Prevalence of Risk for Obstructive Sleep Apnea Syndrome and Association With Risk Factors in Primary Care

Abstract Background: Obstructive sleep apnea syndrome (OSAS) is a chronic, progressive disease with high morbidity and mortality. It is underdiagnosed, especially among women. Objective: To study the prevalence of high risk for OSAS globally and for the Berlin Questionnaire (BQ) categories, and to evaluate the reliability of the BQ use in the population studied. Methods: Observational, cross-sectional study with individuals from the Niterói Family Doctor Program, randomly selected, aged between 45 and 99 years. The visits occurred between August/2011 and December/2012. Variables associated with each BQ category and with high risk for OSAS (global) were included in logistic regression models (p < 0.05). Results: Of the total (616), 403 individuals (65.4%) reported snoring. The prevalence of high risk for OSA was 42.4%, being 49.7% for category I, 10.2% for category II and 77.6% for category III. Conclusion: BQ showed an acceptable reliability after excluding the questions Has anyone noticed that you stop breathing during your sleep? and Have you ever dozed off or fallen asleep while driving?. This should be tested in further studies with samples mostly comprised of women and low educational level individuals. Given the burden of OSAS-related diseases and risks, studies should be conducted to validate new tools and to adapt BQ to better screen OSAS.

Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Seasonal variability on the structure of sublittoral macrozoobenthic association in the Patos Lagoon estuary, southern Brazil

The aim of this study is to analyze and relate the spatial-temporal variability of macrozoobenthic assemblages to bottom characteristics and salinity fluctuations, in an estuarine shallow water region of Patos Lagoon. Monthly samples, between September 2002 and August 2003, were taken on six sampling stations (distant 90 m). Three biological samples with a 10 cm diameter corer, one sample for sediment analysis, fortnightly bottom topography measurements, and daily data of temperature and salinity were taken from each station. Two biotic and environmental conditions were identified: the first corresponding to spring and summer months, with low macrozoobenthos densities, low values of salinity, small variations in bottom topographic level and weak hydrodynamic activity. A second situation occurred in the months of fall and winter, which showed increased salinity, hydrodynamics and macrobenthos organisms. These results which contrast with previous studies carried out in the area, were attributed to failure in macrozoobenthos recruitments during summer period, especially of the bivalve Erodona mactroides Bosc, 1802 and the tanaid Kalliapseuses schubartii Mañe-Garzón, 1949. This results showed that recruitments of dominant species were influenced by salinity and hydrodynamic conditions.

A vegetação no município de Ilhéus Estado da Bahia: IV - Caracaterísticas analíticas e periodicidade sociológica

It is well-known that diverse groups of vegetation with an analogous but not identical floristic composition show an ecological similarity which leads to a determined type of vegetation. Starting from this fact it becomes evident that the scope of phytosociological work is the establishing of the significance of the species within the association and the discovery of the rules which govern associations. The floristic surveys made in the field have to be analysed statistically so as to obtain satisfactory results. The usefulness of this method depends largely on the possibilities of comparing the results with previous studies of the same kind, in the same country, or elsewhere. The method used in this paper is that of measuring circumferences and counting individuals in the different associations studied because it permits the presentation of the results in tables which show the phytosociological complexity of the Brazilian rain-forests. The classical method of characteristics is valuable because the more evolved an association is the less sociable are the species it contains, so that such groups do not show clear differences between species but rather between sinusia or strata of individuals. Five tables are presented in which several of the qualitative and quantitative characteristics are studied with a view to discussing their value in relation to groups and species. They are: I - Abundance (number of individuals). II - Density (distance in meters between the individuals belonging to each stratum). III - Basal coverture (circles measured in square meters of the mean projection of the individuals on the surface). IV - Basal area (mean circle in square meters occupied by individuals on the surface). V - Frequency, abundance and sociability in relation to occurrence. TABLE I. This table indicates first the number of individuals in relation to the sinusia studied: next, the sum total of the individuals belanging to the strata are given for each association, thus providing the numeric value of the sinusia: finally, the relation between the total number of individuals in the association and the total for the sinusium thus fursnishing the abundance per sinusium, in the classic sence, that is the percentage, or rather the relative number, of the elements which compose the group. CONCLUSIONS. The general character of abundance of the regional vegetation of Ilheos may be summed up in the following way: as an association evolves towards permanent equilibirum the number of individuals the inferior strata diminishes in relation to those of the superior strata which increase. For the shrub sinusium, two important facts were observed: a) in a given association the number of elements of the inferior strata diminishes as the diameter of the individuals increases; b) the percentage of individuals belonging to the shrub sinusium in the sere diminishes as the association evolve. In the subarboreal sinusium it is seen that: in the sere the number of subarboreal individuals does not vary much; whereas in the climax or the prisere there is a fall owing to the equilibrum of the biologic forms. In the arboreal sinusium the following conclusion can be deduced from analogous facts: the number of individuals of the lower strata diminishes as circumference increases. Also, in the sere there is a progressive sequence for the individuals belonging to the superior strata. TABLE II. The relation between the mean distances of individuals belonging to the same stratum and the area of an association is equal to the density. The table shows that the mean density of the association and the distance between the individuals belonging to the strata of the same sinusium in relation to the total number of individuals belonging to the association. CONCLUSIONS. As rule, the density of individuals in the associations studied follows a very general character or at least a regional one: the distance between the individuals in the diverse strata varies according to their abundance and sociability. Two other facts of some sociological importance are: a) in identical strata of the same sere the density of individuals oscillates in an analogous manner in teh subclimaces and varies in the stages which have reached equilibrium. b) the density of individuals varias in accordance with the sinusium and the distances between individuals of the same sinusium varg in accordance with the strata. TABLE III. This table presents the mean basal individual coverture, that is the mean projection of the frond of the various individuals belonging to the same stratum. The means were obtained by measurement in the field, of 100 individuals belonging to each stratum and their projection on the surface. In the latoratory these measurements were converted into mean circles (in square meters) and the result was multiplied by the individuals belonging to the strata corresponding to the sinusium of each association. The result obtained is named basal coverture. CONCLUSIONS. As a rule, the basal coverture of the vegetation of the county of Ilhéus indicates that: in the evolution of the vegetation the basal coverture of the arbustive sinusium diminishes progressively whereas that of the arboreal one increases. The special norms obtained are: 1) in the shrub sinusium the basal coverture seems to follow a uniform norm, that is, in stages of evolution of the subclimax the basal coverture oscillates with a certain uniformity. 2) in the subarboreal sinusium this fact is related to the vitality and age of the species, as in the subclimax the number of young trees is large and the vitality of the species very variable. This permits the conclusion that: in the sere the basal coverture increases with the evolution of the vegetation and diminishes when an equilibrium is reached. 3) in the tree sinusium the climax association of the prisere and subsere seem to obey a binomial rule, as the coverture (density-abundance) increases until a determined stratum is reached and...

On the association between HLA-A1 and B5 and clinical forms of schistosomiasis mansoni

The association between both HLA-A1 and B5 antigens and chronic forms of human schistosomiasis was studied in 64 patients and 26 normal controls from a southern Brazilian hospital. No apparent correlation between the chronic forms of the disease and the expression of those antigens was detected. However, the analysis of these date together with those observed on an Egyptian sample suggests that the presence of either of the antigens and the hepatomegalic forms of schistosomiasis is significant, without heterogeneity. Converseley, the association of histocompatibility antigens with splenogegaly is consistent and significant only for HLA-B5, but not HLA-A1

The efficiency of Lutz, Kato-Katz and Baermann-Moraes (adapted) techniques association to the diagnosis of intestinal helmints

The association of Lutz/Kato-Katz and Lutz/Bermann-Moraes (adapted techniques was used to improve better results that ranged from 0.4 to 11 times in the search of eggs of Ascaris lumbricoides, Schistosoma mansoni, Trichiuris trichiura, Taenia sp. and larvae of Strongyloides stercoralis.

Association of Lutzomyia columbiana (Diptera: Psychodidae) with a Leishmaniasis Focus in Colombia Due to Species of the Leishmania mexicana Complex

In Colombia, Leishmania mexicana has a scattered geographical distribution and no sand fly vectors have been associated with its transmission. During the present study, the anthropophilic sand fly Lutzomyia columbiana was found to be the only species collected using diverse methods, in a small focus of Le. mexicana in the municipality of Samaniego, SW Colombia. Ecological data indicate that this sand fly species is present in both peri and intradomestic habitats, where it readily bites man. Further evidence comes from experimental itnfections of wild-caught Lu. columbiana with Le. mexicana after feeding on itnfected hamsters. Based on these results, it is suggested that this sand fly is the most likely vector in the study area, suggesting the existence of a previously unknown sand fly-parasite association.

The association of genetic markers and malaria infection in the Brazilian Western Amazonian region

Almost all individuals (182) belonging to an Amazonian riverine population (Portuchuelo, RO, Brazil) were investigated for ascertaining data on epidemiological aspects of malaria. Thirteen genetic blood polymorphisms were investigated (ABO, MNSs, Rh, Kell, and Duffy systems, haptoglobins, hemoglobins, and the enzymes glucose-6-phosphate dehydrogenase, glyoxalase, phosphoglucomutase, carbonic anhydrase, red cell acid phosphatase, and esterase D). The results indicated that the Duffy system is associated with susceptibility to malaria, as observed in other endemic areas. Moreover, suggestions also arose indicating that the EsD and Rh loci may be significantly associated with resistance to malaria. If statistical type II errors and sample stratification could be ruled out, hypotheses on the existence of a causal mechanism or an unknown closely linked locus involved in susceptibility to malaria infection may explain the present findings.

Association of human leukocyte antigen DQ1 and dengue fever in a white Southern Brazilian population

Dengue is an infectious disease of viral etiology transmitted by the mosquitoes Aedes aegypti, A. albopictus, and A. scutellaris. It can develop either as a benign form or as a severe hemorrhagic form. Previous work showed an association of the hemorrhagic form with human leukocyte antigens (HLA), suggesting a role of genetic factors in disease susceptibility. Nevertheless, data on HLA association with the classical form of the disease is scarce in literature. Sixty-four patients and 667 normal individuals, living in the state of Paraná, Southern Brazil, were used as test and control group, respectively. The patients developed the disease during a virus 1 dengue outbreak either in Maringá city in 1995 (47) or in Paranavaí city in 1999 (17). The diagnostic was confirmed through serology and/or viral culture. HLA class I and II typing was performed by the classical microlynfocitotoxicity test using monoclonal antisera and fluorobeads. Qui-square statistical analysis confirmed a positive association with HLA-DQ1 (76.6% vs 57.7%; p = 0.005243; pc = 0.026215). HLA-DR1 also presented an increased frequency in the test group, not statistically significant after p correction though (32.8% vs 15.9%; p = 0.005729; pc = 0.080206). In conclusion, genetic factors may play a role on the susceptibility to the classical dengue, virus 1, in the Brazilian population. Further independent studies should be performed in the Brazilian population to confirm these preliminary data.

Similarity between the association factor of ribosomal subunits and the protein Stm1p from Saccharomyces cerevisiae

A ribosome association factor (AF) was isolated from the yeast Sacchharomyces cerevisiae. Partial amino acid sequence of AF was determined from its fragment of 25 kDa isolated by treating AF with 2-(2-nitrophenylsulfenyl)-3-methyl-3'-Bromoindolenine (BNPS-skatole). This sequence has a 86% identity to the product of the single-copy S. cerevisiae STM1 gene that is apparently involved in several events like binding to quadruplex and triplex nucleic acids and participating in apoptosis, stability of telomere structures, cell cycle, and ribosomal function. Here we show that AF and Stm1p share some characteristics: both bind to quadruplex and Pu triplex DNA, associates ribosomal subunits, and are thermostable. These observations suggest that these polypeptides belong to a family of proteins that may have roles in the translation process.

Association of rotavirus viroplasms with microtubules through NSP2 and NSP5

Rotavirus replication and virus assembly take place in electrodense spherical structures known as viroplasms whose main components are the viral proteins NSP2 and NSP5. The viroplasms are produced since early times after infection and seem to grow by stepwise addition of viral proteins and by fusion, however, the mechanism of viropIasms formation is unknown. In this study we found that the viroplasms surface colocalized with microtubules, and seem to be caged by a microtubule network. Moreover inhibition of microtubule assembly with nocodazole interfered with viroplasms growth in rotavirus infected cells. We searched for a physical link between viroplasms and microtubules by co-immunoprecipitation assays, and we found that the proteins NSP2 and NSP5 were co-immunoprecipitated with anti-tubulin in rotavirus infected cells and also when they were transiently co-expressed or individually expressed. These results indicate that a functional microtubule network is needed for viroplasm growth presumably due to the association of viroplasms with microtubules via NSP2 and NSP5.