Emulsified and Nanoemulsified Essential Oils in the Control of Clostridium botulinum and Clostridium sporogenes in Mortadella.

Clostridium botulinum is a foodborne pathogen responsible for severe neuroparalytic disease associated with the ingestion of pre-formed toxin in food, with processed meats and canned foods being the most affected. Control of this pathogen in meat products is carried out using the preservative sodium nitrite (NaNO2), which in food, under certain conditions, such as thermal processing and storage, can form carcinogenic compounds. Therefore, the objective was to use nanoemulsified essential oils (EOs) as natural antimicrobial agents, with the aim of reducing the dose of NaNO2 applied in mortadella. The antimicrobial activity of nanoemulsions prepared with mixtures of EOs of garlic, clove, pink pepper, and black pepper was evaluated on endospores and vegetative cells of C. botulinum and Clostridium sporogenes (surrogate model) inoculated in mortadella prepared with 50 parts per million NaNO2. The effects on the technological (pH, water activity, and color) and sensory characteristics of the product were also evaluated. The combinations of EOs and their nanoemulsions showed sporicidal effects on the endospores of both tested microorganisms, with no counts observed from the 10th day of analysis. Furthermore, bacteriostatic effects on the studied microorganisms were observed. Regarding the technological and sensorial characteristics of the product, the addition of the combined EOs had a negative impact on the color of the mortadella and on the flavor/aroma. Despite the strong commercial appeal of adding natural preservatives to foods, the effects on flavor and color must be considered. Given the importance of controlling C. botulinum in this type of product, as well as the reduction in the amount of NaNO2 used, this combination of EOs represents a promising antimicrobial alternative to this preservative, encouraging further research in this direction.

Freezing/thawing as an accelerating process of wet- and dry-aged Nellore beef.

This study aimed to evaluate the use of freezing/thawing as a way of accelerating the aging processes of beef from Nellore animals. Non-frozen (NF) or freezing/thawing (FT) strip loins were aged (for 14 and 28 days) using two systems: bone-in dry-aging (DA); boneless wet-aging (WA). FT-treated samples had greater weight losses (P < 0.05) during aging than NF-treated samples, especially using the DA process. However, the weight loss of the FT 14-days DA beef samples was comparable to that of NF 28-days DA. FT beef had lower fragmentation index and shear force values (P < 0.05), as well as its maximum sensorial tenderness was achieved earlier (P < 0.05) than the NF counterpart. With 28 days of aging, DA beef showed higher (P < 0.05) tenderness and juiciness scores and lower lightness values than WA beef. The FT process decreased the reducing capacity of meat samples, generating more metmyoglobin and lower amounts of chroma than NF. The expected volatile profile of DA beef was achieved faster in FT-treated samples, but the freezing treatments did not compromise the microbial count for either aging system. Our findings indicate that accelerated DA by the FT process could improve the palatability of Nellore beef, allowing the desired tenderness and flavor profile to be achieved in a shorter time, without increasing costs with weight losses or adversely affecting physicochemical, chemical, and microbial characteristics.

S-nitrosothiols as nitrite alternatives: Effects on residual nitrite, lipid oxidation, volatile profile, and cured color of restructured cooked ham.

This study evaluated the use of the S-nitrosothiols, S-nitroso-N-acetylcysteine (NAC-SNO) and S-nitroso-N-acetylcysteine ethyl ester (NACET-SNO), at different concentrations (25-300 mg nitrite equivalent - NEq/kg) as sodium nitrite substitutes in restructured cooked hams. The pH value and instrumental cured color were not affected by the type or amount of curing agent used. Products with 25 and 50 mg/kg ingoing nitrite had lower thiobarbituric acid-reactive substance values than those with equimolar amounts of S-nitrosothiols. Products with >150 mg NEq/kg of S-nitrosothiols had residual nitrite similar to 50 mg/kg nitrite, and this resulted in the same volatile compound profile as nitrite added in equimolar amounts. A 300 mg NEq/kg of S-nitrosothiols was required to obtain a similar and minimally stable cured pink color perception as sliced samples with 50-150 mg/kg added nitrite. The results obtained reinforce the great potential of both alternative curing agents in the complete replacement of nitrite by equimolar amounts in restructured cooked products; however, differences in cured color stability should be considered.

Physical fitness level and the risk of severe COVID-19: A systematic review.

To verify systematically the association between the status of physical fitness and the risk of severe Coronavirus disease 2019 (COVID-19). This systematic review is in accordance with the Preferred Reporting Items for Systematic Review and Meta Analyses (PRISMA) statement and the eligibility criteria followed the Population, Intervention, Comparison, Outcomes and Study (PICOS) recommendation. PubMed, Embase, SciELO and Cochrane electronic databases were searched. All studies that explored the relationship between the pattern of physical fitness and COVID-19 adverse outcomes (hospitalization, intensive care unit admission, intubation, or mortality), were selected. The quality of the studies was assessed by the specific scale of the Newcastle-Ottawa Scale. A total of seven observational studies were identified in this systematic review; 13 â€‹468 patients were included in one case-control study, two cohort studies, and four cross-sectional studies. All studies reported an inverse association between high physical fitness and severe COVID-19 (hospitalization, intensive care admission, or mortality). Only some studies reported comorbidities, especially obesity and cardiovascular disorders, but the results remained unchanged after controlling for comorbidities. The quality of the seven studies included was moderate according to the Newcastle-Ottawa Quality Assessment Scale. The methodological heterogeneity of the studies included did not allow a meta-analysis of the findings. In conclusion, higher physical fitness levels were associated with lower risk of hospitalization, intensive care admissions, and mortality rates among patients with COVID-19.

Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case–control study / Patrones de actividad física y neumonía grave por SARS-CoV-2: un estudio de casos y controles

Background Regular physical activity is associated with a low risk of severe community-acquired infections. However, the hypothesis that a physical inactivity pattern is associated with a higher risk for severe COVID-19 has not been completely proven, especially with severe pneumonia. Objective The goal of this study was to confirm the link between physical activity patterns and severe SARS-CoV-2 pneumonia. Design Case–control study. Methods This study involved 307 patients who developed SARS-CoV-2 severe pneumonia and were hospitalized in an intensive care unit. Age- and sex-matched controls (307) were selected from the same population: patients with mild to moderate forms of COVID-19 who were not hospitalized. Physical activity patterns were assessed using the short version of the International Physical Activity Questionnaire. Results The mean physical activity levels were lower in the SARS-CoV-2 severe pneumonia group as compared to the control group: 1576±2939 vs 2438±2999, metabolic equivalent of task (MET-min/week), p<0.001. A high or moderate physical activity level was more common in the control group, and a low physical activity level was more observed in the case group (p<0.001). Obesity was also associated with severe SARS-CoV-2 pneumonia (p<0.001). Multivariable analysis showed that a low physical activity level was associated with a higher risk for severe SARS-CoV-2 pneumonia, independent of nutritional status (CI 3.7; 2.24–5.99), p<0.001). Conclusion A higher and moderate level of physical activity is linked to a lower risk of SARS-CoV-2 severe pneumonia (AU)

Antecedentes y objetivos La actividad física regular se asocia con un bajo riesgo de infecciones graves adquiridas en la comunidad. Sin embargo, la hipótesis de que un patrón de inactividad física se asocia con un mayor riesgo de COVID-19 grave no ha sido completamente probada, especialmente con neumonía grave. El objetivo de este estudio fue confirmar el vínculo entre los patrones de actividad física y la neumonía grave por SARS-CoV-2. Material y métodos Estudio de casos y controles. Este estudio involucró a 307 pacientes que desarrollaron neumonía grave por SARS-CoV-2 y fueron hospitalizados en una unidad de cuidados intensivos. Se seleccionaron controles emparejados por edad y sexo (307) de la misma población: pacientes con formas leves a moderadas de COVID-19 que no fueron hospitalizados. Los patrones de actividad física se evaluaron utilizando la versión corta del Cuestionario Internacional de Actividad Física. Resultados Los niveles medios de actividad física fueron menores en el grupo de neumonía grave por SARS-CoV-2 en comparación con el grupo control: 1576±2939 vs 2438±2999, equivalente metabólico de la tarea (MET-min/semana), p<0.001. Un nivel de actividad física alto o moderado fue más común en el grupo control, y un nivel de actividad física bajo fue más observado en el grupo de casos (p<0,001). La obesidad también se asoció con neumonía grave por SARS-CoV-2 (p<0,001). El análisis multivariable mostró que un bajo nivel de actividad física se asoció con un mayor riesgo de neumonía grave por SARS-CoV-2, independientemente del estado nutricional (IC 3,7; 2,24-5,99), p<0,001). Conclusión Un nivel de actividad física más alto y moderado se relaciona con un menor riesgo de neumonía grave por SARS-CoV-2 (AU)

Patterns of physical activity and SARS-CoV-2 severe pneumonia: A case-control study.

BACKGROUND: Regular physical activity is associated with a low risk of severe community-acquired infections. However, the hypothesis that a physical inactivity pattern is associated with a higher risk for severe COVID-19 has not been completely proven, especially with severe pneumonia. OBJECTIVE: The goal of this study was to confirm the link between physical activity patterns and severe SARS-CoV-2 pneumonia. DESIGN: Case-control study. METHODS: This study involved 307 patients who developed SARS-CoV-2 severe pneumonia and were hospitalized in an intensive care unit. Age- and sex-matched controls (307) were selected from the same population: patients with mild to moderate forms of COVID-19 who were not hospitalized. Physical activity patterns were assessed using the short version of the International Physical Activity Questionnaire. RESULTS: The mean physical activity levels were lower in the SARS-CoV-2 severe pneumonia group as compared to the control group: 1576±2939 vs 2438±2999, metabolic equivalent of task (MET-min/week), p<0.001. A high or moderate physical activity level was more common in the control group, and a low physical activity level was more observed in the case group (p<0.001). Obesity was also associated with severe SARS-CoV-2 pneumonia (p<0.001). Multivariable analysis showed that a low physical activity level was associated with a higher risk for severe SARS-CoV-2 pneumonia, independent of nutritional status (CI 3.7; 2.24-5.99), p<0.001). CONCLUSION: A higher and moderate level of physical activity is linked to a lower risk of SARS-CoV-2 severe pneumonia.

Application of gamma radiation in the beef texture development during accelerated aging.

This study aimed to evaluate the effects of gamma radiation (3 kGy) on the quality of post-rigor beef (M. longissimus lumborum) aged for up to 21 days at different temperatures (1, 7, and 15°C). Irradiation reduced the mesophilic and lactic acid bacteria counts, which were higher in the non-irradiated samples aged at 7 and 15°C. The water retention capacity was lower in the irradiated beef, resulting in higher values of exudation and cooking losses. High aging temperatures increased the exudation loss and myofibrillar proteolysis (lower fragmentation index; FI) and reduced the total and insoluble collagen contents and the beef Warner-Bratzler square Shear Force (WBsSF). However, irradiated beef had higher FI and SF than non-irradiated ones, increasing the time required for the beef tenderizing. Gamma irradiation (3 kGy) can be used to ensure the microbiological safety during short storage at high temperatures (up to 15°C) in order to accelerate the process of beef tenderizing.

Assessment of Japanese radish derivatives as nitrite substitute on the physicochemical properties, sensorial profile, and consumer acceptability of restructured cooked hams.

This study aimed to evaluate the technological and sensory properties of restructured cooked hams prepared with natural curing agents (0.5% radish powder, HRP; 3% radish juice, HRJ; and 0.5% radish pulp powder, HRPP) and with 40 and 150 mg/kg sodium nitrite (HN40 and HN150, respectively). No difference was observed for pH, proximate composition, or cooking loss. Higher residual nitrite contents were observed in the HN150, followed by the radish derivatives hams and HN40. All radish derivatives hams had a similar hue (h) color to HN40, but the h values of HRJ also did not differ from the HN150 ones. The stability of the cured color was not affected. Consumers perceived a non-characteristic aroma and flavor in the radish derivatives hams, but the HRJ had the best acceptance scores. The HRJ appearance was similar to the HN150, and the other sensory attributes were like the HN40. The potential use of radish derivatives, especially radish juice, as natural curing agents was confirmed.

Quality of honeys from different botanical origins.

Botanical origin is one of the principal factors influencing the composition and quality of honey. This study aimed to evaluate different single-flower (assa-peixe, coffee, eucalyptus, laranjeira, and vassourinha), polyfloral (silvestre), extrafloral (sugarcane), and honeydew (bracatinga) honeys with regard to their chemical, physicochemical, and physical properties; rheological behavior; bioactive compounds; and antioxidant activity. In addition, we assessed their sensory characteristics using the acceptance test and the check-all-that-apply test (CATA). All honeys were compliant with current legislation and presented Newtonian behavior. The honeys of assa-peixe, laranjeira, and coffee presented the highest viscosity, sugarcane honey showed the highest antioxidant activity, and the bracatinga honey had the highest phenolic compound content. With respect to sensory characteristics, floral honeys presented higher acceptability than did honeydew and extrafloral honeys, because honey from honeydew was negatively influenced by its bitter, alcoholic, and astringent taste and extrafloral honey by its burnt smell. These findings indicate that the botanical origin directly influences the characteristics of honeys and can be considered a factor for their differentiation.

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Magnesium supplementation and preeclampsia in low-income pregnant women - a randomized double-blind clinical trial.

BACKGROUND: Preeclampsia is the major cause of maternal morbidity and mortality in developing countries. Magnesium sulfate is considered first-line therapy against eclampsia and magnesium deficiency in pregnancy has been associated with unfavourable perinatal outcomes. However there are doubts if magnesium supplementation during pregnancy can previne preeclampsia especially in population with high nutritional risk. This trial aims to verify the effect of oral magnesium supplmentation on preeclampsia incidence in low income pregnant women. METHODS: This randomized, double-blind, placebo-controlled trial investigated the effect of oral magnesium citrate supplementation for preeclampsia in low-income Brazilian pregnant women, i.e. annual per capita income of US$ 1025 or less. Participants were admitted to the study with gestational age between 12 and 20 weeks. Magnesium serum level was measured pre-randomization and participants with hypermagnesemia were excluded. After randomizationg participants received magnesium citrate capsule (300 mg magnesium citrate) or a daily placebo capsule, until delivery. Intent-to-treat analysis was performed. RESULTS: A total of 416 pregnant women were screened and 318 enrolled according to the inclusion criteria; 159 for each arm. Twenty-eight pregnant women were lost to follow-up. 55/290 (18.9%) of pregnant women developed preeclampsia; 26/143 (18.1%) in magnesium group and 29/147 (19.7%) in the control group; OR 0.90 (CI 95% 0.48-1.69), p = 0.747. No cases of eclampsia were registered. CONCLUSION: Oral magnesium supplementation did not reduce preeclampsia incidence in low-income and low-risk pregnant women. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (Identifier NCT02032186), December 19, 2013.

Visceral Adipose Tissue Depth in Early Pregnancy and Gestational Diabetes Mellitus - a Cohort Study.

Some studies have suggested that abdominal visceral adipose tissue depth (VAD) measured by ultrasound in early pregnancy, may predict the future onset of gestational diabetes mellitus (GDM). Wheter this is true, independent of pre-pregnancy body mass index (BMI), has been debated, leading the current study. A prospective cohort study was completed, in which VAD was measured at around 14 weeks' gestation. GDM was later assessed by an oral glucose tolerance test at 24 to 28 weeks, according to the IADPSG criteria. Logistic regression analysis and receiver operating curve (ROC) analysis were used to estimate the predictive value of VAD, above and beyond pre-pregnancy BMI. 627 pregnant women were enrolled, and 518 completed the study. VAD was measured at a mean of 14.4 weeks' gestation. 87 women (16.8%) subsequently developed GDM. The unadjusted odds ratio (OR) for developing GDM was 1.99 (95% CI 1.59-2.46) per 1-cm increase in VAD. After adjusting for maternal BMI and age, the OR was 2.00 (95% CI 1.61 to 2.50). The ROC under the curve for developing GDM was higher for VAD (0.70, 95% CI 0.63 to 0.75) than for pre-pregnancy BMI (0.57 95% CI 0.50 to 0.64) (p < 0.001). In conclusion, higher VAD may better predict GDM than pre-pregnancy BMI.

Efeito da radiação gama sobre a oxidação lipídica da carne bovina / Effect of gamma radiation on lipid oxidation of beef

Objetivou-se avaliar o efeito de diferentes doses de radiação (1, 2, 3, 6 e 9 kGy) sobre a oxidação lipídica de contrafilés bovinos pela determinação das substâncias reativas ao ácido 2-tiobarbitúrico (TBARS) e por cromatografia gasosa utilizando a técnica de microextração em fase sólida (SPME). As amostras irradiadas apresentaram maior concentração de aldeídos, com maior incidência de nonanal, independentemente da dose aplicada. Maiores concentrações de hexanal foram observadas nas amostras irradiadas por maiores doses (6 e 9 kGy), mas os maiores valores de TBARS foram observados nas amostras irradiadas por 3 e 6 kGy. Uma redução nos valores de aldeídos, especialmente nonanal e octanal, foi observada para amostras irradiadas por 2 kGy quando comparadas às demais amostras irradiadas. Conclui-se que o processo de irradiação aumentou o grau de oxidação das amostras, que consequentemente, aumentou a concentração dos aldeídos presentes.

Análise do perfil de textura de apresuntados elaborados com diferentes concentrações de nitrito / Texture profile analysis of restructured cooked ham elaborated with different nitrite contents

O trabalho objetivou estudar os efeitos da adição de diferentes concentrações de nitrito (0 a 300 mg/Kg) nos atributos de textura de apresuntados ao decorrer do tempo de armazenamento a vácuo (0 a 40 dias) utilizando um delineamento composto central rotacional. Maiores perdas de peso por cozimento foram observadas (P0,05) pelos fatores estudados, enquanto que maiores valores de flexibilidade foram observados nos produtos adicionados de maior quantidade de nitrito. Concluiu-se que o perfil de textura de produtos cárneos cozidos é ligeiramente alterado pela adição de nitrito de sódio.

Efeito da adição de nitrito nos valores de nitrito residual e cor de apresuntados durante o armazenamento / Effect of nitrite addition on residual nitrite values and color of reestructured cooked ham during storage

Objetivou-se avaliar a cinética de redução das concentrações de nitrito adicionado (0 a 300 mg/kg) em apresuntados e seus efeitos na cor curada ao decorrer do tempo de armazenamento a vácuo (0 a 40 dias). O teor de nitrito residual aumentou (P0,05) por nenhum dos fatores. O comportamento para a tonalidade (h) foi o inverso do índice de cor curada, sendo que pequenas adições de nitrito implicaram em uma cor mais avermelhada (mais rosada), com ligeira perda (fading) no decorrer do tempo de armazenamento. Adições de 50 a 300 mg/kg de nitrito basicamente não alteraram a cor dos produtos, sendo pouco afetado pelo tempo de armazenamento à vácuo.

Efeitos da transglutaminase na textura de fiambres elaborados com carne suína PSE e teor reduzido de sal / Effects of transglutaminase addition on the texture of ‘fiambres’ elaborated with pork PSE and salt reduction

Objetivou-se avaliar o perfil de textura instrumental e sensorial de fiambres elaborados com transglutaminase (TG), carne suína PSE e redução de sal. Seis formulações com carnes normais (RFN) e PSE foram formuladas contendo 2% de sal, sem sal adicionado e sem sal + TG. A remoção do sal da formulação resultou (P<0,05) em menores valores de dureza e mastigabilidade, independentemente da carne utilizada. A TG foi capaz de evitar a redução nos valores de dureza e mastigabilidade quando os produtos foram elaborados com carne RFN, mas não quando elaborado com carne PSE. A aceitação sensorial da textura foi reduzida com a redução de sal, mas este foi minimizado pela adição da TG. Concluiu-se que apesar da TG minimizar os problemas de textura oriundos da redução de sal nos fiambres, a percepção sensorial não foi favorecida.

Elaboração de hambúrguer a base de carne de frango com adição de fibras / Elaboration of chicken-based meat patty with added fiber

Este trabalho objetivou avaliar sensorialmente hambúrgueres a base de carne de frango adicionados de farinha de aveia e biomassa de banana verde. Realizou-se a metodologia CATA, na qual foram avaliados os atributos de aparência, aroma, sabor e textura e o teste de intenção de compra. A metodologia CATA permitiu identificar as diferenças entre as formulações e os atributos, ou seja, caracterizou eficientemente as formulações. Para intenção de compra, verificou-se que houve diferença significativa entre as amostras (p≤0,05), sendo que o hambúrguer adicionado de biomassa de banana verde foi o que apresentou maior intenção de compras. Conclui-se que é viável adicionar farinha de aveia e biomassa de banana verde em hambúrgueres a base de carne de frango, uma vez que essas fibras são potenciais ingredientes para substituição de gordura.

Percepção do Estudante de Medicina acerca do Ambiente Educacional Utilizando o Dreem / Medical Students’ Views on the Learning Environment Using Dreem

RESUMO Introdução A percepção sobre o ambiente educativo pode influenciar o desempenho acadêmico, e a sua análise fornece subsídios importantes para melhorá-lo. Objetivo Avaliar a percepção do estudante acerca do ambiente educativo do Hospital Dom Malan/Imip durante o internato médico. Método Estudo do tipo survey, envolvendo 105 estudantes no período de abril a setembro de 2013. Foi utilizado o questionário Dundee Ready Education Environment Measure (Dreem). Resultados Foram considerados os seguintes resultados: questões individuais, as cinco dimensões e o Dreem global. A percepção geral foi considerada “more positive than negative” (pontuação 144,4/200), e a análise das dimensões revelou: percepção da aprendizagem: “a more positive perception”; percepção sobre os preceptores: “model course organisers” (49,5%); percepção dos resultados acadêmicos: “feeling more on the positive side” (70,5%); percepção do ambiente geral: “a more positive atitude” (55,2%); percepção das relações sociais: “not a nice place” (90,5%); e percepção geral do ambiente educativo: “more positive than negative” (69,5%). Não houve diferença estatisticamente significante quando comparados os dois grupos (p >0,05). Conclusões A percepção geral foi positiva, e a dimensão das relações sociais foi apontada como problemática.

ABSTRACT Introduction How quality of life and the educational environment are perceived can influence academic performance and its analysis can provide important insights. Objective To evaluate student’s perceptions about the learning environment of the Hospital Dom Malan/Imip during medical internship. Method Survey study involving 105 students between April and September 2013, based on the Dundee Ready Education Environment Measure (Dreem) questionnaire. Results The following results were considered: individual issues, the five dimensions and overall Dreem. The general perception was considered “more positive than negative” (score 144.4) and analysis of the dimensions revealed the following: perceptions of learning: “a more positive perception”; perception of preceptors: “model course organizers” (49.5%); perception of academic outcomes, “feeling more on the positive side” (70.5%); general perception of the environment: “a more positive attitude” (55.2%); perception of social relations: “not a nice place” (90.5%) and overall perception of the educational environment: “more positive than negative” (69.5%). There was no statistically significant difference when comparing the two groups (P >0.05). Conclusions The general perception was positive, and the dimension of social relations highlighted as problematic.

The BRAzil MAGnesium (BRAMAG) trial: a randomized clinical trial of oral magnesium supplementation in pregnancy for the prevention of preterm birth and perinatal and maternal morbidity.

BACKGROUND: Preterm birth is the leading cause of infant mortality globally, including Brazil. We will evaluate whether oral magnesium citrate reduces the risk of placental dysfunction and its negative consequences for both the fetus and mother, which, in turn, should reduce the need for indicated preterm delivery. METHODS/DESIGN: We will complete a multicenter, randomized double-blind clinical trial comparing oral magnesium citrate 150 mg twice daily (n = 2000 women) to matched placebo (n = 1000 women), starting at 121/7 to 206/7 weeks gestation and continued until delivery. We will include women at higher risk for placental dysfunction, based on clinical factors from a prior pregnancy (e.g., prior preterm delivery, stillbirth or preeclampsia) or the current pregnancy (e.g., chronic hypertension, pre-pregnancy diabetes mellitus, maternal age > 35 years or pre-pregnancy maternal body mass index > 30 kg/m2). The primary perinatal outcome is a composite of preterm birth < 37 weeks gestation, stillbirth > 20 weeks gestation, neonatal death < 28 days, or SGA birthweight < 3rd percentile. The primary composite maternal outcome is preeclampsia arising < 37 weeks gestation, severe non-proteinuric hypertension arising < 37 weeks gestation, placental abruption, maternal stroke during pregnancy or ≤ 7 days after delivery, or maternal death during pregnancy or ≤ 7 days after delivery. DISCUSSION: The results of this randomized clinical trial may be especially relevant in low and middle income countries that have high rates of prematurity and limited resources for acute newborn and maternal care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02032186, registered December 19, 2013.

Mental health and work: meanings and limits of theoretical models.

This text is a revision of the most important theoretical approaches that fundament the studies about Mental Health and Work, pointing to the basic concepts, categories of analyses and respective limits. The objective is to underline some conceptions about the theme, in the attempt to contribute with a way to face the problems, questions and difficulties imposed by the construction of this object of study. Thus, the text is based on the critical review of theoretical paradigms that predominate in studies about Mental Health and Work. Finally, it indicates some important theoretical questions about the relation between mental health and work.