RESUMO Objetivou-se avaliar alterações imunes, entre obesidade e exercício (natação). Ratas Wistar foram alocadas, conforme regime dietético: Grupo Labina (GL) e Grupo Hiperlipídico (GH); e, aos 60 dias, segundo o exercício. Após protocolo de exercício, avaliaram-se parâmetros murinométricos, gordura visceral, série branca do sangue e cultura de macrófagos. Observamos aumento nos parâmetros murinométricos, na gordura visceral do GH sedentário e nos linfócitos, neutrófilos e basófilos do GH exercitado. A taxa de fagocitose e a produção de óxido nítrico estimulado com lipopolissacarídeos aumentaram nos ratos exercitados. A natação parece reverter o fenótipo de sobrepeso, promovido pela dieta hiperlipídica, atenuou os efeitos dessa no sistema imune e melhorou sua resposta.

ABSTRACT The aim was to evaluate immune changes between obesity and swimming. Wistar rats were allocated according to dietary regimen: Labina Group (LG) and Hyperlipid Group (HG); and at 60 days, according to the exercise. After exercise protocol, murinometric parameters, visceral fat, white blood series and macrophage culture were evaluated. We observed an increase in the murinometric parameters and visceral fat of the sedentary HG, and in the lymphocytes, neutrophils and basophils of the exercised HG. The rate of phagocytosis and the production of nitric oxide stimulated with lipopolysaccharides increased in the exercised rats. Swimming seems to reverse the overweight phenotype promoted by the hyperlipid diet and attenuated the effects it on the immune system, improving its response.

RESUMEN El objetivo de este artículo fue evaluar cambios inmunológicos entre obesidad y ejercicio (natación). Se distribuyó a ratas Wistar según el régimen dietético: grupo labina (GL) y grupo hiperlipídico (GH). Y a los 60 días, según el ejercicio. Después del protocolo de ejercicio, se evaluaron los parámetros murinométricos, grasa visceral, serie blanca de la sangre y cultivo de macrófagos. Se observó un aumento de los parámetros murinométricos y de la grasa visceral del GH sedentario, así como en los linfocitos, neutrófilos y basófilos del GH ejercitado. La tasa de fagocitosis y la producción de óxido nítrico estimulado con lipopolisacárido aumentaron en las ratas ejercitadas. Parece que la natación revierte el fenotipo de sobrepeso promovido por la dieta hiperlipídica y atenúa los efectos de esta en el sistema inmunitario, por lo que mejora su respuesta.

Resumo: Objetivo: Avaliar a associação entre processo inflamatório, adiposidade e as vitaminas A, D e E em adolescentes, segundo o sexo. Métodos: Estudo transversal com adolescentes de 12 a 19 anos de ambos os sexos de escolas públicas de Recife. Foi utilizado um questionário para coleta de dados socioeconômicos, de estilo de vida e de consumo alimentar dos adolescentes. Em seguida, realizou-se a avalição antropométrica e coleta de sangue para análise das concentrações séricas de α-1-glicoproteína ácida, retinol, β-caroteno, α-tocoferol e 25-hidroxivitamina D. Resultados: Os níveis de α-1-glicoproteína ácida foram maiores na obesidade abdominal de ambos os sexos. Os meninos com níveis séricos insuficientes de α-tocoferol expressaram níveis reduzidos de α-1-glicoproteína ácida (p = 0,03) e apresentaram um maior risco de deficiência de 25-hidroxivitamina D e β-caroteno na adiposidade total e abdominal, enquanto as meninas mostraram maior risco de insuficiência de β-caroteno com a obesidade abdominal (RP 1,33; IC 95% 1,2-1,5). Conclusão: A adiposidade abdominal reflete maior risco de inflamação e causa alterações distintas nas concentrações das vitaminas lipossolúveis, de acordo com o sexo.

Abstract Objective: Evaluate the association between inflammatory process, adiposity, and vitamins A, D, and E in adolescents, according to gender. Methods: Cross-sectional study with adolescents aged 12-19 years old of both genders attending public schools in Recife. A questionnaire was used to collect data on socioeconomic level, lifestyle, and food intake of adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of α-1-acid glycoprotein, retinol, β-carotene, α-tocopherol, and 25-hydroxy-vitamin D. Results: The levels of α-1-acid glycoprotein were higher for abdominal obesity in both genders. Male adolescents with insufficient serum α-tocopherol levels had low levels of α-1-acid glycoprotein (p = 0.03) and an increased risk of 25-hydroxy-vitamin D and β-carotene deficiency in relation to total and abdominal fat; female adolescents had an increased risk of insufficient β-carotene with abdominal obesity (PR: 1.33; 95% CI: 1.2-1.5). Conclusion: Abdominal adiposity implies a higher risk of inflammation and causes different changes to the levels of fat-soluble vitamins according to gender.

Resumo Objetivo: Avaliar o impacto do treinamento muscular inspiratório (TMI) sobre a qualidade de vida, resposta imune, força muscular inspiratória e de membros inferiores de idosos. Método: Trata-se de um ensaio clínico randomizado, realizado com 30 idosos institucionalizados. Eles foram alocados em dois grupos, Grupo TMI (n=15): TMI com o PowerBreathe Classic, usando carga de 60% da pressão inspiratória máxima (PIM). O TMI foi realizado através de um protocolo de 30 repetições, três vezes por semana, durante seis semanas; e Grupo controle (n=15): não realizavam nenhum tipo de intervenção terapêutica. Em ambos os grupos foram avaliadas a PIM, a força de membros inferiores pelo teste de sentar-levantar, a qualidade de vida pelo questionário SF-36 e a proteína C reativa (PCR). Resultados: Os resultados demonstraram a homogeneidade entre os grupos em relação às variáveis demográficas e clínicas. O grupo TMI apresentou um aumento da variação da PIM (9,20±7,36cmH2O) comparado ao controle (0,93±8,79 cmH2O). Foi observada ainda melhora no teste de sentar e levantar (p<0,05) (teste de Tukey) na diferença entre os valores antes e após o TMI. Em relação à qualidade de vida, dois dos oito domínios do SF-36 sofreram influência do TMI, são eles: capacidade funcional e limitações por aspectos físicos. Não ocorreram mudanças na PCR em nenhum dos grupos. Conclusão: o TMI foi capaz de melhorar a força muscular inspiratória, a força de membros inferiores, e a qualidade de vida de idosos institucionalizados. Estes achados reforçam a contribuição desta terapêutica em reduzir os efeitos deletérios do envelhecimento.

Abstract Objective: To evaluate the impact of inspiratory muscle training (IMT) on the quality of life, immune response, inspiratory and lower limb muscle strength of older adults. Method: A randomized clinical trial was conducted with 30 institutionalized older adults. They were allocated into two groups: the IMT group (n=15), which underwent IMT with PowerBreathe Classic, using a load of 60% of maximal inspiratory pressure (MIP). This was performed using a 30 repetition protocol, three times a week, for six weeks. The second group was the control group (n=15) which did not perform any type of therapeutic intervention. In both groups, MIP, lower limb strength by sit-up test, quality of life by the SF-36 questionnaire and C-reactive protein (CRP) were evaluated. Results: The results demonstrated the homogeneity between the groups regarding the demographic and clinical variables. The IMT group showed an increase in the variation of MIP (9.20±7.36 cmH2O) compared to the control (0.93±8.79 cmH2O). Improvement was also observed in the sitting and standing test (p<0.05) (Tukey Test) in the difference between the values before and after the IMT. In terms of quality of life, two of the eight SF-36 domains were influenced by the IMT, namely: functional capacity and limitations due to physical factors. There were no changes in CRP in either group. Conclusion: IMT improved the inspiratory muscle strength, lower limb strength and quality of life of institutionalized older adults. These findings reinforce the contribution of this therapy to reducing the deleterious effects of aging.

SUMMARY: Peripheral nerve regeneration is a serious clinical problem. The goal of this work was to evaluate comparatively a biopolymer tube of sugarcane with an expanded polyethylene tube as a tube guide in peripheral nerve regeneration. Fourteen male albino Wistar rats were used, separated into three different groups: control (CG), lesion + polyethylene tube (PG) and lesion + sugarcane biopolymer (SBG). At 60 days old, animals from the PG and SBG underwent surgery for tubulization of the sciatic nerve, and 60 days after the injury they were sacrificed for collection of the nerve. In the analysis of the number of nerve fibers, a smaller number was seen in the PG and SBG groups compared to the CG, no difference was seen between the PG and SBG groups (p<0.05). With regard to the number of blood vessels, the SBG group had a larger number than the CG and PG groups (p<0.05). The SBG also presented increase on axonal diameter and G -ratio compared to PG (p<0.05). Taken together these data revealed that biopolymer tube favors a suitable environment for peripheral nerve regeneration.

RESUMEN: La regeneración nerviosa periférica es un problema clínico grave. El objetivo de este trabajo fue evaluar comparativamente un tubo de biopolímero de caña de azúcar con un tubo de polietileno expandido, como guía de tubo en la regeneración de nervios periféricos. Se utilizaron dieciocho ratas Wistar albinas macho, separadas en tres grupos: control (CG), lesión + tubo de polietileno (PG) y lesión + biopolímero de caña de azúcar (SBG). A los 60 días de edad, los animales del PG y SBG fueron sometidos a una cirugía para la tubulización del nervio ciático, y 60 días después de la lesión fueron sacrificados para la recolección del nervio. En el análisis del número de fibras nerviosas, se observó un número menor en los grupos PG y SBG en comparación con el CG; no se observaron diferencias entre los grupos PG y SBG (p <0,05). Con respecto al número de vasos sanguíneos, el grupo SBG tuvo un número mayor que los grupos CG y PG (p <0,05). El SBG también presentó un aumento en el diámetro axonal y la proporción G en comparación con PG (p <0,05). En conjunto, estos datos revelaron que el tubo de biopolímero favorece un entorno adecuado para la regeneración de nervios periféricos.

Resumo Introdução: A reabilitação de pacientes críticos geralmente ocorre no leito e é classificada como de baixa intensidade cardiovascular. Portanto, é essencial conhecermos os efeitos fisiológicos dos recursos que aplicamos na prática clínica. Objetivo: Avaliar o efeito agudo da cicloergometria passiva de membros inferiores sobre a mecânica respiratória e parâmetros cardiovasculares em pacientes críticos. Método: Trata-se de um ensaio clínico, randomizado, controlado, realizado em duas unidades de terapia intensiva na cidade de Recife, entre agosto de 2016 e maio de 2017. Os pacientes foram divididos em dois grupos: grupo cicloergometria passiva (n = 16): o paciente realizou uma sessão de cicloergometria de membros inferiores durante 20 minutos; e grupo-controle (n = 14): não realizou nenhuma intervenção terapêutica, apenas durante a aplicação do protocolo. Foram avaliados os parâmetros cardiovasculares e a mecânica respiratória, antes, durante e após a sua aplicabilidade. Resultados: Não foram encontradas diferenças demográficas entre os dois grupos estudados, mostrando a homogeneidade entre eles. Em relação aos parâmetros cardiovasculares, não houve diferença entre os grupos antes, durante e após o protocolo. Com relação à mecânica respiratória houve uma discreta elevação da resistência do sistema respiratório no grupo cicloergometria e uma redução da mesma no grupo-controle. Conclusão: Os resultados sugerem que a cicloergometria passiva aplicada ao paciente crítico não promoveu alterações cardiovasculares e na mecânica respiratória significativas, sendo considerada uma técnica segura e eficaz na prática clínica, podendo ser aplicada sem causar prejuízos aos pacientes sob ventilação mecânica.

Abstract Introduction: The rehabilitation of critical patients usually occurs in the bed and is classified as low cardiovascular intensity. Therefore, it is essential to understand the physiological effects of these resources that we apply in clinical practice. Objective: Evaluate the acute effect of passive cycloergometry of lower limbs on respiratory mechanics and cardiovascular parameters in critically ill patients. Method: This was a labeled, randomized, controlled trial conducted in two intensive care units in the city of Recife, between August 2016 and May 2017. Patients were divided into two groups: (i) passive cycloergometry group (n = 16), where the patient performed a lower limb cycloergometry session for 20 minutes, and (ii) control group (n = 14), where the patient did not perform any therapeutic intervention, except during the application of the protocol. Cardiovascular parameters and respiratory mechanics were evaluated before, during and after their applicability. Results: No demographic differences were found between the two groups, showing the homogeneity between them. Regarding cardiovascular parameters, there were no differences between groups before, during and after the protocol. Regarding respiratory mechanics, there was a slight elevation of the resistance of the respiratory system in the cycloergometry group and a reduction of the same in the control group. Conclusion: The results suggest that passive cycloergometry applied to the critical patient did not promote significant cardiovascular changes and respiratory mechanics, being considered a safe and effective technique in clinical practice that can be applied without causing harm to patients under mechanical ventilation.

Resumen Introducción: La rehabilitación de pacientes críticos generalmente ocurre en el lecho y se clasifica como de baja intensidad cardiovascular. Por lo tanto, es esencial conocer los efectos fisiológicos de estos recursos que aplicamos en la práctica clínica. Objetivo: Evaluar el efecto agudo de la cicloergometría pasiva de miembros inferiores sobre la mecánica respiratoria y parámetros cardiovasculares en pacientes críticos. Método: Se trata de un ensayo clínico, aleatorizado, controlado, realizado en dos unidades de cuidados intensivos en la ciudad de Recife, entre agosto de 2016 y mayo de 2017. Los pacientes fueron divididos en dos grupos: grupo cicloergometría pasiva (n = 16): el paciente realizó una sesión de cicloergometría de miembros inferiores durante 20 minutos; y grupo control (n = 14): no realizó ninguna intervención terapéutica, sólo durante la aplicación del protocolo. Se evaluaron los parámetros cardiovasculares y la mecánica respiratoria, antes, durante y después de su aplicabilidad. Resultados: No se encontraron diferencias demográficas entre los dos grupos estudiados, mostrando la homogeneidad entre ellos. En relación a los parámetros cardiovasculares, no hubo diferencia entre los grupos antes, durante y después del protocolo. Con respecto a la mecánica respiratoria, hubo una discreta elevación de la resistencia del sistema respiratorio en el grupo cicloergometría y una reducción de la misma en el grupo control. Conclusión: Los resultados sugieren que la cicloergometría pasiva aplicada al paciente crítico no promovió significativas alteraciones cardiovasculares y en la mecánica respiratoria, siendo considerada una técnica segura y eficaz en la práctica clínica, pudiendo ser aplicada sin causar perjuicios a los pacientes bajo ventilación mecánica.

Abstract INTRODUCTION The relationships between phagocytosis, and mucoid phenotype, plasmid profile and virulence, and resistance genetic characteristics of Klebsiella pneumoniae clinical isolates were evaluated. METHODS Thirty isolates were used to determine the mucoid aspect. Four were selected for analysis of phagocytosis by alveolar macrophages. RESULTS Thirty percent of the samples presented the mucoid phenotype. The phagocytosis rate ranged from 21.5% to 43.43%. Phagocytosis was not correlated with the plasmid profile, but was apparently correlated with mucoid phenotype and antibiotic susceptibility. CONCLUSIONS: Several virulence factors act in parallel in K. pneumoniae to impair host defense.

Resumo Contexto O linfedema de membros inferiores é uma doença crônica decorrente de dano no sistema linfático que influencia a mobilidade, a funcionalidade e a qualidade de vida dos indivíduos. Questionários e o teste físico são métodos bastante práticos, de fácil aplicação e baixo custo, que fornecem dados importantes para a avaliação desses pacientes. Objetivos Avaliar a influência do linfedema unilateral de membro inferior na funcionalidade e na qualidade de vida, correlacionando três ferramentas de avaliação. Métodos Estudo descritivo com 25 indivíduos com linfedema unilateral em membro inferior, de ambos os sexos. Foi avaliada a perimetria e foram aplicados The Medical Outcome Study Short Form-36 Health Survey (SF-36) para avaliação da qualidade de vida, Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) para estudo das habilidades físicas, mentais e sociais relacionadas ao linfedema e o Timed Up and Go (TUG) para avaliação da funcionalidade. Resultados Houve a presença de linfedema em todo o membro inferior dos participantes. Os domínios mais prejudicados pelo linfedema foram os aspectos físicos (25,0 ± 31,4) e emocionais (36,0 ± 42,9) no SF-36 e o domínio mobilidade (6,0 ± 2,6) no Lymph-ICF-LL. O TUG foi realizado em 9,88 ± 1,98 s. Houve correlação entre o TUG e os questionários e entre os dois questionários utilizados. Conclusões Indivíduos com linfedema unilateral em membro inferior apresentam um impacto negativo na qualidade de vida e na funcionalidade avaliadas através de questionários, que correlacionam entre si. Não foi encontrada alteração no TUG, mas houve correlação entre ele e os questionários utilizados.

Abstract Background Lymphedema of the lower limbs is a chronic disease caused by damage to the lymphatic system that influences people’s mobility, functionality, and quality of life. Questionnaires and physical test are very practical, easy to apply, and low cost methods that provide important data for evaluation of these patients. Objectives To evaluate the influence of unilateral lower limb lymphedema on functionality and quality of life, correlating 3 assessment tools. Methods This was a descriptive study investigating 25 patients of both sexes with unilateral lymphedema in a lower limb. Limb volume was assessed using circumferential tape measurements, the Medical Outcomes Study Short Form-36 Health Survey (SF-36) was used to assess quality of life, the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) was used to assess physical, mental, and social skills related to lymphedema, and the Timed Up and Go (TUG) test was used for functional assessment. Results Lymphedema was present throughout the affected lower limb of participants. The domains most affected by lymphedema were physical aspects (25.0 ± 31.4) and emotional aspects (36.0 ± 42.9) from the SF-36 and the mobility domain (6.0 ± 2.6) from the Lymph -ICF-LL. Patients performed the TUG in 9.88 ± 1.98 seconds. The TUG was correlated with the questionnaires and the questionnaires were correlated with each other. Conclusions People with unilateral lower limb lymphedema exhibited negative impacts on quality of life and functionality, as evaluated by questionnaires, which were correlated with each other. TUG performance was within normal limits, but results correlated with the questionnaires used.

Abstract INTRODUCTION: The levels of the full-length form of the (pro)renin receptor (PRR), a component of the renin-angiotensin system (RAS), may be reduced in the membranes of kidneys in renal diseases. This study aimed to investigate the RAS components in the kidneys of mice submitted to a combination of a high-fat diet and Schistosoma mansoni infection. METHODS: Female BALB/c mice were maintained on a control or high-fat diet from 3 weeks of age. After 10 weeks on the designated diets, half the mice in each group were infected with S. mansoni cercariae. The blood and kidneys were harvested 8 weeks after infection. RESULTS: The high-fat diet increased the number of eggs in the feces and the number of adult worms in the mesenteric bed. Schistosoma mansoni infection reduced the plasma levels of glucose, triglycerides, and HDL cholesterol in the control and high-fat diet groups. In mice on the control diet, S. mansoni infection resulted in increased expression of IL-6 in the kidneys; however, in mice on the high-fat diet, the levels of IL-6 were reduced and those of superoxide anions were increased. The RAS components evaluated were ACE2, renin, PRR, AT1R, and AT2R, and the levels of PRR were found to be reduced in the kidneys of infected mice on the high-fat diet. CONCLUSIONS: The finding regarding PRR is not yet clear. However, combining a high-fat diet and S. mansoni infection resulted in increased oxidative stress in the kidney that can aggravate hypertension as well as its associated complications.

Abstract Background: fat-soluble vitamin deficiency may be a health problem not recognized in children and adolescents. Objective: to estimate the prevalence and factors associated with the deficiency of vitamins A, D and E among adolescent students from Northeastern Brazil. Methods: transversal study with adolescents aged 12 to 19 of both genders. A questionnaire to collect socioeconomic and lifestyle data and food intake was applied to adolescents. Then, an anthropometric evaluation and a blood sampling were performed to analyze serum concentrations of retinol, β-carotene, α -tocopherol and 25-hydroxy vitamin D (25[OH]D). Results: the intake of vitamins A (50.3%), E (94.0%) and D (99.8%), as well as α-tocopherol (88.1%), α-carotene (74.1%), 25(OH)D (50.9%) and retinol (46.6%) serum levels were mostly deficient/insufficient. An increased risk of α-tocopherol deficiency was observed in girls (PR = 1.11) and an increased risk of 25(OH)D deficiency was observed in boys (PR = 1.41). An increased likelihood of β-carotene (PR = 1.14) and 25(OH)D (PR = 1.38) insufficiency was observed in overweight individuals. Conclusions: the adolescents had a deficit in the intake and in serum levels of fat-soluble vitamins. The greatest risk of inadequacy was associated with gender and weight excess. However, the behavior of fat-soluble vitamins in adolescents needs further research.

Resumen Introducción: la deficiencia de vitaminas liposolubles puede ser un problema de salud no reconocido en niños y adolescentes. Objetivo: estimar la prevalencia y los factores asociados a la deficiencia de las vitaminas A, D y E entre adolescentes escolares del nordeste de Brasil. Métodos: estudio transversal con adolescentes de 12 a 19 años de ambos sexos. Se utilizó un cuestionario para la recolección de datos socioeconómicos, de estilo de vida y de consumo alimentario de los adolescentes. A continuación, se realizó la evaluación antropométrica y la recolección de sangre para el análisis de las concentraciones séricas de retinol, β-caroteno, α-tocoferol y 25-hidroxivitamina D (25[OH]D). Resultados: la ingesta de vitaminas A (50,3%), E (94,0%) y D (99,8%), así como los niveles séricos del α -tocoferol (88,1%), β-caroteno (74,1%), 25(OH)D (50,9%) y retinol (46,6%) se presentaron en su mayoría deficientes/insuficientes. Se observó un mayor riesgo de deficiencia del α-tocoferol en las niñas (RP = 1,11), y mayor riesgo de insuficiencia de 25(OH)D en los niños (RP = 1,41), así como mayor probabilidad de insuficiencia del β -caroteno (RP = 1,14) y 25(OH)D (RP = 1,38) en el exceso de peso. Conclusiones: los adolescentes presentaron déficit en el consumo y en los niveles séricos de las vitaminas liposolubles. El mayor riesgo de inadecuación estuvo asociado al sexo y el exceso de peso, sin embargo el comportamiento de las vitaminas liposolubles en los adolescentes necesita una mayor investigación.

OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.

The aim of the study was to compare the innate immune system of severely malnourished children admitted to the Instituto de Medicina Integral Professor Fernando Figueira and treated according to the protocol of the World Health Organization (WHO) at admission and discharge. An experimental study was conducted with 20 children under two years of age. Ten of them had severe malnutrition and ten were a control group. The malnourished group consisted of hospitalized infants and it was submitted to WHO's protocol. Children with HIV and re-admitted during the study period were excluded. A blood sample was taken at admission and at discharge. Later, an analysis of blood leukocytes, adherence index, phagocytic capacity, production of free radicals superoxide and nitric oxide was performed. Patients with severe malnutrition at hospital discharge showed improved phagocytic function, release of oxygen radicals and reduction of the number of lymphocytes when compared to the time of admission. When compared to the control group, patients at hospital discharge had lower lymphocyte values and lower production of free radicals. Thus, it can be concluded that the duration of hospitalization was insufficient to restore cell-mediated immunity and microbicide activity.

El objetivo del estudio fue comparar el sistema inmune innato de niños con malnutrición grave ingresados en el Instituto de Medicina Integral Professor Fernando Figueira, tratados de acuerdo con el protocolo de la Organización Mundial de la Salud (OMS), al ingreso y al alta hospitalaria. Se llevó a cabo un estudio experimental con 20 niños menores de dos años de edad, 10 con malnutrición grave y 10 niños del grupo de control. El grupo de malnutridos se compuso de lactantes hospitalizados y sometidos al protocolo de la OMS. Se excluyeron los niños afectados por el HIV y los readmitidos durante el período del estudio. Se recogió una muestra de sangre al ingreso y otra al alta, y posterioriormente se realizó el análisis del perfil leucocitario, y el índice de adherencia, la capacidad fagocítica y la producción de los radicales libres superóxido y óxido nítrico. Los pacientes con malnutrición grave en el alta hospitalaria mostraron mejoría de la función fagocítica, la liberación de radicales oxidantes y la reducción del número de linfocitos en comparación con el ingreso hospitalario. En comparación con el grupo de control, los pacientes en el alta hospitalario presentaron valores más bajos de linfocitos y de producción de radicales libres. Por lo tanto, se puede concluir que el tiempo de hospitalización fue insuficiente para restablecer la inmunidad mediada por células, así como para restaurar la actividad microbicida.

INTRODUCTION : Bacterial translocation is the invasion of indigenous intestinal bacteria through the gut mucosa to normally sterile tissues and internal organs. Schistosomiasis may cause alterations in the immune system and damage to the intestines, portal system and mesenteric lymph nodes. This study investigated bacterial translocation and alterations in the intestinal microbiota and mucosa in schistosomiasis and splenectomized mice. METHODS : Forty female 35-day-old Swiss Webster mice were divided into the following four groups with 10 animals each: schistosomotic (ESF), splenectomized schistosomotic (ESEF), splenectomized (EF) and control (CF). Infection was achieved by introduction of 50 Schistosoma mansoni (SLM) cercariae through the skin. At 125 days after birth, half of the parasitized and unparasitized mice were subjected to splenectomy. Body weights were recorded for one week after splenectomy; then, the mice were euthanized to study bacterial translocation, microbiota composition and intestinal morphometry. RESULTS : We observed significant reductions in the weight increases in the EF, ESF and ESEF groups. There were increases of at least 1,000 CFU of intestinal microbiota bacteria in these groups compared with the CF. The EF, ESF and ESEF mice showed decreases in the heights and areas of villi and the total villus areas (perimeter). We observed frequent co-infections with various bacterial genera. CONCLUSIONS : The ESEF mice showed a higher degree of sepsis. This finding may be associated with a reduction in the immune response associated with the absence of the spleen and a reduction in nutritional absorption strengthened by both of these factors (Schistosoma infection and splenectomy).

Objetivo: Analisar dois método de redução da microbiota conjuntival em indivíduos submetidos à facectomia. Métodos: Ensaio clínico, com amostra de conveniência de 57 pacientes, com diagnóstico de catarata senil (57 olhos), submetidos à facoemulsificação com implante de lente intraocular em Recife entre 2011 a 2013. Os pacientes foram alocados em dois grupos: ATB (27 olhos) no qual foi instilado colírio antibiótico (gatifloxacino a 0,3%) e ASS (30 olhos) colírio antisséptico (iodopovidine a 5%), ambas as medicações foram instiladas três vezes (uma gota a cada 20 minutos, uma hora previamente à cirurgia). Os grupos foram avaliados a partir de duas coletas de material conjuntival: a primeira antes de instilar algum colírio e a segunda imediatamente após a cirurgia. Foi realizada bacterioscopia, cultura e antibiograma. Resultados: Comparando-se a redução no número de bactérias encontrado nas lâminas no pré e pós-operatório, não se verificou diferença estatística significativa nos dois grupos. Conclusão: Tanto o uso do antisséptico como do antibiótico usados como profiláticos para a endoftalmite reduzem a microbiota conjuntival

Objective: To analyze two methods of reducing conjunctivalmicrobiota in patients undergoing cataract surgery. Methods: A clinical trial with a convenience sample of 57 patients diagnosed with senile cataract (57 eyes) who underwent phacoemulsification with intraocular lens implantation in Recife from 2011 to 2013. Patients were divided into two groups: ATB (27 eyes) in which was instilled antibiotic eye drops (gatifloxacin 0.3%) and ASS (30 eyes) with antiseptic eye drops (iodopovidine 5%); both medications were instilled three times (one drop every 20 minutes, an hour prior to surgery). The groups were evaluated from two collections of conjunctival material: first before instilling some eye drops and the second one immediately after surgery. Gram stain, culture and sensitivity were performed. Results: Comparing the reduction in the number of bacteria found in the slides in the pre-and postoperative, there was no statistically significant difference in both groups. Conclusions: Both use of antiseptic or antibiotic, used as prophylaxis forendophthalmitis, can reduce the conjunctivalmicrobiota.

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 de desnutrição com cepa resistente induziu baixa produção de mediadores inflamatórios por células efetoras da resposta imunológica, o que poderá resultar em compro-metimento da defesa.

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.

AIM: To evaluate the in vitro antimicrobial effects of photodynamic therapy (PDT). METHODS: The microorganism indicators were: Candida albicans, Pseudomonas aeruginosa,Enterococcus faecalis and Staphylococcus aureus. A microbial pool was prepared (10 8 cells/mL), from which aliquots were transferred to culture plates for carrying out the PDT using methylene blue (50 µM) and low-power laser (660 nm, 100 mW and 9 J).The effect of methylene blue alone, low power laser and the absence of treatments were evaluated. Then, aliquots of 1 µL were plated in a media culture, the number of colony forming units (CFU/mL) was obtained and the data submitted to the F test (ANOVA) with Tamhane's comparisons. RESULTS: The laser radiation in the presence of methylene blue was able to eliminate 74.90% of C. albicans, 72.41% of P. aeruginosa, 96.44% of E. faecalis and 95.42% of S. aureus, thus statistically significant differences were found among the groups (p<0.001). CONCLUSIONS: PDT was effective in reducing the number of viable cells in the studiedmicroorganisms, especially E. faecalis and S. aureus.