Fatores associados ao metabolismo energetico na obesidade

Obesity is fundamentally a problem of energy balance that develops when the energy intake is greater than the total energy expenditure (TEE). TEE is composed by the sum of resting energy expenditure (REE), thermal effect of foods and thermal effect of physical activity. Many factors can affect energy expenditure and energy homeostasis. Historically, the energy expenditure has been measured by indirect calorimetry. However, more recently, the use of doubly labeled water has allowed the assessment of energy expenditure in a 24 hour period, which expanded the knowledge on energy metabolism. Factors such as gender, age, thyroid disorders, physical activity and body composition affect REE as already established in the literature. However, there has been speculation whether other factors, such as adipocytokines and diet composition, which might be involved in the genesis of obesity by decreasing the REE. So, this paper aims to review the factors that can alter the energy metabolism.

A influência do anel na evolução ponderal após quatro anos da derivação gátrica em Y-de-Roux laparoscópica

Use of ring in Roux-en-Y gastric bypass is still a matter of controversy among bariatric surgeons. There is no consensus on its impact in relation to weight loss and weight maintenance in the long term. AIM: To evaluate the influence of the ring on the evolution of body weight over four years after bariatric surgery. METHODS: Retrospective analyzis of 143 women who underwent laparoscopic Roux-en-Y gastric bypass paired on the use or not use of Silastic® ring. Follow-up time was 48 months. Inclusion criteria were age over 18 years, primary bariatric operation and regular attendance at the clinic during the period of interest for research. The technique kept small gastric reservoir estimated in a volume of 30 ml. The food limb had in average 150 cm and the bile one 40 cm from the duodenojejunal angle. The group "ring" used Silastic® device with length of 6.5 cm, placed 2 cm from gastrojejunal anastomosis. The ring was closed for five polypropylene surgical thread sutures. In the morning after surgery the patients received isotonic fluids; on the second day salty liquid diet and were discharged on the third day. Semisolid diet started from the 20th day and solid on the 30th, with daily tablet of polivitamins. RESULTS: The weight loss was larger on the ring than without ring groups in all periods, respectively 10% and only 5% in the third postoperative year. The proportion of not having reached the 50% excess weight loss expectative was significantly higher in the group without ring than in the group with the ring (31% and 8% respectively in the fourth year). There was no difference between groups in delayed recovery of weight lost with the operation. CONCLUSIONS: The results were favorable to use the ring exclusively when it is analyzed only the weight loss.

Potencial do cultivo in vitro e do xenotransplante na sobrevida e desenvolvimento de folículos ovarianos pré-antrais em matrizes de ruminantes domésticos em risco de morte: revisão de literatura

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Limitações da utilização do equivalente metabólico (MET) para estimativa do gasto energético em atividades físicas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

One-hundred days of monitoring of patients undergoing hematopoietic stem cell transplantation: events of metabolic syndrome

Objective This study assessed early manifestations of metabolic syndrome determinants in patients submitted to hematopoietic stem cell transplantation. Methods Twenty-seven individuals participated in the study (20 with autologous and 7 with allogeneic hematopoietic stem cell transplantation). Anthropometric variables and biochemical indicators of lipid and glucose metabolism were determined before and 100 days after hematopoietic stem cell transplantation.Results The mean total cholesterol (p=0.086), very low density lipoprotein-cholesterol (p=0.069) and triglycerides (p=0.086) of all patients did not change significantly between the two study periods, but when the patients were separated by type of hematopoietic stem cell transplantation, triglycerides and very low density lipoprotein-cholesterol were close to the critical level of significance for individuals with allogeneic hematopoietic stem cell transplantation (p=0.060) and total cholesterol was significant in individuals with autologous hematopoietic stem cell transplantation (p=0.027). Anthropometric variables did not change significantly between before and 100 days after hematopoietic stem cell transplantation. Conclusion Metabolic syndrome risk factors may be associated with lipid metabolism in the early phase of allogeneic and autologous hematopoietic stem cell transplantation.

Indicadores antropométricos do estado nutricional entre idosas praticantes e não praticantes de exercício físico na zona norte de São José do Rio Preto-SP

Although the regular practice of physical exercise for the maintenance of the nutritional state and quality of life is important, it is not a common habit among the elderly, especially those of the lower income social bracket. The objective was to characterize and compare according to social-economic conditions and anthropometric indexes of the nutritional state of the elderly who regularly practice and those who do not practice exercises, offered at no cost, in the Northern zone of São José do Rio Preto-SP. In this study, 110 elderly women participated, of which 60 (group P) exercised regularly and 50 did not (group NP). Group P participated in a special gym program, free of charge, for at least 2 years, 2 to 3 times a week, one hour a day. Group NP was recruited from the same location as Group P. The comparison between the groups of elderly women was proportionately distributed according to marital status, level of education, means of locomotion, results of body mass index (IMC), waist to hip ratio (RCQ) and calf circumference, using the chi-square test. Comparisons were also made of average age, per capita family income, individual income, IMC, arm and triceps skin fold measured by t-Test. Differences were not found in all the comparisons made. The variables that stood out were the IMC (overweight) and RCQ (risk of chronic diseases) results, which were above what was expected, and the high frequency of walking and riding buses for both groups of elderly women (about 60%). We came to the conclusion that the low-intensity exercise program evaluated made no difference in the nutritional profi le of the elderly who also used walking as a means of getting around.

Estudio de las caracteristicas de oclusión de niños de 12 años del municipio de Cáceres, Mato Grosso, Brasil

The aim of this study was to evaluate the occlusal condition of 12 year-old children examined by the Oral Health Brazil 2003 Project in Cáceres city. The sample consisted of 170 children, boys and girls, selected at random among 20 schools that took part in this project. It was used for the analysis of the occlusal condition the Dental Aesthetic Index (DAI), as manual of basic epidemic rising in Oral Health extolled by the World Health Organization which describes the occlusal conditions in relation to dentition, space and occlusion of the permanent dentition. It was observed that the prevalence of the normal occlusion and of the malocclusion were, respectively, 21.18% and 78.82%. This last one was present due to the tooth crowding (74.93%), spacing in the incisor segment (23.88%), diastema (17.17%), anterior maxillary misalignment (58.95%) and anterior mandibular (61.19%), excessive overjet (11.94%), negative overjet (4.47%), open bite (1.5%) and molar relationship Class II or III (26.87%). It was concluded that the studied sample presents a high index of factors to compose the malocclusion.

Hanseníase multibacilar e tuberculose cutânea

Introdução: Hanseníase e Tuberculose são enfermidades associadas à supressão da imunidade celular do tipo TH1. As manifestações clínicas da hanseníase são usualmente cutâneas e da tuberculose (Tbc) tegumento-pulmonares. O objetivo é demonstrar a presença de ambas as enfermidades no mesmo paciente. Relato do caso: Paciente masculino, 59 anos, em uso de prednisona 40mg/d há 6 meses devido a um quadro “alérgico”, com queixa de úlcera peri-anal dolorosa e sangrante. Ao exame apresentava úlcera fagedênica peri-anal e inguinal fistulizado e pápulas normocrômicas no antebraço. Histopatológico de lesão nodular e da úlcera mostra infiltrado granulomatoso com BAAR +,interpretado como hanseníase multibacilar. O tratamento não resultou em melhora das lesões inguinais e perianal. Novos exames demonstraram serem as lesões ulceradas causadas pelo Mycobacterium tuberculosis, por cultura, e as lesões pápulo-nodulares serem Mycobacterium leprae, por PCR. Tratamento para ambas foi eficaz. O M.leprae e M.tuberculosis são patógenos intracelulares obrigatórios e a defesa do hospedeiro está diretamente associada à imunidade celular. Mesmo em países endêmicos para ambas as enfermidades a associação das duas doenças é de ocorrência excepcional. O uso da corticoterapia utilizada para quadro alérgico (ENH) facilitou a ocorrência da Tbc. O caso relata a importância dos métodos auxiliares diagnósticos em caso de difícil interpretação clínica.

Hanseníase virchowiana: comprometimento medular

Paciente feminino 36 anos, com queixa de febre noturna, astenia, parestesia de membros inferiores, artralgia, hepatoesplenomegalia, lesões cutâneas, anemia hipocrômica, microcítica e linfopenia. Sorologia negativa para Hepatite B,C e HIV; FAN e anti-DNA também negativos. Histopatologia da medula óssea mostrou-se discretamente hipercelular, com presença de focos de histiócitos com citoplasma vacuolado (células pseudo-gaucher-like),aspecto megaloblástico, linfoplasmocitico e lipogranulomatoso. A coloração Ziehl- -Nielsen positivo; diagnóstico morfológico: micobacteriose de medula óssea. A cultura do sangue e do aspirado de medula óssea foi negativo para M.tuberculosis. Biópsia das lesões cutâneas máculas e pápulas hipercrômicas dos membros inferiores e superiores revelou hanseníase de padrão Vichowiana. A pesquisa BAAR pela Faraco demonstrou numerosos bacilos, sendo a maioria de padrão granuloso. Pacientes com hanseníase virchowiana tem acometimento cutâneo em 100% dos casos, o baço é o órgão mais frequentemente acometido com disseminação através do sangue periférico. O quadro anêmico e a linfopenia provavelmente se deve à cronicidade da infecção, levando a infiltração medular. A ocorrência do comprometimento medular em paciente com hanseníase Virchowiana é excepcional, mesmo em países endêmicos, e pode indicar necessidade de tratamento mais prolongado.

Mortalidade Materna: uma abordagem atualizada

Purpose: to review literature, highlighting current aspects of maternal mortality.  Method: research initiated through electronic data base PubMed [http:// www.ncbi.nlm.nih.gov/pubmed], limited to the last 10 years. The selected cases which related to pre-defined aspects of interest to the study, such as vulnerable population, risk factors, causes, difficulties in obtaining data, preventive measures e new approaches to the problem, among them, ‘near misses’ and severe maternal morbidity.  Results: maternal death is directly related to the quality of life of the population, with relevant disparities among the different social economic areas. Although maternal mortality is the proper indicator to the female population health, its numbers are presented in unrealistic manners due to the difficulties in identifying the cases through death certificates. Preventive measures associated to early and adequate diagnose and treatment are benefic factors in decreasing those maternal deaths. Apart from these, identification and classification of ‘near misses’ and maternal morbidity are featured in the contemporary approach to the issue.  Final considerations: In spite of advanced technology and recognition of preventive measures, a large number of women die daily due to complications in the pregnancy and puerperal cycle. To decrease such tragedy political, social and economical commitment to Health is necessary, in order to promote the needed reforms in the assistance of such cycle.

Qualidade das medidas antropométricas produzidas em unidades de atenção básica à saúde da região de Botucatu-SP, Brasil

The aim of this study was to evaluate the quality of weight measurements produced in Primary Health Care Centers in Botucatu and surroundings. 14 Health Care Centers were included, all of them located in four towns in the area of Botucatu (4,555; 5,656; 18,761 and 128,397 inhabitants). General conditions and scale calibration conditions found in those Health Care Centers were evaluated. In order to evaluate the weight accuracy obtained by the local team, 10 adult users of each Center were addressed by the rater during the service routine in order to get a new weight evaluation, immediately after the measurement made by the team. The statistic method applied for checking the weight measurement held in the Heath Care Center and the scales accuracy was the measurement error technique (MET). The results have showed that out of 19 scales, 6 of them overestimated the weight by 50 grams, 1 of them underestimated the weight by 200 grams and the others were accurate. Evaluated as a group, the result of the scale MET was 44.3g. Regarding the conformity of the measures obtained by the MET of the adults weighing in the Health Care Centers compared to the ones obtained by the researcher, the expected result was obtained in only one Center (< 100g). The results have showed data compromise, rather due to lack of health team training than due to the conditions of the equipment used for the measurement.

Brazilian coffee genome project: an EST-based genomic resource

O café é um dos principais produtos agrícolas, sendo considerado o segundo item em importância do comércio internacional de commodities. O gênero Coffea pertence à família Rubiaceae que também inclui outras plantas importantes. Este gênero contém aproximadamente 100 espécies, mas a produção comercial é baseada somente em duas espécies, Coffea arabica e Coffea canephora, que representam aproximadamente 70 % e 30 % do mercado total de café, respectivamente. O Projeto Genoma Café Brasileiro foi desenvolvido com o objetivo de disponibilizar os modernos recursos da genômica à comunidade científica e aos diferentes segmentos da cadeia produtiva do café. Para isso, foram seqüenciados 214.964 clones escolhidos aleatoriamente de 37 bibliotecas de cDNA de C. arabica, C. canephora e C. racemosa representando estádios específicos do desenvolvimento de células e de tecidos do cafeeiro, resultando em 130.792, 12.381 e 10.566 seqüências de cada espécie, respectivamente, após processo de trimagem. Os ESTs foram agrupados em 17.982 contigs e em 32.155 singletons. A comparação destas seqüências pelo programa BLAST revelou que 22 % não tiveram nenhuma similaridade significativa às seqüências no banco de dados do National Center for Biotechnology Information (de função conhecida ou desconhecida). A base de dados de ESTs do cafeeiro resultou na identificação de cerca de 33.000 unigenes diferentes. Os resultados de anotação das seqüências foram armazenados em base de dados online em http://www.lge.ibi.unicamp.br/cafe. Os recursos desenvolvidos por este projeto disponibilizam ferramentas genéticas e genômicas que podem ser decisivas para a sustentabilidade, a competitividade e a futura viabilidade da agroindústria cafeeira nos mercados interno e externo.

Narciso no labirinto de espelhos: perspectivas pós-modernas na ficção de Roberto Drummond. -

Por meio de rica análise do trabalho do ficcionista mineiro Roberto Drummond, Maria Lúcia Outeiro Fernandes busca, neste livro, articular o trabalho do autor de Coca-Cola e guerrilha e O tecedor de vento com vários temas centrais da arte e da cultura contemporâneas. Explicitando os traços presentes na obra do escritor, Fernandes apresenta uma expressiva contribuição ao estudo dos procedimentos formais e posicionamentos ideológicos que permeiam grande parte da produção literária das últimas décadas do século XX, como o ecletismo de estilos, a metaficção historiográfica, o pastiche, a intertextualidade e o hiper-realismo. O deslocamento de fronteiras entre produção erudita e de massas também faz parte do foco da autora. Fernandes discute ainda as possíveis relações entre essas constantes e alguns problemas que emergiram na cultura ocidental principalmente a partir da década de 1960, como a morte da arte, o ocaso das vanguardas, o anti-humanismo, a sociedade do simulacro, a supervalorização da informação, o ceticismo em relação às utopias. São temas que, em Drummond, conduzem ao que a autora chama de perspectivas pós-modernas da ficção.

passagem de Drummond pelo fantástico

It is quite possible that the story “O Gerente” (1945), by Carlos Drummond de Andrade, is unknown to the Brazilian reader, who’s more familiar with his poetry. However, the peculiarity of its narrative language and the treatment given to fantastic awakening interest in the text, which challenges the possibilities of literary research. The humor, a trait more common in the poetry of Drummond, becomes a stylistic strategy with curious effects of meaning, as well as the structural aspects of the narrative. The fantastic, a category that Drummond has not cultivated, appears so unusual in his narrative. Our purpose is to analyze the discursive construction procedures for establishing differences between the traditional and the new paradigms of the fantastic. For this, we will seek to highlight the story fragments that allow the discussion of certain issues such as social conventions, the everyday, the feeling of love, the tension created between the comic and tragic.