Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment

Abstract Objective To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation. Methods The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05). Results Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively). Conclusion Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

Aspects of cognitive assessments and spectroscopic magnetic resonance imaging in people with chronic hepatitis C: a systematic review.

Extrahepatic manifestations are common in people with hepatitis C virus (HCV). Cognitive changes are pointed out, but the mechanisms are still uncertain. The aim of this systematic review was to analyze studies involving spectroscopic magnetic resonance in people infected with HCV, which also included cognitive tests. The research occurred in six databases (Directory of Open Access Journals, Lilacs, Medcaribe, Medline, Scielo and ScienceDirect) and the selection of studies was carried out in two stages: search for titles and abstracts, then reading of the full articles, excluding those that did not meet the eligibility criteria. 12,888 titles and abstracts were selected, but only 6 articles were included in the review. Impairments in attention, concentration, speed of information processing, memory, verbal fluency and executive functions were identified as well as an increase in the Cho/Cr and mI/Cr ratios and a reduction in the NAA/Cr ratio in some included studies. Longitudinal studies, with more homogeneous samples and methods, as well as with better controlled confounding factors, are necessary to adequately identify the effect of HCV on the brain.

Dark chocolate (70% cocoa) reduces craving in smokers with severe cardiovascular comorbidities without interference in anthropometric measures / Chocolate amargo (70% cacau) reduz fissura em tabagistas com comorbidades cardiovasculares graves sem interferir nas medidas antropométricas

ABSTRACT Objective: Analyze craving in smokers with cardiovascular comorbidities submitted to a nutritional approach. Methods: Two groups were randomized and submitted to clinical intervention (n = 32): Group 1 (G1, n = 15): ingested 40 g of chocolate containing 70% cocoa/day and behavioral intervention for smoking cessation for one month; Group 2 (G2, n = 17): control group, only behavioral intervention. Questionnaire of Smoking Urges-Brief (QSU-Brief) - Brazil version measured total craving and its factors. Anthropometric measurements verified the nutritional interference of the procedure and the serum assessment verified the interference of inflammatory processes related to smoking. The study was registered on the Brazilian Registry of Clinical Trials (ReBEC): RBR-83jr3. Results: After one month, compared to the initial evaluation, the G1 reduced the craving evaluated by the QSU-Brief and its Factors 1 and 2. Total QSU-Brief: 44.27 ± 15.82 x 27.00 ± 18.03 (p = 0.008); Factor 1: 21.90 ± 7.70 x 12.90 ± 8.87 (p = 0.006); Factor 2: 11.90 ± 6.30 x 7.00 ± 6.63 (0.007). G2 showed a reduction in total QSU-Brief and Factor 1, but not in Factor 2. QSU-Brief total 28.17 ± 17.24 x 19.52 ± 9.50 (p = 0.049); Factor 1: 14.47 ± 8.74 x 9.23 ± 6.11 (p = 0.046). Serum levels of cortisol, leptin, serotonin, C-Reactive Protein (CRP) and insulin did not show differences (p > 0.05). No anthropometric differences were found. Conclusion: The results demonstrate that daily consumption of chocolate for one month (70%) reduced craving in smokers at the beginning of treatment. Chocolate potentiated the well-known effect of behavioral counseling on Factor 1 (pleasurable drug effects) and also interfered with factor 2 (unpleasant withdrawal effects).

RESUMO Objetivo: Analisar o craving em fumantes com comorbidades cardiovasculares submetidos a uma abordagem nutricional. Métodos: Intervenção clínica (n = 32) com dois grupos randomizados: Grupo 1 (G1, n = 15): recebendo 40 g de chocolate contendo 70% de cacau/dia e intervenção comportamental para cessação do tabagismo por um mês; Grupo 2 (G2, n = 17): grupo controle, recebendo apenas intervenção comportamental pelo mesmo período. O Questionnaire of Smoking Urges-Brief (QSU-Brief) - versão Brasil foi utilizado para avaliar o craving. As medidas antropométricas verificaram a interferência nutricional do procedimento e a avaliação sérica, a interferência de processos inflamatórios relacionados ao tabagismo. O estudo foi registrado no Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-83jr3. Resultados: Um mês depois, comparado à avaliação inicial, o G1 reduziu o craving total e seus fatores (1 e 2). QSU-Brief total: 44,27 ± 15,82 x 27,00 ± 18,03 (p = 0,008); Fator 1: 21,90 ± 7,70 x 12,90 ± 8,87 (p = 0,006); Fator 2: 11,90 ± 6,30 x 7,00 ± 6,63 (0,007). G2: redução no QSU-Brief total e Fator 1, mas não no Fator 2. QSU-Brief total 28,17 ± 17,24 x 19,52 ± 9,50 (p = 0,049); Fator 1: 14,47 ± 8,74 x 9,23 ± 6,11 (p = 0,046). Níveis séricos de cortisol, leptina, serotonina, proteína C-reativa (PCR) e insulina não apresentaram diferenças (p > 0,05). Não foram encontradas diferenças antropométricas significativas. Conclusão: Os resultados demonstram que o consumo diário de chocolate por um mês (70%) reduziu o craving em fumantes no início do tratamento. O chocolate potencializou o conhecido efeito do aconselhamento comportamental sobre o Fator 1 (efeitos prazerosos da droga) e também interferiu no fator 2 (efeitos desagradáveis da abstinência).

Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment.

PURPOSE: Evaluate the impacts of the nutritional education intervention for patients with multiples chronic conditions during smoking cessation. METHODS: The non-probabilistic sample consisted of adult and elderly 18 individuals of both sexes, participants in a group for smoking cessation treatment. At the beginning of treatment, smoking history, degree of dependence and stage of motivation were evaluated. Craving degree was evaluated weekly during the first month. Anthropometric and biochemical evaluations were conducted at baseline, after 1 month and 3 months. Dietary intake was assessed by the "How is your diet?" questionnaire. There were three moments of nutritional intervention. The themes covered were "Energy balance and physical activity", "Healthy eating" and the importance of fruits and vegetables in the diet, respectively. Statistical analysis with Shapiro Wilk normality test, paired T-Test or Wilcoxon and U-Mann Whitney (Significance ≤0.05). RESULTS: In the intervention group, most people had a high degree of smoking dependence (55.6%), while in the control group the frequency were 22.2%. Craving degree decreased significantly after 1 month of treatment (p= 0.017). After 3 months, the groups presented mean body weight positive variation, however below 3%. In both groups the average percentage of weight gain was below 3%, reinforcing that the holding of the nutrition session and performance of the nutritionist within the protocol proposed by the INCA helped in the control of weight gain. Blood glucose and HOMA-IR in the intervention group showed a significant increase (p= 0.15 and p= 0.50, respectively). CONCLUSION: Greater proximity and more frequent action taken by the nutritionist assists and encourages healthy eating practices during smoking cessation process, which can benefit individuals control of chronic diseases in the long term.

Sobrecarga e qualidade de vida dos cuidadores de pessoas acamadas em domicílio / Sobrecarga y calidad de vida de los cuidadores de personas encamadas en domicilio / Overload and quality of life of caregivers of bedridden people at home

Resumo Objetivo Relacionar o perfil sociodemográfico com a sobrecarga de trabalho e a qualidade de vida dos cuidadores de pessoas acamadas. Métodos Estudo transversal, realizado em 2019, com 240 cuidadores, os quais responderam três instrumentos: questionário sociodemográfico, Zarit Burden Interview e o WHOQOL-bref. Para análise foram utilizados os testes Qui-quadrado, Fisher e Regressão Logística Binária. Resultados Verificou-se que a maioria dos cuidadores (86,6%) apresentam sobrecarga moderada ou severa e o escore geral de qualidade de vida em 48,9 pontos. Cuidadores com ocupação Do Lar (OR=52,89), com a saúde afetada por causa do seu envolvimento como cuidador (OR=22,92) e que perderam o controle de sua vida desde a doença da pessoa acamada (OR=49,38), tiveram maior probabilidade de ter qualidade de vida ruim. Conclusão A ocupação e o período de cuidado relacionaram-se significativamente com a qualidade de vida dos cuidadores de pessoas acamadas, sendo, a ocupação "Do lar" e fatores da sobrecarga preditores significativos da qualidade de vida ruim.

Resumen Objetivo Relacionar el perfil sociodemográfico con la sobrecarga de trabajo y la calidad de vida de los cuidadores de personas encamadas. Métodos Estudio transversal, realizado en 2019, con 240 cuidadores, que respondieron a tres instrumentos: cuestionario sociodemográfico, Zarit Burden Interview y el WHOQOL-bref. Para el análisis se utilizaron las pruebas de ji cuadrado, Fisher y Regresión Logística Binaria. Resultados Se verificó que la mayoría de los cuidadores (86,6 %) presenta una sobrecarga moderada o severa y el puntaje general de calidad de vida es de 48,9 puntos. Cuidadores con ocupación "Amo/a de casa" (OR=52,89), con la salud afectada a causa de su implicación como cuidador (OR=22,92) y que perdieron el control de sus vidas desde la enfermedad de la persona encamada (OR=49,38) tuvieron más probabilidades de tener mala calidad de vida. Conclusión La ocupación y el período de atención se relacionaron de forma significante con la calidad de vida de los cuidadores de personas encamadas. La ocupación "Amo/a de casa" y factores de la sobrecarga fueron predictores significativos de la mala calidad de vida.

Abstract Objective To associate the sociodemographic profile with the work overload and the quality of life of caregivers of bedridden people. Methods Cross-sectional study, carried out in 2019, with a total of 240 caregivers who answered three instruments: sociodemographic questionnaire, Zarit Burden Interview and the WHOQOL-bref. For analysis, the Chi-square, Fisher and Binary Logistic Regression tests were used. Results Most caregivers (86.6%) were found to have moderate or severe overload and the overall quality of life score was 48.9 points. Caregivers that worked at home (OR=52.89), with health affected because of their involvement as a caregiver (OR=22.92) and who have lost control of their lives since the bedridden person's illness (OR=49.38), were more likely to have poor quality of life. Conclusion Occupation and period of care were significantly related to the quality of life of caregivers of bedridden people. The occupation "household" and overload factors are significant predictors of poor quality of life.

Bio-hydrolysis of used soybean oil: environmental-friendly technology using microbial consortium.

In this work, strains of Bacillus subtilis were inoculated in consortium with Rhodotorula mucilaginosa into spent soy oil as aiming to biological treatment and low-cost reuse. The microorganisms were previously isolated and selected for the lipolytic capacity of the alperujo residue generated during the processing of olive oil. For fermentation, bioassays containing Rhodotorula mucilaginosa isolated from alperujo and Candida rugosa CCMA 00371, both co-inoculated with Bacillus subtilis CCMA 0085 in medium containing (% w/v) 0.075 glucose and 0.375 (NH4)3 PO4 in 75 mL of water and 75 mL of spent soy oil. Despite the low biomass productivity, it has favorable characteristics to be used in animal feed supplementation. Spent soy oil was used as a carbon source proven by Bartha respirometer. The strains of R. mucilaginosa UFLA RAS 144 and B. subtilis CCMA 0085 are promising inoculants for oil degradation and can be applied in a waste treatment system.

Seasonal dynamics and rickettsial infection in free-living Amblyomma dubitatum in the Atlantic forest biome in north-eastern Brazil.

The genus Amblyomma is the most representative tick genus in Brazil and some species act as vectors of pathogenic organisms to animals and humans. Information on the seasonal dynamics of Amblyomma spp. as well as on rickettsial organisms infecting these ticks in some regions in Brazil is still fragmentary. Herein, we investigated the seasonal dynamics and rickettsial infections in Amblyomma dubitatum ticks collected in the Atlantic forest biome in north-eastern Brazil. Using carbon dioxide traps, ticks were collected monthly for two consecutive years. In total, 15,789 ticks were collected: 69 females (0.4%), 116 males (0.7%), 1,067 nymphs (6.8%), and 14,537 larvae (92.1%). All nymphs, females and males were identified as A. dubitatum, whereas larvae were identified as Amblyomma spp. Larvae were more frequent in summer (77% of the larvae collected), whereas nymphs were collected with similar frequency in summer (32.8%), autumn (30.0%) and spring (28.4%). Adults were more frequent in spring (47.6%). A total of 648 ticks (485 nymphs, 60 females, and 103 males) were tested by PCR for the gltA gene of Rickettsia spp. and 87 (13.4%; 95% CI: 10.9-16.3%) were positive. A consensus sequence (size, 350 bp) of 66 gltA gene sequences indicate that the organism detected herein is similar to Rickettsia tamurae, Rickettsia monacencis and Rickettsia sp. strain Pampulha. One of these positive samples was also positive for the ompA gene of spotted fever group rickettsiae, but attempts to sequence the amplicon were not successful. We also tested this sample by a PCR targeting the rickettsial htrA gene, but no amplification product could be detected. This study indicates that A. dubitatum may be a common tick in areas where capybaras are present in north-eastern Brazil, occurring during the whole year. It also suggests the circulation of a spotted fever group rickettsia in this A. dubitatum population, whose identity has yet to be determined.

Psammoma Bodies in a Large Myoepithelioma.

Myoepithelioma is a rare benign tumor of the salivary glands, in which the vast majority of neoplastic cells are myoepithelial. A rare microscopic finding in salivary gland tumors, including myoepitheliomas, is the presence of psammoma bodies (PBs), whose etiology and role in the tumors are uncertain. The objective of this study is to describe the unusual histopathologic findings, such as psammomas, of a large myopephelioma on the palate and the prosthetic restorative treatment performed after resection of the tumor. A 52-year-old woman was referred for evaluation of a tumor-like lesion, of smooth surface and normal mucosal color, measuring approximately 5 cm, on the left side hard palate, which had been identified 4 years earlier. The diagnostic hypothesis was a pleomorphic adenoma (PA), and an incisional biopsy was performed. After histopathologic analysis, a PA was suggested, and surgical resection of the tumor was performed. The histopathologic findings were compatible with myoepithelioma showing numerous calcified basophilic structures compatible with PB. Sixteen months after resection of the tumor, a removable maxillary obturator prosthesis was made because of the communication into oral and nasal cavity due from the surgical procedure. The treatment of choice for myoepithelioma is surgical excision with a nonlesional area margin. In the present report, the authors achieve good postoperative results without recurrences. After installation of the prosthesis, the patient had an excellent adaptation and acceptance, thus restoring her function and psychologic condition.

Phenology of Amblyomma sculptum in a degraded area of Atlantic rainforest in north-eastern Brazil.

Amblyomma sculptum is the principal vector of Rickettsia rickettsii, the main agent of spotted fever rickettsiosis in Brazil. Little information is available regarding the population dynamics of this tick in some regions, including north-eastern Brazil, where cases of spotted fever rickettsioses are increasingly reported. Herein, we studied the phenology of A. sculptum in a rural area in north-eastern Brazil. Ticks were collected from the environment, using dry ice-baited traps, monthly for two consecutive years. In total, 1500 ticks were collected: 94 females (6.3%), 74 males (4.9%), 468 nymphs (31.2%), and 864 larvae (57.6%). All nymphs and females were identified as A. sculptum. Males were tentatively identified as A. sculptum and larvae as Amblyomma spp. Ticks were more numerous during spring and summer, followed by autumn and winter. Peaks of larvae and nymphs were recorded during summer and spring, respectively, whereas adults were more frequently collected in spring. A total of 380 ticks were tested by PCR for the gltA gene of Rickettsia spp., but none of them were positive. While our results revealed a seasonal pattern for A. sculptum in north-eastern Brazil that is distinct from the seasonal pattern in south-eastern Brazil, we caution that the observed pattern could have been biased by the relatively low number of ticks collected. Finally, the absence of Rickettsia-infected ticks does not rule out the possibility that rickettsial organisms are circulating in the study area and further long-term studies are warranted.

Solid coffee waste as alternative to produce carotenoids with antioxidant and antimicrobial activities.

Special coffee production involves particular sensorial characteristics of the beverage as well as the production system of coffee beans, in particular environmental issues like water and solid waste disposal. Many countries around the world have problems with that waste disposal. The possibility to integrate the commodite production with suitable agricultural practices was the focus on this work using the solid waste to produce pigments by yeasts with biological activities. The better carotenoids production was tested previously in husk and pulp extract. The production of total carotenoids by yeast was 16.36 ±â€¯0073 mg L-1 was 21.35 ±â€¯0067 mg L-1, in the pulp extract and husk extract respectively. Carotenoids produced, exhibited antioxidant and antimicrobial activities against pathogenic bacteria such as Salmonella colorless, Escherichia coli, Staphylococcus aureus and Listeria monocytogenes as well as toxigenic fungi like Aspergillus flavus, A. parasiticus, A. carbonarius and A. ochraceus. These characteristics of the pigments are important to replace the artificial ones commonly used in food and pharmaceutical industries allowing the consumers to choose more natural products at lower costs.

Behavioral response and dynamics of Eisenia fetida hemocytes exposed to environmentally relevant concentration of sulfentrazone.

Although the toxicity of the pesticide sulfentrazone in some aquatic organisms is known, its effects on edaphic organisms such as earthworms remain completely unknown. Thus, we aimed at evaluating the behavior and immune response of Eisenia fetida exposed to sulfentrazone at environmentally relevant concentrations (EC). E. fetida representatives exposed to this contaminant (for 48 h) were divided in the following groups: environmental concentration (EC1x: 318 ng sulfentrazone/g of dry weight soil) and EC100x (concentration 100 times higher than in EC1x). Based on the avoidance test results, earthworms responded to this pesticide and proved the toxicity of sulfentrazone. The observed immune response induction was expressed by increased granulocytes presenting phagocytic vacuoles and agglomerations/encapsulations, mainly in animals belonging to groups EC1x and EC100x. However, the reduced frequency of plasmocytes in these animals' hemolymphs suggested that the phagocytic immune response was not efficient to assure 100% survival. Our study is the first to report sulfentrazone toxicity in an edaphic organism, at environmental concentration.

Avaliação do desenvolvimento motor de crianças cardiopatas no pré-operatório de cirurgia cardíaca

As cardiopatias congênitas são doenças que ocorrem do resultado de uma má-formação cardíaca no período embrionário, sendo denominadas congênitas por este motivo. Podem ser definidas por alterações estruturais no coração, em suas câmaras cardíacas e em seus vasos. Atualmente, as cardiopatias congênitas são as doenças congênitas mais frequentes entre os nascidos vivos. Em decorrência de suas alterações, ela pode causas atraso no desenvolvimento motor de seus portadores. O objetivo deste estudo foi avaliar o desenvolvimento motor de crianças cardiopatas de 03 à 18 anos no pré-operatório de cirurgia cardíaca da Fundação Pública Hospital de Clinicas Gaspar Vianna (FPHCGV). Fizeram parte da pesquisa 14 crianças de 03 a 18 meses de ambos os sexos, avaliadas quanto ao desenvolvimento motor por meio da Alberta Infant Motor Scale (AIMS). Na amostra houve um predomínio do sexo masculino 64,3% em relação a sexo feminino 35,7%. A raça predominante foi a Negra 42,7%, logo depois a raça Parda 35,8% e a raça Caucasiana (Branca) com 21,5%. As cardiopatias congênitas predominantes foram CIV com 35,7% e T4F com 35,7%, em seguida foi a CIA com 21,4%, o PCA com 14,3% e o DSA VT com 7,1%. Quando separadas em cianóticas e acianóticas, as acianóticas representaram 78,6%, enquanto que as cianóticas representam 32,4%. Os resultados encontrados na avaliação do percentil (TH) da escala AIMS na amostra estudada revelou que 28,6% apresentaram comportamento suspeito em relação ao desenvolvimento motor, 35,7% apresentaram comportamento limítrofe e 35,7% apresentaram desenvolvimento normal. Os resultados sugerem que crianças com cardiopatia congênita apresentam atraso no desenvolvimento motor, podendo ou não relacionar-se sua gravidade ao tipo de patologia

Las cardiopatías congénitas son patologías que ocurren del resultado de una malformación cardíaca en el período embrionario, siendo denominadas congénitas por este motivo. Pueden ser definidas por cambios estructurales en el corazón, en sus cámaras cardíacas y en sus vasos. Actualmente, Ias cardiopatías congénitas son Ias enfermedades congénitas más frecuentes entre Ios nacidos vivos. En consecuencia de sus cambios, puede causar retraso en el desarrollo motor de sus portadores. EI objetivo del estudio fue Evaluar el desarrollo motor de nifíos cardiópatas de 03 a 18 meses en el preoperatorio de cirugía cardíaca de Ia Fundación Pública Hospital de Clínicas Gaspar Vianna (FPHCGV). Se realizaron parte de Ia investigación 14 nifíos de 3 a 18 meses de ambos sexos, que fueron evaluados cuando al desarrollo motor a través de Ia Alberta lnfant Motor Scale (AIMS). En Ia muestra, hubo un predominio del sexo masculino 64,3% en relación ai sexo femenino 35,7%. La raza predominante fue Ia Niegra 42,7%, luego Ia raza Parda 35,8% y Ia raza Caucasiana (Blanca) con el 21,5%. Las cardiopatías congénitas predominantes fueron CIV con 35,7% y T4F con 35,7%, luego fue la ClA con 21,4%, el PCA con el 14,3% y el DSAVT con el 7,1%. Cuando separadas em Cianóticas y Acianóticas, Ias acianóticas representaron el 78,6%, mientras que Ias cianóticas representan eI 32,4%. Los resultados encontrados en Ia evaIuación deI percentiI (TH) de Ia escala AIMS en Ia muestra estudiada revelaron que 28,6% presentaron comportamento sospechoso en relación al desarrollo motor, 35,7% presentaron comportamiento Limítrofe y 35,7% presentaron desarrollo normal. Los resultados sugieren que Ios niííos con cardiopatia congénita presentan retraso en el desarrollo motor, pudiendo o no se relaciona su gravedad al tipo de patologia

Reação adversa a medicamento: uma análise comparativa de protocolos utilizados para o tratamento do câncer colorretal / Adverse drug reaction: a comparative analysis of protocols used for treatment of colorectal cancer

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups (AU)

Study design: Cohort study Objective: Analyze the adverse reactions that occurred in Brazilian patients with colorectal cancer submitted to chemotherapy with two different protocols, in order to identify the types and severity of those most frequent recorded. Methods: Sixty-three patients, who started treatment from June 2014 to May 2015, were separated into two groups: mFOLFOX6 (protocol containing oxaliplatin, folinic acid and 5-fluorouracil in bolus and continuous infusion, n= 40) and FOLFIRI (protocol containing irinotecan, folinic acid and 5-fluorouracil in bolus and continuous infusions, n= 23). Data related to the demographic and clinical profile of the patients were collected from the medical record, as well as information about the treatment performed and the adverse reactions manifested. The reactions were classified according to their severity (grades 1, 2, 3 and 4) and causality (definite, probable, possible and doubtful). Results: A high frequency of adverse reactions was observed in both groups, reaching 92.5% of patients with mFOLFOX6 protocol and 95.6% with FOLFIRI protocol. Gastrointestinal and neurological toxicities were the most frequent among the groups. When comparing the occurrence of intergroup reactions, there was difference only for gastrointestinal toxicities (p= 0.035). In 17.5% of patients mFOLFOX6 group (n= 7) and in 8.7% of patients FOLFIRI group (n= 2), grades 3 and 4 adverse reactions were observed and classified as probable. Conclusion: The adverse reactions were more diversified and frequent in the mFOLFOX6 group compared to the FOLFIRI group. However, no difference was observed in the severity and causality of reactions in both groups.(AU)

Pseudomonas spp. and P. fluorescens: population in refrigerated raw milk / Pseudomonas spp. e P. fluorescens: população em leite cru refrigerado

ABSTRACT: Raw milk samples were collected from cooling tanks (after they cooled for 48 h) in five dairy farms and the corresponding bulk tank (bulk milk transportation, BMT) when they arrived to the industry. Routine physical chemical analyzes and quantification of psychrotrophic ( Pseudomonas spp. and P. fluorescens ) and aerobic mesophilic (AM) populations were performed. Only relative density and titratable acidity values for samples of milk from three farms were in agreement to the quality parameters required by law. In the BMT, only the protein content has not reached the minimum value established by law, and counting was performed for AM (>105 colony forming units (CFU) mL-1) and psychrotrophic bacteria (2.8x106CFU mL-1). Pseudomonas spp. counting corresponded to 17.9% of the psychrotrophic population, and P. fluorescens was 3.4% of Pseudomonas spp . count. In milk samples from dairy farms, counts were variable for AM (3.4x105 to 3.7 x107CFU mL-1), psychrotrophic (4.0x104 to 3.1x106CFU mL-1), Pseudomonas spp. (2.3x104 to 1.8x105CFU mL-1), and P. fluorescens (62 to 8.4x103CFU mL-1). For the populations studied, no statistical difference (P>0.05) was observed between counts reported in milk samples collected in dairy farms (cooling tanks) and BMT. Therefore, the genera Pseudomonas spp. and P. fluorescens were not the most frequent psychrotrophic bacteria in this studied milk transportation line.

RESUMO: Amostras de leite foram coletadas de tanques de refrigeração (após 48h de refrigeração) em cinco fazendas de produção e do respectivo caminhão tanque (leite de conjunto, LC) ao chegar à indústria beneficiadora. Análises físico químicas de rotina e quantificação das populações de bactérias psicrotróficas ( Pseudomonas spp. e P. fluorescens ) e aeróbios mesófilos (AM) foram realizadas. Apenas os valores de densidade relativa e acidez titulável de amostras de leite de três fazendas estavam de acordo com a legislação. No LC, apenas o teor de proteína não atingiu o valor mínimo estabelecido por lei, e a contagem foi realizada para AM (>105 unidades formadoras de colônias (UFC) mL-1) e psicrotróficos (2,8x106UFC mL-1). A contagem de Pseudomonas spp. correspondeu a 17,9% da população de psicrotróficos, e 3,4% da contagem de Pseudomonas spp. eram da espécie P. fluorescens . Nas amostras de leite das fazendas de produtoras, as contagens foram variáveis para AM (3,4x105a 3,7x107UFC mL-1), psicrotróficos (4,0x104 a 3,1x106UFC mL-1), Pseudomonas spp. (2,3x104 a 1,8x105UFC mL-1) e P. fluorescens (62 a 8,4x103UFC mL-1). Para as populações estudadas, nenhuma diferença estatística (P>0,05) foi observada entre as contagens encontradas nas amostras de leite coletadas nas fazendas (tanques de resfriamento) e do LC. Portanto, o gênero Pseudomonas spp. e a espécie P. fluorescens não foram os psicrotróficos mais frequentes nesta linha de transporte de leite estudada.

Proteína C-reativa como biomarcador inflamatório e fatores associados em diabéticos tipo 2 atendidos na rede pública de saúde / C-reactive protein as inflammatory biomarker and associated factors in type 2 diabetics patients treated at public health system

Introdução: O Diabetes configura-se hoje como uma epidemia mundial, traduzindo-se em grande desafio para os sistemas de saúde e favorece o risco de eventos circulatórios. Objetivo: Determinar os níveis de Proteína C-Reativa ultrassensível (PCR-us) e fatores associados em diabéticos do município de Vitória de Santo Antão, PE, Brasil. Métodos: Estudo transversal, de base populacional, realizado entre julho e outubro de 2011. Foram avaliadas variáveis sócio-demográficas, estilo de vida, clínicas, antropométricas e bioquímicas, as quais foram associadas aos níveis PCR-us. Os dados foram analisados no programa Predictive Analytics Software (PASW), versão 13.00; nível de significância de 5%. Resultados: A amostra foi constituída por 409 indivíduos, sendo 73,1% do sexo feminino. A idade variou entre 20 e 90 anos, com média de 61,00 ± 11,62 anos; com maior proporção (56,2%) de idosos. O Índice de massa corporal (IMC) mostrou 75,2% de excesso de peso. Enquanto Razão Cintura Quadril (RCQ), Razão Cintura Estatura (RCEst), Índice de Conicidade (IC) e Circunferência da Cintura (CC) revelaram 65,4%, 90,27%, 89,0% e 58,4% de obesidade central na amostra, respectivamente. Quanto à PCR-us, 53,2% dos participantes mostraram elevado nível sérico (>0,3 mg/L); e as variáveis associadas à ocorrência de inflamação foram: sexo, grau de escolaridade, Glicemia de Jejum, Lipoproteína de alta densidade (HDL-c), RCEst e CC, após ajuste para variáveis de confusão. Discussão: Os resultados sugerem que manter uma GJ abaixo de 100mg/dl, um bom nível de HDL-c e evitar a obesidade central poderia ter um efeito protetor contra a ocorrência de inflamação crônica em diabéticos. Conclusão: Os níveis de PCR-us mostraram-se elevados na maioria dos pacientes estudados e estão associados a tais níveis: o sexo feminino, a obesidade abdominal, baixos níveis de HDL-c, escolaridade e glicemia elevadas (AU)

Introduction: Diabetes is a global epidemic that increases the risk of circulatory events and constitutes a considerable challenge to healthcare services. Objective: Determine levels of high sensitivity C-reactive protein levels and associated factors in patients with diabetes in the municipality of Vitória de Santo Antão, Brazil. Methods: A population-based, cross-sectional study was conducted from July to October 2011. Socio-demographic, lifestyle, clinical, anthropometric and biochemical variables were analyzed and associations with high sensitivity C-reactive protein levels were determined. Statistical analysis was performed with the aid of the Predictive Analytics Software, version 13.00, with a 5% level of significance. Results: The sample comprised 409 individuals, 73.1% of whom were female. Age ranged from 20 to 90 years (mean: 61.00 ± 11.62 years) and older adults accounted for the largest proportion of the sample (56.2%). The body mass index demonstrated that 75.2% had excess weight. The waist-to-hip ratio, waistto-height ratio, conicity index and waist circumference revealed obesity rates of 65.4%, 90.27%, 89.0% and 58.4%, respectively. A total of 53.2% had high sensitivity C-reactive protein levels (> 0.3 mg/L). Moreover, sex, level of schooling, fasting blood sugar, high density lipoprotein cholesterol, waist-to-height ratio and waist circumference were significantly associated with inflammation after controlling for confounding variables. Discussion: The present results suggest that maintaining a fasting blood sugar level below 100 mg/dl and a good HDL-c level as well as avoiding central obesity can have a protective effect against the occurrence of chronic inflammation in patients with diabetes. Conclusion: High sensitivity C-reactive protein levels were high in the majority of patients studied and were associated with the female sex, abdominal obesity, low HDL-c levels, a low level of schooling and high blood sugar levels (AU)