Impact of a 2-year intervention program on cardiometabolic profile according to the number of goals achieved

We investigated the impact of lifestyle goal achievement on cardiovascular risk factors after a 2-year behavioral intervention program applied to 394 adults (113 with diabetes, mean age 60.2 ± 11.4 years, 56% women) and targeting four goals: ≥5% weight loss; ≥150 min/week physical activities; <10% saturated fat intake/day; ≥400 g fruit and vegetable intake/day. Baseline characteristics and changes in variables after intervention among the four categories of number of goals achieved (none, 1, 2, and ≥3) were compared by independent ANOVA or the Kruskal-Wallis test. Individuals without diabetes achieving a higher number of goals were more likely to be older (3 or 4 goals: 61.8 ± 12.6 years vs none: 53.3 ± 10.3 years, P < 0.05) and to have a lower mean BMI (3 or 4 goals: 21.7 ± 2.6 kg/m² vs none: 29.0 ± 4.8 kg/m², P < 0.05), diastolic blood pressure (3 or 4 goals: 77.3 ± 2.1 mmHg vs none: 85.4 ± 9.6 mmHg, P < 0.05), triglyceride (3 or 4 goals: 116.1 ± 95.1 mg/dL vs none: 144.8 ± 65.5 mg/dL, P < 0.05) and insulin levels (3 or 4 goals: 3.6 ± 2.4 μU/L vs none: 5.7 ± 4.0 μU/L, P < 0.05) than those achieving fewer goals. The absolute changes in cardiovascular risk factors tended to be more pronounced with increasing number of goals achieved in individuals without diabetes. The intervention had a beneficial impact on the cardiometabolic profile of individuals with normal or altered glucose metabolism. The number of goals achieved in this lifestyle intervention was associated with the magnitude of improvement of cardiovascular risk factors in individuals without diabetes. Participants with a better cardiometabolic profile seemed to be more likely to have a healthy lifestyle.

Changes in cardiac aldosterone and its synthase in rats with chronic heart failure: an intervention study of long-term treatment with recombinant human brain natriuretic peptide

The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 μg/kg rhBNP and those in the high-dose group (n=8) received 45 μg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.

Preventive effect of reduced glutathione on contrast-induced nephropathy in elderly patients undergoing coronary angiography or intervention: a randomized, controlled trial

Coronary angiography can be a high-risk condition for the incidence of contrast-induced nephropathy (CIN) in elderly patients. Reduced glutathione, under a variety of mechanisms, may prevent CIN in this procedure. We prospectively examined whether hydration with reduced glutathione is superior to hydration alone for prevention of CIN in an elderly Han Chinese population. A total of 505 patients (271 males and 234 females) aged 75 years or older who underwent non-emergency coronary angiography or an intervention were randomly divided into two groups. The treatment group received hydration with reduced glutathione (n=262) and the control group received hydration alone (n=243). Serum creatinine and blood urea nitrogen levels were measured prior to coronary angiography and 48 h after this procedure. The primary endpoint was occurrence of CIN, which was defined as 25% or 44.2 µmol/L above baseline serum creatinine levels 48 h after the procedure. The overall incidence of CIN was 6.49% in the treatment group and 7.41% in the control group, with no significant difference between the groups (P=0.68). In subgroup analysis by percutaneous coronary intervention, no significant differences were found between the two groups. In summary, reduced glutathione added to optimal hydration does not further decrease the risk of CIN in elderly patients undergoing coronary angiography or an intervention.

Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

This study aimed to assess the efficacy of a rural community-based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China. This 18-year cluster-randomized controlled trial encompassing 15 villages included 1008 patients (454 men and 40 women in the intervention group [mean age, 54 ± 10 years]; 482 men and 32 women in the control group [mean age, 53 ± 10 years]) with confirmed COPD or at risk for COPD. Villages were randomly assigned to the intervention or the control group, and study participants residing within the villages received treatment accordingly. Intervention group patients took part in a program that included systematic health education, smoking cessation counseling, and education on management of COPD. Control group patients received usual care. The groups were compared after 18 years regarding the incidence of COPD, decline in lung function, and mortality of COPD. COPD incidence was lower in the intervention group than in the control group (10% vs 16%, <0.05). A decline in lung function was also significantly delayed in the intervention group compared to the control group of COPD and high-risk patients. The intervention group showed significant improvement in smoking cessation compared with the control group, and smokers in the intervention group had lower smoking indices than in the control group (350 vs 450, <0.05). The intervention group also had a significantly lower cumulative COPD-related death rate than the control group (37% vs 47%, <0.05). A rural community-based integrated intervention is effective in reducing the incidence of COPD among those at risk, delaying a decline in lung function in COPD patients and those at risk, and reducing mortality of COPD.

NOVAS APLICAÇÕES DE SISTEMAS SFE "HOME MADE".: I. PLANTAS MEDICINAIS BRASILEIRAS

Neste trabalho, apresenta-se uma visão geral da evolução do uso da SFE (extração com fluido supercrítico) na análise de plantas medicinais brasileiras dentro das pesquisas desenvolvidas pelo Laboratório de Cromatografia do IQSC-USP. Utilizou-se como fluido extrator o CO2, puro ou modificado com solventes de polaridade baixa a alta (pentano, solventes halogenados, álcoois, água), para a extração seletiva de princípios ativos de Maytenus aquifolium ("espinheira santa") e Mikania glomerata ("guaco"), respectivamente contendo triterpenos e cumarina. Os extratos obtidos por SFE foram analisados por CGAR (cromatografia gasosa de alta resolução), CLAE-DAD (cromatografia líquida de alta eficiência com detector" photodiodearray") ou CCD (cromatografia de camada delgada). A SFE forneceu resultados similares ou melhores do que os obtidos com métodos convencionais de extração (Soxhlet, maceração, etc), indicando o potencial uso da SFE para análise e/ou produção de preparações contendo estas plantas medicinais.

NOVAS APLICAÇÕES DE SISTEMAS SFE" HOME MADE".: II. PLANTAS DA AMÉRICA DO SUL

O Laboratório de Cromatografia do IQSC-USP tem desenvolvido pesquisas em conjunto com outros grupos de pesquisa do Brasil e da América Latina, visando a futura implantação da SFE (extração com fluido supercrítico) nestes laboratórios. No presente trabalho, apresenta-se alguns dos resultados obtidos na cooperação com pesquisadores do Chile e da Venezuela, direcionados para a SFE de substâncias de potencial interesse econômico, princípios ativos ou substâncias tóxicas: triglicerídeos, ácidos graxos, flavonóides, alcalóides, etc. Foram estudadas plantas nativas do Chile e da Venezuela, algumas delas nunca estudadas por métodos fitoquímicos convencionais e pertencentes a várias famílias vegetais: Leguminosae, Chrysobalanaceae, Annonnaceae, etc. O uso da SFE em conjunto com CGAR-EM (cromatografia gasosa de alta resolução - espectrometria de massas) ou CLAE-DAD (cromatografia líquida de alta eficiência com detector" photodiodearray") permitiu a identificação de algumas substâncias presentes em baixa concentração, a partir de pequenas quantidades de material vegetal; estes dados são de grande importância para a caracterização química das espécies estudadas.

NOVAS APLICAÇÕES DE SISTEMAS SFE "HOME MADE": III. ENERGIA QUÍMICA E ELÉTRICA

Este trabalho apresenta três aplicações da SFE com diferentes fluídos supercríticos, matrizes e sistemas de extração. Um sistema estático "home made" foi utilizado na pesquisa de fontes alternativas de insumos químicos e energéticos tais como o bagaço de cana-de-açucar e o carvão mineral. Foram usados, respectivamente, o etanol (sem e com catalisador) e o tolueno como fluídos extratores e hidrogênio como gás de pressurização. Na extração dos contaminantes do óleo mineral adsorvidos em bauxita, foi utilizado o dióxido de carbono como fluído extrator em um sistema "home made"/dinâmico. Estudos visando a maximização do rendimento de alguns dos processos também foram realizados, utilizando o planejamento fatorial e a metodologia da superfície de resposta. Os produtos de maior interesse neste trabalho (fração de resinas), obtidos do processo de extração do bagaço de cana-de-açucar e aqueles contaminantes do óleo isolante adsorvidos em bauxita extraídos com fluídos supercríticos foram caracterizados usando cromatografia gasosa de alta resolução com detector de ionização de chama (CGAR - DIC) e cromatografia gasosa de alta resolução com detector seletivo de massas (CGAR - EM) após fracionamento por cromatografia líquida preparativa em 8 frações distintas.

NOVAS APLICAÇÕES DE SISTEMAS SFE "HOME-MADE".: IV. QUALIDADE DOS ALIMENTOS

São apresentadas algumas aplicações de um sistema "Home-Made" para Extração com Fluido Supercrítico (EFS) na análise de resíduos de pesticidas e de óleos essenciais em alimentos. Foram desenvolvidos diversos estudos com os parâmetros: temperatura, pressão, escolha e concentração de modificadores. Os resultados são apresentados para amostras de maracujá (resíduos de pesticidas organofosforados e piretróides), mel (resíduos de pesticidas organoclorados) e laranja (óleo essencial).

NOVAS APLICAÇÕES DE SISTEMAS DE PARA EXTRAÇÃO COM FLUIDO SUPERCRÍTICO (SFE)" HOME-MADE".: VI. CONTROLE DE AGROTÓXICOS EM PRODUTOS ALIMENTÍCIOS

No presente trabalho apresentamos um sistema para extração com fluido supercrítico (SFE)" home-made" utilizado em extrações de resíduos de pesticidas de diversas matrizes. Os pesticidas estudados foram extraídos usando-se como fluido extrator CO2 no estado supercrítico com ou sem modificadores. Os resultados obtidos mostraram-se mais vantajosos do que aqueles obtidos por métodos convencionais de extração.

Evaluation of total carotenoids, alpha- and beta-carotene in carrots (Daucus carota L.) during home processing

This study aims to analyze the influence of dehydration and different preparation methods during home processing related toalpha-carotene, beta-carotene and total carotenoids stability in carrots. Vitamin A values were evaluated after different treatments. Thus, carrots were submitted to steam cooking, water cooking with and without pressure, moist/dry cooking and conventional dehydration. Determination of alpha- and beta-carotenes was made by High-Performance Liquid Chromatography (HPLC) (conditions were developed by us) using spectrophotometric detection visible-UV at 470 nm; a RP-18 column and methanol: acetonitrile: ethyl acetate (80: 10: 10) as mobile phase. Total carotenoids quantification was made by 449 nm spectrophotometer. The retention of the analyzed carotenoids ranged from 60.13 to 85.64%. Water cooking without pressure promoted higher retention levels of alpha- and beta-carotene and vitamin A values, while water cooking with pressure promoted higher retention levels of total carotenoids. Dehydration promoted the highest carotenoid losses. The results showed that, among the routinely utilized methods under domestic condition, cooking without pressure, if performed under controlled time and temperature, is the best method as it reduces losses in the amount of alpha- and beta-carotene, the main carotenoids present in the carrots. Despite the significant carotenoid losses, carrots prepared through domestic methods, remain a rich source of provitamin A.

Acetic acid as an intervention strategy to decontaminate beef carcasses in mexican commercial slaughterhouse

Beef can be contaminated during the slaughter process, thus other methods, besides the traditional water washing, must be adopted to preserve meat safety. The objective of this study was to evaluate the effect of 2% acetic acid interventions on the reduction of indicator bacteria on beef carcasses at a commercial slaughterhouse in Mexico. Reduction was measured by the count of mesophilic aerobic bacteria (TPC), total coliform (TC), and fecal coliform (FC) (log CFU/ cm²). Among the different interventions tested, treatments combining acetic acid solution sprayed following carcass water washing had greater microbial reduction level. Acetic acid solution sprayed at low pressure and longer time (10-30 psi/ 60 s) reached higher TPC, TC, and FC reductions than that obtained under high pressure/ shorter time (1,700 psi/ 15 s; P<0.05). Exposure time significantly affected microbial reduction on carcasses. Acetic acid solution sprayed after carcass washing can be successfully used to control sources of indicator bacteria on beef carcasses under commercial conditions.

Assessment of carotenoids in pumpkins after different home cooking conditions

Carotenoids have antioxidant activity, but few are converted by the body into retinol, the active form of vitamin A. Among the 600 carotenoids with pro-vitamin A activity, the most common are α- and β-carotene. These carotenoids are susceptible to degradation (e.g., isomerization and oxidation) during cooking. The aim of this study was to assess the total carotenoid, α- and β-carotene, and 9 and 13-Z- β-carotene isomer contents in C. moschata after different cooking processes. The raw pumpkin samples contained 236.10, 172.20, 39.95, 3.64 and 0.8610 µg.g- 1 of total carotenoids, β-carotene, α-carotene, 13-cis-β-carotene, and 9-Z-β-carotene, respectively. The samples cooked in boiling water contained 258.50, 184.80, 43.97, 6.80, and 0.77 µg.g- 1 of total carotenoids, β-carotene, α-carotene, 13-Z-β-carotene, and 9-Z-β-carotene, respectively. The steamed samples contained 280.77, 202.00, 47.09, 8.23, and 1.247 µg.g- 1 of total carotenoids, β-carotene, α-carotene,13-Z-β-carotene, and 9-Z-β-carotene, respectively. The samples cooked with added sugar contained 259.90, 168.80, 45.68, 8.31, and 2.03 µg.g- 1 of total carotenoid, β-carotene, α-carotene, 13-Z- β-carotene, and 9-Z- β-carotene, respectively. These results are promising considering that E- β-carotene has 100% pro-vitamin A activity. The total carotenoid and carotenoid isomers increased after the cooking methods, most likely as a result of a higher availability induced by the cooking processes.

Malnourished patients on hemodialysis improve after receiving a nutritional intervention

INTRODUCTION: Malnutrition is multifactorial and may be modified by nutritional intervention. We aimed to assess the impact of an intervention on the nutritional status of malnourished hemodialysis patients and their acceptance of a non-industrialized nutritional supplement. METHODS: 18 patients were studied, they were selected from a previous nutritional assessment where nutritional risk was defined as: subjective global assessment > 15 plus one criterion for malnutrition. The following variables were assessed: anthropometric parameters, subjective global assessment, dietary intake, six-minute walking test, quality of life (SF-36), and biochemical tests. Patients were randomized to either Control or Intervention Groups. The Intervention Group received a dietetic supplement during dialysis containing 355 kcal, prepared from simple ingredients. After three months, subjects from the Control Group and other patients also considered at nutritional risk underwent the same intervention. The study groups were compared after three months, and all patients were analyzed before and after the intervention. RESULTS: Fifteen men and three women, aged 56.4 ± 15.6 years-old, nine in each group, were studied. The Intervention Group showed an improvement in the subjective global assessment (p = 0.04). There were differences in role physical and bodily pain domains of SF-36, with improvement in the Intervention Group and worsening in the Control Group (p = 0.034 and p = 0.021). Comparisons before and after intervention for all patients showed improvement in the subjective global assessment (16.18 ± 4.27 versus 14.37 ± 4.20, p = 0.04), and in the six-minute walking test (496.60 ± 132.59 versus 547.80 ± 132.48 m; p = 0.036). The nutritional supplement was well tolerated by all patients, and it did not cause side effects. CONCLUSIONS: The nutritional intervention improved the subjective global assessment and quality of life of hemodialysis patients at short-term. A global intervention by a dietitian produced specific and nonspecific positive effects in the whole group. Nutritional supplementation was feasible, palatable, and had low cost. Its clinical impact and effectiveness need to be further assessed in a larger group of patients at long-term.