Body composition of obese adolescents: association between adiposity indicators and cardiometabolic risk factors.

BACKGROUND: The association between obesity during adolescence and the increased risk of cardiometabolic diseases indicates the need to identify reproducible and cost effective methods for identifying individuals who are at increased risk of developing diseases. The present cross-sectional study investigated the occurrence of metabolic consequences of obesity in adolescents and the use of adiposity indicators as predictors of cardiometabolic risk. METHODS: A fasting blood sample was taken in 93 pubertal obese adolescents aged 13-18 years old (39 males, 54 females) for the assessment of cardiometabolic risk markers (glucose, lipid profiles, insulin resistence, and inflammatory and endothelial dysfunction markers). Together with anthropometry, total fat mass and lean mass were determined by dual-energy X-ray absorptiometry (DXA). RESULTS: The prevalence of dyslipidaemia and disorders in glucose metabolism are noticeably higher in the present study. There was no correlation between the percentage of body fat according to DXA and most indicators of adiposity. For boys, the arm circumference values predicted the increase in fasting insulin (r² = 0.200), homeostasis model assessment of insulin resistance (r² = 0.267) and cardiometabolic risk score (r² = 0.338). The percentage of body fat according to DXA predicted the inflammation score (r² = 0.172). For girls, body mass index was the parameter that best described the variability of fasting insulin (r² = 0.079) and inflammation score (r² = 0.263). The waist-to-stature ratio was able to predict the triglyceride values (r² = 0.090). CONCLUSIONS: Anthropometric measures of adiposity, such a body mass index, waist-to-stature ratio, arm circumference and waist circumference,should be considered in the clinical evaluation of obese adolescents.

Avaliação do processo de reestruturação da assistência farmacêutica no município de Aracaju-SE / Assessment of the restructuring of pharmaceutical services in the city of Aracaju (SE, Brazil)

O objetivo do estudo é avaliar o efeito da reestruturação da Assistência Farmacêutica (AssistFar) no município de Aracaju-SE. Foi realizado um estudo retrospectivo longitudinal, de fevereiro a junho de 2011. Para avaliação da Assistência Farmacêutica foi utilizado um banco de dados documental, gerado pelo "Sistema de Controle de Administração de Materiais" e aplicaram-se os indicadores do Instrumento de Auto-Avaliação para o Planejamento da Assistência Farmacêutica (IAPAF) do ?Planejar é Preciso?, que aborda tópicos de acordo com o ?Ciclo da Assistência Farmacêutica?. A aplicação do instrumento foi realizada em três momentos na prática da AssistFar no município de Aracaju. Para análise de cada indicador levou-se em consideração os níveis de qualidade classificados de 1 a 3, sendo o nível 3 o melhor estágio. A maioria dos resultados evidenciou o fortalecimento da gestão após a criação de procedimentos e a inclusão de estratégias de monitoramento dos indicadores de avaliação no plano municipal de saúde. As etapas de institucionalização dos serviços perante a gestão foram as que apresentaram os melhores resultados. Enquanto que a etapa de prescrição foi considerada a mais crítica do processo. Os dados mostram que a falta de ações de desenvolvimento da AssistFar contribuíram para a presença de resultados insatisfatórios, principalmente nas etapas de prescrição e dispensação, sinalizando a necessidade de elaborar uma estratégia de gestão que vise sua reformulação. Neste cenário, é preciso incorporar às equipes de saúde mais farmacêuticos que atuem em todas as etapas da AssistFar, promovendo uma gestão racional de medicamentos...

The objective of the study was to evaluate the effect of the restructuring of Pharmaceutical Services (AssistFar) in the city of Aracaju (capital of Sergipe, Brazil). We conducted a retrospective, longitudinal survey, from February to June 2011. A document database generated by the "Materials Management Control System" was analyzed, to assess the pharmaceutical services, by applying the indicators of the Self-Assessment Instrument for Pharmaceutical Services Planning (IAPAF) that are defined in the government-proposed" Planning is Necessary" method, which covers topics referring to the various steps in the "Cycle of Pharmaceutical Services". This instrument was applied to three stages in the practice of AssistFar in the city of Aracaju, within the study period. For each indicator, the quality of each step was graded from 1 to 3, level 3 being the best. Most results showed a strengthening of management after the establishment of procedures and inclusion of strategies for monitoring the quality indicators, for the municipal health plan. Steps towards the institutionalization of management services showedthe best results. In contrast, the step of prescription was considered the most critical of the Cycle. The data showed that the lack of AssistFar development actions contributed to the unsatisfactory results, especially in the steps of prescribing and dispensing, signaling the need to develop a management strategy that aims to recast it. In this scenario, it will be necessary to involve the health teams, plus the pharmacists, in the work at all stages of AssistFar, promoting the rational management of medicines...

Electrocardiographic profile of guinea pig heart submitted to Ginkgo biloba extract and its terpenoids / Perfil eletrocardiográfico do coração de cobaia submetido ao extrato de Ginkgo biloba e seus terpenóides

Electrocardiographic effects produced by Ginkgo biloba extract (EGb) and by ginkgolides A (GA) and B (GB), and bilobalide (BB) were investigated in guinea pig heart mounted in Langendorff apparatus (Tyrode, 34 ± 0.1 ºC, 95% O2, 5% CO2). Electrocardiographic parameters were evaluated in the conditions: 1) control with Tyrode and DMSO, 2) EGb (n=4), GA (n=5), GB (n=5) or BB (n=6), and 3) washout. The results showed that 0.1 and 1.0 mg/ml of EGb do not change the electrocardiographic parameters. However, 10 mg/ml of EGb increased the PR interval (PRi) at 21% (p<0.001). This increase was also observed for 50 mM GA (20%, p<0.001) and 70 mM BB (13%, p<0.001), which indicates Ca2+ channel block. However, the 50 mM GB reduced the PRi at 11 % (p<0.001). The GA (23%, p<0.001), GB (16%, p<0.001), and BB (40%, p<0.001) reduced the QT interval (QTi), which suggests the activation of the potassium channel. However, EGb increased QTi (6%, p<0.001). The EGb (28%, p<0.05) and GB (13%, p<0.05) reduced the heart rate. Atrioventricular (AV) block was observed with EGb, GA, and BB. We can conclude that EGb and its terpenoids alter the ECG parameters inducing AV block, which indicates possible arrhythmogenic potential.

Os efeitos eletrocardiográficos produzidos pelo extrato de Ginkgo biloba (EGb) e gingkolídeos A (GA) e B (GB), e bilobalide (BB) foram investigados em coração de cobaia montado sistema de Langendorff (Tyrode, 34 ± 0.1 ºC, 95% O2, 5% CO2). Os parâmetros do ECG foram avaliados nas condições: 1) Tyrode e DMSO, 2) EGb (n=4), GA (n=5), GB (n=5) ou BB (n=6) diluídos em DMSO e 3) washout. Os resultados demonstram que 0,1 e 1,0 mg/mL de EGb não alteraram os parâmetros eletrocardiográficos. Entretanto, 10 mg/ml de EGb aumentaram o intervalo PR (PRi) em 21% (p<0.001). Esse aumento também foi observado com GA a 50µM (20%, p<0,001) e BB a 70 mM (13%, p<0,001) indicando bloqueio de canais de cálcio. Por outro lado, GB reduziu o PRi (11%, p<0,001). O intervalo QT (QTi) foi reduzido por GA (23%, p<0,001), GB (16%, p<0,001) e BB (40%, p < 0.001) sugerindo uma ativação de canais de potássio. Entretanto, EGb aumentou o QTi (6%, p<0.001). A frequência cardíaca foi reduzida por EGb (28%, p<0.05) e GB (13%, p<0.05). Bloqueios átrio-ventriculares (BAV) foram observados com EGb, GA e BB. Podemos concluir que EGb e os terpenos alteram parâmetros eletrocardiográficos induzindo BAV e demonstrando possível potencial arritmogênico.

Molecular evidence for apoptosis in microfilariae of Wuchereria bancrofti induced by diethylcarbamazine.

Apoptosis, a programmed cell death, is characterized by chromatin condensation, numerous vacuoles, reduction in cell volume, and endonuclease cleavage DNA degradation detected in gel electrophoresis as nucleosomal ladder. Here we report that diethylcarbamazine induces DNA fragmentation in microfilariae of Wuchereria bancrofti revealed by ligation-mediated polymerase chain reaction and by in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling at the light and electron transmission level.

Identification and location of albumin-like antigens in third-stage larva of W. bancrofti, in adult forms of Litomosoides chagasfilhoi and in the free-living nematode Caenorhabditis elegans.

Antigens resembling those of host proteins have been identified on the surface of several filarial parasites, such as immunoglobulins and serum albumins. The origin of albumin-like antigens on filarial parasites remains unclear. Several authors suggested that they have been adsorbed, or that they were metabolic waste products from nutritional utilization of human albumin, or perhaps a contamination with human products. This study searched for human albumin-like antigens by Western blot and ultrastructural analyses on filarial parasites, third stage of W. bancrofti and adult females of Litomosoides chagasfilhoi, and on the free-living Caenorhabditis elegans nematode. Our results showed approximately 67kDa proteins recognized by anti-human albumin antibodies on extracts and excretory-secretory (ES) products of the third-stage W. bancrofti. Similar albumin-like proteins were also detected on the filarial parasite L. chagasfilhoi and on C. elegans extracts. The immunocytochemistry analysis showed human albumin-like antigens on similar tissues of these nematodes. These results provide evidence that these proteins have antigenic similarity and similar distribution in nematodes tissues. Our observations suggest that albumin-like antigens presented on filarial parasites are not acquired from the host, but rather are shared antigenic determinants found even in the third-stage larvae recovered from the invertebrate host.

Ultrastructural analysis and immunocytochemical localization of isolectins in Cratylia mollis seeds.

Cratylia mollis is a native forage from the semi-arid region of Northeast, State of Pernambuco, Brazil, whose seeds have been considered an important lectin source. Multiple molecular forms of lectins, carbohydrate-binding proteins, have been purified from C. mollis seeds (Cra Iso) allowing several applications of these purified proteins. In this work seeds were processed for ultrastructural analysis and immunocytochemical localization of the two most abundant isolectins, Cra Iso 1 and Cra Iso 3, with glucose/mannose and galactose specificities, respectively. The ultrastructural analysis revealed a typical plant cell: organelles, nucleus and cellular wall were visualized. The localization of isolectins occurred mainly in the amorphous matrix of protein bodies, and in the cellular walls of the embryonic axis. The results showed that the isolectins, which differ in relation to carbohydrate specificity and glycosylation are located in the same cellular compartment suggesting different functions inside the same subcellular organelle. Cra Iso 1 and Cra Iso 3 distribution in the C. mollis seeds was consistent with the subcellular localization of several legume lectins.