Beyond forced exhalation: impulse oscillometry as a promising tool for bronchial hyperresponsiveness evaluation.

Introduction: The multiple forced expiratory maneuvers that must be performed during methacholine test require a high degree of collaboration and can lead to fatigue. However, impulse oscillometry (IOS) is a noninvasive test, quick and easy to perform, that does not require effort-dependent maneuvers.Objectives: The primary endpoint was to evaluate the relationship between IOS and spirometry during the methacholine test. The secondary endpoint was to study the predictive value of baseline IOS in the development of bronchial hyperreactivity.Methods: Observational, prospective, cross-sectional study, with recruitment of consecutive patients from the pulmonology department with clinical suspicion of bronchial asthma with negative bronchodilator test and normal FeNO.Results: Twenty-five patients were included, with a mean age of 49 ± 18 years. Thirteen patients (52%) had a positive methacholine test. The correlation between IOS indices and FEV1 was significant (p < 0.05) in all cases. The indices with the highest predictive power were R5-20 and AX. The optimal cutoff points were an increase of greater than 32.96% in R5, greater than 120.83% for X5, an increase of 30.30 [kPa l-1s-1] in R5-20, and an increase of 1.01 [kPa l-1] for AX. Baseline oscillometry demonstrated a strong predictive value in the development of bronchial hyperreactivity, with a sensitivity of 61.5% and a specificity of 91.7%, using the cut-off point of 160.0% for R5.Conclusions: IOS may be a valuable alternative to forced spirometry in detecting bronchial hyperreactivity during the methacholine test, showing a good correlation between both tests.

Dual Contribution of Mesenchymal Stem Cells Employed for Tissue Engineering of Peripheral Nerves: Trophic Activity and Differentiation into Connective-Tissue Cells.

Adult peripheral nerves in vertebrates can regrow their axons and re-establish function after crush lesion. However, when there is extensive loss of a nerve segment, due to an accident or compressive damage caused by tumors, regeneration is strongly impaired. In order to overcome this problem, bioengineering strategies have been employed, using biomaterials formed by key cell types combined with biodegradable polymers. Many of these strategies are successful, and regenerated nerve tissue can be observed 12 weeks after the implantation. Mesenchymal stem cells (MSCs) are one of the key cell types and the main stem-cell population experimentally employed for cell therapy and tissue engineering of peripheral nerves. The ability of these cells to release a range of different small molecules, such as neurotrophins, growth factors and interleukins, has been widely described and is a feasible explanation for the improvement of nerve regeneration. Moreover, the multipotent capacity of MSCs has been very often challenged with demonstrations of pluripotency, which includes differentiation into any neural cell type. In this study, we generated a biomaterial formed by EGFP-MSCs, constitutively covering microstructured filaments made of poly-ε-caprolactone. This biomaterial was implanted in the sciatic nerve of adult rats, replacing a 12-mm segment, inside a silicon tube. Our results showed that six weeks after implantation, the MSCs had differentiated into connective-tissue cells, but not into neural crest-derived cells such as Schwann cells. Together, present findings demonstrated that MSCs can contribute to nerve-tissue regeneration, producing trophic factors and differentiating into fibroblasts, endothelial and smooth-muscle cells, which compose the connective tissue.

Real-life management of primary immune thrombocytopenia (ITP) in adult patients and adherence to practice guidelines.

Very few data exist on the management of adult patients diagnosed with primary immune thrombocytopenia (ITP). The objectives of this study were to describe the diagnostic and treatment patterns for ITP and to compare the findings to recent ITP guidelines. We retrospectively analyzed the medical records of adult ITP patients diagnosed with primary ITP between January 2011 and June 2012 and examined whether management strategies were consistent or not with eight recent guideline-recommended practices. Overall, median age at the diagnosis of the disease (n = 101) was 58 years and median platelet count 12 × 10(9)/L with 75.2 % of patients having symptoms of ITP. The study perceived two major shortcomings in the diagnostic approach: (1) failure to perform peripheral blood film examination in 22.8 % of patients, a test that is mandatory by all guidelines, and (2) ordinary bone marrow assessment in more than half of the patients at diagnosis (50.5 %), a test not routinely recommended by guidelines. Low appropriateness in therapeutic management of patients included (1) unjustified use of intravenous immunoglobulin in the absence of bleeding in 54.8 % of patients and (2) splenectomy not being deferred until 6-12 months from diagnosis (median 161 days). Data also reflect a trend towards the early use of thrombopoietin receptor agonists in the treatment of patients who are refractory to any first-line therapy. We have recognized important areas of inapropriateness in the diagnostic and therapeutic management of adult ITP patients. Compliance with established guidelines should be encouraged in order to improve patient outcomes.

Relaxant effect of a metal-based drug in human corpora cavernosa and its mechanism of action.

We studied the mechanisms involved in the human corpora cavernosa (HCC) relaxation induced by a new metal-based nitric oxide (NO) donor, the ruthenium complex cis-[Ru(bpy)2Imn(NO)](+3) (FOR0811). FOR0811 produced relaxation in phenylephrine (PE)-precontracted HCC with a maximal response that achieved 112.9 ± 10.6%. There was no difference between the maximal relaxation induced by FOR0811 when compared with sodium nitroprusside (SNP) (106.8 ± 7.3%), BAY41-2272 (107.6 ± 4.1%) or vardenafil (103.4 ± 3.8%), however, FOR0811 was less potent than SNP and vardenafil. L-N(G)-nitroarginine methyl ester (L-NAME), a NO synthase inhibitor, had no effect in the concentration-response curve elicited by FOR0811. 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ), a heme-site inhibitor of soluble guanylyl cyclase (sGC) was able to either block or reverse the relaxation induced by FOR0811. On the other hand, the relaxation induced by FOR0811 was not affected by glibenclamide, a blocker of ATP-sensitive potassium channels. FOR0811 (10 µM) was able to increase cyclic guanosine monophosphate (cGMP) levels in corpora cavernosa strips. FOR0811 completely relaxes HCC by a sGC-cGMP-dependent mechanism and can be a lead compound in the development of new stable NO donors.

Low vitamin D intake is associated with increase in cardiovascular risk factors in obese adolescents.

OBJECTIVES: This study aimed to investigate the effect of vitamin D on cardiovascular risk in obese adolescents. METHODS: Thirty (16 females/14 males) post-puberty obese adolescents (15-19 years) were involved and measurements of inflammatory biomarkers, body composition, visceral fat, and vitamin D (serum and intake) were performed. The adolescents were submitted to a long-term interdisciplinary therapy with physical exercise, nutritional, psychological, and clinical interventions. RESULTS: Negative correlations between vitamin D intake with plasminogen activator inhibitor-1 (PAI-1) (r=-0.69; p=0.01) and vascular cell adhesion molecule (VCAM-1) (r=-0.82; p=0.001) were found in the population analyzed. Improvement in PAI-1, VCAM-1, body composition, and visceral fat, were observed. CONCLUSIONS: We showed that low vitamin D intake is associated with an increase in the cardiovascular risk factors in obese adolescents.

Reduction in saturated fat intake improves cardiovascular risks in obese adolescents during interdisciplinary therapy.

BACKGROUND/OBJECTIVES: Obesity is related to inflammation and cardiovascular disease. The increase in saturated fatty acid intake (SFA) can potentiate cardiovascular risks. The aim of this study was to assess the influence of change in SFA on carotid intima-media thickness (cIMT), metabolic profile and anti/pro-inflammatory adipokines in obese adolescents. METHODS: Sixty obese adolescents were subjected to 1 year of interdisciplinary intervention (nutrition, psychology, physical exercise and clinical therapy). Blood glucose, insulin, lipid profile, leptin and adiponectin were analysed. Insulin resistance was estimated by HOMA-IR and HOMA-AD. cIMT was measured by ultrasonography. Dietetic intake was calculated by 3-day dietary record. Volunteers were analysed according to tertiles of change (Δ) in SFA intake: Low-SFA reduction<3.68 g; Moderate-SFA reduction 3.68-13.67 g; and High-SFA reduction>13.67 g. RESULTS: Moderate and High-SFA tertiles presented reduction in insulin, leptin/adiponectin ratio, cIMT and increase in adiponectin and adiponectin/leptin ratio. Adiponectin/leptin ratio was predictor of cIMT. HOMA-IR, total cholesterol and LDL-cholesterol reduced only in High-SFA tertile, and was associated with SFA independent of visceral fat. Negative correlations between Δ of SFA and adiponectin and adiponectin/leptin ratio were observed. CONCLUSION: Obese adolescents with moderate and high reduction in SFA presented improvements on pro/anti-inflammatory biomarkers and cIMT, leading to reduction in cardiovascular risks.

Relação proteína: carboidrato no desempenho e metabolismo de juvenis de pacamã (Lophiosilurus alexandri) / Ratio protein: carbohydrate on performance and metabolism of Juvenile (Lophiosilurus alexandri)

Objetivou-se neste estudo verificar o melhor nível de inclusão entre proteína e carboidrato no desempenho e algumas respostas metabólicas em juvenis de pacamã (Lophiosilurus alexandri). Testaram-se quatro dietas com as relações proteína/carboidrato (PB:CHO) 1,24; 0,84; 0,51 e 0,33 durante 60 dias. Foram utilizados 240 juvenis de pacamã pesando inicialmente 1,90g, alimentados duas vezes ao dia (8% da biomassa). Avaliou-se o ganho de peso total, taxa de crescimento específico, consumo de ração aparente, conversão alimentar aparente, rendimento de carcaça e gordura visceral. Glicemia, aminoácidos totais livres no plasma e glicogênio hepático também foram avaliados. A relação PB:CHO influenciou (P<0,05) os parâmetros de desempenho e metabolismo, exceto o glicogênio hepático. Maiores concentrações de glicose e aminoácidos totais livres no plasma foram observadas nos peixes que se alimentaram com a dieta contendo a maior relação PB:CHO (1,24). Além disso, observaram-se melhores médias de ganho de peso, taxa de crescimento específico e conversão alimentar aparente. Maiores percentuais de gordura visceral e menor rendimento de carcaça foram observados nos animais submetidos à dieta composta pela menor relação PB:CHO (0,33). Pode-se concluir que a dieta com a relação PB:CHO de 1,24 promoveu melhor desempenho e respostas metabólicas em juvenis de pacamã...

The aim of this study was to determine the best level of inclusion between protein and carbohydrate on performance and some metabolic responses in juvenile pacamã (Lophiosilurus alexandri). We tested four diets regarding protein/carbohydrate (PB: CHO) 1.24, 0.84, 0.51 and 0.33 for 60 days. The experiment was conducted with 240 juvenile pacamã initially weighing 1.90g, fed twice daily (8% of the biomass). We evaluated the total weight gain, specific growth rate, feed intake, feed conversion, carcass yield and visceral fat. Glucose, total plasma free amino acids and liver glycogen were also evaluated. The relationship PB: CHO influenced (P <0.05) the performance and metabolism parameters except the liver glycogen. Higher concentrations of glucose and total plasma free amino acids were observed in fish that were fed the diet containing the highest ratio PB: CHO (1.24); and we also observed better mean weight gain, specific growth rate and feed conversion. A higher percentage of visceral fat and lower carcass yield were observed in animals treated with diet composed by the lower ratio PB: CHO (0.33). We can conclude that a diet with a ratio PB: CHO of 1.24, promotes better performance and metabolic responses in juvenile pacamã...

Relação proteína: carboidrato no desempenho e no metabolismo de híbridos de Pseudoplatystoma fasciatum (fêmea) X Leiarius marmoratus (macho) / Evaluation of protein: carbohydrate ratio in the diet of hybrids of Pseudoplatystoma fasciatum (female) X Leiarius marmoratus (male)

Objetivou-se, neste trabalho, determinar a melhor relação entre proteína e carboidrato na dieta do híbrido carnívoro Pseudoplatystoma fasciatum e Leiarius marmoratus. Utilizou-se um sistema fechado de recirculação de água, composto de 12 caixas de 500L e biofiltro. Foram utilizados 144 juvenis (12/caixa) com peso médio inicial de 12,63±2,52g e comprimento total de 12,34±2,06cm durante 50 dias. Os peixes receberam quatro dietas contendo diferentes relações proteína:carboidrato (1,24; 0,84; 0,56 e 0,33). A relação proteína:carboidrato influenciou o desempenho e os parâmetros metabólicos dos animais. A melhor relação proteína:carboidrato para o desempenho foi 0,84. Os resultados metabólicos demonstraram mobilização de nutrientes para manutenção de glicemia e do crescimento. A relação proteína:carboidrato de 0,84 foi a mais indicada para o híbrido...

The purpose of this study was to determine the best protein:carbohydrate ratio in this hybrid's diet. A water recirculation closed system was used, composed of twelve tanks with 500L each. 144 juveniles (12/tank) with initial weight of 12.63±2.52g and total length of 12.34±2.06cm were distributed. The experiment lasted for 50 days and the fingerlings were feed four diets containing different protein:carbohydrate ratios (1.24; 0.84; 0.56 and 0.33). The protein:carbohydrate ratio influenced performance. The 0.84 ratio promoted better weight gain, smaller apparent feed conversion, great feed intake and largest daily specific growth rate. In short, the 0.84 protein:carbohydrate ratio is most indicated for this hybrid. The results demonstrated metabolic mobilization of nutrients for maintenance of glucose and growth. The 0.84 protein: carbohydrate ratio was recommended for the hybrid...

Frequência de alimentação para juvenis de tambaqui / Feeding frequency for tambaqui juveniles

Objetivou-se nesta pesquisa avaliar qual frequência alimentar promove o melhor desempenho em juvenis de tambaqui. Foram testadas quatro frequências alimentares (duas, quatro, seis e oito vezes ao dia) em intervalos regulares. Foram estocados alevinos de tambaqui com peso médio inicial de 15,74±0,28g em 16 aquários de vidro transparentes com capacidade de 70L de volume útil, em um delineamento inteiramente ao acaso, com quatro tratamentos e quatro repetições. O período de alimentação foi de 30 dias, e utilizou-se uma ração comercial contendo 45 por cento de proteína bruta para peixes onívoros, com taxa de arraçoamento de 6 por cento da biomassa total dos peixes de cada aquário. Os resultados médios de pH, temperatura (°C) e condutividade elétrica (mS/cm) para manhã e tarde foram, respectivamente: 6,91; 6,96; 25,85; 27,69; 0,65; e 0,65. Foram avaliados os índices de desempenho: ganho de peso, conversão alimentar aparente, taxa de crescimento específico, sobrevivência, e também foi analisada a glicose sanguínea. Não foram detectadas diferenças significativas para as variáveis estudadas. Recomenda-se a frequência de alimentação de duas vezes ao dia para juvenis de tambaqui, principalmente visando minimizar mão de obra...

The aim of this research was to assess how often food promotes better performance in tambaqui. We tested four food frequencies (two, four, six and eight times a day) at regular intervals. Tambaqui fingerlings with initial weight of 15.74±0.28g were stocked in 16 transparent glass tanks with a capacity of 70L of usable volume in a completely randomized design with four treatments and four replications. The feeding period was thirty days and a commercial diet containing 45 percent crude protein for omnivorous fish and a feeding rate of 6 percent of the total biomass of fish for each experimental unit was used. The average results of pH, temperature °C and electrical conductivity mS/cm for morning and afternoon were respectively 6.91 and 6.96; 25.85 and 27.69; 0.65 and 0.65. We evaluated the performance indices: weight gain, feed conversion, specific growth rate, survival, and also blood glucose. No significant differences were detected for the variables studied. It is recommended that the frequency of feeding be 2 times a day for tambaqui, mainly to minimize labor...

Fish oil supplementation decreases oxidative stress but does not affect platelet-activating factor bioactivity in lungs of asthmatic rats.

Dietary fish oil supplementation increases the content of n-3 polyunsaturated fatty acids (PUFA) in cellular membranes. The highly unsaturated nature of n-3 PUFA could result in an enhanced lipid peroxidation in the oxidative environment characteristic of asthma. The oxidative reaction cascade culminates in an increased production of components associated to oxidative stress and of an important proinflammatory mediator platelet-activating factor (PAF)-like lipid. We evaluated the effect of fish oil supplementation in asthmatic rats upon the PAF bioactivity and parameters related to oxidative stress in the lung. Fish oil supplementation of asthmatic rats resulted in lower concentrations of nitrite (1.719 ± 0.137 vs. 2.454 ± 0.163 nmol/mL) and lipid hydroperoxide (72.190 ± 7.327 vs. 120.200 ± 11.270 nmol/mg protein). In asthmatic animals, fish oil increased the activities of superoxide dismutase (EC 1.15.1.1) (33.910 ± 2.325 vs. 24.110 ± 0.618 U/mg protein) and glutathione peroxidase (EC 1.11.1.9) (164.100 ± 31.250 vs. 12.590 ± 5.234 U/mg protein). However, fish oil did not affect PAF bioactivity in lung tissue of asthmatic rats (0.545 ± 0.098 340/380 vs. 0.669 ± 0.101 340/380 nm ratio). Considering the two-step process--oxidative stress and PAF bioactivity--fish oil exhibited a divergent action on these aspects of asthmatic inflammation, since the supplement lowered oxidative stress in the lungs of asthmatic rats, presenting an antioxidant effect, but did not affect PAF bioactivity. This suggests a dual effect of fish oil on oxidative stress and inflammation in asthma.

Saturated fatty acid intake can influence increase in plasminogen activator inhibitor-1 in obese adolescents.

The aim of this study was to verify if saturated fatty acid intake adjusted by tertiles can influence metabolic, inflammation, and plasminogen activator inhibitor-1 (PAI-1) in obese adolescents. Body mass, height, body mass index, waist circumference, blood pressure, and body composition of 108 obese adolescents were obtained. Fasting glucose, insulin, PAI-1, and CRP were determined. Insulin resistance was assessed by Homeostasis Model Assessment (HOMA-IR) and insulin sensitivity by Quantitative Insulin Sensitivity Check Index (QUICKI). Dietetic intake was estimated by a 3-day dietary record, and volunteers were divided according to consumption of saturated fatty acids: tertile 1 [Low Saturated Fatty Acid Intake (Low-SFA): ≤12.14 g], tertile 2 [Moderate Saturated Fatty Intake (Moderate SFA intake): 12.15-20.48 g], and tertile 3 [High Saturated Fatty Acid Intake (High-SFA Intake); >20.48 g]. Statistical analysis was performed using STATISTICA 7.0 software and the significance level was set at p<0.05. The most important finding in the present study is that Moderate and High-SFA intakes presented significantly higher values of PAI-1 than Low-SFA Intake. PAI-1 was positively associated with saturated fatty intake, waist circumference, mean blood pressure, and HOMA-IR. SFA intake was predictor of PAI-1 independent of body fat, HOMA-IR and total-cholesterol. In addition, PAI-1 was an independent predictor of blood pressure. HOMA-IR and QUICKI presented significantly higher and lower, respectively, in High-SFA compared to Moderate-SFA intake. High-SFA influenced cardiovascular disease risks, since it increased PAI-1 and insulin resistance, and decreased insulin sensibility, leading to vicious cycle among food ingestion, pro-thrombotic state, and cardiovascular risks in obese adolescents.

Effects of different physical exercises on leptin concentration in obese adolescents.

In order to compare the effects of leisure physical activity (LPA), aerobic training (AT) and aerobic plus resistance training (AT + RT) as part of a 6-month interdisciplinary therapy in body composition, insulin resistance and leptin concentrations in obese adolescents, 72 volunteers (n = 24 in each group) ages 15-19 years were evaluated. Delta (Δ) body mass (kg) and Δ BMI (kg/m(2)) was different between AT and LPA groups and in AT + RT group compared to both LPA and AT groups; Δ body fat mass (kg and %) was different only in AT + RT group compared to both LPA and AT; Δ body lean mass (%) was different only in AT + RT group; Δ body lean mass (kg) was negative only in AT and positive and different from AT in AT + RT group; ΔHOMA-IR did not differ among groups; Δ leptin (ng/ml) was negative and different from LPA for both AT and AT + RT groups. In conclusion, both AT and AT + RT promoted a reduction on leptin levels, however, the adolescents subjected to AT + RT presented better results in body composition than the AT group. These results highlight the importance of associating aerobic and resistance training with nutritional and psychological approaches in the treatment of obese adolescents.

Effects of genotype and dietary oil supplementation on performance, carcass traits, pork quality and fatty acid composition of backfat and intramuscular fat.

A 42-day study was conducted to evaluate the effect of genotype: terminal sire line Duroc×F1 (DC×F1); terminal sire line Embrapa MS-115×F1 (MS-115×F1); and MS-115×Moura (MS-115×MO) and three dietary oil sources: soybean; canola; and canola+flax, on performance, carcass traits, pork quality, and fatty acid composition. Genotype affected the technological quality of pork and fatty acid profile. MS-115-sired pigs had better meat color and Duroc-sired pigs had higher intramuscular fat content, more saturated fat and better omega-6/omega-3 ratio. Moura breed influenced positively meat tenderness and intramuscular fat. Diet did not affect the technological quality of the meat. Canola or canola+flax oil diet supplementations increased monounsaturated and C18:3 and decreased C18:2 fatty acids, reducing the omega-6/omega-3 ratio. The best omega-6/omega-3 ratio was obtained through supplementation with canola+flax.

Prevalence of pulmonary hypertension and its association with respiratory disturbances in obese patients living at moderately high altitude.

OBJECTIVE: To determine the point prevalence of pulmonary hypertension (PH) and its relationship with respiratory disturbances in obese patients living at moderate altitude. SUBJECTS: A total of 57 obese patients comprised the final sample and consisted of 34 women and 23 men, with a mean age of 42.7+/-12.1 ys and a mean body mass index (BMI) 47.1+/-10.6 kg/m(2) (range from 30.1 to 76.1). The mean living altitude was 2248.7 m, range 2100-2400 m above sea level. MEASUREMENTS: Doppler echocardiography, pulmonary function tests, arterial blood gas analysis, and polysomnography were performed. RESULTS: Data showed that 96.5% of the studied sample had daytime PH defined as calculated systolic pulmonary artery pressure (PSAP) >30 mmHg (mean PSAP=50, s.d.=13 mmHg). The severity of diurnal PH was found to be related to the presence of alveolar hypoventilation and BMI. The main risk factor for severity of diurnal PH was hypoventilation with a significant odds ratio (OR) 7.96, 95% CI 1.35-46.84, BMI was (OR 1.12, 95% CI 1.02-1.25) and apnea/hypopnea index was not a predictor of pulmonary hypertension severity (OR 0.99, 95% CI 0.97-1.02). CONCLUSION: We concluded that prevalence of diurnal PH is high in obese patients living at moderate altitude, and that hypoventilation is the main risk factor associated with the severity of pulmonary hypertension.

Effect of monensin on Mayaro virus replication in monkey kidney and Aedes albopictus cells.

The effect of a cationic ionophore, monensin, on the replication of Mayaro virus in monkey kidney TC7 and Aedes albopictus cells has been studied. Treatment of these cells with 1 micromol/l monensin during infection did not affect the virus protein synthesis but inhibited severely the virus replication. Electron microscopy of the cells infected with Mayaro virus and treated with monensin revealed that the morphogenesis of Mayaro virus was impaired in TC7 but not in A. albopictus cells.

Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients.

OBJECTIVE: To determine the prevalence of sleep apnea in morbidly obese patients and its relationship with cardiac arrhythmias. RESEARCH METHODS AND PROCEDURES: Fifty-two consecutive morbidly obese (body mass index > or = 40 kg/m2) outpatients from the Obesity Clinic of the National Institute of Nutrition Salvador Zubirán underwent two nights of polysomnography with standard laboratory techniques. Electrocardiographic polysomnography signals (Lead II) were evaluated by two experienced cardiologists, and sleep complaints were measured with a standard sleep questionnaire (Sleep Disorders Questionnaire). In order to make comparisons between groups with different severities of sleep-disordered breathing, we classified the patients in four groups using the apnea-hypopnea index (AHI): Group 1, AHI 5 < 15 (n = 10); Group 2, AHI 15 < 30 (n = 10); Group 3, AHI 30 < 65 (n = 14); Group 4, AHI > or = 65 (n = 17). RESULTS: A wide range of sleep-disordered breathing, ranging from AHI of 2.5 to 128.9 was found. Ninety-eight percent of the sample (n = 51) had an AHI > or = 5 (mean = 51 +/- 37), and 33% had severe sleep apnea with AHI > or = 65 with a mean nocturnal desaturation time of <65% over 135 minutes. Electrocardiographic abnormalities were present in 31% of the patients. Cardiac rhythm alterations showed an association with the level of sleep-disordered breathing and oxygen desaturation. DISCUSSION: We conclude that there is a high prevalence of sleep apnea in morbidly obese patients and that the risk for cardiac arrhythmias increases in this population in the presence of a severe sleep apnea (AHI > or = 65) with severe oxygen desaturation (SaO2 < or = 65%).

Teníase/cisticercose no Estado de Roraima / Taeniasis/cysticercosis in Roraima

O Estado de Roraima está localizado ao norte do Brasil, sendo estado integrante da Amazônia Brasileira. O Estado é formado por quinze (15) municípios e sua populaçäo humana é de 247.724 habitantes. A populaçäo suína do Estado é estimada em 65.000 animais, criados na sua maioria com baixo grau de tecnologia, soltos à campo e alimentados com frutas, pastagens, legumes e resto de comida. No Estado näo há frigorífico que abata suínos para a comercializaçäo da carne "in natura", sendo consumida a carne proveniente de abatedouros clandestinos (sem inspeçäo sanitária) ou de frigoríficos de outros estados (com inspeçäo sanitária). Na capital do Estado, Boa Vista, o índice de saneamento básico (esgoto) é de 13,13 por cento; nas cidades do interior näo há esse serviço. A investigaçäo epidemiológica da doença em humanos e animais no Estado, com o tratamento dos doentes; o incentivo para que se construa abatedouros dentro das normas higiênico-sanitárias com o serviço de inspeçäo no abate de suínos; a orientaçäo técnica para criadores de suínos; a fiscalizaçäo de hortas e pomares com exames laboratoriais da água para irrigaçäo; o aumento da rede de esgoto no Estado; a conscientizaçäo do consumidor para que só adquira produtos de boa qualidade para consumo; campanhas educativas de medidas higiênicas básicas e distribuiçäo de vermífugo para a populaçäo, entre outras medidas, contribuiräo muito para que o complexo teníase/cisticercose quando notificado, seja de fácil controle pelas autoridades de saúde.