Analysis of bone microarchitecture related to anthropometry in climateric women.

BACKGROUND: Osteoporosis is one of the most important public health problems involving a high percentage of costs in the medical care system. Reliable diagnostic techniques for an early detection of bone deterioration and studies of factors that influence its development in menopausal women are crucial. The aim of the study was to determine the relationship between bone microarchitecture and anthropometry in climacteric women. METHODS: Women were recruited at the Menopause Clinic, University Hospital of FMRP/USP, and submitted to anthropometry and to the evaluation of bone quality (Ultrasound Bone Profile Index, UBPI) and quantity (Amplitudedependent Speed of Sound, AD-SoS-) by phalangeal quantitative osteosonography (DBM Sonic BP). Descriptive analysis of the data was reported and a multiple linear regression was performed using the software SAS® 9.0. RESULTS: 71 patients aged 58 ± 7 y were studied: 28% had BMI 18.5-24.9 kg/m(2), 35% BMI 24.9-29.9 and 37% BMI > 30. Mean AD-SoS was 2059 ± 79 m/s and mean UBPI was 0.67 ± 0.13. Considering AD-SoS the dependent variable, there was no statistically significant relationship between age (p = 0.20), BMI (p = 0.76), fat mass by bioelectrical impedance (p = 0.42) and by anthropometry (p = 0.95). The variables had very low effect on the UBPI when it was considered the dependent variable. CONCLUSIONS: The relation between bone microarchitecture and the anthropometry of the women studied shows that, the greater the bone quantity, the better the anthropometric parameters, without statistically significance. This work was a cross-sectional study on a small sample that needs to be validated in a prospective design.

Analysis of bone microarchitecture related to anthropometry in climateric women / Análisis de la microarquitectura ósea relacionada con la antropometría en mujeres postmenopáusicas

Background: Osteoporosis is one of the most important public health problems involving a high percentage of costs in the medical care system. Reliable diagnostic techniques for an early detection of bone deterioration and studies of factors that influence its development in menopausal women are crucial. The aim of the study was to determine the relationship between bone microarchitecture and anthropometry in climacteric women. Methods: Women were recruited at the Menopause Clinic, University Hospital of FMRP/USP, and submitted to anthropometry and to the evaluation of bone quality (Ultrasound Bone Profile Index, UBPI) and quantity (Amplitudedependent Speed of Sound, AD-SoS-) by phalangeal quantitative osteosonography (DBM Sonic BP). Descriptive analysis of the data was reported and a multiple linear regression was performed using the software SAS® 9.0. Results: 71 patients aged 58 ± 7 y were studied: 28% had BMI 18.5-24.9 kg/m2, 35% BMI 24.9-29.9 and 37% BMI > 30. Mean AD-SoS was 2059 ± 79 m/s and mean UBPI was 0.67 ± 0.13. Considering AD-SoS the dependent variable, there was no statistically significant relationship between age (p = 0.20), BMI (p = 0.76), fat mass by bioelectrical impedance (p = 0.42) and by anthropometry (p = 0.95). The variables had very low effect on the UBPI when it was considered the dependent variable. Conclusions: The relation between bone microarchitecture and the anthropometry of the women studied shows that, the greater the bone quantity, the better the anthropometric parameters, without statistically significance. This work was a cross-sectional study on a small sample that needs to be validated in a prospective design (AU)

Introducción y objetivo: La osteoporosis es uno de los problemas más importantes de la Salud Pública e involucra un elevado porcentaje de los costos del Sistema de Salud. Es decisiva la aplicación de técnicas confiables de diagnóstico para la detección precoz del deterioro óseo y estudios de los factores que influencian su desarrollo en mujeres postmenopáusicas. El objetivo del estudio fue determinar la relación entre la micro arquitectura ósea y la antropometría de mujeres postmenopáusicas. Métodos: Se reclutaron mujeres, en el dispensario de Climaterio del Hospital Universitario (FMRP/USP), que fueron sometidas a antropometría y evaluación de la calidad ósea (Índice Ultrasonográfico del Perfil Óseo-UBPI) y de la cantidad ósea (Velocidad del Sonido dependiente de la Amplitud-Ad-SoS) por medio de la osteosonografía cuantitativa de falange (DBM Sonic BP). Se realizaron análisis descriptivos de los datos y regresión lineal múltiple utilizando el software SAS® 9.0. Resultados: Se estudiaron 71 pacientes con edad media de 58 ± 7 años: 28% tuvieron el IMC entre 18,5-24,9 kg/m2, 35% entre 24,9-29,9 y 37% IMC arriba de 30. La media del Ad-SoS fue 2.059 ± 79 m/s y del UBPI fue 0,67 ± 0,13. Considerando el Ad-SoS como la variable dependiente, no hubo relación estadísticamente significativa entre la edad (p = 0,20), IMC (p = 0,76), masa grasa por la impedancia bioeléctrica (p = 0,42) y por la antropometría (p = 0,95). Las variables tuvieron un efecto muy bajo en el UBPI cuando este fue considerado la variable dependiente. Conclusión: La relación entre la micro arquitectura ósea y la antropometría de las mujeres estudiadas mostró que cuanto mayor es la cantidad ósea, mejores son los parámetros antropométricos sin importancia estadística. Este trabajo fue un estudio transversal de una muestra pequeña, por lo cual necesita ser validado en un diseño prospectivo (AU)

Determination of temperature variation during the individual steps of the production of hospital diets of modified consistency.

BACKGROUND & AIM: Many disease outbreaks of food origin are caused by foods prepared in Food Service and Nutrition Units of hospitals, affecting hospitalized patients who, in most cases, are immunocompromised and therefore at a higher risk of severe worsening of their clinical status. The aim of this study was to determine the variations in temperature and the time-temperature factor of hospital diets. METHODS: The time and temperature for the preparation of 4 diets of modified consistency were determined on 5 nonconsecutive days in a hospital Diet and Nutrition Unit at the end of preparation and during the maintenance period, portioning and distribution at 3 sites, i.e., the first, the middle and the last to receive the diets. RESULTS AND DISCUSSION: All foods reached an adequate temperature at the end of cooking, but temperature varied significantly from the maintenance period to the final distribution, characterizing critical periods for microorganism proliferation. During holding, temperatures that presented a risk were reached by 16.7% of the meats and 59% of the salads of the general diet, by 16.7% of the garnishes in the bland diet and by 20% of the meats and garnishes in the viscous diet. The same occurred at the end of distribution for 100% of the hot samples and of the salads and for 61% of the desserts. None of the preparations remained at risk temperature for a time exceeding that established by law. CONCLUSION: The exposure to inadequate temperature did not last long enough to pose risks to the patient.

Determination of temperature variation during the individual steps of the production of hospital diets of modified consistency / Determinación de las variaciones de temperatura durante los distintos pasos de la producción de las dietas del hospital con modificación en la consistencia

Background & aim: Many disease outbreaks of food origin are caused by foods prepared in Food Service and Nutrition Units of hospitals, affecting hospitalized patients who, in most cases, are immunocompromised and therefore at a higher risk of severe worsening of their clinical status. The aim of this study was to determine the variations in temperature and the time-temperature factor of hospital diets. Methods: The time and temperature for the preparation of 4 diets of modified consistency were determined on 5 non consecutive days in a hospital Diet and Nutrition Unit at the end of preparation and during the maintenance period, portioning and distribution at 3 sites, i.e., the first, the middle and the last to receive the diets. Results and discussion: All foods reached an adequate temperature at the end of cooking, but temperature varied significantly from the maintenance period to the final distribution, characterizing critical periods for microorganism proliferation. During holding, temperatures that presented a risk were reached by 16.7% of the meats and 59% of the salads of the general diet, by 16.7% of the garnishes in the bland diet and by 20% of the meats and garnishes in the viscous diet. The same occurred at the end of distribution for 100% of the hot samples and of the salads and for 61% of the desserts. None of the preparations remained at risk temperature for a time exceeding that established by law. Conclusion: The exposure to inadequate temperature did not last long enough to pose risks to the patient (AU)

Antecedentes y objetivos: muchas epidemias de origen alimentario están causadas por alimentos preparados en las unidades de alimentación y nutrición de los hospitales y afectan a pacientes hospitalizados que, en su mayoría, están inmunodeprimidos y presentan, por lo tanto, un mayor riesgo de empeoramiento grave de su estado clínico. El objetivo de este estudio fue determinar las variaciones en la temperatura y el factor tiempo-temperatura en las dietas de los hospitales. Métodos: se determinó el tiempo y la temperatura de preparación de 4 dietas de consistencia modificada durante 5 días consecutivos en una Unidad de alimentación y nutrición, al final de la preparación y durante el periodo de mantenimiento, racionamiento y distribución en 3 sitios, es decir, el primer sitio en recibir la dieta, el intermedio y el último. Resultados y discusión: todos los alimentos alcanzaron una temperatura adecuada al final de su preparación, pero la temperatura varió significativamente desde su periodo de mantenimiento hasta su distribución final, caracterizando periodos críticos para la proliferación de microorganismos. Durante su almacenamiento, las temperaturas que representaron un riesgo se dieron en el16,7% de las carnes y el 59% de las ensaladas de la dieta general, en el 16,7% de las guarniciones de la dieta blanda y en el 20% de las carnes y las guarniciones de la dieta viscosa. Lo mismo ocurrió al final de la distribución en el100% de las muestras calientes y de las ensaladas y en el61% de los postres. Ninguna de las preparaciones permaneció a una temperatura de riesgo durante un tiempo que excediese el tiempo establecido por ley. Conclusión: La exposición a una temperatura inadecuada no fue lo suficientemente prolongada para presentar un riesgo para el paciente (AU)

Influence of the spatial distribution of human hosts and large size containers on the dispersal of the mosquito Aedes aegypti within the first gonotrophic cycle.

It is generally accepted that Aedes aegypti (L.) (Diptera: Culicidae) has a short dispersal capacity, and that displacement can be influenced by the availability of oviposition sites in the surroundings of emergence or release sites. In the present article, we observed the influence of spatial heterogeneity of large containers and human hosts on the cumulative flight direction of Ae. aegypti females during the first gonotrophic cycle, testing the hypothesis that they aggregate in resource-rich areas, i.e. where there are higher concentrations of large containers and/or humans per habitation. We analysed data from pupal surveys and mark-release-recapture experiments (non-blood-fed females were released) carried out in two dengue endemic neighbourhoods of Rio de Janeiro, Brazil: Tubiacanga (a suburb, with a human density of 337 inhabitants/ha) and Favela do Amorim (a slum, with a human density of 901 inhabitants/ha). In both areas, host-seeking females of three different release cohorts showed an overall non-uniform and extensive dispersal from their release point within 1-2 days post-release. At 4-5 days post-release, when many of the released females would be expected to be gravid, in Tubiacanga most mosquitoes were collected in areas with a relatively higher density of containers/premise, independently of the density of residents/house, whereas in Favela do Amorim, almost half of the captured mosquitoes were collected in relatively resource-poorer areas. Although Ae. aegypti dispersal patterns varied between sites, overall the distances travelled from the release point and the cumulative flight directions were correlated with the density of containers and hosts, more markedly in Tubiacanga than in Favela do Amorim.

Loxosceles spider bites in the state of Paraná, Brazil: 1993-2000

This study presents the epidemiological analysis of 20,699 reported spider bites involving the Loxosceles genus in the state of Paraná, Brazil, from 1993 to 2000. The incidence rate in the period was 290.24/100,000 inhabitants. The results show that 95.04 percent of the accidents occurred in two Health Regions of the state: greater metropolitan Curitiba (92.9 percent) and Irati (2.14 percent). The major incidence was recorded in greater metropolitan Curitiba (559.1/100,000). Loxosceles bites were more frequent in females (61 percent) than in males. Antivenin therapy was not necessary in 95.4 percent (19,662) of the cases. From the cases in which information about the time elapsed between the bite and medical treatment was recorded (9,679), 31.8 percent received treatment from 6 to 48 hours after the bite. Among the cases with severity rate recorded (12,096), 2.1 percent were severe, 50.4 percent moderate, and 47.4 percent mild. Seven deaths from Loxosceles bites were recorded, corresponding to a fatality rate of 0.03 percent.

Malaria epidemiology in the Pakaanóva (Wari') Indians, Brazilian Amazon.

This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.

[Spatial analysis of Aedes aegypti larval distribution in the Ilha do Governador neighborhood of Rio de Janeiro, Brazil]. / Análise da distribuição espacial de larvas de Aedes aegypti na Ilha do Governador, Rio de Janeiro, Brasil.

This study aims to help expand knowledge on Aedes aegypti in Rio de Janeiro, based on spatial analysis of the mosquito's breeding sites in the neighborhood of Ilha do Governador, Rio de Janeiro, from June 1992 to July 1994. Use of spatial analysis techniques is proposed for vector surveillance and control. Information obtained from the number of dwellings per block that were used for the analysis. A smoothing method, a Gaussian Kernel, was used in the spatial distribution analysis. Breaks in National Health Foundation intervention activities were observed between cycles 4 and 5 and 5 and 6, respectively, followed by increases in vector density and vector-positive areas. Permanently positive areas, like slums and a military compound, display the persistence of favorable environmental conditions for oviposition and larval growth, indicating flaws in the vector control program. Although Kernel is an exploratory analytical method involving subjective interpretation, it provides easy and fast visualization of sites subject to different degrees of risk, unaffected by existing political and administrative territorial apportionment.

[The factors associated with the occurrence of immature forms of Aedes aegypti in Ilha do Governador, Rio de Janeiro, Brazil]. / Fatores associados à ocorrência de formas imaturas de Aedes aegypti na Ilha do Governador, Rio de Janeiro, Brasil.

Aedes aegypti is the vector of dengue, a disease that can result in epidemics. Ecological studies are important because different geographical populations of the vector may differ in their bioecological characteristics, which can be helpful in guiding control actions. The objective of this study was to identify and to analyze some factors associated with the occurrence of immature forms of A. aegypti on Ilha do Governador, Rio de Janeiro, using data from the National Health Foundation (FNS). The results showed that 58.04% of all the containers examined were supports for plant pots, and plastic or glass cans discarded in the yard. The highest percentages of positive breeding sites were observed in tires (1.41%), wells and cisterns (0.93%), and barrels and large metal cans (0.64%). In the summer, the proportion of positivity was higher for big containers used for water storage and for containers discarded in the yard. In the winter the proportion was higher for small containers used for water storage. The highest rates of positive containers were observed after three months without FNS activities. Our results show the necessity to continue the control, and suggest that less attention was paid to small containers during the winter by FNS. Factorial analysis showed that the determinant factor for the occurrence of immature forms of A. aegypti is represented by environmental factors, while elimination and treatment of breeding sites by FNS play a less important role, a fact possibly causing the maintenance of immature forms of A. aegypti.