Oral supplementation with resveratrol improves hormonal profile and increases expression of genes associated with thermogenesis in oophorectomy mice.

Menopause causes important bodily and metabolic changes, which favor the increased occurrence of cardiovascular diseases, obesity, diabetes, and osteoporosis. Resveratrol exerts proven effects on body metabolism, improving glucose and lipid homeostasis and reducing inflammation and oxidative stress in various organs and tissues. Accordingly, this study evaluates the effects of resveratrol supplementation on the expression of markers associated with thermogenesis in brown adipose tissue, and on the body, metabolic and hormonal parameters of female mice submitted to bilateral oophorectomy. Eighteen female mice were randomized into three groups: G1: control (CONTROL), G2: oophorectomy (OOF), and G3: oophorectomy + resveratrol (OOF+RSV); the animals were kept under treatment for twelve weeks, being fed a standard diet and treated with resveratrol via gavage. Body, biochemical, hormonal, and histological parameters were measured; in addition to the expression of markers associated with thermogenesis in brown adipose tissue. The results showed that animals supplemented with resveratrol showed reduced body weight and visceral adiposity, in addition to glucose, total cholesterol, and triglyceride levels; decreased serum FSH levels and increased estrogen levels were observed compared to the OOF group and mRNA expression of PRDM16, UCP1, and SIRT3 in brown adipose tissue. The findings of this study suggest the important role of resveratrol in terms of improving body, metabolic, and hormonal parameters, as well as modulating markers associated with thermogenesis in brown adipose tissue of female mice submitted to oophorectomy.

Psychometric properties of an oral health literacy scale for people living with diabetes.

This study evaluated the construct validity of the instrument Oral Health Literacy among diabetics. A probabilistic random sample of 239 diabetics from an infinite population answered the 10 items of the questionnaire. The structural validity was assessed by confirmatory factor analysis and goodness of fit, chi-square per degrees of freedom ratio (X2/df), comparative fit index (CFI), goodness-of-fit index (GFI), and root-mean-square error of approximation (RMSEA). Internal consistency was estimated by the average variance extracted (AVE) and composite reliability (CR). The scores were dichotomized with the upper limit of the 95% confidence interval as the cutoff point. The three-dimensional model presented good quality parameters (X2 /df = 2.459; CFI = 0.988; TLI = 0.981) and poor RMSEA (0.078). Internal consistency was adequate; AVE for the Access, Understand/appraise, and Apply subscales were 0.831, 0.981, and 0.954 and the CR for these subscales were 0.893, 0.962, and 0.822, respectively. Inadequate literacy ranged from 41.8 to 48.1%. The three-dimensional model identified (access, understand/appraise, and apply) showed structural validity, good internal consistency, and understandability.

Avaliação da qualidade da assistência à saúde oftalmológica na percepção dos usuários / Evaluation of the quality of ophthalmic health care according to the perception of users

RESUMO Objetivo Avaliar e caracterizar a qualidade da assistência oftalmológica ofertada em uma unidade de serviços ambulatoriais da Atenção Secundária do Sistema Único de Saúde na percepção dos usuários e/ou dos responsáveis por esses usuários. Métodos Foi realizado estudo seccional de prevalência analítica entre usuários assistidos no período de setembro de 2019 a março de 2020 em um dos seis serviços de assistência oftalmológica ofertado pelo Sistema Único de Saúde, no município de Vitória da Conquista (BA). Foram avaliadas as condições demográficas e socioeconômicas e a autopercepção da saúde. Também foram avaliadas as características e os níveis de qualidade da assistência à saúde oftalmológica. A coleta das informações ocorreu por meio de entrevista telefônica. Resultados Participaram do estudo 389 usuários e/ou responsáveis. Observaram-se elevados níveis de satisfação, considerando as perguntas que compõem o constructo do instrumento. Identificaram-se níveis de qualidade comprometidos em relação à liberdade de escolher seu prestador de cuidado ocular (154; 39,7%). Menores níveis de satisfação associaram-se com as variáveis sexo masculino (razão de chance de 1,66; IC95% 1,04-2,65; p=0,033) e raça autodeclada branca (razão de chance de 6,89; IC95% 4,00-11,86; p=0,000). Conclusão Os usuários relataram bons níveis de satisfação da assistência à saúde oftalmológica. Observaram-se maiores chances de menores níveis de satisfação entre homens e aqueles com raça autodeclarada branca.

ABSTRACT Objective To evaluate and characterize the quality of ophthalmic care offered in an outpatient service unit of the SUS secondary care according to the perception of users and/or those responsible for these users. Methods A cross-sectional study of analytical prevalence was carried out among users assisted from September 2019 to March 2020, in one of the six ophthalmic care services offered by the SUS, in the municipality of Vitória da Conquista (BA), Brazil. Demographic and socioeconomic conditions, as well as self-perception of health, were evaluated. The characteristics and quality levels of ophthalmic health care were also evaluated. Data collection took place through a telephone interview. Results A total of 389 users and/or guardians participated in the study. Participants reported high levels of satisfaction, considering the questions that make up the instrument's construct. Compromised quality levels were observed in relation to the freedom to choose their eye care provider (n=154; 39.7%). Lower levels of satisfaction were associated with the variables male gender (OR=1.66; 95%CI=1.04-2.65; p=0.033) and self-reported white race (OR=6.89; 95%CI=4, 00-11.86; p=0.000). Conclusion Users reported good levels of satisfaction with eye health care. There were greater chances of lower levels of satisfaction among men and among those with a self-reported white race.

Psychometric properties of an oral health literacy scale for people living with diabetes

Abstract This study evaluated the construct validity of the instrument Oral Health Literacy among diabetics. A probabilistic random sample of 239 diabetics from an infinite population answered the 10 items of the questionnaire. The structural validity was assessed by confirmatory factor analysis and goodness of fit, chi-square per degrees of freedom ratio (X2/df), comparative fit index (CFI), goodness-of-fit index (GFI), and root-mean-square error of approximation (RMSEA). Internal consistency was estimated by the average variance extracted (AVE) and composite reliability (CR). The scores were dichotomized with the upper limit of the 95% confidence interval as the cutoff point. The three-dimensional model presented good quality parameters (X2 /df = 2.459; CFI = 0.988; TLI = 0.981) and poor RMSEA (0.078). Internal consistency was adequate; AVE for the Access, Understand/appraise, and Apply subscales were 0.831, 0.981, and 0.954 and the CR for these subscales were 0.893, 0.962, and 0.822, respectively. Inadequate literacy ranged from 41.8 to 48.1%. The three-dimensional model identified (access, understand/appraise, and apply) showed structural validity, good internal consistency, and understandability.

Adherence to medication, physical activity and diet among older people living with diabetes mellitus: Correlation between cognitive function and health literacy.

BACKGROUND: Diabetes mellitus (DM) is a public health problem, which requires enhanced self-care in order to avoid complications. However, cognitive impairment can reduce these abilities and may affect health literacy (HL) of patients in terms to understand and apply information. Therefore, this study evaluated the correlation between cognitive condition and HL related to medication adherence, physical activity and nutritional status among people living with DM. METHODS: A cross-sectional study was carried out among elderly people (≥ 60 years old) with DM. The cognitive condition was evaluated using the Mini-Mental State Examination (MMSE) and the HL using the following questionnaires: Literacy Assessment for Diabetes (LAD-60), Nutritional Literacy among People with Diabetes (NLD), Health Literacy on the Practice of Physical Activities among Diabetics (HLPPA - D), and Health Literacy regarding Drug Adherence among Diabetics (HLDA-D). Sociodemographic and biochemical profile was also evaluated. Spearman correlation was used (p < 0.05). RESULTS: 187 individuals with DM were included. Regarding laboratory analyses, insulin dosage had a mean value of 12.3 microUI/mL (SD: ±15.7), mean blood glucose was 148.1 mg/dl (SD: ±59.7) and mean HbA1c was 7.54 % (SD: ±1.8). In the correlation analysis, higher age and lower income were weakly correlated with lower cognitive level. No correlation was identified for biochemical variables and cognitive condition. A positive and weak correlation between cognition and HL was observed in the studied population. CONCLUSIONS: In older people living with DM the cognitive condition is correlated to specific topics of HL (nutritional status, physical activity and medication adherence).

Angiotensin-(1-7), Adipokines and Inflammation.

Nowadays the adipose tissue is recognized as one of the most critical endocrine organs releasing many adipokines that regulate metabolism, inflammation and body homeostasis. There are several described adipokines, including the renin-angiotensin system (RAS) components that are especially activated in some diseases with increased production of angiotensin II and several pro-inflammatory hormones. On the other hand, RAS also expresses angiotensin-(1-7), which is now recognized as the main peptide on counteracting Ang II effects. New studies have shown that increased activation of ACE2/Ang-(1-7)/MasR arm can revert and prevent local and systemic dysfunctions improving lipid profile and insulin resistance by modulating insulin actions, and reducing inflammation. In this context, the present review shows the interaction and relevance of Ang-(1-7) effects on regulating adipokines, and as one adipokine itself, modulating body homeostasis, with emphasis on its anti-inflammatory properties, especially in the context of metabolic disorders with focus on obesity and type 2 diabetes mellitus pandemic.

Obesity and malnutrition similarly alter the renin-angiotensin system and inflammation in mice and human adipose.

The main goal of the present study was to evaluate the metabolic profile, inflammatory markers and the gene expression of the renin-angiotensin system (RAS) components in the visceral adipose tissue of eutrophic, obese and malnourished individuals and mice models of obesity and food restriction. Male Swiss mice were divided into eight groups and fed different levels of food restriction (20%, 40%, or 60%) using standard or high-fat diet. Metabolic profile and adipose tissues were assessed. The expression of AGT (Angiotensinogen), ACE (Angiotensin-converting enzyme), ACE2 (Angiotensin-converting enzyme 2), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in the mice epididymal adipose tissue and the human visceral adipose tissue was assessed. The main findings showed reduced body weight, improved metabolism, decreased adipose tissues weight and reduced adipocyte area in mice submitted to food restriction. Diminished expression of IL-6, TNF-α, AGT, AT1 and ACE was detected in the 20% and 40% food restriction animal groups, although they were increased in the 60% malnourished group. Increased expression of IL-6, TNF-α, AGT and ACE in obese and malnourished individuals was observed. Adipocytes size was increased in obese individuals and reduced in malnutrition. In conclusion, we found that food restriction of 20% and 40% improved the metabolic profile, ameliorated the inflammatory status and down-regulated the RAS in mice. Severe 60% food restriction (malnutrition), however, stimulated a proinflammatory state and increased AGT and ACE expression in the adipose tissue of mice. A similar profile was observed in the adipose tissue of obese and malnourished humans, supporting the critical role of inflammation and RAS as mediators of metabolic disorders.

Effects of Sleeve Gastrectomy on the Metabolic Profile and on the Expression of Renin-Angiotensin System in Adipose Tissue of Obese Rats.

BACKGROUND: Sleeve gastrectomy (SG) has been used as a multipurpose surgical procedure for the treatment of obesity. OBJECTIVES: The present study aimed to assess the effects of SG on the metabolic and inflammatory profile and renin-angiotensin system (RAS) expression in the white adipose tissue of male rats with obesity induced by a high-fat diet. METHODS: Male Wistar rats were treated with a standard diet or high-fat diet and submitted to SG or sham surgery. The glycemic and lipid profiles and gene expression of inflammatory markers and RAS components in adipose tissue were evaluated. RESULTS: SG led to weight loss, decreased adiposity (p < 0.01) and a reduction in plasma glucose (p < 0.05), C-peptide (p < 0.05), insulin (p < 0.001) and total cholesterol (p < 0.05) levels. In addition, SG led to a decrease in the expression of tumor necrosis factor-alpha (TNF-α) (p < 0.01), interleukin- 6 (IL-6) (p < 0.001), angiotensinogen (AGT) (p < 0.001) and angiotensin converting enzyme (ACE) (p < 0.05) and increased the expression of angiotensin converting enzyme 2 (ACE2) (p < 0.05) in white adipose tissue. No statistically significant differences were observed for AT1 (p = 0.10) and Mas (p = 0.22) receptors. CONCLUSION: This study showed that SG leads to weight loss and improves metabolic parameters. Changes in the expression of RAS components and of inflammatory molecules in adipose tissue seem to play a role the before beneficial effects of the SG.