecation occurred outdoors. These findings suggest that the multiple intestinal parasitism in the Mbyá-Guarani community is high to the point of being the rule, and that it relates essentially to the traditional lifestyle and health habits. It is urgently necessary to implement the association of anti-parasitic treatment with sanitation improvement. This should be done simultaneously with health education activities for this population.

Analysis of the NTPDase and ecto-5'-nucleotidase profiles in serum-limited Trichomonas vaginalis.

Trichomonas vaginalis is a parasite of the human urogenital tract that causes trichomonosis, the most prevalent non-viral sexually transmitted disease. Ectonucleoside triphosphate diphosphohydrolase (NTPDase) family members, which hydrolyse extracellular ATP and ADP and ecto-5'-nucleotidase, which hydrolyses AMP, have been characterised in T. vaginalis. For trichomonad culture, the growth medium is supplemented with 10% serum, which is an important source of nutrients, such as adenosine. Here, we investigated the ATP metabolism of T. vaginalis trophozoites from long-term cultures and clinical isolates under limited bovine serum conditions (1% serum). The specific enzymatic activities were expressed as nmol inorganic phosphate (Pi) released/min/mg protein, the gene expression patterns were determined by reverse transcriptase-polymerase chain reaction, the extracellular adenine nucleotide hydrolysis was analysed by high performance liquid chromatography and the cell cycle analysis was assessed by flow cytometry. Serum limitation led to the profound activation of NTPDase and ecto-5'-nucleotidase activities. Furthermore, the levels of NTPDase A and B transcripts increased and extracellular ATP metabolism was activated, which led to enhanced ATP hydrolysis and the formation of ADP and AMP. Moreover, the cell cycle was arrested at the G0/G1 stage, which suggested adenosine uptake. Our data suggest that under conditions of serum limitation, NTPDase and ecto-5'-nucleotidase play a role in providing the adenosine required for T. vaginalis growth and that this process contributes to the establishment of parasitism.

Involvement of purinergic signaling on nitric oxide production by neutrophils stimulated with Trichomonas vaginalis.

Trichomonas vaginalis is a parasite from the human urogenital tract that causes trichomonosis, the most prevalent non-viral sexually transmitted disease. The neutrophil infiltration has been considered to be primarily responsible for cytological changes observed at infection site, and the chemoattractants can play an important role in this leukocytic recruitment. Nitric oxide (NO) is one of the most widespread mediator compounds, and it is implicated in modulation of immunological mechanisms. Extracellular nucleotides and nucleosides are signaling molecules involved in several processes, including immune responses and control of leukocyte trafficking. Ectonucleoside triphosphate diphosphohydrolase members, ecto-5'-nucleotidase, and adenosine deaminase (ectoADA) have been characterized in T. vaginalis. Herein, we investigated the effects of purinergic system on NO production by neutrophils stimulated with T. vaginalis. The trophozoites were able to induce a high NO synthesis by neutrophils through iNOS pathway. The extracellular nucleotides ATP, ADP, and ATPγS (a non-hydrolyzable ATP analog) showed no significant change in NO secretion. In contrast, adenosine and its degradation product, inosine, promoted a low production of the compound. The immunosuppressive effect of adenosine upon NO release by neutrophils occurred due to adenosine A(2A) receptor activation. The ecto-5'-nucleotidase activity displayed by T. vaginalis was shown to be important in adenosine generation, indicating the efficiency of purinergic cascade. Our data suggest the influence of purinergic signaling, specifically adenosinergic system, on NO production by neutrophils in T. vaginalis infection, contributing to the immunological aspects of disease.

Gender differences, polypharmacy, and potential pharmacological interactions in the elderly.

OBJECTIVE: This study aims to analyze pharmacological interactions among drugs taken by elderly patients and their age and gender differences in a population from Porto Alegre, Brazil. METHODS: We retrospectively analyzed the database provided by the Institute of Geriatric and Gerontology, Porto Alegre, Brazil. The database was composed of 438 elderly and includes information about the patients' disease, therapy regimens, utilized drugs. All drugs reported by the elderly patients were classified using the Anatomical Therapeutic and Chemical Classification System. The drug-drug interactions and their severity were assessed using the Micromedex® Healthcare Series. RESULTS: Of the 438 elderly patients in the data base, 376 (85.8%) used pharmacotherapy, 274 were female, and 90.4% of females used drugs. The average number of drugs used by each individual younger than 80 years was 3.2±2.6. Women younger than 80 years old used more drugs than men in the same age group whereas men older than 80 years increased their use of drugs in relation to other age groups. Therefore, 32.6% of men and 49.2% of women described at least one interaction, and 8.1% of men and 10.6% of women described four or more potential drug-drug interactions. Two-thirds of drug-drug interactions were moderate in both genders, and most of them involved angiotensin-converting enzyme inhibitor, non-steroidal anti-inflammatory, loop and thiazide diuretics, and ß-blockers. CONCLUSION: Elderly patients should be closely monitored, based on drug class, gender, age group and nutritional status.

Kinetic characterization and gene expression of adenosine deaminase in intact trophozoites of Trichomonas vaginalis.

Trichomonas vaginalis is a parasite that resides in the human urogenital tract and causes trichomonosis, the most prevalent nonviral sexually transmitted disease. Nucleoside triphosphate diphosphohydrolase (NTPDase), which hydrolyzes extracellular di- and triphosphate nucleotides, and ecto-5'-nucleotidase, which hydrolyzes AMP, have been characterized in T. vaginalis. The aim of this study was to characterize the adenosine deaminase (ADA) activity in intact trophozoites of T. vaginalis. A strong inhibition in adenosine deamination was observed in the presence of calcium and magnesium, which was prevented by EDTA. The apparent K(M) value for adenosine was 1.13 ± 0.07mM. The calculated V(max) was 2.61 ± 0.054 nmol NH(3) min(-1) mg(-1) protein. Adenosine deamination was inhibited in the presence of erythro-9-(2-hydroxy-3-nonyl)adenine. Semi-quantitative reverse transcriptase-PCR experiments were performed and both ADA-related genes ada(125) and ada(231) mRNA were expressed, although ada(231) in higher quantity when compared with the ada(125) : α-tubulin ratio. Furthermore, a phylogenetic analysis showed that the T. vaginalis sequences formed a clade with Entamoeba histolytica and Dictyostelium discoideum sequences, and it strongly suggests homologous functions in the T. vaginalis genome. The presence of ADA activity in T. vaginalis may be important to modulate the adenosine/inosine levels during infection and, consequently, to maintain the anti-inflammatory properties through different nucleoside-signalling mechanisms.

Screening and bioguided fractionation of Amaryllidaceae species with anti-Trichomonas vaginalis activity.

The Amaryllidaceae family is known by its ornamental and medicinal value and has attracted considerable attention due to the content of alkaloids of its species, which showed interesting biological properties. The present study evaluated the anti-Trichomonas vaginalis activity of eighteen extracts (12.5 to 0.19 mg/mL) and six isolated alkaloids (125 to 1.9 µg/mL) from Amaryllidaceae species. The alkaloids diminished the trophozoites viability (from 15 to 40 %). The extracts from Hippeastrum breviflorum demonstrated the highest anti-T. vaginalis activity (viability was 60 % reduced), and a bioguided study was conducted. Six fractions with antiprotozoal activity had lycorine and lycosinine as major components suggesting a synergistic effect, taking into account the higher anti-T. vaginalis activity of extracts when compared to isolated alkaloids. Our results point out the antiprotozoal potential of the Amaryllidaceae species against T. vaginalis. This parasite causes trichomonosis, the most prevalent nonviral sexually transmitted diseases (STD) worldwide and a public health problem that requires new therapeutic alternatives as well bioactive natural products.

Lycorine induces cell death in the amitochondriate parasite, Trichomonas vaginalis, via an alternative non-apoptotic death pathway.

In this study, the mechanism of action of the pro-apoptotic alkaloid lycorine on an amitochondriate cell, the parasite Trichomonas vaginalis, was investigated. The cytotoxicity of lycorine against T. vaginalis was studied from 2.5 to 1000µM and several important ultrastructural alterations were observed by electron microscopy. Lycorine arrested the T. vaginalis cell cycle, although no hallmarks of apoptosis, such as apoptotic bodies, were observed. Consequently, the underlying mechanism of action fails to completely fulfill the criteria for apoptosis. However, some similarities to paraptotic cell death were observed.

Gender differences, polypharmacy, and potential pharmacological interactions in the elderly

OBJECTIVE: This study aims to analyze pharmacological interactions among drugs taken by elderly patients and their age and gender differences in a population from Porto Alegre, Brazil. METHODS: We retrospectively analyzed the database provided by the Institute of Geriatric and Gerontology, Porto Alegre, Brazil. The database was composed of 438 elderly and includes information about the patients' disease, therapy regimens, utilized drugs. All drugs reported by the elderly patients were classified using the Anatomical Therapeutic and Chemical Classification System. The drug-drug interactions and their severity were assessed using the Micromedex® Healthcare Series. RESULTS: Of the 438 elderly patients in the data base, 376 (85.8 percent) used pharmacotherapy, 274 were female, and 90.4 percent of females used drugs. The average number of drugs used by each individual younger than 80 years was 3.2±2.6. Women younger than 80 years old used more drugs than men in the same age group whereas men older than 80 years increased their use of drugs in relation to other age groups. Therefore, 32.6 percent of men and 49.2 percent of women described at least one interaction, and 8.1 percent of men and 10.6 percent of women described four or more potential drug-drug interactions. Two-thirds of drug-drug interactions were moderate in both genders, and most of them involved angiotensin-converting enzyme inhibitor, non-steroidal anti-inflammatory, loop and thiazide diuretics, and β-blockers. CONCLUSION: Elderly patients should be closely monitored, based on drug class, gender, age group and nutritional status.

Candimine-induced cell death of the amitochondriate parasite Trichomonas vaginalis.

Candimine (1), an alkaloid from the bulbs of Hippeastrum morelianum, was found to be cytotoxic for the amitochondriate parasite Trichomonas vaginalis. Candimine (1) induced cell death with an unprecedented group of effects that failed to fulfill the criteria for apoptosis and apoptosis-like death already reported in trichomonads. Arrest of the parasite cell cycle, and morphologic and ultrastructural alterations, including marked cytoplasmic vacuolization, were induced by 1. The present findings suggest some similarities to paraptotic cell death, described for multicellular organisms. This study contributes to both a better understanding of the biological effects of 1 and T. vaginalis cell biology.

Trichomonas vaginalis: dehydroepiandrosterone sulfate and 17beta-estradiol alter NTPDase activity and gene expression.

We investigated the effect of dehydroepiandrosterone sulfate (DHEAS) and 17beta-estradiol on NTPDase activity in fresh clinical (VP60) and long-term-grown (30236 ATCC) isolates of Trichomonas vaginalis followed by NTPDase gene transcriptional analysis. ATP hydrolysis was activated in vitro by 17beta-estradiol (0.01-1.0microM) in the VP60 isolate. Treatment for 2h with 17beta-estradiol (0.01-1microM) promoted an inhibition in nucleotide hydrolysis in the 30236 isolate whereas the 12h-treatment promoted an activation of nucleotide hydrolysis in both isolates. ADP hydrolysis was inhibited in vitro by 1.0-5.0microM DHEAS in the ATCC isolate. The treatment with DHEAS (0.01-1.0microM) for 2h inhibited ATP and ADP hydrolysis in VP60; however, during a 12h-treatment with DHEAS, nucleotide hydrolysis was inhibited in both isolates. Two NTPDase orthologous (NTPDaseA and NTPDaseB) were identified and the treatment with DHEAS for 12h was able to inhibit mRNA NTPDaseA transcript levels from the VP60. These findings demonstrate that NTPDase activity and gene expression pattern are modulated by exposure to steroids in T. vaginalis.

Trichomonas vaginalis nucleoside triphosphate diphosphohydrolase and ecto-5'-nucleotidase activities are inhibited by lycorine and candimine.

Drug discovery from plants plays an important role in the pharmaceutical therapy field and the alkaloids lycorine and candimine are candidates for this purpose. Trichomonas vaginalis is a parasite that infects the human urogenital tract and causes trichomonosis, the most prevalent non-viral sexually transmitted disease. Ecto-nucleotidases including nucleoside triphosphate diphosphohydrolase (NTPDase) members, which hydrolyses extracellular ATP (adenosine triphosphate) and ADP (adenosine diphosphate), and ecto-5'-nucleotidase, which hydrolyses AMP (adenosine monophosphate), have been characterized in T. vaginalis. Because purine nucleotides are released from cells under physiological and stress conditions, the goal of this study was to evaluate the effect of lycorine and candimine on T. vaginalis NTPDase and ecto-5'-nculeotidase activities. The alkaloids (50 to 250microM) were tested against both long-term-grown and clinical isolates. Specific enzymatic activities were expressed as nmolPi released/min/mg protein. The effect of both alkaloids at NTPDase A and B expression levels was investigated. When the alkaloids were added directly to the reaction mixture, no effect on ATP, ADP or AMP hydrolysis was observed. NTPDase and ecto-5'-nucleotidase activities were strongly inhibited by candimine and lycorine on 24h-treated parasites. This effect was abolished when 24-treated parasites were innoculated in a culture medium without alkaloid. Transcript levels of NTPDase A or B were not altered by the alkaloids. Considering the cytotoxic and proinflammatory roles of ATP besides the anti-inflammatory effects of adenosine, the regulation of extracellular nucleotide levels could be relevant in increasing susceptibility of T. vaginalis to host immune response in the presence of lycorine and candimine.

Uso de hipoglicemiantes e adesã à terapia por pacientes diabéticos atendidos no Sistema Único de Saúde / Use of oral hypoglycemic agents and adherence to therapy by diabetics in the Brazilian Unified Health System

Introdução: A incidência de Diabetes Melito atinge proporções epidêmicas fazendo com que sua prevenção seja uma prioridade de saúde pública. Programas de Atenção Farmacêutica vêm se destacando como instrumentos no cuidado dos pacientes diabéticos. Objetivo: Avaliar o uso de hipoglicemiantes e a adesão à terapia por pacientes diabéticos atendidos pelo Sistema Único de Saúde. Métodos: Foi realizado um estudo transversal. Utilizou-se um questionário farmacoterapêutico e avaliaram-se os valores de glicemia capilar, colesterol, triglicerídeos, hemoglobina glicada, pressão arterial e índice de massa corporal. Foi avaliada a existência dos Problemas Relacionados com Medicamentos. Resultados: Foram entrevistados 52 pacientes diabéticos, com idade média de 69,2±10,8 anos para as mulheres e 67,8 ±10,9 anos para os homens. Os valores de hemoglobina glicada mostraram diferença significativa (P<0,001) entre os sexos e o índice de massa corporal mostrou-se acima dos valores normais. Verificou-se que 51,9% dos pacientes utilizava mais de 5 medicamentos e 48,1% eram pouco aderentes à terapia. Encontrou-se 21 potenciais interações medicamentosas. Conclusão: Este estudo mostra a relevância do acompanhamento farmacoterapêutico à pacientes diabéticos e a importância do comprometimento de toda a equipe de saúde para desenvolver e acompanhar o plano terapêutico desses pacientes.

Background: The incidence of diabetes mellitus has reached epidemic proportions; therefore, its prevention is a public health priority in our days. Pharmaceutical care programs have gained prominence as a tool in the care of diabetic patients. Aim: To evaluate the use of hypoglycemic agents as well as the adherence to therapy by diabetic patients receiving treatment from the Brazilian Unified Health System. Methods: We conducted a cross-sectional study. A pharmacotherapeutic questionnaire was administered and values of capillary blood glucose, cholesterol, triglycerides, glycated hemoglobin, blood pressure, and body mass index were assessed. We evaluated the existence of drug related problems and drug interactions. Results: Fifty-two diabetic patients were interviewed with a mean age of 69.2±10.8 for women and 67.8±10.9 for men. Glycated hemoglobin levels showed significant difference (P<0.001) between men and women, body mass index was found to be above normal. The analysis of the drugs showed that 51.9% of the patients used more than five drugs and 48.1% of the patients were poorly adherent to therapy. We found 21 potential drug interactions. Conclusion: The present study demonstrates the relevance of the pharmaceutical follow-up of patients with diabetes; thus, the commitment of the entire health care team to develop and monitor the treatment of these patients is very important.

Steroid hormones alter AMP hydrolysis in intact trophozoites of Trichomonas vaginalis.

Trichomonas vaginalis infection may be influenced by the vaginal concentrations of estrogens. We have investigated the effects of 17beta-estradiol and dehydroepiandrosterone sulfate (DHEAS) on the ecto-5'-nucleotidase activity in fresh clinical (VP60) and in long-term-grown (30236 ATCC) isolates of T. vaginalis. In vitro exposure to DHEAS and 17beta-estradiol did not induce any changes in adenosine monophosphate (AMP) hydrolysis in these isolates. The treatment of parasites in the presence of DHEAS (0.01-1.0 microM) for 2 h inhibited AMP hydrolysis in VP60 isolate, whereas there were no significant changes in nucleotide hydrolysis in the presence of 17beta-estradiol. DHEAS and 17beta-estradiol (0.01-1.0 microM) for 2 h inhibited AMP hydrolysis in 30236 isolate. The 12 treatment with 0.1 microM DHEAS inhibited AMP hydrolysis, whereas 17beta-estradiol did not alter the nucleotide hydrolysis in VP60 isolate. Our findings have shown that the complex effect of steroid hormones and their receptors on T. vaginalis may promote changes in ecto-5'-nucleotidase activity during exposure to these hormones.

A quantitative resazurin assay to determinate the viability of Trichomonas vaginalis and the cytotoxicity of organic solvents and surfactant agents.

Trichomonas vaginalis causes trichomonosis, the most common, non-viral sexually transmitted disease. To test anti-Trichomonas agents, usually many with low water solubility, organic solvents and surfactant agents should be used. Therefore, the minimal inhibitory concentration (MIC) of acetone, methanol, ethanol, isopropanol, DMSO, Tween 20, Tween 80, and Triton X-100 was determined against T. vaginalis isolates using the quantitative resazurin method. Our results showed that solvents and surfactant agents can be employed as vehicles to test bioactive compounds at lower concentrations than MIC values and we suggest acetone and DMSO as preferential. Moreover, a new methodology is established to substitute or to complement the counting of viable trophozoites. The amount of resazurin reduced by T. vaginalis can be quantified by fluorescence spectroscopy, making the test a quantitative determination of cell viability. These results contribute for pharmacological investigations of bioactive compounds that need the use of solvents as solubilization vehicles to test anti-Trichomonas activity.

Indigenous traditional medicine: in vitro anti-giardial activity of plants used in the treatment of diarrhea.

The ethnopharmacology for treatment of parasitic infections facilitates and directs the search for new chemical entities. In this direction, this study evaluated the cytotoxicity in vitro, against trophozoites of Giardia lamblia, of aqueous extracts of leaves Achyrocline satureioides (Lam.) DC., barks of Eugenia uniflora L., aerial parts of Foeniculum vulgare Miller, and barks of Psidium guajava L. These plants are traditionally used for the treatment of diarrhea by the indigenous population Mbyá-Guarani, located at the Lomba do Pinheiro, Porto Alegre, Rio Grande do Sul, Brazil. The in vitro susceptibility qualitative analysis of G. lamblia to aqueous extracts was performed in serial dilutions from 2.5 to 0.02 mg/mL. Results revealed the minimal inhibitory concentrations: 0.313 mg/mL for A. satureioides and E. uniflora, 0.02 mg/mL for P. guajava, and F. vulgare did not present any cytotoxic effect. Quantitative assays of viable trophozoites, showed that A. satureioides presented the highest cytotoxic effect (93.5%), followed by P. guajava (82.2%), and E. uniflora (67.3%). Indigenous Guarani use mainly A. satureioides for the treatment of diarrhea, revealing the conformity with results obtained in vitro. Bioguided assays are necessary to identify the compounds responsible for the activity of the aqueous extract of A. satureioides.