Antioxidant Activity of Egg Yolk Protein Hydrolysates Obtained by Enzymatic and Sub-Critical Water Hydrolysis.

Obtaining peptides with antioxidant properties by enzymatic hydrolysis has been widely described; however, the use of non-enzymatic methods to obtain peptides with antioxidant capacities has been poorly investigated. In this study, non-soluble proteins obtained from delipidated egg yolk granules were hydrolyzed with trypsin, and with a non-enzymatic method using sub-critical water hydrolysis under a non-oxidizing (nitrogen) and oxidizing (oxygen) atmosphere. The effect of the sub-critical water hydrolysis on the amino acids' composition of the hydrolysates was assessed. Furthermore, the antioxidant capacities of the hydrolysates were evaluated using the ABTS•+ scavenging assay, the DPPH radical scavenging activity assay, and by measuring the reducing power of the peptides, the peptides' ferrous ion chelating capacities, and the antioxidant effect of the peptides on beef homogenates. The hydrolysate obtained by sub-critical water hydrolysis under a nitrogen stream showed similar or better results in the antioxidant tests than those obtained using trypsin hydrolysis, except in the ferrous chelating capacity, where the trypsin hydrolysate showed the best performance. The oxidizing environment promoted by the oxygen in the other sub-critical water hydrolysis method tested produced the peptides with the lowest antioxidant capacities, due to changes in the primary structure of the peptides. These results suggest that the sub-critical water hydrolysis method under a nitrogen stream, in comparison with the enzymatic hydrolysis, is a reliable method to obtain peptides with good antioxidant capacities.

Egg Yolk Oil as a Plasticizer for Polylactic Acid Films.

Polylactic acid (PLA) is known to be one of the most extensively used biodegradable thermoplastic polyesters, with the potential to replace conventional petroleum-based packaging materials; however, the low flexibility of films prepared using PLA has limited the applications of this biopolymer. In this study, in order to improve the mechanical properties of PLA films and to provide them with antioxidant properties, egg yolk oil was used as a biobased plasticizer. For this purpose, PLA films with increasing concentrations of egg yolk oil were prepared and the effects of this oil on the light transmission, transparency, colour, water vapour permeability, solubility, antioxidant activity and mechanical properties of the films were characterized. In addition, electron microscopy of the structure of the transverse section of the films was also performed. Results showed that the formulations with higher concentrations of egg yolk oil increased the films' elasticity, and their light barrier and antioxidant properties. Finally, in order to test the films as a packaging material for food applications, extra virgin olive oil and resveratrol, both photosensitive compounds, were packed and exposed to ambient light. Overall, the results show the potential of egg yolk oil as an environmentally friendly plasticizer that can improve the flexibility of PLA films and provide them with additional photoprotective properties.

Blood Infusion and the Risk of Haemorrhage in Patients Undergoing Cardiac Surgery with Extracorporeal Circulation.

PURPOSE: Patients undergoing cardiac surgery with extracorporeal circulation (ECC) frequently present haemorrhages as a complication associated with high morbidity and mortality. One of the factors that influences this risk is the volume of blood infused during surgery. The objective of this study was to determine the optimal volume of autologous blood that can be processed during cardiac surgery with ECC. We also determined the number of salvaged red blood cells to be reinfused into the patient in order to minimize the risk of haemorrhage in the postoperative period. METHODS: This was an observational retrospective cross-sectional study performed in 162 ECC cardiac surgery patients. Data regarding the sociodemographic profiles of the patients, their pathologies and surgical treatments, and the blood volume recovered, processed, and reinfused after cell salvage were collected. We also evaluated the occurrence of postoperative haemorrhage. RESULTS: The volume of blood infused after cell salvage had a statistically significant effect (p < 0.01) on the risk of post-operative haemorrhage; the receiver operating characteristic sensitivity was 0.813 and the optimal blood volume cut-off was 1800 ml. The best clinical outcome (16.7% of patients presenting haemorrhages) was in patients that had received less than 1800 ml of recovered and processed autologous blood, which represented a volume of up to 580 ml reinfused red blood cells. CONCLUSION: The optimum thresholds for autologous processed blood and red blood cells reinfused into the patient were 1800 and 580 ml, respectively. Increasing these thresholds augmented the risk of haemorrhage as an immediate postoperative period complication.

3ª Conferência Municipal de Saúde de Várzea Paulista: a participação da sociedade no processo de priorização e compromisso político / 3rd Varzea Paulista's Municipal Conference of Health: the participation of society in prioritizing proposals and political commitment

O artigo apresenta o relato de experiência da 3ª Conferência Municipal de Saúde de Várzea Paulista, ocorrida em 2008, cuja organização teve como objetivos envolver a sociedade na análise da situação de saúde do município, de forma a priorizar necessidades em saúde e transformar o relatório final em uma carta de compromisso político. Foram realizadas Plenárias Locais, Pré-Conferências Regionais e a Conferência Municipal, com fluxo ascendente de propostas e delegados, nas quais o tema "Garantindo o Direito à Saúde" foi debatido através de cinco eixos temáticos correspondentes aos blocos do Pacto pela Saúde. Inovou-se com a atividade de priorização, através da limitação do número de propostas de cada região a serem encaminhadas para a Conferência Municipal. O Relatório Final foi encaminhado aos candidatos a prefeito, solicitando-se o compromisso com as deliberações. A realização da Conferência de forma ascendente, com etapas locais e regionais, garantiu a participação da comunidade, a representatividade dos delegados eleitos e das propostas aprovadas. A "priorização coletiva" qualificou o debate garantindo a pactuação com a sociedade de um projeto viável. O debate acerca da governabilidade ampliou-se para a intersetorialidade, gerando moções de apelo a outras secretarias municipais. A grande contribuição deste processo para o município foi a oferta de espaços de debate entre os diversos olhares, que favoreceu o ensino-aprendizagem e a formação política dos participantes. O comprometimento político obtido dos candidatos à sucessão municipal evidenciou o empenho dos atores na transformação da política municipal de saúde em uma política de estado, não de governo.

Neck pain from a rheumatologic perspective.

This article provides a comprehensive review of rheumatologic considerations for a clinician when evaluating a patient with neck pain. Clearly, anatomic derangements of the cervical spine should be considered when a patient complains of cervicalgia. However, one must also entertain the possibility of a systemic illness as the cause of the pain. Examples of diseases that may present with a prominent feature of neck pain are discussed, including rheumatoid arthritis, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis, myositis, and fibromyalgia. Evidence of an underlying rheumatic illness may guide the clinician in a different therapeutic direction.

O aterro sanitário como fator de risco para doenças respiratórias em crianças / Landfills as risk factors for respiratory disease in children

OBJETIVO: Avaliar a relação entre a exposição a um aterro sanitário fechado há 6 anos e os sintomas respiratórios em crianças de até 13 anos de idade. MÉTODO: Estudo transversal realizado em Várzea Paulist a, estado de São Paulo, Brasil. Um adulto cada um dos domicílios localizados no bairro próximo ao aterro sanitário e de uma amostra aleatorizada de domicílios de outro bairro com características socioeconômicas semelhantes foram entrevistados, perguntando-se sobre sintomas respiratórios, bem como sobre outras variáveis em crianças de até 13 anos de idade. O modelo de regressão logística foi utilizado para estudar essa relação. RESULTADOS: A chance de uma criança apresentar sintoma respiratório foi função de: -2,36 + 0,43 se a criança tem menos de 2 anos de idade; + 0,24 se a criança morar no bairro em que fica o aterro sanitário; -0,67 se, no domicílio, houver computador; + 0,54 se houvesse consumo de lenha no último ano; + 0,94 se a criança fora diagnosticada com asmática; + 0,87 foi ao serviço de saúde nos últimos 30 dias. CONCLUSÃO: Os autores concluem que morar próximo a um aterro sanitário fechado há 6 anos pode ser um fator de risco para doenças respiratórias em crianças.

OBJECTIVE: To investigate the relationship between exposure to a landfill site closed 6 years previously and respiratory symptoms in children aged up to 13 years. METHOD: This was a cross-sectional study conducted in Várzea Paulista, in the state of São Paulo, Brazil. One adult in every household in a neighborhood close to the landfill and from a randomized sample of households in another neighborhood with similar socioeconomic characteristics but no landfill were interviewed and asked about respiratory symptoms and other variables relating to children aged up to 13. A logistic regression model was used to study this relationship. RESULTS: The likelihood of a child having respiratory symptoms was a function of -2.36 + 0.43 if the child was less than 2 years old; + 0.24 if the child lived in the landfill area; -0.67 if there was a computer at home; + 0.54 if firewood was burnt in the home in the last year; + 0.94 if the child was diagnosed with asthma; + 0.87 if the child visited a health service in the previous 30 days. CONCLUSION: The authors conclude that living near to a landfill closed 6 years previously may be a risk factor for respiratory disease in children.

O pacto pela saúde e o fundo municipal de saúde de Várzea Paulista / Health pact and the municipal health fund of Várzea Paulista

A reestruturação do Fundo Municipal de Saúde de Várzea Paulista teve como objetivos: reorganizar o orçamento municipal de acordo com o Pacto pela Saúde, integrar ações do planejamento e gestão orçamentário-financeira, atualizar a legislação municipal e implantar sistema de monitoramento. Inicialmente foi preenchido o Termo do Limite Financeiro do Município, dividindo os recursos para custeio em 2006 por cinco blocos: Gestão, Atenção Básica, Média e Alta Complexidade, Assistência Farmacêutica e Vigilância em Saúde. Esse cálculo permitiu o planejamento do orçamento para 2007, subdividindo-se cada bloco em cinco itens de despesa (pessoal, obras, serviços de terceiros, material de consumo e permanente) acrescentando-se projetos novos. Foi aprovada lei que alterou o Plano Plurianual (PPA), compatibilizando-o com a Lei Orçamentária Anual para 2007, instituindo cinco planos de trabalho com as respectivas dotações para os itens de despesa, subsidiando a elaboração da Programação Anual para 2007. Em setembro de 2007, já com o acompanhamento financeiro-orçamentário em andamento, elaborou-se a partir de um processo de Planejamento Ascendente a proposta de prioridades para 2008 que, revertidas em necessidades financeiras, transformou-se em proposta orçamentária e converteu-se na Lei Orçamentária 2008. A reorganização do Fundo Municipal de Saúde de Várzea Paulista em cinco blocos de financiamento tem propiciado uma maior interface entre o planejamento e a gestão, com previsão, programação, monitoramento e execução orçamentário-financeira condizentes com as diretrizes e metas estabelecidas no Plano Municipal de Saúde e nas Programações Anuais.

The restructuring of the Municipal Health Fund of Várzea Paulista aimed to reorganize the municipal budget according to the Health Pact, to integrate planning and financial management, to modernize the municipal law and to implement a monitoring system. First, the Municipal Financial Limit Document was filled in, dividing the financial resources of 2006 among five groups: Management, Primary Care, Specialized Care, Pharmaceutical Care and Health Surveillance. This calculation helped in budget planning for 2007, and each group was subdivided into five expenditure items (personnel, construction, outsourced services, equipment and consumption materials), besides new projects. A law that altered the Pluriannual Plan according to the Annual Budget Law for 2007 was passed, introducing five work plans and subsidizing the development of the Annual Program for 2007. In September 2007, in an Ascendant Planning process, a priority list was converted into cost needs for the Budget Law for 2008. The reorganization of the Municipal Health Fund of Várzea Paulista into five groups has made planning and management comply with the objectives of the Municipal Health Plan and Annual Programs.