Assessing mercury contamination in Southern Hemisphere marine ecosystems: The role of penguins as effective bioindicators.

Mercury (Hg) is a global pollutant known for its significant bioaccumulation and biomagnification capabilities, posing a particular threat to marine environments. Seabirds have been recognized as effective bioindicators of marine pollution, and, among them, penguins present a unique opportunity to serve as a single taxonomic group (Sphenisciformes) for monitoring Hg across distinct marine ecosystems in the Southern Hemisphere. In this study, we conducted a comprehensive systematic review of Hg concentrations, and performed a meta-analysis that took into account the various sources of uncertainty associated with Hg contamination in penguins. Beyond intrinsic species-specific factors shaping Hg levels, our results showed that the penguin community effectively reflects spatial patterns of Hg bioavailability. We identified geographic Hg hotspots in Australia, the Indian Ocean, and Tierra del Fuego, as well as coldspots in Perú and the South Atlantic. Furthermore, specific penguin species, namely the Southern Rockhopper (Eudyptes chrysocome) and Macaroni penguin (Eudyptes chrysolophus), are highlighted as particularly vulnerable to the toxic effects of Hg. Additionally, we identified knowledge gaps in geographic areas such as the Galápagos Islands, South Africa, and the coast of Chile, as well as in species including Fiordland (Eudyptes pachyrhynchus), Snares (Eudyptes robustus), Erect-crested (Eudyptes sclateri), Royal (Eudyptes schlegeli), Yellow-eyed (Megadyptes antipodes), and Galápagos (Spheniscus mendiculus) penguins. Overall, our study contributes to the growing body of literature emphasizing the role of penguins as bioindicators of Hg pollution, but it also highlights areas where further research and data collection are needed for a more comprehensive understanding of Hg contamination in marine ecosystems in the Southern Hemisphere.

Food-based dietary guidelines for children and adolescents.

Objective: This study aimed at reviewing food-based dietary guidelines (FBDGs) with content targeted at children and adolescents to present their main characteristics, thus enabling comparisons among countries. Design: We conducted a search of the FBDGs available on the Food and Agriculture Organization (FAO) website, followed by a scoping review with a gray literature search to find FBDGs for children or adolescents non-listed on the FAO's website. Data extraction included the year of publication, language, and guidelines for the target group. Results: From FAO website searches, 109 documents were found, and 17 of them could not be translated. The Scoping review search conducted in 5,190 articles, and none led to new guidelines, nor from the gray literature. Regarding the 92 FBDGs explored, 41 were specific for infants under 24 months old, children, and/or adolescents, and 51 were for the general population with information for the studied group. Twelve percent of the general FBDG and 35% of the specific ones have food icons. All of the guidelines were published after 2001. Latin America and the Caribbean were the regions that presented more specific FBDGs and the majority of countries with guidelines for fruits and vegetables. The information about fat (15 countries) and sugar (26 countries) consumption reduction is frequent. Reduction of sodium intake appears to be in the majority of guidelines after 2015. Food hygiene guidelines are recurrent in Latin American documents. NOVA classification was adopted in five countries and 21 countries approach recommendations for mealtimes. Both exclusive and continued breastfeeding guidance and healthy complementary feeding orientation are present in over 50% of the specific FBDG for infants and children under 24 months old. Conclusion: Food-based dietary guidelines are diverse due to both the nutritional and political aspects of each region. Latin America stands out for its orientations for the studied group. Further studies should measure the possible impacts and comprehension of FBDGs.

Peptide-Grafted Nontoxic Cyclodextrins and Nanoparticles against Bacteriophage Infections.

One of the biggest threats for bacteria-based bioreactors in the biotechnology industry is infections caused by bacterial viruses called bacteriophages. More than 70% of companies admitted to encountering this problem. Despite phage infections being such a dangerous and widespread risk, to date, there are no effective methods to avoid them. Here we present a peptide-grafted compounds that irreversibly deactivate bacteriophages and remain safe for bacteria and mammalian cells. The active compounds consist of a core (cyclodextrin or gold nanoparticle) coated with a hydrophobic chain terminated with a peptide selective for bacteriophages. Such peptides were selected via a phage display technique. This approach enables irreversible deactivation of the wide range of T-like phages (including the most dangerous in phage infections, phage T1) at 37 °C in 1 h. We show that our compounds can be used directly inside the environment of the bioreactor, but they are also a safe additive to stocks of antibiotics and expression inducers (such as isopropyl ß-d-1-thiogalactopyranoside, i.e., IPTG) that cannot be autoclaved and are a common source of phage infections.

Quercetin increases mitochondrial proteins (VDAC and SDH) and downmodulates AXL and PIM-1 tyrosine kinase receptors in NRAS melanoma cells.

Melanoma is a type of skin cancer with low survival rates after it has metastasized. In order to find molecular differences that could represent targets of quercetin in anti-melanoma activity, we have chosen SKMEL-103 and SKMEL-28 melanoma cells and human melanocytes as models. Firstly, we observed that quercetin was able in reducing SKMEL-103 cell viability, but not in SKMEL-28. Besides that, quercetin treatment caused inhibition of AXL in both cell lines, but upregulation of PIM-1 in SKMEL-28 and downregulation in SKMEL-103. Moreover, HIF-1 alpha expression decreased in both cell lines. Interestingly, quercetin was more effective against SKMEL-103 than kinases inhibitors, such as Imatinib, Temsirolimus, U0126, and Erlotinib. Interestingly, we observed that while the levels of succinate dehydrogenase and voltage-dependent anion channel increased in SKMEL-103, both proteins were downregulated in SKMEL-28 after quercetin's treatment. Furthermore, AKT, AXL, PIM-1, ABL kinases were much more active and chaperones HSP90, HSP70 and GAPDH were highly expressed in SKMEL-103 cells in comparison with melanocytes. Our findings indicate, for the first time, that the efficacy of quercetin to kill melanoma cells depends on its ability in inhibiting tyrosine kinase and upregulating mitochondrial proteins, at least when SKMEL-103 and SKMEL-28 cells response were compared.

Nature-Inspired Circular-Economy Recycling for Proteins: Proof of Concept.

The billion tons of synthetic-polymer-based materials (i.e. plastics) produced yearly are a great challenge for humanity. Nature produces even more natural polymers, yet they are sustainable. Proteins are sequence-defined natural polymers that are constantly recycled when living systems feed. Digestion is the protein depolymerization into amino acids (the monomers) followed by their re-assembly into new proteins of arbitrarily different sequence and function. This breaks a common recycling paradigm where a material is recycled into itself. Organisms feed off of random protein mixtures that are "recycled" into new proteins whose identity depends on the cell's specific needs. In this study, mixtures of several peptides and/or proteins are depolymerized into their amino acid constituents, and these amino acids are used to synthesize new fluorescent, and bioactive proteins extracellularly by using an amino-acid-free, cell-free transcription-translation (TX-TL) system. Specifically, three peptides (magainin II, glucagon, and somatostatin 28) are digested using thermolysin first and then using leucine aminopeptidase. The amino acids so produced are added to a commercial TX-TL system to produce fluorescent proteins. Furthermore, proteins with high relevance in materials engineering (ß-lactoglobulin films, used for water filtration, or silk fibroin solutions) are successfully recycled into biotechnologically relevant proteins (fluorescent proteins, catechol 2,3-dioxygenase).

Are Cape Peninsula baboons raiding their way to obesity and type II diabetes? - a comparative study.

Researchers, managers and conservationists in the Cape Peninsula, South Africa, have reported cases of individual baboons (Papio ursinus) appearing overweight, lethargic and having poor teeth. Despite an intensive baboon management programme, there are certain individual baboons and troops that continue to raid human food sources. These food sources often are high in processed carbohydrates and saturated fats. As this diet is highly associated with obesity, insulin resistance and type II diabetes, the present study aimed to establish if these baboons may be at risk of developing insulin resistance. Post mortem muscle samples from 17 Cape Peninsula and 7 control adult male baboons were rapidly frozen in liquid nitrogen and analysed for insulin receptor substrate-1 (IRS-1), glucose transporter 4 (GLUT4), oxidative and glycolytic markers of metabolism (citrate synthase, 3-hydroxyacyl-CoA-dehydrogenase, lactate dehydrogenase and creatine kinase activities), and muscle fibre morphology. The sampled Peninsula baboons were heavier (33 ± 2 vs. 29 ± 2 kg, P < 0.05) and had a higher frequency of poor teeth compared to control baboons. Muscle fibre type, fibre size, GLUT4 content, oxidative and glycolytic metabolism were not different between the two groups. However, IRS-1 content, a marker of insulin sensitivity, was significantly lower (by 43%, P < 0.001) in the Peninsula baboons compared to the controls. This study provides the first indirect evidence that some Peninsula baboons with a history of raiding human food sources, may be at risk of developing insulin resistance in the wild, with long term implications for population health.

Gluteus medius accessorius and gluteus quartus scansorius in one specimen: case report of two rare variations

The gluteal muscles have all the same embryological origin and therefore show typical variations. The gluteus medius has its origin on the external surface of the ilium and inserts at the major greater trochanter. It lies between the gluteus maximus and minimus. Variations included in this case are the gluteus medius accessorius and the gluteus quartus or scansorius. Various sources of literature have described these two muscles on anthropoids and in man, but never with the two very rare variations appearing in one specimen, as we have found in this right lower limb of a 53-year-old woman. The gluteus medius originates from the iliac crest between the gluteus medius and the gluteus minimus and inserts onto the greater trochanter. The gluteus quartus arises from the anterior portion of the gluteus minimus and the fascia lata and inserts into the tip of the greater trochanter. As a clinical consequence, the occurrence of these muscles might lead to instability in the hip joint on the contralateral side, and these anatomical variations are also important to be known during different approaches of total hip replacement surgery

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Quorum sensing communication: Bradyrhizobium-Azospirillum interaction via N-acyl-homoserine lactones in the promotion of soybean symbiosis.

Quorum-sensing (QS) mechanisms are important in intra- and inter-specific communication among bacteria. We investigated QS mechanisms in Bradyrhizobium japonicum strain CPAC 15 and Azospirillum brasilense strains Ab-V5 and Ab-V6, used in commercial co-inoculants for the soybean crop in Brazil. A transconjugant of CPAC 15-QS with partial inactivation of N-acyl-homoserine lactones (AHLs) was obtained and several parameters were evaluated; in vitro, CPAC 15 and the transconjugant differed in growth, but not in biofilm formation, and no differences were observed in the symbiotic performance in vivo. The genome of CPAC 15 carries functional luxI and luxR genes and low amounts of three AHL molecules were detected: 3-OH-C12-AHL, 3-OH-C14-AHL, and 3-oxo-C14-AHL. Multiple copies of luxR-like genes, but not of luxI are present in the genomes of Ab-V5 and Ab-V6, and differences in gene expression were observed when the strains were co-cultured with B. japonicum; we may infer that the luxR-genes of A. brasilense may perceive the AHL molecules of B. japonicum. Soybean symbiotic performance was improved especially by co-inoculation with Ab-V6, which, contrarily to Ab-V5, did not respond to the AHLs of CPAC 15. We concluded that A. brasilense Ab-V5, but not Ab-V6, responded to the QS signals of CPAC 15, and that the synergistic interaction may be credited, at least partially, to the QS interaction. In addition, we confirmed inter- and intra-species QS communication between B. japonicum and A. brasilense and, for Azospirillum, at the strain level, impacting several steps of the symbiosis, from cell growth to plant nodulation and growth.

Screen time, body mass index and neck circumference: is there an association with social class in children? / Tempo de tela, índice de massa corporal e circunferência do pescoço: existe associação com a classe social em crianças?

Abstract Life habits during childhood are decisive for future health conditions. The aim of this study was to evaluate screen time and anthropometry of children enrolled in municipal schools in the interior of the State of São Paulo. A cross-sectional study was carried out with students from 9 to 10 years of age from a city in the State of São Paulo, Brazil. A socioeconomic questionnaire validated by the Brazilian Association of Research Companies was used, containing also the determination of screen time (TV, video game, computer and cell phone), recommended by the Pediatrics Society. Anthropometry data was collected according to the Lohmam Anthropometric Standardization Reference Manual and compared to the z-score level with the WHO 2007. For the statistical analysis, Kruskal-Wallis, Chi-square or Fisher's Exact tests were used.The confidence level was at 95%. Out of the 703 schoolchildren assessed, 97.44% had adequate height, 59.17% eutrophy BMI and 30.44% overweight. There was a correlation between BMI and non-stratified social class (p=0.038) and BMI and neck circumference (NC) (p<0.001).The z-score of the BMI showed that children with weight loss stayed longer watching TV (p=0.0486). The gender comparison showed that girls of higher social class stayed longer at the computer (p=0.0351) and using the cell phone (p<0.0001),and boys playing videogame (p=0.0005). Overweight and weight loss shown in the positive correlation between BMI and NC, although on opposite sides, were associated with screen time and especially with TV in children of higher social class.

Resumo Hábitos de vida apresentados durante a infância, serão decisivos para a situação de saúde no futuro. Objetivou-se avaliar tempo de tela e antropometria de crianças matriculadas em escolas municipais do interior de São Paulo. Estudo transversal com escolares de 9 a 10 anos de idade de uma cidade do estado de São Paulo-Brasil. Utilizou-se um questionário sócio-econômico validado pela Associação Brasileira de Empresas de Pesquisa, contendo também a determinação do tempo de tela (TV, vídeo game, computador e celular), recomendado pela Sociedade de Pediatria. A antropometria foi coletada de acordo com o Anthropometric Standardization Reference Manual de Lohmam e comparada à nível de escore-z, com a WHO 2007. Para a análise estatística utilizou-se os testes de Kruskal-Wallis, Qui-quadrado ou Exato de Fisher. O nível de confiança foi de 95%. Dos 703 escolares avaliados, 97,44% apresentaram estatura adequada, 59,17% IMC de eutrofia e 30,44% de sobrepeso. Houve correlação entre o IMC e a classe social não estratificada (p=0,038) e o IMC e circunferência do pescoço (CP) (p<0,001). O escore-z do IMC mostrou que as crianças com magreza ficaram mais tempo na TV (p=0,0486). A comparação de gêneros mostrou que as meninas de classe social mais alta ficaram mais tempo no computador (p=0,0351) e no celular (p< 0,0001), e os meninos no videogame (p=0,0005). O sobrepeso e a magreza mostrados na correlação positiva entre IMC e CP, embora estejam em lados opostos, foram associados ao tempo de tela e principalmente à TV, nas crianças de maior classe social.

Alzheimer's disease: nutritional status and cognitive aspects associated with disease severity.

INTRODUCTION: Alzheimer's pathology is a neurodegenerative disease characterized by cognitive impairment and functional disability that causesprogressive restrictions in daily activities. The present study associates nutritional status with cognitive and clinical aspects of the elderly withmild, moderate and severe Alzheimer's disease (AD). METHODS: data from the Mini Nutritional Assessment (MNA), bioelectrical impedance (BIA), anthropometric measurements, and physical activityindicators were associated with clinical and cognitive aspects of 43 elderly patients with AD. The data were compared to a paired control group (NC) (n = 51) at a significance level of p < 0.05. RESULTS: elderly patients with AD presented lower cognitive performance, higher risk of malnutrition (p = 0.001), lower weight (t-test, p = 0.017) and body mass index (BMI) (p = 0.006), and higher sedentarity (Chi-square, p = 0.040) when compared with the NC. The elderly with AD presented significant reduction in lean body mass (LM) and increased fat mass (FM). As dementia progresses, significant impairment of nutritional indicators is observed. Elderly patients with severe AD present lower weight, BMI, MNA scores and increased body fat mass index and fat mass when compared with those with mild/moderate AD. A correlation was observed between better cognitive performance and weight, BMI, calf circumference and triceps skinfold thickness. CONCLUSION: elderly patients with AD present high sedentarity, risk of malnutrition, lower weight, BMI and LM, and increased FM. There was progressive impairment of nutritional status and cognition as the disease progressed. There is an association between the nutritional variables and cognitive aspects.

Alzheimer's disease: nutritional status and cognitive aspects associated with disease severity / Enfermedad de Alzheimer: estado nutricional y sus relaciones con los aspectos cognitivos y la gravedad de la enfermedad

Introduction: Alzheimer's pathology is a neurodegenerative disease characterized by cognitive impairment and functional disability that causes progressive restrictions in daily activities. The present study associates nutritional status with cognitive and clinical aspects of the elderly with mild, moderate and severe Alzheimer's disease (AD). Methods: data from the Mini Nutritional Assessment (MNA), bioelectrical impedance (BIA), anthropometric measurements, and physical activity indicators were associated with clinical and cognitive aspects of 43 elderly patients with AD. The data were compared to a paired control group (NC) (n = 51) at a significance level of p < 0.05. Results: elderly patients with AD presented lower cognitive performance, higher risk of malnutrition (p = 0.001), lower weight (t-test, p = 0.017) and body mass index (BMI) (p = 0.006), and higher sedentarity (Chi-square, p = 0.040) when compared with the NC. The elderly with AD presented significant reduction in lean body mass (LM) and increased fat mass (FM). As dementia progresses, significant impairment of nutritional indicators is observed. Elderly patients with severe AD present lower weight, BMI, MNA scores and increased body fat mass index and fat mass when compared with those with mild/moderate AD. A correlation was observed between better cognitive performance and weight, BMI, calf circumference and triceps skinfold thickness. Conclusion: elderly patients with AD present high sedentarity, risk of malnutrition, lower weight, BMI and LM, and increased FM. There was progressive impairment of nutritional status and cognition as the disease progressed. There is an association between the nutritional variables and cognitive aspects

Introducción: la enfermedad de Alzheimer (EA) es una enfermedad neurodegenerativa caracterizada por incapacidad funcional, generalmente progresiva y con restricciones en la vida diaria. El objetivo de este estudio es valorar la asociación entre el estado nutricional y los aspectos cognitivos y clínicos en las personas mayores con EA leve, moderada y grave. Métodos: se relacionaron los datos del Mini Nutritional Assessment (MNA), la impedancia bioeléctrica (BIA), las medidas antropométricas y los indicadores de actividad física con los aspectos clínicos y cognitivos de 43 personas mayores con EA. Los datos se compararon a los de un grupo control (GC) pareado de 51 individuos, con un nivel de significación p < 0,05. Resultados: las personas mayores con EA tuvieron peores resultados en la evaluación cognitiva, un mayor riesgo de desnutrición (Mann-Whitney test; p = 0,001), menor peso (t test; p = 0,017) y menor índice de masa corporal (IMC) (p = 0,006), aunque un mayor sedentarismo (c2; p = 0,040), en comparación al GC. Las personas mayores con EA presentan, de manera significativa, menores medidas de masa magra (MM) y mayores medidas de masa grasa (MG). Según evoluciona la demencia los indicadores nutricionales empeoran. Las personas mayores con EA grave presentan menor peso, IMC y puntuación del MNA, pero mayores índices de masa grasa y masa magra cuando se comparan con los de EA leve y moderado. Hubo una correlación significativa entre un mejor desempeño cognitivo con el peso, IMC y medidas de la circunferencia de la pantorrilla c y el grosor del pliegue tricipital. Conclusión: las personas mayores con EA son más sedentarias, presentan mayor riesgo de desnutrición, menor peso, IMC y MM, y un aumento de la MG según va empeorando la enfermedad. Hay relación entre las variables nutricionales y los aspectos cognitivos

Revealing strategies of quorum sensing in Azospirillum brasilense strains Ab-V5 and Ab-V6.

Azospirillum brasilense is an important plant-growth promoting bacterium (PGPB) that requires several critical steps for root colonization, including biofilm and exopolysaccharide (EPS) synthesis and cell motility. In several bacteria these mechanisms are mediated by quorum sensing (QS) systems that regulate the expression of specific genes mediated by the autoinducers N-acyl-homoserine lactones (AHLs). We investigated QS mechanisms in strains Ab-V5 and Ab-V6 of A. brasilense, which are broadly used in commercial inoculants in Brazil. Neither of these strains carries a luxI gene, but there are several luxR solos that might perceive AHL molecules. By adding external AHLs we verified that biofilm and EPS production and cell motility (swimming and swarming) were regulated via QS in Ab-V5, but not in Ab-V6. Differences were observed not only between strains, but also in the specificity of LuxR-type receptors to AHL molecules. However, Ab-V6 was outstanding in indole acetic acid (IAA) synthesis and this molecule might mimic AHL signals. We also applied the quorum quenching (QQ) strategy, obtaining transconjugants of Ab-V5 and Ab-V6 carrying a plasmid with acyl-homoserine lactonase. When maize (Zea mays L.) was inoculated with the wild-type and transconjugant strains, plant growth was decreased with the transconjugant of Ab-V5-confirming the importance of an AHL-mediated QS system-but did not affect plant growth promotion by Ab-V6.

A medida do músculo adutor do polegar está associada com indicadores antropométricos de avaliação de massa magra e de massa gorda em pacientes hospitalizados / Adductor pollicis muscle measure is associated with anthropometric indicator of muscle mass and fat mass of hospitalized patients

Nutritional assessment is essential to diagnose and correct nutritional status, thus reducing hospital costs and mortality due to malnutrition. A new technique to evaluate the muscular compartment is the assessment of the adductor pollicis muscle thickness. It is a simpler alternative compared to the anthropometric parameters presently used. The objective of this research was to verify the association of the adductor policis muscle thickness with the anthropometric and subjective parameters of hospitalized patients, and subsequently, identify a cutoff point to be used as indicator of nutritional status. One hundred twelve patients hospitalized in the Medical and Surgical Clinic of a University Hospital in the countryside of the State of Sao Paulo were evaluated. The patients were submitted to nutritional assessment using the following parameters: subjective global assessment, classic anthropometry, and measurement of the adductor pollicis muscle thickness. The sample consisted mostly of patients with cardiovascular diseases (30.4%). The nutritional status of patients was characterized according to body mass index on prevalence of overweight and obesity (53.6%) and subjective global assessment of patients classified as nourished (72.3%). The mean thickness of the adductor pollicis muscle was 12.4±5.1mm. The adductor policis muscle thickness was weakly associated with anthropometric and subjective measures and failed to identify the cutoff point as an indicator of nutritional status, since the majority of the patients assessed presented overweight and obesity.

La evaluación nutricional es fundamental para diagnosticar y corregir el estado nutricional, reduciendo así los costos hospitalarios y la mortalidad, derivados de la desnutrición. Una nueva técnica para evaluar el compartimiento muscular consiste en evaluar la espesura del músculo aductor del pulgar (EMAP), que resulta una alternativa tan o más simple que los parámetros antropométricos utilizados actualmente. El objetivo de este estudio fue investigar la asociación de la espesura del músculo aductor del pulgar con parámetros antropométricos y subjetivos de pacientes hospitalizados, y la posterior identificación de un punto de corte a ser usado como indicador del estado nutricional. Se evaluaron 112 pacientes hospitalizados en la Clínica Médica y Clínica Quirúrgica de un Hospital Universitario del interior paulista. Los pacientes fueron sometidos a evaluación nutricional, utilizándose la medida de espesura del músculo aductor del pulgar, la evaluación subjetiva global y la antropometría clásica. La muestra estaba compuesta en su mayoría por pacientes con enfermedades cardiovasculares (30,4%). El estado nutricional de los pacientes se caracterizó, de acuerdo con el índice de masa corporal, por la prevalencia de sobrepeso y obesidad (53,6%) y, de acuerdo con la evaluación subjetiva global, por pacientes clasificados como bien nutridos (72,3%). El promedio de espesura del músculo aductor del pulgar para la muestra total fue de 12,4±5,1mm. El EMAP presentó asociación débil con los indicadores antropométricos y subjetivos, aunque no fue posible determinar un punto de corte del EMAP para su uso como indicador de estado nutricional, como consecuencia de la gran proporción de sobrepeso y obesidad en la población estudiada.

A avaliação nutricional é fundamental para se diagnosticar e corrigir o quadro nutricional, reduzindo-se assim os custos hospitalares e a mortalidade decorrentes da desnutrição. Uma nova técnica para avaliar o compartimento muscular é a avaliação da espessura do músculo adutor do polegar que surge como uma alternativa tão ou mais simples frente aos parâmetros antropométricos já utilizados. O objetivo do trabalho foi verificar a associação da espessura do músculo adutor do polegar com parâmetros antropométricos e subjetivos de pacientes hospitalizados e, posteriormente, identificar um ponto de corte a ser utilizado como indicador do estado nutricional. Foram avaliados 112 pacientes internados nas enfermarias de Clínica Médica e Clínica Cirúrgica de um Hospital Universitário do interior paulista. Os pacientes foram submetidos à avaliação nutricional, sendo utilizada a medida da espessura do músculo adutor do polegar, a avaliação subjetiva global e a antropometria clássica. A amostra foi constituída, na sua maioria, por pacientes com doenças cardiovasculares (30,4%). O estado nutricional dos pacientes caracterizou-se, segundo o índice de massa corporal, por prevalência de sobrepeso e obesidade (53,6%) e, segundo a avaliação subjetiva global, de pacientes classificados como bem nutridos (72,3%). A média da espessura do músculo adutor do polegar para o total da amostra foi de 12,4±5,1mm. A EMAP apresentou fraca associação com os indicadores antropométricos e subjetivos, não sendo possível determinar um ponto de corte do EMAP para a classificação do estado nutricional, tendo em vista a grande proporção de sobrepeso e obesidade na população estudada.

Clinical and nutritional status of surgical patients with and without malignant diseases: cross-sectional study.

CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

Clinical and nutritional status of surgical patients with and without malignant diseases: cross-sectional study / Estado clínico e nutricional de pacientes cirúrgicos com e sem doenças malignas: estudo transversal

CONTEXT: Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE: To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS: This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2 percent females and 49.8 percent males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5 percent. RESULTS: Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION: The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

CONTEXTO: A desnutrição em pacientes com doenças malignas é frequentemente observada durante a hospitalização e pode acarretar num aumento do período de internação. OBJETIVO: Comparar o estado nutricional, valores de linfócitos e hemoglobina e o tempo de internação em pacientes com e sem doenças malignas. MÉTODOS: Estudo comparativo com 928 pacientes cirúrgicos com e sem doenças malignas (50,2 por cento do sexo feminino e 49,8 por cento do sexo masculino), sendo analisados os indicadores do estado nutricional como índice de massa corporal, perda de peso recente, contagem de linfócitos, hemoglobina e o tempo de internação. Foi aplicado o teste qui ao quadrado para comparação de proporções e para a comparação de medidas contínuas entre dois grupos e foi aplicado também o teste de Mann-Whitney, com nível de significância de 5 por cento. RESULTADOS: Os pacientes com doenças malignas ficaram internados por mais tempo (P<0.0001), sendo constatado ainda neste grupo, maior percentual de pacientes com índice de massa corporal <18.5 (P<0.0001) e alteração de peso (P = 0.0002). Na contagem de linfócitos, constatou-se diferença estatística entre os grupos (P = 0,0131), sendo os menores valores encontrados entre os pacientes com doenças malignas (P = 0.01). CONCLUSÃO: A contagem de linfócitos, os valores de hemoglobina e a perda ponderal são achados importantes de depleção nutricional em pacientes com doenças malignas.

Dental and gastrointestinal changes as indicators of nutritional depletion in elderly inpatients.

OBJECTIVE: The objective of this study was to identify the associations between the nutritional status of elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. CASUISTIC AND METHOD: This cross-sectional study analyzed anthropometric and food intake indicators, dental and gastrointestinal changes and length of hospital stay of 441 elderly patients of both genders. The Pearson's correlation coefficient was used to verify the correlation between the nutritional status of the elderly patients and length of hospital stay and presence of dental and gastrointestinal changes. The significance level was set at P < 0.05. RESULTS: Dietary and anthropometric variables as well as length of hospital stay were similar for patients with and without dental changes. Patients with gastrointestinal changes consumed less energy (P < 0.05) than patients without gastrointestinal changes. Length of hospital stay was inversely correlated with body mass index (r = -0.15; P < 0.05); arm circumference was inversely correlated with presence of dental changes (r = -0.12; P < 0.05) and mid-arm muscle circumference was inversely correlated with gastrointestinal changes (r = -0.12; P < 0.05). CONCLUSION: Dental and gastrointestinal changes are important indicators of nutritional depletion and dietary intake of inpatients.

Estado nutricional e composição corporal de pacientes hospitalizados: reflexos da transição nutricional / Nutritional status and body composition of inpatients: the effects of nutritional transition

Objetivos: Investigar o reflexo da transição nutricional sobre o estado nutricional e a composição corporal de pacientes hospitalizados. Métodos: Avaliaram-se 819 pacientes hospitalizados (435 homens e 384 mulheres) sob aspectos clínicos, antropométricos e dietéticos. As variáveis antropométricas estudadas foram: peso atual (PA), altura (A), circunferência da cintura (CC), circunferência do quadril (CQ), circunferência braquial (CB), prega cutânea triciptal (PCT), e prega cutânea subescapular (PCSE). A partir destas medidas foram calculados: o índice de massa corporal (IMC), a relação entre a cintura e o quadril (RCQ), a relação entre a cintura e a altura (RCA), a circunferência muscular do braço (CMB), a área muscular do braço (AMB) e a área adiposa do braço (AAB). Para o diagnóstico da adiposidade central utilizou-se a relação entre a circunferência da cintura e a do quadril. Resultados: A idade média da população foi de 53,7±16,0 anos, com permanência hospitalar de 8 dias, sendo maior entre os idosos sendo maior entre os idosos (p<0,01).Parte dos pacientes (47,8%) apresentou sobrepeso/obesidade, 48,6% valores alterados de circunferência dacintura e 76,4% adiposidade central. As doenças cardiovasculares representaram 45,4%do total de internações, sendo 60,4% entre os idosos. Conclusão: Esse estudo mostrou elevada prevalência de obesidade e adiposidade central entre os pacientes hospitalizados independente do gênero, da idade, e do motivo de internação, tornando evidente o reflexo datransição nutricional na população estudada.

Objectives: To investigate the effects of nutritional transition on the nutritional status and body composition of inpatients. Methods: We assessed 819 inpatients (435 men and 384women) regarding clinical, anthropometric and dietary aspects. The anthropometric variables studied were: current weight (CW), height (H), waist circumference (WC), hip circumference (HC), arm circumference (AC), triceps skinfold (TSF) and subscapular skinfold thickness (SST). From these measures were determined: the body mass index (BMI), the waist and hip ratio (WHR), the waist and height ratio (RCA), the arm muscle circumference (AMC), the arm muscle area (AMA) and arm fat area (AFA). For the diagnosis of central adiposity, we used the relationship between waist and hip circumferences. Results: The mean age was 53.7 ± 16.0 years, with hospital stay of 8 days, being higher among the elderly (p <0.01). Most patients (47.8%) were overweight or obese, 48.6% presented altered values of waist circumference and 76.4% had central adiposity. Cardiovascular disease accounted for 45.4% of total admissions, and 60.4% among the elderly. Conclusion: This study showed high prevalence of obesity and central adiposity among inpatients regardless of gender, age, and the reason for admission, evidencing the effects of nutritional transition in the studied population.

Cross-sectional study on the weight and length of infants in the interior of the state of São Paulo, Brazil: associations with sociodemographic variables and breastfeeding.

CONTEXT AND OBJECTIVE: Increasing obesity is starting to occur among Brazilians. The aim of this study was to investigate the weight and length of children under two years of age in relation to sociodemographic variables and according to whether they were breastfed. DESIGN AND SETTING: Cross-sectional randomized study conducted in 2004-2005, based on the declaration of live births (SINASC) in Campinas, Brazil. METHODS: 2,857 mothers of newborns were interviewed and answered a questionnaire seeking socioeconomic and breastfeeding information. The newborns' weights and lengths were measured at the end of the interviews and the body mass index was calculated. Percentiles (< 15 and > 85) and Z-scores (< -1 and > +1) were used for classification based on the new growth charts recommended by WHO (2006). The log-rank test, multiple linear regression and binomial test (Z) were used. The statistical significance level used was 5%. RESULTS: The predominant social level was class C. The median for exclusive breastfeeding was 90 days; 61.25% of the children were between P15 and P85 for body mass index and 61.12% for length, respectively. Children whose mothers studied for nine to eleven years and children whose mothers were unemployed presented lower weight. Children whose mothers worked in health-related professions presented lower length when correlated with breastfeeding. CONCLUSION: The breastfeeding, maternal schooling and maternal occupation levels had an influence on nutrition status and indicated that obesity is occurring in early childhood among the infants living in the municipality.

Fatores associados à duração mediana do aleitamento materno em lactentes nascidos em município do estado de São Paulo / Factors associated with the median breastfeeding duration of infants born in a city of São Paulo State

OBJETIVO: Verificar a prevalência do aleitamento materno entre lactentes, correlacionada com variáveis sócio-demográficas, em Campinas (SP). MÉTODOS: Entre os anos de 2004 e 2005, entrevistadores visitaram 2 857 domicílios de crianças menores de dois anos e aplicaram às mães um questionário estruturado, composto por perguntas sobre nível socioeconômico, amamentação e alimentação complementar. O estudo foi transversal, de base populacional, randomizado, realizado com base nos dados da Declaração de Nascidos Vivos e da prevalência do aleitamento. A duração mediana do aleitamento foi determinada pela análise de sobrevida de Kaplan Méier, e o ajuste do tempo, pela análise multivariada de Cox. A significância estatística adotada foi de 5 por cento. RESULTADOS: A mediana do aleitamento materno exclusivo foi de 90 dias (Intervalo de Confiança - IC95 por cento: 87,6-92,4) e a do aleitamento materno geral foi de 120 dias (IC95 por cento: 117,7-122,3). Com um mês de vida, 66,2 por cento das crianças estavam sendo amamentadas exclusivamente com leite do peito, índice que diminuiu para 2,3 por cento aos seis meses. A introdução mediana para chá (IC95 por cento: 113,2-126,8) e para leite em pó (IC95 por cento: 112,7-127,3) foi de 120 dias. A cor da pele da criança, a escolaridade, a profissão e o estado civil maternos foram fatores associados à duração e ao tipo de amamentação. CONCLUSÃO: Fatores sócio-demográficos podem interferir na duração mediana do aleitamento materno que, embora esteja melhor do que em outros locais do Brasil, está abaixo do padrão recomendado internacionalmente, sugerindo a necessidade de maiores investimentos em relação a este fato, no município.

OBJECTIVE: The aim of this study was to verify the proportion of breastfed infants and correlate it with sociodemographic data in Campinas (SP), Brazil. METHODS: Between 2004 and 2005, interviewers visited 2,857 homes of children under two years of age and interviewed their mothers with a structured questionnaire containing questions regarding their socioeconomic level, breastfeeding practices and complementary foods. This randomized, cross-sectional, population-based study was based on data of "Children Born Alive" and on the prevalence of breastfeeding. The median breastfeeding duration was determined by Kaplan Meier's survival analysis and the time was adjusted by Cox's multivariate analysis. The significance level was set at 5 percent. RESULTS: Median exclusive breastfeeding was 90 days (CI 95 percent: 87.6 - 92.4); and median general breastfeeding was 120 days (CI 95 percent: 117.7 - 122.3). At 1 month of age, 66.2 percent of the children were exclusively breastfed; this percentage decreased to 2.3 percent at 6 months of age. Tea and powdered milk were introduced at a median age of 120 days (CI 95 percent: 113.2 - 126.8 and CI 95 percent: 112.7 - 127.3 respectively). The child's skin color and the mother's education level, profession and marital status were associated with breastfeeding duration and practices. CONCLUSION: Sociodemographic factors can interfere in median breastfeeding duration. Although the median breastfeeding duration in Campinas is better than elsewhere in Brazil, it is below the internationally recommended median, the city needs to invest more in this area.

Introdução alimentar e anemia em lactentes do município de Campinas (SP) / Feeding pattern and anemia in infants in the city of Campinas, São Paulo, Brazil

OBJETIVO: Verificar a prevalência de anemia em crianças do município de Campinas, levando-se em consideração a introdução de alimentos complementares. MÉTODOS: Estudo transversal realizado com 354 crianças de seis a 12 meses de idade, sorteadas do Sistema de Informações de Nascidos Vivos da cidade de Campinas. Profissionais da área da saúde devidamente treinados realizaram entrevista domiciliar com as mães dos lactentes, as quais responderam a um questionário contendo dados sobre a introdução de alimentos e condições socioeconômicas. Ao final, coletou-se sangue capilar do lactente, para dosagem de hemoglobina com o Hemocue®. Foram consideradas anêmicas as crianças com concentrações de hemoglobina inferiores a 11g/dL. Os dados foram avaliados por análise de sobrevida para verificar a associação da introdução alimentar com a anemia. RESULTADOS: Dos lactentes estudados, 66,5 por cento apresentaram níveis de hemoglobina <11g/dL. A introdução da dieta da família (p=0,036), pão (p=0,012), iogurte (p=0,006), refrigerante (p=0,005), balas (p=0,005) e dos salgadinhos de saquinho (p=0,013) foi mais precoce nas crianças com anemia. CONCLUSÕES: A inadequada introdução de alimentos pode ser considerada fator associado à anemia. Essas informações devem ajudar a direcionar, com maior precisão, os programas de prevenção e de combate dessa enfermidade no município.

OBJECTIVE: To verify the prevalence of anemia associated with the introduction of complementary food in children less than two years old in the city of Campinas, São Paulo, Brazil. METHODS: A cross-sectional survey was performed in 354 children between 6 and 12 months of age which were registered in the Live Births Information System from Campinas area. Health professionals interviewed the mothers, who answered a questionnaire about food introduction and socioeconomic status. Capillary blood was collected and the hemoglobin level was determined by Hemocue®. Anemia was diagnosed if hemoglobin level was below 11g/dL. Survival analysis was performed to determine the influence of complementary food introduction on anemia. RESULTS: 66.5 percent of the children had hemoglobin levels lower than 11g/dl. Anemia was associated to early introduction of the family diet (p=0.036), bread (p=0.012), yogurt (p=0.006), soft drinks (p=0.005), candies (p=0.005) and snacks (p=0.013). CONCLUSIONS: Inadequate complementary food introduction is associated with anemia. This information should be addressed by health programs in order to prevent anemia in children.