Prospective Associations of Erythrocyte Composition and Dietary Intake of n-3 and n-6 PUFA with Measures of Cognitive Function.

Polyunsaturated fatty acid (PUFA) consumption is recommended as part of a healthy diet, but evidence of the impact of individual species and biological concentrations on cognitive function is limited. We examined prospective associations of PUFA erythrocyte composition and dietary intake with measures of cognitive function among participants of the Boston Puerto Rican Health Study (aged 57 years). Erythrocyte and dietary PUFA composition were ascertained at baseline and associated with 2-year scores on the Mini-Mental State Exam (MMSE) (n = 1032) and cognitive domain patterns derived from a battery of tests (n = 865), as well as with incidence of cognitive impairment. Erythrocyte and dietary n-3 PUFA were not significantly associated with MMSE score. However, total erythrocyte and dietary n-3 very-long-chain fatty acids (VLCFA), and intake of individual species, were associated with better executive function (P-trend < 0.05, for all). There was evidence that greater erythrocyte n-6 eicosadienoic acid concentration was associated with lower MMSE and executive function scores (P-trend = 0.02). Only erythrocyte arachidonic acid (ARA) concentration predicted cognitive impairment (Odds Ratio = 1.26; P = 0.01). Among Puerto Rican adults, we found that n-3 VLCFA consumption may beneficially impact executive function. Further, these findings provide some evidence that n-6 metabolism favoring greater ARA tissue incorporation, but not necessarily dietary intake, could increase the risk of cognitive impairment.

Whole Blood ω-3 Fatty Acids Are Inversely Associated with Carotid Intima-Media Thickness in Indigenous Mexican Women.

BACKGROUND: Long-chain ω-3 (n-3) polyunsaturated fatty acids (PUFAs) may reduce the risk of atherosclerosis. The association between n-3 PUFAs and cardiovascular disease may vary across different populations, and there is limited information on Hispanic individuals with mixed Amerindian and European origin. OBJECTIVE: We evaluated the cross-sectional relations between whole blood n-3 PUFAs and carotid intima-media thickness (IMT) in Mexican women living in Mexico and assessed whether this relation was different in women who spoke an indigenous language compared with women who did not. METHODS: In 2012-2013, we assessed the association between blood n-3 PUFAs and IMT in 1306 women free of disease in Chiapas and Yucatan, Mexico. We categorized blood n-3 PUFAs (% of total FAs) in quartiles and adjusted linear regression models by age, indigenous language, site, socioeconomic status, education, smoking, menopause, diabetes, hypertension, hypercholesterolemia, body mass index, physical activity, and diet. We stratified analyses by indigenous/nonindigenous language speakers (n = 315 of 991). RESULTS: Whole blood n-3 PUFAs (means ± SDs) were 3.58% ± 0.78% of total FAs. We did not observe a significant association between n-3 PUFAs and IMT in the overall study population. However, the adjusted mean difference of IMT was -6.5% (95% CI: -10.7%, -2.3%; P-trend < 0.0001) for indigenous women in the highest quartile compared with the lowest quartile of blood n-3 PUFAs. In nonindigenous women, we did not observe an association (-0.6%; 95% CI: -3.0%, 1.8%, comparing extreme quartiles; P-trend = 1.00). CONCLUSIONS: Overall, circulating n-3 PUFAs were not associated with IMT. However, we observed a strong statistically significant inverse association with IMT in indigenous Mexican women. Future studies should evaluate genetic markers that may reflect differences in n-3 PUFA metabolism across populations.

The Omega-3 Index Is Inversely Associated with Depressive Symptoms among Individuals with Elevated Oxidative Stress Biomarkers.

BACKGROUND: Omega-3 (n-3) fatty acid (FA) consumption is thought to improve depressive symptoms. However, current evidence is limited, and whether this association exists among Puerto Ricans, a population burdened by depression, remains uncertain. OBJECTIVES: We examined the association between ω-3 FA biomarkers and depressive symptoms as well as the potential influence of oxidative stress. METHODS: Baseline and longitudinal analyses were conducted in the Boston Puerto Rican Health Study (n= 787; participants aged 57 ± 0.52 y, 73% women). Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) concentration, a measure of oxidative stress, and erythrocyte FA composition were collected at baseline. We calculated the omega-3 index as the sum of eicosapentaenoic and docosahexaenoic acids, expressed as a percentage of total FAs. Baseline and 2-y depressive symptoms were characterized by using the Center for Epidemiological Studies-Depression Scale (CES-D). Statistical analyses included linear and logistic regression. RESULTS: Urinary 8-OHdG concentration tended to modify the relation between the erythrocyte omega-3 index and baseline CES-D score (P-interaction = 0.10). In stratified analyses, the omega-3 index was inversely associated with CES-D score (ß = -1.74, SE = 0.88;P= 0.02) among those in the top quartile of 8-OHdG concentration but not among those in the lower quartiles. The relation between the omega-3 index and CES-D at 2 y was more clearly modified by 8-OHdG concentration (P-interaction = 0.04), where the omega-3 index was inversely associated with CES-D at 2 y, adjusted for baseline (ß = -1.66, SE = 0.66;P= 0.02), only among those with elevated 8-OHdG concentrations. Among individuals not taking antidepressant medications and in the top tertile of urinary 8-OHdG concentration, the omega-3 index was associated with significantly lower odds of a CES-D score ≥16 at baseline (OR: 0.72; 95% CI: 0.53, 0.96) but not at 2 y (OR: 0.83; 95% CI: 0.60, 1.15). CONCLUSIONS: An inverse association between the omega-3 index and depressive symptoms was observed among participants with elevated oxidative stress biomarkers. These data suggest that oxidative stress status may identify those who might benefit from ω-3 FA consumption to improve depressive symptoms.

Associations of erythrocyte fatty acid patterns with insulin resistance.

BACKGROUND: Synergistic or additive effects or both on cardiometabolic risk may be missed by examining individual fatty acids (FAs). A pattern analysis may be a more useful approach. In addition, it remains unclear whether erythrocyte FA composition relates to insulin resistance among Hispanics/Latinos. OBJECTIVE: We derived erythrocyte FA patterns for a Puerto Rican cohort and examined their association with diet and insulin resistance in cross-sectional and prospective analyses. DESIGN: At baseline, principal components analysis was used to derive factor patterns with the use of 24 erythrocyte FAs from 1157 participants of the Boston Puerto Rican Health Study (aged 45-75 y). Dietary intake was assessed with a validated semiquantitative food-frequency questionnaire. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated at baseline and at the 2-y follow-up. Relations between FA patterns and HOMA-IR were analyzed in a sample of 922 participants with available data. RESULTS: Five FA patterns were derived, differentiated by 1) relatively high de novo lipogenesis (DNL) FAs and low n-6 (ω-6) FAs, 2) high very-long-chain saturated FAs, 3) high n-3 (ω-3) FAs, 4) high linoleic acid and low arachidonic acid, and 5) high trans FAs. The DNL pattern was positively correlated with sugar and inversely with n-6 and monounsaturated FA intakes. Only the DNL pattern was positively related to baseline HOMA-IR [adjusted geometric means (95% CIs) for quartiles 1 and 4: 1.72 (1.58, 1.87) and 2.20 (2.02, 2.39); P-trend < 0.0001]. Similar associations were observed at 2 y, after adjustment for baseline status [quartiles 1 and 4 means (95% CIs): 1.61 (1.48, 1.76) and 1.84 (1.69, 2.00); P-trend = 0.02]. These results remained consistent after the exclusion of participants with diabetes (n = 485). CONCLUSION: Our findings suggest that upregulated DNL associated with a diet high in sugar and relatively low in unsaturated FAs may adversely affect insulin sensitivity in a Hispanic/Latino cohort.

Evolution of membrane oxygenator technology for utilization during pediatric cardiopulmonary bypass.

The development of the membrane oxygenator for pediatric cardiopulmonary bypass has been an incorporation of ideology and technological advancements with contributions by many investigators throughout the past two centuries. With the pursuit of this technological achievement, the ability to care for mankind in the areas of cardiac surgery has been made possible. Heart disease can affect anyone within the general population, but one such segment that it can affect from inception includes children. Currently, congenital heart defects are the most common birth defects nationally and worldwide. A large meta-analysis study from 1930 to 2010 was conducted in review of published medical literature totaling 114 papers with a study population of 24,091,867 live births, and divulged a staggering incidence of congenital heart disease involving 164,396 subjects with diverse cardiac illnesses. The prevalence of these diseases increased from 0.6 per 1,000 live births from 1930-1934 to 9.1 per 1,000 live births after 1995. These data reveal an emphasis on a growing public health issue regarding congenital heart disease. This discovery displays a need for heightened awareness in the scientific and medical industrial community to accelerate investigative research on emerging cardiovascular devices in an effort to confront congenital anomalies. One such device that has evolved over the past several decades is the pediatric membrane oxygenator. The pediatric membrane oxygenator, in conjunction with the heart lung machine, assists in the repair of most congenital cardiac defects. Numerous children born with congenital heart disease with or without congestive heart failure have experienced improved clinical outcomes in quality of life, survival, and mortality as a result of the inclusion of this technology during their cardiac surgical procedure. The purpose of this review is to report a summary of the published medical and scientific literature related to development of the pediatric membrane oxygenator from its conceptual evolutionary stages to artificially supporting whole body perfusion in the modern pediatric cardiac surgical setting.

Determinants of erythrocyte omega-3 fatty acid content in response to fish oil supplementation: a dose-response randomized controlled trial.

BACKGROUND: The erythrocyte membrane content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which constitutes the omega-3 index (O3I), predicts cardiovascular disease mortality. The amount of EPA+DHA needed to achieve a target O3I is poorly defined, as are the determinants of the O3I response to a change in EPA+DHA intake. The objective of this study was to develop a predictive model of the O3I response to EPA+DHA supplementation in healthy adults, specifically identifying factors that determine the response. METHODS AND RESULTS: A randomized, placebo-controlled, double-blind, parallel-group study was conducted in 115 healthy men and women. One of 5 doses (0, 300, 600, 900, 1800 mg) of EPA+DHA was given daily as placebo or fish oil supplements for ≈5 months. The O3I was measured at baseline and at the end of the study. There were no significant differences in the clinical characteristics between the groups at baseline. The O3I increased in a dose-dependent manner (P<0.0001), with the dose of EPA+DHA alone accounting for 68% (quadratic, P<0.0001) of the variability in the O3I response. Dose adjusted per unit body weight (g/kg) accounted for 70% (linear, P<0.0001). Additional factors that improved prediction of treatment response were baseline O3I, age, sex, and physical activity. Collectively, these explained 78% of the response variability (P<0.0001). CONCLUSIONS: Our findings validate the O3I as a biomarker of EPA+DHA consumption and identify additional factors, particularly body weight, that can be used to tailor EPA+DHA recommendations to achieve a target O3I.

Deixa de ser obrigatório no Brasil o exame médico para fins de aulas de educaçäo física escolar: fim de uma farsa e um equívoco / Compulsory medical examinations preceeding physical education for school children are abolished in Brazil: burlesque and mistakes come to an end

Descreve a luta para por fim à exigência legal, há mais de vinte anos, de exames clínicos (ou médicos ou físicos como querem alguns) para fins de aulas de educaçäo física escolar, dando ênfase aos atos formais havidos em diversas épocas e em diversas localidades/estados brasileiros. A discussäo é permeada com a participaçäo da Associaçäo Brasileira de Saúde Escolar e outras entidades e órgäos governamentais de saúde pública e especificamente de saúde escolar a partir de 1983. Inclui a Resoluçäo n§ 40 de 4 fev.1993 do Conselho Nacional de Saúde que fundamentou o Decreto n§888 de 4 ago.1993 que revogou o Artigo 12§ do Decreto Federal n§69450 de 1 nov.1971 gerador desta exigência legal. Argumenta que o Artigo 12§ do Decreto, tecnicamente nunca foi obedecido. A ABRASE tem apoiado posicionamentos e se manifestado contra estes exames dos escolares pleiteando sua substituiçäo pela assistência (ou atençäo) integral à saúde do cidadäo em idade escolar acompanhado pelos pais ou responsáveis na unidade básica de saúde. Comenta o direito inalienável de educaçäo física escolar inclusive para crianças portadoras de deficiências físicas

História da saúde escolar no Rio de Janeiro / School health history in Rio de Janeiro, Brazil

Relata a evoluçäo histórica e legislaçäo da saúde escolar na cidade do Rio de Janeiro desde o início do século XX

Reciclagem: atualizaçäo em saúde escolar, II / Atualization in health school, II

Questionário sobre saúde escolar, com respostas ao final para auto-avaliaçäo do leitor (MC)

Saúde, educaçäo e sociedade: uma interaçäo para a saúde escolar / Health education and society: an interaction towards school health

Focaliza a importância dos encontros científicos, onde os pesquisadores discutem seus sucessos, falhas e expectativas. Enfase é colocada no planejamento da saúde, a nível local e mençäo é feita ao conflito entre igualdade de condiçöes e de oportunidades. As conclusöes apontam para os direitos do cidadäo e da comunidade em saúde e educaçäo como a verdadeira base para o progresso em qualquer área

Reciclagem/atualizaçäo em saúde escolar / Refresher course of school health

Questionário proposto pelo comitê de Saúde Escolar da Sociedade publicado inicialmente na Revista Paulista de Pediatria, a fim de servirem de base de reflexäo e eventualmente questionamento buscando-se pôr termoa diversos assuntos contravertidos

I Simpósio Iberoamericano de Salud Escolar. Buenos Aires, outubro 1987 / I Iberoamerican Symposium of School Health. Buenos Aires, October 1987

Visa criar consciência a nível pediátrico, docente e comunitário sobre a necessidade da prevençäo primária, secundária e terciária em Saúde Escolar com a implementaçäo regional, nacional e iberoamericana correspondente. O SIMPOSIO foi dividido em oito SEMINARIOS (sistema modular) que agruparam conferências, mesas-redondas, seminários propriamente ditos (taller), apresentaçäo de temas (trabalhos) livres, painéis, debates e colóquios

Carta de Vitória / Vitoria letter

Apresenta as conclusöes e propostas elaboradas nos diversos módulos do 6§ Congresso Brasileiro de Saúde Escolar, realizado entre 16 e 22 de julho de 1988 em Vitória-ES, organizado pela Associaçäo Brasileira de Saúde Escolar - ABRASE (CAC)

Grupo informal de estudos e discussöes sobre saúde escolar (Giédise): evoluçäo de uma experiência / Informal group of studies and discussions on school health (Giedise): an experience evolution

Existe no Brasil grande diversificaçäo das atividades concernentes à Saúde Escolar decorrente de filosofias diferentes com maior ou menor valorizaçäo de determinados da mesma. Privilegia-se mais a assistência médico-odontológica na maioria das localidades e em alguns envolve-se mais o pessoal na promoçäo e proteçäo à saúde por meio de açöes educativas. A descontinuidade administrativa e o feudalismo interferem muito também. O primeiro GIÉDISE fundado em Säo Paulo em outubro de 1986 reune informalmente uma dúzia de pessoas de categorias profissionais diferentes de localidades e instituiçöes diversas e com experiências variadas na área. As reuniöes, a cada dois meses, têm por objetivo trocar estas experiências pessoais, incorporar conhecimentos novos ao Grupo, organizar levantamento e pesquisas e posteriormente levar suas preocupaçöes e sugestöes aos responsáveis por serviços de Saúde Escolar. O Grupo concentrou suas atençöes, em suas primeiras cinco reuniöes, discutindo essencialmente aspectos concentuais e em sua avaliaçäo mostrou que vem atingindo seus objetivos devido à multiprofissionalidade, informalismo e multiprocedência de seus membros. Todos os componenetes do GIÉDISE concordam em que a experiência deva continuar