Effects of calcium supplementation on changes in the IL2, IL4, IL6, IL10 axes and oxidative stress in pregnant women at risk for pre-eclampsia.

BACKGROUND: Pregnant women with hypertensive disorders are at increased risk for inflammatory diseases and oxidative stress. The dilemma raised by the best dosage of calcium supplementation on these factors is evident. The aim of the current study was to examine the effects of calcium on biomarkers of the purinergic system, inflammation and oxidative stress, which are factors contributing to vascular damage in pregnant women at high risk of pre-eclampsia. METHODS: A prospective, double-blind and placebo-controlled study conducted with 101 women at risk of pre-eclampsia were randomized to take 500 mg calcium/day or 1,500 mg calcium/day or placebo for 6 weeks from the 20th gestational week until delivery. Fasting blood samples were collected at the beginning of the study and 6 weeks after the intervention. RESULTS: Taking calcium supplements (500 mg calcium/day) led to a significant increase in ATP hydrolysis (p < 0.05), NTPDase activity with increased hydrolysis of ADP and AMP nucleotides in platelets and lymphocytes. In the intragroup analysis IL-2, IL-6, IL-4 and interferon-É£ presented lower values in the calcium 1,500 mg/day group (p < 0.005). Oxidative stress was assessed by TBARS pro-oxidant marker, with an increase for the calcium groups when compared to the placebo group. The Vitamin C antioxidant marker presented a significant increase (p < 0.005) for the group that received high calcium doses. CONCLUSIONS: Calcium administration for 6 weeks had antioxidant action and positively modulated the purinergic system and inflammatory markers in pregnant women at risk of pre-eclampsia.

Nutritional profile and biochemical alterations in non-institutionalized senior citizens with Alzheimer disease: a case-control study / Perfil nutricional e alterações bioquímicas em idosos com doença de Alzheimer não institucionalizados: um estudo caso-controle

Assess the nutritional and biochemical state of patients with Alzheimer Disease (AD) compared to a control group. This is an observational, case-control and descriptive type study, based on the recruiting of 22 elderly individuals with a clinical diagnosis of AD considered as the case group, and 22 other elderly individuals considered as the control group. Evaluations were made using the results from the following scales Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), anthropometric measurements for obtaining the body mass index (BMI) and biochemical analyses. The analyses were performed on the program SPSS version 20.0, using absolute and relative measures, T test for independent samples for measurement comparisons and the Spearman correlation test. In the cognitive evaluation MMSE, those participants with AD present higher risk of cognitive decline (81.8%), greater risk of malnutrition according to MNA (45.5%) and altered levels of leptin (90.9%). Upon performing the comparison analysis between the group with AD and the control group, there existed noteworthy differences between the means for the variables MNA (4.40; BMI95% 2.75 ­ 6.06), MMSE (10.54; BMI95% 7.09 ­ 13.99) and doses of HDL (High Density Lipoproteins) (14.53; BMI95% 6.18 ­ 22.88). As well as differences in the p-value < 0.09 in the leptin doses (11.54; BMI95% (-24.98 ­ 1.89) and transferrin dose (-72.31; BMI95% -159.48 ­ 14.84). The Spearman correlation demonstrated that the cognitive decline in the group of senior citizens with AD was strongly associated with nutritional conditions MNA (R 0.484) and the leptin dose (R 0.590). Senior citizens with AD present worse nutritional conditions, cognitive decline and biochemical alterations when compared to senior citizens in the control group. As such, the study demonstrated the need for an integrated healthcare assistance concerning senior citizens with AD.

Avaliar o estado nutricional e bioquímico de pacientes com Doença de Alzheimer (DA) comparando com um grupo controle. Materiais e métodos: trata-se de um tipo observacional, caso-controle e descritivo a partir do recrutamento de 22 idosos diagnosticados clinicamente com DA considerados grupo caso e outros 22 idosos considerados controle, foi utilizado a escala Mini Avaliação nutricional (MNA), Mini Exame do Estado Mental (MMSE), medidas antropométricas para obtenção do índice de massa corporal (IMC) e análises bioquímicas. As análises foram realizadas no programa SPSS versão 20.0, utilizou-se de medidas absolutas e relativas, teste T para amostras independentes para comparação de médias e o teste de correlação de Spearman. Na avaliação cognitiva MMSE os participantes com DA apresentaram maior prevalência de declínio cognitivo (81,8%), maior prevalência de risco para desnutrição segundo MNA (45,5%) e níveis alterados de leptina (90,9%). Ao se realizar a análise de comparação o grupo com DA e o controle observou-se diferenças significativas entre as médias das variáveis MNA (4,40; IC95% 2,75 ­ 6,06), MMSE (10,54; IC95% 7,09 ­ 13,99) e dosagens de HDL (14,53; IC95% 6,18 ­ 22,88). E diferenças com o p-valor < 0,09 nas dosagens de leptina (11,54; IC95% (-24,98 ­ 1,89) e dosagem de transferrina (-72,31; IC95% -159,48 ­ 14,84). A correlação de Spearman demonstrou que o declínio cognitivo no grupo de idosos com DA, esteve associado significativamente às condições nutricionais MNA (R 0,484) e dosagem de leptina (R 0,590). Idosos com DA apresentaram piores condições nutricionais, declínio cognitivo e alterações bioquímicas, ao compara-los com idosos controles. Desta forma, o estudo demonstra a necessidade de uma assistência integral a esses idosos.

Hospitalizations due to primary care sensitive conditions: an ecological study.

OBJECTIVE: To evaluate the trend of hospitalizations due to primary care sensitive conditions and its relationship with the Family Health Strategy coverage. METHODS: Ecological study of time series using the records from the Hospital Information System, from 2005 to 2015, with data for the state of Goiás, Brazil. Trend analyses were performed by the generalized linear regression method of Prais-Winsten with robust variance, which allowed to verify if the trend of hospitalizations due to primary care sensitive conditions was stationary (p > 0.05), declining (p < 0.05 and negative regression coefficient), or ascending (p < 0.05 and positive regression coefficient) in each region of Goiás and for each diagnosis group, stratified by sex. Pearson correlation was used to verify the degree of association between the Family Health Strategy coverage and the rate of hospitalizations due to primary care sensitive conditions. RESULTS: Hospitalizations due to primary care sensitive conditions accounted for 1,092,070 (30.0%) of hospitalizations in Goiás. The average hospitalizations rate due to primary care sensitive conditions was statically less than the rate for other conditions in the analyzed period (167.6% against 386.2%; t = -13.18; p < 0.001). There has been a downward trend in hospitalizations trend due to primary care sensitive conditions in Goiás and in most health regions. The trends varied between sexes in the groups of causes. We observed a negative correlation between the Family Health Strategy coverage and the hospitalizations trend due to primary care sensitive conditions in the state and also in most health regions. CONCLUSIONS: Hospitalizations due to primary care sensitive conditions had a significant reduction trend over the analyzed period. Despite this progressive decrease, this rate remains high and the reduction trend was not linear for all causes. These results allow for directing public policies, while drawing a general overview of hospitalizations due to primary care sensitive conditions by sex and region in the state.