Factors influencing life satisfaction in basic education teachers / Fatores que influenciam a satisfação de vida em professores da educação básica / Factores que influyen en la satisfacción de vida en docentes de educación básica

This study explored how the following aspects may influence basic education teachers' life satisfaction: self-esteem, general self-efficacy, self-compassion, positive and negative feelings, moral competence, social support, positive relationships with a colleague, work engagement, age, professional experience (in years), time teaching in the same school, number of schools currently teaching, and approximate number of students per week. One hundred primary and high-school teachers (74 women) participated in the study (mean age 40.9; SD = 10.01). Network analysis provided a model which encompasses the six most relevant aspects that interfere in the life and work of basic education teachers: life satisfaction, self-efficacy, self-esteem, positive affects, work engagement, and giving instrumental social support. In addition, the yielded model showed that self-efficacy presented the closest relationship with life satisfaction. We discuss the results in line with previous studies on self-efficacy. Interventions directed at basic education teachers may be more effective if self-efficacy is part of the program.(AU)

Este estudo explorou como os seguintes aspectos influenciam a satisfação de vida de professores da educação básica: autoestima, autoeficácia, autocompaixão, sentimentos positivos e negativos, competência moral, suporte social, relacionamento positivo com colega, engajamento no trabalho, idade, experiência profissional, tempo de ensino na mesma escola, número de escolas e de estudantes. Cem docentes do ensino básico (74 mulheres) participaram do estudo (média de 40,9 anos de idade; DP = 10.01). A análise de rede proporcionou um modelo com os seis aspectos mais relevantes para a vida e o trabalho de professores: satisfação de vida, autoeficácia, autoestima, afetos positivos, engajamento no trabalho e dar suporte social instrumental. Além disso, o modelo mostrou que a autoeficácia apresentou a relação mais próxima com satisfação de vida. Os resultados são discutidos com base em estudos prévios sobre autoeficácia. Intervenções dedicadas a docentes da educação básica podem se beneficiar da inclusão da autoeficácia como parte da programação.(AU)

Este estudio exploró cómo los siguientes aspectos influyen en la satisfacción de vida de los profesores de educación básica: autoestima, autoeficacia, autocompasión, sentimientos positivos y negativos, competencia moral, apoyo social, relación positiva con compañeros, compromiso laboral, edad, experiencia profesional, tiempo de enseñanza en la misma escuela, número de escuelas y número de estudiantes. Cien profesores de educación básica (74 mujeres) participaron en el estudio (edad media 40,9 años; DS = 10,01). El análisis de red proporcionó un modelo con los seis aspectos más relevantes para la vida y el trabajo: satisfacción con la vida, autoeficacia, autoestima, afecto positivo, compromiso en el trabajo y proporcionar apoyo social instrumental. Además, el modelo mostró que la autoeficacia tiene la relación más cercana con la satisfacción en la vida. Los resultados son discutidos con base en estudios previos sobre la autoeficacia. Las intervenciones dirigidas a profesores de educación básica pueden beneficiarse al incluir la autoeficacia como parte del programa.(AU)

Does the Brazilian cash transfer program (bolsa familia): Protect nutritional deviations among infants and breastfeeding practices in a capital of the Central Region of Brazil?

Cash transfer programs are strategies used by countries, intended for impoverished families, which play an essential role in promoting access to public services such as health, education, and social protection. Programs may also promote food and nutrition security. The Brazilian Cash Transfer Program ("Bolsa Familia") (BFP) aims to alleviate immediate poverty and combat hunger. The aim of this study is to characterize the nutritional and breastfeeding status of children under two years old among both beneficiaries and non-beneficiaries of BFP. Data from the Brazilian Food and Nutritional Surveillance System, available in the primary healthcare service system of Goiania, Brazil, in 2013 were collected. The following variables were evaluated: sex, weight, height/length, age, and breastfeeding status. Data from 4,567 children under 24 months old were assessed, of which 2.72% (n= 124) were BFP beneficiaries. Beneficiaries had a lower odd of receiving breast milk compared to non-beneficiaries (OR= 0.46, 95% CI:0.31; 0.66, p= 0.0001). Regarding nutritional status, 18.14% (n= 790) of children were diagnosed with nutritional deviation, and overweight was the most prevalent (n=352, 8.04%). Beneficiaries presented a lower odd of developing stunting when compared to non-beneficiaries of BFP (OR= 0.44, 95% CI:0.25; 0.77, p= 0.006). Being a BFP beneficiary was a protective factor for the stunting in children under 24 months old in Goiania, Brazil. However, measures to promote and support breastfeeding should be intensified in primary healthcare service, aimed primarily at children in social vulnerability.

Los programas de transferencias en efectivo son estrategias utilizadas por los países, destinadas a familias en situación de pobreza y pobreza extrema, que juegan un papel fundamental en la promoción del acceso a los servicios públicos como salud, educación y protección social, además de promover la seguridad alimentaria y nutricional. El Programa Brasileño de Transferencias en Efectivo ("Bolsa Familia") (BFP) tiene como objetivo aliviar la pobreza inmediata y combatir el hambre. El objetivo de este estudio es caracterizar el estado nutricional y de lactancia de los niños menores de dos años, tanto beneficiarios como no beneficiarios del BFP. Se recogieron datos del Sistema de Vigilancia Alimentaria y Nutricional Brasileña, disponibles en el sistema de atención primaria de salud de Goiânia, Brasil, en 2013. Se evaluaron las siguientes variables, sexo, peso, talla, edad y estado de lactancia. Se evaluaron datos de 4.567 menores de 24 meses, de los cuales el 2.72% (n=124) eran beneficiarios del BFP. Las beneficiarias presentaron menos posibilidades de recibir leche materna en comparación con las no beneficiarias (OR= 0.46, IC95%:0,31; 0,66, p= 0,0001). En cuanto al estado nutricional, el 18,14% (n= 790) de los niños fueron diagnosticado con desviación nutricional, siendo el sobrepeso el más prevalente (n= 352, 8, 04%). Los beneficiarios presentaron menos probabilidad de desarrollar talla baja en comparación con los no beneficiarios del BFP (OR= 0.44, IC95%: 0.25; 0.77, p= 0.006). Ser beneficiario del BFP fue un factor de protección para la baja talla en menores de 24 meses en Goiania, Brasil. Sin embargo, se deben intensificar las medidas de promoción y apoyo a la lactancia materna en los servicios de atención primaria de salud, dirigidas principalmente a los niños en situación de vulnerabilidad social.

Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay.

Rheumatoid arthritis (RA) is an autoimmune inflammatory and heterogeneous disease that affects several systems, especially the joints. Among the extra-articular manifestations of RA, pleuropulmonary involvement occurs frequently, with different presentations, potentially in all anatomic thoracic compartments, and may determine high morbidity and mortality. The most common pleuropulmonary manifestations in patients with RA include interstitial lung disease (ILD), pleural disease, pulmonary arterial hypertension, rheumatoid lung nodules, airway disease (bronchiectasis and bronchiolitis), and lymphadenopathy. Pulmonary hypertension and ILD are the manifestations with the greatest negative impact in prognosis. HRCT of the chest is essential in the evaluation of patients with RA with respiratory symptoms, especially those with higher risk factors for ILD, such as male gender, smoking, older age, high levels of rheumatoid factor, or positive anti-cyclic citrullinated peptide antibody results. Additionally, other etiologies that may determine tomographic pleuropulmonary manifestations in patients with RA are infections, neoplasms, and drug-induced lung disease. In these scenarios, clinical presentation is heterogeneous, varying from being asymptomatic to having progressive respiratory failure. Knowledge on the potential etiologies causing tomographic pleuropulmonary manifestations in patients with RA coupled with proper clinical reasoning is crucial to diagnose and treat these patients.

Leishmania infantum NTPDase1 and NTPDase2 play an important role in infection and nitric oxide production in macrophages.

Leishmania infantum, the causative agent of American Visceral Leishmaniasis (VL), is known for its ability to modulate the host immune response to its own favor. Ecto-nucleoside triphosphate diphosphohydrolase (ENTPDase) represents a family of enzymes that hydrolyze nucleotides and are involved in nucleotide-dependent biological processes. L. infantum has two ENTPDases, namely LiNTPDase1 and LiNTPDase2. Here, we used genetic tools to overexpress or abolish the expression of LiNTPDase1 and -2 to assess their role in parasite growth in culture and macrophage infection. While LiNTPDase1 or 2-overexpressing clones showed no morphological or growth changes in promastigotes, LiNTPDase2 overexpression increased macrophage adhesion and infection by 50% and 30%, respectively. The individual LiNTPDase1 and 2 knockout mutants showed lag in growth profile, which was reversed by the addition of adenine and guanine to the culture media. Moreover, the morphology of the knockout mutants even in supplemented media was changed to an amastigote-like form. The double knockout of both genes was lethal and a mechanism of compensation of deletion of one isoform was detected in these mutants. Correspondingly, the absence of LiNTPDase1 or LiNTPDase2 led to a dramatic reduction in in vitro infection (∼90%). Interestingly, nitric oxide production was decreased in both knockout mutants during infection, which suggests that both LiNTPDases can inhibit macrophage responses against the parasite. Overall, our results show important roles of LiNTPDase1 and -2 concerning in vitro macrophage infection and reinforce their use as potential targets to control Leishmania infections.

Tomographic pleuropulmonary manifestations in rheumatoid arthritis: a pictorial essay / Manifestações pleuropulmonares tomográficas na artrite reumatoide: ensaio pictórico

ABSTRACT Rheumatoid arthritis (RA) is an autoimmune inflammatory and heterogeneous disease that affects several systems, especially the joints. Among the extra-articular manifestations of RA, pleuropulmonary involvement occurs frequently, with different presentations, potentially in all anatomic thoracic compartments, and may determine high morbidity and mortality. The most common pleuropulmonary manifestations in patients with RA include interstitial lung disease (ILD), pleural disease, pulmonary arterial hypertension, rheumatoid lung nodules, airway disease (bronchiectasis and bronchiolitis), and lymphadenopathy. Pulmonary hypertension and ILD are the manifestations with the greatest negative impact in prognosis. HRCT of the chest is essential in the evaluation of patients with RA with respiratory symptoms, especially those with higher risk factors for ILD, such as male gender, smoking, older age, high levels of rheumatoid factor, or positive anti-cyclic citrullinated peptide antibody results. Additionally, other etiologies that may determine tomographic pleuropulmonary manifestations in patients with RA are infections, neoplasms, and drug-induced lung disease. In these scenarios, clinical presentation is heterogeneous, varying from being asymptomatic to having progressive respiratory failure. Knowledge on the potential etiologies causing tomographic pleuropulmonary manifestations in patients with RA coupled with proper clinical reasoning is crucial to diagnose and treat these patients.

RESUMO A artrite reumatoide (AR) é uma doença inflamatória autoimune e heterogênea que afeta vários sistemas, principalmente as articulações. Dentre as manifestações extra-articulares da AR, o acometimento pleuropulmonar ocorre com frequência, com diferentes apresentações, potencialmente em todos os compartimentos anatômicos do tórax e pode determinar alta morbidade e mortalidade. As manifestações pleuropulmonares mais comuns em pacientes com AR incluem doença pulmonar intersticial (DPI), doença pleural, hipertensão arterial pulmonar, nódulos pulmonares reumatoides, doença das vias aéreas (bronquiectasia e bronquiolite) e linfadenopatia. A hipertensão pulmonar e a DPI são as manifestações com maior impacto negativo no prognóstico. A TCAR de tórax é essencial na avaliação de pacientes com AR sintomáticos respiratórios, principalmente aqueles com fatores de risco maiores para DPI, como sexo masculino, tabagismo, idade mais avançada, níveis elevados de fator reumatoide ou anticorpos antipeptídeos citrulinados cíclicos positivos. Além disso, outras etiologias que podem determinar manifestações pleuropulmonares tomográficas em pacientes com AR são infecções, neoplasias e doença pulmonar induzida por drogas. Nesses cenários, a apresentação clínica é heterogênea, variando de ausência de sintomas a insuficiência respiratória progressiva. O conhecimento das possíveis etiologias causadoras de manifestações pleuropulmonares tomográficas em pacientes com AR, aliado a um raciocínio clínico adequado, é fundamental para o diagnóstico e tratamento desses pacientes.

Aspectos relacionados ao estudante na construção da identidade médica: uma revisão integrativa / Student-related aspects in the construction of the Medical Identity: an integrative review

Resumo: Introdução: A construção da identidade médica (IM) é fenômeno dinâmico influenciado por fatores relacionados ao estudante, ao ambiente educacional e à sociedade. Objetivo: Este estudo teve como objetivo sintetizar o conhecimento produzido a respeito dos aspectos referentes ao estudante na construção da IM. Método: Trata-se de uma revisão integrativa de estudos empíricos publicados em periódicos indexados na MEDLINE e LILACS, utilizando a expressão medical identity e os descritores identity crisis, social identification, physician's role e professional role. Os critérios de inclusão foram: textos completos disponíveis em português, espanhol, francês ou inglês de estudos empíricos sobre fatores que influenciam na formação da IM com foco nos aspectos relacionados ao estudante e tendo médicos ou estudantes de graduação em Medicina como participantes. Resultado: Na primeira etapa, identificaram-se 1.365 artigos. Foram triados 194 artigos para leitura em profundidade. Destes, incluíram-se 18 para análise temática com classificação em categorias em diálogo com a literatura, tendo como base o conceito de IM saudável. A maioria dos artigos foi publicada na última década. Identificaram-se três categorias: expectativa versus realidade, referente ao que o estudante pensa sobre o que um médico é ou deveria ser; médico "super-herói", relativa à percepção caricaturada da medicina criada pelos próprios alunos e oferecida pela sociedade por meio de programas, séries e filmes televisivos; e modelagem de papéis, que diz respeito à importância da experiência prática do estudante supervisionada por um preceptor ou docente. A IM construída ao longo do curso médico influencia na forma como a medicina é exercida e, quando ela não é congruente com a realidade que o recém-formado encontra, provoca sofrimento no médico e interfere na atuação profissional dele. Conclusão: Instituições de ensino, professores e preceptores devem estar atentos às expectativas e às idealizações de seus alunos sobre o que é ser um médico e o papel desse profissional na sociedade, de maneira a promover intervenções que auxiliem em uma construção identitária mais saudável e mais resiliente às intempéries peculiares à profissão médica.

Abstract: Introduction: The Medical Identity (MI) construction is a dynamic phenomenon influenced by factors related to the student, the educational environment and society. Objective: To synthesize the produced knowledge about the student-related aspects regarding the construction of the MI. Method: This is an integrative review of empirical studies published in journals indexed in the MEDLINE and LILACS databases, using the term Medical Identity and the descriptors Identity Crisis, Social Identification, Physician's Role and Professional Role. The inclusion criteria were: full texts available in Portuguese, Spanish, French or English of empirical studies on factors that influence the development of MI focused on student-related aspects and having physicians or undergraduate medical students as participants. Results: In the first stage, 1,365 articles were identified. Subsequently, 194 articles were chosen for in-depth reading. Of these, 18 were included for thematic analysis with classification into categories in dialogue with the literature, based on the concept of healthy MI. Most articles were published in the last decade. Three categories were identified: expectation versus reality, related to what the student thinks about what a physician is or should be; the 'superhero' physician, related to the caricatured perception of Medicine created by the students themselves and offered by society through TV programs, series and films; and role modeling, which concerns the importance of the student's practical experience supervised by a preceptor or teacher. The MI built throughout the medical course influences the way medicine is practiced and when it is not consistent with the reality that the recently graduated student encounters, it causes suffering to the physician and interferes with their professional performance. Conclusion: Educational institutions, teachers and preceptors must be aware of the expectations and ideals of their students about what it means to be a physician and the role of this professional in society, aiming to promote interventions that help establishing a healthier and more resilient identity construction, particular to the medical profession.

Prevalência e fatores associados a sintomas de depressão em familiares de pessoas hospitalizadas em unidade de terapia intensiva / Prevalence and factors associated with symptoms of depression in family members of people hospitalized in the intensive care unit

RESUMO Objetivo: Avaliar prevalência e fatores associados à depressão em familiares de pessoas hospitalizadas em unidades de terapia intensiva. Métodos: Estudo transversal, desenvolvido com 980 familiares de pacientes internados nas unidades de terapia intensiva de um hospital público de grande porte no interior da Bahia. A depressão foi mensurada pelo Patient Health Questionnaire-8. O modelo multivariado foi composto pelas seguintes variáveis: sexo e idade do paciente, sexo e idade do familiar, escolaridade, religião, residir com o familiar, problema psíquico prévio e ansiedade. Resultados: A depressão apresentou prevalência de 43,5%. Na análise multivariada, o modelo com melhor representatividade indicou que fatores associados à maior prevalência de depressão foram ser do sexo feminino (39%), idade menor que 40 anos (26%) e problema psíquico prévio (38%). A maior escolaridade se associou a uma prevalência de depressão 19% menor em familiares. Conclusão: O aumento na prevalência de depressão esteve associado a sexo feminino, idade menor de 40 anos e problemas psíquicos prévios. Tais elementos devem ser valorizados nas ações direcionadas aos familiares de pessoas internadas na terapia intensiva.

ABSTRACT Objective: To evaluate the prevalence and factors associated with depression in family members of people hospitalized in intensive care units. Methods: A cross-sectional study was conducted with 980 family members of patients admitted to the intensive care units of a large public hospital in the interior of Bahia. Depression was measured using the Patient Health Questionnaire-8. The multivariate model consisted of the following variables: sex and age of the patient, sex and age of the family member, education level, religion, living with the family member, previous mental illness and anxiety. Results: Depression had a prevalence of 43.5%. In the multivariate analysis, the model with the best representativeness indicated that factors associated with a higher prevalence of depression were being female (39%), age younger than 40 years (26%) and previous mental illness (38%). A higher education level was associated with a 19% lower prevalence of depression in family members. Conclusion: The increase in the prevalence of depression was associated with female sex, age younger than 40 years and previous psychological problems. Such elements should be valued in actions aimed at family members of people hospitalized in intensive care.

Participação e diversidade - a construção inclusiva e pluriepistêmica da Saúde Global / Participation and diversity - the inclusive and multiepistemic construction of Global Health

Resumo A conformação de nova área para abarcar formulações e práticas de saúde em escala planetária deve considerar a multiplicidade de agentes e territórios envolvidos, bem como suas diferenças e desigualdades. A inserção dos diversos segmentos sociais nos processos decisórios e de elaborações teóricas da Saúde Global, por meio da participação, apresenta-se como condição estratégica e necessária ao enfrentamento de questões transnacionais. Uma participação que garanta diversidade política e epistêmica na constituição de uma Saúde Global comprometida com a equidade sanitária no plano mundial. A tradição latino-americana que articula pesquisa e ação e a proposta de Encontro de Saberes podem contribuir com processos participativos de constituição do campo da Saúde Global em seus aspectos práticos e teóricos.

Abstract The shaping of a new field to encompass health formulations and practices on a planetary scale must consider the multiple agents and territories involved and their differences and inequalities. The inclusion of different social segments in the decision-making processes and theoretical elaboration of Global Health, through participation, is presented as a strategic and necessary condition for facing transnational issues. This participation ensures political and epistemic diversity in establishing a global health committed to Global Health equity. The Latin American tradition that articulates research and action and the proposal for the Knowledge Meeting can contribute to participatory processes of constituting the field of Global Health in its practical and theoretical aspects.

Diet quality index and its components have not associated with the development of breast cancer risk assessed by the diet quality index: a case-control study.

OBJECTIVE: To investigate if the diet quality and its components are associated with breast cancer risk. METHODS: A case-control study was conducted with 332 women, 114 who were diagnosed with breast cancer, and 218 control individuals. Groups were matched for age, body mass index, and menopausal status. The quality of diet was assessed using Brazilian Healthy Eating Index Revised (BHEI-R) and its components. Food consumption was measured through three 24-h dietary recalls and assessed using the NDS-R software. For statistical analyses, it was performed an adjusted logistic regression, estimation of the Odds Ratio (OR), and 95% confidence interval (95%CI), with a p-value <0.05. RESULTS: The BHEI-R score, classified into quartiles, did not differ between groups in the lowest quartile of diet quality (p=0.853). The components total cereals (p=0.038), saturated fat (p=0.039) and Gord_AA (fat, alcohol, and added sugar) (p=0.023) had higher scores among the case group. The scores for total fruits (p=0.010) and milk and dairy products (p=0.039) were higher among the control group. The BHEI-R components and the quality of diet were not associated with the outcome. CONCLUSION: Diet quality, assessed by the BHEI-R and its components, was not associated with breast cancer.

Perfil demográfico y epidemiológico de los casos de dengue en un municipio de Brasil / Demographic and Epidemiological Profile of Dengue Cases in a Municipality from Brazil

Introducción: Las epidemias de dengue imponen una carga importante a los servicios de salud, además de la pérdida económica ocasionada por bajas temporales del trabajo o por años de vidas perdidas como consecuencia de la muerte, lo que interfiere en el desempeño de las economías de los países. Objetivo: Analizar el perfil demográfico, social y epidemiológico de los casos de dengue en la población de Contagem-MG, además de evaluar los factores climáticos con el fin de brindar herramientas para la planificación de estrategias de salud pública. Método: Se realizó un estudio ecológico, a partir de una serie de tiempo, entre los años 2013 a 2017, en el municipio de Contagem-MG en Brasil. Resultados: Los grupos más afectados fueron las mujeres, adultos, mestizos, individuos con pocos años de estudio y los que vivían en regiones periféricas. Más del 99 por ciento de las personas tenía dengue sin signos de alarma. Las lluvias no parecen haber sido determinantes para el aumento del número de casos, dado que hubo lluvias en todos los años. Conclusiones: Para mejorar la lucha contra las epidemias estacionales de dengue, se sugiere el enfoque de planificación estratégica, con la elección y definición de metodologías para planificar una estrategia intersectorial en la solución de situaciones recurrentes. Así se puede incrementar la eficiencia de las políticas públicas y, por ende, las posibilidades de una gestión pública exitosa en la reducción de inequidades(AU)

Introduction: Dengue epidemics impose a significant burden on health services, in addition to the economic loss caused by temporary leaves from work or deaths, which interferes in the economic performance of countries. Objective: To analyze the demographic, social and epidemiological profile of dengue cases in the population of Contagem-MG; and to evaluate climatic factors in order to provide tools for planning public health strategies. Methods: An ecological study was conducted from a time series between 2013 and 2017 in Contagem-MG municipality from Brazil. Results: The most affected groups were women, adults, mestizos, people with few years of schooling, and those living in peripheral regions. More than 99 percent of the people suffered from dengue without warning signs. Rain does not seem to be a determinant factor in the increase on the number of cases, since it rained every year. Conclusions: To better fight against dengue seasonal epidemics, the strategic planning approach is suggested, with the selection and definition of methodologies for planning an intersectoral strategy to solve recurrent events. This could increase the efficiency of public policies and, therefore, the possibility of successful public management in the reduction of inequities(AU)

Mentha aquatica L. aerial parts: in vitro anti-proliferative evaluation on human tumour and non-tumour cell lines.

Bearing in mind the several medicinal properties of Mentha genus, this work aimed to evaluate the anti-proliferative potential of the ethanolic extract (EE) and fractions from M. aquatica L aerial parts. Using the anti-proliferative protocol developed by the NCI/USA, four fractions (F2 - F4 and F6) obtained from EE showed promising anti-proliferative profile against a panel of human tumor and non-tumor cell lines. After 24-h exposure, F2 (0.25 µg/mL) showed potent and irreversible anti-proliferative effect without inducing cell cycle arrest in both NCI-H460 and MCF-7 cells, without (anti) estrogenic activity. These effects were lost after storage of F2 diluted in dimethyl sulfoxide at -80 °C during 2 weeks. Analysis by gas chromatography coupled to mass detection evidenced some chemical changes induced by F2 storage in solution. The present study demonstrated the anti-proliferative effect of M. aquatica. Further studies are necessary to determine better storage conditions to enhance F2 stability.

Inadequate distribution of dietary protein and muscle mass in older adults

Objective: To assess protein intake, protein distribution across meals, and a possible association between protein distribution and muscle mass in older adults. Methods: This cross-sectional study included 47 older adults attending a community center in Campo Grande, MS, Brazil. A sociodemographic questionnaire was used to characterize the population. Dietary intake data were collected using two 24-hour dietary recalls on nonconsecutive days. Anthropometric measures, such as weight, height, and body circumferences, and measures of handgrip strength were collected. Skeletal muscle mass was calculated from the anthropometric measures. Descriptive statistics were used to derive means and standard deviations. Analysis of variance and Tukey tests were performed, with a significance level of 5% (p < 0.05). Results:The older adults, mostly Caucasian, female, physically active, at risk of malnutrition, and with a low level of education, had an energy intake of 1,305.28 kcal/day. Protein intake was 65.19 g/day, with a mean of 0.93 g/kg/day. Lunch was the meal with the highest protein intake (33.85 ± 2.47 g). The lowest protein intake was observed at breakfast (8.56 ± 0.82 g). All meals were below the recommendation of 40 g of protein/meal. Protein intake at breakfast was associated with calf circumference (p = 0.04). Conclusions: The older adults consumed a low amount of total and per-meal protein. Breakfast showed the lowest protein intake, and this was associated with calf circumference in the study sample.

Objetivo: Avaliar o consumo proteico, sua distribuição nas principais refeições e sua possível associação com a massa muscular de idosos. Metodologia: Estudo transversal realizado com 47 idosos frequentadores de um centro de convivência em Campo Grande (MS). Aplicou-se um questionário sociodemográfico e dois recordatórios de 24 horas, em dias alternados, para a avaliação do consumo alimentar, e realizou-se avaliação antropométrica por meio da aferição de medidas como peso, estatura, circunferências corporais e a força de pressão palmar. Com as medidas antropométricas, foi calculada a quantidade de massa muscular esquelética. Realizou-se estatística descritiva e, para as análises de associação, aplicaram-se os testes de variância (ANOVA) e de Tukey, com significância estatística quando p < 0,05. Resultados: Os idosos, majoritariamente caucasianos, do sexo feminino, fisicamente ativos, em risco de desnutrição e com escolaridade reduzida apresentaram consumo energético de 1.305,28 kcal/dia e consumo proteico 65,19 g/dia, sendo 0,93 g de proteína/kg/dia. O almoço foi a refeição com maior aporte proteico (33,85 ± 2,47 g). O menor consumo proteico foi observado no café da manhã (8,56 ± 0,82 g). Todas as refeições ficaram abaixo da recomendação de 40 g de proteína/refeição. O consumo proteico no café da manhã associou-se à circunferência da panturrilha (p = 0.04). Conclusões: Os idosos consumiram baixa quantidade de proteínas totais e nas principais refeições. O café da manhã foi a refeição com menor aporte proteico e este associou-se à circunferência da panturrilha em idosos da amostra.

Diet quality index and its components have not associated with the development of breast cancer risk assessed by the diet quality index: a case-control study / Índice de qualidade da dieta e seus componentes não se associaram ao desenvolvimento de câncer de mama: um estudo caso-controle

ABSTRACT Objective: To investigate if the diet quality and its components are associated with breast cancer risk. Methods: A case-control study was conducted with 332 women, 114 who were diagnosed with breast cancer, and 218 control individuals. Groups were matched for age, body mass index, and menopausal status. The quality of diet was assessed using Brazilian Healthy Eating Index Revised (BHEI-R) and its components. Food consumption was measured through three 24-h dietary recalls and assessed using the NDS-R software. For statistical analyses, it was performed an adjusted logistic regression, estimation of the Odds Ratio (OR), and 95% confidence interval (95%CI), with a p-value <0.05. Results: The BHEI-R score, classified into quartiles, did not differ between groups in the lowest quartile of diet quality (p=0.853). The components total cereals (p=0.038), saturated fat (p=0.039) and Gord_AA (fat, alcohol, and added sugar) (p=0.023) had higher scores among the case group. The scores for total fruits (p=0.010) and milk and dairy products (p=0.039) were higher among the control group. The BHEI-R components and the quality of diet were not associated with the outcome. Conclusion: Diet quality, assessed by the BHEI-R and its components, was not associated with breast cancer.

RESUMO Objetivo: Avaliar se a qualidade da dieta e seus componentes estão associados ao desenvolvimento de câncer de mama. Métodos: Trata-se de estudo caso-controle com a participação de 332 mulheres, sendo 114 casos e 218 controles. Os grupos foram pareados por idade, índice de massa corporal e estado menopausal. A qualidade da dieta foi avaliada pelo Índice de Qualidade da Dieta Revisado (IQD-R) e seus componentes. O consumo alimentar foi mensurado por meio da aplicação de três recordatórios alimentares de 24 horas e analisados no software NDS-R. Foi realizada regressão logística ajustada, estimativa de odds ratio (OR) e intervalo de confiança de 95% (IC95%), com valor de p<0,05. Resultados: A pontuação do IQD-R, classificada em quartis, não diferiu entre os grupos no quartil inferior de qualidade da dieta (p=0,853). Os componentes cereais totais (p=0,038), gordura saturada (p=0,039) e Gord_AA (gordura, álcool e açúcar de adição) (p=0,023) tiveram maior pontuação no grupo caso. Já a pontuação de frutas totais (p=0,010) e leites e derivados (p=0,039) foi maior no grupo controle. Os componentes do IQD-R, assim como a qualidade da dieta, não se associaram ao desfecho investigado. Conclusão: A qualidade da dieta, avaliada pelo IQD-R e os seus componentes, não se associou ao câncer de mama.

Amiodarone-Induced Thyrotoxicosis - Literature Review & Clinical Update. / Tireotoxicose Induzida pela Amiodarona - Revisão de Literatura e Atualização Clínica.

Amiodarone is widely used in treating atrial and ventricular arrhythmias; however, due to its high iodine concentration, the chronic use of the drug can induce thyroid disorders. Amiodarone-induced thyrotoxicosis (AIT) can decompensate and exacerbate underlying cardiac abnormalities, leading to increased morbidity and mortality, especially in patients with left ventricular ejection fraction <30%. AIT cases are classified into two subtypes that guide therapeutic management. The risks and benefits of maintaining the amiodarone must be evaluated individually, and the therapeutic decision should be taken jointly by cardiologists and endocrinologists. Type 1 AIT treatment is similar to that of spontaneous hyperthyroidism, using antithyroid drugs (methimazole and propylthiouracil) at high doses. Type 1 AIT is more complicated since it has proportionally higher recurrences or even non-remission, and definitive treatment is recommended (total thyroidectomy or radioiodine). Type 2 AIT is generally self-limited, yet due to the high mortality associated with thyrotoxicosis in cardiac patients, the treatment should be implemented for faster achievement of euthyroidism. Furthermore, in well-defined cases of type 2 AIT, the treatment with corticosteroids is more effective than treatment with antithyroid drugs. In severe cases, regardless of subtype, immediate restoration of euthyroidism through total thyroidectomy should be considered before the patient progresses to excessive clinical deterioration, as delayed surgery indication is associated with increased mortality.

A amiodarona é amplamente utilizada no tratamento de arritmias atriais e ventriculares, porém devido sua alta concentração de iodo, o uso crônico da droga pode induzir distúrbios tireoidianos. A tireotoxicose induzida pela amiodarona (TIA) pode descompensar e exacerbar anormalidades cardíacas subjacentes, provocando aumento da morbidade e mortalidade, principalmente em pacientes com fração de ejeção do ventrículo esquerdo <30%. Os casos de TIA são classificados em dois subtipos que direcionam a conduta terapêutica. Os riscos e benefícios de manter a amiodarona devem ser avaliados de maneira individualizada, e a decisão de continuar ou suspender a droga deve ser tomada conjuntamente por cardiologistas e endocrinologistas. O tratamento de TIA tipo 1 é semelhante ao do hipertireoidismo espontâneo, sendo indicado o uso de drogas antitireoidianas (metimazol e propiltiouracil) em doses elevadas. A TIA tipo 1 mostra-se mais complicada, pois apresenta proporcionalmente maiores números de recorrências ou até mesmo a não remissão do quadro, sendo recomendado o tratamento definitivo (tireoidectomia total ou radioiodo). TIA tipo 2 é geralmente autolimitada, mas devido a elevada mortalidade associada a tireotoxicose em pacientes cardiopatas, o tratamento deve ser instituído para que o eutireoidismo seja atingido mais rapidamente. Em casos bem definidos de TIA tipo 2, o tratamento com corticosteroides é mais efetivo do que o tratamento com drogas antitireoidianas. Em casos graves, independentemente do subtipo, a restauração imediata do eutiroidismo por meio da tireoidectomia total deve ser considerada antes que o paciente evolua com piora clínica excessiva, pois a demora na indicação da cirurgia está associada ao aumento da mortalidade.

Tireotoxicose induzida pela amiodarona - revisão de literatura e atualização clínica / Amiodarone-induced thyrotoxicosis - literature review & clinical update

Resumo A amiodarona é amplamente utilizada no tratamento de arritmias atriais e ventriculares, porém devido sua alta concentração de iodo, o uso crônico da droga pode induzir distúrbios tireoidianos. A tireotoxicose induzida pela amiodarona (TIA) pode descompensar e exacerbar anormalidades cardíacas subjacentes, provocando aumento da morbidade e mortalidade, principalmente em pacientes com fração de ejeção do ventrículo esquerdo <30%. Os casos de TIA são classificados em dois subtipos que direcionam a conduta terapêutica. Os riscos e benefícios de manter a amiodarona devem ser avaliados de maneira individualizada, e a decisão de continuar ou suspender a droga deve ser tomada conjuntamente por cardiologistas e endocrinologistas. O tratamento de TIA tipo 1 é semelhante ao do hipertireoidismo espontâneo, sendo indicado o uso de drogas antitireoidianas (metimazol e propiltiouracil) em doses elevadas. A TIA tipo 1 mostra-se mais complicada, pois apresenta proporcionalmente maiores números de recorrências ou até mesmo a não remissão do quadro, sendo recomendado o tratamento definitivo (tireoidectomia total ou radioiodo). TIA tipo 2 é geralmente autolimitada, mas devido a elevada mortalidade associada a tireotoxicose em pacientes cardiopatas, o tratamento deve ser instituído para que o eutireoidismo seja atingido mais rapidamente. Em casos bem definidos de TIA tipo 2, o tratamento com corticosteroides é mais efetivo do que o tratamento com drogas antitireoidianas. Em casos graves, independentemente do subtipo, a restauração imediata do eutiroidismo por meio da tireoidectomia total deve ser considerada antes que o paciente evolua com piora clínica excessiva, pois a demora na indicação da cirurgia está associada ao aumento da mortalidade.

Abstract Amiodarone is widely used in treating atrial and ventricular arrhythmias; however, due to its high iodine concentration, the chronic use of the drug can induce thyroid disorders. Amiodarone-induced thyrotoxicosis (AIT) can decompensate and exacerbate underlying cardiac abnormalities, leading to increased morbidity and mortality, especially in patients with left ventricular ejection fraction <30%. AIT cases are classified into two subtypes that guide therapeutic management. The risks and benefits of maintaining the amiodarone must be evaluated individually, and the therapeutic decision should be taken jointly by cardiologists and endocrinologists. Type 1 AIT treatment is similar to that of spontaneous hyperthyroidism, using antithyroid drugs (methimazole and propylthiouracil) at high doses. Type 1 AIT is more complicated since it has proportionally higher recurrences or even non-remission, and definitive treatment is recommended (total thyroidectomy or radioiodine). Type 2 AIT is generally self-limited, yet due to the high mortality associated with thyrotoxicosis in cardiac patients, the treatment should be implemented for faster achievement of euthyroidism. Furthermore, in well-defined cases of type 2 AIT, the treatment with corticosteroids is more effective than treatment with antithyroid drugs. In severe cases, regardless of subtype, immediate restoration of euthyroidism through total thyroidectomy should be considered before the patient progresses to excessive clinical deterioration, as delayed surgery indication is associated with increased mortality.

ENTPDases from Pathogenic Trypanosomatids and Purinergic Signaling: Shedding Light towards Biotechnological Applications.

ENTPDases are enzymes known for hydrolyzing extracellular nucleotides and playing an essential role in controlling the nucleotide signaling via nucleotide/purinergic receptors P2. Moreover, ENTPDases, together with Ecto-5´-nucleotidase activity, affect the adenosine signaling via P1 receptors. These signals control many biological processes, including the immune system. In this context, ATP is considered as a trigger to inflammatory signaling, while adenosine (Ado) induces anti-inflammatory response. The trypanosomatids Leishmania and Trypanosoma cruzi, pathogenic agents of Leishmaniasis and Chagas Disease, respectively, have their own ENTPDases named "TpENTPDases," which can affect the nucleotide signaling, adhesion and infection, in order to favor the parasite. Besides, TpENTPDases are essential for the parasite nutrition, since the Purine De Novo synthesis pathway is absent in them, which makes these pathogens dependent on the intake of purines and nucleopurines for the Salvage Pathway, in which TpENTPDases also take place. Here, we review information regarding TpNTPDases, including their known biological roles and their effect on the purinergic signaling. We also highlight the roles of these enzymes in parasite infection and their biotechnological applications, while pointing to future developments.