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Effect of menopause on low density lipoprotein oxidation: is estrogen an important determinant? Oxidized low-density lipopropteins: What is understood and what remains to be clarified purchase discount mefenamic line. Paraoxonaseinhibitis high-density lipoprotein oxidation and preserves its function buy 500mg mefenamic visa. Increasing the vegetable intake dose is associated with a rise in plasma car otenoids without modifying oxidative stress or inflammation in overweight or obese postmenopausal women 500 mg mefenamic free shipping. Effect of a 2-month treatment with Klamin purchase mefenamic 250 mg online, a Kla math algae extract, on the general well-being, antioxidant profile and oxidative status of postmenopausal women. Menopause: A review on the role of oxygen stress and favorable effects of dietary antioxidants. Soymilk supplementation does not alter plasma markers of inflammation and oxida tive stress in postmenopausal women. Dietary soya intake alters plasma antioxidant status and lipid peroxidation in postmenopausal women with the metabolic syndrome. American ginseng supplementation induces an oxidative stress in postmenopausal women. Dietary intakes and antioxidant status in mind-body exercising pre- and postmenopausal women. Response of oxidative stress markers and antioxi dant parameters to an 8week aerobic physical activity program in healthy, postmenopausal women. Exercise effect on oxidative stress is independent of change in estrogen me tabolism. Effect of cardiorespiratory fitness on vascular regulation and oxidative stress in postmeno pausal women. Effect of moderate-intensity exercise on oxidative stress indices in metabolically healthy obese and metabolically unhealthy obese phenotypes in postmenopausal women: a pilot study. Introduction The oral cavity is a region interconnected with other systems of the body; it should not be viewed as an isolated area. Diseases that it lays down can have systemic scope and signifi cantly affect the quality of life of individuals who suffer them. Periodontal disease is one of the oral health problems that most often affect the global population, lack of treatment leads to loss of tooth organs and consequently alters the digestion and nutrition, without consid ering other relevant aspects as phonation, aesthetics and social or emotional impact. The im portance of periodontal disease has raised possible bidirectional relationships with systemic diseases such as diabetes, metabolic syndrome and cardiovascular disease. We address here in the role of oxidative stress in the etiopathogeny of periodontal disease. In the same con text, another disease that has become relevant in our days is the oral cancer. Epidemiological data show that the incidence of this neoplasm has been increasing in several countries. The role of oxidative stress in the development of this disease and some alternatives for its treatment, are topics addressed in this brief review. These two oral diseases are a sample of the plethora of effects that oxi dative stress may have at local and systemic level. Periodontal disease Periodontitis is the second world health problem since it affects between 10 to 15% of the world population [1] Although the various states in this disease depend on the degree of. In fact, within the 300 to 400 species of bacteria located in the oral cavity consider that some of them are exclusive to the periodontal tissues. However in recent years it has been determined that the evolution and spread of the disease will play a decisive role in the host response to bacterial attack. This is reflected in the model of the critical path in the pathogenesis of this disease. Through this one can understand that there are diseases and systemic conditions that have risk factors for periodontal disease, because they are going to modify the host response and favor the development of damage [3]. When it is lost in the inclusion of periodontal fibers, usually after puberty, the cases that are reported before this stage are only 5%. Previously it has reported that there was a ratio of two to one in the frequency of periodontal disease, women being the most affected in this order. In adults with more than 1 mm of affected dental faces periodontal insertion loss increases with age. An epidemiological report in United States mentions that approximately 80-92% of the population between the ages of 35 and 64 years performed, lost more than 1 mm inser tion in 20 to 47% of teeth. From 18 to 22% of the population of 35 to 64 years were more 2 mm deep in the probing of the periodontal bags in 11 to 13% of tooth surfaces. Periodontitis occurs when tissue destruction due to the direct effect of bacterial toxins and removal prod ucts, in addition, the effects caused indirectly by the harmful organic defense mechanisms. Bacteria causes tissue destruction with its deletion, this is a feature of marginal periodontitis products. The hydrolysis of the connective tis sue associated with the inflammation is due to the reactive oxygen species and the elastase/ lysosomic-like enzymes. Prostaglandin E, Interleukin 1-/ J and the lipopolysaccharide activates osteoclasts and induce a resorption of alveolar bone. Cellular and humoral components of the immune system, mainly involved in the periodontal immune response are leukocytes, immunoglobulins, complement system and lysozyme. If the immune defenses are working properly, the periodontium is pro tected from the harmful effect of pathogenic substances secreted by the microorganisms. The immunocompetent host is able to defend itself against microbial attacks that occur every day. We can say that the periodontal inflammation is a local reaction to a tissue injury whose purpose is the destruction of the causal factor, dilution or its encapsulation. The human immune system can be classified according to their function within the perio dontium, follows: Secretory system Neutrophils, antibodies and complement system Leukocytes and macrophages Immune regulation system. The system formed by neutrophils, antibodies and complement is crucial to the immune de fense against periodontal infections. When functional defects of neutrophils occur, it increas es the frequency of serious marginal periodontitis [4]. Oxidative stress A phenomenon that occurs within the periodontal disease is called oxidative stress. A fundamental characteristic of the reactions of free radicals is that act of chain reactions, where a radical reaction generates another consecutively. The tetravalent reduction of oxygen to produce water through the electron transport chain in mitochondria is relatively safe. The most important function is serving as a10 suppressor of primary free radicals, located in the membranes in the vicinity of unsaturated lipid chains. There are less established functions that include the oxidation/reduction of the control of the origin and transmission of signals in cells that induce the expression of gender, the control of membrane channels, the structure and solubility in lipids [7]. The living organism has adapted to an existence under a continuous output of radi cal free flow. Between the different antioxidant defense mechanism adaptation mechanism is of great importance. Antioxidants are "those substances that when they are present in lower concentrations compared to the substrate of an oxidizable, significantly delay or in hibit the oxidation of the substrate". The various possible mechanisms that antioxidants can offer protection against damage from free radicals are: The prevention of the formation of radical free. Antioxidant defense system is very dynamic and responsive to any disturbance that occurs in the body redox balance. Antioxidants can be regulated and neutralize the formation of radical free that can occur due to oxidative stress, such as the factor transcription factors Ac tivator protein 1 and nuclear-kb are redox sensitive. The presence of inflammatory infiltrate is a constant feature in periodontal disease. It is known that these cells release lots of free radicals; it is suspected that these metabolites are involved in the pathogenesis of the disease. The presence of a dense inflammatory infiltrate in periodontal disease leads to the suspicion that the relationship of periodontal leukocyte- tissue has a double aspect.

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In general 500mg mefenamic fast delivery, these studies are less expensive than cohort studies to conduct purchase mefenamic us, but differential recall between cases and controls of past exposures can lead to bias buy discount mefenamic 500 mg line. This kind of recall bias can lead to inaccurate associations of environment exposures with disease order mefenamic 500mg without prescription. Despite this potential bias, case control studies are extremely helpful in identifying potential risk factors, especially for rare diseases. Cohort studies involve measuring potential risk factors or exposures in disease-free individuals and then following these individuals over a period until some of them develop the disease of interest. These studies can be conducted prospectively in time or, if past exposure data are available, they can be conducted retrospectively. Because the study population is usually followed very closely over a long period, cohort studies can be quite expensive to conduct. However, cohort studies can provide estimates of the true relative risk of a factor with disease. A major advantage of cohort studies is that they can estimate the temporal sequence between exposure and disease. These are experiments where subjects or groups of individuals with equal characteristics are randomly assigned to receive or not receive the therapy or intervention (2). Because the study subjects are randomly assigned to a treatment or a control group and followed over time for health events, these studies are regarded as the most scientifically rigorous methods of hypothesis testing. Epidemiology Subdisciplines The study designs just reviewed form some of the basic tools in a field that is becoming increasingly specialized. Subdisciplines of epidemiology, like those shown in Table 3, each have developed very specific approaches to measuring and modifying disease risk factors, often incorporating newly developed technology and statistical methods. For example, social epidemiology focuses on the complex social distribution and social determinants of health (6). Social epidemiologists take a broad population and life-course perspective, building multilevel models incorporating community measures in addition to risk factors on the individual level. Given the wide pharmacotherapeutic options for treating rheumatic diseases and their variable effects on individuals, pharmacoepidemiology is an extremely important field for rheumatologists. Understanding individual responses to medications is the first step to personalized medicine. Environmental exposures have been implicated in the etiology of some chronic diseases, but quantifying these exposures is often extremely difficult. Environ- mental epidemiologists specialize in measuring the relationships between exogenous Table 3 Examples of Epidemiology Subdisciplines Subdiscipline Social/behavioral epidemiology Pharmacoepidemiology Environmental epidemiology Genetic/molecular epidemiology 44 Part I / Introduction to Rheumatic Diseases and Related Topics environmental agents and health (9). Genetic or molecular epidemiological studies seek to link a particular genotype or biological marker of a specific effect (i. These types of studies combine principles of human and population genetics with classical epidemiological methods. They can be used to help determine disease etiology and also to improve our understanding of disease risk, classification, and progression. Genetic epidemiological studies determine the role of inherited causes of disease in families and in populations. Often, family or twin studies are used to first establish whether there is a genetic component to a disease. Next, segregation analyses are used to estimate the mode of genetic transmission and linkage and association studies are used to estimate the genetic locus and alleles associated with disease. Once the genes and alleles are identified, genetic epidemiologists also evaluate gene gene and gene environment interactions with disease risk. Genetic epidemiology is a particu- larly dynamic field that is being shaped by very rapid improvements in genotyping and bioinformatics technology, falling genotyping costs, and advances in statistical methods. Rheumatic diseases are clinically complex and this presents many methodological challenges in studying these diseases. Some of the major methodological issues in rheumatic disease epidemiology are shown in Table 4. Fortunately, this problem is being addressed by the adoption of very specific criteria to classify cases. The creation and continual refinement of these classification criteria to reflect new disease knowledge greatly improves the ability to conduct epidemiological studies and it allows study results to be more easily compared. The difficulty in identifying individuals with rheumatic disease in populations is another limitation to better understanding the epidemiology of these disorders. The difficulty of diagnosis and variability in disease course and treatments can also affect the ability to identify and track cases for epidemiological investigations over time. For this reason, investigators often use multiple clinic and hospital sources for case ascertainment and employ disease registries to more easily track patients over time. Many of these conditions are thought to be polygenic and involve multiple environmental exposures, and this complicated etiology has resulted in the identification of few potentially modifiable risk factors for rheumatic diseases. The lack of previously identified risk factors can dissuade investigators from carrying out epidemiological studies. However, rheumatic disease classification criteria are by definition restrictive (i. Furthermore, 27% reported pain or stiffness in or around a joint in the past 30 days that began more than 3 months ago. Prevalence was lowest among Asian and Hispanics and highest among Native Americans and Alaska Natives. Arthritis diagnosis and chronic joint symptoms were also more common among individuals with the lowest education and income levels. For a more complete review of the epidemiology of these and other rheumatic diseases, refer to Silman and Hochberg (14). Disease onset can occur at any age, but a majority of cases are diagnosed between ages 40 and 60. Unlike previous diagnostic guidelines, subgroups are not assigned according to severity. Perhaps the broadest range occurs between populations of North American Natives, from 0. Estimates are based on household interviews of a sample of the civilian noninstitutionalized population. Therefore, regardless of gender, higher levels of reproductive hormones may provide an avenue by which primary prevention methods may be established (27). Furthermore, these markers correlate with disease severity (31) and early age of onset (32). It calls into question whether there are common genetic risk factors underlying many autoimmune diseases (30). Additionally, many pharmacogenetic studies are underway to determine the genetic influences on treatment response, partic- ularly toward understanding the pharmacogenetics of methotrexate response (30). With the advent of affordable genome-wide association studies, these investigations may soon yield further exciting results. The crude rates are indicated, and the age-standardized rates and 95% confidence intervals are noted when available. The overall age-standardized incidence rates in the Baltimore study were remarkably similar to rates in Allegheny County. For the most part, although different criteria were applied to classify cases, the gender- and race-specific rates are strikingly similar between the studies. Of these environmental factors, silica particles and smoking appear to have the strongest associations. Infectious agents may also be risk factors but their role need clarification (15). Comparisons of age-specific incidence rates for African-American and white females with definite systemic lupus erythematosus. These relatives may also have higher rates of autoimmune disease but this need confirmation in carefully conducted population-based studies. Concordance rates are approximately 25 to 50% among monozygotic twins and 5% among dizygotic twins. Whole genome-wide association studies will likely replicate many of these and identify new genetic associations. There are also no significant differences in the prevalence for men versus that of women. Overall incidence rates within the United States, standardized for age and gender, have been found to be 0. High levels of bone density, as well as low levels of serum vitamin D necessary for bone remodeling, also correspond with increased risk (59,60).

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Diseases of Mites and Ticks 77 Table 2 continued Study Association between Results fungus and ticka Fernandes B order mefenamic with american express. Isolation of entomopathogenic fungi from naturally infected ticks Studies have reported that several tick species are naturally infected by pathogenic fungi purchase mefenamic once a day. The isolation of indigenous entomopathogenic fungi is important for developing isolates that avoid the introduction of new (exotic) fungal isolates for tick biological control in certain environments generic mefenamic 250 mg line. Metarhizium anisopliae and (1) Increased mortality (32 45% at 105 108 conidia ml-1 purchase discount mefenamic line, unfed nymphs of A. Diseases of Mites and Ticks 79 Table 3 continued Study Association between fungus Results and ticka M. Studies are ordered according to year of publication a Fungus was applied as an aqueous conidial suspension, unless specied differently 80 J. Diseases of Mites and Ticks 81 Table 4 continued Study Association between Resultsb fungus and ticka Samish et al. Simplicillium (1) Conidial suspension with highest concentration (108 conidia lamellicola and R. Metarhizium anisopliae to (1) Decreased number of females parasitizing cattle: (1997) control Rhipicephalus 43. No evidence of the fungus in natural cavities was detected by histological analysis. Adhesion of conidia was observed 24 h post-infection, and germination started on the tick s cuticle. Conidia differentiate to form appressoria and infection pegs exert mechanical pressure, and secrete hydrolytic enzymes for cuticle penetration. Massive penetration was observed after 72 h, and hyphae emerged from the cuticle to start the conidiogenesis process 96 h post-inoculation. After fungal penetration, the principal alteration observed was the lyses of intestine and leakage of intestinal content to hemocoel. Mortality was observed after 96 and 120 h post-infection, and sporulation was detected after 120 144 h (Garcia et al. The penetration process of the fungi through the cuticle involves secretion of enzymes such as proteases and chitinases, and is assisted by mechanical processes of the appressorium infection peg (Charnley and St. After penetration, the fungus invades the internal organs, produces mycotoxins, and kills the host (Kaaya et al. However, tick species may display differential susceptibility to entomopathogenic fungi due to fungistatic compounds present in the epicuticle of certain tick species (Kirkland et al. Possibly, there is cooperation (mass action) between neighboring germi- nating conidia on the arthropod cuticle (Zhioua et al. Formulation Several entomopathogenic organisms need to be ingested to infect their arthropod host; however, the penetration of pathogens via oral ingestion is not feasible for arthropods that are exclusively hematophagous. Conidial suspension formulation may improve eld performance of conidia under adverse envi- ronmental conditions. Oil formulations have been used with ultra low volume spray technology, which proved effective probably due to improved promotion of conidial adhesion to the hydrophobic surfaces (Prior et al. Other studies have also demonstrated satisfactory results when conidia are formulated in a polymerized cellulose gel (Bittencourt et al. Formulation of conidial suspensions also may protect conidia against desiccation and ultraviolet radiation. Therefore, correct formulation may greatly enhance the effectiveness of entomopathogenic fungi as biocontrol agents. Immune system of ticks As with vertebrates, the immune system of invertebrates recognizes invading foreign bodies as non-self, responding with cellular (hemocytic) and acellular (humoral) reactions (Ratcliffe et al. However, spherulocytes and oenocytoids seem to be related to the granular cell complex (Tanada and Kaya 1993), and possibly store antimicrobial peptides that are secreted following contact with foreign organisms (Goodman et al. A well developed capability for phagocytizing microbes and other foreign organisms appears to exist in ticks, similar to many other arthropods (Sonenshine 1991). A similar phenomenon may occur in ticks infected with a virulent form of entomopathogenic fungi, such as B. Humoral factors facilitate self/non-self recognition and activate defense reactions. It is important to note that no globulins similar to those of vertebrates have been detected in insects (Tanada and Kaya 1993) or ticks. Besides lectins, defensins, lysozyme and possibly other antimicrobial peptides are secreted into the hemolymph plasma to combat invasion by foreign organisms (Goodman et al. More studies are necessary to understand the role of hemolymph contents in humoral immunity. Diseases of Mites and Ticks 87 Many studies on the tick immune system are limited in identifying and quantifying hemocytes, or in characterizing antimicrobial peptides (Sonenshine 1991; Carneiro and Daemon 1996; Pereira et al. The expression of four forms of defensin was observed in the intestine, fat body and reproductive tract of Orni- thodorus moubata (Nakajima et al. It is not known, however, if expression of these peptides increases after infection. Greater understanding of the immune responses of ticks to infection by entomopatho- genic fungi would help elucidate the infection process, and this information might be useful in choosing appropriate entomopathogenic fungal isolates for biological control of ticks. Also, knowledge on the effects of formulation products may prove important in devising superior formulations for eld use. Biocontrol strategies Based on the results reviewed in this study and the ecological conditions in South America, the best use of entomopathogenic fungi to control ticks would probably be to apply formulated conidia directly onto tick-infested animals. Although the spraying of conidial suspensions on pasture plants has reduced the population of tick larvae (see Table 5), the concentration of fungal inoculum used to control ticks in the eld still remains high in comparison to those used for agriculture arthropod pests (Maniania et al. On the other hand, a system with pheromones and carbon dioxide delivery in the eld could possibly attract ticks to a localized fungus-treated spot in the vegetation; however, further investigation is needed to improve this system (Maranga et al. Combinations of chemical acaricides and entomopathogenic fungi also have been studied, aiming for compatibility and synergism between them. It is important to note that most of the studies evaluated the possible negative effects of chemical products on entomopathogenic fungi; however, Paiao et al. The results suggest that the combination of chemical acaricides with entomopathogenic fungi is potentially an important tool for integrated management of ticks. Conclusion Entomopathogenic fungi are the most promising of the currently available alternatives to chemical acaricides for tick control; especially since these organisms penetrate directly 88 J. In addition, fungi might initiate natural epizootic outbreaks (Alves 1998), and where environmental conditions (e. The genetic variability among fungal isolates is another advantage, in that simple assays may detect the most virulent isolates, level of host specicity, and tolerance to eld conditions. Unfortunately, most eld trials performed to date have reported rather low efcacy of fungi for the control of tick populations in South America, with the exception of A. Only a few eld trials have been conducted in South America, and in most cases, a simple aqueous conidial suspension was used. In Brazil, an acaricide needs to achieve 95% efcacy to be commercialized (Ministerio da Agricultura, Pecuaria e Abas- tecimento 1997). Therefore, studies on formulation are required to improve conidial performance under environmental conditions. These programs may vary with tick species due to different biological behavior and geographic region. Tick biological control offers several advantages over currently available chemical acaricides, including lower costs; and therefore, there are increased efforts in South America to develop new biological products. Unfortunately, regulations for microbial pesticides in many South American countries are poorly developed and/or virtually not enforced, and thus have impeded the development of quality biological control products. However, while more research is necessary, entomopathogenic fungi have great promise as alternatives to current tick control methods, and they could alleviate many of the current environmental and health concerns that come with the present-day methods. Am J Trop Med 19:103 108 Dutra V, Nakazato L, Broetto L et al (2004) Application of representational difference analysis to identify sequence tags expressed by Metarhizium anisopliae during the infection process of the tick Boophi- lus microplus. Rev Bras Parasitol 15:157 162 Ministerio da Agricultura Pecuaria e Abastecimento (1997) Regulamento tecnico para licenciamento e/ou renovacao de licenca de produtos antiparasitarios de uso veterinario. Cienc Rural 35:855 861 Prior C, Jollands P, Le Patourel G et al (1988) Infectivity of oil and water formulation of Beauveria bas- siana (Deuteromycotina: Hyphomycetes) to the cocoa weevil pest Pantorhytes plutus (Coleoptera: Curculionidae). Academic, New York Samish M, Rehacek J (1999) Pathogens and predators of ticks and their potential in biological control. J Parasitol 87:1355 1359 Samish M, Ginsberg H, Glazer I (2004) Biological control of ticks. Losson Originally published in the journal Experimental and Applied Acarology, Volume 46, Nos 1 4, 95 104.

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