Metabolic Syndrome Criteria As Predictors of Insulin Resistance, Inflammation and Mortality in Chronic Hemodialysis Patients

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Analysis of criteria for metabolic syndrome in a population-based study of Japanese-Brazilians

Objective: Criteria for metabolic syndrome (MS) differ particularly regarding the definition of central obesity and consequently, there could be differences in the assessment of cardiovascular risk. We estimated the prevalence of metabolic syndrome, compared the agreement of the World Health Organization (WHO) criteria with the standard and a modified National Cholesterol Education Program (NCEP) criterion and investigated whether additional factors were associated with the diagnosis of the syndrome in a Japanese descendant population.Methods: In this cross-sectional, population-based survey, 1166 Japanese-Brazilians (533 men, 633 women) aged 57.4 +/- 12.4 years with mean body mass index (BMI) and waist of 25.2 +/- 4.0 kg/m(2) and 84.5 +/- 10.6 cm, respectively, were included. McNemar and kappa statistics were used to assess the concordance between WHO criteria with the standard and a modified NCEP criteria (waist of 90 and 80 cm, for men and women, respectively). in logistic regression analysis, a number of metabolic variables and albumin-to-creatinine ratio were included to test independent associations with metabolic syndrome defined by the modified NCEP criteria.Results: According to WHO, 55.4% (95% Cl 52.5-58.2%) of the subjects had MS and to NCEP 47.4% (95% Cl 44.6-50.0%). WHO criterion detected 48.3% of central obese subjects while NCEP only 14.0%. Kappa statistics showed a good strength of agreement (k = 0.67, p < 0.01) between WHO and NCEP standard definitions of MS. Using the modified NCEP criterion for Asians, more subjects with metabolic syndrome were identified (58%) and agreement with WHO was improved (k = 0.72, p < 0.001). However, similar Framingham risk scores were attributed to the subsets of subjects classified by any of the three criteria. Areas under the receiver operating characteristic curves, obtained for the modified waist values to diagnose metabolic syndrome according to WHO, were > 0.80 and corresponded, respectively, to sensitivity and specificity of 63 and 83% for men and 77 and 72% for women. In final logistic regression model, age, male sex, BMI and homeostasis model assessment-insulin resistance but not with albumin-to-creatinine ratio (ACR) were independently associated with the syndrome.Conclusions: High prevalence of MS, independent of the criterion considered, was found in this Japanese-Brazilian population. The replacement of waist cutoff by those proposed by WHO for Asians lead to this diagnosis in a higher number of subjects with elevated cardiovascular risk. Our data did not support that ACR should be included in the classical definition of MS in Japanese descendants as previously suggested by WHO.

Identificação e análise da relação entre a utilização de construtos da qualidade e o desempenho e competitividade organizacional

A growing number of companies is adopting quality management systems to achieve better performance and remain competitive in the market. These systems, however, can prove quite complex because they involve different practices and factors. This paper seeks to identify and analyze how each of these factors and practices, defined as quality constructs, influence the performance and competitiveness in the organizational environment and thus contribute to the strategic decisions in the area of quality. To achieve that, a survey was conducted with industrial companies located in the state of São Paulo, and the data was analyzed by a structural equation software. As a result, it was observed that the constructs Customer Focus and Human Resources are the most influent for the competitive criteria of a company, while the constructs Supplier development and Customer Focus exert greater impact on performance

Seleção de fornecedores em uma indústria de transformadores utilizando o método de análise hierárquica

The optimal supply chain management (SCM) is considered by the companies a new frontier in order to gain efficiently competitive advantage. Through the SCM companies must define their competitive strategies by positioning inside the supply chain wich belongs both as suppliers and as consumers. The main objectives of SCM is integrate multiple suppliers to satisfy the market demand and make possible the synergies between the parts of the supply chain in order to better serve the consumer Meanwhile, selection, evaluation and development of suppliers play important roles in establishing an efficient supply chain. Thus, the SCM covers elements such as manufacturing, assembly, raw materials, and distribution to the final consumer. Due to the factors described, the focus of this paper is to present the Analytic Hierarchical Process (AHP) application as an appropriate and structured method for the supplier selection of a strategic line of low voltage transformers of a transformers industry and compare it with the selection process currently used by this industry, showing the advantages of applying a multiple criteria decision making method. In this study, the research methodology used was modeling and simulation

Gestão de estoque em uma empresa de varejo de produtos de limpeza e higiene pessoal

The deficiency in the product inventory management is common in small businesses, affecting several areas, especially the purchasing department that has difficulty in performing their tasks, acquiring the supplier's products at the time and in the most appropriate amount. Especially in the retail sector, the loss of quality of services is visible, because the availability of the product when there is demand is essential for the occurrence of sales and customer satisfaction. In this study, looking to improve inventory management in a retail company of cleaning products and personal hygiene, apply the classification method ABC (or Pareto Rule) to segment the available products. Thus are adopted buying criteria of new products based on the concepts of economic order quantity, safety stock and resupply point. The results show the feasibility of this procedure adopted because it was possible to propose an improved inventory management in a simple and effective way, contributing to company's competitive advantage

A perspective on the proposal for neurocognitive disorder criteria in DSM-5 as applied to HIV-associated neurocognitive disorders

HIV-associated neurocognitive disorders remain common in the current era of effective antiretroviral therapy. However, the severity at presentation of these disorders has been reduced, and the typical manifestations have changed. A revision of the American Academy of Neurology (AAN) criteria has been made on this basis, and a revision of the analogous criteria by the American Psychiatric Association will be forthcoming in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5. This article compares the relevant sets of diagnostic criteria that will be employed. It is concluded that a greater degree of integration of the revised, HIV-specific AAN criteria for HIV-associated neurocognitive disorders with the criteria proposed for the DSM-5 would prove advantageous for research, clinical, educational and administrative purposes.

Comparative analysis of different meat traceability systems using multiple criteria and a social network approach

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Orthodontic extrusion as treatment option for crown-root fracture: literature review with systematic criteria

To review the literature searching for a consensus for the choice of orthodontic extrusion as treatment for crown-root fracture. An electronic search was performed in the databases PubMed, Cochrane Central Register of Controlled Trials and Scopus and a manual search of the Journal Dental Traumatology. Forty articles were found in PubMed and 38 in Scopus and after removal of duplicate sample 51 contained articles. Of these, 48 were excluded for not having orthodontic treatment, no follow-up or follow-up less than 6 months, or not report the presence of crown-root fracture. In manual search in Dental Traumatology 20 articles were found, but none of them met the prerequisites established. So, three articles formed the basis of the study. The choice of how to treat orthodontic extrusion of crown-root fracture was effective and stable, without root and periodontal changes. Factors, such as root formation and presence of pulp vitality were decisive for determining the stages of treatment, however, there is no consensus based on scientific evidence about these protocols.