Effect of essential oil obtained from Croton cajucara Benth. on gastric ulcer healing and protective factors of the gastric mucosa

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

Resiliência no trabalho contemporâneo: promoção e/ou desgaste da saúde mental

Este estudo teórico resgata a concepção processual e contextual de resiliência, a qual compreende esse fenômeno enquanto relação complexa entre indivíduo e ambiente na produção de fatores de risco e no provimento de fatores protetores da subjetividade do indivíduo, buscando aplicá-la à realidade organizacional, haja vista que o mundo do trabalho contemporâneo demanda uma força de trabalho específica, qual seja, o trabalhador flexível, polivalente, sujeito a mudanças - portanto, um trabalhador resiliente. A partir dessas considerações, realiza-se um processo de reflexão sobre as situações em que a resiliência pode ser promotora de saúde mental, bem como acerca dos contextos que contribuem para o processo de adoecimento do trabalhador, buscando aventar possibilidades de atuação do profissional psicólogo diante de um contexto de trabalho adverso, considerando-se que o principal objetivo dessa atuação profissional é garantir a proteção/promoção da saúde e qualidade de vida no ambiente de trabalho.

Fatores protetores e de risco envolvidos na transmissão vertical do HIV-1

Este estudo avalia os fatores maternos e fetais envolvidos na transmissão vertical do HIV-1 em 47 pares de mãe e filho. As variáveis comportamentais, demográficas e obstétricas foram obtidas mediante entrevista; os dados referentes ao parto e ao recém-nascido, dos prontuários das maternidades. Durante o terceiro trimestre de gestação foi realizada a contagem da carga viral materna e dos linfócitos T CD4+. A média de idade foi de 25 anos e 23,4% das gestantes eram primigestas, e o fator comportamental mais prevalente foi não usar preservativos. Dentre as gestantes, 48,9% tinham células CD4+ superior a 500 células/mm³ e 93,6% se enquadravam na categoria clínica A; 95,7% submeteram-se à profilaxia com zidovudina durante a gestação ou no parto, a qual foi ministrada a todos os recém-nascidos; 50,0% delas foram submetidas à cesárea eletiva. Apesar de expostas a vários fatores de risco e protetores, nenhuma criança tornou-se infectada. A transmissão vertical resulta de um desequilíbrio entre os fatores, com predomínio dos de risco sobre os protetores.

O papel da escola na vida de adolescentes vítimas de violência sexual: risco e proteção

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. Clin J Am Soc Nephrol 6: 1944-1951, 2011. doi: 10.2215/CJN.11431210

Low Apgar scores at 5 minutes in a low risk population: maternal and obstetrical factors and postnatal outcome

OBJETIVO: Avaliar a associação entre índice de Apgar menor que sete no 5º minuto, os fatores pré-natais e resultados pós-natais. MÉTODOS: Trata-se de estudo retrospectivo com 27.252 recém-nascidos em maternidade escola com população de baixo risco obstétrico, de janeiro de 2003 a dezembro de 2010. Prontuários de todos os casos com índice de Apgar < 7 no 5º minuto (n = 121; - 0,4%) e de 363 casos com Apgar > 7 no 5º minuto, escolhidos ao acaso, foram revisados. Os principais desfechos estudados foram: óbito neonatal, insuficiência respiratória neonatal, necessidade de intubação orotraqueal e de unidade terapia intensiva (UTI) neonatal e encefalopatia hipóxico-isquêmica. RESULTADOS: Após análise de regressão múltipla, desacelerações tardias (DIP II) (OR: 2,4; IC95%: 1,4-4,1) e período expulsivo prolongado (OR: 3,3; IC 95%: 1,3-8,3) se associaram com Apgar < 7 no 5º minuto; assim como com insuficiência respiratória ao nascimento (OR: 3,0; IC 95%: 1,3-6,9), intubação traqueal (OR: 2,5; IC 95%: 1,2-4,8), necessidade de UTI neonatal (OR: 9,5; IC 95%: 6,7-16,8) e encefalopatia hipóxico-isquêmica (OR: 14,1; IC 95%: 3,6-54,7). Nenhuma outra variável prénatal se associou com Apgar < 7 no 5º minuto (p < 0,05). CONCLUSÃO: DIP II e período expulsivo prolongado estão associados com Apgar < 7 no 5º minuto em população obstétrica de baixo risco; situação essa relacionada com maior risco de insuficiência respiratória no parto, necessidade de suporte ventilatório e encefalopatia hipóxico-isquêmica.

Penile carcinoma: Risk factors and molecular alterations

Penile carcinoma is a rare, male cancer. Although the incidence of penile carcinoma is very low in Western countries, in some countries, the incidence is significantly greater, with penile carcinoma accounting for ≤10% of all male malignancies. Greater insight has been gained in recent years as to its pathogenesis, the risk factors associated with its development, and the clinical and histological precursor lesions related to this disease. In this review, risk and conditions factors for penile carcinoma, molecular alterations in this type of cancer, histological types, and prognostic factors will be discussed in order to further our understanding of the biology and behavior of this cancer. ©2011 with author. Published by TheScientificWorld.

Genetic and modifying factors that determine the risk of brain tumors

Some modifying factors may determine the risk of brain tumors. Until now, it could not be attempted to identify people at risk and also to improve significantly disease progression. Current therapy consists of surgical resection, followed by radiation therapy and chemotherapy. Despite of these treatments, the prognosis for patients is poor. In this review, we highlight general aspects concerning genetic alterations in brain tumors, namely astrocytomas, glioblastomas, oligodendrogliomas, medulloblastomas and ependymomas. The influence of these genetic alterations in patients' prognosis is discussed. Mutagen sensivity is associated with cancer risk. The convincing studies that linked DNA damages and DNA repair alterations with brain tumors are also described. Another important modifying factor is immunity. General immune response against cancer, tumor microenvironment and immune response, mechanisms of tumor escape, CNS tumor immunology, immune defects that impair anti-tumor systemic immunity in brain tumor patients and local immunosuppressive factors within CNS are also reviewed. New hope to treatment perspectives, as dendritic-cell-based vaccines is summarized too. Concluding, it seems well established that there is association between brain tumor risk and mutagen sensivity, which is highly heritable. Primary brain tumors cause depression in systemic host immunity; local immunosuppressive factors and immunological characteristics of tumor cells may explain the poor prognosis and DNA damages responses can alert immune system. However, it is necessary to clarify if individuals with both constitutional defects in immune functions and genetic instability have higher risk of developing brain tumors. Cytogenetic prospective studies and gene copy number variations analysis also must be performed in peripheral lymphocytes from brain tumor patients. © 2011 Bentham Science Publishers Ltd.

Psychosocial factors for risk and protection to child malnutrition in mothers of malnourished and eutrophic children: the role of maternal mental health

In this study, the relationship between child malnutrition, depression, anxiety and other maternal socio-demographic variables was investigated in mothers of malnourished (MD) and eutrophic (ME) children. The causes attributed by mothers to malnutrition were also studied. Ten mothers from each group, with children aged from 11 months to three years and who were users of primary health care units, participated in the study. They answered Beck depression and anxiety inventory, a questionnaire on vital events and an open question concerning the causes of malnutrition. The evaluation instruments were corrected according to proper guidelines and comparative analyses between the groups were performed. The answers to the open question were qualitatively evaluated, submitted to content analysis. The mothers in the two groups were nearly 30 years old or older. They had a steady partner and were subject to very similar life conditions. They had attended school for 5.5 years and were housewives or worked in low-income jobs. Concerning mental health indicators, a significantly larger number of mothers in the MM group showed depression indicators when compared to mothers in the EM group. Most mothers attributed malnutrition to biological factors or to the lack of maternal care, with more moralist statements in the EM group, and statements filled with guilt in MM. Results suggest that in order to fight malnutrition, in addition to nutritional interventions, it is necessary to heed attention to maternal socio-emotional issues.

Linking genetic and environmental factors in amphibian disease risk

A central question in evolutionary biology is how interactions between organisms and the environment shape genetic differentiation. The pathogen Batrachochytrium dendrobatidis (Bd) has caused variable population declines in the lowland leopard frog (Lithobates yavapaiensis); thus, disease has potentially shaped, or been shaped by, host genetic diversity. Environmental factors can also influence both amphibian immunity and Bd virulence, confounding our ability to assess the genetic effects on disease dynamics. Here, we used genetics, pathogen dynamics, and environmental data to characterize L.yavapaiensis populations, estimate migration, and determine relative contributions of genetic and environmental factors in predicting Bd dynamics. We found that the two uninfected populations belonged to a single genetic deme, whereas each infected population was genetically unique. We detected an outlier locus that deviated from neutral expectations and was significantly correlated with mortality within populations. Across populations, only environmental variables predicted infection intensity, whereas environment and genetics predicted infection prevalence, and genetic diversity alone predicted mortality. At one locality with geothermally elevated water temperatures, migration estimates revealed source-sink dynamics that have likely prevented local adaptation. We conclude that integrating genetic and environmental variation among populations provides a better understanding of Bd spatial epidemiology, generating more effective conservation management strategies for mitigating amphibian declines.

Nutrition-related habits and associated factors of Brazilian adolescents

To investigate the nutrition-related habits (NRH) of Brazilian adolescents and evaluate the associations with risk factors.Cross-sectional school-based was carried out among high school adolescents aged 14-18 years (n = 1,759) from public and private schools from two cities. The NRH were investigated by the weekly consumption of vegetables, fruit, sweet food and fried food. Risk factors investigated were: city, sex, age, socioeconomic status and nutritional status. In statistics, Poisson regression was used with robust variance adjustment.Data indicated low consumption of fruits and vegetables, 70.0 and 71.0%, respectively, and high consumption of sweets and fried food, 66.7 and 63%, respectively. Boys showed risk of inadequate intake of vegetables [prevalence ratios (PR) 1.10, 95% CI 1.01-1.16] and fruit (PR 1.09, 95% CI 1.01-1.16). Furthermore, adolescents who live in Maringa had greater likelihood of consuming vegetables and fruit (20 and 25%, respectively). However, they presented risk of inadequate consumption of sweets (PR 1.19, 95% CI 1.11-1.28) for adolescents who live in Presidente Prudente.We concluded that inadequate NRH show high prevalence among adolescents and indicate the need to employ educational strategies that promote the adoption of more healthy habits and behaviors.

Safety Assessment of Potentially Inappropriate Medications (PIM) use in Older People and the Factors Associated with Hospital Admission

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dietary factors associated with metabolic syndrome in Brazilian adults

Background: Metabolic Syndrome (MS) is defined as the association of numerous factors that increase cardiovascular risk and diet is one of the main factors related to increase the MS in the population. This study aimed to evaluate the association of diet on the presence of MS in an adult population sample.Methodology: 305 adults were clinically screened to participate in a lifestyle modification program. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m(2)) and muscle-mass index (MMI kg/m(2)). Dietary intake was estimated by 24 h dietary recall. Fasting blood was used for biochemical analysis. MS was diagnosed using NCEP-ATPIII (2001) criteria with adaptation for glucose (>= 100 mg/dL). Logistic regression (Odds ratio) was performed in order to determine the odds ratio for developing MS according to dietary intake.Results: An adequate intake of fruits, OR = 0.52 (CI:0.28-0.98), and an intake of more than 8 different items in the diet (variety), OR = 0.31 (CI: 0.12-0.79) showed to be a protective factor against a diagnosis of MS. Saturated fat intake greater than 10% of total caloric value represented a risk for MS diagnosis, OR = 2.0 (1.04-3.84).Conclusion: Regarding the dietary aspect, a risk factor for MS was higher intake of saturated fat, and protective factors were high diet variety and adequate fruit intake.

CYP1A2*1C, CYP2E1*5B, and GSTM1 polymorphisms are predictors of risk and poor outcome in head and neck squamous cell carcinoma patients

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

Grading and staging chronic hepatitis C and its relation to genotypes and epidemiological factors in brazilian blood donors

Progression of chronic hepatitis C is known to be associated with some factors, but influence of HCV genotypes is still controversial. Association between HCV genotypes and other risk factors was examined to determine which factors are associated with progression of infection. One hundred consecutive anti-HCV positive volunteer blood donors were evaluated for several risk factors, examined for HCV genotypes, and submitted to hepatic biopsy and biochemical exams.HCV genotyping were carried out in 89 patients and hepatic biopsy in 78. Transmission routes were found to be illicit intravenous drug use (26%), Gluconergan® use in a non-safe manner (48%) and blood transfusion (15%). HCV genotype was 1 in 45%, 3 in 40%, and it was not associated with the stage of fibrosis or with inflammatory activity. There was no significant association of factors related to infection, chronic alcohol use, or duration of illness, with progression of the lesion. There was a significant association of aminotransferase levels and the fibrosis stage. Univariate analysis showed that the age at contamination, patient's age, GT-gamma, and aminotransferase levels over three times the upper normal limits, were associated with fibrosis stages 2 to 4. Multivariate analysis detected age (odds ratio=1.19), and GT-gamma (odds ratio=2.02) as independent factors.