The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used.

We performed a systematic review of the prevalence of metabolically healthy obesity (MHO). Medline, Web of Science and EMBASE were searched for original articles from inception to November 2013. Only prospective and cross-sectional studies were included. After screening 478 titles, we selected 55 publications, of which 27 were population-based studies and were used in the narrative synthesis. From the 27 studies, we identified 30 definitions of metabolic health, mainly based on four criteria: blood pressure, high-density lipoprotein cholesterol, triglycerides and plasma glucose. Body mass index ≥30 kg m(-2) was the main indicator used to define obesity (74% of the studies). Overall, MHO prevalence ranged between 6% and 75%. In the studies that stratified the analysis by sex, prevalence was higher in women (seven out of nine studies) and in younger ages (all four studies). One-third of the studies (n = 9) reported the response rate. Of these, four reported a response rate of ≥70% and they showed MHO prevalence estimates between 10% and 51%. The heterogeneity of MHO prevalence estimates described in this paper strengthens calls for the urgent need for a commonly established metabolic health definition.

Effect of continuous and pulsed therapeutic ultrasound in the appearance of local recurrence of mammary cancer in rats.

PURPOSE: Ultrasound (US) therapy is an electrothermotherapeutic modality that uses US energy to provoke physical and chemical alterations. US therapy has been widely used in physical therapy. However, in clinical practice, it is contraindicated in cancer patients due to the possibility of exacerbating tumor growth. METHODS: Sixty-eight female Sprague-Dawley rats bred in UNIFAE vivarium were studied. At 50 days of age, 7,12-dimetylbenz(a)anthracene (7,12-DMBA) was administered to 35 rats by gastric gavage to induce mammary cancer. After 90 days the mammary glands of the rats belonging to the group with mammary cancer induction and stimulated by US were removed. Animals received either continuous or pulsed US. US waves were generated at a frequency of 1 MHz during 10 days, with an intensity dose of 0.5 W in the continuous group, and 0.9 W (duty cycle: 20%) in the pulsed group. RESULTS: Among the rats treated with continuous US, 44.4% developed local recurrence, while among the rats treated with pulsed US, 22.2% had local tumor recurrence (p<0.05). No evidence of distant metastases was shown in any of the rats studied. CONCLUSION: The use of continuous and pulsed therapeutic US promoted the development of local recurrence of mammary cancer in female Sprague-Dawley rats in the postoperative period.

Granular cell tumors of the esophagus: report of five cases and review of diagnostic and therapeutic techniques.

Granular cell tumors (GCT) of the esophagus are stromal lesions originating from the Schwann cells of the submucosal neuronal plexus. Although they are very infrequent, they constitute the second largest cause of non-epithelial tumors in the esophagus after leiomyomas. These tumors are generally benign, although a certain number of malignant, aggressive cases have been reported. Diagnosis requires that this possibility be ruled out before deciding on which course of therapeutic action to take as well as familiarization with the relevant indicators. GCT linked synchronically or metachronically to other malignant neoplasias of the esophagus have also been described, but the actual extent of this association is uncertain. This report describes five cases of GCT recently diagnosed as incidental findings following endoscopic exploration. All of these were benign and were treated conservatively. The article discusses new aspects relating to the diagnosis of these lesions and the role carried out by endoscopic ultrasonography in their characterization, both at preliminary diagnosis and monitoring levels. No standard therapeutic guidelines exist for the management of GCT, but endoscopic treatment without invading the muscularis propria layer would be used for symptomatic patients, creating histopathological doubts requiring research on the entire organ. Endoscopic therapeutic techniques are analyzed (resection with forceps or diathermy handles, yttrium-aluminum-garnet laser ablation, alcohol injection) in esophageal GCT, which have overtaken surgery in most cases due to their efficiency, greater safety and fewer complications.

pH at the micellar interface: synthesis of pH probes derived from salicylic acid, acid-base dissociation in sodium dodecyl sulfate micelles, and Poisson-Boltzmann simulation.

The study of the H+ concentration at the micellar interface is a convenient system for modeling the distribution of H+ at interfaces. We have synthesized salicylic acid derivatives to analyze the proton dissociation of both the carboxylic and phenol groups of the probes, determining spectrophotometrically the apparent pK(a)'s (pK(ap)) in sodium dodecyl sulfate, SDS, micelles with and without added salt. The synthesized probes were 2-hydroxy-5-(2-trimethylammoniumacetyl)benzoate; 2-hydroxy-5-(2-dimethylhexadecylammoniumacetyl)benzoate; 2-hydroxy-5-(2-dimethylhexadecylammoniumhexanoyl)benzoate; 2-hydroxy-5-(2-dimethylhexadecylammoniumundecanoyl)benzoate; 2-hydroxy-5-acetylbenzoic acid; and 2-hydroxy-5-dodecanoylbenzoic acid. Upon incorporation into SDS micelles the pK(ap)'s of both carboxylic and phenol groups increased by ca. 3 pH units and NaCl addition caused a decrease in the probe-incorporated pK(ap). The experimental results were fitted with a cell model Poisson-Boltzmann (P-B) equation taking in consideration the effect of salt on the aggregation number of SDS and using the distance of the dissociating group as a parameter. The conformations of the probes were analyzed theoretically using two dielectric constants, e.g., 2 and 78. Both the P-B analysis and conformation calculations can be interpreted by assuming that the acid groups dissociate very close to, or at, the interface. Our results are consistent with the assumption that the intrinsic pK(a)'s of both carboxylic and phenol groups of the salicylic acid probes used here can be taken as those in water. Using this assumption the micellar and salt effects on the pK(ap)'s of the (trialkylammonium)benzoate probes were described accurately using a cell model P-B analysis.

[Productivity of a breeding place of Aedes albopictus in an urban environment]. / Produtividade de criadouro de Aedes albopictus em ambiente urbano.

INTRODUCTION: Aedes albopictus has been found at Cananeia city in the Southeastern State of S. Paulo, Brazil. A study was carried out to evaluate the productivity of its breeding place. MATERIAL AND METHOD: A container classified as large and permanent was chosen. Water had accumulated at the bottom and was rich in organic matter, mainly of vegetal origin. From November 1996 until May 1997, fortnightly observations were performed, sampling immature stages found in a seventh part of the container's total water volume (nearly 70 litres). Pupae were collected, identified and sexed. The productivity of the breeding place was estimated using Focks et al's. (1981) formula adapted for a single large container. At the same time adults were caught by using human bait and the aspiration of resting places. The first catch was performed at six meters from the breeding place studied. Williams' mean was calculated for the human bait and mean hourly density for the aspiration results of the resting places (Subbarao et al., 1988). RESULTS: Immature stages of Ae. albopictus represented 44.9% of the total collected through fifteen fortnightly regular samplings (November 1996 to May 1997). The pupae mean was 31.13 and so the emergence index was 2.1. Multiplied by seven the result was 14.7 as the estimated mean number of females per day produced in that container. Adult females caught on human bait gave a general Williams' mean of 30.7, while the mean hour by density was 9.2. According to the accumulated calculated adult number, 22.8 females per day were available to seek human bait, under the conditions of the observations performed. DISCUSSION: Counting pupae is an efficient method of estimating the productivity of the breeding place of Ae. albopictus. The richness of the organic matter in the water in the container made it quite inappropriate to establish comparisons with water reservoirs for domestic use. Nevertheless, a lack of or deficient maintenance approximate these containers to the one here studied. So cleaning is an important factor and it must be emphasized as necessary to prevent the installation of mosquito breeding. Though it is a distinct species it is reasonable to expect that the application of these study methods to Ae. aegypti would be useful in the attempt being made to eradicate this latter species from our country.