The Burden of Helminth Coinfections and Micronutrient Deficiencies in Patients with and without Leprosy Reactions: A Pilot Study in Minas Gerais, Brazil.

Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case-control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against Schistosoma mansoni, Strongyloides, and Ascaris antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.

Modulatory Effect of Polyphenolic Compounds from the Mangrove Tree Rhizophora mangle L. on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in High-Fat Diet Obese Mice.

No scientific report proves the action of the phytochemicals from the mangrove tree Rhizophora mangle in the treatment of diabetes. The aim of this work is to evaluate the effects of the acetonic extract of R. mangle barks (AERM) on type 2 diabetes. The main chemical constituents of the extract were analyzed by high-performance liquid chromatography (HPLC) and flow injection analysis electrospray-iontrap mass spectrometry (FIA-ESI-IT-MS/MS). High-fat diet (HFD)-fed mice were used as model of type 2 diabetes associated with obesity. After 4 weeks of AERM 5 or 50 mg/kg/day orally, glucose homeostasis was evaluated by insulin tolerance test (kiTT). Hepatic steatosis, triglycerides and gene expression were also evaluated. AERM consists of catechin, quercetin and chlorogenic acids derivatives. These metabolites have nutritional importance, obese mice treated with AERM (50 mg/kg) presented improvements in insulin resistance resulting in hepatic steatosis reductions associated with a strong inhibition of hepatic mRNA levels of CD36. The beneficial effects of AERM in an obesity model could be associated with its inhibitory α-amylase activity detected in vitro. Rhizophora mangle partially reverses insulin resistance and hepatic steatosis associated with obesity, supporting previous claims in traditional knowledge.

Associação entre variação anatômica da veia safena magna e insuficiência venosa em pacientes à ultrassonografia vascular dos membros inferiores / Association between anatomical variation of the great saphenous vein and venous failure in patients undergoing vascular ultrasound of the lower limbs

97 Artigo Original Associação entre Variação Anatômica da Veia Safena Magna e Insuficiência Venosa em Pacientes Submetidos à Ultrassonografia Vascular dos Membros Inferiores Association between Anatomical Variation of the Great Saphenous Vein and Venous Failure in Patients Undergoing Vascular Ultrasound of the Lower Limbs Ana Cristina Lopes Albricker, 2,3 Ane Graziela Ferreira Andrade, 1 Danila Simões Almeida, 1 Gisely Simões Almeida, 1 Jaider Matheus Monteiro de Andrade, 1 Paola Souza dos Santos, 1 Marcio Vinícius Lins Barros 1,3 Faculdade de Saúde e Ecologia Humana, 1 Vespasiano, MG; Faculdade de Ciências Médicas de Minas Gerais; 2 Centro Especializado em Ultrassonografia, 3 Belo Horizonte, MG - Brasil Resumo Introdução: A anatomia venosa pode apresentar significativa variabilidade, com ampla incidência de afluentes venosos, veias duplicadas, tributárias ou acessórias relacionadas às veias safenas. O reconhecimento e a identificação destas variações são importantes no manejo terapêutico destes pacientes, sendo que a ultrassonografia vascular é o método de escolha na avaliação do sistema venoso periférico. Objetivos: avaliar a associação entre variação anatômica da veia safena magna (VSM) e insuficiência venosa dos membros inferiores em pacientes com varizes primárias dos membros inferiores. Métodos: Foram avaliados consecutivamente pacientes com clínica de varizes de membros inferiores no período de 2014 a 2015, excluindo pacientes com história de cirurgia prévia e trombose venosa profunda. A ecografia vascular foi realizada para exame do sistema venoso superficial, em especial ao estudo da VSM, determinando os diversos padrões de variação anatômica deste vaso e sua associação com a presença de insuficiência venosa e classificação CEAP. Resultados: foram examinados 422 membros inferiores de 211 pacientes, com idade entre 21 e 86 anos, média de 45,7 anos, sendo 81% do sexo feminino, com predomínio de CEAP 1 (43,8%) e 2 (46,2%). Refluxo na VSM foi encontrado em 35,1%. A presença de variação anatômica foi encontrada em 8,8% dos pacientes sendo mais frequente em terço distal da coxa e proximal da perna (27,3%), não sendo observado associação entre a variação anatômica da VSM e CEAP (p = 0,25). Observou-se associação estatisticamente significativa entre ausência de variação anatômica e de insuficiência de VSM (p = 0,03). Conclusão: no presente estudo observou-se variação anatômica da veia safena magna em cerca de 9% dos pacientes, com associação significativa entre insuficiência de veia safena magna e ausência de variação anatômica

ntroduction: Venous anatomy may present significant variability, with a wide incidence of venous tributaries, duplicate or accessory veins related to saphenous veins. The recognition and identification of these variations are important in the therapeutic management of these patients, and vascular ultrasonography is the method of choice in the evaluation of the peripheral venous system. Objectives: To evaluate the association between anatomic variance of the great saphenous vein (VSM) and venous insufficiency of the lower limbs in patients with primary varicose veins of the lower limbs. Methods: Patients with varicose veins were consecutively evaluated in the period from 2014 to 2015, excluding patients with a history of previous surgery and deep venous thrombosis. Vascular ultrasound was performed to examine the superficial venous system, in particular to the VSM study, determining the different patterns of anatomical variation of this vessel and its association with the presence of venous insufficiency and CEAP classification. Results: 422 lower limbs of 211 patients, aged between 21 and 86 years, mean age of 45.7 years, 81% female, with a predominance of APC 1 (43.8%) and 2 (46.2% %). Reflux in the VSM was found in 35.1%. The presence of anatomical variation was found in 8.8% of the patients, being more frequent in the distal third of the thigh and proximal of the leg (27.3%). No association was found between the anatomical variation of MSV and CEAP (p = 0.25). There was a statistically significant association between no anatomic variation and the presence of VSM insufficiency (p = 0.03). Conclusion: in the present study, anatomic variation of the great saphenous vein was observed in about 9% of the patients, with a significant association between insufficiency of the great saphenous vein and no anatomical variation

Extracellular matrix remodeling and matrix metalloproteinase inhibition in visceral adipose during weight cycling in mice.

Extracellular matrix (ECM) remodeling is necessary for a health adipose tissue (AT) expansion and also has a role during weight loss. We investigate the ECM alteration during weight cycling (WC) in mice and the role of matrix metalloproteinases (MMPs) was assessed using GM6001, an MMP inhibitor, during weight loss (WL). Obesity was induced in mice by a high-fat diet. Obese mice were subject to caloric restriction for WL followed by reintroduction to high-fat diet for weight regain (WR), resulting in a WC protocol. In addition, mice were treated with GM6001 during WL period and the effects were observed after WR. Activity and expression of MMPs was intense during WL. MMP inhibition during WL results in inflammation and collagen content reduction. MMP inhibition during WL period interferes with the period of subsequent expansion of AT resulting in improvements in local inflammation and systemic metabolic alterations induced by obesity. Our results suggest that MMPs inhibition could be an interesting target to improve adipose tissue inflammation during WL and to support weight cyclers.

Evaluation of structured lipids with behenic acid in the prevention of obesity.

Obesity affects all social classes, making it necessary to develop effective products that aid weight loss or help prevent weight gain. The objective of this work was to study the anti-obesity effects of structured lipids (SL) obtained by enzymatic interesterification, based on olive oil, soy oil and fully hydrogenated crambe oil. Twenty-four C57Bl/6 mice were distributed into four experimental groups according to the diet consumed: Control Diet (CD), Structured Lipids Diet (SLD), High-fat Control Diet (HCD), High-fat Structured Lipids Diet (HSLD). The animals that were fed SLs presented a smaller weight gain, despite a larger intake of the diet. The lowest weight gain was reflected in reduced amounts of adipose tissue and lower liver weight. A significant increase in lipids excreted by the animals in the feces was observed, despite there being no sign of toxicity or presence of diarrhea. The animals that consumed the HSLD presented lower total and LDL-cholesterol, increased HDL-cholesterol and increased hepatic arachidonic acid and docosahexaenoic acid levels. In addition, they did not develop hepatic steatosis. The study therefore showed that SLs could play a major role in combating or preventing obesity and other resultant diseases, without producing side effects.