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El síndrome de hipoplasia de ventrículo izquierdo (SHVI) es una cardiopatía congénita de baja prevalencia y alta letalidad. Objetivo: determinar la evolución perinatal y sobrevida al año y cinco años de fetos con diagnóstico prenatal de SHVI. Pacientes y Método: Estudio de cohorte prospectivo de todos los fetos con SHVI ingresados al Centro de Referencia Perinatal (CERPO) nacidos entre enero 2008 y diciembre 2017. Se obtuvieron datos demográficos y clínicos perinatales de la base de datos de CERPO. Al año y quinto año de edad, se realizó encuesta telefónica para conocer el tratamiento quirúrgico y sobrevida. Resultados: Se ingresaron 1.573 pacientes a CERPO, 899 con cardiopatías congénitas, confirmándose diagnóstico prenatal de SHVI en 7% (110/1.573). El promedio de edad gestacional al diagnóstico y la mediana al ingreso fue 26+3 y de 32+3 semanas respectivamente. 89% nacieron vivos, 90% a término y 57% por cesárea. La mediana de peso al nacer fue 3.128 gramos. 89% sobrevivió al periodo prenatal, 50% al periodo neonatal precoz, 33% al periodo neonatal tardío, 19% el primer año y 17% a los 5 años. Conclusiones: En este centro, la sobrevida al año y cinco años de fetos con diagnóstico prenatal de SHVI fue 19% y 17% respectivamente. Es importante que la consejería prenatal considere publicaciones basadas en casuísticas locales, con diagnóstico prenatal, postnatal y de aquellos que alcanzan la cirugía, para entregar información más precisa a los padres.

Complications arising from COVID-19 reflect an abnormal immune response in people previously diagnosed with chronic, non-communicable diseases (NCD), such as cardiovascular, metabolic and pulmonary conditions. Physical inactivity is recognized as a condition that affects the development of chronic low-grade inflammation, NCD, and susceptibility to cell infections. Anxiety and mental stress, poor nutritional status, drug use and circadian rhythm disturbances can further aggravate the harm caused by physical inactivity. Therefore, the purpose of the review is to invite health professionals, their respective regulatory boards, universities, research promotion foundations, media, political authorities and lay citizens to raise awareness of immunity and health in the medium- to long-term control of the current pandemic. Level of evidence V; Expert opinion. RESUMO As complicações decorrentes da COVID-19 refletem uma resposta imune irregular em pessoas previamente acometidas por doenças crônicas não transmissíveis (DCNT), como por exemplo, cardiovasculares, metabólicas e pulmonares. A inatividade física é reconhecidamente uma condição que impacta o desenvolvimento de inflamação crônica de baixo grau, DCNT e suscetibilidade a infecções celulares. Ansiedade e estresse mental, estado nutricional deficiente, consumo de drogas e ritmo circadiano perturbado podem agravar ainda mais os prejuízos da inatividade física. Sendo assim, o objetivo da revisão é convidar profissionais da área da saúde, seus respectivos conselhos regulatórios, universidades, fundações de amparo à pesquisa, mídia, autoridades políticas e cidadãos leigos para a conscientização sobre imunidade e saúde no controle em médio a longo prazo da atual pandemia. Nível de evidência V; Opinião do especialista. RESUMEN Las complicaciones derivadas del COVID-19 reflejan una respuesta inmune irregular en personas previamente afectadas por enfermedades crónicas no transmisibles (ECNT) como, por ejemplo, cardiovasculares, metabólicas y pulmonares. La inactividad física es reconocidamente una condición que impacta en el desarrollo de inflamación crónica de bajo grado, ECNT y susceptibilidad a infecciones celulares. La ansiedad y el estrés mental, el estado nutricional deficiente, el consumo de drogas y el ritmo circadiano alterado pueden agravar aún más los perjuicios de la inactividad física. Por lo tanto, el objetivo de la revisión es invitar a profesionales del área de la salud, a sus respectivos consejos reguladores, universidades, fundaciones de apoyo a la investigación, medios de comunicación, autoridades políticas y ciudadanos laicos para la concienciación sobre inmunidad y salud en el control a mediano y largo plazo de la actual pandemia. Nivel de evidencia V; Opinión del especialista.

Complications arising from COVID-19 reflect an abnormal immune response in people previously diagnosed with chronic, non-communicable diseases (NCD), such as cardiovascular, metabolic and pulmonary conditions. Physical inactivity is recognized as a condition that affects the development of chronic low-grade inflammation, NCD, and susceptibility to cell infections. Anxiety and mental stress, poor nutritional status, drug use and circadian rhythm disturbances can further aggravate the harm caused by physical inactivity. Therefore, the purpose of the review is to invite health professionals, their respective regulatory boards, universities, research promotion foundations, media, political authorities and lay citizens to raise awareness of immunity and health in the medium- to long-term control of the current pandemic. Level of evidence V; Expert opinion.

RESUMEN INTRODUCCIÓN: La anemia fetal es una importante causa de morbilidad y mortalidad perinatal. En la actualidad la principal herramienta terapéutica es la transfusión fetal intrauterina, permitiendo una mejoría en el pronóstico y sobrevida en fetos con anemia severa. El objetivo de este estudio fue reportar los resultados obtenidos en el Centro de Referencia Perinatal Oriente (CERPO). MÉTODO: Se realizó un análisis descriptivo retrospectivo de los casos de anemia fetal que requirieron transfusión intrauterina en CERPO entre los años 2003-2019. RESULTADOS: Se incluyeron 17 embarazos, con un total de 27 procedimientos. La sobrevida perinatal fue de 82%, con un 18% de mortalidad perinatal. Se reporta una tasa de mortalidad de 3,7% asociado al procedimiento. CONCLUSIÓN: Los resultados observados son similares a lo publicado, con una tasa de complicaciones similar a lo reportado en la literatura internacional y nacional. SUMMARY INTRODUCTION: Fetal anemia is an important cause of perinatal morbidity and mortality. At present, the main therapeutic tool is intrauterine fetal transfusion, allowing an improvement in the prognosis and survival in fetuses with severe anemia. The objective of this study was to report the results obtained in Centro de Referencia Perinatal Oriente (CERPO). METHOD: A retrospective descriptive analysis of the cases of fetal anemia that required intrauterine transfusion in CERPO between 2003-2019. RESULTS: There were 17 pregnancies included, with a total of 27 procedures. Perinatal survival was 82%, with 18% perinatal mortality; a mortality rate of 3.7% is reported per procedure. CONCLUSION: The observed results agree with previous reports.

Physical exercise has been described as an important tool in the prevention and treatment of numerous diseases as it promotes a range of responses and adaptations in several biological systems, including the immune system. Studies on the effect of exercise on the immune system could play a critical role in improving public health. Current literature suggests that moderate intensity exercise can modulate the Th1/Th2 dichotomy directing the immune system to a Th1 cellular immune response, which favors the resolution of infections caused by intracellular microorganisms. Leishmaniasis is a group of diseases presenting a wide spectrum of clinical manifestations that range from self-limiting lesions to visceral injuries whose severity can lead to death. The etiological agents responsible for this group of diseases are protozoa of the genus Leishmania. Infections by the parasite Leishmania major in mice (Balb/c) provide a prototype model for the polarization of CD4+ T cell responses of both Th1 (resistance) or Th2 (susceptibility), which determines the progression of infections. The aim of this study was to evaluate the effect of exercise on the development of L. major experimental infections by scanning the pattern of immune response caused by exercise. Groups of Balb/c mice infected with L. major were divided into groups that preformed a physical exercise of swimming three times a week or were sedentary along with treatment or not with the reference drug, meglumine antimoniate. Animals in groups submitted to physical exercise did not appear to develop lesions and presented a significantly lower parasite load independent of drug treatment. They also showed a positive delayed hypersensitivity response to a specific Leishmania antigen compared to control animals. The IFN-γ/IL-4 and IFN-γ/IL10 ratios in trained animals were clearly tilted to a Th1 response in lymph node cells. These data suggest that moderate intensity exercise is able to modulate the Th1 response that provides a protective effect against the development of leishmanial lesions.

Background: Inflammatory cytokines and acute phase proteins increase with aging, promoting a chronic low-grade inflammation. Studies have shown a positive effect of exercise on inflammatory markers in older persons. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) are the main biomarkers investigated. However, it is unclear if exercise could decrease all these biomarkers. Purpose: The aim was to analyze the effect of chronic exercise on IL-6, TNF-α, and CRP levels in older persons. Methods: Preferred Reporting Items in Systematic Reviews and Meta-analyses guidelines were adopted. Original articles that investigated the effect of chronic exercise on inflammatory profile of the elderly persons were eligible for this review. The databases PubMed, PEDro, EBSCO, and BioMed Central were searched. Three reviewers evaluated each publication for reducing bias. Data about IL-6, TNF-α, and CRP were collected and analyzed. A standardized mean difference based on estimated pooled effect size was calculated considering heterogeneity index (I2) and random effect. Results: Seventy-six studies were retrieved from databases, and 8 of them were analyzed. IL-6 and CRP levels decreased after chronic exercise (overall effect P Conclusion: Regular exercise decreases IL-6 and CRP levels in older persons. The effect of exercise on TNF-α remains unclear.

Physical exercise can improve health and may lead to changes in the functionality of the immune system. Moderate intensity exercise can reduce the risk of infection by shifting the overall immune response towards a T helper type 1 pattern. This study investigates the effect of 12 weeks of swimming on the cytokine profile of lymph node cells and macrophages and of the nitric oxide production by these cells. BALB/c mice were divided into 2 groups. The exercise group was subjected to swimming exercise. Lymph node cells culture showed that concentrations of interferon-γ and tumour necrosis factor-α were higher in the exercised group, while levels of interleukine-4 and interleukine-10 were significantly decreased in this group. The interleukine-10/interferon-γ ratio tended towards a T helper type 1 profile. Moreover, macrophages isolated from exercised mice produced more interleukine-12 and tumour necrosis factor-α following lipopolysaccharide stimulus. Challenging these macrophages with Leishmania major resulted in higher interleukine-12 production than was observed with macrophages from the control group. Nitric oxide production was increased in macrophages isolated from exercised group following lipopolysaccharide stimulus but not following infection with Leishmania major. These data suggest that exercise biases the immune system towards a T helper type 1 response profile.

INTRODUÇÃO: Durante o último século, o homem tornou-se menos ativo fisicamente, adotando hábitos cada vez mais sedentários. Isto promoveu aumento na incidência de doenças crônicas tais como doenças cardiovasculares, diabetes do tipo 2 e síndrome metabólica. A prática de atividade física pode influenciar o estado de higidez alterando estados metabólicos e também o sistema imunológico. OBJETIVO: Revisar na literatura estudos que abordem os efeitos promovidos pelo exercício físico no desenvolvimento da resposta imunológica e suas possíveis vias de transdução de sinais. MÉTODOS: Foram consultadas as bases de dados SciELO e PubMed. RESULTADOS: A literatura disponível mostra que durante a prática de exercício, várias subpopulações de leucócitos são alteradas de acordo com a intensidade e duração da atividade desempenhada. Exercícios de intensidade moderada estimulam uma resposta pró-inflamatória, enquanto aqueles de alta intensidade tendem a promover respostas anti-inflamatórias visando diminuir os danos na musculatura esquelética. Tais alterações são vistas em células apresentadoras de antígeno (como macrófagos e células dendríticas), neutrófilos, células natural killers (NK) e em moléculas de superfície como os receptores do tipo Toll (TLR) e do complexo principal de histocompatibilidade de classe II (MHC II), além das modificações promovidas em todo o repertório de citocinas. CONCLUSÃO: O estado atual do conhecimento permite considerar que as alterações no sistema imune são dependentes dos parâmetros inerentes ao exercício e que para que todas estas alterações ocorram, algumas cascatas de sinalização celular são acionadas, dando origem a um complexo processo de fosforilação/desfosforilação que culmina em ativação de fatores de transcrição, tradução de RNAm, síntese proteica e proliferação celular. INTRODUCTION: Over the last century, people have become less active, adopting more sedentary habits. This scenario has increased the incidence of chronic diseases such as cardiovascular diseases, type 2 diabetes and metabolic syndrome. The practice of physical activities can influence healthiness by altering the metabolic state and also the immune system. OBJECTIVE: To review the literature for studies that address the effects promoted by physical exercise on the development of immune responses and the possible signal transduction pathways. METHODS: The SciELO and PubMed data bases were consulted. RESULTS: The available literature shows that during the practice of exercise, various subpopulations of leukocytes are altered in accordance with the intensity and duration of the activity performed. Exercise of moderate intensity stimulates a pro-inflammatory response, while those of high intensity tend to promote anti-inflammatory responses with the purpose to decrease damage to skeletal muscle. Such alterations are observed in cells that present antigens (such as macrophages and dendritic cells), neutrophils, natural killer cells (NK) and in surface molecules like Toll-like receptors (TLR) and major histocompatibility complex class II, as well as the entire repertoire of cytokines. CONCLUSION: The current state of knowledge suggests that the alterations in the immune system are dependent on parameters inherent to exercise and that in order to have all these alterations occurring, some cell signaling cascades are activated, giving rise to a complex process of phosphorylation/dephosphorylation that culminates in the activation of transcription factors, translation of mRNA's, protein synthesis and cell proliferation.

O Acidente Vascular Cerebral (AVC) é definido como um sinal clíni­co de rápido desenvolvimento de perturbação focal da função cerebral, de suposta origem vascular com mais de 24 horas de duração. A dis­função mais comum apresentada é a hemiparesia, a qual acarreta limi­tações nas atividades diárias do indivíduo, devido a debilidade motora em um lado do corpo. Objetivo. Verificar os efeitos da terapia de res­trição e indução de movimento (TRIM) na recuperação funcional do membro superior de indivíduos hemiparéticos após AVC. Método. Trabalho de revisão de literatura. Foram utilizados artigos publicados nas bases de dados LILACS, SciELO, PubMed e PEdro, nas línguas portuguesa e inglesa. Resultados. Foram selecionados 28 artigos cien­tíficos. Conclusão. Os estudos demonstraram grande efetividade da TRIM na superação do “não-uso aprendido”, qualidade e quantidade de movimento do membro superior parético.

Objetive: Evaluate the intrauterine blood transfusions performed in fetuses with anemia due to red blood cell alloimmunization in our unit and the detection rate of the middle cerebral artery Doppler to predict anemia after the first transfusion. Material and methods: We performed 53 intrauterine blood transfusions in 15 patients with red blood cell alloimmunization. We analyze the characteristics of the cases and the value of the middle cerebral artery Doppler to predict fetal anemia. Results: The detection rate of fetal anemia with the peak systolic velocity Doppler in the middle cerebral artery was 85% after the first transfusion and 72% after the second or more. There were no false positive results of the test in our series.

The intracellular protozoaLeishmaniaspp. andTrypanosoma cruziand the causative agents of Leishmaniasis and Chagas disease, respectively, belong to the Trypanosomatidae family. Together, these two neglected tropical diseases affect approximately 25 million people worldwide. Whether the host can control the infection or develops disease depends on the complex interaction between parasite and host. Parasite surface and secreted molecules are involved in triggering specific signaling pathways essential for parasite entry and intracellular survival. The recognition of the parasite antigens by host immune cells generates a specific immune response.Leishmaniaspp. andT. cruzihave a multifaceted repertoire of strategies to evade or subvert the immune system by interfering with a range of signal transduction pathways in host cells, which causes the inhibition of the protective response and contributes to their persistence in the host. The current therapeutic strategies in leishmaniasis and trypanosomiasis are very limited. Efficacy is variable, toxicity is high, and the emergence of resistance is increasingly common. In this review, we discuss the molecular basis of the host-parasite interaction ofLeishmaniaandTrypanosoma cruziinfection and their mechanisms of subverting the immune response and how this knowledge can be used as a tool for the development of new drugs.

Leishmaniasis is a neglected tropical disease with no effective vaccines. Actin, microtubules and the actin-based molecular motor myosin Va were investigated for their involvement inLeishmania braziliensismacrophage interactions. Results showed a decrease in the association index when macrophages were without F-actin or microtubules regardless of the activation state of the macrophage. In the absence of F-actin, the production of NO in non-activated cells increased, while in activated cells, the production of NO was reduced independent of parasites. The opposite effect of an increased NO production was observed in the absence of microtubules. In activated cells, the loss of cytoskeletal components inhibited the release of IL-10 during parasite interactions. The production of IL-10 also decreased in the absence of actin or microtubules in non-activated macrophages. Only the disruption of actin altered the production of TNF-αin activated macrophages. The expression of myosin Va tail resulted in an acute decrease in the association index between transfected macrophages andL. braziliensispromastigotes. These data reveal the importance of F-actin, microtubules, and myosin-Va suggesting that modulation of the cytoskeleton may be a mechanism used byL. braziliensisto overcome the natural responses of macrophages to establish infections.

Objetivo: Evaluar la prevalence del uso de procedimientos invasivos prenatales en una población chilena con cribado y diagnóstico de alteraciones morfológicas y/o cromosómicas. Método: Estudio descriptivo en 17.906 embarazadas entre junio de 2000 y octubre de 2006, a las cuales se les realizó cribado ecogrático de aneuploidia y malformaciones congénitas durante el primer y segundo trimestre. Las pacientes fueron informadas y aconsejadas acerca de las implicancias de dichos procedimientos. Los procedimientos efectuados fueron la biopsia de vellosidades coriales (BVC), amniocentesis (AMCT) y cordocentesis. Se calculó la prevalencia y las indicaciones de dichos procedimientos. Resultados:Se realizaron 81 procedimientos invasivos (0,45%). Las BVC representaron un 43,3%, las AMCT el 37,0% y las cordocentesis un 19,7%. Las principales motivaciones para realizarse un estudio invasivo fueron malformaciones congénitas (48,1 %) y aumento del riesgo de aneuploidia (40,7%). Los cariotipos alterados fueron 43,2% del total de los procedimientos, encontrándose 29% de trisomías 21, 46% de trisomías 18 y 13 y 20% de síndrome de Turner. Conclusión: La prevalencia de procedimientos invasivos fue 10 veces inferior a la descrita en países donde el aborto es legal, y aproximadamente la mitad de ellos resultaron alterados. En nuestra población utilizando una asesoría adecuada, la principal motivación para realizarse un procedimiento invasivo fue el mejor manejo obstétrico del embarazo y, secundariamente, la posibilidad de contar con una mejor información sobre la salud del hijo no nacido Objective: The purpose of this study was to evaluate the prevalence and indications of invasive procedures in a population without termination of pregnancy. Method: This descriptive study was performed in pregnant women who had either assessment of risk for chromosomal abnormalities during the first and second trimester of pregnancy or detection of soft markers or structural defects at any gestational age from June 2000 to October 2006. The patients were counseled with regards their estimated risk, and were informed about invasive diagnostic tests. The invasive testing offered were chorion villous sampling (CVS), amniocentesis (AMCT) and fetal blood sampling (FBS). The prevalence of invasive testing was calculated and its causes analyzed according to the type of screening test. Results: Ultrasound was carried out in 17,906 pregnant women, being 70% performed either during the first or second trimester of pregnancy. Eighty one invasive procedures were performed (0.45%). CVS accounted for 43.3%, AMCT for 37.0% and FBS for 19.7%. The main motivation for opting for invasive testing was fetal abnormalities (48.1 %) and increased risk of chromosomal anormalities (40.7%). Abnormal fetal kaiyotypes were 43.2%, being 29% Down's syndrome, 46% Edwards and Pateau's syndromes, and 20% Turner syndrome. Conclusion:Jhe low frequency of invasive procedures observed in this population might be an expression of our social, cultural and legal characteristics, but it is also a demonstration of pragmatic and ethically rational decisions about invasive testing for chromosomal abnormalities

Antecedentes. La evaluación gráfica del parto fue descrito originalmente por Friedman, sin embargo, una descripción de la evolución del trabajo de parto con un manejo médico contemporáneo no ha sido completamente evaluado. Objetivo: Analizar el efecto de un manejo médico estandarizado del trabajo de parto, que incluye anestesia regional, rotura artificial de membranas y conducción ocitócica, sobre la fase activa del trabajo de parto en multíparas. Método. Análisis retrospectivo de 130 multíparas en trabajo de parto espontáneo, que ingresaron con 3 a 4 cm de dilatación. Resultados. Se observó una duración de la fase activa del trabajo de parto de aproximadamente 3,5 horas, con una progresión promedio de 1,5 cm/ h, produciéndose la mayor progresión entre los 7 y 9 cm de dilatación con 1,9 cm/h. La segunda fase del trabajo de parto presento una duración promedio de 28 minutos. Conclusiones. Nuestros resultados muestran que el manejo "médico estandarizado" del trabajo de parto no reduce los tiempos de la fase activa ni de la segunda fase en multíparas. Creemos que es necesario implementar estudios randomizados para determinar la influencia de este tipo manejo del trabajo de parto en la incidencia de cesáreas Objective. To analyze the influence of a standardised protocol for the management of labour applied during the active phase of labour. Method. The graphic partograms of 130 multiparous women with spontaneous onset of labor were retrospectively analysed. A standardised protocol was defined by use of regional anaesthesia, early rupture of membranes and oxytocin acceleration during the active phase of labour. Results. The mean duration of the active phase of labour and the mean cervical rate dilatation were approximately 3.5 hours and 1.5 cm/h, respectively. The maximum mean rate of dilatation was 1.9 cm/h at the range of 7 to 9 cm, being the mean duration of the second phase of labour only 28 minutes. Conclusions. This study shows that the application of this standardised protocol of management of labour do not appear to be associated with a shortenning in the duration of the active dilatation and second stage of labour. Therefore, it would be necessary to set up a randomized control trial to evaluate the influence of this kind of managements in the caesarean section rate

Objetivo: Conocer si la divulsión del polo inferior, realizada semanalmente desde las 38 semanas de gestación en pacientes de bajo riesgo, es un método seguro y eficaz para disminuir la incidencia de partos mayores de 41 semanas. Método: 110 embarazadas de bajo riesgo y de edad gestacional segura fueron randomizadas a divulsión de polo (casos) y no divulsión (controles). Desde las 38 semanas, tanto a las controles como las intervenidas, se les realizó tactos vaginales para evaluar pelvimetría, puntaje de Bishop y divulsión de polo en aquellas gestantes aleatorizadas y que cumplían las condiciones para poder realizar el procedimiento. El objetivo primario fue determinar la incidencia de parto espontáneo antes de las 41 semanas y el secundario fue evaluar la morbimortalidad materna y neonatal. Los datos fueron analizados por Chi cuadrado, test exacto de Fisher, test t de Student y test Wilcoxson rank-sum según correspondiera. Resultados: La población estudiada en ambos grupos fueron demográficamente similares. Las gestantes divulsionadas tuvieron significativamente (p

Se presenta la experiencia de la Maternidad del Hospital Clínico de la Universidad de Chile de un programa diseñado especialmente con el objetivo de disminuir las cesáreas evitables. Tomando el porcentaje de cesáreas del trimestre enero-marzo de 2003 como base. Se efectuó un programa de intervención entre los meses de abril-septiembre de 2003, que considera: entrega diaria del turno de residencia, segunda opinión para operación cesárea, diagnóstico pormenorizado de pelvis en ficha clínica, auditoría mensual de cesáreas "evitables" y estandarización de un protocolo de presentaciones distócicas. El propósito del estudio fue evaluar el efecto de la introducción de un sistema de auditoría en la reducción de la tasa de cesáreas, según propuesta de Robson y cols. El porcentaje global de cesáreas disminuyó de 44,9% a 37,1%, en nulíparas de 39,0% a 29,5% y en multíparas de 48,1% a 42,2%, diferencias estadísticamente significativas SUMMARY The experience at the Maternity Ward of Hospital Clínico de la Universidad de Chile in reducing avoidable cesarean sections is presented. The purpose of this study is to analyze the effects of an audit cycle in the cesarean section rate, using the proposal of Robson et al. A specifically designed program is used. Using the cesarean section rate of january to march trimester as a baseline, we designed an intervention protocol for april to september period which involves: daily resident report, second opinion for cesarean section, detailed pelvis diagnosis in the medical file, monthly "avoidable" cesarean section audit cycle and abnormal lie protocol standardization. The overall cesarean section rate was reduced from 44.9% to 37.1%, in nulliparous from 39.0% to 29.5% and in multiparous from 48.1% to 42.2%, all these differences were statistically significant

Submitted by Boris Flegr (boris@uerj.br) on 2021-01-05T18:50:03Z No. of bitstreams: 1 Pedro Jose Falci Alves - Dissertacao.pdf: 3235033 bytes, checksum: fb8efb4eb2d3a76ae0c68c1ffa63e64e (MD5) Made available in DSpace on 2021-01-05T18:50:03Z (GMT). No. of bitstreams: 1 Pedro Jose Falci Alves - Dissertacao.pdf: 3235033 bytes, checksum: fb8efb4eb2d3a76ae0c68c1ffa63e64e (MD5) Previous issue date: 2019-09-03 Exercise can bring health benefits through responses and adaptations promoted in various biological systems, including the immune system. Moderate intensity exercise can reduce the risk of infection by intracellular microorganisms by directing the immune response to a Th1 type pattern. Strenuous physical exercise can lead to immune cell targeting, causing an immune window that can make the body susceptible to infection through the prevalence of a Th2-type response. This study investigates the effect of a single exercise session, acute, moderate or strenuous, on nitric oxide production by peritoneal macrophages of Balb / C mice. The mice were divided into 3 groups for acute exercise (sedentary control, moderate exercise and strenuous exercise). The acute exercise consisted of a single moderate session and a single strenuous session. A single session of moderate (acute) exercise promoted a significant increase in NO production in LPS-stimulated macrophages infected with Leishmania major or Leishmania braziliensis. A single session of moderate and strenuous exercise promoted a decrease in the Leishmania / Macrophage association index in in vitro Leishmania major and Leishmania braziliensis infection. These data suggest that acute exercise promotes an improvement in macrophage microbicidal capacity, which facilitates the resolution of infections by intracellular microorganisms, but further studies are needed to better understand such mechanisms O exercício físico pode trazer benefícios para saúde através de respostas e adaptações promovidas nos diversos sistemas biológicos, incluindo o sistema imunológico. Exercício físico de intensidade moderada pode reduzir o risco de infecção por microrganismos intracelulares, através do direcionamento da resposta imune para um padrão do tipo Th1. Exercício físico extenuante pode gerar um direcionamento das células imunes, causando uma janela imunológica , podendo deixar o organismo suscetível a infecções, através da prevalência de uma resposta do tipo Th2. Este estudo investiga o efeito de uma única sessão de exercício, agudo, moderado ou extenuante, na produção de óxido nítrico por macrófagos peritoneais de camundongos Balb/C. Os camundongos foram divididos em 3 grupos para o exercício agudo (controle sedentário, exercício moderado e exercício extenuante). O exercício agudo consistiu de uma única sessão moderada e uma única sessão extenuante. Uma única sessão de exercício moderado (agudo) promoveu aumento significativo na produção NO em macrófagos estimulados por LPS e infectados por Leishmania major ou por Leishmania braziliensis. Uma única sessão de exercício moderado e extenuante promoveu a diminuição do índice de associação Leishmania/Macrófago na infecção in vitro por Leishmania major e Leishmania braziliensis. Estes dados sugerem que exercício físico agudo promove uma melhora na capacidade microbicida de macrófagos, o que facilita a resolução de infecções por microrganismos intracelulares, porém, há a necessidade de mais estudos para melhor entender tais mecanismos