Influência da proteína de soja e dos exercícios com pesos sobre o gasto energético de repouso de mulheres na pós-menopausa

OBJETIVO: Analisar a influência da ingestão alimentar de proteína da soja e dos exercícios com pesos sobre o gasto energético de repouso (GER) de mulheres na pós-menopausa. MÉTODOS: Ensaio clínico, 16 semanas, envolvendo 60 mulheres, 59 (7) anos, distribuídas em quatro grupos: G1 (proteína da soja e exercício), G2 (placebo e exercício), G3 (proteína da soja e sem exercício) e G4 (placebo e sem exercício). A proteína da soja e o placebo (maltodextrina) foram distribuídos, aleatoriamente, sob a forma de pó, na porção de 25 gramas/dia. Foram 10 exercícios com pesos, realizados em três sessões semanais, com 3 séries de 8-12 repetições cada, carga de 60 por cento-80 por cento de uma repetição máxima (RM). O GER foi calculado a partir do O2 e CO2, obtidos por calorimetria indireta (Quinton-QMC®), durante 30 minutos, sob temperatura e umidade controladas. Na análise estatística foi utilizada ANOVA, teste T de Student e regressão múltipla, por meio do software Stata 9.2, α<0,05. RESULTADOS: As mulheres apresentaram homogeneidade em todas as variáveis do estudo. Houve aumento, significante, do GER (p<0,05) no G1 (158 kcal/dia) e G2 (110 kcal/dia), correspondente a 17 por cento e 9 por cento, respectivamente, enquanto, o G4, diminuição em 4 por cento (p<0,05). CONCLUSÃO: Exercícios com pesos são determinantes para o aumento do gasto energético de repouso, de mulheres na pós-menopausa, podendo ser potencializado pela ingestão de proteína da soja

Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007

Objective To assess trends in the prevalence and social distribution of child stunting in Brazil to evaluate the effect of income and basic service redistribution policies implemented in that country in the recent past. Methods The prevalence of stunting (height-for-age z score below \22122 using the Child Growth Standards of the World Health Organization) among children aged less than 5 years was estimated from data collected during national household surveys carried out in Brazil in 1974\201375 (n = 34 409), 1989 (n = 7374), 1996 (n = 4149) and 2006\201307 (n = 4414). Absolute and relative socioeconomic inequality in stunting was measured by means of the slope index and the concentration index of inequality, respectively. Findings Over a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1 per cent to 7.1 per cent. Prevalence dropped from 59.0 per cent to 11.2 per cent in the poorest quintile and from 12.1 per cent to 3.3 per cent among the wealthiest quintile. The decline was particularly steep in the last 10 years of the period (1996 to 2007), when the gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sanitation services; and reproductive health indicators.Conclusion In Brazil, socioeconomic development coupled with equity-oriented public policies have been accompanied by marked improvements in living conditions and a substantial decline in child undernutrition, as well as a reduction of the gap in nutritional status between children in the highest and lowest socioeconomic quintiles. Future studies will show whether these gains will be maintained under the current global economic crisis

Causas do declínio da desnutrição infantil no Brasil, 1996-2007

OBJETIVO: Estabelecer a evolução da prevalência de desnutrição na população brasileira de crianças menores de cinco anos de idade entre 1996 e 2007 e identificar os principais fatores responsáveis por essa evolução.MÉTODOS: Os dados analisados procedem de inquéritos "Demographic Health Surveys" realizados no Brasil em 1996 e 2006/7 em amostras probabilísticas de cerca de 4 mil crianças menores de cinco anos. A identificação dos fatores responsáveis pela variação temporal da prevalência da desnutrição (altura-para-idade inferior a -2 escores z; padrão OMS 2006) considerou mudanças na distribuição de quatro determinantes potenciais do estado nutricional. Modelagem estatística da associação independente entre determinante e risco de desnutrição em cada inquérito e cálculo de frações atribuíveis parciais foram utilizados para avaliar a importância relativa de cada fator na evolução da desnutrição infantil. RESULTADOS: A prevalência da desnutrição foi reduzida em cerca de 50%: de 13,5% (IC 95%: 12,1%;14,8%) em 1996 para 6,8% (5,4%;8,3%) em 2006/7. Dois terços dessa redução poderiam ser atribuídos à evolução favorável dos quatro fatores estudados: 25,7% ao aumento da escolaridade materna; 21,7% ao crescimento do poder aquisitivo das famílias; 11,6% à expansão da assistência à saúde e 4,3% à melhoria nas condições de saneamento.CONCLUSÕES: A taxa anual de declínio de 6,3% na proporção de crianças com déficits de altura-para-idade indica que em cerca de mais dez anos a desnutrição infantil poderia deixar de ser um problema de saúde pública no Brasil. A conquista desse resultado dependerá da manutenção das políticas econômicas e sociais que têm favorecido o aumento do poder aquisitivo dos mais pobres e de investimentos públicos que permitam completar a universalização do acesso da população brasileira aos serviços essenciais de educação, saúde e saneamento

Causas do declínio acelerado da desnutrição infantil no Nordeste do Brasil (1986-1996-2006)

OBJETIVO: Descrever a variação temporal na prevalência de desnutrição infantil na região Nordeste do Brasil, em dois períodos sucessivos, identificando os principais fatores responsáveis pela evolução observada em cada período. MÉTODOS: Os dados analisados provêm de amostras probabilísticas da população de crianças menores de cinco anos estudadas por inquéritos domiciliares do programa Demographic Health Surveys realizados em 1986 (n=1.302), 1996 (n=1.108) e 2006 (n=950). A identificação dos fatores responsáveis pela variação na prevalência da desnutrição (altura para idade < -2 z) levou em conta mudanças na freqüência de cinco determinantes potenciais do estado nutricional, modelagens estatísticas da associação independente entre determinante e risco de desnutrição no início de cada período e cálculo de frações atribuíveis. RESULTADOS: A prevalência da desnutrição foi reduzida em um terço de 1986 a 1996 (de 33,9 por cento para 22,2 por cento ) e em quase três quartos de 1996 a 2006(de 22,2 por cento para 5,9 por cento ). Melhorias na escolaridade materna e na disponibilidade de serviços de saneamento foram particularmente importantes para o declínio da desnutrição no primeiro período, enquanto no segundo período foram decisivos o aumento do poder aquisitivo das famílias mais pobres e, novamente, a melhoria da escolaridade materna. CONCLUSÕES: A aceleração do declínio da desnutrição do primeiro para o segundo período foi consistente com a aceleração de melhorias em escolaridade materna, saneamento, assistência à saúde e antecedentes reprodutivos e, sobretudo, com o excepcional aumento do poder aquisitivo familiar, observado apenas no segundo período. Mantida a taxa de declínio observada entre 1996 e 2006, o problema da desnutrição infantil na região Nordeste poderia ser considerado controlado em menos de dez anos. ) Para se chegar a este resultado será preciso manter o aumento do poder aquisitivo dos mais pobres e assegurar investimentos públicos para completar a universalização do acesso a serviços essenciais de educação, saúde e saneamento

Vidas arriscadas: uma reflexão sobre a relação entre o número de gestações e mortalidade materna

Este estudo teve por objetivo identificar o risco e os fatores associados à mortalidade materna de multigestas (cinco ou mais gestações). Descreve a tendência da Taxa de Fecundidade Total (TFT) e da Razão de Mortalidade Materna (RMM) de 1998 a 2004 no Paraná. Apresenta uma análise dos 822 óbitos maternos deste período, o cálculo da Razão de Mortalidade Materna Específica, o Risco Relativo, a freqüência e o Odds Ratio para algumas variáveis segundo número de gestações. Analisa também as causas e a evitabilidade dos óbitos maternos. Os resultados apontaram TFT baixa (1,8 filhos por mulher) e a RMM elevada (69,7/100.000 nascidos vivos) no Paraná em 2004. Um quarto dos 822 óbitos maternos (206) era de multigestas (cinco ou mais gestações), o risco relativo de morte materna foi seis vezes superior do que para as mulheres com até duas gestações, e os perfis sociodemográfico e o reprodutivo foram mais desfavoráveis para aquele grupo de mulheres. A baixa escolaridade, a idade igual ou acima de 30 anos e o pré-natal com menos de quatro consultas apresentaram associação com o maior número de gestações. A proporção de mortes por causas obstétricas indiretas, hemorragias e aborto, foi maior entre as multigestas, e cerca de 90% dos óbitos deste grupo foi considerado evitável. Concluiu-se que o monitoramento das multigestas com idade avançada e em desvantagem social, bem como ações efetivas de planejamento familiar, e serviços obstétricos qualificados para gestação de alto risco são medidas que podem contribuir para a redução da mortalidade materna

Relationship between training status and maximal fat oxidation rate

This study aimed to compare maximal fat oxidation rate parameters between moderate-and low-performance runners. Eighteen runners performed an incremental treadmill test to estimate individual maximal fat oxidation rate (Fat(max)) based on gases measures and a 10,000-m run on a track. The subjects were then divided into a low and moderate performance group using two different criteria: 10,000-m time and VO(2)max values. When groups were divided using 10,000-m time, there was no significant difference in Fat(max) (0.41 +/- 0.16 and 0.27 +/- 0.12 g.min(-1), p = 0.07) or in the exercise intensity that elicited Fat(max) (59.9 +/- 16.5 and 68.7 +/- 10.3 % (V) over dotO(2max), p = 0.23) between the moderate and low performance groups, respectively (p > 0.05). When groups were divided using VO(2max) values, Fat(max) was significantly lower in the low VO(2max) group than in the high VO(2max) group (0.29 +/- 0.10 and 0.47 +/- 0.17 g.min(-1), respectively, p < 0.05) but the intensity that elicited Fat(max) did not differ between groups (64.4 +/- 14.9 and 61.6 +/- 15.4 % VO(2max)). Fat(max) or % VO(2max) that elicited Fat(max) was not associated with 10,000 m time. The only variable associated with 10,000-m running performance was % VO(2max) used during the run (p < 0.01). In conclusion, the criteria used for the division of groups according to training status might influence the identification of differences in Fat(max) or in the intensity that elicits Fat(max).

Lsa21, a novel leptospiral protein binding adhesive matrix molecules and present during human infection

Background: It has been well documented over past decades that interaction of pathogens with the extracellular matrix (ECM) plays a primary role in host cell attachment and invasion. Adherence to host tissues is mediated by surface-exposed proteins expressed by the microorganisms during infection. The mechanisms by which pathogenic leptospires invade and colonize the host remain poorly understood since few virulence factors contributing to the pathogenesis of the disease have been identified. Whole-genome sequencing analysis of L. interrogans allowed identification of a repertoire of putative leptospiral surface proteins. Results: Here, we report the identification and characterization of a new leptospiral protein that exhibits extracellular matrix-binding properties, called as Lsa21 (leptospiral surface adhesin, 21 kDa). Compatible with its role in adhesion, the protein was shown to be surface-exposed by indirect immunofluorescence. Attachment of Lsa21 to laminin, collagen IV, and plasma fibronectin was specific and dose dependent. Laminin oxidation by sodium metaperiodate reduced the protein-laminin interaction in a concentration-dependent manner, indicating that laminin sugar moieties are crucial for this interaction. The gene coding for Lsa21 is present in pathogenic strains belonging to the L. interrogans species but was not found in the saprophytic L. biflexa serovar Patoc strain Patoc 1. Loss of gene expression occurs upon culture attenuation of pathogenic strains. Environmental factors such as osmolarity and temperature affect Lsa21 expression at the transcriptional level. Moreover, anti-Lsa21 serum labeled liver and kidney tissues of human fatal cases of leptospirosis. Conclusion: Our data suggest a role of Lsa21 in the pathogenesis of leptospirosis.

PREVALENCE OF ANTIBODIES TO TRYPANOSOMA CRUZI, LEISHMANIA INFANTUM, ENCEPHALITOZOON CUNICULI, SARCOCYSTIS NEURONA, AND NEOSPORA CANINUM IN CAPYBARA, HYDROCHOERUS HYDROCHAERIS, FROM SAO PAULO STATE, BRAZIL

Little is known about the importance of capybara. Hydrochoerus hydrochaeris, as reservoirs for parasites of zoonotic or veterinary importance. Sera from 63 capybaras, from 6 counties in the state of Sao Paulo, Brazil, were examined for antibodies to Trypanosoma cruel, Leishmania infantum, Encephalitozoon cuniculi. Sarcacystis neurona, and Neospora caninum using an indirect immunofluorescent antibody test. Five (8%) of the 63 capybaras had antibodies to T cruzi epimastigotes. None of the samples from capybara reacted positively with L. infantum promastigotes or with spores of E. cuniculi. Two (3%) of the serum samples were positive for antibodies to S. neurona merozoites, and 2 (3%) of the serum samples were positive for antibodies to N. caninum tachyzoites. A serum sample from 1 capybara was positive for antibodies to both T cruzi and N. caninum. None of the remaining 62 samples reacted with more than 1 parasite.

Serologic Survey for Rickettsiosis in Bats from Sao Paulo City, Brazil

Blood serum samples were collected from 451 bats captured within the Sao Paulo city from April 2007 to November 2008, and individually tested by indirect immunofluorescence assay against antigens derived from five Rickettsia species reported to occur in Brazil: the spotted fever group (SFG) species R. rickettsii, R. parkeri, R. amblyommii, R. rhipicephali, and the ancestral group species R. bellii. For this purpose, an anti-bat immunoglobulin G was produced and used in the present study. Overall, 8.6% (39/451), 9.5% (34/358), 7.8% (28/358), 1.1% (4/358), and 0% (0/358) serum samples were reactive to R. rickettsii, R. parkeri, R. amblyommii, R. rhipicephali, and R. bellii, respectively. Endpoint titers of reactive sera ranged from 64 to 256. From 20 bat species of 3 different families (Molossidae, Vespertilionidae, and Phyllostomidae), 46 animals were shown to be reactive to at least one rickettsial antigen. Seropositivity per bat species ranged from 0% to 33.3%. Most of the serologically positive sera reacted with two or more rickettsial antigens. Seropositivity for SFG rickettsial antigens in the absence of reactivity against R. bellii (ancestral group species) suggests that bats from Sao Paulo city can be infected by SFG rickettsiae. The possible role of soft ticks in serving as vectors of SFG rickettsiae to bats within the Sao Paulo city, associated to its public health risks, is discussed.

Serological Survey for Antibodies to Encephalitozoon cuniculi in Ownerless Dogs From Urban Areas of Brazil and Colombia

There are 3 strains of Encephalitozoon cuniculi that occur in mammals. Strain III is associated with clinical disease in dogs, although some can be asymptomatic carriers and excrete spores in their urine. Several cases of human E. cuniculi infection caused by strain III have been observed in immunocompromised patients, indicating that E. cuniculi should be considered a zoonotic agent. Encephalitozoon cuniculi can cause fatal disease in maternally-infected or young dogs. Clinical signs in these animals included blindness, encephalitis, retarded growth rate, and nephritis. Encephalitozoon cuniculi has also been associated with primary renal failure in adult dogs. The present study used the direct agglutination test (DAT, cut-off 1:50) and the indirect fluorescent antibody test (IFAT, cut-off 1:10) to examine the prevalence of antibodies to E. cuniculi in dogs from Brazil and Colombia. Using the DAG, 31 (27.4%) of 113 dogs from Brazil and 47 (18.5%) of 254 dogs from Colombia were seropositive. Nine (14.3%) of 63 dogs from Brazil and IS (35.3%) of the 51 dogs from Colombia were seropositive by indirect immunofluorescent antibody test. These results indicate that dogs from Brazil and Colombia are exposed to E. cuniculi.

Tick-Borne Bacteria in Free-Living Jaguars (Panthera onca) in Pantanal, Brazil

Tick-borne bacteria were investigated in 10 free-living jaguars and their ticks in the Pantanal biome, Brazil. Jaguar sera were tested by indirect fluorescent antibody assays using Rickettsia rickettsii, Rickettsia parkeri, Rickettsia amblyommii, Rickettsia rhipicephali, Rickettsia felis, Rickettsia bellii, Ehrlichia canis, and Coxiella burnetii as crude antigens. All 10 jaguar sera reacted (titer >= 64) to at least one Rickettsia species; 4 and 3 sera reacted with E. canis and C. burnetii, respectively. One jaguar presented antibody titer to R. parkeri at least fourfold higher than those to any of the other five Rickettsia antigens, suggesting that this animal was infected by R. parkeri. Ticks collected from jaguars included the species Amblyomma cajennense, Amblyomma triste, and Rhipicephalus (Boophilus) microplus. No Rickettsia DNA was detected in jaguar blood samples, but an A. triste specimen collected on a jaguar was shown by PCR to be infected by R. parkeri. The blood of two jaguars and samples of A. triste, A. cajennense, and Amblyomma sp. yielded Ehrlichia DNA by PCR targeting the ehrlichial genes 16S rRNA and dsb. Partial DNA sequences obtained from PCR products resulted in a new ehrlichial strain, here designated as Ehrlichia sp. strain Jaguar. A partial DNA sequence of the 16S rRNA gene of this novel strain showed to be closest (99.0%) to uncultured strains of Ehrlichia sp. from Japan and Russia and 98.7% identical to different strains of Ehrlichia ruminantium. The ehrlichial dsb partial sequence of strain jaguar showed to be at most 80.7% identical to any Ehrlichia species or genotype available in GenBank. Through phylogenetic analysis, Ehrlichia sp. strain jaguar grouped in a cluster, albeit distantly, with different genotypes of E. ruminantium. Results highlight risks for human and animal health, considering that cattle ranching and ecotourism are major economic activities in the Pantanal region of Brazil.

New Epidemiological Data on Brazilian Spotted Fever in an Endemic Area of the State of Sao Paulo, Brazil

The present work evaluated rickettsial infection in dogs and their ticks in an area endemic for Brazilian spotted fever (BSF) in the metropolitan area of Sao Paulo, Brazil, where the tick Amblyomma aureolatum was presumed to be the vector of the disease. Ticks were collected on dogs from 185 houses, encompassing single infestations by Rhipicephalus sanguineus, Amblyomma aureolatum, Amblyomma longirostre, or Amblyomma sp. in dogs from 60 (32.4%), 77 (41.6%), 2 (1.1%), and 25 (13.5%) houses, respectively; 19 (10.3%) houses had dogs with mixed infestations by R. sanguineus and A. aureolatum; 1 (0.5%) house had dogs with infestations by A. aureolatum and A. longirostre; and 1 (0.5%) house had dogs with infestations by R. sanguineus and Amblyomma sp. Overall, A. aureolatum was present in dogs from 97 (52.4%) houses, and R. sanguineus in dogs from 80 (43.2%) houses. A total of 287 ticks (130 A. aureolatum and 157 R. sanguineus) infesting dogs from 98 houses were selected for testing by polymerase chain reaction (PCR) targeting rickettsial genes. Overall, 3.1% of the A. aureolatum ticks were infected by Rickettsia bellii, and 1.3% of the R. sanguineus were infected by Ricketttsii rickettsii. For serology, we selected 23 dogs living in and in the vicinity of the house where the R. rickettsii-infected ticks were collected. The indirect fluorescent antibody (IFA) test detected antibodies reactive with R. rickettsii in sera from 16 (69.6%) dogs, with titers ranging from 256 to 32,768. It is established that Amblyomma aureolatum is a vector of R. rickettsii in the Sao Paulo metropolitan area, but our results highlight for the first time in Brazil, a possible role of R. sanguineus in the epidemiology of R. rickettsii, corroborating previous findings in Mexico and the United States, where R. sanguineus has been implicated in the transmission of R. rickettsii to humans.

Occurrence of Neospora caninum antibodies in capybaras (Hydrochaeris hydrochaeris) from Sao Paulo State, Brazil

Capybara (Hydrochaeris hydrochaeris) is a large rodent distributed throughout tropical America. Antibodies to Neospora caninum in 213 feral capybaras from 11 counties of the State of Sao Paulo, Brazil. were assessed using the indirect immunofluorescent antibody test (titer >= 1:25) and found in 20 (9.4%), with titers of 1:25 in 4, 1:50 in 7, and 1:100 in 9 animals. This is the first report of occurrence of N. caninum antibodies in capybaras.

Experimental Infection of the Opossum Didelphis aurita by Rickettsia felis, Rickettsia bellii, and Rickettsia parkeri and Evaluation of the Transmission of the Infection to Ticks Amblyomma cajennense and Amblyomma dubitatum

This work evaluated the infection of opossums (Didelphis aurita) by Rickettsia felis, Rickettsia bellii, and Rickettsia parkeri and their role as amplifier hosts for horizontal transmission to Amblyomma cajennense and/or Amblyomma dubitatum ticks. Infection in D. aurita was induced by intraperitoneal inoculation with R. felis (n = 4 opossums), R. bellii (n = 4), and R. parkeri (n = 2). Another group of six opossums were inoculated intraperitoneally with Leibovitz-15 sterile culture medium, representing the uninfected groups (n = 2 opossums simultaneously to each infected group). Opossum blood samples collected during the study were used for DNA extraction, followed by real-time polymerase chain reaction targeting the rickettsial gene gltA, hematology, and detection of Rickettsia spp.-reactive antibodies by indirect immunofluorescence assay. Opossums were infested with uninfected A. cajennense and/or A. dubitatum for 30 days postinoculation (DPI). Flat ticks molted from ticks fed on opossums were allowed to feed on uninfected rabbits, which were tested for seroconversion by immunofluorescence assay. Samples of flat ticks were also tested by real-time polymerase chain reaction. Inoculated opossums showed no clinical abnormalities. Antibodies to Rickettsia spp. were first detected at the second to fourth DPI, with detectable titers until the 150th DPI. Rickettsemia was detected only in one opossum inoculated with R. parkeri, at the eighth DPI. Only one A. cajennense tick (2.0%) previously fed on a R. parkeri-inoculated opossum became infected. None of the rabbits infested with opossum-derived ticks seroconverted. The study demonstrated that R. felis, R. bellii, and R. parkeri were capable to produce antibody response in opossums, however, with undetectable rickettsemia for R. felis and R. bellii, and very low rickettsemia for R. parkeri. Further studies must be done with different strains of these rickettsiae, most importantly the strains that have never gone through in vitro passages.

Experimental Infection of Opossums Didelphis aurita by Rickettsia rickettsii and Evaluation of the Transmission of the Infection to Ticks Amblyomma cajennense

The present study evaluated the infection of opossums (Didelphis aurita) by Rickettsia rickettsii and their role as amplifier hosts for horizontal transmission of R. rickettsii to Amblyomma cajennense ticks. Three groups of opossums were evaluated: on day 0, group 1 (G1) was inoculated intraperitoneally with R. rickettsii; group 2 (G2) was infested by R. rickettsii-infected ticks; and group 3 (G3) was the uninfected control group. Opossum rectal temperature was measured daily. Blood samples were collected every 2 to 4 days during 30 days, and used to (1) inoculate guinea pigs intraperitoneally; (2) extract DNA followed by real-time polymerase chain reaction (PCR) targeting the rickettsial gene gltA; (3) study hematology; (4) detect R. rickettsii-reactive antibodies by indirect direct immunofluorescence assay (IFA). Blood was also collected every 10 days from days 30 to 180, to be tested by serology. Opossums were infested by uninfected A. cajennense larvae and nymphs from days 3 to 15. Engorged ticks were collected and allowed to molt in an incubator. Thereafter, the subsequent flat ticks were allowed to feed on uninfected rabbits, which were tested for seroconversion by IFA. Samples of flat ticks were also tested by real-time PCR. All G1 and G2 opossums became infected by R. rickettsii, as demonstrated by real-time PCR or/and guinea pig inoculation, but they showed no clinical abnormality. Rickettsemia was first detected at days 2 to 8, lasting intermittently till days 1 to 30. Approximately 18% and 5% of the flat ticks previously fed on G1 and G2 opossums, respectively, became infected by R. rickettsii, but only the rabbits infested with G1-derived ticks seroconverted. The study demonstrated that R. rickettsii was capable of infecting opossums without causing illness and developing rickettsemia capable of causing infection in guinea pigs and ticks, although the infection rate in ticks was low.