In vitro and clinical evaluation of specific dentifrices for complete denture hygiene

To study the physical properties of two experimental dentifrices for complete denture hygiene, their effect on denture biofilm removal and antimicrobial properties by means of a clinical trial. The experimental dentifrices comprised two compositions. One was based on the addition of 1% chloramine T (D1) and the other on the presence of 0.01% fluorosurfactant (D2). Measurements of density, pH, consistency, rheological features and abrasiveness were conducted. Sixty complete denture wearers were randomly assigned to three groups and were instructed to brush their dentures with a specific toothbrush: (1) Water (control); (2) D1; or (3) D2. Each method was used for 21 days. Denture biofilm was disclosed by a 1% neutral red solution and quantified by means of digital photos taken from the internal surface. Microbiological assessment was conducted to quantify Candida sp. and mutans streptococci. Data were evaluated by one-way anova and Tukey HSD, or Kruskal-Wallis (alpha = 0.05). Both dentifrices decreased biofilm coverage when compared with the control group. D1 was the most efficacious treatment to reduce mutans streptococci, whereas D2 showed an intermediate outcome (anova, p < 0.040). No treatment influenced Candida albicans or non-albicans species (Kruskal-Wallis, p = 0.163 and 0.746, respectively). It can be concluded that brushing complete dentures with the experimental dentifrices tested could be effective for the removal of denture biofilm.

Problems with accessibility to health services by persons with disabilities in Sao Paulo, Brazil

Purpose. To describe the occurrence of self-reported problems of accessibility to health services used by persons with disabilities in terms of social and health services variables. Methods. We performed a cross-sectional household survey designed to assess problems with accessibility to health services faced by persons with disabilities. We interviewed 333 persons in Sao Paulo city, in 2007. Variables related to the presence of accessibility problems, disabilities, gender, age, family head income, ethnicity, use of health services and others were analysed using frequencies, percentages, chi(2)-test, ANOVA and Poisson regression models. Results. 15.92% of the interviewed persons reported problems with accessibility to health services. Persons having multiple (prevalence ratios; PR = 2.91) or mobility disability (PR = 6.46) had more problems with accessibility than persons with hearing disability. Persons younger than 78 years old had more problems with accessibility; those who needed help to go to the health service (PR = 3.01) also. Conclusions. Persons with multiple or mobility disability, younger than 78 years, and those who needed help of others to go to the health service were more likely to have problems with accessibility to health services. This information could be one of the first steps to the management and/or planning of appropriate health services for persons with disabilities.

Seasonal patterns of viral and bacterial infections among children hospitalized with community-acquired pneumonia in a tropical region

Community-acquired pneumonia (CAP) is a common cause of morbidity among children. Evidence on seasonality, especially on the frequency of viral and bacterial causative agents is scarce; such information may be useful in an era of changing climate conditions worldwide. To analyze the frequency of distinct infections, meteorological indicators and seasons in children hospitalized for CAP in Salvador, Brazil, nasopharyngeal aspirate and blood were collected from 184 patients aged < 5 y over a 21-month period. Fourteen microbes were investigated and 144 (78%) cases had the aetiology established. Significant differences were found in air temperature between spring and summer (p = 0.02) or winter (p < 0.001), summer and fall (p = 0.007) or winter (p < 0.001), fall and winter (p = 0.002), and on precipitation between spring and fall (p = 0.01). Correlations were found between: overall viral infections and relative humidity (p = 0.006; r = 0.6) or precipitation (p = 0.03; r = 0.5), parainfluenza and precipitation (p = 0.02; r = -0.5), respiratory syncytial virus (RSV) and air temperature (p = 0.048; r = -0.4) or precipitation (p = 0.045; r = 0.4), adenovirus and precipitation (p = 0.02; r = 0.5), pneumococcus and air temperature (p = 0.04; r = -0.4), and Chlamydia trachomatis and relative humidity (p = 0.02; r = -0.5). The frequency of parainfluenza infection was highest during spring (32.1%; p = 0.005) and that of RSV infection was highest in the fall (36.4%; p < 0.001). Correlations at regular strength were found between several microbes and meteorological indicators. Parainfluenza and RSV presented marked seasonal patterns.

Procalcitonin is useful in identifying bacteraemia among children with pneumonia

Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-alpha) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-alpha were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-alpha (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56-7.56), non-bacteraemic typical bacterial (1.47; 0.24-4.07), atypical bacterial (0.18; 0.06-1.03) and only viral (0.65; 0.11-2.22) subgroups was significant (p = 0.02). PCT was >= 2 ng/ml in 52 (33%) cases. The presence of IFN-alpha was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT >= 2 ng/ml was 95% (89-100%), 89% (78-100%), 93% (85-100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49-68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-alpha was uncommonly detected.

Physical disability, recent illnesses and health self-assessment in a population-based study in Sao Paulo, Brazil

Objectives. To investigate health self-assessment and to estimate the prevalence of chronic diseases and recent illnesses in people with and without physical disabilities (PD) in the state of Sao Paulo, southeastern Brazil. Study design. A Cross-sectional study comprising two population-based health surveys conducted in 2002 and 2003. Methods. A total of 8317 persons (165 with PD) were interviewed in the two studies. Variables concerning to health self-assessment; chronic disease and recent illness were compared in the people with and without PD. Negative binomial regression was used in the analysis. Results. Subjects with PD more often assessed their health as poor/very poor compared to non-disabled ones. They reported more illnesses in the 15 days prior to interview as well as more chronic diseases (skin conditions, anaemia, chronic kidney disease, stroke, depression/anxiety, migraine/headache, pulmonary diseases, hypertension, diabetes, arthritis/arthrosis/rheumatic conditions and heart disease). This higher disease prevalence can be either attributed to disability itself or be associated to gender, age and schooling. Conclusions. Subjects with PD had more recent illnesses and chronic diseases and poorer health self-assessment than non-disabled ones. Age, gender, schooling and disability have individual roles in disease development among disabled people.

Health in Brazil 5 Violence and injuries in Brazil: the effect, progress made, and challenges ahead

Although there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate was 26.8 per 100 000 people and traffic-related mortality was 23.5 per 100 000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Regional differentials are also substantial. Besides the sociocultural determinants, much of the violence in Brazil has been associated with the misuse of alcohol and illicit drugs, and the wide availability of firearms. The high traffic-related morbidity and mortality in Brazil have been linked to the chosen model for the transport system that has given priority to roads and private-car use without offering adequate infrastructure. The system is often poorly equipped to deal with violations of traffic rules. In response to the major problems of violence and injuries, Brazil has greatly advanced in terms of legislation and action plans. The main challenge is to assess these advances to identify, extend, integrate, and continue the successful ones.

The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country

We report an investigation for 16 bacteria and viruses among 184 children hospitalized with pneumonia in Salvador, Brazil. Etiology was established in 144 (78%) cases. Viral, bacterial, and mixed infections were found in 110 (60%), 77 (42%), and 52 (28%) patients, respectively. Rhinovirus (21%) and Streptococcus pneumoniae (21%) were the most common pathogens. Our results demonstrate the importance of viral and pneumococcal infections among those patients.

Psychometric evaluation of the Disordered Eating Attitude Scale (DEAS). English version

Eating attitudes are defined as beliefs, thoughts, feelings, behaviors and relationship with food They could influence people`s food choices and their health status Objective This study aimed to adapt from Portuguese to English the Disordered Eating Attitude Scale (DEAS) and evaluate its validity and reliability. The original scale in Portuguese was translated and adapted into English and was applied to female university students of University of Minnesota USA (n = 224). Internal consistency was determined (Cronbach`s Alpha). Convergent validity was assessed by correlations between Eating Attitude Test-26 (EAT-26) and Restrain Scale (RS). Reliability was evaluated applying twice the scale to a sub-sample (n = 30). The scale was back translated into Portuguese and compared with the original version and discrepancies were not found. The internal consistency was .76 The DEAS total score was significantly associated with EAT-26 (r = 0.65) and RS (r = 0 69) scores The correlation between test-retest was r = 09 The English version of DEAS showed appropriate internal consistency, convergent validity and test-retest reliability and will be useful to assess eating attitudes in different population groups in English spoken countries. (C) 2010 Elsevier Ltd. All rights reserved

Socio-economic variables influence the prevalence of inadequate nutrient intake in Brazilian adolescents: results from a population-based survey

Objective: To estimate the prevalence of inadequate nutrient intake among adolescents and the association between socio-economic variables and nutritional status. Design: Cross-sectional study with a population-based sample. Settings: The usual nutrient intake distribution was estimated using the Iowa State University method. The Estimated Average Requirement cut-off point method was used to determine the proportion of adolescents with inadequate intake for each nutrient, according to sex, income, parental educational level and nutritional status. Subjects: Twenty-four-hour dietary recalls were applied in 525 male and female Brazilian adolescents aged 14-18 years. Results: The highest prevalence of inadequate nutrient intake was observed for vitamin E (99% in both sexes). For male and female adolescents, the prevalence of inadequate intake was: Mg, 89% and 84%; vitamin A, 78% and 71 %; vitamin C, 79% and 53%; and vitamin B(6), 21% and 33%, respectively. The prevalence of inadequate intake for niacin, thiamin, riboflavin, Se, Cu and vitamin B(12) was <15 %. Individuals in the lower income and lower parental educational level strata had the highest risk of having inadequate intake for P, riboflavin and vitamins A, B(6) and B(12). Compared with non-overweight individuals, overweight individuals had a higher risk of inadequate intake for Mg, vitamin A, P, thiamin and riboflavin. Conclusions: The present study found a high prevalence of inadequate intake of nutrients that are recognised as being protective against chronic diseases. Adolescents in the lower income and lower parental educational level strata were less likely to have their nutrient intake requirements met.

Subclinical thyroid dysfunctions are independent risk factors for mortality in a 7.5-year follow-up: the Japanese-Brazilian thyroid study

Objective: The currently available data concerning the influence of subclinical thyroid disease (STD) on morbidity and mortality are conflicting. Our objective was to investigate the relationships between STD and cardiometabolic profile and cardiovascular disease at baseline, as well as with all-cause and cardiovascular mortality in a 7.5-year follow-up. Design: Prospective, observational study. Methods: An overall of 1110 Japanese-Brazilians aged above 30 years, free of thyroid disease, and not taking thyroid medication at baseline were studied. In a cross-sectional analysis, we investigated the prevalence of STD and its relationship with cardiometabolic profile and cardiovascular disease. All-cause and cardiovascular mortality rates were assessed for participants followed for up to 7.5 years. Association between STD and mortality was drawn using multivariate analysis, adjusting for potential confounders. Results: A total of 913 (82.3%) participants had euthyroidism, 99 (8.7%) had subclinical hypothyroidism, and 69 (6.2%) had subclinical hyperthyroidism. At baseline, no association was found between STD and cardiometabolic profile or cardiovascular disease. Multivariate-adjusted hazard ratios (HRs (95% confidence interval)) for all-cause mortality were significantly higher for individuals with both subclinical hyperthyroidism (HR, 3.0 (1.5-5.9); n=14) and subclinical hypothyroidism (HR, 2.3 (1.2-4.4); n=13) than for euthyroid subjects. Cardiovascular mortality was significantly associated with subclinical hyperthyroidism (HR, 3.3 (1.4-7.5); n=8), but not with subclinical hypothyroidism (HR, 1.6 (0.6-4.2); n=5). Conclusion: In the Japanese-Brazilian population, subclinical hyperthyroidism is an independent risk factor for all-cause and cardiovascular mortality, while subclinical hypothyroidism is associated with all-cause mortality.

Garlic (Allium sativum L.) and ready-to-eat garlic products: In vitro antioxidant activity

Garlic contains polyphenol and sulphur compounds, which are responsible for its antioxidant activity (AA). This study aimed at evaluating the AA of fresh garlic and its commercialised products and their shelf life. Fresh garlic (FG) and its products, i.e. chopped with salt (CGS), chopped without Salt (CG), fried (FRG) and mixed garlic (FG with dehydrated garlic; MG) antioxidant activity was evaluated by three different methods: DPPH (1,1-diphenyl-2-picrylhydrazyl) assay, beta-carotene/linoleic acid assay and Rancimat method. Amongst all the analysed products, fried garlic presented the highest antioxidant activity. The free radical-scavenging activity decreased during the shelf life of all analysed products that correlated with the decrease in the total polyphenol content. Our findings suggest that some compounds other than phenol may have contributed towards this outcome. (c) 2008 Elsevier Ltd. All rights reserved.

Perception of eating practices and stages of change among Brazilian adolescents

Objective. To evaluate the perception of eating practices and the stages of change among adolescents. Methods. Cross-sectional study involving a representative sample of 390 adolescents from 11 public schools in the city of Piracicaba, Brazil, in 2004. Food consumption was identified by a food frequency questionnaire and the perception of eating practices evaluation was conducted by comparing food consumption and individual classification of healthy aspects of the diet. The participants were classified within stages of change by means of a specific algorithm. A reclassification within new stages of change was proposed to identify adolescents with similar characteristics regarding food consumption and perception. Results. Low consumption of fruit and vegetables and high consumption of sweets and fats were identified. More than 44% of the adolescents had a mistaken perception of their diet. A significant relationship between the stages of change and food consumption was observed. The reclassification among stages of change, through including the pseudo-maintenance and non-reflective action stages was necessary, considering the high proportion of adolescents who erroneously classified their diets as healthy. Conclusion. Classification of the adolescents into stages of change, together with consumption and perception data, enabled identification of groups at risk, in accordance with their inadequate dietary habits and non-recognition of such habits. (C) 2009 Elsevier Inc. All rights reserved.

Physical and sensory properties of regular and reduced-fat pound cakes with added amaranth flour

The sum of wheat flour and corn starch was replaced by 10, 20, or 30% whole amaranth flour in both conventional (C) and reduced fat (RF) pound cakes. and the effects on physical and sensory properties of the cakes were investigated. RF presented 33% fat reduction. The increasing amaranth levels darkened crust and crumb of cakes, which decreased color acceptability. Fresh amaranth-containing cakes had similar texture characteristics to (he controls, evaluated both instrumentally and sensorially. Sensory evaluation revealed that replacement by 30% amaranth flour decreased C cakes overall acceptability scores, clue to its lower specific volume and darker color. Amaranth flour levels had no significant effect on overall acceptability of RF cakes. Hence, the sum of wheat flour and corn starch could be successfully replaced by up to 20% amaranth flour in C and up to 30% in RF pound cakes without negatively affecting sensory quality in fresh cakes. Moisture losses for all the cakes were similar, approximate to 1% per day during storage. After six days of storage, both C and RF amaranth-containing cakes had higher hardness and chewiness values than control cakes. Further experiments involving sensory evaluation during storage are necessary to determine the exact limit of amaranth flour replacement.

Effects of processing methods on amaranth starch digestibility and predicted glycemic index

Amaranth has attracted a great deal of interest in recent decades due to its valuable nutritional, functional, and agricultural characteristics. Amaranth seeds can be cooked, popped, roasted, flaked, or extruded for consumption. This study compared the in vitro starch digestibility of processed amaranth seeds to that of white bread. Raw seeds yielded rapidly digestible starch content (RDS) of 30.7% db and predicted glycemic index (pGI) of 87.2, the lowest among the studied products. Cooked, extruded, and popped amaranth seeds had starch digestibility similar to that of white bread (92.4, 91.2, and 101.3, respectively), while flaked and roasted seeds generated a slightly increased glycemic response (106.0 and 105.8, respectively). Cooking and extrusion did not alter the RDS contents of the seeds. No significant differences were observed among popped, flaked, and roasted RDS contents (38.0%,46.3%, and 42.9%, respectively), which were all lower than RDS content of bread (51.1%). Amaranth seed is a high glycemic food most likely because of its small starch granule size, low resistant starch content (< 1%), and tendency to completely lose its crystalline and granular starch structure during those heat treatments.

Changing attitudes, beliefs and feelings towards food in bulimic patients

Eating attitudes are defined as beliefs. thoughts, feelings and behaviors towards food. Bulimia nervosa (BN) is ail eating disorder, in which the eating, attitudes are Seriously disturbed. Studies that evaluated nutritional aspects of BN focus mainly oil food intake, dietary restriction and binge eating. while the follow-up Studies evaluate mainly clinical symptoms. The objective of this study was to evaluate eating attitudes of patients with BN. during and after cognitive-behavioral intervention. Thirty nine (39) BN female patients received cognitive behavioral treatment with a Multidisciplinary team and had eating attitudes assessed by a questionnaire developed for this research. Frequencies of the attitudes assessed were compared at baseline. after 12 weeks and 24 weeks of treatment. After treatment, patients had less distorted beliefs about food, less guilty after eating ""forbidden"" foods and they felt more tranquil while caring outside home. Other negative behaviors, as dietary restriction, the desire of not cat, being angry when feeling hungry and using the food to relive stress. persisted. Eating attitudes of patients with BN are hard to be changed in a short-term. More attention to this disease`s component and new approaches to treatment are needed in order to have a better recovery.