Australian Pelvic Floor Questionnaire: translation, cultural adaptation, and validation.

INTRODUCTION AND HYPOTHESIS: The aim was to translate, culturally adapt, and validate the APFQ (Australian Pelvic Floor Questionnaire) for the population of Brazilian pregnant and postpartum women. METHODS: The translation and validation of the APFQ were performed according to Beaton's guideline recommendations, with a sample of 150 patients (75 pregnant, 75 postpartum). Cronbach's alpha assessed the scale's internal consistency and reproducibility with the intraclass correlation coefficient (ICC). To analyze the construct validity, two questionnaires were applied, and the Spearman correlation was performed. Confirmatory factor analysis (CFA) was executed to assess the fit of the data to the theoretical model. The ability to generate diagnosis was analyzed by sensitivity and specificity. RESULTS: Only 1% of the sample scored in the prolapse domain, so it was removed from the validation analyses. Cronbach's alpha values greater than 0.70 were obtained for the bladder and bowel domains, and 0.69 for sexual function. As for reproducibility, the ICC was greater than 0.75 for all domains. Spearman's correlation was good for bowel (r=0.74), moderate for bladder (r=0.58), and poor for sexual function (r=0.23). CFA results showed a non-optimal adherence: despite the Chi-squared value being significant (p<0.001), the CMIN- which is the adherence of the data to the model- value is less than 3. Sensitivity above 80% was obtained, whereas specificity of 43%, 16%, and 12% was obtained for bowel, bladder, and sexual functions respectively. CONCLUSION: The APFQ was translated, culturally adapted, and validated for Brazilian pregnant and postpartum women. It showed good indexes of internal consistency, construct validity, reproducibility, and sensitivity. However, the prolapse domain could not be validated.

Avaliação dos alunos deficientes visuais e videntes do Instituto de Cegos Padre Chico / Evaluation of the visually impaired and sighted students at the Instituto de Cegos Padre Chico

RESUMO Objetivo Avaliar o perfil dos alunos concluintes, deficientes visuais e videntes do Instituto de Cegos Padre Chico entre os anos 2011 e 2020. Métodos Entre janeiro e março de 2021, foi realizada uma análise documental dos alunos concluintes entre os anos de 2011 e 2020. Foram coletados dados relacionados à situação social, educacional, socioeconômica e oftalmológica. Os dados foram tratados no programa Microsoft Excel 2013 da Microsoft e analisados no software livre Bioestat, versão 5.0. Resultados Foram coletados os dados de 110 concluintes cegos, com baixa visão e videntes. Mais de 90% dos alunos declararam rendimento familiar equivalente a um salário-mínimo e meio. Do total da amostra, 52 alunos eram cegos; 38 tinham baixa visão, e 20 eram videntes. Dentre as 36 patologias identificadas entre os alunos, 57,78% levaram à cegueira e 42,22%, à baixa visão. Em alunos cegos, as patologias mais frequentes foram glaucoma congênito (32,69%) e amaurose congênita de Leber (11,53%); em alunos com baixa visão, foram glaucoma congênito e distrofias de retina (ambas em 10,53% da amostra). Conclusão É de suma importância a avaliação da saúde ocular para que o professor realize de forma mais rápida as práticas de ensino e alcance resultados satisfatórios na alfabetização de crianças com deficiência visual.

ABSTRACT Objective To evaluate the profile of visually impaired and sighted students at the Instituto de Cegos Padre Chico (ICPC) between 2011 and 2020. Methods Between January and March 2021, a document analysis of the students who completed the undergraduate course between 2011 and 2020. Data related to social, educational, socioeconomic, and ophthalmological situation were collected. The data were treated in Microsoft Excel 2013 and analyzed in the free software Bioestat, version 5.0. Results Retrospective data were collected from 110 blind, low-vision and sighted students who were graduating. More than 90% of the students declared family income equivalent to one and a half minimum wages. Of the total sample, 52 students were blind; 38 had low vision, and 20 were sighted students. Among the 36 pathologies identified among the students, 57.78% led to blindness, and 42.22%, to low vision. In blind students, the most frequent diagnosis was congenital glaucoma (32.69%) and Leber congenital amaurosis (11.53%); in low vision students, congenital glaucoma and retinal dystrophies (both in 11.53% of the population of this study). Conclusion The evaluation of the eye health is of vital importance for the teacher to perform teaching practices faster and achieve satisfactory results in the literacy of visually impaired children.

Profile of professionals working in intradialytic exercise programs in Brazil: a national survey / Perfil dos profissionais que atuam em programas de exercício físico durante as sessões de hemodiálise: um estudo nacional

Abstract Objective: This survey was designed to assess the profile of professionals working in intradialytic exercise programs (IEPs) in Brazil and reveal the motivators and barriers they face. Methods: The survey was sent to physiotherapists and exercise physiologists working in IEPs in Brazil. Phone interviews and electronic forms were used to collect the answers to the survey questionnaire. Results: Forty-one of the 261 included dialysis centers had IEPs; 44 professionals answered the questionnaire over the phone and 26 used the electronic form to do it. A total of 70 professionals (mean age 33.4±7.4 years; 84.3% physiotherapists) answered the questionnaire. Resistance training was the preferred mode of therapy. Most of the IEPs were connected to research and were paid for by private health insurance. The desire to work in a different field (30.0%) and lack of resources (31.4%) were the most prevalent motivator and barrier cited by IEP professionals working in dialysis centers, respectively. Conclusion: The majority of the few professionals that work in IEPs in Brazil are physiotherapists. Lack of resources was the most commonly reported barrier faced by survey respondents.

Resumo Objetivo: Avaliar o perfil dos profissionais que atuam em programas de exercício físico intradialítico (EFI) no Brasil e as motivações e barreiras para a atuação desses profissionais. Métodos: Foram incluídos fisioterapeutas e profissionais de educação física que atuam em programas de EFI no Brasil. Para coletar os dados, foi aplicado um questionário por ligação telefônica ou formulário eletrônico. Resultados: Dos 261 centros de diálise analisados, 41 apresentaram programas de EFI, sendo que 44 profissionais responderam ao questionário por telefone e outros 26, por meio eletrônico. Foram avaliados 70 profissionais (33,4±7,4 anos, 84,3% fisioterapeutas). A modalidade terapêutica mais aplicada foi o treinamento resistido. A maioria dos programas de EFI está associada a atividades de pesquisa e é financiada pela saúde suplementar. A possibilidade de atuação em um novo campo de trabalho (30,0%) e a falta de recursos (31,4%) foram a motivação e a barreira mais prevalentes para atuação dos profissionais nos centros de diálise, respectivamente. Conclusão: Poucos profissionais atuam em programas de EFI no Brasil, sendo a maioria fisioterapeutas. A falta de recursos foi a barreira mais prevalente para a atuação desses profissionais.

6-nitrodopamine is a major endogenous modulator of human vas deferens contractility.

BACKGROUND: Rat isolated vas deferens releases 6-nitrodopamine (6-ND), and the spasmogenic activity of this novel catecholamine is significantly reduced by tricyclic compounds such as amitriptyline, desipramine, and carbamazepine and by antagonists of the α1 -adrenergic receptors such as doxazosin, tamsulosin, and prazosin. OBJECTIVES: To investigate the liberation of 6-ND by human epididymal vas deferens (HEVDs) and its pharmacological actions. METHODS: The in vitro liberation of 6-ND, dopamine, noradrenaline, and adrenaline from human vas deferens was evaluated by LC-MS/MS. The contractile effect of the catecholamines in HEVDs was investigated in vitro. The action of tricyclic antidepressants was evaluated on the spasmogenic activity ellicited by the catecholamines and by the electric-field stimulation (EFS). The tissue was also incubated with the inhibitor of nitric oxide (NO) synthase L-NAME and the release of catecholamines and the contractile response to EFS were assessed. RESULTS: 6-ND is the major catecholamine released from human vas deferens and its synthesis/release is inhibited by NO inhibition. The spasmogenic activity elicited by EFS in the human vas deferens was blocked by tricyclic antidepressants only at concentrations that selectively antagonize 6-ND induced contractions of the human vas deferens, without affecting the spasmogenic activity induced by dopamine, noradrenaline, and adrenaline in this tissue. Incubation of the vas deferens with L-NAME reduced both the 6-ND release and the contractions induced by EFS. DISCUSSION AND CONCLUSION: 6-ND should be considered a major endogenous modulator of human vas deferens contractility and possibly plays a pivotal role in the emission process of ejaculation. It offers a novel and shared mechanism of action for tricyclic antidepressants and α1 -adrenergic receptor antagonists.

ß1- and ß1/ß2-adrenergic receptor antagonists block 6-nitrodopamine-induced contractions of the rat isolated epididymal vas deferens.

6-Nitrodopamine (6-ND) is an endogenous modulator of the contractility in the rat isolated epididymal vas deferens (RIEVD) and considered to be the main peripheral mediator of the emission process. Use of selective and unselective ß-adrenergic receptor antagonists has been associated with ejaculatory failure. Here, the effects of selective ß1- and ß1/ß2-adrenergic receptor antagonists on RIEVD contractions induced by 6-ND, dopamine, noradrenaline, adrenaline, and electric-field stimulation (EFS) were investigated. The selective ß1-adrenergic receptor antagonists atenolol (0.1 and 1 µï»¿M), betaxolol (1 µï»¿M), and metoprolol (1 µï»¿M) and the unselective ß1/ß2-adrenergic receptor antagonists propranolol (1 and 10 µï»¿M) and pindolol (10 µï»¿M) caused significant rightward shifts of the concentration-response curve to 6-ND (pA2 6.41, 6.91, 6.75, 6.47, and 5.74; for atenolol, betaxolol, metoprolol, propranolol, and pindolol), but had no effect on dopamine-, noradrenaline-, and adrenaline-induced contractions. The effects of selective ß1- and ß1/ß2-adrenergic receptor antagonists at a higher concentration (atenolol 1 µï»¿M, betaxolol 1 µï»¿M, metoprolol 1 µï»¿M, propranolol 10 µï»¿M, and pindolol 10 µï»¿M) also reduced the EFS-induced RIEVD contractions in control, but not in RIEVD obtained from L-NAME-treated animals. The selective ß1-adrenoceptor agonist RO-363, the selective ß2-adrenoceptor agonist salbutamol, and the selective ß3-adrenoceptor agonist mirabegron, up to 300 µï»¿M, had no effect on the RIEVD tone. The results demonstrate that ß1- and ß1-/ß2-adrenoceptor receptor antagonists act as 6-ND receptor antagonists in RIEVD, further confirming the main role of 6-ND in the RIEVD contractility.

Profile of professionals working in intradialytic exercise programs in Brazil: a national survey.

OBJECTIVE: This survey was designed to assess the profile of professionals working in intradialytic exercise programs (IEPs) in Brazil and reveal the motivators and barriers they face. METHODS: The survey was sent to physiotherapists and exercise physiologists working in IEPs in Brazil. Phone interviews and electronic forms were used to collect the answers to the survey questionnaire. RESULTS: Forty-one of the 261 included dialysis centers had IEPs; 44 professionals answered the questionnaire over the phone and 26 used the electronic form to do it. A total of 70 professionals (mean age 33.4±7.4 years; 84.3% physiotherapists) answered the questionnaire. Resistance training was the preferred mode of therapy. Most of the IEPs were connected to research and were paid for by private health insurance. The desire to work in a different field (30.0%) and lack of resources (31.4%) were the most prevalent motivator and barrier cited by IEP professionals working in dialysis centers, respectively. CONCLUSION: The majority of the few professionals that work in IEPs in Brazil are physiotherapists. Lack of resources was the most commonly reported barrier faced by survey respondents.

Geomorphometric environmental fragility of a watershed: a multicriteria spatial approach.

Knowledge and understanding of the functioning of watersheds is essential for constructing future scenarios that aim to minimize instability. However, new approaches including variables, methods, and techniques into traditional methodologies contribute to environmental planning and management of such territorial units. This study aims to propose a model based on a multicriterion spatial approach for the analysis of the geomorphometric environmental fragility of watersheds. This study was conducted in the Murundú-Paiol watershed, located in the state of São Paulo, Brazil. Morphometric, geological, pedological, hypsometric, slope, land use, and land cover data were evaluated and integrated using geotechnologies for processing and analytical hierarchy process (AHP) considering a weighted linear combination for an integrated spatial analysis of the watershed. The study area shows a greater predisposition to fragility in areas of flat and smooth reliefs, especially around the main river, where there is a greater presence of anthropic areas. The methodology proposed here, which uses a multicriterion spatial approach and AHP, combined with technical and scientific data, allows replicating the model to another watersheds. Modeling was validated in a cooperative way using an in-field, traditional method. The watershed evaluated showed that 49.13% and 26.83% of lands have medium and low fragility, respectively, while about 17% of lands have a high fragility and their management should be a priority. Modeling correlates strongly and positively with fragility class detailing, and field areas corroborate the model proposed here. This evidenced a robust analysis of factors that affect the geomorphometric environmental fragility of watersheds. The method is efficient in contributing to environmental planning and management of this territorial unit.

Desempenho intelectual e crenças disfuncionais em crianças vítimas de abuso sexual / Intellectual performance and dysfunctional beliefs in children victims of sexual abuse

O abuso sexual infantil pode gerar consequências que afetam a cognição em níveis intelectuais e socioemocionais. Desse modo, o presente estudo buscou avaliar a inteligência de um grupo de crianças que sofreu abuso sexual e relacioná-la com crenças disfuncionais. Foi realizado no Hospital Universitário Júlio Müller em Cuiabá, Mato Grosso, no Programa de Atendimento às Vítimas de Violência Sexual. A amostra foi constituída de 17 participantes, de 6 a 10 anos e 11 meses de idade (M=8,1 anos; DP=1,4). A ela, foram administrados o teste Matrizes Progressivas Coloridas de Raven (MPCR), para avaliação da inteligência, e a Escala de Atribuições e Percepções de Crianças (CAPS), para avaliação das crenças disfuncionais. Por meio da análise das classificações obtidas no MPCR, não foram encontradas crianças com déficits intelectuais. Por meio da correlação de Spearman, constatou-se que houve correlações moderadas entre o MPCR e o CAPS, com médio e grande tamanhos de efeito, mas inversamente proporcionais. Ou seja, quanto maior foi o desempenho intelectual, menores foram as crenças disfuncionais, e vice-versa. Tais dados encontrados permitiram concluir que o investimento em processos educacionais e interventivos psicoterápicos que visem o atendimento a ambas as variáveis se torna um dos fatores protetivos a esse grupo clínico.

Sexual abuse against children can have consequences that affect cognition at an intellectual and socio-emotional levels. Thus, the present study sought to assess the intelligence of a group of children who suffered sexual abuse and to relate it to dysfunctional beliefs. It was carried out at the Júlio Müller University Hospital in Cuiabá, Mato Grosso, in the Program of Assistance to Victims of Sexual Violence. The sample consisted of 17 participants, aged from 6 to 10 years and 11 months old (M=8.1 years; SD=1.4). Was administered the Raven's Progressive Color Matrices (RPCM) test, to assess intelligence, and the Scale of Attributions and Perceptions of Children (CAPS), to assess dysfunctional beliefs. Through the analysis of the classifications obtained in the RPCM, children with intellectual deficits were not found. Through Spearman's correlation, it was found that there were moderate correlations between RPCM and CAPS, with medium and large effect sizes, but inversely proportional. In other words, the higher the intellectual performance, the lower the dysfunctional beliefs, and vice versa. Results provided enough information to conclude that investments in educational process and interventional psychotherapeutic that seeks the accomplishment of both variables becomes one of the protective factors for this clinical group.

Development and validation of a rapid RP-HPLC method for simultaneous quantification of paclitaxel and cetuximab in immunoliposomes.

The development of rational therapies against complex diseases, such as cancer, has increased in the past few years due to the advances of 'omics' technologies. Concomitantly, several efforts have been made to design sophisticated drug delivery systems in order to increase specificity and drug accumulation in tumor sites. The complexity of these drug delivery systems highlights the need for suitable analytical methods to determine encapsulation/conjugation efficiency of drugs and molecules responsible for the targeted delivery. Therefore, this study focuses on the development and validation of a RP-HPLC-DAD methodology for concurrent quantification of paclitaxel (PTX) and cetuximab (CTX) in immunoliposomes. Chromatographic separation was achieved using a wide pore C8 column, and a gradient mobile phase consisting of 0.1% trifluoroacetic acid (TFA) in Milli-Q water/acetonitrile/isopropanol with a flow rate of 1 mL min-1. Drug peaks were fully separated and detected at 280 nm using UV detector. The method was validated according to ICH and FDA guidelines in terms of specificity and forced degradation studies, system suitability, linearity, limit of detection, limit of quantification, repeatability, intermediate precision, accuracy, robustness, and short-term stability. The developed method was linear over the concentration range of 37.5-150 µg mL-1 of PTX and 75-300 µg mL-1 of CTX. All parameters evaluated satisfied the acceptance criteria, according to both FDA and ICH guidelines. The applicability of the analytical method was assessed following the development of PTX-loaded immunoliposomes conjugated with CTX. Thus, the present study shows a novel, simple, stability-indicating and suitable method to quantify simultaneously PTX and CTX in immunoliposomes.

Intravaginal pressure profile of continent and incontinent women.

A well-functioning pelvic floor muscle plays an important role in maintaining urinary continence. The aim of this study was to describe and compare the intravaginal pressure profile using a multisensor device along the vaginal length in women with and without urinary incontinence (UI), while performing pelvic floor muscle tasks. Fifty-four adult pre-menopausal women (31 continent and 23 incontinent) participated in this cross-sectional observational cohort study. The intravaginal pressure profile was assessed at rest, during maximum and sustained pelvic floor muscle contractions, using the Pliance® multisensor device. Between-group comparisons were performed considering the overall pressure and the pressure profile of 10-subregions along the vaginal length. In the overall pressure assessment, women with UI presented lower pressures at rest, similar pressures during maximum contraction and lower capacity to maintain pressure during sustained contraction compared to those in the continent group. The pressure profile assessment showed between-group differences that were consistent throughout tasks, with the incontinent group presenting lower pressures than the continent group, specifically in the mid-vaginal length, around 3-4 cm from the vaginal opening. We observed consistent deficits in pressure generation in incontinent compared to continent women, precisely in the region of the pelvic floor muscles. With this protocol and novel instrument, we obtained a reliable and consistent intravaginal pressure profile of continent and incontinent women. This approach could assist clinicians in the assessment of pelvic floor muscle function and foster a better understanding of the urinary incontinence mechanism.

High spatial resolution pressure distribution of the vaginal canal in Pompoir practitioners: A biomechanical approach for assessing the pelvic floor.

BACKGROUND: Pompoir is a technique poorly studied in the literature that claims to improve pelvic floor strength and coordination. This study aims to investigate the pelvic floor muscles' coordination throughout the vaginal canal among Pompoir practitioners and non-practitioners by describing a high resolution map of pressure distribution. METHODS: This cross-sectional, study included 40 healthy women in two groups: control and Pompoir. While these women performed both sustained and "waveform" pelvic floor muscle contractions, the spatiotemporal pressure distribution in their vaginal canals was evaluated by a non-deformable probe fully instrumented with a 10×10 matrix of capacitive transducers. FINDINGS: Pompoir group was able to sustain the pressure levels achieved for a longer period (40% longer, moderate effect, P=0.04). During the "waveform" contraction task, Pompoir group achieved lower, earlier peak pressures (moderate effect, P=0.05) and decreased rates of contraction (small effect, P=0.04) and relaxation (large effect, P=0.01). During both tasks, Pompoir group had smaller relative contributions by the mid-region and the anteroposterior planes and greater contributions by the caudal and cranial regions and the latero-lateral planes. INTERPRETATION: Results suggest that specific coordination training of the pelvic floor muscles alters the pressure distribution profile, promoting a more-symmetric distribution of pressure throughout the vaginal canal. Therefore, this study suggests that pelvic floor muscles can be trained to a degree beyond strengthening by focusing on coordination, which results in changes in symmetry of the spatiotemporal pressure distribution in the vaginal canal.

Novel instrumented probe for measuring 3D pressure distribution along the vaginal canal.

We developed an intravaginal instrumented probe (covered with a 10×10 matrix of capacitive sensors) for assessing the three-dimensional (3D) spatiotemporal pressure profile of the vaginal canal. The pressure profile was compared to the pelvic floor (PF) digital assessment, and the reliability of the instrument and repeatability of the protocol was tested. We also tested its ability to characterize and differentiate two tasks: PF maximum contraction and Valsalva maneuver (maximum intra-abdominal effort with downward movement of the PF). Peak pressures were calculated for the total matrix, for three major sub-regions, and for 5 planes and 10 rings throughout the vaginal canal. Intraclass correlation coefficients indicated excellent inter- and intra-rater reliability and intra-trial repeatability for the total and medial areas, with moderate reliability for the cranial and caudal areas. There was a moderate correlation between peak pressure and PF digital palpation [Spearman's coefficient r=0.55 (p<0.001)]. Spatiotemporal profiles were completely different between tasks (2-way ANOVAs for repeated measures) with notably higher pressures (above 30kPa) for the maximum contraction task compared to Valsalva (below 15kPa). At maximum contraction, higher pressures occurred in the mid-antero-posterior zone, with earlier peak pressure onsets and more variable along the vaginal depth (from rings 3 to 10-caudal). During Valsalva, the highest pressures were observed in rings 4-6, with peak pressure onsets more synchronized between rings. With this protocol and novel instrument, we obtained a high-resolution and highly reliable innovative 3D pressure distribution map of the PF capable of distinguishing vaginal sub-regions, planes, rings and tasks.

Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women.

Pelvic floor muscle (PFM) force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation. Twenty healthy, nulliparous women were evaluated using two strain-gauge dynamometers (one cylinder-like inside the vaginal cavity, and the other measuring hip adduction/abduction forces around both thighs) while performing three different tasks: (a) isolated PFM contraction; (b) PFM contraction combined with hip adduction (30% and 50% maximum hip force); and (c) PFM contraction combined with hip abduction (30% and 50% maximum hip force). Data were sampled at 100Hz and subtracted from the offset if existent. We calculated a gradient between the isolated PFM contraction and each hip condition (Δ Adduction and Δ Abduction) for all variables: Maximum force (N), instant of maximum-force occurrence (s), mean force in an 8-second window (N), and PFM force loss (N.s). We compared both conditions gradients in 30% and 50% by paired t-tests. All variables did not differ between hip conditions both in 30% and 50% of maximum hip force (p>.05). PFM contraction combined with isometric hip abduction did not increase vaginal force in healthy and nulliparous women compared to PFM contraction combined with isometric hip adduction. Therefore, so far, the use of hip adduction or abduction in PFM training and treatments are not justified for improving PFM strength and endurance.

Using Therapeutic Toys to Facilitate Venipuncture Procedure in Preschool Children.

Intravenous access procedures in children are considered to be one of the most stressful because it is invasive, and the use of needles generates anxiety, insecurity, and fear. Playful strategies using dolls and even the materials used for venipuncture can assist children in understanding, accepting, and coping with the procedure. Field research was developed on the applicability of the therapeutic toy in the preparation of preschool children for venipuncture procedure based on the protocol developed by Martins, Ribeiro, Borba, and Silva (2001) and Kiche and Almeida (2009). The study was done in a private hospital in Greater São Paulo, Brazil, with 10 children ages 3 to 6 years. Data were gathered through observation and questionnaires completed by the children's adult guardians. Before the activity, the children showed fearful facial expressions, used monosyllabic responses, and avoided looking at the health care professional. After the strategy of using therapeutic toy dolls and puppets, 40% of the children calmly accepted the venipuncture procedure, and 100% showed a change to their initial negative reaction, became more communicative and cooperative, and participated and interacted with researchers, even after the end of the activity and procedure. The strategy of therapeutic toys helps make an unfamiliar environment, strangers, and a procedure characterized as painful and difficult less stressful. Pediatric nurses are in a good position to use this resource to offer more humanized care to children.

Avaliação da qualidade microbiológica de queijos do tipo Minas padrão de produção industrial, artesanal e informal / Microbiological evaluation of Minas type cheeses from industrial, artisanal and informal manufacturing

Os objetivos deste estudo foram de avaliar a qualidade microbiológica de queijos do tipo Minas padrão,produzidos de forma industrial com inspeção federal, artesanal com inspeções estadual e municipal (a partir de leite não pasteurizado) e informal (produção caseira), bem como de analisar os hábitos de consumo desse tipo de queijo no Distrito Federal, Brasil. As amostras (n = 21) foram submetidas a análises para a pesquisa de coliformes a 30 °C e 45 °C, Staphylococcus coagulase positiva, Listeria monocytogenes e Salmonella spp. Os resultados foram avaliados de acordo com a RDC 12/2001 da ANVISA; 57,14% das amostras de queijos industriais, 100% das informais e 100% das artesanais estavam em desacordo quanto às contagens de Staphylococcus coagulase positiva. As contagens de coliformes a 45°C estavam em desacordo em 71,42% das amostras de queijos informais e 14,28% das industrializadas e artesanais. Nenhuma amostra foi positiva para L. monocytogenes ou Salmonella spp. Um questionário simplificado sobre o consumo de queijo Minas foi aplicado a 50 pessoas no momento da compra e houve indicação de 47% de preferência ao sabor de queijos informais. Em virtude destes queijos não serem inspecionados e não seguirem padrões de produção, representam um risco à saúde pública...

Expression of the zinc transporters genes and metallothionein in obese women.

Research has investigated the participation of zinc transport proteins and metallothionein in the metabolism of this mineral. However, studies about the genetic expression of these proteins in obese patients are scarce. The study determined the expression of zinc transporter protein codifying genes (ZnT-1, Zip-1 and Zip-3) and of metallothionein in 55 obese women, aged between 20 and 56 years. The assessment of body composition was carried out using anthropometric measurements and bioelectrical impedance. Zinc intake was obtained by recording diet over a 3-day period, and the nutritional analysis was carried out using NutWin software version 1.5. The plasmatic and erythrocytary zinc were analyzed by atomic absorption spectrophotometry (λ=213. 9 nm). The determination of mRNA expression of the zinc transporter proteins and metallothionein was carried out using blood, using the RT-PCR method. The mean values of body mass index were 37.9±5.5 kg/m2. The average intake of zinc was 9.4±2.3 mg/day. The analysis of the zinc plasma concentrations showed values of 58.4±10.9 µg/dL. The mean values of zinc in the erythroytes were 38.7±9.1 µg/g Hb. The metallothionein gene had a higher expression in the blood, when compared to zinc transporters ZnT-1, Zip-1, and Zip-3 (p=0.01). The study shows that there are alterations in the biochemical parameters of zinc in obese patients assessed, as well as higher expression of the codifying gene metallothionein, when compared to the investigated zinc transporters.

Erythrocytary zinc and the infant growth profile in northeast Brazil.

This study evaluated nutritional status linked to zinc levels in 239 randomly selected children at crèches in Teresina, Brazil, aged 3 to 6. Blood samples were collected after fasting of 10 h. Erythrocytary zinc levels were determined through flame atomic absorption spectrophotometry. Zinc deficiency was determined as below 40 microg Zn/g Hb. Infant linear growth was evaluated measuring weight and height, and nutritional status by height/age, weight/height, and weight/age indices, expressed as Z scores, in line with the National Center for Health Statistics. The mean zinc concentration was 35.50 +/- 10.95 microg Zn/g Hb. Zinc distribution in the 10, 50, 75, and 90 percentiles was 24.73 microg Zn/g Hb, 35.45 microg Zn/g Hb, 40.73 microg Zn/g Hb and 52.77 microg Zn/g Hb, respectively. Based on this distribution, normal values were found only from the 75th percentile and above. Since the cutoff point adopted was 40 microg Zn/g Hb, the prevalence of zinc deficiency was 74.3%. As for growth profile, 8.4% were chronically malnourished, although the statistical association between linear impairment and nutritional status regarding zinc was insignificant. The study revealed that an important segment of the infant population was mineral deficient; however, the degree of deficiency did not influence growth profiles.

Assessment of weight changes during and after pregnancy: practical approaches.

The usefulness of routine prenatal weight measurements in predicting pregnancy outcomes is still a controversial issue. Comparisons among studies and the interpretation of research findings are complicated due to the variety of indicators applied to express maternal weight changes during and after pregnancy. A review of literature was conducted to clarify the definitions and examine the strengths and limitations of methods for measuring gestational weight gain (WG) and postpartum weight changes. The reasons for weak correlations or non-significant associations between gestational WG and maternal and neonatal outcomes were probably owing to poor quality of obstetrics records and selection of wrong indicators to compute gestational WG. The choice of an indicator depends on clinical and research purpose, availability and reliability of data and cost. Considering the health implication of gestational WG, it is necessary to take into account the measurements used as initial and final weight, accuracy of gestational age estimation and the inclusion of fetal weight as part of maternal WG. Regardless of the indicators used to compute the weight changes after delivery, attention is drawn to the approach for designating prepregnancy weight, the time frame of postpartum weight measurements and the use of overlapping variables, which results in bias (part-whole correlation). It is necessary to address criticisms on the accuracy of prenatal weight measurements and the way of expressing the maternal weight changes during and after pregnancy in order to have reliable results from research.

Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI?

OBJECTIVE: The objective was to assess the relevance of the recommendations of the Institute of Medicine (IOM), regarding gestational weight gain (GWG) for long-term BMI development. RESEARCH METHODS AND PROCEDURES: The Stockholm Pregnancy and Women's Nutrition is a follow-up study of 483 women who delivered children in 1984 to 1985. ANOVA was used to examine the change in body weight before pregnancy, at 6 months, and 1 year postpartum and 15 years after childbirth. Multiple linear regression was used to assess the predictors of BMI at 15-year follow-up. RESULTS: The weight increase from baseline to 15-year follow-up was 6.2 kg for IOM-insufficient, 6.7 kg for IOM-recommended, and 10.0 kg for IOM-excessive weight gain (p < 0.01). ANOVA showed a main effect of time, group and group by time interaction. The weight of the women who had excessive GWG was significantly greater at each time-point of follow-up than the weight of those who gained within or below recommendations. GWG was related to BMI at 15-year follow-up even after accounting for several confounders. Women who gained excessive weight during pregnancy had an increase of 0.72 kg/m(2) in long-term BMI compared with women who gained within recommendations. DISCUSSION: The findings support the adequateness of IOM guidelines, not only for the pregnancy-related health matters, but also for preventing long-term weight retention after delivery. Healthcare providers should give women appropriate advice for controlling GWG and motivate them to lose pregnancy-related weight during postpartum to prevent future overweight.

Impacto do estilo de vida no controle de peso durante a gestação e pós-parto / Impact of lifestyle factors on weight control during pregnancy and post-partum

O objetivo desta tese é avaliar o impacto do estilo de vida materno no ganho de peso durante a gestação e na sua evolução durante o pós-parto. Inicialmente, foi realizada uma revisão da literatura sobre os indicadores utilizados para computar as mudanças de peso ocorridas durante a gestação e o pós-parto. Posteriormente, utilizou-se o modelo de regressão logística para avaliar a associação entre a abstinência ao fumo durante o pré-natal e o ganho de peso gestacional (GPG) excessivo, segundo as recomendações do Institute of Medicine (IOM), em 1.249 mulheres que deram à luz a recém-nascidos vivos a termo em 1984/85 em Estocolmo, Suécia. Em seguida, foi utilizado o modelo de regressão linear múltipla para avaliar o efeito do GPG excessivo no índice de massa corporal (IMC) materno 15 anos após o parto. A populaçãoelegível para análise foi constituída de 483 mulheres suecas, que foram acompanhadas desde o nascimento da criança índice em 1984/85 até 1999/2000. Por último, uma revisão sistemática com a utilização de metanálise foi realizada para apreciar o efeito da dieta, exercício ou ambos na perda de peso no pós-parto. A diversidade de indicadores utilizada para computar o GPG e a retenção de peso no pós-parto dificulta a interpretação e comparação dos resultados de pesquisas sobre o tema. A baixa qualidade dos registros obstétricos e a escolha inadequada do indicador são consideradas as possíveis causas da não associação entre o ganho de peso materno e os desfechos gestacionais encontrada em alguns estudos. Ex-fumantes apresentam 1,8 vezes mais chance de GPG excessivo em relação às mulheres não fumantes, mesmo após o ajuste pelas variáveis de confusão, como o consumo de álcool, atividade física, entre outras. Mulheres que tiveram GPG excessivo apresentaram maior retenção de peso 15 anos após parto (10,0 kg) do que as mulheres que ganharam peso conforme os limites recomendados pelo IOM (6,7 kg). Mesmo após o controle pelas variáveis de confusão, o GPG excessivo...