Metabolic profile of patients with endometrial adenocarcinoma and association with tumor grade.

OBJECTIVE: To describe the prevalence of metabolic syndrome and other metabolic indicators in patients with endometrial cancer and its association with tumor grade. METHODS: This is a cross-sectional study of patients with endometrial cancer referred to the Brazilian National Cancer Institute. We collected data on sociodemographic variables, smoking, co-morbidities, physical activity level, menopausal status, and tumor characteristics (histological subtype, stage, and tumor grade). In addition, weight, height, and waist circumference were measured. Laboratory evaluation included lipid profile, fasting blood glucose and insulin, and C-reactive protein. Insulin resistance was estimated by the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Characterization of metabolic syndrome and cardiovascular risk profile was performed. Binary logistic regression models were used to test the association between metabolic syndrome and its metabolic parameters, HOMA-IR, and C-reactive protein with tumor grade. RESULTS: We included a total of 313 patients, 245 (78.3%) aged <65 years, 262 (83.7%) with endometrioid adenocarcinoma, 193 (61.7%) early stage, and 201 (64.2%) with lower tumor grade (G1 and G2). Metabolic syndrome, insulin resistance, and low levels of leisure-time physical activity were highly prevalent (90.7%). In binary logistic regression models, an association was observed between HOMA-IR and lower tumor grade (p<0.05), while high-grade tumors were associated with the highest C-reactive protein values (p<0.05). CONCLUSION: The main finding of this study was the association between insulin resistance and low-grade tumors, and the association between high C-reactive protein levels and high-grade tumors.

Prevalence of chronic pulmonary aspergillosis regarding time of tuberculosis diagnosis in Brazil.

BACKGROUND: Data on the prevalence of chronic pulmonary aspergillosis (CPA) in patients with active or cured tuberculosis (TB) are scarce, mainly due to diagnostic difficulties. The diagnosis of CPA is based on pulmonary symptoms and chest computed tomography (CT) scans and is considered confirmed when there is microbiological or serological evidence of Aspergillus spp. OBJECTIVES: To estimate the prevalence of CPA in patients treated or undergoing treatment for PTB, seen in two referral hospitals in Mato Grosso do Sul, Brazil. PATIENTS AND METHODS: A total of 193 consecutive patients who were treated or previously treated for pulmonary tuberculosis underwent prospective evaluation: (a) clinical evaluation; (b) chest CT scan; (c) sputum examination-culture for fungi and smears for direct mycology; (d) detection of anti-Aspergillus fumigatus antibodies using an enzyme-linked immunosorbent assay Platelia® test; and (e) anti-Aspergillus spp. antibodies were assessed via a DID test. RESULTS: The global prevalence of CPA was 10.9% (95% confidence interval, 7.2%-16.1%), but it increased with the time of TB diagnosis. The variables independently associated with CPA were previous pulmonary tuberculosis over 4 years ago and haemoptysis. Cavities, pleural thickening and the presence of a fungal ball were the most frequent tomographic findings in patients with CPA. CONCLUSIONS: The high prevalence observed and its increase over time suggest the need for continuous surveillance of CPA in patients with active or previous pulmonary tuberculosis and throughout life, with clinical, tomographic and serological evaluations (ELISA) for a timely diagnosis and a better prognosis.

The prevalence and prognostic impact of tumor-infiltrating lymphocytes in uterine carcinosarcoma.

OBJECTIVE: To examine the prevalence and prognostic role of tumor microenvironment (TME) markers in uterine carcinosarcoma (UCS) through immunohistochemical characterization. METHODS: The internal database of our institution was queried out for women with UCS who underwent surgery and thereafter postoperative chemotherapy with carboplatin and paclitaxel between January 2012 and December 2017. Tissue microarrays containing surgical samples of UCS from 57 women were assessed by immunohistochemistry for CD3, CD4, CD8, FOXP3, PD-1, PD-L1, and PD-L2. RESULTS: The mean age was 65.3 years (range, 49 to 79 years). For the epithelial component (E), CD3_E and CD4_E were highly expressed in 38 (66.7%) and in 40 (70.1%) patients, respectively, and were significantly associated with more advanced stages (p = 0.038 and p = 0.025, respectively). CD8_E was highly expressed in 42 (73.7%) patients, FOXP3_E 16 (28.1%), PD-1_E 35 (61.4%), PD-L1_E 27 (47.4%) and PD-L2_E 39 (68.4%). For the sarcomatous component (S), the prevalence of high expression was: CD3_S 6 (10.5%), CD4_S 20 (35.1%), CD8_S 44 (77.2%), FOXP3_S 8 (14%), PD-1_S 14 (24.6%), PD-L1_S 14 (24.6%) and PD-L2_S 8 (14%). By multivariate analysis, the CD8/FOXP3_S ratio (p = 0.026), CD4_E (p = 0.010), PD-L1_E (p = 0.013) and PD-L1_S (p = 0.008) markers significantly influenced progression-free survival. CD4/FOXP3_S ratio (p = 0.043), PD-1_E (p = 0.011), PD-L1_E (p = 0.036) and PD-L1_S (p = 0.028) had a significant association with overall survival. CONCLUSION: Some differences in UCS clinical outcomes may be due to the subtype of TILs and PD-1/PD-L1 axis immune checkpoint signaling.

The papillomavirus E5 gene does not affect EGFR transcription and overall survival in cervical cancer.

INTRODUCTION: The human papillomavirus (HPV) E5 gene encodes a small and highly hydrophobic oncoprotein that affects immune evasion, cell proliferation, loss of apoptotic capacity and angiogenesis in tumors. E5 shows an affinity for biological membranes and was associated with an increase of epidermal growth factor/epidermal growth factor receptor (EGF/EGFR) signaling through the accumulation of EGFR in cellular membranes. Due to the frequent integration of the HPV genome into the host cell genome, E5 is frequently not transcribed in cervical tumors. AIM: In this study we looked forward to verifying whether the potential expression of E5 protein in human papillomavirus 16 positive (HPV16+ ) and human papillomavirus 18 positive (HPV18+ ) cervical tumors was associated with levels of EGFR and vascular endothelial growth factor A (VEGFA) transcription and with patients overall survival. RESULTS: Association between the presence of E5 transcripts and viral genome disruption was observed for HPV16+ and HPV18+ tumors. Association was not observed between tumors potentially capable of translating E5 and EGFR or VEGFA transcriptional levels. Similarly, the capability of translating E5 and overall survival in patients with HPV16+ squamous cell carcinoma tumors stage ≥ IB2 were not associated. CONCLUSION: The likely presence of E5 transcripts was neither associated to a higher activity of the EGFR-VEGFA pathway nor to the overall survival of patients with HPV16+ squamous cell carcinoma in stages ≥ IB2.

Affectivity in schizophrenia: Its relations with functioning, quality of life, and social support satisfaction.

OBJECTIVE: To evaluate the relationship between affectivity and sociodemographic and clinical characteristics, quality of life, functioning, and social support satisfaction in schizophrenia. METHOD: Cross-sectional study of a sample of 282 schizophrenic patients. An interview was performed using a sociodemographic and clinical questionnaire and scales to evaluate positive and negative affect, quality of life, social support satisfaction, and functioning. RESULTS: Participants' employment status, gender, whether they smoked, hospitalization in the last year, antidepressant medication and benzodiazepines, quality of life, functioning, and satisfaction with social support had relationships with positive or negative affect. CONCLUSION: This study provides further understanding of the factors related to affectivity in schizophrenia. More studies are needed to prove these relations and their effects on rehabilitation in people with schizophrenia.

Non-clonal occurrence of pmrB mutations associated with polymyxin resistance in carbapenem-resistant Klebsiella pneumoniae in Brazil.

BACKGROUND: Polymyxins are currently used as a "last-line" treatment for multidrug-resistant Gram-negative infections. OBJECTIVES: To identify the major mechanisms of resistance to polymyxin and compare the genetic similarity between multi-drug resistant Klebsiella pneumoniae strains recovered from inpatients of public hospitals in the Mid-West of Brazil. METHODS: 97 carbapenems non-susceptible K. pneumoniae were studied. ß-lactamases (bla OXA-48, bla KPC, bla NDM, bla CTX-M, bla SHV, bla TEM, bla IMP, bla VIM) and mcr-1 to mcr-5 genes were investigated by polymerase chain reaction (PCR). Mutations in chromosomal genes (pmrA, pmrB, phoP, phoQ, and mgrB) were screened by PCR and DNA sequencing. Clonal relatedness was established by using pulsed-field gel electrophoresis and multilocus sequence typing. FINDINGS: K. pneumoniae isolates harbored bla KPC (93.3%), bla SHV (86.6%), bla TEM (80.0%), bla CTX-M (60%) genes. Of 15 K. pneumoniae resistant to polymyxin B the authors identified deleterious mutations in pmrB gene, mainly in T157P. None K. pneumoniae presented mcr gene variants. Genetic polymorphism analyses revealed 12 different pulsotypes. MAIN CONCLUSIONS: Deleterious mutations in pmrB gene is the main chromosomal target for induction of polymyxin resistance in carbapenem-resistant K. pneumoniae in public hospitals in the Mid-West of Brazil.

Overweight and obesity do not determine worst prognosis in endometrioid endometrial carcinoma.

PURPOSE: The aim of this study was to investigate the impact of body mass index (BMI) on disease-free survival (DFS) and overall survival (OS) in women diagnosed with EEC and treated at the Brazilian National Cancer Institute. METHODS: The study comprised 849 women diagnosed with EEC who underwent surgical treatment between January, 2000 and December, 2011. The demographic and clinical characteristics of these patients were collected from medical records and their nutritional status was based on the BMI criteria. Univariate (OS and DFS) and multivariate analyses were performed using the Kaplan-Meier method and Cox proportional hazards models, respectively. RESULTS: About 83.2% of patients were obese or overweight at time of diagnosis, with a mean BMI of 31.83. Patients were followed for an average of 34.97 months. There were 111 recurrences (13.1%) and 140 deaths (16.5%), with mean DFS of 51.90 months and mean OS of 52.25 months. There was no significant association between BMI and DFS or OS. In multivariate analysis we did not find an increased hazard of recurrence or death among overweight or obese patients. CONCLUSION: Overweight and obesity had no impact on EEC prognosis on the assessed cohort. Further studies are warranted.

Fatal Cronobacter sakazakii Sequence Type 494 Meningitis in a Newborn, Brazil.

We describe a case of infection with Cronobacter sakazakii sequence type 494 causing bacteremia and meningitis in a hospitalized late premature infant in Brazil. We conducted microbiological analyses on samples of powdered infant formula from the same batch as formula ingested by the infant but could not identify the source of contamination.

Second-Sphere Effects in Dinuclear FeIIIZnII Hydrolase Biomimetics: Tuning Binding and Reactivity Properties.

Herein, we report the synthesis and characterization of two dinuclear FeIIIZnII complexes [FeIIIZnIILP1] (1) and [FeIIIZnIILP2] (2), in which LP1 and LP2 are conjugated systems containing one and two pyrene groups, respectively, connected via the diamine -HN(CH2)4NH- spacer to the well-known N5O2-donor H2L ligand (H2L = 2-bis{[(2-pyridylmethyl)aminomethyl]-6-[(2-hydroxybenzyl)(2-pyridylmethyl)]aminomethyl}-4-methylphenol). The complex [FeIIIZnIIL1] (3), in which H2L was modified to H2L1, with a carbonyl group attached to the terminal phenol group, was included in this study for comparison purposes.1 Both complexes 1 and 2 were satisfactorily characterized in the solid state and in solution. Extended X-ray absorption fine structure data for 1 and 3 in an acetonitrile solution show that the multiply bridged structure seen in the solid state of 3 is retained in solution. Potentiometric and UV-vis titration of 1 and 2 show that electrostatic interaction between the protonated amino groups and coordinated water molecules significantly decreases the pKa of the iron(III)-bound water compared to those of 3. On the other hand, catalytic activity studies using 1 and 2 in the hydrolysis of the activated substrate bis(2,4-dinitrophenyl)phosphate (BDNPP) resulted in a significant increase in the association of the substrate (Kass ≅ 1/KM) compared to that of 3 because of electrostatic and hydrophobic interactions between BDNPP and the side-chain diaminopyrene of the ligands H2LP1 and H2LP2. In addition, the introduction of the pyrene motifs in 1 and 2 enhanced their activity toward DNA and as effective antitumor drugs, although the biochemical mechanism of the latter effect is currently under investigation. These complexes represent interesting examples of how to promote an increase in the activity of traditional artificial metal nucleases by introducing second-coordination-sphere effects.

Genetic diversity of human papillomavirus types 35, 45 and 58 in cervical cancer in Brazil.

In Brazil, most studies of intra-type variants of human papillomavirus (HPV) have focused on HPV16 and HPV18, but other high-risk HPV types have not been studied. Here, we report the prevalence of lineages and variants of HPV35, HPV45 and HPV58 in cervical cancers from the Amazonian and Southeast Brazilian regions. The most frequent sublineages were A1 for HPV35, B2 for HPV45, and A2 for HPV58. The Southeast region had a higher frequency of the B2 sublineage of HPV45, and for HPV35, the genetic and nucleotide sequence diversity were higher in the Southeast region, suggesting that regional factors are influencing the diversity and lineage prevalence.

Domestic violence in pregnancy: prevalence and characteristics of the pregnant woman.

AIMS AND OBJECTIVES: To determine the prevalence of domestic violence (physical, psychological or sexual) during pregnancy and to characterise these women. BACKGROUND: Pregnant women are not immune to domestic violence and therefore may be subject to any form of physical, psychological or sexual violence by partners. Health professionals' knowledge and awareness are important in the identification and intervention of pregnant women who experience domestic violence. METHODS: Quantitative, descriptive, correlational study, using a nonprobabilistic convenience sample consisting of a total of 852 postpartum women, of whom 370 were experiencing domestic violence according to the criteria adopted through the modified scale of prevalence, applied between February-June 2012 in two Portuguese public health institutions. Authorisation was given by the Ethics Committees/Administration Councils of both institutions involved and the National Committee of Data Protection. RESULTS: The prevalence of DV during pregnancy was 43·4% (physical violence - 21·9%; psychological violence - 43·2%; and sexual violence - 19·6%). These women had the following profile: immigrant (OR = 5·70; IC95% 3·32-9·78), non-Caucasian (OR = 6·27; IC95% 3·76-10·46), single/divorced/widowed (OR = 2·28; IC95% 1·70-3·05), academic qualifications up to year 9 (OR = 4·94; IC95% 3·31-7·37); between 10-12 years of schooling (OR = 2·36; IC95% 1·70-3·29); unemployed (OR = 2·01; IC95% 1·50-2·69); and with a monthly income <1000 euros (OR = 1·90; IC95% 1·44-2·50). Through logistic regression, the following protective factors have been identified: nationality (Portuguese), race (Caucasian) and place of residence (city). CONCLUSIONS: Almost half of the sample had experienced some form of domestic violence. This is associated with certain sociodemographic factors identified in the study. Psychological violence was the most prevalent during pregnancy. RELEVANCE TO CLINICAL PRACTICE: Knowledge of the prevalence and characteristics of pregnant women who experience domestic violence is of paramount importance in planning appropriate strategies for their needs during pregnancy. Results indicate the need for nurses to intervene when warning signs of domestic violence against pregnant women are detected.

Influence of sociodemographic and clinical characteristics on the quality of life of patients with schizophrenia.

OBJECTIVE: Evaluating the quality of life of Portuguese patients with schizophrenia and linking it to sociodemographic and clinical aspects. METHOD: A quantitative cross-sectional study carried out with individuals affected by schizophrenia, living in the entire continental territory of Portugal, through application of a sociodemographic and clinical questionnaire and the Quality of Life Scale short version (QLS7PT). Parametric and non-parametric tests were performed to evaluate the correlation between variables. RESULTS: The sample consisted of 282 participants. The results point to a better quality of life for individuals living in autonomous residences or with their parents, who are employed/students, who have had the disorder for less time and are younger, who have completed the 12th grade of schooling and who are not medicated with first-generation neuroleptics. CONCLUSION: The results indicate that some sociodemographic and clinical characteristics influence the quality of life of patients with schizophrenia and should be considered in the patient evaluation and in planning appropriate and effective strategies for their psychosocial rehabilitation. OBJETIVO: Avaliar a qualidade de vida dos indivíduos portugueses com esquizofrenia e relacioná-la com aspetos sociodemográficos e clínicos. MÉTODO: Estudo quantitativo de natureza transversal realizado com portadores de esquizofrenia, residentes em todo o território continental de Portugal, tendo sido aplicado um questionário sociodemográfico e clínico e a Quality of Life Scale versão reduzida (QLS7PT). Foram realizados testes paramétricos e não paramétricos para avaliar a correlação entre as variáveis. RESULTADOS: A amostra foi constituída por 282 participantes. Apontam para uma melhor qualidade de vida os indivíduos que vivem em residências autônomas ou com os pais, empregados/estudantes, com transtorno há menos tempo e menor idade, com o 12º ano de escolaridade e não medicados com neurolépticos de primeira geração. CONCLUSÃO: Os resultados indicam que algumas características sociodemográficas e clínicas influenciam a qualidade de vida dos indivíduos com esquizofrenia, pelo que devem ser consideradas na avaliação psiquiátrica e no planejamento das estratégias adaptadas e eficazes à sua reabilitação psicossocial. OBJETIVO: Evaluar la calidad de vida de los individuos portugueses con esquizofrenia y relacionarla con aspectos sociodemográficos y clínicos. MÉTODO: Estudio cuantitativo de naturaleza transversal realizado con portadores de esquizofrenia, residentes en todo el territorio continental de Portugal, habiendo sido aplicado un cuestionario sociodemográfico y clínico y la Quality of Life Scale versión reducida (QLS7PT). Se realizaron pruebas paramétricas y no paramétricas para evaluar la correlación entre las variables. RESULTADOS: La muestra fue constituida por 282 participantes. Los resultados apuntan a una mejor calidad de vida de quienes residen en residencias autónomas o con los padres, los empleados / estudiantes, con trastorno por menos tiempo y menor edad, con 12 años de escolaridad y no medicados con neurolépticos de primera generación. CONCLUSIÓN: Los resultados indican que algunas características sociodemográficas y clínicas influyen en la calidad de vida de los individuos con esquizofrenia, por lo que deben ser consideradas en la evaluación psiquiátrica y en la planificación de las estrategias adaptadas y eficaces a su rehabilitación psicosocial.

Genetic diversity of HPV16 and HPV18 in Brazilian patients with invasive cervical cancer.

Cervical cancer is the fourth most common cancer among women, and ∼70-80% of these cancers are associated with two human papillomavirus types: HPV16 and HPV18. Several studies have reported that intra-type diversity is associated with the progression of infection to invasive cancer. Herein, we report the genetic diversity of HPV16 and HPV18 in a cohort of 594 Brazilian women with invasive cervical cancer and describe the prevalence of lineages and intra-type diversity prior to the implementation of the public immunization program in Brazil. HPV detection and genotyping were performed using PCR, PGMY/GP primers, and DNA extracted from fresh tumors. The HPV16 (378 women) and HPV18 (80 women) lineages were identified by PCR and sequencing of the LCR and E6 fragments, followed by SNV comparison and phylogenetic analysis. In our cohort, was found a higher frequency of the lineage A (in 217 women), followed by lineage D (in 97 women) and lineages B and C (in 10 women each) for HPV16; and a higher frequency of lineage A (in 56 women) followed by lineage B (in 15 women) in HPV18. The genetic diversity of HPV16 indicated a recent expansion of specific variants or a selective advantage that is associated with invasive cancer; this pattern was not observed for HPV18.

Construction and validation of the Scale Sources of Information about AIDS (SSIA).

OBJECTIVE: To characterize sources of information students of higher education turn to for clarification about AIDS. RESEARCH DESIGN: Cross-sectional, non-experimental research, with the features of descriptive, correlational and explanatory studies. The data collection protocol includes personal and academic data and the sources of information about AIDS scale. PARTICIPANTS: 2002 students participated, 60.7% girls (X=21.76; years ± 4.43 SD), of the first and last years of higher education in the North and Centre of Portugal. RESULTS: Students rely mainly on reading informational materials for information about AIDS. Approximately 37% have good information on AIDS with young people up to the age of 25 and attending courses in field of health having higher scores. CONCLUSIONS: Changes are needed in health education models in the area of HIV/AIDS, since these are not showing a satisfactory level of efficiency. On the other hand, it is important to motivate young people to change their behaviours. Although many young people have knowledge, they do not change their risk behaviours.

Sleep-wake patterns and their influence on school performance in Portuguese adolescents.

OBJECTIVE: To characterise sleep-wake patterns and their influence on academic performance for a sample of Portuguese adolescents. RESEARCH DESIGN: Cross-sectional, analytical-explanatory, correlational epidemiological research. The protocol includes the composite morningness questionnaire (Barton et al, 1985 adapted by Silva et al, 1985), the Epworth Sleepiness Scale (Murray, 1991), chronic fatigue scale (Smith et al, 1995), the Pittsburgh Sleep Quality Index (Buysse, 1988), Educational Achievement (Fermin, 2005), personal and academic data. PARTICIPANTS: 2094 students (55.3% girls; 16-23 years old; M=16.82±1.25) attending secondary school in central Portugal. Living in urban areas, living with their parents and about 57.1% are in a family with reasonable economic resources. RESULTS: Adolescents' sleep patterns reveal that they sleep on average between 8-9 hours a night, do not use medication to sleep, with sleep latency within the normal range, with good sleep efficiency, without daytime dysfunction and with undisturbed sleep, predominantly intermediate chronotype. Minor drowsiness, increased sleep efficiency, improved subjective sleep satisfaction, less sleep disturbance, less daytime dysfunction, not consuming hypnotic medications, associated with better academic performance. Morningness/eveningness, sleep efficiency, daytime dysfunction and sleep latency emerge as predictors of academic performance. The chronotype interacts to predict the quality of sleep enhancing it as a mediator of school performance. CONCLUSIONS: Sleep and associated individual characteristics should be considered in the diagnosis and intervention process in secondary education.

Scale of knowledge about sexually transmitted infections.

Adherence of adolescents to health practices in the context of sexuality is relevant, not only from the point of view of physical and psychological well-being, but also the model effect of their knowledge of infections transmitted sexually and their behaviours may have on other adolescents and lifestyles adopted. The need thus emerges to work with this target group with issues related with their knowledge of sexually transmitted infections, debating and reflecting on everyday situations of social life in the context of sexuality.

Pregnancy and childbirth: What changes in the lifestyle of women who become mothers?

Pregnancy is a period influenced by the interaction of several factors, therefore this study aimed to identify changes in lifestyles due to pregnancy and childbirth in Portuguese and immigrant women in Portugal. This is a qualitative study, using the semi-structured interview, with eighty-two Portuguese and immigrant women. Content analysis was used, with verbatim classification supported by Nvivo 10. It was authorized by an Ethics Commission. Results revealed that the primary changes in lifestyles due to pregnancy were in eating habits (nutrition), daily activity, exposure to danger, sleep and rest patterns, social and family relationships, going out, self-care, work, clothing and footwear, travel, health monitoring and sexual activity and substances consumption. The main change after the birth, manifested by these women, was that their lives began to revolve around their baby.

Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central Portugal.

This cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment's effectiveness.

Development and Rapid Sensory Descriptive Characterization of Cereal Bars Made with Brazilian Licuri Nut (Syagrus coronata).

Licuri (Syagrus coronata) is an oilseed fruit common in the Brazilian caatinga and cerrado biomes. This fruit has high socioeconomic importance in the regions where it grows, being incorporated into exported animal feed and also into gastronomic preparations. Cereal bars are ready-to-eat highly consumed products with increased demand, commonly made with cereals and oilseeds such as licuri. In this sense, the incorporation of licuri in cereal bars may increase its socioeconomic value and expand its potential use. Thus, the objective of the study was to analyze acceptance and describe the sensory characteristics of cereal bars incorporated with licuri nuts. This study was conducted in four stages: (1) development of samples; (2) chemical composition analysis; (3) sensory analysis; and (4) statistical analysis. Cereal bars with licuri presented proportionally lower carbohydrate and protein content as the incorporation of licuri nut increased. However, the dietary fiber content increased. Further, 122 untrained panelists participated in the analysis. The results showed that samples with all proportions of incorporation of licuri nuts were acceptable. Furthermore, the sensory descriptors related to the presence of licuri were positively associated with product acceptance. In this way, this study demonstrates yet another possibility for use of the fruit, increasing its socioeconomic potential.

Health-related quality of life among celiacs in Portugal: a comparison between general and specific questionnaires.

Objective: This study aimed to compare the 36-Item Short Form Survey Instrument version 2 (SF-36-v2) (generic) and Celiac Disease Questionnaire (CDQ) (specific) questionnaires used to evaluate the quality of life (QoL) in celiac Portuguese adult individuals. Methods: This cross-sectional study used non-probabilistic sampling based on Portuguese celiac patients who accessed the online survey in 2022. The online data collection used a self-reported instrument composed of three parts: (i) socioeconomic, health, and gluten-free diet (GFD) adherence questions; (ii) SF-36 v2 - Portuguese version (generic questionnaire) and (iii) Celiac Disease Questionnaire (CDQ) (specific questionnaire). Results: A total of 234 individuals who accessed the survey completed the questionnaire. Seven of the eight SF-36 domains positively correlated to the specific questionnaire CDQ. The "General Health" domain (domain 4) showed a negative correlation with the CDQ. Differences in content between the two instruments might be able to explain this finding since the CDQ explores issues regarding the specificities of celiac disease (CD) and the lifelong GFD burden. About half of the sample from this study displayed poor diet adherence, it is possible that the SF-36 could not reflect the impact of CD treatment - the complete elimination of gluten from the diet - on patients' health. Therefore, this issue should be carefully evaluated in future research. Conclusion: Specific validated questionnaires for CD individuals, such as the CDQ, contemplate social, economic, and clinical variables that permeate the patient's life context. Therefore, these instruments may be more suitable for evaluating QoL in this public. However, using a general questionnaire such as the SF-36 would be indicated for comparing QOL between celiac patients and the general population or even between CD and other disease individuals. In this case, we recommend assessing GFD compliance for control parallelly.