Mortes maternas e mortes por causas maternas

Ao mensurar-se mortalidade materna, é necessário distinguir ' mortes por causas maternas' e 'mortes maternas' Para a Organização Mundial da Saúde-OMS-,mortes maternas são as que ocorrem na gestação, no parto e até 42 dias após o parto; e mortes por causas maternas englobam as causas classificadas no Capítulo XV da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde, Décima Revisão (CID-10), incluindo as ocorridas quando passados 42 dias do parto. Apresentam-se resultados da investigação de mortes femininas em idade fértil-10 a 49 anos- nas capitais de Estados e no Distrito Federal do Brasil, em 2002. Adotou-se a metodologia RAMOS, comparando-se as causas básicas das declarações de óbito originais com as das declarações preenchidas após o resgate de informações, obtidas em entrevistas domiciliares e prontuários. Entre as mortes por causas maternas originais, 15,9 por cento não eram mortes maternas, de acordo com a definição da OMS. Houve, concomitantemente, subenumeração de mortes maternas. Sugestões são feitas para melhorar o preenchimento das declarações de óbito e inclusão de novas categorias na CID-10, visando melhorar a informação das causas maternas

Mortes maternas: revisão do fator de correção para os dados oficiais

O objetivo foi comparar as mortes maternas existentes no Sistema de Informações sobre Mortalidade (SIM/MS) com as do "Estudo da mortalidade de mulheres em idade fértil" e estimar novos fatores de correção. Analisaram-se 7.332 declarações de óbito feminino (DO) de dez a 49 anos, de residentes nas capitais brasileiras, no 1o semestre de 2002. Realizou-se pareamento dos conjuntos de DO (as originalmente preenchidas pelos médicos e aquelas obtidas com o resgate de dados) com as DO do SIM/MS. A subenumeração das mortes por causas maternas, no SIM/MS, foi de 21,4 por cento e, das mortes maternas, 16 por cento . Os novos fatores de ajuste para as mortes maternas nas regiões brasileiras foram: 0,93 (Norte), 1,17 (Nordeste), 1,28 (Sudeste), 1,10 (Sul) e 1,47 (Centro-oeste); para o pa's, foi igual a 1,19. Os Comitês de Morte Materna investigam os óbitos femininos em idade fértil, mas, ainda, restam imprecisões que podem inviabilizar condutas preventivas eficientes

Padrão de atividade física em adultos brasileiros: resultados de um inquérito por entrevistas telefônicas, 2006

O estudo descreve as características do padrão de atividade física da população adulta das capitais de Estados brasileiros e do Distrito Federal em 2006. Os dados foram coletados pelo sistema de vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico (Vigitel) em uma amostra probabilística da população com 18 ou mais anos de idade (n=54.369). Foram analisados dois indicadores: ativo no lazer; e sedentário. Os indivíduos ativos no lazer foram 14,9%, a maioria homens. A caminhada é a modalidade mais comum, para ambos os sexos. A freqüência de ativos no lazer aumenta com a escolaridade e diminui com a idade. O sedentarismo já atingiu 29,2% da população adulta, com maior freqüência no sexo masculino, e aumenta com a idade e com a escolaridade. O perfil de atividade física é insatisfatório em todas as cidades, o que determina a necessidade de mais esforços no estímulo à prática da atividade física

Registro de Aedes albopictus em áreas epizoóticas de febre amarela das Regiões Sudeste e Sul do Brasil (Díptera:Culicidae)

Durante estudo biológico e ecológico sobre mosquitos levado a cabo em área com registro de epidemia de febre amarela silvestre e epizootia em macacos, foram encontrados adultos de Aedes Albopictus. A tendência da espécie para invadir ambiente extradomiciliar potencializa a chance de infecção natural, ao tempo em que evolui para formar um elo entre focos naturais de vírus e o ambiente urbano. Esta Nota Técnica representa um alerta aos gestores dos três poderes públicos sobre perspectivas de mudanças no perfil epidemiológico atual da febre amarela no Brasil

Structural basis of GC-1 selectivity for thyroid hormone receptor isoforms

Background: Thyroid receptors, TRa and TR beta, are involved in important physiological functions such as metabolism, cholesterol level and heart activities. Whereas metabolism increase and cholesterol level lowering could be achieved by TR beta isoform activation, TRa activation affects heart rates. Therefore, beta-selective thyromimetics have been developed as promising drug-candidates for treatment of obesity and elevated cholesterol level. GC-1 [ 3,5-dimethyl-4-(4'-hydroxy- 3'-isopropylbenzyl)-phenoxy acetic acid] has ability to lower LDL cholesterol with 600-to 1400-fold more potency and approximately two-to threefold more efficacy than atorvastatin (Lipitor(C)) in studies in rats, mice and monkeys. Results: To investigate GC-1 specificity, we solved crystal structures and performed molecular dynamics simulations of both isoforms complexed with GC-1. Crystal structures reveal that, in TRa Arg228 is observed in multiple conformations, an effect triggered by the differences in the interactions between GC-1 and Ser277 or the corresponding asparagine (Asn331) of TR beta. The corresponding Arg282 of TR beta is observed in only one single stable conformation, interacting effectively with the ligand. Molecular dynamics support this model: our simulations show that the multiple conformations can be observed for the Arg228 in TR alpha, in which the ligand interacts either strongly with the ligand or with the Ser277 residue. In contrast, a single stable Arg282 conformation is observed for TR beta, in which it strongly interacts with both GC-1 and the Asn331. Conclusion: Our analysis suggests that the key factors for GC-1 selectivity are the presence of an oxyacetic acid ester oxygen and the absence of the amino group relative to T(3). These results shed light into the beta-selectivity of GC-1 and may assist the development of new compounds with potential as drug candidates to the treatment of hypercholesterolemia and obesity.

Dopamine-beta hydroxylase polymorphism and cocaine addiction

Cocaine addiction involves a number of medical, psychological and social problems. Understanding the genetic aetiology of this disorder will be essential for design of effective treatments. Dopamine-beta hydroxylase (DbH) catalyzes the conversion of dopamine to norepinephrine and could, therefore, have an influence on both cocaine action and the basal sensitivity of neurotransmitter systems to cocaine. Recently, the - 1021C> T polymorphism have been found to strongly correlated with individual variation in plasma DbH activity. To test the influence of this polymorphism on the susceptibility of cocaine addiction, we decided to genotype it in a sample of 689 cocaine addicts and 832 healthy individuals. Genotypic and allelic analyses did not show any evidence of association with cocaine addiction, even after correcting for the effect of population stratification and other possible confounders. Our results do not support a major role of the - 1021C> T polymorphism or the gene itself in the development of cocaine addiction but further examination of other variants within this gene will be necessary to completely rule out an effect.

Leucine supplementation improves adiponectin and total cholesterol concentrations despite the lack of changes in adiposity or glucose homeostasis in rats previously exposed to a high-fat diet

Background: Studies suggest that leucine supplementation (LS) has a therapeutic potential to prevent obesity and to promote glucose homeostasis. Furthermore, regular physical exercise is a widely accepted strategy for body weight maintenance and also for the prevention of obesity. The aim of this study was to determine the effect of chronic LS alone or combined with endurance training (ET) as potential approaches for reversing the insulin resistance and obesity induced by a high-fat diet (HFD) in rats. Methods: Forty-seven rats were randomly divided into two groups. Animals were fed a control diet-low fat (n = 10) or HFD (n = 37). After 15 weeks on HFD, all rats received the control diet-low fat and were randomly divided according to treatment: reference (REF), LS, ET, and LS+ET (n = 7-8 rats per group). After 6 weeks of treatment, the animals were sacrificed and body composition, fat cell volume, and serum concentrations of total cholesterol, HDL-cholesterol, triacylglycerol, glucose, adiponectin, leptin and tumor necrosis factor-alpha (TNF-alpha) were analyzed. Results: At the end of the sixth week of treatment, there was no significant difference in body weight between the REF, LS, ET and LS+ET groups. However, ET increased lean body mass in rats (P = 0.019). In addition, ET was more effective than LS in reducing adiposity (P = 0.019), serum insulin (P = 0.022) and TNF-alpha (P = 0.044). Conversely, LS increased serum adiponectin (P = 0.021) levels and reduced serum total cholesterol concentration (P = 0.042). Conclusions: The results showed that LS had no beneficial effects on insulin sensitivity or adiposity in previously obese rats. On the other hand, LS was effective in increasing adiponectin levels and in reducing total cholesterol concentration.

A Draft of the Human Septin Interactome

Background: Septins belong to the GTPase superclass of proteins and have been functionally implicated in cytokinesis and the maintenance of cellular morphology. They are found in all eukaryotes, except in plants. In mammals, 14 septins have been described that can be divided into four groups. It has been shown that mammalian septins can engage in homo- and heterooligomeric assemblies, in the form of filaments, which have as a basic unit a hetero-trimeric core. In addition, it has been speculated that the septin filaments may serve as scaffolds for the recruitment of additional proteins. Methodology/Principal Findings: Here, we performed yeast two-hybrid screens with human septins 1-10, which include representatives of all four septin groups. Among the interactors detected, we found predominantly other septins, confirming the tendency of septins to engage in the formation of homo- and heteropolymeric filaments. Conclusions/Significance: If we take as reference the reported arrangement of the septins 2, 6 and 7 within the heterofilament, (7-6-2-2-6-7), we note that the majority of the observed interactions respect the ""group rule"", i.e. members of the same group (e. g. 6, 8, 10 and 11) can replace each other in the specific position along the heterofilament. Septins of the SEPT6 group preferentially interacted with septins of the SEPT2 group (p<0.001), SEPT3 group (p<0.001) and SEPT7 group (p<0.001). SEPT2 type septins preferentially interacted with septins of the SEPT6 group (p<0.001) aside from being the only septin group which interacted with members of its own group. Finally, septins of the SEPT3 group interacted preferentially with septins of the SEPT7 group (p<0.001). Furthermore, we found non-septin interactors which can be functionally attributed to a variety of different cellular activities, including: ubiquitin/sumoylation cycles, microtubular transport and motor activities, cell division and the cell cycle, cell motility, protein phosphorylation/signaling, endocytosis, and apoptosis.

Anabolic steroid associated to physical training induces deleterious cardiac effects

DO CARMO, E. C., T. FERNANDES, D. KOIKE, N. D. DA SILVA JR., K. C. MATTOS, K. T. ROSA, D. BARRETTI, S. F. S. MELO, R. B. WICHI, M. C. C. IRIGOYEN, and E. M. DE OLIVEIRA. Anabolic Steroid Associated to Physical Training Induces Deleterious Cardiac Effects. Med. Sci. Sports Exerc., Vol. 43, No. 10, pp. 1836-1848, 2011. Purpose: Cardiac aldosterone might be involved in the deleterious effects of nandrolone decanoate (ND) on the heart. Therefore, we investigated the involvement of cardiac aldosterone, by the pharmacological block of AT1 or mineralocorticoid receptors, on cardiac hypertrophy and fibrosis. Methods: Male Wistar rats were randomized into eight groups (n = 14 per group): Control (C), nandrolone decanoate (ND), trained (T), trained ND (TND), ND + losartan (ND + L), trained ND + losartan (TND + L), ND + spironolactone (ND + S), and trained ND + spironolactone (TND + S). ND (10 mg.kg(-1).wk(-1)) was administered during 10 wk of swimming training (five times per week). Losartan (20 mg.kg(-1).d(-1)) and spironolactone (10 mg.kg(-1).d(-1)) were administered in drinking water. Results: Cardiac hypertrophy was increased 10% by using ND and 17% by ND plus training (P < 0.05). In both groups, there was an increase in the collagen volumetric fraction (CVF) and cardiac collagen type III expression (P < 0.05). The ND treatment increased left ventricle-angiotensin-converting enzyme I activity, AT1 receptor expression, aldosterone synthase (CYP11B2), and 11-beta hydroxysteroid dehydrogenase 2 (11 beta-HSD2) gene expression and inflammatory markers, TGF beta and osteopontin. Both losartan and spironolactone inhibited the increase of CVF and collagen type III. In addition, both treatments inhibited the increase in left ventricle-angiotensin-converting enzyme I activity, CYP11B2, 11 beta-HSD2, TGF beta, and osteopontin induced by the ND treatment. Conclusions: We believe this is the first study to show the effects of ND on cardiac aldosterone. Our results suggest that these effects may be associated to TGF beta and osteopontin. Thus, we conclude that the cardiac aldosterone has an important role on the deleterious effects on the heart induced by ND.

VEGETABLE OIL STRUCTURE AND ANTIOXIDANTS

Five vegetable oils: canola, soybean, corn, cottonseed and sunflower oils were characterized with respect to their composition by gas chromatography and viscosity. The compositions of the vegetable oils suggest that they exhibit substantially different propensity for oxidation following the order of: canola < corn < cottonseed < sunflower approximate to soybean. Viscosities at 40 degrees C and 100 degrees C and the viscosity index (VI) values were determined for the vegetable oils and two petroleum oil quenchants: Microtemp 157 (a conventional slow oil) and Microtemp 153B (an accelerated or fast oil). The kinematic viscosities of the different vegetable and petroleum oils at 40 degrees C were similar. The VI values for the different vegetable oils were very close and varied between 209-220 and were all much higher than the VI values obtained for Microtemp 157 (96) and Microtemp 153B (121). These data indicate that the viscosity variations of these vegetable oils are substantially less sensitive to temperature variation than are the parafinic oil based Microtemp 157 and Microtemp 153B. Although these data suggest that any of the vegetable oils evaluated could be blended with minimal impact on viscosity, the oxidative stability would surely be substantially impacted. Cooling curve analysis was performed on these vegetable oils at 60 degrees C under non-agitated conditions. These results were compared with cooling curves obtained for Microtemp 157, a conventional, unaccelerated petroleum oil, and Microtemp 153B, an accelerated petroleum oil under the same conditions. The results showed that cooling profiles of the different vegetable oils were similar as expected from the VI values. However, no boiling was observed wit any of the vegetable oils and heat transfer occurs only by convection since there is no full-film boiling and nucleate boiling process as typically observed for petroleum oil quenchants, including those of this study. Therefore, high-temperature cooling is considerable faster for vegetable oils as a class. The cooling properties obtained suggest that vegetable oils would be especially suitable fur quenching low-hardenability steels such as carbon steels.

Photodegradation of Thermodegraded Polypropylene/High-Impact Polystyrene Blends: Mechanical Properties

The influence of the addition of high-impact polystyrene (HIPS) on polypropylene (PP) photodegradation was studied with blends obtained by extrusion with and without styrene-butadiene-styrene (SBS) copolymer (10 wt % with respect to the dispersed phase). The concentrations of HIPS ranged from 10 to 30 wt %. The blends and pure materials were exposed for periods of up to 15 weeks of UV irradiation; their mechanical properties (tensile and impact), fracture surface, and melt flow indices were monitored. After 3 weeks of UV exposure, all of the materials presented mechanical properties of the same order of magnitude. However, for times of exposure greater than 3 weeks, an increasing concentration of HIPS resulted in a better photostability of PP. These results were explained in light of morphological observations. This increase of photostability was even greater when SBS was added to the blends. It was more difficult to measure the melt flow index of the binary PP/HIPS blends than that of PP for low concentrations of HIPS; this was most likely due to energy transfer between the blend domains during photodegradation. This phenomenon was not observed for the ternary blends. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 120: 770-779, 2011

Effect of Brazil nut supplementation on the blood levels of selenium and glutathione peroxidase in hemodialysis patients

Objective: In patients who have undergone hemodialysis, large amounts of reactive oxygen species (ROS) are produced and, at higher concentrations, ROS are thought to be involved in the pathogenesis of cardiovascular disease. It has been proposed that selenium (Se) may exert an anti-atherogenic influence by reducing oxidative stress. The richest known food source of selenium is the Brazil nut (Bertholletia excelsa, family Lecythidaceae), found in the Amazon region. We evaluated the effect of Brazil nut supplementation on blood levels of Se and glutathione peroxidase (GSH-Px) activity in patients on hemodialysis. Methods: A total of 81 patients on hemodialysis (52.0 +/- 15.2 y old, average time on dialysis 82.3 +/- 91.4 mo, body mass index 24.9 +/- 4.4 kg/m(2)) from the RenalCor and RenalVida Clinics in Rio de Janeiro, Brazil, were studied. All patients received one nut (around 5 g, averaging 58.1 mu g Se/g) a day for 3 mo. The Se concentrations in the nuts and in plasma and erythrocytes were determined by atomic absorption spectrophotometry with hydride generation (Hitachi, Z-500). GSH-Px levels were measured using Randox commercial kits. Results: Plasma Se (18.8 +/- 17.4 mu g/L) and erythrocyte (72.4 +/- 37.9 mg/L) levels were below the normal, range before nut supplementation. After supplementation, the plasma level increased to 104.0 +/- 65.0 mu g/L and erythrocytes to 244.1 +/- 119.5 mg/L (P<0.0001). The activity of GSH-Px also increased after supplementation, from 46.6 +/- 14.9 to 55.9 +/- 23.6 U/g of hemoglobin (P<0.0001). Before supplementation, 11% of patients had GSH-Px activity below the normal range (27.5-73.6 U/g of hemoglobin). After supplementation, all patients showed GSH-Px activity within the normal range. Conclusion: The data revealed that the investigated patients presented Se deficiency and that the consumption of only one Brazil nut a day (5 g) during 3 mo was effective to increase the Se concentration and GSH-Px activity in these patients, thus improving their antioxidant status. (C) 2010 Elsevier Inc. All rights reserved.

Associations between glutathione peroxidase-1 Pro198Leu polymorphism, selenium status, and DNA damage levels in obese women after consumption of Brazil nuts

Objective: Alterations in selenium (Se) status may result in suboptimal amounts of selenoproteins, which have been associated with increased oxidative stress levels. The Pro198Leu polymorphism at the glutathione peroxidase-1 (GPx1) gene is supposed to be functional. The response of Se status, GPx activity, and levels of DNA damage to a Se supplementation trial between the genotypes related to that polymorphism was investigated. Methods: A randomized trial was conducted with 37 morbidly obese women. Participants consumed one Brazil nut, which provided approximately 290 mu g of Se a day, for 8 wk. Blood Se concentrations, erythrocyte GPx activity, and DNA damage levels were measured at baseline and at 8 wk. The results were compared by genotypes. Results: The genotype frequencies were 0.487, 0.378, and 0.135 for Pro/Pro (the wild-type genotype), Pro/Leu, and Leu/Leu, respectively. At baseline, 100% of the subjects were Se deficient, and after the supplementation, there was an improvement in plasma Se (P < 0.001 for Pro/Pro and Pro/Leu, P < 0.05 for Leu/Leu), erythrocyte Se (P = 0.00 for Pro/Pro and Pro/Leu, P < 0.05 for Leu/Leu), and GPx activity (P = 0.00 for Pro/Pro, P < 0.00001 for Pro/Leu, P < 0.001 for Leu/Leu). In addition, the Pro/Pro group showed a decrease in DNA damage after Brazil nut consumption compared with baseline (P < 0.005), and those levels were higher in Leu/Leu subjects compared with those with the wild-type genotype (P < 0.05). Conclusion: Consumption of one unit of Brazil nuts daily effectively increases Se status and increases GPx activity in obese women, regardless of GPx1 Pro198Leu polymorphism. However, the evaluated biomarkers showed distinct results in response to the supplementation when the polymorphism was considered. (c) 2011 Elsevier Inc. All rights reserved.

Effects of oral supplementation with glutamine and alanyl-glutamine on glutamine, glutamate, and glutathione status in trained rats and subjected to long-duration exercise

Objective: We investigated the effect of supplementation with the dipeptide L-alanyl-L-glutamine (DIP) and a solution containing L-glutamine and L-alanine, both in the free form, on the plasma and tissue concentrations of glutamine, glutamate, and glutathione (GSH) in rats subjected to long-duration exercise. Methods: Rats were subjected to sessions of swim training. Twenty-one days before sacrifice, the animals were supplemented with DIP (1.5 g/kg, n = 6), a solution of free L-glutamine (1 g/kg) and free L-alanine (0.61 g/kg; GLN + ALA, n = 6), or water (CON, n = 6). Animals were sacrificed before (TR, n = 6) or after (LD, n = 6) long-duration exercise. Plasma concentrations of glutamine, glutamate, glucose, and ammonia and liver and muscle concentrations of glutamine, glutamate, and reduced and oxidized (GSSG) GSH were measured. Results: Higher concentrations of plasma glutamine were found in the DIP-TR and GLN + ALA-TR groups. The CON-LD group showed hyperammonemia, whereas the DIP-LD and GLN + ALA-LD groups exhibited lower concentrations of ammonia. Higher concentrations of glutamine, glutamate, and GSH/GSSG in the soleus muscle and GSH and GSH/GSSG in the liver were observed in the DIP-TR and GLN + ALA-TR groups. The DIP-LD and GLN + ALA-LD groups exhibited higher concentrations of GSH and GSH/GSSG in the soleus muscle and liver compared with the CON-LD group. Conclusion: Chronic oral administration of DIP and free GLN + ALA before long-duration exercise represents an effective source of glutamine and glutamate, which may increase muscle and liver stores of GSH and improve the redox state of the cell. (C) 2009 Published by Elsevier Inc.