Excesso de peso e o risco cardiovascular em jovens seguidos por 17 anos: estudo do Rio de Janeiro

FUNDAMENTO: A adoção de medidas de prevenção primária em jovens é de potencial impacto favorável no cenário das doenças cardiovasculares. OBJETIVO: Avaliar a pressão arterial (PA) e variáveis de risco cardiovascular em jovens estratificados pelo comportamento do índice de massa corporal (IMC) obtido ao longo de 17 anos, desde a infância/adolescência (I/A). MÉTODOS: Três avaliações foram feitas em 115 indivíduos pertencentes à coorte do Estudo do Rio de Janeiro: A1:12,97 ± 1,48 anos; A2:21,90 ± 1,71 anos; A3:30,65 ± 2,00 anos e divididos em três grupos segundo o IMC nas três avaliações: Grupo N (IMC sempre normal; n=46), Grupo L (IMC variável; n=49) e Grupo S/O (IMC sempre aumentado; n=20). Em A1, A2 e A3 foram obtidos PA e IMC. Em A2 e A3, dosados glicose (G) e perfil lipídico. Ainda em A2, dosada insulina (INS) e calculado HOMA-IR. Em A3 acrescentou-se medida da circunferência abdominal (CA), relação abdômen/quadril (RAQ) e percentual de gordura corporal (%GC). RESULTADOS: 1) Grupo S/O apresentou maiores médias de PA aumentada (p<0,0001) nas três avaliações; 2) Em A3, o grupo S/O mostrou maiores médias de CA, RAQ e %GC, e maiores prevalências de CA aumentada e síndrome metabólica (SM) (p<0,0001); 3) Foram observadas maiores médias de INS, HOMA-IR, LDL-c em A2, e G, colesterol, LDL-c e triglicerídeos em A3 no grupo S/O (p<0,05); 4) Gênero masculino e S/O em A1 determinaram maior risco para a ocorrência de SM na idade adulta. CONCLUSÃO: A Presença de S/O desde a I/A associou-se a maiores valores da PA, índices antropométricos e maior prevalência de SM na fase adulta jovem.

More letters of Charles Darwin. A record of his work in a series of hitherto unpublished letters, ed. by Francis Darwin ... and A.C. Seward ...

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Nutrição mineral de hortaliças: XXXIII. acúmulo de matéria seca e de nutrientes pela cultura do jiló (Solanum gilo, cultivar morro grande oblongo)

No intuito de se obter dados básicos para estudos de adubação, plantas de jiló (Solanum gilo cultivar Morro Grande Oblongo), foram coletadas em épocas diversas, situadas em um solo Terra Roxa Estruturada, série "Luiz de Queiroz", Piracicaba. As plantas coletadas aos 30, 55, 80, 105, 130, 155 e 180 dias após a germinação receberam uma adubação fundamental de 100 g da formula 4-12-8 por cova (duas plantas). Quinze dias após aplicou-se 20 g de sulfato de amônio por cova sendo a aplicação repetida 40 dias após. O material coletado foi dividido em folhas, caule e frutos. O jiló apresenta um crescimento lento até aos 105 dias, aumentando bruscamente até ao final do ciclo. Por ocasião do florescimento as folhas apresentam a seguinte concentração em função da mate ria seca: N-4, 5%; P-0, 30%, K-2,00%; Ca-1,21%; Mg-0,22%; S-0,27%; B-50 ppm; Cu-11 ppm; Fe-774 ppm; Mn-69 ppm; Mo-0,5 ppm; Zn-22 ppm. Uma população de 25.000 plantações/ha extrae aos 180 dias (folha + caule + frutos): N-154 kg; P-16 kg; K-164 kg; Ca-60 kg; Mg-20 kg; S-14 kg; B-221 g; Cu-106 g; Fe-1118 g; Mn-490 g; Mo-7,4 g; Zn-147 g. O jilo é uma hortaliça tropical exigente em nutrientes.

Silurian Ischadites tenuis n.sp. (Receptaculitids) from Indiana / Matthew H. Nitecki -- and Charles C. Dapples --.

v.35:no.2(1975)

Estudo comparativo das inclusões do alastrim e da variola vera

Resulta das descripções e documentos examinados que as inclusões cytoplasmaticas da variola vera, no material humano examinado, apresentam caracteres geraes que poderão ser assim resumidos: 1. intensa coloração pela safranina nos preparados pelo methodo de Unna modificado (Fig. 42), mostrando a inclusão matiz semelhante ao dos nucleolos da mesma cellula. 2. reacção predominantemente acidophila nos preparados pela hematoxylina-eosina, traduzida pela tonalidade rosea ou vermelha de coloração (Figs. 27, 29, 30, 31 e 31). 3. frequente multiplicidade de inclusões de fórma e dimensões variadas na mesma cellula (Figs. 29 e 30), as maiores inclusões (Figs. 29 e 32), sendo menores que as grandes inclusões cytoplasmaticas solitarias do alastrim (Figs. 15, 16 e 18). É a regra, ainda, observar-se desapparecimento de qualquer estructura no cytoplasma das cellulas com inclusões em zona muito extensa, tornando-se difficil explicar tal aspecto unicamente pela retracção das inclusões no acto da fixação (Figs. 31 e 32). Quanto ás inclusões intranucleares, ellas se apresentam sob tres aspectos, dois dos quaes bem reconhecidos por Luger e Lauda (1926). Em um primeiro aspecto, o nucleo conserva, em parte, o reticulo de linina e encerra uma massa irregular (Fig. 35) ou, então, pequenas massas e granulos de dimensões variaveis (Figs. 33 e 34) constituidos por material acidophilo que ali não existe em condições normaes. A membrana nuclear tem espessura visinha do normal. Em um segundo aspecto, a inclusão occupa a totalidade do nucleoplasma (Fig. 3), apenas separado da membrana nuclear, em alguns casos (Fig. 38), por um estreito espaço claro (zona de retracção). Por vezes apresenta um aspecto homogeneo (Fig. 37); outras vezes a inclusão mostra pequenas areas chromophobas ( Fig. 38). A hyperchromatose da membrana nuclear é accentuada, tanto neste como no aspecto seguinte. No terceiro aspecto (aspecto corpuscular) (Figs. 39, 40, 48 e 50), a inclusão intranuiclear é formada por um ou mais corpusculos acidophilos, de contornos muito nitidos e fórma regular, ora ovoide, ora espherica. No interior de cada corpusculo, apparecem zonas chromophobas multiplas, sendo ordinariamente uma maior que as outras (Figs. 39, 40, 48 e 50). Fóra desses corpusculos, o nucleoplasma contem, por vezes material menos intensamente corado pelo eosina ou pela safranina (Figs. 40). O reticulo de linina, porém, acha-se completamente desapparecido, e não raro se observa, em torno dos corpusculos acidophilos, uma zona algum tanto extensa de nucleoplasma sem nenhuma estructura apparente (Fig. 48, á direita). Frisamos o modo peculiar de se comportar o nucleolo nas cellulas epidermicas com inclusões intranucleares da variola. Recalcado, a principio, de encontro á membrana nuclear (Fig. 36), elle em seguida é englobado pela propria membrana nuclear, parecendo incluso nessa estructura (Figs. 37, 35, 38 e 48, á direita). A « marginação » do nucleolo, e o seu englobamento ou inclusão na membrana nuclear, bem como o terceiro aspecto que descrevemos, de corpusculos intranucleares esphericos ou ovoides com zonas chromophobas, são caracteres que differenciam, de modo nitido, as inclusões intranucleares da variola vera da das demais inclusões das doenças de virus. Nem sempre, porém, os aspectos encontrados podem ser incluidos, com facilidade, em um dos tres grupos atraz mencionados, o que indica a existencia de phases de transição entre elles. Tal como assignalou Ewing, as cellulas epidermicas com inclusões intranucleares são geralmente as attingidas pela « ballonierende Degeneration ». Em geral taes elementos revestem o fundo da vesicula, ás vezes formando uma unica camada, e representando tudo o que resta da epiderme. Comtudo, em nosso material, conseguimos encontrar inclusões intranucleares em cellulas espinhosas do corpo mucoso de Malpighi que ainda conservaram relações normaes com os elementos contiguos e não eram attingidas pela « ballonierende Degeneration ». Em taes inclusões é que, de preferencia, observamos o aspecto de granulos mencionado no grupo I (Fig. 34). A hyperchromatose da membrana nuclear é, então, pouco notavel, constratando como o grau pronunciado que apresenta nos dois outros aspectos. Existiam, ellas em «lambeaux » epitheliaes, presos em certos pontos, por extreito pediculo, á camada basal, no fundo da vesicula.

Distribuição temporal de perfis eletrofocéticos de Acido nucleico de rotavírus em fezes de crianças em Belém, Pará

Amostras de rotavírus provenientes de crianças habitantes na periferia de Belém, Pará, foram analisadas por eletroforese em gel de policrilamida (PAGE). As bandas correspondentes aos 11 segmentos de ARN foram detectadas em 46 (76,7%) das 60 amostras de rotavírus. Das amostras classificadas 5 (109%) foram relativas ao subgrupo I, 41 (89,1%) ao subgrupo II e, em 23,3%) não foi possível classificação face a ausência das bandas 10 e 11. As amostras de rotavírus sub-grupo II e codificadas como "1N2L" foram as mais freqüentes, ocorrendo em 30 (65,2%) das 46 classificadas.

Direct analysis of peptide binding to cell-associated MHC class I molecules.

Exogenously added synthetic peptides can mimic endogenously produced antigenic peptides recognized on target cells by MHC class I-restricted cytolytic T lymphocytes. While it is assumed that exogenous peptides associate with class I molecules on the target cell surface, direct binding of peptides to cell-associated class I molecules has been difficult to demonstrate. Using a newly developed binding assay based on photoaffinity labeling, we have investigated the interaction of two antigenic peptides, known to be recognized in the context of H-2Kd or H-2Db, respectively, with 20 distinct class I alleles on living cells. None of the class I alleles tested, with the exception of H-2Kd or H-2Db, bound either of the peptides, thus demonstrating the exquisite specificity of peptide binding to class I molecules. Moreover, peptide binding to cell-associated H-2Kd was drastically reduced when metabolic energy, de novo protein synthesis or protein egress from the endoplasmic reticulum was inhibited. It is thus likely that exogenously added peptides do not associate with the bulk of class I molecules expressed at the cell surface, but rather bind to short-lived molecules devoid of endogenous peptides.

Protective effects of hypercapnic acidosis on ventilator-induced lung injury.

To investigate whether respiratory acidosis modulates ventilator-induced lung injury (VILI), we perfused (constant flow) 21 isolated sets of normal rabbit lungs, ventilated them for 20 min (pressure controlled ventilation [PCV] = 15 cm H(2)O) (Baseline) with an inspired CO(2) fraction adjusted for the partial pressure of CO(2) in the perfusate (PCO(2) approximately equal to 40 mm Hg), and then randomized them into three groups. Group A (control: n = 7) was ventilated with PCV = 15 cm H(2)O for three consecutive 20-min periods (T1, T2, T3). In Group B (high PCV/normocapnia; n = 7), PCV was given at 20 (T1), 25 (T2), and 30 (T3) cm H(2)O. The targeted PCO(2) was 40 mm Hg in Groups A and B. Group C (high PCV/hypercapnia; n = 7) was ventilated in the same way as Group B, but the targeted PCO(2) was approximately equal to 70 to 100 mm Hg. The changes (from Baseline to T3) in weight gain (Delta WG: g) and in the ultrafiltration coefficient (Delta K(f) = gr/min/ cm H(2)O/100g) and the protein and hemoglobin concentrations in bronchoalveolar lavage fluid (BALF) were used to assess injury. Group B experienced a significantly greater Delta WG (14.85 +/- 5.49 [mean +/- SEM] g) and Delta K(f) (1.40 +/- 0.49 g/min/cm H(2)O/100 g) than did either Group A (Delta WG = 0.70 +/- 0.43; Delta K(f) = 0.01 +/- 0.03) or Group C (Delta WG = 5.27 +/- 2.03 g; Delta K(f) = 0.25 +/- 0.12 g/min/cm H(2)O/ 100 g). BALF protein and hemoglobin concentrations (g/L) were higher in Group B (11.98 +/- 3.78 g/L and 1.82 +/- 0.40 g/L, respectively) than in Group A (2.92 +/- 0.75 g/L and 0.38 +/- 0.15 g/L) or Group C (5.71 +/- 1.88 g/L and 1.19 +/- 0.32 g/L). We conclude that respiratory acidosis decreases the severity of VILI in this model.

Anaplastic astrocytoma in adults.

Anaplastic astrocytoma is an uncommon disease in the adult population. Prognosis is influenced by age, symptom duration, mental status and Karnofsky performance status. A truly complete resection, which is a recognized independent prognostic factor, is not possible and recurrence in the surgical cavity is common. Based on randomized data available, chemotherapy has consistently failed to improve the outcome of patients with anaplastic astrocytoma, while a meta-analysis showed a small, but significant improvement in survival favouring the use of chemotherapy. Outside a clinical trial, postoperative radiotherapy (30 x 2 Gy) remains the standard adjuvant therapy for most patients. For elderly patients, the application of treatment is usually based on performance status and neurological function. In recurrent disease, chemotherapy with temozolomide has been proven to be active and well-tolerated in phase II trials, but no comparative phase III trials of other cytotoxic drugs have been conducted.

Anti-TNF Therapy in the Swiss Inflammatory Bowel Disease G8 Cohort

Background: A nti-TNF d rugs (Infliximab (IFX), Adalimumab (ADA), Certolizumab pegol (CZP)) are effective in inducing and maintaining response a nd remission in i nflammatory bowel disease (IBD). Insufficient response or side effects may lead to a switch o f the anti-TNF d rug. W e aimed to e valuate the frequency and reasons for anti-TNF switches. Methods: Analysis of data from the Swiss Inflammatory Bowel Disease Cohort (SIBDCS). Eighty percent of included patients were recruited in hospitals and 20% from private practice. Results: From 2,058 patients ( 1,172 with Crohn's disease (CD), 842 with ulcerative colitis (UC) and 44 with indeterminate colitis (IC)), 772 received at least one anti-TNF. Forty-eight % of patients w ith CD, 23% with U C, a nd 30% with IC w ere ever treated with an anti-TNF drug. There was no gender difference with respect to the frequency of a nti-TNF treatment. A total of 584 patients (76%) were treated with one, 142 (18%) with two, and 46 (6%) with three anti-TNF (of which 32 were female). A total of 89% patients were treated with IFX, 28% ADA and 13% with CZP. Overall response rate (defined as drop in CDAI >100 points) to anti-TNF was 50%, with best response rates for the first used anti-TNF. Reasons t o switch t he anti-TNF w ere in 11% a primary non-response, in 38% a loss of response and in 36% anti-TNF s ide effects o r intolerance ( reasons for 15% of treatment failures not documented). Conclusion: A nti-TNF d rugs were used in h alf of the CD patients a nd in o ne quarter of U C patients. Anti-TNF d rug switch d ue to insufficient response a nd/or side effects w as necessary in one quarter of IBD patients. IFX was mainly used as first-line therapy. Best response rates were observed for the first used anti-TNF. Following analyses will identify risk median treatment duration as well as risk factors for anti-TNF switch.

Molecular determinants for membrane association of the hepatitis C virus NS2 protease domain

Background: Hepatitis C virus (HCV) nonstructural protein 2 (NS2) plays essential roles in particle assembly and polyprotein processing. It harbors an N-terminal membrane domain comprising three putative transmembrane s egments ( amino acids [aa] 1-93) a nd a C-terminal cysteine protease domain (aa 94-217). Given that the latter has been predicted to be membrane-associated, we aimed to identify molecular determinants for membrane association of the NS2 protease domain. Methods: A comprehensive panel of NS2 deletion constructs was analyzed by fluorescence microscopy, selective membrane extraction, and m embrane flotation assays. Candidate aa r esidues involved in membrane association were substituted by site-directed mutagenesis. Results: The NS2 protease domain alone was found to associate with membranes. Two N-terminal α-helices comprising aa 102-114 and aa 123-136 were found to m ediate this a ssociation, w ith c onserved hydrophobic and positively charged aa residues representing the key determinants. I nterestingly, m utagenesis analyses r evealed that electrostatic interactions involving a positively charged aa residue in α-helix aa 123-136 are required for membrane association. Mono- and bicistronic (i.e. NS2 c leavage-independent) HCV constructs were prepared to i nvestigate the effect o f these substitutions on RNA replication and infectious viral particle formation. Conclusions: T he NS2 protease d omain itself harbors m olecular determinants for membrane association within α-helices aa 102-114 and aa 1 23-136 which may contribute to p roper p ositioning of t he active site. These results provide new insights i nto the membrane topology and t he p oorly understood f unction of t his essential viral protease.

Brain-derived neurotrophic factor enhances the expression of the monocarboxylate transporter 2 through translational activation in mouse cultured cortical neurons.

MCT2 is the predominant neuronal monocarboxylate transporter allowing lactate use as an alternative energy substrate. It is suggested that MCT2 is upregulated to meet enhanced energy demands after modifications in synaptic transmission. Brain-derived neurotrophic factor (BDNF), a promoter of synaptic plasticity, significantly increased MCT2 protein expression in cultured cortical neurons (as shown by immunocytochemistry and western blot) through a translational regulation at the synaptic level. Brain-derived neurotrophic factor can cause translational activation through different signaling pathways. Western blot analyses showed that p44/p42 mitogen-activated protein kinase (MAPK), Akt, and S6 were strongly phosphorylated on BDNF treatment. To determine by which signal transduction pathway(s) BDNF mediates its upregulation of MCT2 protein expression, the effect of specific inhibitors for p38 MAPK, phosphoinositide 3-kinase (PI3K), mammalian target of rapamycin (mTOR), mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) kinase (MEK), p44/p42 MAPK (ERK), and Janus kinase 2 (JAK2) was evaluated. It could be observed that the BDNF-induced increase in MCT2 protein expression was almost completely blocked by all inhibitors, except for JAK2. These data indicate that BDNF induces an increase in neuronal MCT2 protein expression by a mechanism involving a concomitant stimulation of PI3K/Akt/mTOR/S6, p38 MAPK, and p44/p42 MAPK. Moreover, our observations suggest that changes in MCT2 expression could participate in the process of synaptic plasticity induced by BDNF.

Towards standardization of UV eye protection: what can be learned from photodermatology?

While knowledge about standardization of skin protection against ultraviolet radiation (UVR) has progressed over the past few decades, there is no uniform and generally accepted standardized measurement for UV eye protection. The literature provides solid evidence that UV can induce considerable damage to structures of the eye. As well as damaging the eyelids and periorbital skin, chronic UV exposure may also affect the conjunctiva and lens. Clinically, this damage can manifest as skin cancer and premature skin ageing as well as the development of pterygia and premature cortical cataracts. Modern eye protection, used daily, offers the opportunity to prevent these adverse sequelae of lifelong UV exposure. A standardized, reliable and comprehensive label for consumers and professionals is currently lacking. In this review we (i) summarize the existing literature about UV radiation-induced damage to the eye and surrounding skin; (ii) review the recent technological advances in UV protection by means of lenses; (iii) review the definition of the Eye-Sun Protection Factor (E-SPF®), which describes the intrinsic UV protection properties of lenses and lens coating materials based on their capacity to absorb or reflect UV radiation; and (iv) propose a strategy for establishing the biological relevance of the E-SPF.

Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level.

BACKGROUND: During stress, vasopressin is a potent synergistic factor of CRH as a hypothalamic stimulator of the HPA axis. The measurements of CRH and vasopressin levels are cumbersome because of their instability and short half-life. Copeptin is a more stable peptide stoichiometrically released from the same precursor molecule. The aim of our study was to compare copeptin and cortisol levels in different stress situations. METHODS: Three groups of patients with increasing stress levels were investigated: a) healthy controls without apparent stress (n=20), b) hospitalized medical patients with moderate stress (n=25) and c) surgical patients 30 minutes after extubation, with maximal stress (n=29). In all patients we assessed cortisol and copeptin levels. Copeptin levels were measured with a new sandwich immunoassay. RESULTS: Cortisol levels in controls were (median, IQ range, 486 [397-588] nmol/L), not significantly different as compared to medical patients (438 [371-612] nmol/L, p=0.69). Cortisol levels in surgical patients after extubation were higher (744 [645-1062] nmol/L p<0.01 vs controls and medical patients). Copeptin levels in controls were 4.3 [3.2-5.5] pmol/L, which was lower as compared to medical patients (17.5 [6.4-24.1], p<0.001) and surgical patients after extubation (67.5 [37.8-110.0] pmol/L, p<0.001). The correlation between copeptin levels and cortisol was r=0.46, p<0.001. CONCLUSION: Copeptin is a novel marker of the individual stress level. It more subtly mirrors moderate stress as compared to cortisol values.