These data show that lowered HRQoL in major affective disorders could at least in part result from the effects of lipid peroxidation, protein oxidation, lowered antioxidant enzyme activities, and higher levels of TSH.

Variability of the HIV reverse transcriptase (RT) and protease (PR) genes has been used as indicators of drug resistance and as a mean to evaluate phylogenetic relationships among circulating virus. However, these studies have been carried in HIV mono-infected populations. The goal of this study was to evaluate, for the first time, the HIV PR and RT sequences from HIV/HBV and HIV/HCV co-infected patients. HIV PR and RT genes were amplificated and sequenced to resistance analysis. The bioinformatics analysis was performed to infer about sequences clustering and molecular evolution. The results showed that the most frequent amino acid substitutions in RT were L214F (67.6%), I135T (55.9%), and in PR was V15I (41.2%). The molecular clock analysis showed that the HIV circulating in co-infected patients were separated in two clusters in the years 1999–2000. Some patients included as HIV mono-infected according patients’ medical records and inside the co-infected cluster were, in fact, co-infected by PCR analysis. Analysis of the decision trees showed susceptibility to lamivudine and emtricitabine were important attribute to characterize co-infected patients. In conclusion, the results obtained in this study suggest, for the first time, that HIV RT and PR genes variability could be a genetic biomarker to coinfection.

Na região Sul do Brasil, a leishmaniose tegumentar americana predomina no Estado do Paraná, especialmente ao Norte e Oeste, onde um dos circuitos de produção da doença é localizado. Estima-se que 3 a 5% dos casos de leishmaniose cutânea desenvolvam lesão mucosa, e que cerca de 1% destas podem evoluir para óbito. De longa data, as drogas de escolha para tratamento da doença são os compostos antimoniais sob a forma de sais pentavalentes. O objetivo deste estudo foi descrever características epidemiológicas e de tratamento dos pacientes com leishmaniose mucosa, diagnosticados no período de 2001 a 2007, em municípios localizados na área de abrangência da 13ª Regional de Saúde, com sede no município de Cianorte, no Paraná. As informações foram coletadas do prontuário ambulatorial e das fichas de investigação epidemiológicas do Sistema de Notificação e Informação de Agravos. No período estudado, foram notificados 505 casos de leishmaniose tegumentar americana, 30 deles (6%) na forma mucosa. Foram incluídos no estudo pacientes com diagnóstico de leishmaniose mucosa, que apresentavam exames complementares realizados antes e durante o tratamento. Os resultados evidenciaram a necessidade de acompanhamento cuidadoso dos doentes nas equipes de saúde, dado a possível evolução e presença de efeitos medicamentosos indesejáveis nos pacientes afetados pela condição.

Cutis laxa is a rare inherited or acquired disorder of elastic tissue characterized by inelastic and loose skin. Congenital cutis laxa may present with internal organ involvement, determining a worse prognosis. The authors present the case of a female patient with clinical manifestations suggestive of the hereditary form of the disease, with consanguineous parents (second-degree cousins) and a brother who died with a similar clinical presentation. The genetic study of the FBLN5 gene was important to confirm the diagnosis, define the prognosis, and provide genetic counseling to the family. Keywords: Consanguinity; Cutis laxa; Genetic counseling Resumo: A Cútis laxa é uma doença rara, hereditária ou adquirida. Resulta da alteração do tecido elástico, tornando a pele frouxa e inelástica. A forma congênita tem geralmente acometimento sistêmico, com pior prognóstico. Os autores relatam o caso de uma paciente, com quadro clínico sugestivo da forma hereditária da doença, com pais consangüíneos (primos de 2º grau) e irmão falecido com clínica semelhante. O estudo genético do gene FBLN5 teve importância na confirmação diagnóstica, na definição do prognóstico e no aconselhamento genético familiar.

resumo Na região Sul do Brasil, a leishmaniose tegumentar americana predomina no Estado do Paraná, especialmente ao Norte e Oeste, onde um dos circuitos de produção da doença é localizado. Estima-se que 3 a 5% dos casos de leishmaniose cutânea desenvolvam lesão mucosa, e que cerca de 1% destas podem evoluir para óbito. De longa data, as drogas de escolha para tratamento da doença são os compostos antimoniais sob a forma de sais pentavalentes. O objetivo deste estudo foi descrever características epidemiológicas e de tratamento dos pacientes com leishmaniose mucosa, diagnosticados no período de 2001 a 2007, em municípios localizados na área de abrangência da 13ª Regional de Saúde, com sede no município de Cianorte, no Paraná. As informações foram coletadas do prontuário ambulatorial e das fichas de investigação epidemiológicas do Sistema de Notificação e Informação de Agravos. No período estudado, foram notificados 505 casos de leishmaniose tegumentar americana, 30 deles (6%) na forma mucosa. Foram incluídos no estudo pacientes com diagnóstico de leishmaniose mucosa, que apresentavam exames complementares realizados antes e durante o tratamento. Os resultados evidenciaram a necessidade de acompanhamento cuidadoso dos doentes nas equipes de saúde, dado a possível evolução e presença de efeitos medicamentosos indesejáveis nos pacientes afetados pela condição. abstractIn South Brazil, American tegumentary leishmaniasis is predominant at Paraná, specially on the North and West areas, where it is localized one of the disease's production circuits. It is believed that 3 to 5% of the cases evolve to the mucosal form, and that 1% of these can evolve to death. There is a long time that first choice drugs to treat this disease are the antimony compounds as pentavalent salts. The purpose of this study was to describe epidemiological and treatment characteristics of patients with mucosal leishmaniasis, who were diagnosed during the period from 2001 to 2007 in cities located on the coverage area of the 13 Heath Regional, which is situated in Cianorte, Paraná. The data were collected at the outpatient medical records and the System of Notifications and Information of Diseases epidemiological investigation records. During the mentioned period, 505 cases of American tegumentary leishmaniasis were notified, 30 of them (6%) as the mucosal form. In this study, the patients included were those with diagnosis of mucosal leishmaniasis that had complementary exams performed before and during the treatment. The results showed the need of patients' careful monitoring by health teams, due to the possible evolution of the disease and the presence of unwanted drug effects.

Objectives Nonalcoholic fatty liver disease (NAFLD) is an increasingly condition seen in patients with obesity predicting cardiovascular mortality. NAFLD ranges from simple steatosis without significant inflammation(90%), to steatohepatitis (10–30%). Growing evidence suggests that either obesity and gut-flora dysbiosis may activate inflammatory signaling pathways in hepatic cells. Both risk factors may be controlled by dietary components. Manipulated and processed foods consumption would lead to intestinal bacterial overgrowth and/or altered mucosal permeability allowing the bacterial lipopolysaccharides (LPS) to activate TNF-a production in Kupffer cells. OBJECTIVE: Following previous finding that food inadequacy is an environmental risk factor for NAFLD, we presently look at the effects of dietary components on the circulating LPS. Methods Baseline data of 74 women (35–67 yrs) were analyzed cross-sectional. Analysis included medical, dietary, anthropometry, and plasma biochemistry. Obesity was diagnosed by BMI values and NAFLD by “fatty liver index” ≥60. Plasma immune-nephelometric assay of us-CRP and ELISA of lipopolysaccharide binding protein (LBP) were used as inflammatory markers. LBP values were split into tertiles for comparison with co-variables. SPSS version 19.0 was used to complete ANOVA and evaluated LBP tertiles (T1-T3) at significance level of P = 0.05. Results Obesity reached 45.9% of the sample and NAFLD, 48.6%. LBP concentrations were significantly higher(T3) in obese and NAFLD women, ingesting high proportion of highly processed diets with high amount of fructose and high sodium/potassium ratio. There was a weak association of higher LBP(T3) with altered us-CRP. Analysis revealed that increased LBP was independently associated with higher intake of fructose and lower polyunsaturated fat, higher glutamic-pyruvic transaminase and higher percentage of body fatness. Conclusions LBP is associated with body fatness and NAFLD connected to dietary refined food(high fructose and low PUFA), probably impacting gut-flora LPS production and/or translocation to liver, activating TLRs and, from there, spreading systemicaly, bound to liver-born LBP. Funding Sources ACKNOWLEDGEMENTS: Brazilian foundations CNPq and CAPES.

O estudo tem como objetivo relatar a experiência de uma residente, na aplicação da metodologia do Arco de Maguerez, dentro de uma unidade básica de saúde, utilizando da criação de material educativo como ferramenta de qualificação do processo de trabalho. O método utilizado, baseado no Arco de Maguerez, foi a elaboração de uma cartilha como material educativo para qualificar o primeiro atendimento do paciente com dor lombar. Observou-se como resultado a eficiência da utilização de medidas educativas na promoção à saúde. Assim, conclui-se que a utilização da metodologia ativa desenvolve as habilidades de resolução de problemas ampliando os conhecimentos nas práticas em saúde e observa-se que os métodos de assistência e educação em saúde possibilitam o aumento da autonomia no cuidado e na prevenção à saúde.