Polymorphism rs1800255 from COL3A1 gene and the risk for pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: Genetic variations of type III collagen may compromise the supportive structures of the female pelvic floor and consequently favor pelvic organ prolapse. The single nucleotide polymorphism G/A rs1800255 located in the coding region for type III collagen (COL3A1) was evaluated as a risk factor for pelvic organ prolapse. METHODS: A single-center prospective cohort study including women with clinical diagnosis of stage III and IV prolapse (POP group) and prolapse stage 0 or I (control group). Sociodemographic, clinical data and obstetric history were retrieved by physician interview. DNA including the rs1800255 polymorphism was amplified by polymerase chain reaction from blood genomic cells and digested with AluI restriction enzyme for distinction of G and A variants. Qualitative variables were compared using the chi-square and Fisher's exact tests and unpaired t-test for quantitative variables. After stratification of the groups, risk factors for POP were estimated using odds ratios (ORs) from the binary logistic regression model. RESULTS: A total of 292 women were included, 112 in the POP group and 180 in the control group. There was no significant difference between groups regarding rs1800255. Age and home birth were the only significant risk factors for pelvic organ prolapse. CONCLUSION: Polymorphism rs1800255 from COL3A1 gene was not a risk factor for pelvic organ prolapse.

Evaluation of COLIA1-1997 G/T polymorphism as a related factor to genital prolapse.

INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse has a multifactorial etiology. There is increasing evidence that genetic factors greatly impact its development. This study aimed to evaluate the possible relation of the collagenous polymorphism -1997 G/T with genital prolapse in Brazilian women. METHODS: A cohort study of 180 women with stage 0 or I (group A) pelvic organ prolapse disorder and 112 women with stage III or IV (group B) was conducted. Blood DNA was isolated, and the -1997 G/T polymorphism was identified by amplifying a region of the COLIA1 gene starting prior to the protein's coding sequence. RESULTS: No significant difference in the prevalence of genotypes TG and TT was found between groups (p = 0.67); differences were not found even when patients were grouped by the presence of 0 or ≥ 1 polymorphic alleles (p = 0.46). Age and home birth were found to be independent risk factors for prolapse. CONCLUSIONS: Our study could not find any association between the -1997G/T polymorphism and genital prolapse in Brazilian women.

Temporal trend of mortality and hospitalization for chronic kidney disease in adults from Northern Brazil.

We aimed to evaluate mortality and hospital admissions for chronic kidney disease in young adults according to sex and state in the northern region of Brazil, between 1996 and 2017. A population-based time series study using official data on mortality and hospital admissions due to chronic kidney disease in individuals aged 20 to 49 years old, residents of the northern region of Brazil, in the periods 1996-2017 and to 2008-2017, respectively. Chronic kidney disease was defined according to the International Classification of Diseases, 10th revision (N18). The evolution of mortality from chronic kidney disease decreased by 0.881% per year over the period (1996-2017). In the states of Acre and Amapá, there was a reduction of 5.85% and -5.68% per year, respectively, and in Tocantins, an increase of 4.16% per year. The incidence of hospitalization did not vary between 2008 and 2017. However, 2 states showed an increase in hospitalization rates: Acre (6.08% per year) and Pará (2.83% per year), and 2 states showed a reduction: Amazonas (5.09% per year) and Tocantins (6.23% per year). In general, there was decrease in mortality rate overtime. However, rate of mortality due to chronic kidney disease increased in the state of Tocantins. The evolution of hospitalization due to chronic kidney disease in a population of young adults remained stationary.

Medication non-adherence in patients with type 2 diabetes mellitus with full access to medicines.

PURPOSE: The pharmacological treatment for Type 2 diabetes mellitus (T2DM) is continuous and adherence to medication is critical for disease control. Restricted access to medicines is one of the most important barriers to adherence to T2DM treatment. This study aimed to evaluate other factors for medication non-adherence by studying patients with full access to oral hypoglycemic agents. METHODS: Cross-sectional study with 300 patients receiving their medication without costs from a referral center for diabetes care in Crato, Ceará (Brazil). Participants were recruited from January to December 2017. Information was obtained by self-applied questionnaires, and the drugs used were confirmed in the prescription. Adherence to medication was determined by the Morisky Medication Adherence Scale (MMAS-4). Patient perceptions of drugs were assessed by the Beliefs about Medicines Questionnaire (BMQ). RESULTS: Only 22.7% of participants met the criterion of high adherence to medication. The most frequent characteristics in the low adherence group were married; hypertension; no regular physical activity; therapy based on the combination of two or more oral antidiabetic agents without insulin; low score in the BMQ necessity scale. Necessity score in BMQ increased with age and the number of medications used and decreased if the patient had family members with the same disease and had children. CONCLUSIONS: Full access to medicines did not assure high adherence to pharmacological treatment of type 2 diabetes mellitus. Distinctive factors to medication non-adherence may be found and specific barriers should be considered when planning actions for improving adherence in such populations.

Evaluation of the fibulin 5 gene polymorphism as a factor related to the occurrence of pelvic organ prolapse.

OBJECTIVE Pelvic organ prolapse (POP) is a very frequent situation in our population that may lead to a significant decrease in patients' quality of life. Currently, we are looking for predictive factors for the development of POPs; thus, this study seeks to evaluate whether the Fibulin 5 polymorphism (FBLN5) is associated with the occurrence of POP. METHODS This is a cohort study with postmenopausal women who were divided into groups by POP stage: POP stages 0 and I (control group) and POP stages III and IV (case group). Subsequently, analyses of genetic polymorphisms of FBLN5 were performed using the Restriction Fragment Length Polymorphism (RFLP) technique. RESULTS A total of 292 women were included in the study. Pregnancy, parity and vaginal delivery in the patients, as well as in data described in the literature, were related to the occurrence of POP in the univariate analysis. However, after binary logistic regression, home birth and age remained independent risk factors for POP. We found no association between the FBLN5 polymorphism and the occurrence of POP (p = 0.371). CONCLUSION There was no association between the FBLN5 polymorphism and the occurrence of POP in Brazilian women.

Assessment of Metalloproteinase Matrix 9 (MMP9) Gene Polymorphisms Risk Factors for Pelvic Organ Prolapse in the Brazilian Population.

OBJECTIVE: To evaluate the C-1562T matrix metalloproteinase 9 (MMP9) gene polymorphisms as risk factors related to the occurrence of pelvic organ prolapse (POP) and to identify the clinical variables associated with the occurrence of the disease. Epidemiological studies of risk factors for POP do not explain why nulliparous women with no known risk factors also develop POP. Therefore, genetic factors may be involved. METHODS: Cohort study with 86 women with symptomatic POP (cases), and 158 women without a prior or current diagnosis of this disorder (controls). The groups were analyzed for the presence of MMP9 gene polymorphisms. Genotyping was performed using polymerase chain reaction (PCR) with DNA obtained from a peripheral venous puncture of both groups. RESULTS: There were no differences between the cases and controls even when we grouped the mutant homozygous and heterozygous genotypes. The analysis of patients with a complete absence of POP versus patients with total POP also showed no statistically significant differences. Age and home birth were found to be independent risk factors for POP. CONCLUSIONS: There were no statistically significant differences in the C-1562T MMP9 polymorphisms between the cases and controls in Brazilian women.

OBJETIVO: Avaliar polimorfismos do gene C-1562T do gene matriz de metaloproteinase 9 (MMP9) como fatores de risco relacionados à ocorrência de prolapso de órgão pélvico (POP) e identificar variáveis clínicas associadas à ocorrência da doença. Estudos epidemiológicos de fatores de risco para POP não explicam por que mulheres nulíparas sem fatores de risco conhecidos também desenvolvem POP. Portanto, fatores genéticos podem estar envolvidos. MéTODOS: Estudo de coorte com 86 mulheres com POP sintomático (casos) e 158 mulheres sem diagnóstico prévio ou atual deste transtorno (controles). Os grupos foram analisados quanto à presença de polimorfismo do gene MMP9. A genotipagem foi realizada por reação em cadeia da polimerase (RCP) com DNA obtido por punção venosa periférica dos indivíduos em ambos os grupos. RESULTADOS: Não houve diferenças entre os casos e controles, mesmo quando agrupamos os genótipos mutantes homozigotos e heterozigotos. A análise de pacientes com ausência completa de POP versus pacientes com POP total também não mostrou diferenças estatisticamente significativas. Idade e parto domiciliar foram considerados fatores de risco independentes para o POP. CONCLUSãO: Não houve diferenças estatisticamente significativas no polimorfismo C-1562T do gene MMP9 entre os casos e controles em mulheres brasileiras.

Association between col1a2 Polymorphism and the Occurrence of Pelvic Organ Prolapse in Brazilian Women.

OBJECTIVE: To evaluate the rs42524 polymorphism of the procollagen type I alpha (α) 2 (COL1A2) gene as a factor related to the development of pelvic organ prolapse (POP) in Brazilian women. METHODS: The present study involved 112 women with POP stages III and IV (case group) and 180 women with POP stages zero and I (control group). Other clinical data were obtained by interviewing the patients about their medical history, and blood was also collected from the volunteers for the extraction of genomic DNA. The promoter region of the COL1A2 gene containing the rs42524 polymorphism was amplified, and the discrimination between the G and C variants was performed by digestion of the polymerase chain reaction (PCR) products with the MspA1I enzyme followed by agarose gel electrophoresis analysis. RESULTS: A total of 292 women were analyzed. In the case group, 71 had the G/G genotype, 33 had the G/C genotype, and 7 had the C/C genotype. In turn, the ratio in the control group was 117 G/G, 51 G/C, and 11 C/C. There were no significant differences between the groups. CONCLUSION: Our data did not show an association between the COL1A2 polymorphism and the occurrence of POP.

OBJETIVO: Avaliar o polimorfismo rs42524 do gene pró-colágeno tipo I alfa (α) 2 (COL1A2) como fator relacionado ao desenvolvimento de prolapso de órgãos pélvicos (POP) em mulheres brasileiras. MéTODOS: O estudo envolveu 112 mulheres com POP nos estádios III e IV (grupo caso) e 180 mulheres com POP nos estádios zero e I (grupo controle). Outros dados clínicos foram obtidos por meio de entrevistas com as pacientes sobre seu histórico médico, e o sangue das voluntárias também foi coletado para extração de DNA genômico. A região promotora do gene COL1A2 contendo o polimorfismo rs42524 foi amplificada, e a discriminação entre as variantes G e C foi realizada por digestão dos produtos de reação em cadeia da polimerase (RCP) com a enzima MspA1I, seguida de análise por eletroforese em gel de agarose. RESULTADOS: Foram analisadas 292 mulheres. No grupo caso, 71 tinham o genótipo G/G, 33 tinham o genótipo G/C, e 7 tinham o genótipo C/C. Por sua vez, a relação no grupo controle foi de 117 G/G, 51 G/C e 11 C/C. Não houve diferenças significativas entre os grupos. CONCLUSãO: Nossos dados não mostraram associação do polimorfismo do gene COL1A2 com a ocorrência de POP.

[Metformin and AMPK: an old drug and a new enzyme in the context of metabolic syndrome]. / Metformina e AMPK: um antigo fármaco e uma nova enzima no contexto da síndrome metabólica.

Metformin is one of the most commonly prescribed oral antidiabetic agents worldwide. However, its mechanism of action remains unknown. The Diabetes Prevention Program Research Group studies have shown that metformin administration and lifestyle-intervention (diet and exercise) reduce the incidence of Diabetes Mellitus type 2 (DM2). A possible biochemical connection between both therapies may be the AMP-activated protein kinase (AMPK). This enzyme was originally described as a sensor of cellular energy status, being activated in exercise. On the other hand, several experimental evidences indicate that AMPK may be an important target of metformin action. This paper discusses various ways for AMPK regulation, suggesting a possible mechanism for its activation by metformin that involves the production of reactive nitrogen species. AMPK activation determines a wide variety of physiological effects, including enhanced glucose uptake by skeletal muscle and enhanced lipid catabolism. Thus, it may be a key player not only in the prevention and treatment of DM2, but also in the development of new treatments for obesity and the metabolic syndrome. The finding of AMPK activation by metformin draws attention to this enzyme as an important pharmacological target.

Association between Matrix Metallopeptidase 9 Polymorphism and Breast Cancer Risk.

OBJECTIVE: Epidemiological studies have shown evidence of the effect of genetic variations in the pathogenesis of breast cancer and have suggested a relationship of the disease with genetic polymorphisms. Matrix metallopeptidase 9 (MMP-9) is a collagenase responsible for the degradation of type IV collagen, the major component of the basement membrane, and other essential extra cellular matrix components, being involved in the tumor cell invasion and metastasis. Our objective was to evaluate the relationship between the MMP-9-1562 C/T polymorphism (rs 3918242) and the risk of developing breast cancer. METHODS: In this case-control study, the frequency of the MMP-9-1562 C/T polymorphism (rs 3918242) was determined in 148 women with breast cancer and 245 women without the disease. The DNA was extracted from plasma samples, and the gene was amplified by polymerase chain reaction (PCR); the presence of the polymorphism was determined using restriction enzymes. RESULTS: After adjusting for confounding variables, we found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio [OR] = 1.159, 95% confidence interval [CI]: 0.6625-1.997, p = 0.5964). We also found no association with more advanced disease, the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2) overexpression, or rate of tumor cell proliferation. CONCLUSION: We did not observe a relationship between MMP-9-1562 C/T polymorphism (rs 3918242) and the occurrence of breast cancer.

OBJETIVO: Estudos epidemiológicos vêm demonstrando evidências da influência de variações genéticas na patogênese do câncer de mama, e têm sugerido associação de polimorfismos com uma maior susceptibilidade à doença. A metalopeptidase de matriz 9 (MMP-9) é uma colagenase responsável pela degradação do colágeno tipo IV, o maior componente da membrana basal, e outros componentes essenciais da matriz extra celular, estando envolvido na invasão da célula tumoral e metástase. Nosso objetivo foi avaliar a associação entre o polimorfismo da 1562 C/T (rs 3918242) do gene MMP-9 e o desenvolvimento da neoplasia mamária. MéTODOS: Neste estudo caso­controle, a frequência de polimorfismo 1562 C/T (rs 3918242) do MMP-9 foi determinada em 148 mulheres com câncer de mama e 245 mulheres sem a doença. O DNA foi extraído do plasma e o gene foi amplificado por meio de reação em cadeia da polimerase (RCP). O polimorfismo foi determinado por enzimas de restrição. RESULTADOS: O polimorfismo, após o ajuste para variáveis confundidoras, não foi associado com a ocorrência de câncer de mama (razão de possibilidade [RP] = 1,159, intervalo de confiança de 95% [IC95]: 0,6625­1,997, p = 0,5964). Também não foi demonstrado associação com estadiamentos mais avançados, presença de receptores hormonais, superexpressão de HER2 e tampouco com a taxa de proliferação celular do tumor. CONCLUSãO: Não observamos relação entre o polimorfismo 1562 C/T (rs 3918242) do gene MMP-9 e a ocorrência de câncer de mama.

The Influence of CYP3A4 Polymorphism in Sex Steroids as a Risk Factor for Breast Cancer.

OBJECTIVE: Epidemiological studies have shown evidence of the effect of sex hormones in the pathogenesis of breast cancer, and have suggested a relationship of the disease with variations in genes involved in estrogen synthesis and/or metabolism. The aim of the present study was to evaluate the association between the CYP3A4*1B gene polymorphism (rs2740574) and the risk of developing breast cancer. METHODS: In the present case-control study, the frequency of the CYP3A4*1B gene polymorphism was determined in 148 women with breast cancer and in 245 women without the disease. The DNA of the participants was extracted from plasma samples, and the gene was amplified by polymerase chain reaction. The presence of the polymorphism was determined using restriction enzymes. RESULTS: After adjusting for confounding variables, we have found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio = 1.151; 95% confidence interval: 0.714-1.856; p = 0.564). We have also found no association with the presence of hormone receptors, with human epidermal growth factor receptor 2 (HER2) overexpression, or with the rate of tumor cell proliferation. CONCLUSION: We have not observed a relationship between the CYP3A4*1B gene polymorphism and the occurrence of breast cancer.

OBJETIVO: Estudos epidemiológicos têm mostrado evidências da influência dos hormônios sexuais na patogênese do câncer de mama, e têm sugerido uma relação entre a doença e variações em genes envolvidos na síntese e/ou metabolização de estrógenos. O objetivo do presente estudo foi avaliar a associação entre o polimorfismo do gene CYP3A4*1B (rs2740574) e o risco de desenvolvimento da neoplasia mamária. MéTODOS: No presente estudo de caso-controle, a frequência de polimorfismo do gene CYP3A4*1B foi determinada em 148 mulheres com câncer de mama, e em 245 mulheres sem a doença. O DNA das participantes foi extraído do plasma, e o gene foi amplificado por meio de reação em cadeia da polimerase, enquanto o polimorfismo foi determinado por enzimas de restrição. RESULTADOS: O polimorfismo, após o ajuste para variáveis de confusão, não foi associado à ocorrência de câncer de mama (razão de possibilidades = 1,151; intervalo de confiança de 95%: 0,714­1,856; p = 0,564). Também não observamos associação com a presença de receptores hormonais, superexpressão do receptor tipo 2 do fator de crescimento epidérmico humano (HER2, na sigla em inglês), ou com a taxa de proliferação celular do tumor. CONCLUSãO: Não observamos relação entre o polimorfismo do gene CYP3A4*1B e a ocorrência de câncer de mama.

Night eating syndrome among university students: are aspects of academic life associated with eating disorders? / Síndrome do comer noturno entre estudantes universitários: aspectos da vida acadêmica estariam associados ao distúrbio alimentar?

Introduction: the critical period in the lives of college adults implies lifestyle changes such as reducing physical activity and adopting unhealthy eating habits that can result in increased body fat. Thus, college students may represent a population at increased risk for Night Eating Syndrome. Objective: to analyze aspects of university students' academic life, work and housing that could be associated with Night Eating Syndrome. Methods: cross-sectional study carried out with 900 students from Architecture, Engineering, Medicine and Psychology courses at a higher education institution located in Cajazeiras, Paraíba, Brazil. Self-administered questionnaires were used for data collection: the Night Eating instrument Questionnaire (NEQ) to quantify Night Eating Syndrome (NCS) behaviors and a form for variables on demographic, health, academic life, work and housing aspects. Results: the prevalence of NES determined by the NEQ≥25 score was 16.8%. In the Engineering course, the prevalence of SCN was higher in women than in men, and in the Psychology course, it was higher in men than in women. Among students with a job and who lived at home, the prevalence of the syndrome was higher for those who worked in the afternoon and lower for those who worked at night. Conclusion: the prevalence of NES found among Brazilian university students was high (16.8%), particularly in two situations: (1) being enrolled in an undergraduate course with a predominance of students of the other sex; and (2) live with parents and work in the afternoon. These observations may be helpful in identifying subpopulations of students at increased risk for eating disorders.

Introdução: o período crítico da vida de adultos universitários implica mudanças do estilo de vida como a diminuição da atividade física e a adoção de hábitos alimentares pouco saudáveis que podem resultar em aumento da gordura corporal. Assim, estudantes universitários podem representar uma população com risco aumentado para a Síndrome do Comer Noturno. Objetivo: analisar aspectos da vida acadêmica, do trabalho e da moradia de estudantes universitários que poderiam se associar à Síndrome do Comer Noturno. Método: estudo transversal realizado com 900 estudantes dos cursos de Arquitetura, Engenharia, Medicina e Psicologia de uma instituição de ensino superior localizada em Cajazeiras, Paraíba, Brasil. Para a coleta de dados foram usados questionários autoaplicados: o instrumento Night Eating Questionnaire (NEQ) para quantificar comportamentos da Síndrome do Comer Noturno (SCN) e um formulário para variáveis sobre aspectos demográficos, de saúde, vida acadêmica, trabalho e moradia. Resultados: a prevalência da SCN determinada pelo escore NEQ≥25 foi 16,8%. No curso de Engenharia a prevalência da SCN foi maior nas mulheres em relação aos homens, e no curso de Psicologia, foi maior nos homens em relação as mulheres. Entre os estudantes com emprego e que moravam na casa dos pais, a prevalência da síndrome foi maior para aqueles que trabalham no período da tarde e menor para aqueles que trabalham à noite. Conclusão: a prevalência da SCN encontrada entre os estudantes universitários brasileiros foi alta (16,8%), particularmente em duas situações: (1) estar matriculado um curso de graduação com predominância de estudantes do outro sexo; e (2) morar com os pais e trabalhar no período da tarde. Estas observações podem ser úteis na identificação de subpopulações de estudantes com risco aumentado de distúrbios de alimentação

Evaluation of the g473a polymorphism in the lysyl oxidase gene as a risk factor related to the occurrence of breast cancer in Brazilian women / Avaliação do polimorfismo g473a no gene da lisil oxidase como fator de risco relacionado à ocorrência de câncer de mama em mulheres brasileiras

Introdução: o câncer de mama é o tipo de câncer mais diagnosticado e a principal causa de morte entre as mulheres em todo o mundo. Aproximadamente 1,67 milhões de novos casos de câncer de mama foram diagnosticados em 2012, levando a mais de meio milhão de mortes. O câncer de mama foi responsável por 11,6% dos novos casos de cânceres diagnosticados (2.089 milhões) e 9,2% (787.000) das mortes relacionadas ao câncer para ambos os sexos e em todas as idades em todo o mundo em 2018.Objetivo: o câncer de mama como o carcinoma mais diagnosticado no mundo e a principal causa de morte entre as mulheres, é uma morbidade de grande importância, sendo o objetivo deste estudo avaliar a associação entre o polimorfismo do gene LOX G473A (rs1800449) a ocorrência de câncer de mama, potencialmente estabelecendo um novo achado na identificação de riscos, prevenção, e atendimento a um grupo específico de mulheres.Método: neste estudo de coorte retrospectivo, a frequência do polimorfismo LOX G473A foi avaliada em 148 mulheres com câncer de mama e 245 mulheres sem a doença. Todas as pacientes responderam a um questionário para identificação de possíveis fatores de risco e posteriormente realizaram coleta de sangue periférico para estudo do gene LOX. O DNA foi extraído seguido da amplificação gênica via PCR, e o polimorfismo foi estudado por eletroforese de fragmentos específicos após digestão das amostras com a endonuclease de restrição do organismo Providencia stuartii.Resultados: este estudo identificou o uso de anticoncepcional oral e o antecedente familiar de câncer de mama como fatores de risco par a doença; o polimorfismo G473A na LOX não foi identificado como fator de risco.Conclusão: não foi observada relação entre o polimorfismo LOX G473A e a ocorrência de câncer de mama.

Introduction: breast cancer is the most diagnosed type of cancer and the leading cause of death among women worldwide. Approximately 1.67 million new cases of breast cancer were diagnosed in 2012, leading to more than half a million deaths. Breast cancer accounted for 11.6% of newly diagnosed cancers (2,089 million) and 9.2% (787,000) of cancer-related deaths for both sexes and at all ages worldwide in 2018.Objective: breast cancer, as the most diagnosed carcinoma in the world and the leading cause of death among women, is a morbidity of outstanding importance, and the object of this study is to evaluate the association between the LOX gene G473A (rs1800449) polymorphism and breast cancer occurrence, potentially establishing a new finding in the identification of risks, prevention, and care for a specific group of women.Methods:in this retrospective cohort study, LOX G473A polymorphism frequency was assessed in 148 women with breast cancer and 245 women without breast cancer. All patients completed a questionnaire to identify possible risk factors and subsequently underwent peripheral blood collection to study the LOX gene. DNA was extracted followed by gene amplification via PCR, and the polymorphism was studied by specific fragment electrophoresis after digestion of the samples with the restriction endonuclease Pstl.Results: this study identified the use of oral contraceptives and family history of breast cancer as risk factors for breast cancer; the G473A polymorphism in LOX was not identified as a risk factor.Conclusion: a relationship was not observed between the LOX G473A polymorphism and the occurrence of breast cancer.

Profile of pharmaceutical care in primary health centers in São Bernardo do Campo, Southeastern Brazil

The effective insertion of the pharmacist into primary care is an important goal for health policies. The objective of this study was to describe and analyze pharmacists and Pharmaceutical Care in the primary health centers (UBS) of São Bernardo do Campo. Data were obtained through an interview applied to pharmacists. The instrument has three sections: (1) Pharmacist identification; (2) Pharmacist work; and (3) Pharmaceutical activities. Items in section 3 correspond to the guidelines of agencies that promote Pharmaceutical Care in the primary health system. All 24 pharmacists working in UBS in São Bernardo do Campo were interviewed. Every center dispensing medicines has a responsible pharmacist. These pharmacists are predominantly women and postgraduates. Activities of Pharmaceutical Care reported were: daily prescription analysis (75% of interviewees); monthly participation in patient groups (70.8%); monthly follow-up of pharmacotherapy adherence (58.3%); monthly participation in multiprofessional team meetings (54.2%); monthly home visits (12.5%); health education to the community (83.3%); and pharmacist consultation (37.5%). Frequency of prescription analysis and home visits was weakly associated with aspects of the pharmacist and the facility. This study showed that Pharmaceutical Services are structured in primary care in São Bernardo do Campo and many Pharmaceutical Care activities are offered in its UBS

Evaluation of the fibulin 5 gene polymorphism as a factor related to the occurrence of pelvic organ prolapse

SUMMARY OBJECTIVE Pelvic organ prolapse (POP) is a very frequent situation in our population that may lead to a significant decrease in patients' quality of life. Currently, we are looking for predictive factors for the development of POPs; thus, this study seeks to evaluate whether the Fibulin 5 polymorphism (FBLN5) is associated with the occurrence of POP. METHODS This is a cohort study with postmenopausal women who were divided into groups by POP stage: POP stages 0 and I (control group) and POP stages III and IV (case group). Subsequently, analyses of genetic polymorphisms of FBLN5 were performed using the Restriction Fragment Length Polymorphism (RFLP) technique. RESULTS A total of 292 women were included in the study. Pregnancy, parity and vaginal delivery in the patients, as well as in data described in the literature, were related to the occurrence of POP in the univariate analysis. However, after binary logistic regression, home birth and age remained independent risk factors for POP. We found no association between the FBLN5 polymorphism and the occurrence of POP (p = 0.371). CONCLUSION There was no association between the FBLN5 polymorphism and the occurrence of POP in Brazilian women.

RESUMO OBJETIVOS O prolapso de órgãos pélvicos (POP) é uma situação muito frequente em nossa população que pode levar a uma diminuição significativa da qualidade de vida dos pacientes. Atualmente, buscam-se fatores preditivos para o desenvolvimento de POPs e, assim, este estudo correlaciona um polimorfismo de Fibulina 5 (FBLN5) com a ocorrência da doença. MÉTODOS Estudo de coorte com mulheres na pós-menopausa, divididas por grupos pelos estádios 0 e I do POP (grupo controle) e POP III e IV (grupo caso). Posteriormente, análises do polimorfismo genético de FBLN5 foram realizadas utilizando a técnica de Polimorfismo de Comprimento de Fragmentos de Restrição (RFLP). RESULTADOS Um total de 292 mulheres foi incluído no estudo. Gestação, paridade e parto vaginal, como bem descritos na literatura, foram relacionados à ocorrência de POPs na análise univariada. No entanto, após a regressão logística binária, o parto domiciliar e a idade permaneceram como fatores de risco independentes para os POPs. Não encontramos associação deste polimorfismo FBLN5 com a ocorrência de POP (p=0,371). CONCLUSÃO Não houve associação deste polimorfismo FBLN5 com a ocorrência de POPs em mulheres brasileiras.

Association between col1a2 polymorphism and the occurrence of pelvic organ prolapse in Brazilian women / Associação entre polimorfismo do gene col1a2 e a ocorrência do prolapso de órgãos pélvicos em mulheres brasileiras

Abstract Objective To evaluate the rs42524 polymorphism of the procollagen type I alpha (α) 2 (COL1A2) gene as a factor related to the development of pelvic organ prolapse (POP) in Brazilian women. Methods The present study involved 112 women with POP stages III and IV (case group) and 180 women with POP stages zero and I (control group). Other clinical data were obtained by interviewing the patients about their medical history, and blood was also collected from the volunteers for the extraction of genomic DNA. The promoter region of the COL1A2 gene containing the rs42524 polymorphism was amplified, and the discrimination between the G and C variants was performed by digestion of the polymerase chain reaction (PCR) products with the MspA1I enzyme followed by agarose gel electrophoresis analysis. Results A total of 292 women were analyzed. In the case group, 71 had the G/G genotype, 33 had the G/C genotype, and 7 had the C/C genotype. In turn, the ratio in the control group was 117 G/G, 51 G/C, and 11 C/C. There were no significant differences between the groups. Conclusion Our data did not show an association between the COL1A2 polymorphism and the occurrence of POP.

Resumo Objetivo Avaliar o polimorfismo rs42524 do gene pró-colágeno tipo I alfa (α) 2 (COL1A2) como fator relacionado ao desenvolvimento de prolapso de órgãos pélvicos (POP) em mulheres brasileiras. Métodos O estudo envolveu 112 mulheres com POP nos estádios III e IV (grupo caso) e 180 mulheres com POP nos estádios zero e I (grupo controle). Outros dados clínicos foramobtidos pormeio de entrevistas comas pacientes sobre seu históricomédico, e o sangue das voluntárias também foi coletado para extração de DNA genômico. A região promotora do gene COL1A2 contendo o polimorfismo rs42524 foi amplificada, e a discriminação entre as variantes G e C foi realizada por digestão dos produtos de reação em cadeia da polimerase (RCP) com a enzima MspA1I, seguida de análise por eletroforese em gel de agarose. Resultados Foram analisadas 292 mulheres. No grupo caso, 71 tinham o genótipo G/G, 33 tinham o genótipo G/C, e 7 tinham o genótipo C/C. Por sua vez, a relação no grupo controle foi de 117 G/G, 51 G/C e 11 C/C. Não houve diferenças significativas entre os grupos. Conclusão Nossos dados não mostraram associação do polimorfismo do gene COL1A2 com a ocorrência de POP.

The influence of CYP3A4 polymorphism in sex steroids as a risk factor for breast cancer / Influência do polimorfismo do gene CYP3A4 nos esteroides sexuais como fator de risco para câncer de mama

Abstract Objective Epidemiological studies have shown evidence of the effect of sex hormones in the pathogenesis of breast cancer, and have suggested a relationship of the disease with variations in genes involved in estrogen synthesis and/or metabolism. The aim of the present study was to evaluate the association between the CYP3A4*1B gene polymorphism (rs2740574) and the risk of developing breast cancer. Methods In the present case-control study, the frequency of the CYP3A4*1B gene polymorphism was determined in 148 women with breast cancer and in 245 women without the disease. The DNA of the participants was extracted from plasma samples, and the gene was amplified by polymerase chain reaction. The presence of the polymorphism was determined using restriction enzymes. Results After adjusting for confounding variables, we have found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio = 1.151; 95% confidence interval: 0.714-1.856; p= 0.564). We have also found no association with the presence of hormone receptors, with human epidermal growth factor receptor 2 (HER2) overexpression, or with the rate of tumor cell proliferation. Conclusion We have not observed a relationship between the CYP3A4*1B gene polymorphism and the occurrence of breast cancer.

Resumo Objetivo Estudos epidemiológicos têm mostrado evidências da influência dos hormônios sexuais na patogênese do câncer de mama, e têm sugerido uma relação entre a doença e variações em genes envolvidos na síntese e/ou metabolização de estrógenos. O objetivo do presente estudo foi avaliar a associação entre o polimorfismo do gene CYP3A4*1B (rs2740574) e o risco de desenvolvimento da neoplasia mamária. Métodos No presente estudo de caso-controle, a frequência de polimorfismo do gene CYP3A4*1B foi determinada em 148 mulheres com câncer de mama, e em 245 mulheres sem a doença. O DNA das participantes foi extraído do plasma, e o gene foi amplificado por meio de reação em cadeia da polimerase, enquanto o polimorfismo foi determinado por enzimas de restrição. Resultados O polimorfismo, após o ajuste para variáveis de confusão, não foi associado à ocorrência de câncer de mama (razão de possibilidades = 1,151; intervalo de confiança de 95%: 0,714-1,856; p= 0,564). Também não observamos associação com a presença de receptores hormonais, superexpressão do receptor tipo 2 do fator de crescimento epidérmico humano (HER2, na sigla em inglês), ou com a taxa de proliferação celular do tumor. Conclusão Não observamos relação entre o polimorfismo do gene CYP3A4*1B e a ocorrência de câncer de mama.

Association between matrix metallopeptidase 9 polymorphism and breast cancer risk / Associação entre o polimorfismo do gene metalopeptidase de matriz 9 e o risco de câncer de mama

Abstract Objective Epidemiological studies have shown evidence of the effect of genetic variations in the pathogenesis of breast cancer and have suggested a relationship of the disease with genetic polymorphisms. Matrix metallopeptidase 9 (MMP-9) is a collagenase responsible for the degradation of type IV collagen, the major component of the basement membrane, and other essential extra cellular matrix components, being involved in the tumor cell invasion and metastasis. Our objective was to evaluate the relationship between the MMP-9-1562 C/T polymorphism (rs 3918242) and the risk of developing breast cancer. Methods In this case-control study, the frequency of the MMP-9-1562 C/T polymorphism (rs 3918242) was determined in 148 women with breast cancer and 245 women without the disease. The DNA was extracted from plasma samples, and the gene was amplified by polymerase chain reaction (PCR); the presence of the polymorphism was determined using restriction enzymes. Results After adjusting for confounding variables, we found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio [OR] = 1.159, 95% confidence interval [CI]: 0.6625-1.997, p = 0.5964). We also found no association with more advanced disease, the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2) overexpression, or rate of tumor cell proliferation. Conclusion We did not observe a relationship between MMP-9-1562 C/T polymorphism (rs 3918242) and the occurrence of breast cancer.

Resumo Objetivo Estudos epidemiológicos vêm demonstrando evidências da influência de variações genéticas na patogênese do câncer de mama, e têm sugerido associação de polimorfismos comuma maior susceptibilidade à doença. A metalopeptidase dematriz 9 (MMP-9) é uma colagenase responsável pela degradação do colágeno tipo IV, omaior componente da membrana basal, e outros componentes essenciais da matriz extra celular, estando envolvido na invasão da célula tumoral emetástase. Nosso objetivo foi avaliar a associação entre o polimorfismo da 1562 C/T (rs 3918242) do gene MMP-9 e o desenvolvimento da neoplasia mamária. Métodos Neste estudo caso-controle, a frequência de polimorfismo 1562 C/T (rs 3918242) do MMP-9 foi determinada em 148 mulheres com câncer de mama e 245 mulheres sem a doença. O DNA foi extraído do plasma e o gene foi amplificado por meio de reação em cadeia da polimerase (RCP). O polimorfismo foi determinado por enzimas de restrição. Resultados O polimorfismo, após o ajuste para variáveis confundidoras, não foi associado coma ocorrência de câncer de mama (razão de possibilidade [RP] = 1,159, intervalo de confiança de 95% [IC95]: 0,6625-1,997, p = 0,5964). Também não foi demonstrado associação comestadiamentos mais avançados, presença de receptores hormonais, superexpressão de HER2 e tampouco com a taxa de proliferação celular do tumor. Conclusão Não observamos relação entre o polimorfismo 1562 C/T (rs 3918242) do gene MMP-9 e a ocorrência de câncer de mama.

Síndrome do comer noturno e estados emocionais em estudantes universitários / Night eating syndrome and emotional states in university students

INTRODUCTION: University students are exposed to many factors related to Night Eating Syndrome (NES), an eating disorder that may be associated with obesity. OBJECTIVE: To determine the prevalence of NES among students from a Brazilian university and evaluate the association of the syndrome behaviours with emotional. biological and environmental factors. METHODS: Cross-sectional study with 200 students from a private higher education institution located in the city of Juazeiro do Norte. Ceará. Brazil. NES was evaluated using the Night Eating Questionnaire (NEQ). considering the NEQ score ≥ 25 as the cut-off value for indication of the syndrome. Depression. anxiety. and stress symptoms were assessed using the Depression Anxiety Stress Scales (DASS-21) questionnaire. Additional information was collected about the participants (gender. age. weight and height). the academic status (enrolled course. study period and year) and the employment status (whether the participant worked at least 4h daily in addition to studying. RESULTS: 30 participants (15%) presented NEQ score ≥ 25. indicative of NES. There was no association between the NEQ score and the variables: gender, nutritional status, work, enrolled course. study period and academic year. There was an association between NEQ score and severity of depression (p=0.0001). anxiety (p=0.0001) and stress (p=0.0218). CONCLUSION: Evidence of a high prevalence of NES was found among Brazilian university students and an association between the behaviours of the syndrome with depressive. anxiety and stress symptoms was found.

INTRODUÇÃO: Estudantes universitários estão expostos a muitos fatores relacionados à Síndrome do Comer Noturno (SCN), um transtorno alimentar que pode estar associado à obesidade. OBJETIVO: Determinar a prevalência da SCN entre estudantes de uma universidade brasileira e avaliar a associação de comportamentos da síndrome a fatores emocionais, biológicos e ambientais. MÉTODO: Estudo transversal realizado com 200 estudantes de instituição de ensino superior privada localizada na cidade de Juazeiro do Norte, Ceará, Brasil. A SCN foi avaliada por meio do Night Eating Questionnaire (NEQ), considerando-se o escore NEQ ≥ 25 como valor de corte para indicação da síndrome. Sintomas depressivos, de ansiedade e de estresse foram avaliados por meio do questionário Depression Anxiety Stress Scales (DASS-21). Informações adicionais foram coletadas sobre os participais (sexo, idade, peso, altura); seu status acadêmico (tipo de curso, período, série); e seu status empregatício (se o participante trabalha ao menos 4h diárias além de estudar. RESULTADOS: 30 participantes (15%) apresentaram o escore NEQ ≥ 25, indicativo da SCN. Não houve associação entre o escore NEQ e as variáveis: sexo, estado nutricional, trabalho, curso matriculado, período de estudo e série cursada. Foi observada associação entre o escore NEQ e a severidade de depressão (p=0,0001), de ansiedade (p=0,0001) e de estresse (p=0,0218). CONCLUSÃO: Foram encontradas evidências de alta prevalência da SCN entre estudantes universitários brasileiros e verificou-se associação dos comportamentos da síndrome com sintomas depressivos, de ansiedade e de estresse.

Cholesteatoma gene expression of matrix metalloproteinases and their inhibitors by RT-PCR.

UNLABELLED: Acquired middle ear cholesteatoma is a benign keratinizing hyperproliferative squamous epithelial lesion that may result in the destruction of the bone structures surrounding the temporal bone. Recent studies show that variations in cellular production of matrix metalloproteinases (MMPs) and their specific inhibitors (TIMPs) contribute to the pathophysiology of cholesteatoma. OBJECTIVE: This study aims to analyze the use of RNA amplification tests to evaluate the expression of MMP and TIMP isoforms in cholesteatomas and their correlation with disease severity. MATERIALS AND METHODS: This is a prospective study. Nineteen cholesteatoma cases at different stages were selected. RNA collected from biopsy specimens was submitted to reverse transcription polymerase chain reaction (RT-PCR) for semiquantitative amplification of MMP2, MMP3, MMP9, MMP13 and TIMP1. RESULTS: Six cholesteatomas were positive for at least one of the studied genes. Four samples amplified a single gene (MMP2 or MMP13) and two samples amplified three genes (MMP2, TIMP1 and MMP3 or MMP13). No sample amplified MMP9. CONCLUSION: RT-PCR can be used to assess MMP and TIMP gene expression in cholesteatomas despite technical difficulties. Gene expression profiles could not be related to disease severity.

Adiponectin expression in epicardial adipose tissue after percutaneous coronary intervention with bare-metal stent.

BACKGROUND: The classical view of adipose tissue as a passive reservoir for energy storage is no longer valid. In the past decade, adipose tissue has been shown to have endocrine functions and the most abundant peptide secreted by adipocytes is adiponectin. Pericardial adipose tissue (PAT) is distributed around coronary arteries and endovascular injury, caused by the presence of intracoronary bare-metal stent (BMS), could promote inflammatory changes in the periadvential fat, contributing to vascular restenosis. OBJECTIVE: We sought to determine gene expression of inflammatory mediator in pericardial adipose tissue after bare-metal stent implantation and vascular restenosis that had been referred to operative treatment. METHODS: Paired samples of PAT were harvested at the time of elective coronary artery bypass surgery (CABG) in 11 patients (n = 22), one sample was obtained of the tissue around BMS area and another sample around coronary artery without stent. Local expression of adiponectin was determined by real-time polymerase chain reaction (RT-PCR) using Taq DNA polymerase. RESULTS: In two samples, there was no gene expression of adiponectin. We are able to identify adiponectin in 20 samples, however, the pattern of gene expression were heterogeneous.We did not notice specificity when we compared PAT obtained near BMS area or far from BMS area. CONCLUSION: There were no correlation between adiponectin gene expression and presence of BMS.