Situationella faktorer i sexuellt utnyttjande av barn modererar effekten på hälsoriskbeteenden : en metaanalys

Sexuellt utnyttjande av barn har ett samband med en högre risk att uppvisa hälsoriskbeteenden, men det är oklart huruvida sambandet modereras av situationella faktorer såsom barnets ålder vid första utnyttjandet, mängden utnyttjande, användning av fysiskt våld, intra- eller extrafamiliär förövare och förekomst av penetration. För att undersöka detta genomfördes en metaanalys, där effekterna på hälsoriskbeteendena alkohol- och drogmissburk, stört ätbeteende och självskadebeteende undersöktes. Empiriska studier skrivna på engelska, som gav tillräckliga data gällande förhållandet mellan nämnda situationella faktorer och hälsoriskbeteenden inkluderades i metaanalysen. Litteratursökningen resulterade i 47 studier, med ett totalt sampel på 19555 individer som utnyttjats sexuellt före 18 års ålder. Små till medelstora modererande effekter hittades för användning av fysiskt våld (r = 0,252; 95 % CI [0,155; 0,345]), mängd (r = 0,107; 95 % CI [0,051; 0,162]) och penetration (r = 0,122; 95 % CI [0,075; 0,169]), där förekomsten av dessa variabler har ett samband med högre risk att uppvisa hälsoriskbeteenden. Effekten av användning av fysiskt våld var endast signifikant för självskadebeteenden. Effekten av mängd och penetration var signifikant för alkohol- och drogmissbruk och självskadebeteenden. Inga effekter hittades för barnets ålder vid första utnyttjandet eller intra- eller extrafamiliär förövare. I föreliggande studie understryks vikten av att ta situationella faktorer i beaktande vid forskning kring sexuellt utnyttjande av barn.

Influence of gender on psychomotor vigilance task performance by adolescents

During adolescence, the sleep phase delay associated with early school times increases daytime sleepiness and reduces psychomotor performance. Some studies have shown an effect of gender on psychomotor performance in adults and children. Males present faster reaction times (RT) compared with females. The aim of the present study was to evaluate the influence of gender on Palm psychomotor vigilance task (PVT) performance in adolescents. Thirty-four adolescents (19 girls, 13 to 16 years old) attending morning school classes of a public school in Curitiba, PR, Brazil, participated in the study. Sleep patterns were measured using actigraphy and sleepiness data were accessed with the Karolinska Sleepiness Scale (KSS). KSS and PVT measurements were collected at two times in the morning (8:00 and 11:00 h). The data were compared using one-way ANOVA, considering gender as a factor. ANOVA indicated that gender did not affect sleep patterns and subjective somnolence; however, a statistically significant effect of gender was detected for PVT performance. Boys presented faster RT (RT-PVT1: 345.51 ms, F = 6.08, P < 0.05; RT-PVT2: 343.30 ms, F = 6.35, P < 0.05) and fewer lapses (lapses-PVT1: 8.71, F = 4.45, P < 0.05; lapses-PVT2: 7.82, F = 7.06, P < 0.05) compared with girls (RT-PVT1: 402.96; RT-PVT2: 415.70; lapses-PVT1: 16.33; lapses-PVT2: 17.80). These results showed that this effect of gender, already reported in adults and children, is also observed in adolescents. The influence of gender should be taken into account in studies that use Palm PVT to evaluate psychomotor performance in this age range.

Effect of a cholesterol-rich diet on the metabolism of the free and esterified cholesterol components of a nanoemulsion that resembles LDL in rabbits

We have shown that the free cholesterol (FC) and the cholesteryl ester (CE) moieties of a nanoemulsion with lipidic structure resembling low-density lipoproteins show distinct metabolic fate in subjects and that this may be related to the presence of dyslipidemia and atherosclerosis. The question was raised whether induction of hyperlipidemia and atherosclerosis in rabbits would affect the metabolic behavior of the two cholesterol forms. Male New Zealand rabbits aged 4-5 months were allocated to a control group (N = 17) fed regular chow and to a 1% cholesterol-fed group (N = 13) during a 2-month period. Subsequently, the nanoemulsion labeled with ³H-FC and 14C-CE was injected intravenously for the determination of plasma kinetics and tissue uptake of the radioactive labels. In controls, FC and CE had similar plasma kinetics (fractional clearance rate, FCR = 0.234 ± 0.056 and 0.170 ± 0.038 h-1, respectively; P = 0.065). In cholesterol-fed rabbits, the clearance of both labels was delayed and, as a remarkable feature, FC-FCR (0.089 ± 0.033 h-1) was considerably greater than CE-FCR (0.046 ± 0.010 h-1; P = 0.026). In the liver, the major nanoemulsion uptake site, uptake of the labels was similar in control animals (FC = 0.2256 ± 0.1475 and CE = 0.2135 ± 0.1580%/g) but in cholesterol-fed animals FC uptake (0.0890 ± 0.0319%/g) was greater than CE uptake (0.0595 ± 0.0207%/g; P < 0.05). Therefore, whereas in controls, FC and CE have similar metabolism, the induction of dyslipidemia and atherosclerosis resulted in dissociation of the two forms of cholesterol.

Candidate gene linkage analysis indicates genetic heterogeneity in Marfan syndrome

Marfan syndrome (MFS) is an autosomal dominant disease of the connective tissue that affects the ocular, skeletal and cardiovascular systems, with a wide clinical variability. Although mutations in the FBN1 gene have been recognized as the cause of the disease, more recently other loci have been associated with MFS, indicating the genetic heterogeneity of this disease. We addressed the issue of genetic heterogeneity in MFS by performing linkage analysis of the FBN1 and TGFBR2 genes in 34 families (345 subjects) who met the clinical diagnostic criteria for the disease according to Ghent. Using a total of six microsatellite markers, we found that linkage with the FBN1 gene was observed or not excluded in 70.6% (24/34) of the families, and in 1 family the MFS phenotype segregated with the TGFBR2 gene. Moreover, in 4 families linkage with the FBN1 and TGFBR2 genes was excluded, and no mutations were identified in the coding region of TGFBR1, indicating the existence of other genes involved in MFS. Our results suggest that the genetic heterogeneity of MFS may be greater that previously reported.

Prognostic significance of snail expression in hilar cholangiocarcinoma

Many patients with hilar cholangiocarcinoma (HC) have a poor prognosis. Snail, a transcription factor and E-cadherin repressor, is a novel prognostic factor in many cancers. The aim of this study was to evaluate the relationship between snail and E-cadherin protein expression and the prognostic significance of snail expression in HC. We examined the protein expression of snail and E-cadherin in HC tissues from 47 patients (22 males and 25 females, mean age 61.2 years) using immunohistochemistry and RT-PCR. Proliferation rate was also evaluated in the same cases by the MIB1 index. High, low and negative snail protein expression was recorded in 18 (38%), 17 (36%), and 12 (26%) cases, respectively, and 40.4% (19/47) cases showed reduced E-cadherin protein expression in HC samples. No significant correlation was found between snail and E-cadherin protein expression levels (P = 0.056). No significant correlation was found between snail protein expression levels and gender, age, tumor grade, vascular or perineural invasion, nodal metastasis and invasion, or proliferative index. Cancer samples with positive snail protein expression were associated with poor survival compared with the negative expresser groups. Kaplan-Meier curves comparing different snail protein expression levels to survival showed highly significant separation (P < 0.0001, log-rank test). With multivariate analysis, only snail protein expression among all parameters was found to influence survival (P = 0.0003). We suggest that snail expression levels can predict poor survival regardless of pathological features and tumor proliferation. Immunohistochemical detection of snail protein expression levels in routine sections may provide the first biological prognostic marker.

Effect of different durations of overdistention on rat bladder function and morphology

We investigated the contribution of the duration of overdistention (DOD) to rat bladder function and morphology and explored its possible molecular mechanisms. Bladder overdistention was induced in male Sprague-Dawley rats (200-250 g) by an infusion of saline. Forty rats were divided into 5 groups submitted to different DOD, i.e., 1, 2, 4, and 8 h, and control. Bladder function was evaluated by cystometry. Morphological changes were observed by light and transmission electron microscopy. Compared to control (44.567 ± 3.472 cmH2O), the maximum detrusor pressure of groups with 2-, 4- and 8-h DOD decreased significantly (means ± SEM): 32.774 ± 3.726, 31.321 ± 2.847, and 29.238 ± 3.724 cmH2O. With the increase of DOD, inflammatory infiltration and impairment of ultrastructure were more obvious in bladder tissue. Compared to control (1.90 ± 0.77), the apoptotic indexes of groups with 1-, 2-, 4-, and 8-h DOD increased significantly (6.47 ± 2.10, 10.66 ± 1.97, 13.91 ± 2.69, and 18.33 ± 3.28%). Compared to control (0.147 ± 0.031/0.234 ± 0.038 caspase 3/β-actin and Bax/Bcl-2 ratios), both caspase 3/β-actin and Bax/Bcl-2 ratios of 1-, 2-, 4-, and 8-h DOD increased significantly (0.292 ± 0.037/0.508 ± 0.174, 0.723 ± 0.173/1.745 ± 0.471, 1.104 ± 0.245/4.000 ± 1.048, and 1.345 ± 0.409/8.398 ± 3.332). DOD plays an important role in impairment of vesical function and structure. With DOD, pro-apoptotic factors increase and anti-apoptotic factors decrease, possibly contributing to the functional deterioration and morphological changes of the bladder.

Myosin light chain kinase is necessary for post-shock mesenteric lymph drainage enhancement of vascular reactivity and calcium sensitivity in hemorrhagic-shocked rats

Vascular hyporeactivity is an important factor in irreversible shock, and post-shock mesenteric lymph (PSML) blockade improves vascular reactivity after hemorrhagic shock. This study explored the possible involvement of myosin light chain kinase (MLCK) in PSML-mediated vascular hyporeactivity and calcium desensitization. Rats were divided into sham (n=12), shock (n=18), and shock+drainage (n=18) groups. A hemorrhagic shock model (40±2 mmHg, 3 h) was established in the shock and shock+drainage groups. PSML drainage was performed from 1 to 3 h from start of hypotension in shock+drainage rats. Levels of phospho-MLCK (p-MLCK) were determined in superior mesenteric artery (SMA) tissue, and the vascular reactivity to norepinephrine (NE) and sensitivity to Ca2+ were observed in SMA rings in an isolated organ perfusion system. p-MLCK was significantly decreased in the shock group compared with the sham group, but increased in the shock+drainage group compared with the shock group. Substance P (1 nM), an agonist of MLCK, significantly elevated the decreased contractile response of SMA rings to both NE and Ca2+ at various concentrations. Maximum contractility (Emax) in the shock group increased with NE (from 0.179±0.038 to 0.440±0.177 g/mg, P<0.05) and Ca2+ (from 0.515±0.043 to 0.646±0.096 g/mg, P<0.05). ML-7 (0.1 nM), an inhibitor of MLCK, reduced the increased vascular response to NE and Ca2+ at various concentrations in the shock+drainage group (from 0.744±0.187 to 0.570±0.143 g/mg in Emax for NE and from 0.729±0.037 to 0.645±0.056 g/mg in Emax for Ca2+, P<0.05). We conclude that MLCK is an important contributor to PSML drainage, enhancing vascular reactivity and calcium sensitivity in rats with hemorrhagic shock.

Estudo da composição química de flocos de cereais com ênfase nos teores de fenilalanina

Foi estudada a composição química e o teor de fenilalanina em 13 tipos de flocos de cereais produzidos no país e disponíveis no comércio de São Paulo. Todos os produtos contêm elevado teor de carboidratos totais, superior a 77%, fornecendo no mínimo 345 kcal/100g. Os seus teores protéicos (Nx5,7) são variáveis e se situam entre 3,8 e 7,3%. Os teores de fenilalanina variam entre 224 e 451 mg/100g de produto, sendo os valores mais baixos encontrados nos cereais com o menor teor protéico, que correspondem aos flocos de milho com maior concentração de açúcar. Através da análise de aminoácidos, foram encontrados em média 5,96g de fenilalanina/100g de aminoácidos recuperados. As diferenças em torno desta média não foram estatisticamente significativas e mostraram-se independentes do cereal que deu origem aos produtos. Houve correlação linear entre o teor de nitrogênio (micro-Kjeldahl) e a concentração de fenilalanina nas amostras (coef. correl. 0,9887) o que permite estimar o teor de fenilalanina unicamente a partir da análise de nitrogênio, adotando o teor de 5,96g de fenilalanina/100g aminoácidos. Os cálculos resultaram nos teores de fenilalanina dos 13 produtos, que não diferiram estatisticamente dos obtidos pela análise de aminoácidos.

Utilização de mostos concentrados na produção de cervejas pelo processo contínuo: novas tendências para o aumento da produtividade

O presente trabalho avaliou a produtividade volumétrica em etanol durante a fermentação de mostos com elevadas concentrações de extrato original, para a produção de cerveja pelo processo contínuo, utilizando as leveduras imobilizadas em bagaço de malte. Os mostos com diferentes concentrações de extrato original (14,3 ºP, 15,2 ºP e 19,6 ºP) foram preparados a partir de um mosto de 22 ºP elaborado com malte e adjunto de alta maltose em uma relação adjunto: malte de 1:2,8. As fermentações foram conduzidas em um reator de coluna de bolhas, a 15 ºC, empregando uma taxa de diluição de 0,04 h-1 e um fluxo constante de gases de 250 mL/min (200 mL/min de CO2 e 50 mL/min de ar). De acordo com os resultados, a produtividade volumétrica em etanol aumentou quando a concentração de extrato original do mosto foi aumentada, sendo o valor máximo (2,09 g.L-1.h-1) obtido para o mosto de 19,6 ºP. Esse valor representa um aumento de 345% quando comparado com a produtividade (0,47 g.L-1.h-1) da fermentação descontínua de um mosto de 20 ºP. Conclui-se, então, que o processo contínuo de fermentação de mostos com elevadas concentrações de extrato para a produção de cerveja permite obter expressivos ganhos na produtividade em etanol quando comparado ao processo descontínuo.

Pohjavesiensuojelun ja kiviaineshuollon yhteensovittaminen : Uudenmaan ja Itä-Uudenmaan loppuraportti

Pohjavesien suojelun ja kiviaineshuollon yhteensovittamista (POSKI-projekti) selvitettiin Uudenmaan ja Itä-Uudenmaan maakunnissa vuosina 1998 - 2004. Tavoitteena oli turvata geologisen luonnon ympäristöarvot, hyvälaatuinen pohjavesi yhdykuntien vesihuoltoon sekä laadukkaiden kiviainesten saanti yhdyskuntarakentamiseen. Selvitysalueella on 520 pohjavesialuetta, joista vedenhankintakäytössä on 345 kappaletta. Niiden arvioitu antoisuus on noin 248 000 m3/d. Käyttämättömiä vedenhankintaan soveltuvia pohjavesivaroja selvitysalueella on 99 pohjavesialueella noin 33 000 m3/d. Normaaliolosuhteissa pohjavesivarat riittävät tyydyttämään alueen tarpeen. Selvitysalueen pohjavesialueet kuuluvat kuitenkin riskialtteimpiin Suomessa. Poikkeusolosuhteiden tai mahdollisten vedenottamoiden likaantumistapausten varalta korvaavat pohjavesivarat ovat pienet ja vaikeasti hyödynnettävät. Selvitysalueen pohjavesipinnan yläpuoliset hiekka-ja soravarat ovat yhteensä noin 1 770 milj.k-m3. Näistä suurin osa sijaitsee alueilla, jotka eivät selvitystyön perusteella sovellu maa-ainesten ottoon. Maa-ainesten ottoon soveltuvilla ja osittain soveltuvilla alueilla arvioidaan olevan hiekka-ja soravaroja noin 64 milj.k-m3:ksi. Nämä ovat laadultaan valtaosaltaan hiekkaa. Soraa ja karkeampaa ainesta tästä on alle 15 milj. k-m3, mikä nykyisillä harjukiviainesten käyttömäärillä vastaa vajaan neljän vuoden tarvetta. Käytännössä selvitysalueen hiekka- ja soravarat eivät ole enää pitkään aikaan riittäneet tyydyttämään tarvetta, vaan sorajalosteita on tuotu Etelä-Hämeestä. Selvitysalueen tutkitut kalliokiviainesvarat maanpinnan 0-tasoon laskettuna ovat noin 2 520 milj.k-m3. Tästä määrästä maa-ainesten ottoon soveltuvilla alueilla on reilut 420 milj.k-m3 ja 10 m maanpinnan 0-tason alapuolelle laskettuna reilut 700 milj.k-m3. Tulosten perusteella näyttää siltä, että merkittävä osa alueen kiviaineshuollosta voidaan vielä järjestää kalliokiviaineksiin perustuen, mikäli kiviaineshuolto huomioidaan aikaisempaa tarkemmin maankäytön suunnittelussa.

Study of thermodynamic water properties and moisture sorption hysteresis of mango skin

The equilibrium moisture content for adsorption and desorption isotherms of mango skin was determined using the static gravimetric method at temperatures of 20, 26, 33, 38 and 44 oC in the 0.056 to 0.873 water activity range. Both sorption curves show a decrease in equilibrium moisture content as the temperature increasing. The hysteresis effect was observed at constant water activity. The Guggenheim, Anderson, and de Boer (GAB) model presented the best fitting accuracy among a group of models and was used to determine the thermodynamic properties of water sorption. Integral enthalpy and integral entropy areas showed inverted values for the adsorption and desorption isotherms over the wide range of water activity studied. These values confirm, in energetic terms, the difference between adsorption and desorption isotherms observed in the hysteresis phenomenon. Finally, the Gibbs free energy revealed that the sorption process was spontaneous for both sorption isotherms.

Prevalência e fatores associados à doença renal crônica em pacientes internados em um hospital universitário na cidade de São Paulo, SP, Brasil

Introdução: A doença renal crônica (DRC) constitui importante problema de saúde pública mundial. Contudo, dados sobre prevalência e comorbidades são escassos no Brasil. Objetivo: Identificar a prevalência e fatores associados à DRC em pacientes internados em um hospital universitário. Métodos: Foram selecionados, aleatoriamente, 826 prontuários de pacientes internados em clínica médica. A DRC foi baseada no diagnóstico médico descrito no prontuário. Foram coletadas informações clínico-demográficas e feitas comparações entre pacientes com e sem DRC. Resultados: A prevalência de DRC foi 12,7%. Os pacientes com DRC se distinguiram daqueles sem a doença (p < 0,05) por terem companheiro (59,8% vs. 47,3%); idade mais elevada (65,8 ± 15,6 vs. 55,3 ± 18,9 anos); mais comorbidades como hipertensão arterial (75,2% vs. 46,3%), diabetes (49,5% vs. 22,4%), dislipidemia (23,8% vs. 14,9%), infarto do miocárdio (14,3% vs. 6,0%) e insuficiência cardíaca congestiva (18,1% vs. 4,3%); maior período de internação (11 (8-18) vs. 9 (6-12) dias) e; mais óbitos (12,4% vs. 1,4%). A análise de regressão logística indicou associação independente (OR, odds ratio; IC, intervalo de confiança de 95%) da DRC com idade (OR 1,019, IC 1,003-1,036), hipertensão arterial (OR 2,032, IC 1,128-3,660), diabetes (OR 2,097, IC 1,232-3,570) e insuficiência cardíaca congestiva (OR 2,665, IC 1,173-6,056). Conclusão: A prevalência de DRC em pacientes internados em clínica médica foi alta, sendo estes pacientes clinicamente mais complexos, visto apresentarem idade mais elevada e maior número de comorbidades, refletindo em maior risco de óbito durante internação hospitalar.

Qualidade de vida de pacientes renais crônicos em diálise peritoneal e hemodiálise

ResumoIntrodução:Há controvérsias quanto à qualidade de vida (QV) de pacientes renais crônicos tratados com diferentes métodos dialíticos.Objetivo:Comparar a QV de pacientes renais crônicos em diálise peritoneal (DP) e hemodiálise (HD).Métodos:Estudo transversal nos três centros de diálise de Pelotas/RS. Pacientes em DP foram entrevistados após consulta mensal de rotina e os em HD, entre 1ª-2ª horas da sessão dialítica, com questionário estruturado. QV foi avaliada com Short-Form Health Survey (SF-36). Médias dos oito domínios do SF-36 foram comparadas entre os grupos.Resultados:Dos 345 pacientes elegíveis (63 em DP e 282 em HD), foram entrevistados 317 (8% de perdas/recusas). Cerca da metade nos dois grupos estava em diálise há no máximo 3 anos. Havia maioria de mulheres em DP e de homens em HD. Pacientes em DP relataram menos "dor" do que os em HD (escores médios 76,5 e 64,3, respectivamente; p = 0,0040). Não houve diferença nos demais domínios do SF-36.Discussão:A utilização de HD em Pelotas é um pouco menor que a detectada pelo Censo Brasileiro de Diálise (2011), sendo o uso de DP semelhante ao de alguns países europeus. Melhor escore no domínio "dor" entre pacientes em DP é consistente com o observado em outros estudos, embora haja também relatos de nenhuma diferença entre as modalidades e de vantagens da DP em outros domínios que não foram detectados no atual estudo.Conclusão:É semelhante a QV dos pacientes em DP ou HD, exceto no domínio dor, que foi menos intensa entre os pacientes em DP.

Plan för hantering av översvämningsrisker i kustområdet vid Åbo, Reso, Nådendal och Raumo

Kustområdet vid Åbo, Reso, Nådendal och Raumo är ett område med nationellt betydande översvämningsrisk. Närings-, trafik- och miljöcentralen i Egentliga Finland har utarbetat denna plan för hantering av översvämningsrisker under vägledning av översvämningsarbetsgruppen för kustområdet vid Åbo, Reso, Nådendal och Raumo. I planen presenteras de för området föreslagna målen och åtgärderna för hantering av översvämningsriskerna, en beskrivning av myndigheternas åtgärder vid översvämning samt en planens miljörapport. Sammanfattat är åtgärderna följande: Minska översvämningsrisker - Beakta översvämningar vid planläggning och beslut om bygglov och miljötillstånd, regionala anvisningar för planläggning och byggande - Höja eller skydda gator, varna för översvämningsvatten med skyltar vid vägrenarna - Avlägsna från det översvämmade området eller skydda anordningar för el- och värmedistribution samt för vattenförsörjning och datakommunikation Beredskapsåtgärder - Kontrollera och uppdatera säkerhetsplaner för anläggningar som hanterar ämnen som är skadliga för miljön - Utveckla ett prognossystem för havsvattenståndet - Sammanställa ett paket med information om översvämningar och utdela det till invånare, fastighetsägare och arbetsplatser i översvämningsområdet Översvämningsskydd - Objektsvisa skyddskonstruktioner, tillfälliga och permanenta Verksamhet vid översvämningsrisk och översvämningar - Skydd av värdefulla kulturarvsobjekt genom tillfälliga konstruktioner - Utveckling av en översvämningsvarningstjänst för medborgare och företag Information om vägavsnitt som är ur bruk och som används