SUMMARY: The exercise could play a central role to the fat management and glucose metabolism what can be a critical role in the health status of diabetic people, but the high intense exercise remains with controversial data about their effects. To identify the effect of the multimodal high-intensity interval training on body composition, lipid profile, and glucose metabolism in elderly diabetics. Methods: Elderly diabetic individuals (n = 48) were randomly divided in a Sedentary Control (SC) group, a Moderate-Intensity Continuous Training (MICT) group, and a High-Intensity Interval Training (HIIT) group. MICT and HITT were conducted over 60 days, 3x per week, with 40 minutes of exercise. Blood was collected prior to intervention, at four, and at eight weeks subsequently to assess glucose metabolism and lipid profiles. Body composition was determined before and after the intervention period. To verify the normality Kolmogorov-Smirnov statistical test was performed, followed by student "t" test or two-way ANOVA with Bonferroni’s post hoc test with significance of 5 % the Cohen’s f test to indicate the magnitude of the differences. HIIT significantly lowered cholesterol and triglyceride levels, and significantly lowered blood glucose and glycosylated haemoglobin levels (p<0.05). MICT and HIIT significantly increased levels of high-density lipoprotein, decreased total body mass and body mass index. HIIT resulted in significantly smaller waist circumferences, waist-to-hip ratios, and weight-to-height ratios over 60 days of training. HIIT is more effective than MICT for improving lipid and glycaemic profiles, decreasing body fat, and improving fat distribution elderly diabetics.

RESUMEN: El ejercicio podría desempeñar un papel central en el manejo de la grasa y el metabolismo de la glucosa, lo que puede ser un papel crítico en el estado de salud de las personas diabéticas, pero el ejercicio intenso intenso sigue teniendo datos controvertidos sobre sus efectos. El objetivo del estudio fue identificar el efecto del entrenamiento multimodal de intervalos de alta intensidad sobre la composición corporal, el perfil lipídico y el metabolismo de la glucosa en diabéticos de edad avanzada. Los individuos diabéticos de edad avanzada (n = 48) se dividieron aleatoriamente en un grupo de control sedentario (SC), un grupo de entrenamiento continuo de intensidad moderada (MICT) y un grupo de entrenamiento de intervalos de alta intensidad (HIIT). MICT y HITT se realizaron durante 60 días, 3 veces por semana, con 40 minutos de ejercicio. Se recogió sangre antes de la intervención, a las cuatro y a las ocho semanas posteriormente para evaluar el metabolismo de la glucosa y los perfiles de lípidos. La composición corporal se determinó antes y después del período de intervención. Para verificar la normalidad se realizó la prueba estadística de Kolmogorov-Smirnov, seguida de la prueba "t" de Student o ANOVA de dos vías con la prueba post hoc de Bonferroni con una significancia del 5 % de la prueba f de Cohen, indicando las diferencias. HIIT redujo significativamente los niveles de colesterol y triglicéridos, además de reducir de manera importante los niveles de glucosa en la sangre y la hemoglobina glicosilada (p <0.05). MICT y HIIT aumentaron significativamente los niveles de lipoproteína de alta densidad, disminuyeron la masa corporal total y el índice de masa corporal. HIIT resultó en circunferencias de cintura significativamente más pequeñas, relaciones cintura-cadera y relaciones peso-altura durante 60 días de entrenamiento. HIIT es más efectivo que MICT para mejorar los perfiles de lípidos y glucémicos, disminuir la grasa corporal y mejorar la distribución de grasa en los diabéticos de edad avanzada.

Abstract Purpose To evaluate the neuroprotective effect of L-alanyl-glutamine in a gerbil model of brain ischemia-reperfusion injury based on immunohistochemical quantification of pro-inflammatory and cell activation biomarkers (TNF-α, NF-κB, IL-6 and HO-1). Methods Male gerbils weighing 100-180 g were pretreated with either 0.75 g/kg L-Ala-Gln (n=18) or 2.0 mL saline (n=18) administered i.v. 30 minutes before the bilateral ligation of the common carotid artery during 15 min and then the ligation was removed. Under anesthesia with urethane, brain tissue was harvested at 0 min (T0), 30 min (T30) and 60 min (T60) after reperfusion. The tissue was embedded in 10% formalin overnight and 4-μm sections were prepared for immunostaining with monoclonal antibodies. Immunostained cells were counted by optical microscopy. The statistical analysis used mean values based on 4 sections. Results The pretreatment with L-Ala-Gln animal group 1 demonstrated significantly lower levels of TNF-α, NF-κB and IL-6. On the other hand, the levels of HO-1 were significantly higher, suggesting a protective role in model of brain ischemia-reperfusion injury. Conclusion These findings suggest a protective effect of L-Ala-Gln by decreasing levels of TNF-alpha, IL-6 and NF-κB and Increasing levels of HO-1.

RESUMO Comunicar notícias com sensibilidade é competência dos profissionais de saúde. Para analisar falas de profissionais e familiares de internos da Unidade de Terapia Intensiva Neonatal de um Hospital Universitário, foi realizada pesquisa qualitativa tendo como instrumentos entrevistas e Roda de Conversa, norteados pelo protocolo SPIKES. As categorias produzidas foram analisadas por meio das Práticas Discursivas e Produção de Sentidos. Os resultados evidenciaram ambiência desumanizada; sobrecarga de serviço; ausência de local e falta de treinamento para comunicar notícias e apontam a importância de valorizar a comunicação em saúde para melhorar a qualidade do trabalho e relações interpessoais.

ABSTRACT Reporting news sensitively is the responsibility of health professionals. In order to analyze speeches of professionals and family members of patients of the Neonatal Intensive Care Unit of a university hospital, qualitative research was conducted with interviews and Conversation Wheel as instruments, guided by the SPIKES protocol. The categories produced were analyzed by the Discursive Practices and Sense Production. The results showed dehumanized ambience; service overload; absence of place and unpreparedness to communicate news and they point out the importance of promoting health communication to improve the quality of work and interpersonal relations.

RESUMO Comunicar notícias com sensibilidade é competência dos profissionais de saúde. Para analisar falas de profissionais e familiares de internos da Unidade de Terapia Intensiva Neonatal de um Hospital Universitário, foi realizada pesquisa qualitativa tendo como instrumentos entrevistas e Roda de Conversa, norteados pelo protocolo SPIKES. As categorias produzidas foram analisadas por meio das Práticas Discursivas e Produção de Sentidos. Os resultados evidenciaram ambiência desumanizada; sobrecarga de serviço; ausência de local e falta de treinamento para comunicar notícias e apontam a importância de valorizar a comunicação em saúde para melhorar a qualidade do trabalho e relações interpessoais.

ABSTRACT Reporting news sensitively is the responsibility of health professionals. In order to analyze speeches of professionals and family members of patients of the Neonatal Intensive Care Unit of a university hospital, qualitative research was conducted with interviews and Conversation Wheel as instruments, guided by the SPIKES protocol. The categories produced were analyzed by the Discursive Practices and Sense Production. The results showed dehumanized ambience; service overload; absence of place and unpreparedness to communicate news and they point out the importance of promoting health communication to improve the quality of work and interpersonal relations.

FUNDAMENTOS: A psoríase é uma doença inflamatória crônica, com etiologia multifatorial, com participação de fatores genéticos, auto-imunes e ambientais. Estudos recentes demonstram o papel de células e mediadores inflamatórios na patogênese da psoríase, que passou a ser definida como uma afecção inflamatória sistêmica e auto-imune, podendo associarse a outras doenças de natureza inflamatória. OBJETIVOS: Avaliar a ocorrência de obesidade e dislipidemia em pacientes com psoríase atendidos num ambulatório de dermatologia de Manaus. MÉTODOS: Foi realizado estudo descritivo e prospectivo para avaliar a ocorrência de obesidade e dislipidemia em pacientes com psoríase. Além do atendimento dermatológico preconizado, foi realizado exame físico com medida de peso, altura e circunferência abdominal. RESULTADOS: Foram incluídos 72 pacientes, sendo 44 (61,1%) do sexo feminino e 28 (38,9%) do sexo masculino, com média de idade de 51,0 anos ± 15,9 anos. Quanto ao índice de massa corporal, 16 (22,2%) apresentavam sobrepeso e 20 (27,8%), obesidade. Na análise da circunferência abdominal em relação ao gênero, observou-se que 79,5% das mulheres examinadas apresentavam obesidade central, percentual estatisticamente maior que o observado entre os homens (42,9%), ao nível de 5% de significância (p= 0,001). Em relação ao diagnóstico de dislipidemia, 29 (65,9%) do sexo feminino e 22 (78,6%) do masculino apresentaram alteração no lipidograma. CONCLUSÕES: A ocorrência de dislipidemia e obesidade nos pacientes com psoríase pode alterar a qualidade e expectativa de vida, aumentando o risco de doenças sistêmicas e metabólicas, o que torna obrigatória a investigação periódica dessas comorbidades nos portadores de psoríase.

BACKGROUND: Psoriasis is a chronic inflammatory disease of multifactorial etiology, with participation of genetic, autoimmune and environmental factors. Recent studies have demonstrated the role of inflammatory cells and mediators in the pathogenesis of psoriasis, which is now defined as a systemic and autoimmune inflammatory disease that may be associated with other diseases of inflammatory nature. OBJECTIVES: To evaluate the occurrence of obesity and dyslipidemia in patients with psoriasis treated at a dermatology clinic in Manaus. METHODS: We performed a prospective descriptive study to assess the prevalence of obesity and dyslipidemia in patients with psoriasis. Besides the recommended dermatological care, a physical examination was performed to measure weight, height and waist circumference. RESULTS: We included 72 patients, 44 (61.1%) female and 28 (38.9%) male, with a mean age of 51.0 years ± 15.9 years. As for body mass index (BMI), 16 (22.2%) were overweight and 20 (27.8%) were obese. In the analysis of waist circumference in relation to gender, we found that 79.5% of women surveyed had central obesity, a percentage statistically higher than that observed among men (42.9%) at the 5% level of significance (p = 0.001). Regarding the diagnosis of dyslipidemia, 29 (65.9%) females and 22 (78.6%) males showed alterations in lipid profile. CONCLUSIONS: The occurrence of dyslipidemia and obesity in patients with psoriasis can affect life quality and expectancy, increasing the risk of systemic and metabolic diseases, which makes periodic investigation of these comorbidities in patients with psoriasis mandatory.

As candidíases bucais (também chamadas sapinhos) que ocorrem em crianças são causadas por uma deficiência imunológica, bem como por outros fatores tais como má higiene bucal e esterilização inadequada dos utensílios utilizados pelas mesmas, que potencializam a ocorrência dessa infecção fúngica. Considerando esse fato, foram avaliadas a freqüência e a atividade enzimática de Candida sp. isoladas em crianças de uma creche pública (Aprisco) na cidade de Fortaleza, Ceará. Foram coletadas amostras da mucosa bucal de 364 alunos de 1 a 5 anos de idade. Elas foram semeadas em ágar Sabouraud dextrose com cloranfenicol, incubadas por 72 horas a 37ºC e identificadas por testes micológicos. Verificou-se que 67 (18%) apresentaram leveduras do gênero Candida. A Candida albicans foi a mais freqüente, com 30 isolados (45%), seguida pelas C. tropicalis (31%), C. guilliermondii (17%), C. glabrata (4,5%) e C. stellatoidea (1,5%). Com relação às atividades enzimáticas das cepas de Candida albicans, 20% produziram a enzima proteinase e 33%, a fosfolipase. As Candida albicans isoladas da mucosa bucal de crianças dessa creche da prefeitura apresentaram uma fraca atividade enzimática. Assim, conclui-se que essas cepas parecem ter uma baixa virulência.

Immunedefficiency is one of the main causes of buccal candidiasis, also called thrush, in children. Other factors like inadequate mouth hygiene and inappropriate sterilization utensils potentialize this fungal infection. Considering these facts, Candida sp. frequency and enzymatic activity were evaluated in 364 stocks from mouth mucous of one to five year-old children from a public day care center in Fortaleza, Ceará (Brazil). The samples were cultured in dextrose Sabouraud with chloranfenicol agar and incubated for 72 hours at 37°C. They were identified by mycological tests. It was verified that 67 samples (18%) presented Candida sp. and the most frequent genus was Candida albicans (30%-45%) followed by C. tropicalis (31%), C. guilliermondi (17%), C. glabrata (4.5%) and C. stellatoidea (1,5%). Considering enzymatic activitie of Candida albicans strains, 20% produced proteinasis and 33% produced phospholipasis. Candida albicans isolated from children mouth mucous from a public day care center in Fortaleza presented a weak enzymatic activity. This finding leads to the conclusion that those strains seem to be of low virulence.