Effects of a physiotherapeutic protocol in cardiorespiratory, muscle strength, aerobic capacity and quality of life after hematopoietic stem cell transplantation.

OBJECTIVE: To analyze the effects of hospital cardiorespiratory physical therapy protocol on the functional capacity and quality of life of patients submitted to hematopoietic stem cell transplantation (HSCT). METHODS: From January to December 2019, bilateral dynamometry, Manovacuometry and Ventilometry, peak expiratory flow "Peak Flow", 6-min walk test (6MWT), SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS) were applied in patients who have undergone an allogeneic or autologous hematopoietic stem cell transplantation (HSCT), pre-conditioning (initial evaluation) and pre-discharge (final evaluation). The patients were submitted to an intervention protocol, consisting of aerobic training, muscle strengthening and respiratory muscle training, between the two assessments. RESULTS: 29 patients were enrolled in the study and 24 (83%) completed all procedure. Myeloablative and reduced intensity conditioning were performed in 89.6% and 10.4%, respectively; 17 (58%) patients have undergone an autologous HSCT; 10 (35%) identical related allogeneic HSCT, and 2 (7%) haploidentical allogeneic HSCT. The median number of interventions per patient was 3 (1-9). A decreasing in the right and left dynamometry (p  ≤ 0.0001 and 0.002, respectively) and, also in the distance covered in the 6MWT (p  = 0.004), was observed after HSCT. There was no significant difference in respiratory muscle strength, quality of life and fatigue sensation. CONCLUSION: Cardiorespiratory rehabilitation can preserve functional capacity and quality of life.

Aeromonassp. in freshwater fish and antimicrobial resistance: emerging pathogen / Quantificação deAeromonassp. em peixes de água doce e resistência a antimicrobianos: patógeno emergente

ABSTRACT: The bacteria Aeromonassp. are naturally reported in aquatic ecosystems and possess pathogenic potential, being considered as emerging pathogens in humans and animals. They also cause considerable losses in fish farming and, through water, can contaminate numerous foods. This study quantified and analyzed the antimicrobial resistance profile of Aeromonassp. in fish. A total of 72 samples of two fish varieties (leather fish, Pseudoplatystomafasciatumx Leiariusmarmoratusand round fish, Colossomamacropomumx Piaractusmesopotamicusand Colossomamacropomumx Piaractusbrachypomus) were purchased from two types of sources (fresh and frozen) and three commercial establishments (supermarket, market, and fishmonger). The 55 isolated Aeromonascultures were evaluated for their antimicrobial resistance profile by the disc diffusion method. Upon quantification, the count of Aeromonassp. ranged from 4.22 to 6.00 Log CFU/g; ten different species, including A. eucrenophila, A. hydrophila, A. caviae, A. media, A. jandaei, A. veroniibv. sobria, A. trota, A. schubertii, A. veroniibv. veronii, and A. shigelloides, were identified. Among the 55 isolates, 64.45% showed resistance to Ampicillin-sulbactam, and 75% were sensitive to gentamicin and ciprofloxacin. It was concluded that 100% of the evaluated samples were contaminated by Aeromonassp., which may present a risk to consumer health since bacteria can be etiological agents of Foodborne Diseases. The antimicrobial resistance profile showed resistance to ampicillin and multi-resistance to different classes of antimicrobials, demonstrating problems with choosing an antimicrobial for treatment of any disease.

RESUMO: Aeromonas sp. são bactérias presentes naturalmente no ecossistema aquático e apresentam potencial patogênico, sendo considerados patógenos emergentes em humanos e animais. Ainda, causam perdas consideráveis em piscicultura e, através da água, podem também contaminar inúmeros alimentos. Diante disso o objetivo do trabalho foi quantificar e analisar o perfil de resistência aos antimicrobianos de bactérias do gênero Aeromonas sp. em peixes. Um total de 72 amostras foram adquiridas, sendo duas variedades de peixes (peixe de couro Pseudoplatystoma fasciatum x Leiarius marmoratus e os peixes redondos Colossoma macropomum x Piaractus mesopotamicus e Colossoma macropomum x Piaractus brachypomus), dois tipos (fresco e congelado) e de três estabelecimentos comerciais (supermercado, feira e peixaria). As 55 culturas isoladas de Aeromonas foram avaliadas quanto ao perfil de resistência aos antimicrobianos pelo método de difusão em disco. Os valores encontrados na quantificação de Aeromonas sp. variaram de 4,22 a 6,00 Log UFC/g, e foram identificadas dez espécies diferentes, sendo A. eucrenophila, A. hydrophila, A. caviae, A. media, A. jandaei, A. veronii bv. sobria, A. trota, A. schubertii, A. veronii bv. veronii e A. shigelloides. Entre os 55 isolados, 64,45% apresentaram resistência a Ampicilina-sulbactam, 75% foram sensíveis à gentamicina e ciprofloxacina. Concluiu-se que 100% das amostras avaliadas estavam contaminadas por Aeromonas sp. podendo apresentar risco à saúde do consumidor visto que estas podem ser agentes etiológicos de Doenças Transmitidas por Alimentos (DTAs). O perfil de resistência aos antimicrobianos comprovou a resistência a ampicilina e apresentou multirresistência a diferentes classes de antimicrobianos, demonstrando um problema relacionado à opção de antimicrobiano para tratamento no caso do desenvolvimento de alguma doença.

Effects of a physiotherapeutic protocol in cardiorespiratory, muscle strength, aerobic capacity and quality of life after hematopoietic stem cell transplantation

Abstract Objective To analyze the effects of hospital cardiorespiratory physical therapy protocol on the functional capacity and quality of life of patients submitted to hematopoietic stem cell transplantation (HSCT). Methods From January to December 2019, bilateral dynamometry, Manovacuometry and Ventilometry, peak expiratory flow "Peak Flow", 6-min walk test (6MWT), SF-36 Quality of Life Questionnaire and Visual Analog Scale (VAS) were applied in patients who have undergone an allogeneic or autologous hematopoietic stem cell transplantation (HSCT), pre-conditioning (initial evaluation) and pre-discharge (final evaluation). The patients were submitted to an intervention protocol, consisting of aerobic training, muscle strengthening and respiratory muscle training, between the two assessments. Results 29 patients were enrolled in the study and 24 (83%) completed all procedure. Myeloablative and reduced intensity conditioning were performed in 89.6% and 10.4%, respectively; 17 (58%) patients have undergone an autologous HSCT; 10 (35%) identical related allogeneic HSCT, and 2 (7%) haploidentical allogeneic HSCT. The median number of interventions per patient was 3 (1-9). A decreasing in the right and left dynamometry (p ≤ 0.0001 and 0.002, respectively) and, also in the distance covered in the 6MWT (p = 0.004), was observed after HSCT. There was no significant difference in respiratory muscle strength, quality of life and fatigue sensation. Conclusion Cardiorespiratory rehabilitation can preserve functional capacity and quality of life.

High prevalence of protozoan infections: a permanent cycle in a brazilian semi-arid peripheric area

In regions where sanitary conditions are poor, prophylactic administration of antiparasitic drugs is common and affects the prevalence of intestinal parasites, in spite of the environmental maintenance of their life cycle. The purpose of this study was to evaluate the prevalence of parasitic infections, patient lifestyles, health conditions and environmental sources of contamination. One hundred seventy two children and adolescents, 5 to 15 years of age of both sexes were analyzed. Data were obtained through epidemiological questionnaires, parasitological examinations using Paratest®, IgG testing for Entamoeba histolytica, and analysis of sources of contamination in living areas. The study detected a prevalence of 45.9% (79/172) parasitic infections, of which 62.0% (49/79) Entamoeba histolytica/E. dispar complex; 46.8% (37/79) Entamoeba coli; 27.8% (22/79) Giardia intestinalis; 12.7% (10/79) Endolimax nana; 10.1% (8/79) Hymenolepis nana; 8.9% (7/79) Ascaris lumbricoides and 2.5% (2/79) Trichuris trichiura. Out of the 49 samples positive for Entamoeba histolytica complex, there was only one case of antibodies to E. histolytica. The children's life habits demonstrated inadequate food hygiene practices. These insufficient sanitary parameters revealed a general lack of information in face of an alarming situation regarding sewage and other sources of environmental contamination in 20% of the areas. The high prevalence of protozoan infections despite chemoprophylaxis, with environmental sources of contamination/risk, inadequate health conditions and the general apathy of the population suggest the ineffectiveness of current preventive practices. Thus, it is advisable that control actions include protozoa as therapeutic targets and, above all, health education as a routine practice to prevent the long-term continuance of this vicious cycle.

Capacidade adaptativa específica do município de São Paulo às mudanças climáticas: uma análise a partir do mapeamento das áreas de risco, sistema de alerta e planos de contingência de Defesa Civil / Specific adaptive capacity of the city of São Paulo to climate change an analysis based on the mapping of risk areas, warning system and Civil Defense contingency plans

O processo de urbanização da cidade de São Paulo foi caracterizado pelo rápido adensamento populacional e desordenada expansão da área urbana, que destinou às populações mais vulneráveis socioeconomicamente áreas distantes dos núcleos centrais e sem infraestrutura urbana. Esse processo é refletido até os dias atuais, uma vez que parcela significativa da população paulistana reside em ocupações subnormais expostas aos riscos ambientais, o que a torna mais vulnerável aos impactos das mudanças climáticas se comparada às camadas sociais mais privilegiadas e melhor localizadas espacialmente. Apesar das projeções e pesquisas mais recentes relacionadas aos impactos das mudanças climáticas no Brasil, eventos recentes evidenciam que as cidades brasileiras ainda não estão devidamente adaptadas para lidar com esse fenômeno. Entendendo que a capacidade adaptativa de um sistema (uma cidade, por exemplo) refere-se à sua aptidão em mudar para um estado mais sustentável e em mobilizar os recursos necessários para antecipar ou responder aos riscos e impactos das mudanças climáticas, o objetivo desta dissertação é contribuir para uma compreensão sobre a capacidade adaptativa, particularmente quanto à capacidade específica, do município de São Paulo frente às mudanças climáticas. Para tanto, foram analisados três instrumentos vigentes: o mapeamento de áreas de risco, o sistema de alerta e os planos de contingência que possuem interface com o clima - Plano Preventivo para Chuvas de Verão (PPCV), Plano de Contingência para situações de Baixas Temperaturas (PCBT) e Plano de Contingência para situações de Baixa Umidade (PCBU), ferramentas gerenciadas atualmente pela Coordenação Municipal de Defesa Civil (COMDEC). Os resultados obtidos nesta pesquisa, a partir de revisão de literatura, pesquisa documental, realização de entrevistas e grupos focais, evidenciam que as discussões sobre mudanças climáticas e as projeções futuras ainda não estão internalizadas nas ferramentas analisadas e que não há uma integração fortemente estabelecida entre o Comitê Municipal de Mudanças do Clima e Ecoeconomia e os demais setores da Prefeitura. Ademais, revelam que há um distanciamento da população nas ações de planejamento e execução dessas ferramentas e que as descontinuidades político-partidárias interferem negativamente no andamento dessas e de outras políticas públicas, além do déficit de recursos humanos, tecnológicos e financeiros estar associado, principalmente, às práticas ineficazes de gestão (má administração) e distribuição. Um diagnóstico sobre esses instrumentos e recomendações para facilitar o processo de adaptação e aprimorar a capacidade de adaptação específica da cidade de São Paulo serão reunidos e disponibilizados também na forma de um relatório técnico.

The urbanization process of the city of São Paulo was characterized by a rapid population density increase and disorderly expansion of the urban area, which allocated remote areas without urban infrastructure to the most socioeconomically vulnerable population. This process is reflected to the present days, since a significant part of the population of São Paulo resides in subnormal occupations exposed to environmental risks, which makes it more vulnerable to the impacts of climate change when compared to the more privileged and better located social strata. Despite recent projections and researches related to the impacts of climate change in Brazil, recent events show that Brazilian cities are not yet adequately adapted to deal with this phenomenon. Assuming that the adaptive capacity of a system (a city, for example) refers to its ability to move to a more sustainable state and to mobilize necessary resources to anticipate or respond to the risks and impacts of climate change, the objective of this dissertation is to contribute to an understanding of the adaptive capacity, particularly regarding the specific capacity of the city of São Paulo in the face of climate change. For that, the mapping of risk areas, the alert system and contingency plans that have interface with the climate were analyzed - Preventive Plan for Summer Rain (PPCV), Contingency Plan for Low Temperature Situations (PCBT) and Contingency Plan for Low Humidity Situations (PCBU), tools currently managed by the Municipal Civil Defense Coordination (COMDEC). The results obtained in this research, based on literature review, documentary research, interviews and focus groups, show that the discussions about climate change and projections were not yet internalized by the analyzed tools and that there is no strongly established integration between the Municipal Committee on Climate Change and Ecoeconomics and other sectors of the City Hall. In addition, they reveal that there is a distancing between the population and the planning and execution of these tools and that party-political discontinuities impact negatively in the progress of these and other public policies, besides the fact that the lack of human, technological and financial resources is mainly associated with ineffective management (maladministration) and distribution. A diagnosis of these instruments and recommendations to facilitate the adapting process and to improve the specific adaptation capacity of the city of São Paulo will be gathered and made available in the form of a technical report.

Relation between neonatal malnutrition and gene expression: inflammasome function in infections caused by Candida Albicans.

PURPOSE: To investigate the effects of neonatal malnutrition followed by nutritional replacement on the signaling mechanisms developed by the inflammasome complex by analyzing the expression of the targeted TLR2, TLR4, NLRP3, caspase-1 and release of IL-1ß and IL-18 by alveolar macrophages infected in vitro with Candida albicans. METHODS: Male Wistar rats (n = 24), 90-120 days, were suckled by mothers whose diet during lactation contained 17 % protein in the nourish group and 8 % protein in the malnourished group. After weaning, both groups were fed a normal protein diet. Macrophages were obtained after tracheostomy, through the collection of bronchoalveolar lavage fluid. The quantification of the expression levels of targets (TLR2, TLR4, NLRP3 and caspase-1) was performed by real-time RT-PCR. Production of cytokines was performed by ELISA. RESULTS: The malnourished animals during lactation showed reduced body weight from the fifth day of life, remaining until adulthood. Further, the model applied malnutrition induced a lower expression of TLR4 and caspase-1. The quantification of the TLR2 and NLRP3, as well as the release of IL-1ß and IL-18, was not different between groups of animals nourished and malnourished. The system challenged with Candida albicans showed high expression levels of all targets in the study. CONCLUSIONS: The tests demonstrate nutritional restriction during critical periods of development, although nutritional supplementation may compromise defense patterns in adulthood in a timely manner, preserving distinct signaling mechanism, so that the individual does not become widely vulnerable to infections by opportunistic pathogens.

Effect of neonatal malnutrition on expression of nitric oxide synthase enzyme, production of free radicals and in vitro viability of alveolar macrophages infected with methicillin-sensitive and methicillin-resistant Staphylococcus aureus.

OBJECTIVE: Evaluate the effects of neonatal malnutrition on the microbicidal response and viability of in vitro macrophages infected with Staphylococcus aureus sensitive/resistant to methicillin. METHODS: Male Wistar rats (n = 24) were divided into two distinct groups: nourished (rats breast-fed by mothers undergoing diet with 17% casein) and malnourished (rats breast-fed by mothers undergoing diet with 8% casein). Macrophages were recovered after surgical tracheostomy procedure by collecting bronchoalveolar lavage. Four systems were established: negative control, composed only by phagocytes; positive control, macrophages plus lipopolysaccharide; and two test systems, macrophages plus Staphylococcus aureus sensitive and resistant to methicillin. Plates were incubated at 37 °C for 24 h. After this period, tests for the analysis of cell viability and microbicidal response were performed. In the statistical analysis, the Student's t and ANOVA tests were used, accepting p < 0.05. RESULTS: The neonatal malnutrition impaired the animals' body weight. There was a lower expression of the inducible nitric oxide enzyme (iNOS), nitric oxide production, and viability of macrophages infected with methicillin-resistant Staphylococcus aureus. However, increased production of superoxide anion in the malnourished group was detected. CONCLUSION: Neonatal malnutrition focusing on critical periods of development promoted lower expression of iNOS, nitric oxide production, cell viability, and exacerbated reactive oxygen species production. The high levels of reactive oxygen species may favor the onset of serious and systemic infections with fatal outcome if associated with methicillin-resistant Staphylococcus aureus.

Long-term effects of neonatal malnutrition on microbicide response, production of cytokines, and survival of macrophages infected by Staphylococcus aureus sensitive/resistant to methicillin / Efeitos tardios da desnutrição neonatal na resposta microbicida, produção de citocinas e viabilidade de macrófagos na infecção por Staphylococcus aureus sensível/resistente a meticilina

OBJECTIVE: To assess microbicide function and macrophage viability after in vitro cellular infection by methicillin-sensitive/resistant Staphylococcus aureus in nourished rats and rats subjected to neonatal malnutrition. METHODS: Male Wistar rats (n=40) were divided in two groups: Nourished (rats suckled by dams consuming a 17% casein diet) and Malnourished (rats suckled by dams consuming an 8% casein diet). Macrophages were recovered after tracheotomy, by bronchoalveolar lavage. After mononuclear cell isolation, four systems were established: negative control composed exclusively of phagocytes; positive control composed of macrophages plus lipopolysaccharide; and two testing systems, macrophages plus methicillin-sensitive Staphylococcus aureus and macrophages plus methicillin-resistant Staphylococcus aureus. The plates were incubated in a humid atmosphere at 37 degrees Celsius containing 5% CO2 for 24 hours. After this period tests the microbicidal response, cytokine production, and cell viability were analyzed. The statistical analysis consisted of analysis of variance (p<0.05). RESULTS: Malnutrition reduced weight gain, rate of phagocytosis, production of superoxide anion and nitric oxide, and macrophage viability. Production of nitrite and interleukin 18, and viability of macrophages infected with methicillin-resistant Staphylococcus aureus were lower. CONCLUSION: The neonatal malnutrition model compromised phagocyte function and reduced microbicidal response and cell viability. Interaction between malnutrition and the methicillin-resistant strain decreased the production of inflammatory mediators by effector cells of the immune response, which may compromise the immune system's defense ability. .

OBJETIVO: Avaliar a função microbicida e a viabilidade de macrófagos, após infecção celular in vitro, com Staphylococcus aureus sensível/resistente a meticilina, em ratos nutridos ou submetidos a desnutrição neonatal. MÉTODOS: Ratos machos Wistar (n=40) foram divididos em dois grupos distintos: Nutrido (ratos amamentados por mães submetidas a dieta com 17% de caseína) e Desnutrido (ratos amamentados por mães submetidas a dieta com 8% de caseína). Os macrófagos foram recuperados após procedimento cirúrgico de traqueostomia, através da coleta do lavado broncoalveolar. Após o isolamento dos mononucleares, foram estabelecidos quatro sistemas: controle negativo, composto apenas pelos fagócitos; controle positivo, macrófagos mais lipopolissacarídeo; e dois sistemas teste, macrófagos mais Staphylococcus aureus sensível e resistente a meticilina. As placas foram incubadas por 24 horas, à temperatura de 37ºC, com atmosfera úmida e 5% de dióxido de carbono. Transcorrido esse período, foram realizados ensaios para análise da resposta microbicida, produção de citocinas e viabilidade celular. Na análise estatística, utilizou-se analysis of variance, admitindo-se p<0,05. RESULTADOS: A desnutrição acarretou redução do crescimento ponderal dos animais, da taxa de fagocitose, da produção de óxido nítrico, do ânion superóxido e da viabilidade de macrófagos. Houve menor produção de nitrito, de interleucina 18 e da viabilidade dos macrófagos infectados com Staphylococcus aureus meticilina-resistente. CONCLUSÃO: O modelo de desnutrição neonatal adotado comprometeu a função dos fagócitos, com redução da resposta microbicida e da viabilidade celular. A interação ...

Immunological parameters of macrophages infected by methicillin resistant/sensitive Staphylococcus aureus / Parâmetros imunológicos de macrófagos frente à infecção por Staphylococcus aureus meticilina sensível/resistente

INTRODUCTION: Could changes in Staphylococcus aureus cellular walls, which are commonly associated with multidrug resistance phenotype, influence their immune evasion mechanisms? OBJECTIVE: To evaluate the microbicide response and survival of alveolar macrophages after in vitro infection with methicillin-sensitive and methicillin-resistant Staphylococcus aureus. MATERIAL AND METHODS: We used 20 adult, male, albino, Wistar rats. The alveolar macrophage samples were obtained after tracheostomy and bronchoalveolar lavage. The alveolar macrophages were cultured in the proportion of 1:1 cells/ml Roswell Park Memorial Institute (RPMI) medium/well and isolated by plate adhesion. For the assessment of immunological parameters, four systems were established: negative control, positive control, methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA). RESULTS: When comparing MRSA and MSSA systems, there was no significant difference as to adhesion and phagocytosis rates, superoxide anion production and macrophage viability. By analyzing the kinetics of nitric oxide production, after 4 to 10 hours of cellular culture incubation, there was lower average production of this radical in the MRSA system when compared to MSSA. However, after 12 hours, no differences were detected between both systems. CONCLUSION: It is claimed that methicillin resistance may be a factor that influences the bacteria's ability to escape from macrophage microbicide response. Although the results of some immunological parameters were similar in the surveyed systems, the oscillations occurred during the production of nitric oxide may contribute significantly to the survival of Staphylococcus aureus.

INTRODUÇÃO: Modificações nas paredes celulares das cepas de Staphylococcus aureus relacionadas com o fenótipo de multirresistência poderiam influenciar seus mecanismos de evasão frente à resposta imune? OBJETIVO: Avaliar a resposta microbicida e a sobrevivência de macrófagos alveolares após infecção in vitro com Staphylococcus aureus meticilina sensível/resistente. MATERIAL E MÉTODOS: Utilizaram-se 20 ratos adultos, machos, albinos e da linhagem Wistar. Os macrófagos alveolares foram obtidos após procedimento cirúrgico de traqueostomia, por meios da coleta do lavado broncoalveolar. Os macrófagos alveolares foram cultivados na proporção de 1:1 células/ml de Roswell Park Memorial Institute (RPMI)/poço e isolados pela capacidade de adesão à placa. Para avaliação de parâmetros imunológicos, foram estabelecidos quatro sistemas: controle negativo, controle positivo, S. aureus sensível a meticilina (MSSA) e S. aureus resistente à meticilina (MRSA). RESULTADOS: Ao comparar os sistemas de MSSA e MRSA, não foi observada diferença no índice de aderência, na taxa de fagocitose, na produção do ânion superóxido e na viabilidade dos macrófagos. Ao analisar a cinética de óxido nítrico, houve menor produção média desse radical para o MRSA quando comparado com o MSSA, no período de 4 a 10 horas de incubação das culturas celulares. Entretanto, após 12 horas, não foi detectada divergências entre esses sistemas. CONCLUSÃO: Sugere-se que a resistência à meticilina poderá ser um fator que influenciará a capacidade de evasão da bactéria à resposta microbicida dos macrófagos. Apesar dos resultados de alguns parâmetros imunológicos terem sido similares entre os sistemas analisados, as oscilações ocorridas durante a produção do óxido nítrico poderão contribuir de forma importante para a sobrevivência da bactéria Staphylococcus aureus.

Desnutrição neonatal e produção de IFN-γ IL-12 e IL-10 por macrófagos/linfócitos: estudo da infecção celular, in vitro, por Staphylococcus aureus meticilina sensível e meticilina resistente / Early malnutrition and production of IFN, IL-12 and IL-10 by macrophages/lymphocytes: in vitro study of cell infection by methicillin-sensitive and methicillin-resistant Staphylococcus aureus

OBJETIVO: Avaliar a influência da desnutrição neonatal sobre a produção de Interferon gama, Interleucina-12 e Interleucina-10 em cultura de macrófagos alveolares e linfócitos infectados, in vitro, com Staphylococcus aureus sensível/resistente à meticilina. MÉTODOS: Ratos machos Wistar foram amamentados por mães cuja dieta, durante a lactação, continha 17% de proteína no grupo nutrido e 8% no grupo desnutrido. Após desmame, ambos os grupos receberam a dieta normoproteica. Os macrófagos foram obtidos após traqueostomia, através da coleta do lavado broncoalveolar. Para obtenção dos linfócitos, foi realizado o procedimento cirúrgico de punção cardíaca. Após o isolamento dos diferentes tipos celulares, procedeuse à realização dos estímulos com as cepas de estudo. A dosagem das citocinas foi realizada pelo método de Enzyme-Linked Immunosorbent Assay, a partir de amostras coletadas do sobrenadante das culturas após 24 horas de incubação. RESULTADOS: A desnutrição acarretou diminuição do crescimento ponderal, redução na produção de Interferon gama em cultura de macrófagos alveolares e linfócitos e diminuição na produção de Interleucina-12 em cultura de macrófagos alveolares. Apenas a produção de Interferon gama e Interleucina-10 em cultura de macrófagos alveolares apresentou diferença entre as cepas analisadas, em ambos os grupos estudados. CONCLUSÃO: O modelo de desnutrição neonatal produziu sequela no peso corporal e reduziu a produção de citocinas próinflamatórias (Interleucina-12 e Interferon gama), indicando que esse modelo de desnutrição pode comprometer a resolução de um processo infeccioso. A cepa de Staphylococcus aureus resistente à meticilina estimulou uma maior produção de Interferon gama e Interleucina-10 por macrófagos alveolares, o que sugeriu estimulação imunológica mais intensa, por essa cepa, nesse tipo celular especificamente.

OBJECTIVE: The present study assessed the influence of neonatal malnutrition on the production of interferon gamma, interleukin-12 and interleukin-10 in cultured macrophages and lymphocytes infected in vitro with methicillin-sensitive or methicillin-resistant Staphylococcus aureus. METHODS: Male Wistar rats were suckled by mothers fed during lactation a chow containing 17% protein for the nourished group and 8% for the undernourished group. After weaning, both groups received a normal diet in terms of protein content. The macrophages were obtained by bronchoalveolar lavage after tracheostomy. Cardiac puncture was used for the collection of lymphocytes. After isolation of different cell types, the challenge with the different strains was performed. Cytokines were measured by enzymelinked immunosorbent assay (ELISA), using samples collected from the culture supernatant after an incubation period of 24 hours. RESULTS: Malnutrition let to slow weight gain, low interferon gamma in cultured alveolar macrophages and lymphocytes and low production of interleukin-12 in cultured alveolar macrophages. Only interferon gamma and interleukin-10 in cultured alveolar macrophages differed between the two groups and study strains. CONCLUSION: The neonatal malnutrition model used impaired weight gain and reduced production of proinflammatory cytokines (interleukin-12 and interferon gamma), indicating that protein malnutrition may result in an inability to fight infections. The methicillin-resistant Staphylococcus aureus strain stimulated macrophages to produce interferon gamma and interleukin-10, suggesting that this strain better provokes the immune system, specifically for this cell type.

Suplementação de antioxidantes no tratamento da lesão pulmonar aguda: meta-análise / Antioxidant supplementation for the treatment of acute lung injury: a meta-analysis

OBJETIVO: A pesquisa foi conduzida de maneira a se esclarecer, através de uma meta-análise, as evidências da suplementação de antioxidantes como terapia adjuvante na prevenção dos danos oxidativos e melhora do desfecho clínico, tais como mortalidade, tempo de hospitalização e ventilação mecânica. MÉTODOS: A estratégia de busca de ensaios clínicos randomizados (ECRs) envolveu a participação de dois pesquisadores que avaliaram, de forma independente, a qualidade metodológica de cada artigo, disponível full text, nas bases de dados PubMed, ISI of Knowledge e ScienceDirect. RESULTADOS: Foram extraídos 110 estudos dos últimos 10 anos, porém somente 30 artigos preencheram os critérios metodológicos (ensaios controlados, randomizados, cego e estatisticamente significativo), totalizando 241 animais e 256 pacientes. Este trabalho encontrou um OR de 0,45 [intervalo de confiança (IC) 95 por cento: 0,26 - 0,79] para a mortalidade na comparação do grupo experimental com placebo (6 estudos, n = 256), um OR de de 0,46 [intervalo de confiança (IC) 95 por cento: 0,26 - 0,87] para tempo de hospitalização e um OR de 0,63 [intervalo de confiança (IC) 95 por cento: 0,35 - 1,12] para o tempo de ventilação mecânica assistida entre os grupos. CONCLUSÃO: As evidências são conflitantes e, desta forma, ainda não é possível recomendar o uso rotineiro da suplementação com antioxidantes em pacientes criticamente enfermos.

OBJECTIVE: This meta-analysis was performed to evaluate the evidence supporting antioxidant supplementation as an adjunct therapy to prevent oxidative damage and improve the clinical outcomes (mortality, length of hospital stay and duration of mechanical ventilation). METHODS: The search strategy for randomized controlled trials (RCTs) involved the participation of two researchers who independently assessed the methodological quality of each full-text article that was available in the PubMed, ISI WEB of Knowledge and ScienceDirect databases. RESULTS: We extracted 110 studies from the past 10 years, but only 30 articles met the methodological criteria (RCT, blinded and statistically significant results), for a total of 241 animals and 256 patients. This study found an odds ratio (OR) of 0.45 [95 percent confidence interval (CI): 0.26 to 0.79] for death in the experimental group compared with placebo (six trials, n = 256), an OR of 0.46 [95 percent CI: 0.26 to 0.87] for hospitalization time and an OR of 0.63 [95 percent CI: 0.35 to 1.12] for mechanical ventilation time between groups. CONCLUSION: Conflicting evidence makes it impossible to recommend the routine use of antioxidant supplementation in critically ill patients.

Antioxidant supplementation for the treatment of acute lung injury: a meta-analysis. / Suplementação de antioxidantes no tratamento da lesão pulmonar aguda: meta-análise.

OBJECTIVE: This meta-analysis was performed to evaluate the evidence supporting antioxidant supplementation as an adjunct therapy to prevent oxidative damage and improve the clinical outcomes (mortality, length of hospital stay and duration of mechanical ventilation). METHODS: The search strategy for randomized controlled trials (RCTs) involved the participation of two researchers who independently assessed the methodological quality of each full-text article that was available in the PubMed, ISI WEB of Knowledge and ScienceDirect databases. RESULTS: We extracted 110 studies from the past 10 years, but only 30 articles met the methodological criteria (RCT, blinded and statistically significant results), for a total of 241 animals and 256 patients. This study found an odds ratio (OR) of 0.45 [95% confidence interval (CI): 0.26 to 0.79] for death in the experimental group compared with placebo (six trials, n = 256), an OR of 0.46 [95% CI: 0.26 to 0.87] for hospitalization time and an OR of 0.63 [95% CI: 0.35 to 1.12] for mechanical ventilation time between groups. CONCLUSION: Conflicting evidence makes it impossible to recommend the routine use of antioxidant supplementation in critically ill patients.