Revisiting Purine Nucleoside Cholinesterase Inhibitors - An Experimental Glycon Structure/Activity Relationship Study.

BACKGROUND: A new family of purine nucleoside cholinesterase inhibitors was disclosed by us, with potency and selectivity over acetylcholinesterase or butyrylcholinesterase controlled by tuning structural and stereochemical features of nucleosides with perbenzylated glycosyl moieties. OBJECTIVE: Design, synthesis, and biological evaluation of new purine nucleosides were used to investigate glycon protecting group pattern required for anticholinesterase activity and selectivity. METHODS: Regioselective chemistry to introduce methyl/benzyl groups in glycon donors and Nglycosylation was used to acquire the target nucleosides. Evaluation of their biological potential and selectivity as cholinesterase inhibitors was performed. RESULTS: Synthetic strategies chosen resulted in high glycon donor's overall yield and regio- and stereoselectivity was found in N-glycosylation reaction. Some of the new nucleosides are cholinesterase inhibitors and selectivity for butyrylcholinesterase was also achieved. CONCLUSION: N-glycosylation reaction was stereoselective for the ß-anomers while regioselectivity was achieved for the N9 isomers when glycon positions 2 and 3 were methylated. Cholinesterase inhibition was found when the 2,3-di-O-benzyl-4-O-methyl pattern is present in the sugar moiety. Amongst the new compounds, the two most promising ones showed micromolar inhibition (mixed inhibition), being one of them selective for butyrylcholinesterase inhibition.

Gas-phase oxidation reactions of Ta2+: synthesis and properties of TaO(2+) and TaO2(2+).

Gas-phase reactions of Ta(2+) and TaO(2+) with oxidants, including thermodynamically facile O-atom donor N(2)O and ineffective donor CO, as well as intermediate donors C(2)H(4)O (ethylene oxide), H(2)O, O(2), CO(2), NO, and CH(2)O, were studied by Fourier transform ion cyclotron resonance mass spectrometry. All oxidants reacted with Ta(2+) by electron transfer yielding Ta(+), in accord with the high second ionization energy of Ta (ca. 16 eV). TaO(2+) was also produced with N(2)O, H(2)O, O(2), and CO(2), oxidants with ionization energies above 12 eV; CO reacted only by electron transfer. The following charge separation products were also observed: TaN(+) and TaO(+) with N(2)O; and TaO(+) with O(2), CO(2), and CH(2)O. TaOH(2+), formed with H(2)O, reacted with a second H(2)O by proton transfer. TaO(2+) abstracted an electron from N(2)O, H(2)O, O(2), CO(2), and CO. Oxidation of TaO(2+) by N(2)O was also observed to produce TaO(2)(2+); on the basis of density functional theory (DFT) results, this species is a dioxide, {O-Ta-O}(2+). TaO(2)(2+) reacted by electron transfer with N(2)O, CO(2), and CO to give TaO(2)(+). Additionally, it was found that TaO(2)(2+) oxidizes CO to CO(2) and that it acts as a catalyst in the oxidation of CO by N(2)O. TaO(2)(2+) also activates H(2) to form TaO(2)H(2+). On the basis of the rates of electron transfer from N(2)O, CO(2), and CO to Ta(2+), TaO(2+), and TaO(2)(2+), the following estimates were made for the second ionization energies of Ta, TaO, and TaO(2): IE[Ta(+)] = 15.8 ± 0.3 eV, IE[TaO(+)] = 16.0 ± 0.5 eV, and IE[TaO(2)(+)] = 16.9 ± 0.4 eV. These IEs, together with recently reported bond dissociation energies, D[Ta(+)-O] and D[OTa(+)-O], result in the following bond energies: D[Ta(2+)-O] = 657 ± 58 kJ mol(-1) and D[OTa(2+)-O] = 500 ± 63 kJ mol(-1), the first of which is in good agreement with the value obtained by DFT.

Gas-phase reaction studies of dipositive hafnium and hafnium oxide ions: generation of the peroxide HfO2(2+).

Fourier transform ion cyclotron resonance mass spectrometry was used to characterize the gas-phase reactivity of Hf dipositive ions, Hf(2+)and HfO(2+), toward several oxidants: thermodynamically facile O-atom donor N(2)O, ineffective donor CO, and intermediate donors O(2), CO(2), NO, and CH(2)O. The Hf(2+) ion exhibited electron transfer with N(2)O, O(2), NO, and CH(2)O, reflecting the high ionization energy of Hf(+). The HfO(2+) ion was produced by O-atom transfer to Hf(2+) from N(2)O, O(2), and CO(2), and the HfO(2)(2+) ion by O-atom transfer to HfO(2+) from N(2)O; these reactions were fairly efficient. Density functional theory revealed the structure of HfO(2)(2+) as a peroxide. The HfO(2)(2+) ion reacted by electron transfer with N(2)O, CO(2), and CO to give HfO(2)(+). Estimates were made for the second ionization energies of Hf (14.5 ± 0.5 eV), HfO (14.3 ± 0.5 eV), and HfO(2) (16.2 ± 0.5 eV), and also for the bond dissociation energies, D[Hf(2+)-O] = 686 ± 69 kJ mol(-1) and D[OHf(2+)-O] = 186 ± 98 kJ mol(-1). The computed bond dissociation energies, 751 and 270 kJ mol(-1), respectively, are within these experimental ranges. Additionally, it was found that HfO(2)(2+) oxidized CO to CO(2) and is thus a catalyst in the oxidation of CO by N(2)O and that Hf(2+) activates methane to produce a carbene, HfCH(2)(2+).

SDR enzymes oxidize specific lipidic alkynylcarbinols into cytotoxic protein-reactive species.

Hundreds of cytotoxic natural or synthetic lipidic compounds contain chiral alkynylcarbinol motifs, but the mechanism of action of those potential therapeutic agents remains unknown. Using a genetic screen in haploid human cells, we discovered that the enantiospecific cytotoxicity of numerous terminal alkynylcarbinols, including the highly cytotoxic dialkynylcarbinols, involves a bioactivation by HSD17B11, a short-chain dehydrogenase/reductase (SDR) known to oxidize the C-17 carbinol center of androstan-3-alpha,17-beta-diol to the corresponding ketone. A similar oxidation of dialkynylcarbinols generates dialkynylketones, that we characterize as highly protein-reactive electrophiles. We established that, once bioactivated in cells, the dialkynylcarbinols covalently modify several proteins involved in protein-quality control mechanisms, resulting in their lipoxidation on cysteines and lysines through Michael addition. For some proteins, this triggers their association to cellular membranes and results in endoplasmic reticulum stress, unfolded protein response activation, ubiquitin-proteasome system inhibition and cell death by apoptosis. Finally, as a proof-of-concept, we show that generic lipidic alkynylcarbinols can be devised to be bioactivated by other SDRs, including human RDH11 and HPGD/15-PGDH. Given that the SDR superfamily is one of the largest and most ubiquitous, this unique cytotoxic mechanism-of-action could be widely exploited to treat diseases, in particular cancer, through the design of tailored prodrugs.

Antioxidative response of lettuce (Lactuca sativa) to carbamazepine-induced stress.

Carbamazepine (CBZ) is a widely used anti-epileptic drug that has been detected in wastewaters from sewage treating plants and thus appears in rivers, streams and other water bodies. As plants can absorb this compound, it can also appear in edible plants like lettuce, entering the food chain. In this study, the effect of carbamazepine in lettuce plants grown in hydroponic solution is analyzed. CBZ was detected both in roots and in leaves and is shown to induce oxidative stress. Hydrogen peroxide levels increased both in leaves and in roots while malondialdehyde increased only in leaves. Regarding the activity of antioxidative enzymes in the leaves, it is shown that superoxide dismutase (SOD), catalase (CAT), guaiacol peroxidase (GPOD) and ascorbate peroxidase (APX) have a relevant role in quenching reactive oxygen species induced by oxidative stress. In roots, the only enzymes that showed increased activity were CAT, GPOD and glutathione reductase (GR). Ascorbate and glutathione also appear to have an important role as antioxidants in response to increased concentrations of carbamazepine. Although the roots are in direct contact with the contaminant, the leaves showed the strongest oxidative effects.

C-Glucosylation as a tool for the prevention of PAINS-induced membrane dipole potential alterations.

The concept of Pan-Assay Interference Compounds (PAINS) is regarded as a threat to the recognition of the broad bioactivity of natural products. Based on the established relationship between altered membrane dipole potential and transmembrane protein conformation and function, we investigate here polyphenols' ability to induce changes in cell membrane dipole potential. Ultimately, we are interested in finding a tool to prevent polyphenol PAINS-type behavior and produce compounds less prone to untargeted and promiscuous interactions with the cell membrane. Di-8-ANEPPS fluorescence ratiometric measurements suggest that planar lipophilic polyphenols-phloretin, genistein and resveratrol-act by decreasing membrane dipole potential, especially in cholesterol-rich domains such as lipid rafts, which play a role in important cellular processes. These results provide a mechanism for their labelling as PAINS through their ability to disrupt cell membrane homeostasis. Aiming to explore the role of C-glucosylation in PAINS membrane-interfering behavior, we disclose herein the first synthesis of 4-glucosylresveratrol, starting from 5-hydroxymethylbenzene-1,3-diol, via C-glucosylation, oxidation and Horner-Wadsworth-Emmons olefination, and resynthesize phloretin and genistein C-glucosides. We show that C-glucosylation generates compounds which are no longer able to modify membrane dipole potential. Therefore, it can be devised as a strategy to generate bioactive natural product derivatives that no longer act as membrane dipole potential modifiers. Our results offer a new technology towards rescuing bioactive polyphenols from their PAINS danger label through C-C ligation of sugars.

Metabolomic Profile and Biological Properties of Sea Lavender (Limonium algarvense Erben) Plants Cultivated with Aquaculture Wastewaters: Implications for Its Use in Herbal Formulations and Food Additives.

Water extracts from sea lavender (Limonium algarvense Erben) plants cultivated in greenhouse conditions and irrigated with freshwater and saline aquaculture effluents were evaluated for metabolomics by liquid chromatography-tandem high-resolution mass spectrometry (LC-HRMS/MS), and functional properties by in vitro and ex vivo methods. In vitro antioxidant methods included radical scavenging of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS), ferric-reducing antioxidant power (FRAP), and copper and iron chelating assets. Flowers' extracts had the highest compounds' diversity (flavonoids and its derivatives) and strongest in vitro antioxidant activity. These extracts were further tested for ex vivo antioxidant properties by oxidative haemolysis inhibition (OxHLIA), lipid peroxidation inhibition by thiobarbituric acid reactive substances (TBARS) formation, and anti-melanogenic, anti-tyrosinase, anti-inflammation, and cytotoxicity. Extract from plants irrigated with 300 mM NaCl was the most active towards TBARS (IC50 = 81 µg/mL) and tyrosinase (IC50 = 873 µg/mL). In OxHLIA, the activity was similar for fresh- and saltwater-irrigated plants (300 mM NaCl; IC50 = 136 and 140 µg/mL, respectively). Samples had no anti-inflammatory and anti-melanogenic abilities and were not toxic. Our results suggest that sea lavender cultivated under saline conditions could provide a flavonoid-rich water extract with antioxidant and anti-tyrosinase properties with potential use as a food preservative or as a functional ingredient in herbal supplements.

[Prevalence of medical visits and associated factors: a population-based study in Southern Brazil]. / Prevalência de consultas médicas e fatores associados: um estudo de base populacional no sul do Brasil.

OBJECTIVE: Describe the prevalence of medical visits and associated factors in an adult population of a midsized town in Southern Brazil. METHODS: A population-based cross-sectional study was carried out in a representative random cluster sampling in Lages, Santa Catarina. The reference population were adults (aged 20 to 59 years) and 2,022 persons were queried. The outcome was medical visits during twelve months prior to the survey. Information related to kind of service (public/private) and evaluation of this service were also collected. The independent variables were gender, race/skin color, marital status, income, educational background, health self-perception, nutritional state, self-reported diabetes, hypertension, smoking and alcohol problems. Poisson regression was carried out and the Prevalence Rate was obtained. RESULTS: The prevalence of medical visits was 76.0% (CI95% 73.6-78.4). Women, the wealthier, those who have diabetes, smokers, ex-smokers, those with alcohol problems, also those who evaluated their health negatively, reported a greater prevalence of medical visits. It was also observed that among lower income people, medical visits to the Public Health System (Sistema Unico de Saúde) were more frequent.. CONCLUSION: Prevalence of medical visits varied according to the population queried. Health policies at the three government levels must acknowledge such inequality to subsidize actions in the sector to propose equanimous policies.

Integrated Green Chemical Approach to the Medicinal Plant Carpobrotus edulis Processing.

Many plants have medicinal properties due to substances known as phytochemicals. To utilize these plants in practice, numerous procedures, such as extraction, isolation and characterization methods and toxicology and bioactivity studies, must be designed and implemented. Integrated approach to process Carpobrotus edulis, a weed medicinal plant widely spread in Portugal, was developed into a closed loop of two processes: microwave assisted extraction (MAE) and activation (MAA), to produce both phytochemicals and biochar. The use of MAE for phytochemical extraction was shown to be more energy efficient than conventional Soxhlet extraction: the process time was decreased by 7-8 times, and the energy efficiency was increased by up to 97%. The yield of the extracts is of 27%. Qualitative and quantitative identification/characterization of the phytochemicals were performed by LC-MS and phytochemical screening assays. The results clearly indicated that Carpobrotus edulis is rich by flavonoids (up to 24%). The use of MAA to process the residual biomass could shorten the activation time, resulting in reduced energy consumption. Biochar with a high yield of 65% (on a biomass basis) and a well-developed texture (surface area of 68.9 m2/g; total pore volume of 0.10 cm3/g; micropore volume of 0.07 cm3/g) is obtained.

The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique.

PURPOSE: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. METHODS: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. RESULTS: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. CONCLUSIONS: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.

Design and Synthesis of CNS-targeted Flavones and Analogues with Neuroprotective Potential Against H2O2- and Aß1-42-Induced Toxicity in SH-SY5Y Human Neuroblastoma Cells.

With the lack of available drugs able to prevent the progression of Alzheimer's disease (AD), the discovery of new neuroprotective treatments able to rescue neurons from cell injury is presently a matter of extreme importance and urgency. Here, we were inspired by the widely reported potential of natural flavonoids to build a library of novel flavones, chromen-4-ones and their C-glucosyl derivatives, and to explore their ability as neuroprotective agents with suitable pharmacokinetic profiles. All compounds were firstly evaluated in a parallel artificial membrane permeability assay (PAMPA) to assess their effective permeability across biological membranes, namely the blood-brain barrier (BBB). With this test, we aimed not only at assessing if our candidates would be well-distributed, but also at rationalizing the influence of the sugar moiety on the physicochemical properties. To complement our analysis, logD7.4 was determined. From all screened compounds, the p-morpholinyl flavones stood out for their ability to fully rescue SH-SY5Y human neuroblastoma cells against both H2O2- and Aß1-42-induced cell death. Cholinesterase inhibition was also evaluated, and modest inhibitory activities were found. This work highlights the potential of C-glucosylflavones as neuroprotective agents, and presents the p-morpholinyl C-glucosylflavone 37, which did not show any cytotoxicity towards HepG2 and Caco-2 cells at 100 µM, as a new lead structure for further development against AD.

Organic dyes in illuminated manuscripts: a unique cultural and historic record.

In this study, we successfully addressed the challenges posed by the identification of dyes in medieval illuminations. Brazilwood pigment lakes and orcein purple colours were unequivocally identified in illuminated manuscripts dated by art historians to be from the thirteenth to the fifteenth centuries and in the Fernão Vaz Dourado Atlas (sixteenth century). All three works were on a parchment support. This was possible by combining Raman microscopy and surface-enhanced Raman spectroscopy with microspectrofluorimetry. To the best of our knowledge, this is the first time that brazilein, the main chromophore in brazilwood lake pigments, has been unequivocally identified by surface-enhanced Raman spectroscopy in an illuminated work (the Dourado Atlas). Complementing this identification, through microspectrofluorimetry and micro-Fourier transform infrared spectroscopy, it was possible to propose a complete paint formulation by comparison with our database of references; the dark pink hues, in the three case studies, were produced by combining brazilwood pigment lakes and gypsum in a protein- and gum arabic-based tempera. Orcein purple, also known as orchil dye, has been previously identified in medieval manuscripts, dated from the sixth to the ninth centuries. Our findings in fourteenth-sixteenth century manuscripts confirm the hypothesis that this dye was lost during the High Middle Ages, to be later rediscovered.This article is part of the themed issue 'Raman spectroscopy in art and archaeology'.

Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System. / Acidentes envolvendo indígenas brasileiros atendidos em serviços de urgência e emergência do Sistema Único de Saúde.

Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

Thermal stability of simvastatin under different atmospheres.

Simvastatin (SV) is a widely used drug for the treatment of hypercholesterolemia in humans. Nevertheless, serious efforts are still being made to develop new SV formulations with, for example, improved tabletability or bioavailability properties. These efforts frequently involve heating the compound well above ambient temperature or even fusion. In this work, the thermal stability of solid SV under different atmospheres was investigated by using isothermal tests in glass ampules, differential scanning calorimetry, and Calvet-drop microcalorimetry experiments. These tests were combined with analytical data from diffuse reflectance infrared Fourier-transform spectroscopy and liquid chromatography coupled with tandem mass spectrometry or Fourier transform ion cyclotron resonance mass spectrometry (LC-FT-ICR-MS). No decomposition was observed when the sample was kept at a temperature ≤373 K under N2 or reduced pressure (13.3 Pa) atmospheres. Thermal degradation was, however, observed for temperatures ≥353 K in the presence of pure or atmospheric oxygen. The nature of the two main oxidative degradation products was determined through MS/MS experiments and accurate mass measurements of the precursor ions using FT-ICR-MS. The obtained results indicated that the decomposition process involves the oxidation of the hexahydronaphthalene fragment of SV.

The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique

Abstract Purpose: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. Methods: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. Results: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. Conclusions: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.

Níveis glicêmicos e sobrevida de pacientes graves em Unidade de Terapia Intensiva, Manaus - Amazonas / Glycemic levels, and survival of critical patients in the Intensive Care Unit, Manaus - Amazonas

Introdução: A hiperglicemia induzida por estresse ocorre com frequência em pacientes internados em unidade de tratamento intensivo (UTI) e pode estar associada a não sobrevida. Objetivo: Avaliar o perfil glicêmico dos pacientes graves, analisando a associação entre glicemia e desfecho clínico em UTI; e se a glicemia é um marcador de piores diagnósticos. Método: Estudo transversal descritivo, de associação no período de dezembro de 2013 a dezembro 2015, provenientes de uma UTI de Manaus. Foram acessados os valores de glicemia, 24 horas antes do desfecho clínico (alta ou óbito). As análises de associação realizaram-se utilizando variáveis, preditivas ou independentes dos valores de índices glicêmicos (mg/dL). Média, desvio padrão análises de associação foram desenvolvidos no Programa Epi info 7.0. Resultados: Participaram do estudo 34 pacientes adultos, maioria eutróficos, conforme Índice de Massa Corporal (IMC) estimado. A regressão linear e logística mostrou glicemia (mg/dL) associada positivamente com a não sobrevida (p<0,05), independente do IMC e covariáveis. Além disso, a classe de glicemia entre 95 a 140 mg dL associou-se à sobrevida de pacientes críticos, enquanto valores superiores mostraram correlação com não sobrevida na UTI. Conclusão: O estudo sugere que concentrações glicêmicas no sangue coletadas 24 horas antes do desfecho clínico entre participantes na UTI parece ser um bom indicador de desfechos clínicos, e níveis glicêmicos entre 95 a 140 mg dL protegem os pacientes críticos.(AU)

Introduction: Stress-induced hyperglycaemia occurs frequently in hospitalized illness critical patients and it could be associated with increased non-survive. Objective: To evaluate the glycemic profile of critically ill patients analyzing the association between blood glucose levels and clinical outcome of critically ill patients; and if the blood glucose is a marker of serious diseases. Methods: This is a descriptive cross-sectional study and cross tabulation from December 2013 to December 2015 from a Manaus Intensive Care Unity. Blood glucose values were accessed 24 hours prior to the clinical outcome (discharge or death) of patients older than 18 years. Association analyses were carried out using as variables predictive or independent, the values of glycaemia (mg/dL). Mean, standard deviation and associations analyses were performed in Epi info 7.0. Results: The study included a total of 34 patients, most eutrophic, according to Body Mass Index (BMI) estimated. Linear and logistic regression showed blood glucose (mg/ dL) positively associated with no survival and statistically significant (p<0.05), independent of BMI and co-variable. In addition, the class of glucose between 95 to 140 mg dL correlated with non-survive among critically ill patients, while greater glycaemic values increase mortality in ICU. Conclusion: Therefore, the glucose level collected 24 hours before the clinical outcome (survival or not survival), of the participants in the ICU seems to be a good indicator with clinical outcomes, and the cut off of glucose levels between 95 to 140 mg/dL can be desirable to avoiding of mortality of critically ill patients.(AU)

Risk factors associated with malnutrition in hospitalized patients / Fatores de risco associados à desnutrição em pacientes hospitalizados

ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable) and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.

RESUMO Objetivo Identificar fatores associados à desnutrição em pacientes internados em hospitais gerais da rede pública de Manaus, Amazonas. Métodos Estudo transversal que envolveu 397 pacientes, de ambos os sexos e idade superior a 18 anos, internados em três hospitais públicos de Manaus, Amazonas. Foi realizada avaliação antropométrica e avaliação subjetiva global, sendo esta última o método de diagnóstico principal. Para análises de associação entre desnutrição (variável dependente) e as demais covariáveis, foi realizado o teste Qui-quadrado para seleção das variáveis e regressão logística múltipla para teste de efeito independente entre exposição e desfecho. A força de associação entre as variáveis foi expressa em valores de odds ratio, com intervalo de confiança de 95%. As análises foram realizadas por meio do programa Epi Info 7.0. Resultados Dentre os fatores de risco associados com desnutrição hospitalar, o tempo de internação superior a 15 dias, quando analisado isoladamente, quase triplicou a chance de o indivíduo desnutrir. Entretanto, no modelo final, as variáveis que mantiveram associação foram: mudança persistente na dieta; presença de sintomas gastrointestinais; perda de peso recente; e, nos últimos seis meses, câncer e idade superior a 60 anos. Conclusão A desnutrição é recorrente no meio hospitalar, e os fatores a ela associados podem ser identificados no momento da internação, o que permite um monitoramento adequado durante o período de hospitalização. Para tanto, torna-se imprescindível a atuação mais efetiva de programas de triagem e acompanhamento nutricional.

Acidentes envolvendo indígenas brasileiros atendidos em serviços de urgência e emergência do Sistema Único de Saúde / Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System

Resumo Foram analisados os acidentes ocorridos com indígenas brasileiros atendidos em serviços de urgência e emergência do Sistema Único de Saúde (SUS). Os dados provêm do Viva Inquérito de 2014, que incluiu 86 serviços de 24 capitais e do Distrito Federal. Caracterizou-se o perfil sociodemográfico dos indígenas, o evento e o atendimento. A maioria dos atendidos era do sexo masculino e tinha entre 20-39 anos. Acidentes de transporte e quedas foram os principais motivos dos atendimentos. O uso de bebida alcoólica foi informado por 5,6% dos atendidos. Nos acidentes de transporte esse uso sobe para 19,1%; 26,1% entre condutores e 22,8% nos motociclistas. Houve diferença estatística entre os sexos em relação à faixa etária, deficiência, local de ocorrência do evento, evento relacionado ao trabalho e condição da vítima no acidente de transporte. Destaca-se a importância de dar visibilidade aos acidentes com indígenas e de envolvê-los na prevenção desses eventos. A fidedignidade desses dados depende do seu adequado preenchimento nos sistemas de informações sobre saúde de indígenas.

Abstract Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

Self-rated health among adults in Southern Brazil.

OBJECTIVE: To analyze factors associated with self-rated health in adults. METHODS: A population-based, cross-sectional study was performed with a sample of 2,051 adults aged between 20 and 59 years, in the city of Lages, Southern Brazil, in 2007. Household questionnaires were applied to obtain data on self-rated health, socioeconomic and demographic conditions, smoking habit, lifestyle and self-reported morbidities. Blood pressure, weight, height and abdominal circumference were measured. multivariable analysis was performed using Poisson regression, adjusted for the sampling design effect and stratified by sex. RESULTS: Prevalence of positive self-rated health was 74.2% (95% CI: 71.3;77.0), significantly higher in men (82.3%, 95%CI: 79.3;85.0) than in women (66.9%, 95%CI: 63.2;70.7). Poorer, less educated and older men showed higher prevalences of negative self-rated health. After adjustment, high blood pressure levels and reporting chest wheezing were strongly associated with negative self-rated health in men. Prevalence of negative self-assessment was higher in poorer, less educated and older women and in those who showed abdominal obesity. High blood pressure levels, diabetes, chest wheezing and shortness of breath remained associated with the outcome after adjustment in women. The number of morbidities self-reported by women and men showed an association with negative self-rated health. CONCLUSIONS: Women and individuals who were older, poorer or less educated considered their health condition to be fair or poor. The higher the number of self-reported morbidities, the greater the proportion of individuals with negative self-rated health; the effect of morbidities was greater in women.

[Prevalence of respiratory symptoms and associated factors: a population-based study in adults from Lages, Santa Catarina State, Brazil]. / Prevalência de sintomas respiratórios e fatores associados: estudo de base populacional em adultos de Lages, Santa Catarina, Brasil.

A cross-sectional population-based study was conducted in Lages, Santa Catarina State, Brazil, in order to estimate the prevalence of symptoms of chronic bronchitis, breathlessness, and wheezing and associated factors in a sample of adults 20 to 59 years of age (n = 2,051). The study employed a cluster sample design and Poisson regression analyses. Prevalence rates for chronic bronchitis, breathlessness, and wheezing were 5%, 35.7%, and 20.2%, respectively. The adjusted analysis showed chronic bronchitis associated with low schooling, smoking, and hospital admissions due to respiratory illness during childhood. Breathlessness was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Wheezing was associated with female gender, low schooling and family income, non-white race, hospital admissions due to respiratory illness during childhood, smoking, and occupational exposure to dust. Public health planners should consider climatic factors and work activities when developing activities to prevent respiratory diseases.