Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

Análise da variabilidade da frequência cardíaca na síndrome dos ovários policísticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Eficácia do treinamento de força sobre parâmetros cardiovasculares e antropométricos em adultos sedentários

This study aimed to determine the influence of strength training (ST), in three weekly sessions over ten weeks, on cardiovascular parameters and anthropometric measurements. It is a before and after intervention trial, with a sample composed of 30 individuals. Participants were adults aged between 18 and 40 years, from both sexes and sedentary for at least three months previously. Tests were computed ergospirometry, CRP, PWV and body composition (dependent variables) before and after the experiment. Independent variables, age and sex, were considered in order to determine their influence on the dependent variablesevaluatedend. By comparing the initial cardiovascular parameters with those obtained after intervention in patients undergoing the ST proposed (a Student s t-test was conducted within each group for samples matched to parameters with normal distribution, while the Wilcoxin was applied for those without), there was no significant difference in PWV(p =0469) or PCR(p =0.247), but there was an increase in anaerobic threshold(AT) (p=0.004) and Maximal Oxygen Uptake(VO2max) (p =0.052). In regard to anthropometric measures, individuals significantly reduced their body fat percentage (p<0.001) and fat mass (p<0,001), as well as increasing lean mass (p<0.001). However, no changes were recorded in the waist-to-hip ratio (WHR) (p= 0.777), body mass (p=0.226) or body mass index (BMI) (p =0.212). Findings of this study lead us to believe that the proposed ST, and did not increase the VOP or PCR improves cardiorespiratory capacity and body composition. Devotees of this training can therefore safely enjoy all its benefits without risk to the cardiovascular system

FERRITINA: intervalos de referência para adultos no Estado do Rio Grande do Norte

Ferritin is a protein composed of heavy and light chains, non-covalently linked and which accommodates, in its core, thousands of atoms of iron. Furthermore, this protein represents the stock of iron in the body and it is characterized as an acute marker and predictor of diseases, such as iron deficiency anemia, hereditary hemochromatosis and others. Considering the variability of reference values and the analytical methods currently available, the aim of this work was to propose 95% confidence intervals for adults in the State of Rio Grande do Norte, Brazil, after determining the average concentration of serum ferritin for both sexes, beyond its correlation with the age. We analyzed 385 blood samples, collected by venipuncture from individuals residing in the State, after 12-14 hours of fast. The populational sample had 169 men and 216 women between 18-59 years old, which filled a questionnaire on socioeconomic, food habits and accounts about previous and current diseases. The sample collections were itinerant and the results of erythrogram, fasting glucose, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, urea, creatinine, leukocyte count and platelets, beyond C-reactive protein, were issued to each participant, so that, after selection of the apparently healthy individuals, the dosage of serum ferritin was carried out. Statistical analysis was performed using the softwares SPSS 11.0 Windows version, Epi Info 3.3.2 and Graf instant pad (version 3.02), and the random population sample was single (finite population), for which the test of linear correlation and diagram of dispersion were also made. After selection of individuals and determination of serum ferritin, the most discrepant outliers were disregarded (N = 358, Men = 154/Women = 207) and the average value determined for the masculine sex individuals was 167,18 ng / dL; for the feminine sex individuals, the average value obtained was 81,55 ng / dL. Moreover, we found that 25% of men had values < 90,30 ng / dL; 50% ≤ 156,25 ng / dL and 75% ≤ 229,00 ng / dL. In the group of women, 25% had values < 38,80 ng / dL; 50% ≤ 65,00 ng / dL and 75% ≤ 119,00 ng / dL. Through the correlation coefficient (r = 0,23 with p = 0,003), it is possible to suggest the existence of positive linear correlation between age and serum ferritin for men. The correlation coefficient for women (r = 0,16 with p = 0,025) also confirms the existence of positive linear correlation between serum ferritin and age. Considering the analysis carried out and specific methods corroborating with the proposed benchmarks, we concluded that the average value found for men is higher than that found for women. Furthermore, this scenario rises with age for both sexes, and the 95% confidence intervals obtained were 74 ng/dL ≤ μ ≤ 89 ng/dL and 152ng/dL ≤ μ ≤183ng/dL for the feminine and masculine sex individuals respectively

Soroprevalência da infecção pelo Trypanosoma cruzi no município de Caicó, RN, e caracterização genética por RAPD do parasito isolado de humanos e de triatomíneos no semiárido potiguar

Trypanosoma cruzi infection was evaluated in 390 resident individuals in different rural communities of Caicó municipality, State of Rio Grande do Norte (RN). Of 28 investigated communities the soroprevalence of T. cruzi infection was 2.8% in eight rural communities individuals. The epidemiological characteristics of seropositive shown that the age ranged from 22 to 64 years, being significantly raised from 31 years (90.9%). The female gender was predominant and low education degree. Those individuals reported that they never donated blood, but they had direct contact with triatomines bug. The isolation of the parasite was performed by blood culture and xenoculture methods to determine the genetic variability of the samples. Twenty seven T. cruzi isolates were analyzed by RAPD as genetic marker using three random primers (M13-40, gt11-F and L15996). The T. cruzi isolates showed 73.7% of shared bands considering the average obtained with the three primers, and were genetically well correlated. Using this marker it was possible to separate the populations of the parasite in three distinct groups. The first group composed by isolates obtained of triatomines and humans from four different districts (Caicó, Caraúbas, Serra Negra doNorte and Governador Dix-Sept Rosado); the second contained isolates obtained of triatomines of two different species (T. brasiliensis and P. lutzi) captured in Caraúbas and Serra Negra do Norte. The third grouped isolates obtained from humans of Angicos and Caicó municipalities. In different localities of distinct mesoregions, State of RN, a profile genetic well correlated was identified among all isolates and the presence of three distinct groups of the parasite circulating among vertebrate and invertebrate hosts

Avaliação do status de zinco e da expressão gênica de metalotioneínas em pacientes com aterosclerose tratados com rosuvastatina

The study had as objective to evaluate the zinc status by means of dietary intake, zinc in plasma and in erythrocytes and the metallothionein gene expression in patients with atherosclerosis in use of rosuvastatin. The research involved 27 adult and elderly patients of both genders with atherosclerosis that were treated with rosuvastatin (10mg/day) during 4 months. We performed the dosage of lipids, glucose, AST and ALT, ultrasensitive C-reactive protein (hsCRP), plasmatic and erythrocyte zinc and 1 and 2 metallothionein gene expression. The assessment of body mass index (BMI) and abdominal circumference (AC) was performed, besides the analysis of dietary intake of patients. The majority of the evaluated patients presented overweight, before and after the treatment, with no significant difference between the times of the study. It was identified that the AC was significantly reduced in the group (p<0.05) after the intervention. The majority of the patients had intake below the recommendation of calories and fibers and above recommendation of proteins. The mono and polyunsaturated fats were adequate for the majority of the patients, however, the saturated fat and cholesterol were consumed in excess by a great part of the individuals. The intake of zinc was inadequate, being noticed an inadequacy of 100% in the male gender and of 84% in the female. After the treatment with rosuvastatin there was a significant reduction in the total cholesterol (TC) and LDL-c (p<0.01) and no alterations were observed in the HDL-c and triacylglycerols. It was also verified that the reduction of glycemia (p<0.05) and of hsCRP (p<0.01). The analysis did not demonstrate significant differences in the plasmatic and erythrocyte zinc concentration after the treatment. There was, after the treatment, reduction of the MT1F gene (p<0.05) without, however, occurring significant alterations in the MT2A gene. The treatment with rosuvastatin was effective in the reduction of TC and LDL-c, and promoted the reduction of inflammatory marker hsCRP. The zinc in the plasma and erythrocyte was not altered by the use of the medication and there was a reduction in the MT1F gene, possibly due to the reduction of inflammation. The majority of patients presented inadequate intake of zinc and this inadequacy did not have relation with the mineral parameters in plasma and erythrocytes or with the metallothionein gene expression

Efeito do ácido alfa-lipóico sobre biomarcadores de estresse oxidativo, inflamação e fatores de risco cardiovascular em hipertensos

Alpha-lipoic acid (ALA) is a potent antioxidant with favourable anti-inflammatory, metabolic and endothelial effects, and has been widely investigated due to its potential against cardiovascular risk factors. This study aimed to evaluate the effect of oral ALA supplementation on oxidative stress biomarkers, inflammation and cardiovascular risk factors in patients with hypertension. This is a double-blind placebo-controlled randomized clinical trial, where the intervention was evaluated prospectively comparing results in both groups. The sample consisted of 64 hypertensive patients who were randomly distributed into ALA group (n = 32), receiving 600 mg / day ALA for twelve weeks and control group (n = 32), receiving placebo for the same period. The following parameters were evaluated before and after intervention: lipid peroxidation, content of reduced glutathione (GSH), enzymatic activities of glutathione peroxidase (GPx) and superoxide dismustase, ultrasensitive C-reactive protein (hs-CRP), triglycerides, total cholesterol and fractions, fasting glucose and anthropometric indicators. There was a statistically significant reduction (p <0.05) in serum concentrations of total cholesterol, very low density lipoprotein (VLDL), high density lipoprotein (HDL), triglycerides and blood glucose. There was a reduction in body weight and waist, abdominal and hip circumferences in the group that received ALA. In addition, there was a statistically significant increase (p <0.05) in the contents of reduced glutathione (GSH) and glutathione peroxidase (GPx) in the group receiving ALA. Oral administration of ALA appears to be a valuable adjuvant therapy, which may contribute to decrease the damage caused by oxidative stress and other risk factors associated with the atherosclerotic process

Proteção da relação de emprego sob o prisma da dignidade da pessoa humana

This work aims to show that the protection of the employment relation is one of the determining factors to respect the principle of the human dignity. The goal is initially to show the devaluation of work from antiquity to the early twentieth century, when the constitutions began to standardize protective devices. This way, the consecration of the social labor rights in the Constitution of 1988 represents the culmination of the historical achievements. This work demonstrates that such rights can not be reduced or suppressed by political conveniences, once these rights are included in the list of immutable clauses. It is displayed that to achieve the fundamental right to work is not well advised to encourage the creation of jobs that maculates the worker s dignity. The outsourced work is, therefore, a classic example of the advancement of precarious forms of contemporary labor. It is inferred that the presence of various forms of harassment results in a degradation of working environment, bringing about dire consequences on professional and personal life of the worker. Thus, decent work must be the appropriate benchmark for the creation of new jobs. It is also shown that the flexibilization of the propaganda rights by certain pressure groups has as main goal to reduce or eliminate rights, based on fallacious data depicting an increase of competitiveness and jobs. In addition, the flexibility implies a growth of the precarization of the work - a reality felt by many workers subjected to such a situation due to the unemployment phenomenon whose origin is not in the protectionism of the norms. It is necessary to expand and structure the constitutionally legitimate institutions to monitor and curb the precarized work, as well as all practices that go against the dignity of the worker. It is also shown the loss of power of the sindicates in the last few years as a consequence of the pulverization workes and the capital attacks through the productive restructure whose outsourcings and privatizations are notorious examples

Os saberes em potencial da atividade policial ostensiva: sistematizando modelos a partir da experiência potiguar

This work of research presents an investigation into the knowledge related to the ostensive policing activities of a group of the Rio Grande do Norte State Military Police Captains. This knowledge, which is decisive and part of Brazilian Military Police Constitutional matters, must be taken into consideration when it comes down to planning and putting into force the services related to ostensive public security. Thus, a historical and social analysis about the formation of the police by starting from foreigner experiences down to Rio Grande do Norte s reality, led by such knowledge, was made. Further, studying Brazilian and local scene, this knowledge was analyzed on the ostensive policing activities as for the principles of the Brazilian National Public Security Plan, Brazilian Classification of Occupations / CBO 2002, the reference documents and studies for police graduation Curricular Basis and Matrix; the Variables of Ostensive Policing, as well as some important competences of police service. Arguing that this knowledge is somehow related to what is presented in this work as Orientation Axis to Military Police Service , research tools such as Critical Case Solution and the answers to the Questionnaire on Fundamental Areas of Military Police Service , having in the end six knowledge models related to ostensive policing activities were used within that group. This knowledge can be classified in three distinct categories of connotations within the military police activity: one with reactive/repressive characteristics being the most predominant; the second as preventive; and another one that revealed that the military police activity is being misused for actions and/or missions outside the scope of action of military police

Estimulação transcraniana por corrente contínua e a flutuação de força em idosas durante exercício isométrico

The fluctuacion force has been increasingly used in studies with elderly as a good predictor of performance and functionality of the motor. However, most analyzes the fluctuation of force in one session. Thus, identifying the minimum amount of sessions needed for familiarization with the fluctuation strength in isometric exercise become relevant. Furthermore, to investigate the effects of applying transcranial direct current stimulation (tDCS) associated with regular exercise on rates fluctuation task force is extremely important. In the first experiment, volunteers were subjected to a protocol marked by a familiarization session to establish the parameters of VCM and eight sessions with intensity of 30% MVC in office. It was observed that two familiarization sessions are required so there is a fluctuation stabilizing force. In experiment II, subjects performed an isometric contraction before and after applying tDCS (cathode, anode and sham) applied to M1. ETCC anodic effectively contributed to reducing the fluctuation of force during isometric exercise in the elderly, while the cathodic caused the increased levels of strength fluctuation. It was concluded that there is a need to implement a familiarization protocol with at least two sessions to avoid possible misunderstandings of measurements in tests of fluctuacion force. Besides that tDCS interfered with the behavior of the oscillations of force, with cathodic promoting increased fluctuation strength and anodic contributed to greater stability, demonstrating the potential of this technique neuromodulation associated with exercise as rehabilitation tools

Caracterização de matérias-primas regionais e desenvolvimento de formulações de massas cerâmicas para porcelanato

Initially concentrated in some poles at the South and Southeast regions of Brazil, the ceramic tiles industry became wide during the 80 s decade, with a disconcentration industrial and regional pulverization. The competitiveness in the ceramic tiles internal and external consumers markets, it has debtor the industries to invest in sophisticated products each time more, either in design or the technology, but, mainly, in its final properties. Amongst the diverse types of ceramic coating, the porcelanato if has detached had to its process of technological production and excellent characteristics techniques. The Porcelanato is currently the material for coatings that presents the best technical and aesthetic features when compared with others ceramics found on the market. The chemical composition and the others raw materials characteristics have an importance that must to be ally to the inherent characteristics of fabrication process, essentially those related to the cycle of burning. This work had as purpose to develop formularizations of ceramic mass for production of porcelanato without glass coating, pertaining to the group BIa (text of absorption of water ≤ 0.5%) and with resistance superior mechanics 35MPa from raw materials characterized. The ceramic raw materials selected to the development of this study (A1 and A2 clays, feldspate, talc and quartz) were submitted to the following tests: X-ray fluorescence - chemical analysis determination; X-ray diffraction - Analysis of the stages mineralogics; Laser granulometry - size distribution of particles; and Differential thermal analysis - thermal behavior. Were performed tests of absorption of water, lineal retraction of it burns, apparent specific mass and rupture tension the flexing. The results had evidenced that the formularizations that had the A1 clay and talc on its composition were efficient for the porcelanato production remaining their technological characteristics inside of the intervals of variation desired by the Norms of the ABNT

Interferindo com oscilações de alta frequência no hipocampo epiléptico: consequências para as crises espontâneas

Conselho Nacional de Desenvolvimento Científico e Tecnológico

Adesão de células mesenquimais da medula óssea de camundongos e do ligamento periodontal de ratos a diferentes superfícies de titânio: estudo comparativo in vitro

The present experiment used cell culture to analyze the adhesion capacity of mouse mesenchymal bone marrow cells and rat periodontal ligament to different titanium surfaces. Grade II ASTM F86 titanium discs 15mm in diameter and 1.5mm thick were used and received 2 distinct surface treatments (polished and cathodic cage plasma nitriding). The cells were isolated from the mouse bone marrow and rat periodontal ligament and cultured in α-MEM basic culture medium containing antibiotics and supplemented with 10% FBS and 5% CO2, for 72 hours at 37ºC in a humidified atmosphere. Subculture cells were cultured in a 24-well plate with a density of 1 x 104 cells per well. The titanium discs were distributed in accordance with the groups, including positive controls without titanium discs. After a 24-hour culture, the cells were counted in a Neubauer chamber. The results show that both the mouse mesenchymal bone marrow cells and rat periodontal ligament cells had better adhesion to the control surface. The number of bone marrow cells adhered to the polished Ti surface was not statistically significant when compared to the same type of cell adhered to the Ti surface treated by cathodic cage plasma nitriding. However a significant difference was found between the control and polished Ti groups. In relation to periodontal ligament cell adhesion, a significant difference was only found between the control and plasma-treated Ti surfaces. When comparing equal surfaces with different cells, no statistically significant difference was observed. We can therefore conclude that titanium is a good material for mesenchymal cell adhesion and that different material surface treatments can influence this process

Avaliação in vitro da adesão e proliferação de células mesenquimais do ligamento periodontal humano em diferentes superfícies de titânio

In the last years, many scientific researches in implantology have been focused on alternatives that would provide higher speed and quality in the process of osseointegration. Different treatment methods can be used to modify the topographic and chemical properties of titanium surface in order to optimize the tissue-implant reactions by a positive tissue response. This study aimed to evaluate the adhesion and proliferation of mesenchymal cells from human periodontal ligament on two different titanium surfaces, using cell culture techniques. Grade II titanium discs received different surface treatments, forming two distinct groups: polished and cathodic cage plasma nitriding. Human periodontal ligament mesenchymal cells were cultured on titanium discs in 24-well cell culture plates, at a density of 2 x 104 cells per well, including wells with no discs as positive control. Data obtained by counting the cells that adhered to the titanium surfaces (polished group and cathodic cage group) and to the plastic surface (control group), in the 24, 48 and 72-hour periods after plating, were used to analyze cell adhesion and proliferation and to obtain the cell growing curve in the different groups. The data were submitted to nonparametric analysis and the differences between groups were compared by Kruskal-Wallis and Friedman statistical tests. No statistically significant differences were found in the cells counts between the groups (p>0.05). It was concluded that both treatments produced surfaces compatible with the adhesion and proliferation of human periodontal ligament mesenchymal cells

Adsorção de Mn (II) e Zn (II) em soluções aquosas usando perlita expandida revestida com quitosana

In this work, chitosan was used as a coating of pure perlite in order to increase the accessibility of the groups OH- e NH2+the adsorptionof ions Mn2+ e Zn2+.The characterization results of the expanded perlite classified as microporous and whose surface area 3,176 m2 g-1after the change resulted in 4,664 m2g-1.From the thermogravimetry(TG) it was found that the percentage of coating was34,3%.The infrared analysis can prove the presence of groups Si-OH, Si-O e Al-O-Siresulting from the perlite and C=O, NH2and OH characterization of chitosan. The experiments on experiments on the adsorption of Mn and Zn were performed in the concentration range of10 a 50 mgL-1and the adsorption capacity inpH 5,8 e 5,2 was 19,49 and 23,09 mgg-1to 25 oC,respectively.The adsorption data were best fitted to Langmuir adsorption model to Langmuir adsorption model for both metalionsisindicative of monolayer adsorption. The kinetics of adsorption were calculated from the equation of Lagergren fitting the model pseudo-second-order for all initial concentrations, suggesting that adsorption of ions Mn2+ and Zn2+ follows the kinetics of pseudo-second-order and whose constant Speedk2(g/mg.min) are 0,105 e 3,98 and capacity and maximum removal qe 4,326 e 3,348,respectively.In this study we used a square wave voltammetry cathodic stripping voltammetry to quantify the adsorbed ions, and the working electrode glassy carbon, reference electrode silver / silver chloride and a platinum auxiliary electrode. The attainment of the peaks corresponding to ions Mn2+ and Zn2+ was evaluated in and electrochemical cell with a capacity of 30 mL using a buffer system (Na2HPO4/NaH2PO4)at pH 4 and was adjusted with solutionsH3PO4 0,1molL-1and NaOH 0,1 molL-1and addition of the analyte has been a cathodic peak in- 0,873 Vand detection limit of2,55x10-6molL-1para Zn.The dough used for obtaining the adsorption isotherm was 150 mg and reached in 120 min time of equilibrium for both metal ions.The maximum adsorption for 120 min with Mn concentration 20 mgL-1 and Zn 10 mgL-1,was91, 09 e 94, 34%, respectively