Factors associated with metabolic syndrome in climacteric women of southern Brazil.

AIM: To investigate the association between socioeconomic, demographic, behavioral, and reproductive factors and the metabolic syndrome (MS) in climacteric women. METHOD: This cross-sectional study was carried out in a sample of 527 women aged 40-65 years seen at an outpatient menopause and gynecologic surgery clinic in Southern Brazil. MS was defined according to NCEP-ATP III diagnostic criteria. Poisson regression was used to calculate crude and adjusted prevalence ratios and their respective 95% confidence intervals (CI). RESULTS: The prevalence of MS was 54.8% (95% CI 50.6-59.1%), varying with menopausal status (45.7% before menopause, 56.3% in perimenopause, and 57.5% in postmenopausal women). Among the components of MS, hypertension and abdominal obesity were the most prevalent (84.8% and 66.8%, respectively). The prevalence of MS rose with advancing age and increasing parity. Women with low education (years of schooling) showed a higher prevalence of MS compared to those with a high education level (64% vs. 36.8%). Women with early menarche (≤11 years of age) showed an increase of 32% in MS prevalence (95% CI 1.08-1.62) compared to those with a late menarche (≥14 years of age). CONCLUSION: These findings are relevant to public health, particularly as they show the significance of exposure to long-term, hard-to-reverse effects, such as early menarche and low educational achievement, in the development of metabolic syndrome.

Drug utilization patterns in pregnant women: a case study at the Mount Hope Women's Hospital in Trinidad, West Indies.

OBJECTIVE: To explore drug (prescription, over-the-counter and herbal) utilization in pregnant women attending a public sector tertiary healthcare institution. METHODS: This was a cross-sectional case study in women attending antenatal clinics at the Mount Hope Women's Hospital. Women (506) who consecutively presented for routine care at the antenatal clinic were interviewed on the medication they took. Descriptive statistics and logistic regression for predictors of drug use were done using SPSS 16. RESULTS: There were 200 (39.5%) primigravidae, 306 (60.5%) multigravidae and 299 (59%) women were in the third trimester of pregnancy. Most women (69.8%) were between 20-35 years of age. Women took an average of 1.32, 1.22 and 0.94 prescribed drugs in each trimester respectively. Multivitamins (59.8%) and iron/folic acid (54.2%) were the most frequently prescribed drugs. Regardless of trimester only 20% of women took supplemental calcium. Very few women (2.4%) took herbal medications. Paracetamol was the most common over-the-counter (OTC) medication in all trimesters. Women with secondary level education were most likely to use OTC iron/folic acid (p = 0.02), paracetamol and histamine2 receptor antagonists [H2RAs] (p = 0.001). More primigravidae took non-steroidal anti-inflammatory drugs (p = 0.02) and more women in the first trimester used antiemetics (p = 0.001). Age group (p = 0.048), marital status (p = 0.001) and the trimester of pregnancy (p = 0.001) were predictors of drug utilization. CONCLUSION: Overall, women in tertiary healthcare institutions took medication as prescribed particularly multivitamins and iron/folic acid. More women with higher education took OTC paracetamol, iron/folic acid and vitamin supplements. Herbal supplements were rarely used. Research on drug utilization in primary care facilities is recommended.

Organ donation: acceptance and refusal among users of the public health system from Brazil.

The present study sought to identify the perception of a given group of users of the Brazilian Public Health System (Sistema Unico de Saúde) regarding organ donation and to implement an educational policy. Structured interviews were conducted with the aim of describing the profile of donor and nondonor subjects, the importance of organ donation, and the knowledge regarding donation and brain death. One hundred subjects were interviewed: 33% of them considered themselves potential donors; 40% were donors; 13% were nondonors; and 14% were ill-informed potential donors. However, only 40% of users have already officially expressed to their families a willingness to donate. Regarding their knowledge about the propitious moment for organ donation, only 64% of them associated the donation act with brain death. Although the present results revealed that users of the Brazilian Public Health System are prone to organ donation, there actually was a high amount of refusals, which may be due to lack of information and knowledge regarding the donation-transplantation process.

Effect of Hepatic Preconditioning with the Use of Methylene Blue on the Liver of Wistar Rats Submitted to Ischemia and Reperfusion.

BACKGROUND: The liver may be injured in situations where it is submitted to ischemia, such as partial hepatectomy and liver transplantation. In all cases, ischemia is followed by reperfusion and, although it is essential for the reestablishment of tissue function, reperfusion may cause greater damage than ischemia, an injury characterized as ischemia-reperfusion (I/R) damage. The aim of this work was to analyze the effect of ischemic preconditioning with the use of methylene blue (MB; 15 mg/kg) 5 or 15 minutes before I/R (IRMB5' and IRMB15', respectively) on the hepatic injury occurring after I/R. METHODS: Twenty-eight male Wistar rats were used, and liver samples submitted to partial ischemia (IR) or not (NI) were obtained from the same animal. The samples were divided into 7 groups. Data were analyzed statistically by means of the nonparametric Mann-Whitney test and Wilcoxon Matched test, with the level of significance set at 5% (P < .05). RESULTS: The rate of oxygen consumption by state 3 mitochondria was inhibited in all ischemic groups compared with the sham group (SH vs IR: P = .0052; SH vs IRMB5': P = .0006; SH vs IRMB15': P = .0048), which did not occur in the nonischemic contralateral portion of the same liver (SH vs NI: P = .7652; SH vs NIMB5': P = .059; SH vs NIMB15': P = .3153). The inhibition of the rate of oxygen consumption by state 3 mitochondria was maintained in the presence of MB (IR vs IRMB5': P = .4563; IR vs IRMB15': P = .9021). The respiratory control ratio was reduced in all ischemic groups compared with the sham group, owing to the inhibition of oxygen consumption in state 3 (SH vs IR: P = .0151; SH vs IRMB5': P = .005; SH vs IRMB15': P = .0007). CONCLUSIONS: Methylene blue had no effect on the mitochondrial respiratory parameters studied, but was able to reduce lipid peroxidation, preventing the production of reactive oxygen species (SH vs IRMB15': P = .0210).

Anxiety and Stress Levels on Liver Transplantation Candidates.

The objective of the present study was to determine the anxiety and stress levels of liver transplant candidates during the preoperative period. A cross-sectional, prospective study was conducted on 52 liver transplantation candidates seen at a specialized public hospital outpatient clinic in the interior of the state of São Paulo, Brazil. Data were collected from November 2014 to April 2015 using a self-applicable questionnaire for the assessment of anxiety (State-Trait Anxiety Inventory, short version) and stress (Perceived Stress Scale), in addition to sociodemographic and clinic characterization. The mean (±SD) anxiety level detected was 23.06 ± 5.51 points, with 1.92% of the subjects showing minimum levels (0 to 12 points), 59.62% a medium level (12 to 24 points), 36.54% a moderate level (24 to 36 points), and 1.92% a severe level (36 to 48 points) of anxiety. The mean level on the stress scale was 12.10 ± 5.62 points, with 7.69% of the subjects showing high stress levels. When individuals with good and poor stress levels were compared, a significant difference was observed between them (P = .0004). The Spearman correlation test showed that the higher the stress, the higher the levels of anxiety (r = 0.4258), P < .0001. The present study contributes to the analysis of the mental health of liver transplantation candidates in view of the need for interventions for the improvement of anxiety and stress levels since the waiting period for the organ generates emotional changes that can affect the quality of life of the patient and the success of this complex therapeutic modality.

Sleep Quality Assessment and Daytime Sleepiness of Liver Transplantation Candidates.

OBJECTIVE: The goal of this study was to evaluate the sleep quality and daytime sleepiness of patients eligible for liver transplants. METHODS: A cross-sectional prospective study was conducted on liver transplant candidates from a transplant center in the interior of São Paulo State. The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires were applied to obtain demographic and clinical characteristics and to assess sleep quality and daytime sleepiness. RESULTS: The mean (±SD) score on the Epworth Sleepiness Scale of the 45 liver transplantation candidates was 7.00 ± 2.83 points, with 28.89% having scores >10 points, indicating excessive daytime sleepiness. The mean score on the Pittsburgh Sleep Quality Index was 6.64 ± 4.95 points, with 60% of the subjects showing impaired sleep quality, with scores >5 points. The average sleep duration was 07:16 h. Regarding sleep quality self-classification, 31.11% reported poor or very poor quality. It is noteworthy that 73.33% of patients had to go to the bathroom, 53.33% woke up in the middle of the night, and 40.00% reported pain related to sleeping difficulties. Comparison of subjects with good and poor sleep quality revealed a significant difference in time to sleep (P = .0002), sleep hours (P = .0003), and sleep quality self-classification (P = .000072). CONCLUSION: Liver transplant candidates have a compromised quality of sleep and excessive daytime sleepiness. In clinical practice, we recommend the evaluation and implementation of interventions aimed at improving the sleep and wakefulness cycle, contributing to a better quality of life.

Relevance of anxiety and stress levels on sleep quality after liver transplantation.

The goal of this study was to assess the effects of anxiety and stress on sleep quality in liver transplantation recipients. A prospective cross-sectional study was performed including 45 recipients enrolled at a liver transplantation program at Ribeirão Preto, State of São Paulo, Brazil. Anxiety and stress were evaluated by using a reduced version of the State-Trait Anxiety Inventory and the Perceived Stress Scale, respectively. Sleep quality and excessive daytime sleepiness were evaluated by using the Brazilian Portuguese versions of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Thirty-two (71.11%) recipients presented with compromised sleep quality and 5 (11.11%) presented with excessive daytime sleepiness. Recipients with bad sleep quality had anxiety (mean, 26.91 points) and stress (mean, 17.88 points) levels that were higher than the levels of patients with normal sleep quality patterns, with anxiety levels presenting with statistically significant differences (P = .0420). Patients with above-average stress levels also had increased anxiety (mean, 28 points) and compromised sleep quality (mean, 7.03 points). In conclusion, a liver transplantation recipient who experiences bad sleep quality also has higher levels of anxiety and stress, suggesting a relationship between the sleep-wakefulness cycle and anxiety/stress. Planning strategies aimed at reducing such emotional shifts among recipients is of paramount importance. Therefore, new strategies focusing on improving the sleep pattern of patients are necessary because unhealthy sleep behavior may impair postoperative recovery.

Drug utilization patterns in pregnant women: a case study at the Mount Hope Women's Hospital in Trinidad, West Indies / Patrones de utilización de medicamentos en las mujeres embarazadas: un caso de estudio en el Hospital de Mujeres Mount Hope en Trinidad, West Indies

OBJECTIVE: To explore drug (prescription, over-the-counter and herbal) utilization in pregnant women attending a public sector tertiary healthcare institution. METHODS: This was a cross-sectional case study in women attending antenatal clinics at the Mount Hope Women's Hospital. Women (506) who consecutively presented for routine care at the antenatal clinic were interviewed on the medication they took. Descriptive statistics and logistic regression for predictors of drug use were done using SPSS 16. RESULTS: There were 200 (39.5%) primigravidae, 306 (60.5%) multigravidae and 299 (59%) women were in the third trimester of pregnancy. Most women (69.8%) were between 20-35 years of age. Women took an average of 1.32, 1.22 and 0.94 prescribed drugs in each trimester, respectively. Multivitamins (59.8%) and iron/folic acid (54.2%) were the most frequently prescribed drugs. Regardless of trimester, only 20% of women took supplemental calcium. Very few women (2.4%) took herbal medications. Paracetamol was the most common over-the-counter (OTC) medication in all trimesters. Women with secondary level education were most likely to use OTC iron/folic acid (p = 0.02), paracetamol and histamine2 receptor antagonists [H2RAs] (p = 0.001). More primigravidae took non-steroidal anti-inflammatory drugs (p = 0.02) and more women in the first trimester used antiemetics (p = 0.001). Age group (p = 0.048), marital status (p = 0.001) and the trimester of pregnancy (p = 0.001) were predictors of drug utilization. CONCLUSION: Overall, women in tertiary healthcare institutions took medication as prescribed particularly multivitamins and iron/folic acid. More women with higher education took OTC paracetamol, iron/folic acid and vitamin supplements. Herbal supplements were rarely used. Research on drug utilization in primary care facilities is recommended.

OBJETIVO: Explorar el uso de los medicamentos (con prescripción, sin receta médica, herbarios) en mujeres embarazadas que asisten a una institución terciaria de atención a la salud pública dentro del sector público. MÉTODOS: Se trató de un estudio transversal de mujeres que asisten a las clínicas prenatales en el Hospital de Mujeres Mount Hope. Las mujeres (506) que consecutivamente se presentaron para cuidados de rutina en la clínica prenatal, fueron entrevistadas acerca de la medicación que tomaban. Se hicieron estadísticas descriptivas y se hizo una regresión logística para los predictores del uso del medicamento usando SPSS 16. RESULTADOS: Había 200 (39.5%) primerizas, 306 (60.5%) multíparas, y 299 (59%) embarazadas en su tercer trimestre. La mayoría de las mujeres (69.8%) tenían entre 20-35 años de edad. Las mujeres tomaban un promedio de 1.32, 1.22 y 0.94 medicamentos prescritos en cada trimestre, respectivamente. Las multivitaminas (59.8%) y el hierro/ácido fólico (54.2%) fueron los medicamentos más frecuentemente prescritos. Con independencia del trimestre, sólo 20% de las mujeres tomaron suplemento de calcio. Muy pocas mujeres (2.4%) tomaban medicaciones herbarias. El paracetamol fue el medicamento sin receta más común en todos los trimestres. Las mujeres con nivel de educación secundaria presentaban una mayor probabilidad de usar hierro/ácido fólico (p = 0.02), el paracetamol y los antagonistas de los receptores de la histamina-2- [H2RAs] (p = 0.001). Un mayor número de primerizas tomaron medicamentos anti-inflamatorios no esteroideos (p = 0.02) y más mujeres en el primer trimestre usaron anti-eméticos (p = 0.001). El grupo etario (p = 0.048), el estado matrimonial (p = 0.001) y el trimestre de embarazo (p = 0.001) fueron predictores de la utilización de medicamentos. CONCLUSIÓN: En general, las mujeres en las instituciones terciarias de atención a la salud tomaron la medicación como fue prescrita, en particular las multivitaminas y el hierro/ácido fólico. Más mujeres con mayor escolaridad tomaron medicamentos sin recetas: paracetamol, hierro/ácido fólico y suplementos de vitamina. Raramente se usaron suplementos herbarios. Se recomienda la investigación del uso de medicamentos en centros de atención primaria.

Estudo comparativo entre diferentes dinamizaçöes do Bioterápico Tripanosominum na doença de Chagas experimental / Comparative study between diferent dinamizations of the biotherapic \"Tripanosominum\"in experimental Chagas disease

O Trypanosoma cruzi, agente etiológico da doença de Chagas, evolui em grande número de espécies de mamíferos, sendo o único tripanossomo que näo se multiplica diretamente no sangue do hospedeiro vertebrado, e sim no interior do citoplasma de células do hospedeiro

Comportamento da curva de infecçäo na doença de Chagas experimental frente a via de administraçäo do Bioterápico Tripanosominum TcD30 / Infectious behavior of experimental Chagas disease as a result of biotherapic Tripanosominum TC D30 treatment

O curso da infecçäo em mamíferos suscetíveis ao Trypanosoma cruzi apresenta características próprias sofrendo, entretanto, a influência de fatores relacionados, principalmente à populaçäo do parasita e ao hospedeiro, entre outros

Testes sorológicos para pesquisa de anticorpos em soros de camundongos tratados pelo Trypanosominum TC D30 / Serum test methods for research of antibodies in serum of mice treated by Trypanosominum TC D30

Propomos para o presente trabalho a realizaçäo das reaçöes sorológicas: de fixaçäo do complemento, imunofluorescência indireta e hemaglutinaçäo, onde foram testados soros de camundongos tratados com Trypanosominum TC D30, na pesquisa de imunoglobulinas circulantes, eventualmente existentes no sangue desses animais. Como controle, foram utilizados soros de animais normais associados a soluçäo fisiológica, em substituiçäo ao antígeno, seguindo-se o mesmo esquema usado no tratamento