Aspectos metodológicos do Projeto SBBrasil 2010 de interesse para inquéritos nacionais de saúde

The SBBrasil 2010 Project (SBB10) was designed as a nationwide oral health epidemiological survey within a health surveillance strategy. This article discusses methodological aspects of the SBB10 Project that can potentially help expand and develop knowledge in the health field. This was a nationwide survey with stratified multi-stage cluster sampling. The sample domains were 27 State capitals and 150 rural municipalities (counties) from the country's five major geographic regions. The sampling units were census tracts and households for the State capitals and municipalities, census tracts, and households for the rural areas. Thirty census tracts were selected in the State capitals and 30 municipalities in the countryside. The precision considered the demographic domains grouped by density of the overall population and the internal variability of oral health indices. The study evaluated dental caries, periodontal disease, malocclusion, fluorosis, tooth loss, and dental trauma in five age groups (5, 12, 15-19, 35-44, and 65-74 years).

Estratégias tróficas do peixe traíra, Hoplias malabaricus e do peixe cascudo, Hypostomus pusarum do açude Marechal Dutra, Rio Grande do Norte, Brasil

The fish, Hoplias malabaricus (Osteichthyes: Erythrinidae) and armored catfish, Hypostomus pusarum (Loricariidae) are of freshwater origin from the neotropical region, and are considered ecologically and economically of important. This work investigated the trophic strategies, the morphology and histology of the digestive tract of these fish captured from the Marechal Dutra reservoir, Acari, the semiarid region of Rio Grande do Norte, Brazil. A total of 133 individuals of H. malabaricus and 118 specimens of H. pusarum were analyzed. The two study species occupy different levels in the food chain and spatial distribution in the water column of the reservoir. The results of this study are presented in the form of four scientific papers. The first article describes the morphology and histology of the digestive tract and the feeding habits of H. malabaricus (Bloch, 1794). This fish has a short intestine, with an intestinal coefficient of 0.72 ± 0.09. The dietary importance index indicates that H. malabaricus feeds preferentially on animal matter, especially on fish (72.8%) and prawns (27.2%). The histology of its digestive tract confirms the carnivorous feeding habit. The second article discusses about the pioneering work on the feeding strategy and the characterization of anatomy and histology of the digestive tract of H. pusarum. The intestine of this fish is long, with an intestinal coefficient of 10.8±0.7. The dietary importance index indicates that H. pusarum feeds preferentially on organic matter in decomposition (88.7%) and on filamentous microalgae and diatoms (11.3%). The third article compares the morphological aspects of the digestive tract of H. malabaricus and H. pusarum, in relation to their food habits. The arrangement of the digestive organs in both species is directly related to the shape of the peritoneal cavity and the form of the body. The short intestine of H. malabaricus and the long intestine of H. pusarum are associated with their feeding habits. The morphology of the digestive tracts of H. malabaricus and H. pusarum confirm their food habits, carnivorous and detritivorous / herbivorous, respectively. The fourth article discusses the food and reproductive aspects (length and weight, length-weight relationship, type of growth and sex ratio) of H. pusarum. This species has a negatively allometric growth, with the predominance of females in the sampled population. H. malabaricus inhabits the pelagic environment and is a carnivore, while H. pusarum, lives in the benthic environment and is characterized as a detritivore/herbivore. Each species studied shows a very different diet, without trophic competition between them. The morphological and anatomical structures of the digestive tract reflect their feeding strategy.

Using Bird Distributions to Assess Extinction Risk and Identify Conservation Priorities in Biodiversity Hotspots

Habitat loss, fragmentation, and degradation threaten the World’s ecosystems and species. These, and other threats, will likely be exacerbated by climate change. Due to a limited budget for conservation, we are forced to prioritize a few areas over others. These places are selected based on their uniqueness and vulnerability. One of the most famous examples is the biodiversity hotspots: areas where large quantities of endemic species meet alarming rates of habitat loss. Most of these places are in the tropics, where species have smaller ranges, diversity is higher, and ecosystems are most threatened.

Species distributions are useful to understand ecological theory and evaluate extinction risk. Small-ranged species, or those endemic to one place, are more vulnerable to extinction than widely distributed species. However, current range maps often overestimate the distribution of species, including areas that are not within the suitable elevation or habitat for a species. Consequently, assessment of extinction risk using these maps could underestimate vulnerability.

In order to be effective in our quest to conserve the World’s most important places we must: 1) Translate global and national priorities into practical local actions, 2) Find synergies between biodiversity conservation and human welfare, 3) Evaluate the different dimensions of threats, in order to design effective conservation measures and prepare for future threats, and 4) Improve the methods used to evaluate species’ extinction risk and prioritize areas for conservation. The purpose of this dissertation is to address these points in Colombia and other global biodiversity hotspots.

In Chapter 2, I identified the global, strategic conservation priorities and then downscaled to practical local actions within the selected priorities in Colombia. I used existing range maps of 171 bird species to identify priority conservation areas that would protect the greatest number of species at risk in Colombia (endemic and small-ranged species). The Western Andes had the highest concentrations of such species—100 in total—but the lowest densities of national parks. I then adjusted the priorities for this region by refining these species ranges by selecting only areas of suitable elevation and remaining habitat. The estimated ranges of these species shrank by 18–100% after accounting for habitat and suitable elevation. Setting conservation priorities on the basis of currently available range maps excluded priority areas in the Western Andes and, by extension, likely elsewhere and for other taxa. By incorporating detailed maps of remaining natural habitats, I made practical recommendations for conservation actions. One recommendation was to restore forest connections to a patch of cloud forest about to become isolated from the main Andes.

For Chapter 3, I identified areas where bird conservation met ecosystem service protection in the Central Andes of Colombia. Inspired by the November 11th (2011) landslide event near Manizales, and the current poor results of Colombia’s Article 111 of Law 99 of 1993 as a conservation measure in this country, I set out to prioritize conservation and restoration areas where landslide prevention would complement bird conservation in the Central Andes. This area is one of the most biodiverse places on Earth, but also one of the most threatened. Using the case of the Rio Blanco Reserve, near Manizales, I identified areas for conservation where endemic and small-range bird diversity was high, and where landslide risk was also high. I further prioritized restoration areas by overlapping these conservation priorities with a forest cover map. Restoring forests in bare areas of high landslide risk and important bird diversity yields benefits for both biodiversity and people. I developed a simple landslide susceptibility model using slope, forest cover, aspect, and stream proximity. Using publicly available bird range maps, refined by elevation, I mapped concentrations of endemic and small-range bird species. I identified 1.54 km2 of potential restoration areas in the Rio Blanco Reserve, and 886 km2 in the Central Andes region. By prioritizing these areas, I facilitate the application of Article 111 which requires local and regional governments to invest in land purchases for the conservation of watersheds.

Chapter 4 dealt with elevational ranges of montane birds and the impact of lowland deforestation on their ranges in the Western Andes of Colombia, an important biodiversity hotspot. Using point counts and mist-nets, I surveyed six altitudinal transects spanning 2200 to 2800m. Three transects were forested from 2200 to 2800m, and three were partially deforested with forest cover only above 2400m. I compared abundance-weighted mean elevation, minimum elevation, and elevational range width. In addition to analyzing the effect of deforestation on 134 species, I tested its impact within trophic guilds and habitat preference groups. Abundance-weighted mean and minimum elevations were not significantly different between forested and partially deforested transects. Range width was marginally different: as expected, ranges were larger in forested transects. Species in different trophic guilds and habitat preference categories showed different trends. These results suggest that deforestation may affect species’ elevational ranges, even within the forest that remains. Climate change will likely exacerbate harmful impacts of deforestation on species’ elevational distributions. Future conservation strategies need to account for this by protecting connected forest tracts across a wide range of elevations.

In Chapter 5, I refine the ranges of 726 species from six biodiversity hotspots by suitable elevation and habitat. This set of 172 bird species for the Atlantic Forest, 138 for Central America, 100 for the Western Andes of Colombia, 57 for Madagascar, 102 for Sumatra, and 157 for Southeast Asia met the criteria for range size, endemism, threat, and forest use. Of these 586 species, the Red List deems 108 to be threatened: 15 critically endangered, 29 endangered, and 64 vulnerable. When ranges are refined by elevational limits and remaining forest cover, 10 of those critically endangered species have ranges < 100km2, but then so do 2 endangered species, seven vulnerable, and eight non-threatened ones. Similarly, 4 critically endangered species, 20 endangered, and 12 vulnerable species have refined ranges < 5000km2, but so do 66 non-threatened species. A striking 89% of these species I have classified in higher threat categories have <50% of their refined ranges inside protected areas. I find that for 43% of the species I assessed, refined range sizes fall within thresholds that typically have higher threat categories than their current assignments. I recommend these species for closer inspection by those who assess risk. These assessments are not only important on a species-by-species basis, but by combining distributions of threatened species, I create maps of conservation priorities. They differ significantly from those created from unrefined ranges.

Geodesically reversible Finsler 2-spheres of constant curvature

A Finsler space is said to be geodesically reversible if each oriented geodesic can be reparametrized as a geodesic with the reverse orientation. A reversible Finsler space is geodesically reversible, but the converse need not be true. In this note, building on recent work of LeBrun and Mason, it is shown that a geodesically reversible Finsler metric of constant flag curvature on the 2-sphere is necessarily projectively flat. As a corollary, using a previous result of the author, it is shown that a reversible Finsler metric of constant flag curvature on the 2-sphere is necessarily a Riemannian metric of constant Gauss curvature, thus settling a long- standing problem in Finsler geometry.

Reproductive state of hunted female mammals during 2000-2015 in Nueva Esperanza, Peruvian Andes

The annual birthrate of female offspring and the intrinsic rate of natural increase (rmax) of populations are key reproductive parameters in models for assessing hunting sustainability or population viability of species. We calculated wild birthrate (pregnancy rate) for ten mammal species, using 180 months (from 2000 to 2015) of reproductive data from 950 hunted female animals collected with the participation of local hunters in the Peruvian Amazon. The methodology assured that no animals were killed outside the hunter's normal activities. The data included shows the reproductive state (pregnant or non-pregnant) of all collected individuals (n=1090), related to the date of collection. Hunters registered required data from genital organs from 950 (87.2%) hunted females, and 140 (12.8%) collected tracts lacked the collection date due to lost or non-legible individual sample codification.

Miocene to Pleistocene gluconite-rich layers of the US Mid-Atlantic margin

Glauconite is generally agreed to be a reliable indicator of low sedimentation rate, but little systematic work has been done to specify the role of glauconite in a sequence-stratigraphic framework. Ocean Drilling Program Leg 174A recovered a good record of late Tertiary sediments along the shelf edge of the New Jersey US Atlantic margin, and glauconite was present in many intervals of the cores, sometimes in vertical proximity to sequence boundaries. Leg 174A glauconite was analyzed with binocular microscope, XRD and SEM to determine the percent of potassium and degree of maturity in order to relate occurrence to depositional environment. Seismic data were used to locate sequence boundaries, and percent glauconite was visually estimated. Glauconite samples from Site 1073 were found to have formed within a lowstand systems tract (LST), and as part of a distal condensed section (CS) within a transgressive systems tract (TST). These results are comparable to those from nearby Site 903 of Leg 150, which indicate a similar depositional setting for glauconite. Glauconites at shelf Sites 1071 and 1072 likely formed in the TST as well. Onshore, glauconite occurs mainly in transgressive systems tracts. The Miocene appears to be the upper limit of glauconite formation onshore. As the magnitude of sea-level change decreased, present onshore locations became too nearshore to maintain sediment-free environments, and the zone of glauconite deposition moved seaward. The same process did not occur offshore until the Plio-Pleistocene. Low subsidence-rate margins such as the US Atlantic are subject more to the variations of sea-level than to changes in sediment supply, tectonics, or other factors influencing their depositional patterns. Although glauconite occurrence is widespread in the stratigraphic record, this study demonstrates that for low subsidence-rate margins, primary deposition of glauconite is largely restricted to the TST.

‘The voice speaking, desired, awaited’: Jack Lindsay’s 1649, Textual Form and Communist Historiography

This article examines the 1938 historical novel 1649: A Novel of a Year by the Anglo-Australian communist polymath Jack Lindsay in the context of the politics of the Popular Front, and identifies the aesthetic and historiographic debates questions that inform Lindsay’s inventive rendition of the historical novel. The novel may be considered in light of what Lindsay later called his desire ‘to use the novel to revive revolutionary traditions’, as well as his ‘struggle to achieve an understanding of the Novel while writing novels’. Lindsay’s novel figures a reality becoming prosaic: it reproduces contemporary textual sources – tracts, pamphlets, newspapers – as part of its meditation on a nascent print culture whose products circulate in processes that mirror the increasingly conspicuous flow of commodities. In this sense, the novel offers a marxist reflection on its own conditions of possibility in emergent bourgeois culture, as well as intervening in the vexed question of the Civil War as a ‘bourgeois revolution’. The novel however seeks to capture a dialectical method of representing the revolution that acknowledges defeat while rearticulating the utopian content of the defeated radicals, a practice integral to Lindsay’s vision of popular history as a transhistorical dialogue. That utopian content is transmitted through two forms: popular song, which acts to supplement political writing; and the heroic portrayal of the Leveller John Lilburne on trial, whose conduct exemplifies praxis conceived as a unity of word, thought and action.

Strontium isotopes and sedimentology of a marine Triassic succession (upper Ladinian) of the westernmost Tethys, Spain

Chemical Stratigraphy, or the study of the variation of chemical elements within sedimentary sequences, has gradually become an experienced tool in the research and correlation of global geologic events. In this paper 87Sr/ 86Sr ratios of the Triassic marine carbonates (Muschelkalk facies) of southeast Iberian Ranges, Iberian Peninsula, are presented and the representative Sr-isotopic curve constructed for the upper Ladinian interval. The studied stratigraphic succession is 102 meters thick, continuous, and well preserved. Previous paleontological data from macro and micro, ammonites, bivalves, foraminifera, conodonts and palynological assemblages, suggest a Fassanian-Longobardian age (Late Ladinian). Although diagenetic minerals are present in small amounts, the elemental data content of bulk carbonate samples, especially Sr contents, show a major variation that probably reflects palaeoenvironmental changes. The 87Sr/86Sr ratios curve shows a rise from 0.707649 near the base of the section to 0.707741 and then declines rapidly to 0.707624, with a final values rise up to 0.70787 in the upper part. The data up to meter 80 in the studied succession is broadly concurrent with 87Sr/86Sr ratios of sequences of similar age and complements these data. Moreover, the sequence stratigraphic framework and its key surfaces, which are difficult to be recognised just based in the facies analysis, are characterised by combining variations of the Ca, Mg, Mn, Sr and CaCO3 contents

Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos

PEREIRA, C. R. S. et al. Impacto da estratégia saúde da família com equipe de saúde bucal sobre a utilização de serviços odontológicos. Cad. Saúde Pública, v. 25, n. 5, p.985-996. Maio, 2009. ISSN 0102-311X.

Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos

PEREIRA, Carmen Regina dos Santos et al. Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos. Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 5, p. 985-996, maio 2009.

An Integrated Study on the Holocene Aquifer and the Water Resource Potential of Karamana River Basin, Southern Kerala, India

Water constitutes the basic resource for life. Management of coastal aquifers, which are the important sources of freshwater that feed the rapid economic growth of the region is facing increasing challenges. A large portion of the global population inhabits the coastal and adjoining areas leading to a high demand for water both surface and ground water resources of coastal tracts. With increasing population this puts significant stress on water resources of many of the coastal tracts of the world. Several recent studies have indicated that coastal aquifers of Cenozoic age are globally under threat due to several reasons. Climate change is expected to affect the freshwater resources of coastal aquifers, which in turn will affect half of the global population residing in coastal areas. Sea-level rise will induce landward migration of the freshwater-saltwater transition zone, i.e., seawater or saltwater intrusion, jeopardizing freshwater availability. In order to facilitate the management of fresh coastal groundwater resources, a comprehensive understanding of the SLR-SWI relationship is crucial.

Modifications neurométaboliques et microstructurales à la suite d'une commotion cérébrale chez les athlètes féminines.

L’utilisation de méthodes d’investigation cérébrale avancées a permis de mettre en évidence la présence d’altérations à court et à long terme à la suite d’une commotion cérébrale. Plus spécifiquement, des altérations affectant l’intégrité de la matière blanche et le métabolisme cellulaire ont récemment été révélées par l’utilisation de l’imagerie du tenseur de diffusion (DTI) et la spectroscopie par résonance magnétique (SRM), respectivement. Ces atteintes cérébrales ont été observées chez des athlètes masculins quelques jours après la blessure à la tête et demeuraient détectables lorsque les athlètes étaient à nouveau évalués six mois post-commotion. En revanche, aucune étude n’a évalué les effets neurométaboliques et microstructuraux dans la phase aigüe et chronique d’une commotion cérébrale chez les athlètes féminines, malgré le fait qu’elles présentent une susceptibilité accrue de subir ce type de blessure, ainsi qu’un nombre plus élevé de symptômes post-commotionnels et un temps de réhabilitation plus long. Ainsi, les études composant le présent ouvrage visent globalement à établir le profil d’atteintes microstructurales et neurométaboliques chez des athlètes féminines par l’utilisation du DTI et de la SRM. La première étude visait à évaluer les changements neurométaboliques au sein du corps calleux chez des joueurs et joueuses de hockey au cours d’une saison universitaire. Les athlètes ayant subi une commotion cérébrale pendant la saison ont été évalués 72 heures, 2 semaines et 2 mois après la blessure à la tête en plus des évaluations pré et post-saison. Les résultats démontrent une absence de différences entre les athlètes ayant subi une commotion cérébrale et les athlètes qui n’en ont pas subie. De plus, aucune différence entre les données pré et post-saison a été observée chez les athlètes masculins alors qu’une diminution du taux de N-acetyl aspartate (NAA) n’a été mise en évidence chez les athlètes féminines, suggérant ainsi un impact des coups d’intensité sous-clinique à la tête. La deuxième étude, qui utilisait le DTI et la SRM, a révélé des atteintes chez des athlètes féminines commotionnées asymptomatiques en moyenne 18 mois post-commotion. Plus spécifiquement, la SRM a révélé une diminution du taux de myo-inositol (mI) au sein de l’hippocampe et du cortex moteur primaire (M1) alors que le DTI a mis en évidence une augmentation de la diffusivité moyenne (DM) dans plusieurs faisceaux de matière blanche. De iii plus, une approche par région d’intérêt a mis en évidence une diminution de la fraction d’anisotropie (FA) dans la partie du corps calleux projetant vers l’aire motrice primaire. Le troisième article évaluait des athlètes ayant subi une commotion cérébrale dans les jours suivant la blessure à la tête (7-10 jours) ainsi que six mois post-commotion avec la SRM. Dans la phase aigüe, des altérations neuropsychologiques combinées à un nombre significativement plus élevé de symptômes post-commotionnels et dépressifs ont été trouvés chez les athlètes féminines commotionnées, qui se résorbaient en phase chronique. En revanche, aucune différence sur le plan neurométabolique n’a été mise en évidence entre les deux groupes dans la phase aigüe. Dans la phase chronique, les athlètes commotionnées démontraient des altérations neurométaboliques au sein du cortex préfrontal dorsolatéral (CPDL) et M1, marquées par une augmentation du taux de glutamate/glutamine (Glx). De plus, une diminution du taux de NAA entre les deux temps de mesure était présente chez les athlètes contrôles. Finalement, le quatrième article documentait les atteintes microstructurales au sein de la voie corticospinale et du corps calleux six mois suivant une commotion cérébrale. Les analyses n’ont démontré aucune différence au sein de la voie corticospinale alors que des différences ont été relevées par segmentation du corps calleux selon les projections des fibres calleuses. En effet, les athlètes commotionnées présentaient une diminution de la DM et de la diffusivité radiale (DR) au sein de la région projetant vers le cortex préfrontal, un volume moindre des fibres de matière blanche dans la région projetant vers l’aire prémotrice et l’aire motrice supplémentaire, ainsi qu’une diminution de la diffusivité axiale (DA) dans la région projetant vers l’aire pariétale et temporale. En somme, les études incluses dans le présent ouvrage ont permis d’approfondir les connaissances sur les effets métaboliques et microstructuraux des commotions cérébrales et démontrent des effets délétères persistants chez des athlètes féminines. Ces données vont de pair avec la littérature scientifique qui suggère que les commotions cérébrales n’entraînent pas seulement des symptômes temporaires.

Caractérisation fonctionnelle de facteurs de virulence chez "Streptococcus suis"

Les progrès technologiques dans l’industrie de la viande ont des répercussions considérables sur les agents pathogènes de ces environnements. Parmi ceux-ci, Streptococcus suis occupe une place prédominante dans l’industrie porcine. En effet, S. suis, colonisateur naturel des voies respiratoires et digestives du porc, peut infecter son hôte en provoquant des méningites, septicémies, endocardites, arthrites ou pneumonies. De surcroît, S. suis peut également infecter l’humain en provoquant majoritairement des méningites et septicémies, et a notamment été la cause de deux épidémies en Chine en 1998 et 2005. La pathogenèse des infections à S. suis demeure partiellement connue à l’heure actuelle, rendant difficile le contrôle des infections. Il est par conséquent essentiel de caractériser les facteurs de virulence chez S. suis puisqu’ils pourraient représenter des cibles d’intérêt pour des applications préventives ou thérapeutiques. Ce projet de doctorat consiste donc en la caractérisation fonctionnelle de facteurs de virulence chez S. suis. Dans un premier temps, la capacité de S. suis à moduler son potentiel pro-inflammatoire en présence de concentrations sous-inhibitrices d’amoxicilline a été mise en évidence. Dans un second temps, la caractérisation plus avancée de la hyaluronate lyase de S. suis a permis de démontrer que son activité ne contribue pas à la virulence de la bactérie étant donné son absence au sein de souches les plus virulentes, mais que les interactions avec l’acide hyaluronique pourraient moduler la virulence de S. suis. Par la suite, l’étude fonctionnelle d’une DNase de S. suis a permis de démontrer son implication comme facteur de virulence et suggère son intérêt dans le développement de vaccins. Finalement, le dernier objectif du projet a permis la mise en évidence de la production de microvésicules fortement immunogéniques par S. suis. La présence de facteurs de virulence dans leur contenu protéique représente un élément encourageant dans le développement de vaccins contre l’agent pathogène. Ce projet a donc permis d’élargir les connaissances sur le potentiel néfaste de l’utilisation des antibiotiques à faible concentration dans l’industrie porcine, sur le rôle des activités hyaluronate lyase et DNase dans la virulence de S. suis, et de découvrir un nouveau mécanisme impliqué dans la virulence de la bactérie par le biais des microvésicules.

Neuroreceptor availability and cerebral morphology in human obesity

Obesity is a major challenge to human health worldwide. Little is known about the brain mechanisms that are associated with overeating and obesity in humans. In this project, multimodal neuroimaging techniques were utilized to study brain neurotransmission and anatomy in obesity. Bariatric surgery was used as an experimental method for assessing whether the possible differences between obese and non-obese individuals change following the weight loss. This could indicate whether obesity-related altered neurotransmission and cerebral atrophy are recoverable or whether they represent stable individual characteristics. Morbidly obese subjects (BMI ≥ 35 kg/m2) and non-obese control subjects (mean BMI 23 kg/m2) were studied with positron emission tomography (PET) and magnetic resonance imaging (MRI). In the PET studies, focus was put on dopaminergic and opioidergic systems, both of which are crucial in the reward processing. Brain dopamine D2 receptor (D2R) availability was measured using [11C]raclopride and µ-opioid receptor (MOR) availability using [11C]carfentanil. In the MRI studies, voxel-based morphometry (VBM) of T1-weighted MRI images was used, coupled with diffusion tensor imaging (DTI). Obese subjects underwent bariatric surgery as their standard clinical treatment during the study. Preoperatively, morbidly obese subjects had significantly lower MOR availability but unaltered D2R availability in several brain regions involved in reward processing, including striatum, insula, and thalamus. Moreover, obesity disrupted the interaction between the MOR and D2R systems in ventral striatum. Bariatric surgery and concomitant weight loss normalized MOR availability in the obese, but did not influence D2R availability in any brain region. Morbidly obese subjects had also significantly lower grey and white matter densities globally in the brain, but more focal changes were located in the areas associated with inhibitory control, reward processing, and appetite. DTI revealed also signs of axonal damage in the obese in corticospinal tracts and occipito-frontal fascicles. Surgery-induced weight loss resulted in global recovery of white matter density as well as more focal recovery of grey matter density among obese subjects. Altogether these results show that the endogenous opioid system is fundamentally linked to obesity. Lowered MOR availability is likely a consequence of obesity and may mediate maintenance of excessive energy uptake. In addition, obesity has adverse effects on brain structure. Bariatric surgery however reverses MOR dysfunction and recovers cerebral atrophy. Understanding the opioidergic contribution to overeating and obesity is critical for developing new psychological or pharmacological treatments for obesity. The actual molecular mechanisms behind the positive change in structure and neurotransmitter function still remain unclear and should be addressed in the future research.

Impacto da Estratégia Saúde da Família com equipe de saúde bucal sobre a utilização de serviços odontológicos

PEREIRA, C. R. S. et al. Impacto da estratégia saúde da família com equipe de saúde bucal sobre a utilização de serviços odontológicos. Cad. Saúde Pública, v. 25, n. 5, p.985-996. Maio, 2009. ISSN 0102-311X.