Prior studies show that melatonin enhances the immune response. This study investigated the possible therapeutic effects of melatonin during the course of Trypanosoma cruzi infection. T. cruzi-infected male Wistar rats were orally treated with 5 mg/kg body weight/day of melatonin. Animals treated with melatonin showed a significant reduction in the number of blood trypomastigotes during the acute phase of infection compared with untreated animals (P<0.05). A significant increase in leucocytes numbers during the peak of parasitaemia was also observed (P<0.05). Moreover, both prior and concomitant treatment with melatonin increased interleukin-2 levels, especially 9 days postinfection (P<0.05). Histopathological observations of heart tissue revealed that melatonin administration also resulted in fewer and smaller amastigote burdens, and less inflammatory infiltrate and tissue disorganization, indicating a reduced parasitism of this tissue. These results show that melatonin is effective in controlling parasite replication and suggest that melatonin might serve as an effective therapeutic agent in the treatment of American trypanosomiasis.

The objectives of this study were to analyze the fecal incontinence (FI) in adults living in Pouso Alegre (Minas Gerais, Brazil) and the associated demographic and clinical variables. This epidemiological study developed sing stratified sampling by conglomerates. The final sample consisted of 519 individuals, of age >18 years, with adequate mental and physical conditions, living in 341 homes, which were randomly selected. Prevalence rates were standardized by gender and age, and revealed 7.0% of FI, overall and for men and women. In the final model of logistical regression, the number of children (OR=5.1; p<0.001), hemorrhoids (OR=4.4; p<0.001) and cystocele (OR=3.0; p<0.001) were statistically correlated to FI. This study identified the epidemiology of fecal incontinence in a small town in Brazil and may contribute to establish public policies and programs for primary and secondary prevention and treatment of FI, starting at the local level.

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Control of the acute phase of Trypanosoma cruzi infection is critically dependent on cytokine-mediated macrophage activation to intracellular killing, natural killer (NK) cells, CD4(+) T cells, CD8(+) T cells and B cells. Cell-mediated immunity in T. cruzi infection is also modulated by cytokines, but in addition to parasite-specific responses, autoimmunity can be also triggered. Importantly, cytokines may also play a role in the cell-mediated immunity of infected subjects. Here we studied the role of cytokines in the regulation of innate and adaptive immunity during the acute phase of T. cruzi infection in Wistar rats. Melatonin is an effective regulator of the immune system. Macrophages and T lymphocytes, which have melatonin receptors, are target cells for the immunomodulatory function of melatonin. In this paper melatonin was orally given via two protocols: prior to and concomitant with infection. Both treatments were highly effective against T. cruzi with enhanced action for the concomitant treatment. The data suggest an up-regulation of the TH-1 immune response as all analyzed parameters, interleukin (IL)-4, IL-10, transforming growth factor-beta1 and splenocyte proliferation, displayed reduced levels as compared with the untreated counterparts. However, the direct effects of melatonin on immune cells have not been fully investigated during T. cruzi infection. We conclude that in light of the current results, melatonin exerted important therapeutic benefits through its immune regulatory effects.

This study determines and analyzes the prevalence of Urinary Incontinence (UI) and its demographic and clinical predictors. This epidemiological and cross-sectional study was approved by the Research Ethics Committee of the University of São Paulo, Nursing School.The sample was randomly selected by cluster technique and included 519 individuals aged ≥18 years, living in 341 houses in urban areas. Data were analyzed through Chi-Square, Hosmer Lemeshow's test and multivariate logistic regression (stepwise). Prevalence rates were standardized by gender and age. Of the 519 people composing the sample: 20.1% had UI, 32.9% were women and 6.2% were men. Longer duration of losses (OR = 29.3; p<0.001), diabetes mellitus (OR = 17.7; p<0.001), stroke (OR = 15.9; p<0.001), and cystocele (OR = 12.5; p <0.001) were the factors most strongly associated with UI. This study enabled the identification of UI epidemiology and can contribute to the development of public policies for its primary and secondary prevention and treatment, even if such measures are initially implemented at the city level. Descritores: Incontinência Urinária; Epidemiologia; Enfermagem. Prevalencia de la incontinencia urinaria en muestra aleatoria de la población urbana de Pouso Alegre, Minas Gerais, BrasilEl estudio tiene por objetivo conocer la prevalencia de la incontinencia urinaria (IU), de los factores de predicción demográficos y clínicos de la presencia de IU. Se trata de un estudio epidemiológico de corte transversal, aprobado por el Comité de Ética de la Escuela de Enfermería de la Universidad de Sao Paulo. Muestreo estratificado por conglomerado compuesto de 519 individuos con edad ≥18 años, residentes en 341 domicilios del área urbana, sorteados aleatoriamente. Las pruebas utilizadas fueron Chi-cuadrado, HosmerLemeshow y regresión logística multivariante (stepwise). Las prevalencias de IU fueron estandarizadas por sexo y edad, en una muestra de 519 personas, siendo 20,1 % en la población general -32,9% eran mujeres y 6,2% hombres. Los factores más fuertemente asociados a la IU fueron: mayor tiempo de pérdidas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), accidente vascular encefálico (OR=15,9; p<0,001) y cistocele (OR=12,5; p<0,001). El estudio permitió conocer la epidemiologia de la IU y puede contribuir para el desarrollo de políticas públicas para su prevención primaria y secundaria, su tratamiento, inclusive considerando su inicio en el ámbito municipal.

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