Trans fatty acid intake is associated with insulin sensitivity but independently of inflammation

High saturated and trans fatty acid intake, the typical dietary pattern of Western populations, favors a proinflammatory status that contributes to generating insulin resistance (IR). We examined whether the consumption of these fatty acids was associated with IR and inflammatory markers. In this cross-sectional study, 127 non-diabetic individuals were allocated to a group without IR and 56 to another with IR, defined as homeostasis model assessment-IR (HOMA-IR) >2.71. Diet was assessed using 24-h food recalls. Multiple linear regression was employed to test independent associations with HOMA-IR. The IR group presented worse anthropometric, biochemical and inflammatory profiles. Energy intake was correlated with abdominal circumference and inversely with adiponectin concentrations (r = -0.227, P = 0.002), while saturated fat intake correlated with inflammatory markers and trans fat with HOMA-IR (r = 0.160, P = 0.030). Abdominal circumference was associated with HOMA-IR (r = 0.430, P < 0.001). In multiple analysis, HOMA-IR remained associated with trans fat intake (β = 1.416, P = 0.039) and body mass index (β = 0.390, P < 0.001), and was also inversely associated with adiponectin (β = -1.637, P = 0.004). Inclusion of other nutrients (saturated fat and added sugar) or other inflammatory markers (IL-6 and CRP) into the models did not modify these associations. Our study supports that trans fat intake impairs insulin sensitivity. The hypothesis that its effect could depend on transcription factors, resulting in expression of proinflammatory genes, was not corroborated. We speculate that trans fat interferes predominantly with insulin signaling via intracellular kinases, which alter insulin receptor substrates.

Variações nos níveis de adiponectina nos pacientes com doença renal crônica: um estudo prospectivo de 12 meses

INTRODUÇÃO: As complicações cardiovasculares permanecem como a principal causa de mortalidade nos pacientes portadores de doença renal crônica (DRC). A adiponectina é uma proteína produzida pelo tecido adiposo que apresenta importante propriedade cardioprotetora. O nosso objetivo foi investigar os determinantes dos níveis de adiponectina nos pacientes com DRC. MÉTODOS: Este estudo prospectivo observacional incluiu 98 pacientes [taxa de filtração glomerular (TFG) 36,1+-14,4 ml/min; 56,5+-10,4 anos; 63% homens; 31% diabéticos e índice de massa corporal (IMC) 27,1+-5,2 kg/m²]. A avaliação da adiponectina (teste imunoenzimático), dos parâmetros laboratoriais, do estado nutricional (avaliação global subjetiva), da gordura corporal total (absortometria de raios-x de dupla energia) e da gordura abdominal visceral e subcutânea (tomografia computadorizada) foi realizada no início e após 12 meses. RESULTADOS: A adiponectina correlacionou-se com a TFG (r = -0,45; p < 0,001), a proteinúria (r = 0,21; p = 0,04), o IMC (r = -0,33; p < 0,01) e a gordura visceral (r = -0,49; p < 0,001). Na análise de regressão múltipla, os determinantes das concentrações de adiponectina foram o sexo (feminino β = 3,8; p < 0,01), a idade (β = 0,14; p = 0,03), a TFG (β = -0,15; p < 0,01) e a gordura visceral (β = -0,04; p < 0,001) (R² = 0,41). Após 12 meses, a progressão da DRC foi evidenciada pela diminuição da TFG (-1,6+-6,3 ml/min; p = 0,01) e aumento da proteinúria (0,3+-0,8 g/d; p < 0,01). Houve um aumento da gordura visceral de 97+-73 cm² para 111+-82 cm² (p < 0,001) e concomitante redução dos níveis de adiponectina, de 27,6+-7,5 mg/l para 22,2+-11,6 mg/l (p < 0,001). O peso corporal, o IMC, a gordura corporal total e a gordura abdominal subcutânea não se alteraram neste período. Ajustando pelos fatores associados à adiponectina, observamos que somente o acúmulo de gordura visceral ao longo do tempo determinou a redução nos níveis de adiponectina (β = -0,04; p = 0,025; R² = 0,21). CONCLUSÃO: A idade, o sexo, a função renal e a gordura visceral estiveram independentemente associados com os níveis de adiponectina nos pacientes com DRC na fase não dialítica. No entanto, a mudança da gordura visceral foi o único preditor das variações nos níveis de adiponectina ao longo de 12 meses.

Anemia em pacientes submetidos à diálise peritoneal ambulatorial: prevalência e fatores associados

Resumo Introdução: A anemia é uma complicação frequente em pacientes em diálise e poucos estudos avaliaram sua ocorrência em pacientes submetidos à diálise peritoneal (DP). Objetivo: Este estudo teve como objetivo investigar a prevalência e fatores associados à presença de anemia em pacientes submetidos à DP de um único centro onde havia acesso irrestrito a agentes estimulantes da eritropoiese (AEE) e a suplementação de ferro intravenoso. Métodos: Estudo transversal que analisou variáveis demográficas, clínicas e laboratoriais de 120 pacientes. Anemia foi definida como hemoglobina (Hb) < 11g/dl. Resultados: Os pacientes estavam em DP por 17 meses, sendo 86% automatizada. A idade média foi de 58 ± 16,5 anos, 52% dos pacientes eram do sexo feminino e 29% diabéticos. Anemia esteve presente em 34 pacientes (28%). Quando comparados com pacientes sem anemia, aqueles com anemia recebiam maior dose de ferro (p = 0,02) e apresentavam menores triglicérides (p = 0,01). A Hb se correlacionou negativamente com as doses de ferro (r = -0,20;p = 0,03) e AEE (r = -0,23; p = 0,01), e positivamente com albumina (r = 0,38; p = 0,01), triglicérides (r = 0,24; p = 0,01) e índice de saturação da transferrina (r = 0,20; p = 0,03). Na análise múltipla, a concentração de albumina (coefβ = 0,84; 95% IC = 0,381,31;p < 0,001) e a dose de AEE (coefβ = -0,06; 95% IC = 0,00-0,00; p = 0,02) foram associadas de forma independente com a Hb. Conclusões: No presente estudo, anemia foi observada em aproximadamente 30% dos pacientes em programa de diálise peritoneal, com uso irrestrito de AEE e suplementação intravenosa de ferro. A saturação de transferrina e o estado nutricional, avaliado pela albumina, foram os fatores independentes associados à concentração de hemoglobina nesta população.

Financial working capital - management and measurement

Unexpected changes in cash flow have started to occur more frequently after the financial crisis. The capital structures of companies have also changed, and financial flexibility as well as flexible asset management have therefore become more important. This thesis aims at presenting financial working capital management, a part of flexible asset management, as a possibility to gain financial flexibility and survive the changes. This thesis operates in the interface of corporate finance, strategic management and management accounting, and it has two main objectives: to examine financial working capital management and to develop measures of financial working capital. The research in this thesis has been conducted using archival research and design science. Qualitative comparative analysis and model building are used to formulate tools and strategies for financial working capital management. The tools are tested with simulations, case studies and statistical analysis. The empirical data is collected from companies listed in the Helsinki Stock Exchange. The results of this thesis indicate that there are several possible financial working capital management strategies. FOCAL matrix is created in the thesis to assist in the selection of a strategy. The results also imply that profitability can be improved by reducing financial working capital, which creates a need to change the financial working capital management strategy. Financial flow cycle, and its modification, is developed in this thesis to measure financial working capital. Financial working capital as a concept is presented in this thesis with an orientation towards the management view. New dimensions have also been produced to financial management and working capital management, while providing a holistic approach to financial flexibility. Financial working capital management strategies are presented to managers and practical tools are provided for decision-making.

La formación de un príncipe de la ilustración : selección de la correspondencia privada de Luis XIV a Felipe V durante la Guerra de Sucesión.

Todas las cartas se presentan en su idioma original (francés) y su traducción al castellano. - Contiene índice onomástico, de cartas, reseñas biográficas de personajes citados en la correspondencia y a modo de epílogo una reflexión sobre la Restauración Borbónica en España 175 años después

Enciclopedia temática Lectus Vergara : de Altamira a Granada, iniciando el repaso de la historia de España.

En este cd pueden encontrarse los conceptos más importantes, así como la cronología, historia, hechos, personajes y documentos más significativos de la historia de España, centrados en el período que comprende los pueblos preromanos, romanos, visigodos, hispanoárabes y cristianos.

Enciclopedia temática Lectus Vergara : España contemporánea, un período repleto de acontecimientos.

En este cd pueden encontrarse los conceptos más importantes, así como la cronología, historia, hechos, personajes y documentos más significativos de la historia contemporánea de España.

Violència a la reraguarda. 'Violencia en la retaguardia'.

Reportaje sobre la guerra civil española. Se muestra la represión franquista que sufrió Cataluña durante este periodo y los castigos a los republicanos que perdieron la guerra. Bombardeos en el territorio catalán, ejecuciones y detenciones son algunos de los aspectos que aparecen en el vídeo, además del testimonio de los que sufrieron dichos castigos.

Catalunya sota les bombes. 'Cataluña bajo las bombas'.

Durante la Guerra Civil Española, Cataluña fue duramente castigada por la aviación fascista. Este vídeo muestra los acontecimientos a partir de imágenes de los desastres causados por las bombas y a través del testigo de los ciudadanos que sufren los bombardeos.

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Efeitos das inomogeneidades da matéria em Cosmologias Aceleradas

The recent observational advances of Astronomy and a more consistent theoretical framework turned Cosmology in one of the most exciting frontiers of contemporary science. In this thesis, homogeneous and inhomogeneous Universe models containing dark matter and different kinds of dark energy are confronted with recent observational data. Initially, we analyze constraints from the existence of old high redshift objects, Supernovas type Ia and the gas mass fraction of galaxy clusters for 2 distinct classes of homogeneous and isotropic models: decaying vacuum and X(z)CDM cosmologies. By considering the quasar APM 08279+5255 at z = 3.91 with age between 2-3 Gyr, we obtain 0,2 < OM < 0,4 while for the j3 parameter which quantifies the contribution of A( t) is restricted to the intervalO, 07 < j3 < 0,32 thereby implying that the minimal age of the Universe amounts to 13.4 Gyr. A lower limit to the quasar formation redshift (zJ > 5,11) was also obtained. Our analyzes including flat, closed and hyperbolic models show that there is no an age crisis for this kind of decaying A( t) scenario. Tests from SN e Ia and gas mass fraction data were realized for flat X(z)CDM models. For an equation of state, úJ(z) = úJo + úJIZ, the best fit is úJo = -1,25, úJl = 1,3 and OM = 0,26, whereas for models with úJ(z) = úJo+úJlz/(l+z), we obtainúJo = -1,4, úJl = 2,57 and OM = 0,26. In another line of development, we have discussed the influence of the observed inhomogeneities by considering the Zeldovich-Kantowski-DyerRoeder (ZKDR) angular diameter distance. By applying the statistical X2 method to a sample of angular diameter for compact radio sources, the best fit to the cosmological parameters for XCDM models are OM = O, 26,úJ = -1,03 and a = 0,9, where úJ and a are the equation of state and the smoothness parameters, respectively. Such results are compatible with a phantom energy component (úJ < -1). The possible bidimensional spaces associated to the plane (a , OM) were restricted by using data from SNe Ia and gas mass fraction of galaxy clusters. For Supernovas the parameters are restricted to the interval 0,32 < OM < 0,5(20") and 0,32 < a < 1,0(20"), while to the gas mass fraction we find 0,18 < OM < 0,32(20") with alI alIowed values of a. For a joint analysis involving Supernovas and gas mass fraction data we obtained 0,18 < OM < 0,38(20"). In general grounds, the present study suggests that the influence of the cosmological inhomogeneities in the matter distribution need to be considered with more detail in the analyses of the observational tests. Further, the analytical treatment based on the ZKDR distance may give non-negligible corrections to the so-calIed background tests of FRW type cosmologies

Sono e síndrome da fragilidade em idosos residentes em instituições de longa permanência

Introduction: The aging process causes quantitative and qualitative changes in sleeping. Such changes affects more than half of the adults above 65 years old, that live in the community and 70% of the institutionalized, a great negative impact in their quality of life. One of the pathological displays of aging, that share some characteristics with sleeping disorders and predict similar results, is the Frailty Syndrome, that characterize the most weakened and vulnerable elderly. The way sleeping disorders play a role in the frailty pathogeneses remains uncertain. Objective: Evaluate the relation between the sleeping and the frailty syndrome on institutionalized elderly. Methodology: A transversal study was performed with 69 elderly in institutions in the city of João Pessoa PB. Were used the Pittsburgh Sleeping Quality Index and actigraphy to subjective and objective variables, respectively, and questionnaires and specific tests to frailty phenotype variant (Fried Frailty Criteria). In the statistic analysis were used the Pearson correlation test, Chi Square and One-way ANOVA test, with Tukey-Krammer posttest. Subsequently, a Simple Linear Regression model was built. On every statistical analysis were considered a confidence interval of 95% and a p < 0,05. Results: The sample was characterized by the prevalence of the frail (49,3%), women (62,3%), single (50,7%) and 77,52 (±7,82).The frail elderly obtained the worst sleeping quality 10,37 (±4,31) (f = 4,15, p = 0,02), when compared with the non-frail. The sleep latency influenced more the frailty (R2 = 0,13, β standard = 1,76, β = 0,41, p = 0,001). Weren t found differences between the standard resting-activity variable and the frailty phenotype categories. Conclusion: Sleeping alterations, including bad sleeping quality, prolonged sleep latency, low sleep efficiency and day drowsiness, influenced the frailty in institutionalized elderly

Diferenciación social campesina y señorío episcopal. Zamora, siglos XI-XIII

El presente trabajo indaga acerca de los procesos de diferenciación social campesina temprana en la Zamora medieval. Dicho proceso adquiere características particulares de acuerdo al marco señorial en que se inserten las comunidades. La documentación zamorana ha permitido agrupar los casos empíricos en dos tipos ideales, aquellos que presentan desarrollo de caballería y los que maduran al interior de cotos de abadengo. En cuanto al primer tipo, comprobamos que la caballería que surge de las propias clases campesinas tiende a transformarse en un sector privilegiado en la comunidad. Tal proceso de diferenciación se presenta con importantes disparidades evolutivas en las distintas comunidades. Las comunidades de este tipo que ingresan a la órbita episcopal evidencian conflictos violentos relacionados con la imposición de nuevos derechos señoriales y nuevas pautas de reproducción señorial. En cambio, en las aldeas desarrolladas desde su inicio al interior de cotos monásticos la diferenciación por el ejercicio de la función militar se encuentra negada. La única posibilidad estructural de diferenciación se relaciona con el ejercicio de funciones en representación del señor. El surgimiento de tales sectores evoluciona, entonces, de manera coherente con la construcción del poder señorial a escala local. En las comunidades con presencia de caballería será necesario desmontar las jerarquías preexistentes, proceso que determina que únicamente bien entrado el siglo XIII puedan comenzar a esbozarse nuevas elites locales y condiciones de poblamiento afines a la reproducción del señorío eclesiástico.

El régimen señorial castellano. Estudio del proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios pertenecientes a la Merindad de Castilla Vieja, entre los siglos XIV y XVI

Estudio sobre el proceso de acumulación patrimonial y político llevado adelante por la Casa de los Velasco en los territorios septentrionales de Castilla la Vieja en los siglos XIV y XVI.

Estructura y dinámica del dominio de Santo Toribio de Liébana : Siglos XIII-XVI

En "Estructura y dinámica del dominio de Santo Toribio de Liébana (siglos XIII-XVI)" se trata de explicar las características diferenciales que presenta un dominio monástico del área septentrional de la Península Ibérica. En la primera parte, siglo XIII y principios del siglo XIV, se considera que la pobreza material que ostenta el cenobio, observable en el escaso volumen de la renta y en las sucesivas enajenaciones de bienes efectuadas por sectores jerarquizados locales, es el resultado de la dispar consolidación de las estructuras feudales en el espacio. Frente a áreas cercanas al emplazamiento del monasterio en donde el señor limita la movilidad campesina y extrae excedentes elevados y estables, existen otras, consideradas como la "periferia" del dominio, en donde la pervivencia del ejercicio del derecho de retorno limitaba seriamente la consolidación de la propiedad dominical señorial. En dichas áreas, la estabilización de los derechos de propiedad del señor sólo se concretó a partir de la conformación de estructuras coercitivas de poder a nivel local que anularon el ejercicio efectivo del retorno familiar. En la segunda parte, siglos XIV-XVI, se analizan las estrategias específicas que permitieron el incremento del volumen de la renta en el largo plazo. Frente a las tesis que sostienen una temprana parcelación de la reserva y una conmutación de las prestaciones de trabajo, se observa aquí, por el contrario, el aumento de su extensión en los siglos finales de la Edad Media. Al mismo tiempo se detecta un proceso de parcelación de las tenencias campesinas, impulsado por el señor, que propiciaba un incremento de los fuegos sobre los que recaían las exacciones. Ambos aspectos, apropiación señorializada del espacio y aumento de la tasa de la renta, fueron el resultado del ejercicio efectivo de la coacción política.