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1.
Preprint em Inglês | SciELO Preprints | ID: pps-1827

RESUMO

Cesarean section was developed to reduce maternal-fetal morbidity and mortality, however when performed without scientific evidence it is associated with complications. This study analyses the temporal trend and factors associated with cesarean section in Brazil, its regions and Federation Units between 2000 and 2017. Ecological study. The prevalence of cesarean sections and maternal variables were identified from the Information System on Live Births. The Prais-Winsten method was used for time series analysis. In the whole period there were 53.497.303 births in Brazil, 48.4% by cesarean section. Between 2000 and 2009, the mean cesarean section in Brazil increased from 39.7% (SD 9.8) to 53% (SD 9.4) between 2010 and 2017 with an annual variation of 1.7 p.p (95%CI 1.6; 1.8). There is stability between 2010 and 2017, with a slight decline from 2015 in the Southeast region with an annual variation of -0.9 (95%CI -1.5; 0.0). It is observed that the caesarean section has remained stable in most macro-regions and even decreasing in the southeast and in the group of women with higher education, not adolescents and better prenatal coverage. It is believed that Brazil has reached the plateau in the prevalence of cesarean section (60%) in most states and in the next years there is a decrease in these prevalences.

2.
Artigo em Inglês | MEDLINE | ID: mdl-33260357

RESUMO

The aims of this study were to analyse the effects of unstable and stable bodyweight neuromuscular training on dynamic balance control and to analyse the between-group differences after the training period. Seventy-seven physically active young adults (48 males, 29 females, 19.1 ± 1.1 years, 170.2 ± 9.2 cm, 64.1 ± 10.7 kg) were distributed into an unstable training group (UTG), a stable training group (STG), and a control group (CG). Training was conducted three times a week for nine weeks. Pre-intervention and post-intervention measures included dynamic balance control using a Y Balance Test (YBT), anterior (A), posteromedial (PM), and posterolateral (PL) reach direction. A mixed ANOVA was executed to test the within-subjects factor and the between-subjects factor. Statistically significant differences were found for all YBT measures within groups (p = 0.01) and between groups (p = 0.01). After the intervention, UTG and STG presented meaningfully improved results in all YBT measures (A: 7%, p = 0.01; 4%, p = 0.02, PM: 8%, p = 0.01; 5%, p = 0.01, PL: 8%, p = 0.01; 4%, p = 0.04, respectively). No statistical changes were found for any of the measures in the CG. After the intervention, significant differences were observed between the UTG and CG for the YBTA and PM (p = 0.03; p = 0.01). The results suggest that neuromuscular training using an unstable surface had similar effects on dynamic balance control as training using a stable surface. When compared to CG, UTG showed better performance in YBTA and PM.

3.
Res Sports Med ; : 1-17, 2020 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-33322936

RESUMO

The purpose of this study was to analyse the effects of a nine-week unstable vs stable bodyweight neuromuscular training programme on balance control. Seventy-seven physically active universitarians were randomly distributed into an unstable training group (UTG), a stable training group (STG), and a control group (CG). The intervention was conducted three times a week for nine weeks. Pre- and post-intervention assessments included static balance control under an unstable surface (eyes open (EOFS), eyes closed (ECFS), challenging visual-vestibular system (CVVS)), assessed as centre-of-pressure fluctuations with a force plate. A mixed ANOVA was performed to test the within- and between-subjects factors. After the intervention, no significant differences were found between groups. All groups presented significant improvements in balance measurements in EOFS (p = 0.01), ECFS (p = 0.01; p = 0.02), and CVVS (p = 0.01) conditions. The training groups tended to have significantly better balance control (antero-posterior) than the CG on EOFS. In the CVVS condition, the UTG tended to have better balance control than the CG. There was no overall significant training advantage gained by using unstable or stable surfaces in terms of the improvement in static balance control in active universitarians. Both training groups exhibited similar training adaptations.

4.
Rev. esp. nutr. comunitaria ; 26(4): 0-0, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-FGT-6053

RESUMO

FUNDAMENTOS: Portugal no fue una excepción al panorama europeo de alto consumo de sal, registrando una alta prevalencia de hipertensión y siendo las enfermedades cardiovasculares la principal causa de muerte en la última década. En 2012, Portugal se comprometió a reducir la ingesta de sal en la población en un 30% hasta 2025 con un objetivo de 5 g por día. Por lo tanto, el objetivo de este estudio es presentar una visión general de la última década (2009-2019) de las políticas de reducción de sal implementadas en Portugal con el objetivo de reducir la ingesta de sal en la dieta de la población, a través de una revisión narrativa. MÉTODOS: Se realizó una revisión documental y bibliográfica de artículos científicos y documentos gubernamentales publicados entre enero de 2009 y diciembre de 2019. RESULTADOS: Se identificaron catorce iniciativas implementadas utilizando diferentes herramientas (acuerdos voluntarios con la industria, legislación obligatoria, etc.), e intentando intervenciones integrales del sistema alimentario para promover la producción, distribución y consumo de menos sal. CONCLUSIONES: Para lograr los objetivos de 2025, el desafío es la implementación de estrategias de acción efectivas (incluidos enfoques innovadores) y el monitoreo de las tendencias de consumo


BACKGROUND: Portugal was not exception to the European panorama of high salt consumption, registering high prevalence of hypertension and being cardiovascular diseases the leading cause of death in the last decade. In 2012, Portugal compromised to target the reduction of salt intake in the population by 30% until 2025 with a target of 5 g per day. Therefore, the aim of this study is to present an overview of the last decade (2009-2019) of salt reduction policies implemented in Portugal with the objective of reducing the dietary salt intake of the population, through one narrative review. METHODS: A documentary and bibliographical review of scientific articles and governmental documents published between January 2009 and December 2019 was carried out. RESULTS: Was identified fourteen initiatives implemented using different policy tools (voluntary agreements with industry, mandatory legislation, etc.), and trying comprehensive food system interventions to promote the production, distribution and consumption of less salt. CONCLUSIONS: To achieve the 2025 goals, the challenge is the implementation of effective action strategies (including innovative approaches) and the monitoring of consumption trends

5.
Nutrients ; 12(11)2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33182820

RESUMO

This review aims to examine the relationship of sodium and potassium intake and cardiovascular disease (CVD) among older people. METHODS: We performed a literature search using PubMed and Web of Science (January 2015 to July 2020) without language restriction. Observational and experimental studies that reported the relationship between sodium, potassium, or sodium-to-potassium ratio with CVD among older adults aged higher than 60 years were included. The authors independently screened all identified studies, extracted information, and assessed the quality of included studies. Risk of bias was assessed using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) for observational studies and the revised Cochrane risk-of-bias tool (RoB 2 tool) for randomized trials. RESULTS: We included 12 studies (6 prospective cohort studies, 5 cross-sectional studies, and 1 experimental study). Five of the studies reported on sodium-to-potassium ratio (n = 5), and the others on potassium and/or sodium intake. Cardiovascular events (e.g., stroke and heart failure) were the most reported outcome (n = 9). Of the 12 studies included, five observational studies had low bias risk and the randomized controlled trial was judged as uncertain risk of bias. We found inconsistent results for the effect of the reduction of sodium intake in this population for lower risk of CVD. We found that both the increase of potassium intake and the decrease of sodium-to-potassium ratio were associated with lower risk of hypertension and CVD, particularly stroke. CONCLUSION: The present review suggests that both higher potassium and lower sodium-to-potassium ratio are associated with lower risk of CVD.

6.
Front Oncol ; 10: 570958, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33102226

RESUMO

Combined hepatocellular-cholangiocarcinoma (cHCC-ICC) is an uncommon and aggressive form of primary liver cancer. Currently, there are no international guidelines for optimal management. For localized tumors, radical resection represents the preferred treatment option, whereas for advanced tumors, systemic therapies recommended for intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) are often selected. Emerging information from comparative cohort studies, genomic and transcriptomic data sets are starting to build a case for rationalized approaches to systemic treatment in the advanced setting specific to cHCC-ICC.

7.
Life Sci ; 259: 118210, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32763289

RESUMO

AIMS: From the synthesis of 43 lipophilic dihydropyridines, the aim of this study was to verify whether the new dihydropyridines have calcium channel affinity using coupling studies and to determine antihypertensive and antioxidant properties, as well as toxicology and toxicity nifedipine and three new compounds, were chosen from the previous results. MATERIALS AND METHODS: The animals were treated for 56 days, 28 days with N (ω) -nitro-L-arginine methyl ester to induce hypertension, and then treated for another 28 days with the new di- hydropyridine and the standard drug nifedipine. Throughout the treatment the animals had their blood pressure measured and their heart rate checked by pletysmography. After treatment the animals were euthanised, blood samples were collected for creatine kinase and urea analysis, and the brain, heart and liver were collected for oxidative status analysis (quantification of reactive oxygen species, total antioxidant capacity, and lipid peroxidation). KEY FINDINGS: Compounds 2c, and 9a, and nifedipine significantly reduced blood pressure to control group levels. The tachycardia caused by the induction of hypertension was reversed by 2c and 9a compounds. Regarding oxidative stress analyzes, the compounds that had the best performances were also 2c and 9a. Overall the results demonstrate that two of the three new dihydropyridines tested demonstrated performance equal to or superior to the standard drug nifedipine. SIGNIFICANCE: In this study, for the first time, docking was applied to analyse 43 fatty dihydropyridines regarding their calcium channel binding. Afterwards, three fatty dihydropyridines were chosen and their antihypertensive and antioxidant properties.


Assuntos
Canais de Cálcio Tipo L/metabolismo , Canais de Cálcio Tipo L/ultraestrutura , Di-Hidropiridinas/farmacologia , Animais , Anti-Hipertensivos/farmacologia , Antioxidantes/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Cálcio/farmacologia , Bloqueadores dos Canais de Cálcio/farmacologia , Canais de Cálcio , Di-Hidropiridinas/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Hipertensão/fisiopatologia , Masculino , Nifedipino/farmacologia , Piridinas/farmacologia , Ratos , Ratos Wistar
8.
Arch. Clin. Psychiatry (Impr.) ; 47(4): 89-94, July-Aug. 2020. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1130995

RESUMO

Abstract Background Brazil has the third largest prison population in the world. Research in the world has confirmed a high prevalence of mental disorders in this population. Objective To identify prevalence and associated factors with depression and anxiety in prisoners of the closed prison system. Methods This is a cross-sectional study with 643 prisoners were interviewed in six prisons in Rio Grande do Sul, Brazil. To evaluate depression and anxiety, the Mini International Neuropsychiatric Interview 5.0 (MINI) was used and sociodemographic, inprisonment and lifestyle habits variables were also collected. Results The prevalence of depression found in the study was 20.6% (95% CI: 17.5-23.8) and of anxiety was 19.9% (95% CI: 16.8-23.0). The following were identified as risk factors for depression: being female, having a history of mental illness, non-white skin color, having a religion, not receiving visits, smoking, using drugs and not performing physical activities. Risk factors for anxiety were: being female, having a history of mental illness, a family history of mental illness, smoking and using drugs. Discussion The study confirmed the high rates of depression and anxiety in the population deprived of liberty. In addition, women were twice as likely to have both disorders compared to men.

9.
BMJ Open ; 10(5): e035898, 2020 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-32423935

RESUMO

INTRODUCTION: Excessive salt intake is a public health concern due to its deleterious impact on health. Most of the salt consumed come from those that are added when cooking. This study will improve knowledge on the effectiveness of interventions to reduce salt consumption among consumers. METHODS AND ANALYSIS: In this randomised clinical trial, we will be evaluating the efficacy of an intervention-the Salt Control H, an innovative prototype equipment to monitor and control use of salt when cooking-among workers from a public university, with the aim of reducing their dietary salt intake. We will randomly select 260 workers who meet the eligibility criteria and who are enrolled to an occupational health appointment and randomise them into one of the two arms of the study (either control or intervention), with matched baseline characteristics (sex and hypertension). The intervention will last for 8 weeks, during which the participants will use the equipment at home to monitor and control their use of salt when cooking. The main outcome will be 24-hour urinary sodium excretion at baseline, at fourth and eighth weeks of intervention, and at 6 months after intervention. ETHICS AND DISSEMINATION: Ethical approval for the study has been obtained from the Ethics Committee of the Centro Hospitalar Universitário São João. The results of the investigation will be published in peer-reviewed scientific papers and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT03974477 EQUIPMENT PROVISIONAL PATENT NUMBER: Registered at INPI: 20191000033265.

10.
J Infect Dev Ctries ; 14(4): 332-340, 2020 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-32379709

RESUMO

INTRODUCTION: Considering that Group B Streptococcus (GBS) persists as an important cause of neonatal morbidity and mortality, the objective of this study was to evaluate the frequency of maternal colonization by GBS, comparing the culture by the Granada broth with the GeneXpert real-time PCR diagnostic methods and the impact of chemoprophylaxis in high-risk pregnant women. METHODOLOGY: A prospective cohort of 110 pregnant women hospitalized for gestational complications was formed and recruited following interview and collection of rectovaginal swabs. RESULTS: The frequency of maternal colonization was 28.2% and statistically associated with Capurro> 37 weeks (p = 0.030) and neonatal infection (p = 0.008). Chemoprophylaxis was offered to 80% of those colonized. Among the pregnant women treated, a fivefold reduction in the rate of prematurity and rate of neonatal infection was observed. The sensitivity was 76.6% and 86.6% in culture and PCR, respectively, with an optimal index of agreement between the methods (K = 0.877). Grenade culture was considered an easy and low-cost method, while GeneXpert presented higher cost and error rate of 10%. However, 23.3% of the pregnant women were diagnosed exclusively by GeneXpert and the results were obtained in two hours. CONCLUSIONS: This study showed a significant prevalence of maternal colonization for GBS and that both culture and molecular methods had peculiarities that allow different applicability, with the culture being feasible for antenatal screening and in the hospital for high-risk pregnant women with no sign of imminent delivery and GeneXpert being prioritized for situations of preterm birth.

11.
Yeast ; 37(4): 313-320, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32061177

RESUMO

The Wickerhamiella and Starmerella genera form a clade (W/S clade) that branches close to Yarrowia lipolytica in the Saccharomycotina species tree. It comprises approximately 90 recognized species and 50 putative new species not formally described yet. The large majority of the members of the W/S clade are ecologically associated with flowers and floricolous insects. Many species exhibit unusual metabolic traits, like fructophily and the production of sophorolipids, which are glycolipids that can be used as environmentally friendly biosurfactants. Genomic data have not only firmly established the W/S clade but have also revealed a tumultuous evolution of metabolism marked by losses and gains of important metabolic pathways, among which alcoholic fermentation. Possibly the most surprising finding brought to light by comparative genomics concerned the large number of genes acquired by some species of the W/S clade from bacteria through horizontal gene transfer, many of which were shown to be functional in their new setting. This was facilitated by the genetic tractability of one species in the clade, Starmerella bombicola, which is used for the industrial production of sophorolipids. We suggest that high-density coverage of genome sequencing in this clade, combined with the possibility to conduct molecular genetics experiments in at least one species, has the potential to set the stage for yet more exciting discoveries concerning the evolution of yeast metabolism.


Assuntos
DNA Fúngico/isolamento & purificação , Saccharomycetales/classificação , Saccharomycetales/genética , Animais , DNA Fúngico/genética , Evolução Molecular , Flores/microbiologia , Transferência Genética Horizontal , Glicolipídeos/biossíntese , Glicolipídeos/genética , Insetos/microbiologia , Redes e Vias Metabólicas , Filogenia , Saccharomycetales/isolamento & purificação
12.
Rev Bras Ginecol Obstet ; 42(1): 5-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32107760

RESUMO

OBJECTIVE: Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. METHODS: Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencing were used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. RESULTS: The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. CONCLUSION: The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.

13.
JMIR Res Protoc ; 9(1): e15299, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31958068

RESUMO

BACKGROUND: Chronic noncommunicable diseases such as arterial hypertension have a high impact in the context of public health. Previous studies have shown improvements in blood pressure due to simple lifestyle changes, which were supported by electronic health (eHealth) solutions. OBJECTIVE: The aim of this study is to develop an eHealth platform and assess the effects of its use on the health conditions of patients with hypertension, with assistance from health professionals in the public health system of a Brazilian city. METHODS: The platform will include a server that centralizes all the data and business rules, a website dashboard for health professionals, and a mobile app for patients. We will analyze the effects of its use through a controlled, nonrandomized, nonblind, prospective, monocentric clinical trial. We will enroll 68 participants diagnosed with arterial hypertension and under medical follow-up and categorize them into two groups. The participants of the intervention group will use the platform as a monitoring method, whereas the participants of the control group will use conventional methods. In both groups, we will assess and compare the evolution of blood pressure and treatment adherence before, during, and after the intervention. RESULTS: The project was funded at the end of 2018. We have been developing the software since 2019 with plans to complete it in 2020, and we will enroll patients between 2020 and 2021. We expect to submit the first results for publication in 2020. CONCLUSIONS: For the primary outcome, we expect a reduction and stabilization of blood pressure. For the secondary outcomes, we hope to see improvements in treatment adherence, physical activities and dietary practices, and acceptance of the eHealth platform. In public health, the technology that favors disease control also helps reduce complications and, consequently, treatment costs. The platform might encourage the adaptation of medical assistance to incorporate this technology into patient monitoring. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/15299.

14.
Rev. bras. ginecol. obstet ; 42(1): 5-11, Jan. 2020. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1092632

RESUMO

Abstract Objective Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors. Methods Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencingwere used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition. Results The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood. Conclusion The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.


Resumo Objetivo Estimar a prevalência do DNA do vírus herpes humano 1 (HSV-1) em amostras de placenta, sua incidência no sangue do cordão umbilical de recém-nascidos e fatores de risco associados. Métodos Biópsias de placenta e de sangue de cordão umbilical foram analisadas, totalizando 480 amostras de parturientes assintomáticas e seus recém-nascidos emum hospital universitário. Reação de cadeia de polimerase (RCP) nested e sequenciamento gênico foram usados para identificar o vírus; odds ratio (OR) e risco relativo (RR) foram realizados para comparar os fatores de risco associados à essa condição. Resultados A prevalência do DNA do HSV-1 em amostras de placenta foi de 37,5%, e a incidência no sangue do cordão foi de 27,5%. A via transplacentária hematogênica foi identificada em 61,4% das amostras de HSV-1+do sangue do cordão umbilical, pareadas com o tecido placentário. Nenhuma evidência do vírus foi observada nos restantes 38,6% dos tecidos placentários, sugerindo uma infecção ascendente do trato genital. A falta de uso do preservativo aumentou o risco de encontrar o HSV-1 na placenta e no sangue do cordão umbilical. Conclusão A ocorrência de DNA do HSV-1 na placenta e no sangue do cordão umbilical sugere uma transmissão vertical de gestantes assintomáticas para o feto.

15.
Arq Gastroenterol ; 56(4): 394-398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800735

RESUMO

BACKGROUND: In recent years the management of hepatitis C virus infection and the possibility of its eradication have been researched due to the importance that they represent in the health of the world population. Obtaining data that help to cope with this pathology improves the quality of life of those affected by it. The present study evaluated the effectiveness of direct-acting antiviral therapies provided by the Brazilian Ministry of Health in accordance to the Clinical Protocol and Therapeutic Guidelines of 2015. OBJECTIVE: To evaluate the epidemiological profile of patients with chronic hepatitis C and the rate of sustained virologic response using direct-acting antivirals of all individuals that attended the referral service for the treatment of chronic hepatitis C at the Hospital of the Federal University of Rio Grande. METHODS: This was an observational, retrospective/prospective study with all patients with chronic hepatitis C who had their treatments available from December 2015 to August 2017 according to the criteria of the Clinical Protocol and Therapeutic Guidelines of 2015. In the first phase, the clinical and demographic variables of all individuals enrolled in a treatment for hepatitis C were selected and collected from the Reference Service database. In the second phase, treatment data were collected. The outcome variable, sustained virologic response, was defined as an undetectable viral load on the blood test three months after the end of treatment. The descriptive and bivariate analyzes were performed with Pearson's chi-square and Fisher's Exact test, adopting a P value ≤0.05 in the SPSS 20 software. RESULTS: Of the 252 participants in the study, 228 (90.5%) had a sustained virologic response, 55.2% were male with an average age of 58.6 years (SD±9.1). Genotype 1 was the most prevalent, observed in 54.4% of the participants, and 87.4% of the patients had moderate/advanced hepatic fibrosis. After the statistical analysis, it was observed that the individuals with genotype 3 and moderate/advanced hepatic fibrosis had lower sustained virologic response rate (P=0.05 and P=0.04, respectively). CONCLUSION: It was observed that the use of direct-acting antivirals, in comparison to previous therapeutic regimens, increases the sustained virologic response, reaching all patients with mild fibrosis. This study provides information that helps in the hepatitis C treatment by showing that prescribing early treatment for patients without hepatic fibrosis and/or genotype 3 virus could increase therapeutic effectiveness.


Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Resposta Viral Sustentada , Idoso , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento , Carga Viral
16.
Rev Bras Epidemiol ; 22: e190060, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31826115

RESUMO

INTRODUCTION: Nutrition counseling has played a critical role in the prevention and treatment of various diseases. OBJECTIVE: To evaluate how adults and elderly people, who are residents in an urban area of Southern Brazil, received nutritional counseling. METHODS: This was a cross-sectional population based study. Data was collected through a questionnaire applied at home. The outcome was the prevalence of nutritional counseling received in the past year that came from different means, including means of communication. Sociodemographic variables, doctor visits in the past year, nutritional state and other healthcare variables were analyzed. RESULTS: The sample included 1,296 individuals (rate of answer of 90.7%). The results indicate that the majority of the people interviewed were females (56.6%), with their age ranging from 18 to 59 years-old (75.3%). The prevalence of people receiving nutritional counseling was 19.9% (95%CI 17.3 -22.5). It was higher among women than men (p = 0.01). The sex-adjusted analyses showed a statistically significant (p < 0.05) association in men for the variables: schooling ≥ 12 years; medical consultation in the last year; low weight; obesity; diabetes and hypertension. Among the women, the following variables were associated with the outcome: health insurance; medical consultation in the last year; obesity and diabetes. CONCLUSIONS: The low prevalence of nutritional counseling and its association with diseases exposes the need for it to be implemented not only for treatment purposes but also as preventive health actions.


Assuntos
Doença Crônica/prevenção & controle , Aconselhamento/estatística & dados numéricos , Educação em Saúde/métodos , Estado Nutricional , Adolescente , Adulto , Brasil/epidemiologia , Doença Crônica/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana , Adulto Jovem
17.
Front Microbiol ; 10: 2510, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31736930

RESUMO

The yeasts belonging to the Wickerhamiella and Starmerella genera (W/S clade) share a distinctive evolutionary history marked by loss and subsequent reinstatement of alcoholic fermentation mediated by horizontal gene transfer events. Species in this clade also share unusual features of metabolism, namely the preference for fructose over glucose as carbon source, a rare trait known as fructophily. Here we show that fructose may be the preferred sugar in W/S-clade species because, unlike glucose, it can be converted directly to mannitol in a reaction with impact on redox balance. According to our results, mannitol is excreted to the growth medium in appreciable amounts along with other fermentation products such as glycerol and ethanol but unlike the latter metabolites mannitol production increases with temperature. We used comparative genomics to find genes involved in mannitol metabolism and established the mannitol biosynthesis pathway in W/S-clade species Starmerella bombicola using molecular genetics tools. Surprisingly, mannitol production seems to be so important that St. bombicola (and other W/S-clade species) deploys a novel pathway to mediate the conversion of glucose to fructose, thereby allowing cells to produce mannitol even when glucose is the sole carbon source. Using targeted mutations and 13C-labeled glucose followed by NMR analysis of end-products, we showed that the novel mannitol biosynthesis pathway involves fructose-6-phosphate as an intermediate, implying a key role for a yet unknown fructose-6-P phosphatase. We hypothesize that mannitol production contributed to mitigate the negative effects on redox balance of the ancient loss of alcoholic fermentation in the W/S clade. Presently, mannitol also seems to play a role in stress protection.

18.
Proc Natl Acad Sci U S A ; 116(44): 22219-22228, 2019 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-31611373

RESUMO

Horizontal acquisition of bacterial genes is presently recognized as an important contribution to the adaptation and evolution of eukaryotic genomes. However, the mechanisms underlying expression and consequent selection and fixation of the prokaryotic genes in the new eukaryotic setting are largely unknown. Here we show that genes composing the pathway for the synthesis of the essential vitamin B1 (thiamine) were lost in an ancestor of a yeast lineage, the Wickerhamiella/Starmerella (W/S) clade, known to harbor an unusually large number of genes of alien origin. The thiamine pathway was subsequently reassembled, at least twice, by multiple HGT events from different bacterial donors involving both single genes and entire operons. In the W/S-clade species Starmerella bombicola we obtained direct genetic evidence that all bacterial genes of the thiamine pathway are functional. The reconstructed pathway is composed by yeast and bacterial genes operating coordinately to scavenge thiamine derivatives from the environment. The adaptation of the newly acquired operons to the eukaryotic setting involved a repertoire of mechanisms until now only sparsely documented, namely longer intergenic regions, post-horizontal gene transfer (HGT) gene fusions fostering coordinated expression, gene relocation, and possibly recombination generating mosaic genes. The results provide additional evidence that HGT occurred recurrently in this yeast lineage and was crucial for the reestablishment of lost functions and that similar mechanisms are used across a broad range of eukaryotic microbes to promote adaptation of prokaryotic genes to their new environment.


Assuntos
Transferência Genética Horizontal , Genes Bacterianos , Óperon , Saccharomycetales/genética , Tiamina/genética , Bactérias/genética , Tiamina/metabolismo
19.
Arq. gastroenterol ; 56(4): 394-398, Oct.-Dec. 2019. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1055164

RESUMO

ABSTRACT BACKGROUND: In recent years the management of hepatitis C virus infection and the possibility of its eradication have been researched due to the importance that they represent in the health of the world population. Obtaining data that help to cope with this pathology improves the quality of life of those affected by it. The present study evaluated the effectiveness of direct-acting antiviral therapies provided by the Brazilian Ministry of Health in accordance to the Clinical Protocol and Therapeutic Guidelines of 2015. OBJECTIVE: To evaluate the epidemiological profile of patients with chronic hepatitis C and the rate of sustained virologic response using direct-acting antivirals of all individuals that attended the referral service for the treatment of chronic hepatitis C at the Hospital of the Federal University of Rio Grande. METHODS: This was an observational, retrospective/prospective study with all patients with chronic hepatitis C who had their treatments available from December 2015 to August 2017 according to the criteria of the Clinical Protocol and Therapeutic Guidelines of 2015. In the first phase, the clinical and demographic variables of all individuals enrolled in a treatment for hepatitis C were selected and collected from the Reference Service database. In the second phase, treatment data were collected. The outcome variable, sustained virologic response, was defined as an undetectable viral load on the blood test three months after the end of treatment. The descriptive and bivariate analyzes were performed with Pearson's chi-square and Fisher's Exact test, adopting a P value ≤0.05 in the SPSS 20 software. RESULTS: Of the 252 participants in the study, 228 (90.5%) had a sustained virologic response, 55.2% were male with an average age of 58.6 years (SD±9.1). Genotype 1 was the most prevalent, observed in 54.4% of the participants, and 87.4% of the patients had moderate/advanced hepatic fibrosis. After the statistical analysis, it was observed that the individuals with genotype 3 and moderate/advanced hepatic fibrosis had lower sustained virologic response rate (P=0.05 and P=0.04, respectively). CONCLUSION: It was observed that the use of direct-acting antivirals, in comparison to previous therapeutic regimens, increases the sustained virologic response, reaching all patients with mild fibrosis. This study provides information that helps in the hepatitis C treatment by showing that prescribing early treatment for patients without hepatic fibrosis and/or genotype 3 virus could increase therapeutic effectiveness.


RESUMO CONTEXTO: O manejo e a possibilidade de erradicação da infecção pelo vírus da hepatite C têm sido muito pesquisados nos últimos anos pela importância que representam na saúde pública para a população mundial. A obtenção de dados que auxiliem o enfrentamento dessa patologia resulta na melhor qualidade de vida dos seus portadores. O presente estudo avaliou a efetividade da terapêutica com os antivirais de ação direta, fornecida pelo Ministério da Saúde, através do Protocolo Clínico e Diretrizes Terapêuticas de 2015. OBJETIVO: Avaliar o perfil epidemiológico dos portadores de hepatite C crônica e a taxa de resposta viral sustentada com o uso dos antivirais de ação direta em todos os indivíduos atendidos no Centro de Referência no tratamento da hepatite C crônica do Hospital Universitário da Universidade Federal do Rio Grande. MÉTODOS: Estudo observacional retrospectivo/prospectivo com todos os portadores de hepatite C crônica que tiveram seus tratamentos disponibilizados no período de dezembro de 2015 a agosto de 2017 segundo os critérios do Protocolo Clínico e Diretrizes Terapêuticas de 2015. Na primeira fase foram selecionadas e coletadas as variáveis demográficas e clínicas, no banco de dados do centro de referência de todos os indivíduos cadastrados para tratamento para hepatite C e na segunda fase foram coletados dados referentes ao tratamento. A variável desfecho, resposta viral sustentada, foi definida pela carga viral indetectável no exame sanguíneo três meses após o término do tratamento. Foram realizadas as análises descritivas e bivariadas com cálculo do qui quadrado de Pearson e Exato de Fisher, adotando um valor P≤0,05, no programa SPSS 20. RESULTADOS: Dos 252 participantes do estudo 228 (90,5%) obtiveram resposta viral sustentada, sendo 55,2% do sexo masculino com média de idade de 58,6 anos (DP±9,1). O genótipo 1 foi o mais prevalente, presente em 54,4% dos participantes, 87,4% dos estudados apresentavam grau de fibrose hepática moderada/avançada. Após a análise estatística observou-se que os indivíduos com genótipo 3 e fibrose hepática moderada/avançada, tiveram menor taxa de resposta viral sustentada (P=0,05 e P=0,04 respectivamente). CONCLUSÃO: Observou-se que com o uso dos antivirais de ação direta as taxas de resposta viral sustentada foram altas, em relação aos esquemas terapêuticos anteriores, podendo chegar à totalidade nos pacientes com fibrose leve. Este estudo mostra que a realização do tratamento precoce, ou seja, de forma antecipada em pacientes sem fibrose hepática e genótipo 3 pode aumentar a taxa de sucesso.

20.
Nutrients ; 11(10)2019 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-31546602

RESUMO

This study aimed to investigate the association between dairy product consumption and metabolic and inflammatory biomarkers in Portuguese adolescents, and whether the association differed by weight status. A cross-sectional study was conducted during the school year 2011/2012 with 412 Portuguese adolescents (52.4% girls) in 7th and 10th grade (aged 12 to 18 years old). The World Health Organization cutoffs were used to categorize adolescents as non-overweight (NW) or overweight (OW). Blood samples were collected to analyze C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and adiponectin. Dairy product intake was evaluated using a food frequency questionnaire. Participants were divided by tertiles according to the amount of dairy product consumed. The associations between dairy product consumption with metabolic and inflammatory biomarkers were evaluated using generalized linear regression models with logarithmic link and gamma distribution and adjusted for potential confounders. The majority of adolescents were NW (67.2%). NW adolescents had lower IL-6, CRP, and leptin concentration than their counterparts (p < 0.05, for all comparisons). Higher levels of total dairy product and milk intake were inversely associated with IL-6 (P for trend <0.05, for all) in NW adolescents, but not in OW adolescents. NW adolescents in the second tertile of yogurt consumption had lower level of IL-6 compared to those in the first tertile (p = 0.004). Our results suggest an inverse association between total dairy product and milk intake and serum concentrations of IL-6 only among NW adolescents.


Assuntos
Adiponectina/sangue , Proteína C-Reativa/análise , Laticínios/análise , Interleucina-6/sangue , Leptina/sangue , Sobrepeso/sangue , Adolescente , Biomarcadores/sangue , Criança , Estudos Transversais , Dieta/efeitos adversos , Inquéritos sobre Dietas , Feminino , Humanos , Modelos Lineares , Masculino , Portugal
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