Nutrional aspects of the prevention and treatment of osteoporosis

A osteoporose é um problema de saúde global, caracterizada por baixa massa óssea e deterioração da microarquitetura do tecido ósseo, com consequente aumento da fragilidade óssea e suscetibilidade a fraturas. A nutrição desempenha um papel fundamental na redução do risco de osteoporose por seu efeito sobre todos os fatores relacionados à fragilidade óssea, principalmente no desenvolvimento e na manutenção da massa óssea. Uma adequada ingestão de cálcio, vitamina D e proteína leva à redução da remodelação óssea, à maior retenção de cálcio, à redução da perda óssea relacionada à idade e à redução do risco de fraturas. Evidências recentes indicam que uma alimentação saudável, incluindo a ingestão de produtos lácteos (principalmente os desnatados), frutas e verduras, e uma quantidade adequada de carnes, peixes e aves, está relacionada positivamente com a saúde óssea. Além disso, a suplementação de vitaminas e minerais deve ser monitorada de perto, por profissionais de saúde, uma vez que pode ter efeitos adversos e ser insuficiente para assegurar uma eficaz proteção à saúde óssea

Consumption of a flaxseed-rich food is not more effective than a placebo in alleviating the climacteric symptoms of postmenopausal women

Our objective in this work was to test the effects of daily intake of bread produced with partially defatted ground flaxseed on the climacteric symptoms and endometrial thickness of postmenopausal women. A double-blind, placebo-controlled, randomized clinical trial was performed with 38 women who had been postmenopausal for 1–10 y and consumed 2 slices of bread containing 25 g of flaxseed (46 mg lignans) or wheat bran (<1 mg lignans; control) every day for 12 consecutive weeks. The outcome variables were the daily number of hot flashes, the Kupperman Menopausal Index (KMI), and endometrial thickness. The plasma lipid profile (total cholesterol and HDL, LDL, and VLDL cholesterol fractions and triglycerides) and the hormones estradiol, follicle-stimulating hormone, thyroid-stimulating hormone, and free thyroxine also were measured. Food intake was evaluated by means of 2 24-h recalls, before and after the treatment. Twenty patients in the study group and 18 in the control group completed the study. The general characteristics did not differ between the 2 groups at the start of the study. Both had significant, but similar, reductions in hot flashes and KMI after 3 mo of treatment. Moreover, endometrial thickness was not affected in either group. Our findings clearly show that although flaxseed is safe, its consumption at this level (46 mg lignans/d) is no more effective than placebo for reducing hot flashes and KMI

Violência sexual como questão de saúde pública: importância da busca ao agressor

Apesar de predominar junto à população a idéia de que a violência sexual é praticada por pessoas desconhecidas, na realidade a maioria desses crimes é praticada por pessoa identificável pela vítima. Além de conseqüências físicas e psicológicas, também há risco em adquirir o vírus HIV. Para prevenção deste, em situação de risco, há orientação para uso da quimioprofilaxia anti-retroviral. Esse uso, por 28 dias, pode trazer efeitos adversos com intensidades variáveis. O conhecimento da sorologia anti-HIV do agressor torna-se fundamental para manter, ou suspender, com segurança, essa indicação. Este estudo descritivo, realizado no Conjunto Hospitalar de Sorocaba, teve como objetivo identificar os agressores e suas respectivas sorologias. Foi realizado a partir de fichas de notificação e os prontuários no período de julho de 2003 a dezembro de 2005. Encontraram-se 920 vítimas de violência sexual, com idades entre oito meses e 77 anos, havendo predomínio do sexo feminino (86,5 por cento). Dentre os agressores, 76 por cento foram referidos como identificáveis. Indicou-se profilaxia anti-retroviral para 24,9 por cento das vítimas. Para 80 (33,2 por cento) agressores localizados, a busca foi realizada através de contato telefônico. Encontrou-se 52,5 por cento em seus domicílios, 45 por cento em Presídio/Delegacia e 2,5 por cento no Pronto Socorro. Um agressor (1,3 por cento) apresentou sorologia positiva para HIV. As buscas encerraram-se, em sua maioria, em até seis dias (80 por cento), possibilitando a suspensão da quimioprofilaxia em 30,6 por cento dos casos. Concluiu-se que a busca ao denunciado permitiu conhecer sua sorologia anti-HIV e suspender, para um terço das vítimas, o uso da quimioprofilaxia anti-retroviral, diminuindo, com isso, a possibilidade de efeitos adversos

Sobre as dores e temores do parto: dimensões de uma escuta

OBJETIVOS: desenvolver algumas reflexões sobre os possíveis efeitos benéficos de uma escuta responsiva à verbalização da presença de dor, medos e seus correlatos na cena do parto tomando como base dados empíricos de pesquisa realizada em maternidade situada na cidade de São Paulo, Brasil. MÉTODOS: estudo descritivo, de metodologia qualitativa, referenciado no quadro teórico da Psicologia Social, Psicanálise e Lingüística, utilizando entrevistas semi-estruturadas com 20 parturientes e sete doulas e observação de rotinas da maternidade. RESULTADOS: a análise, apoiada em categorias estabelecidas (subjetividade auto-referida, intersubjetividade, acolhimento, apropriação da experiência) mostrou, entre outros pontos, a importância e a valorização da interlocução qualificada no processo da parturição. Processo esse referido pelas parturientes como experiência de elevado grau de estresse, com vivências de dor, medos e ansiedades, porém mitigados pelo apoio recebido. CONCLUSÕES: a análise permitiu compreender as relações interpessoais como campo de interlocução e acolhimento percebidos pelas mulheres do estudo capazes de produzir efeitos favoráveis sobre as vivências do estresse materno, configurando-se como recurso técnico, qualificado e valioso, oferecido à parturiente

Síndrome metabólica: o novo desafio da Nutrição

A síndrome metabólica (SM) consiste em um conjunto de fatores de risco cardiovascular relacionados à obesidade abdominal e à resistência à insulina, refletindo no aumento da glicemia e da pressão arterial e na ocorrência de dislipidemia. Critérios recentes utilizados para a classificação da síndrome consideram a circunferência da cintura e a pressão arterial elevadas, pré-diabetes, hipertrigliceridemia e HDL colesterol reduzido. A SM pode aumentar consideravelmente o risco de desenvolvimento e de mortalidade por doenças e agravos não transmissíveis, como diabetes e doenças cardiovasculares. Sua ocorrência é multifatorial, envolvendo aumento ponderal, alimentação inadequada, inatividade física, predisposição genética e tabagismo. Ações preventivas mostram-se mais efetivas para a diminuição de riscos, quando comparadas ao tratamento de suas consequências, sendo importante a promoção da alimentação saudável, que envolve incentivo ao consumo de fibras e de gorduras insaturadas e moderação das saturadas e trans e de sódio

Effectiveness of a School-Based Intervention on Physical Activity for High School Students in Brazil: The Saude na Boa Project

Background: We evaluated the effectiveness of a school-based intervention on the promotion of physical activity among high school students in Brazil: the Saude no Boa project. Methods: A school-based, randomized trial was carried out in 2 Brazilian cities: Recife (northeast) and Florianopolis (south). Ten schools in each city were matched by size and location, and randomized into intervention or control groups. The intervention included environmental/organizational changes, physical activity education, and personnel training and engagement. Students age 15 to 24 years were evaluated at baseline and 9 months later (end of school year). Results: Although similar at baseline, after the intervention, the control group reported significantly fewer d/wk accumulating 60 minutes+ moderate-to-vigorous physical activity (MVPA) in comparison with the intervention group (2.6 versus 3.3, P < .001). The prevalence of inactivity (0 days per week) rose in the control and decreased in the intervention group. The odds ratio for engaging at least once per week in physical activity associated with the intervention was 1.83 (95% CI = 1.24-2.71) in the unadjusted analysis and 1.88 (95% CI = 1.27-2.79) after controlling for gender. Conclusion: The Saude no Boa intervention was effective at reducing the prevalence of physical inactivity. The possibility of expanding the intervention to other locations should be considered.

Mobility and social network effects on extremist opinions

Understanding the emergence of extreme opinions and in what kind of environment they might become less extreme is a central theme in our modern globalized society. A model combining continuous opinions and observed discrete actions (CODA) capable of addressing the important issue of measuring how extreme opinions might be has been recently proposed. In this paper I show extreme opinions to arise in a ubiquitous manner in the CODA model for a multitude of social network structures. Depending on network details reducing extremism seems to be possible. However, a large number of agents with extreme opinions is always observed. A significant decrease in the number of extremists can be observed by allowing agents to change their positions in the network.

Fermentation of Groundnut Shell Enzymatic Hydrolysate for Fuel Ethanol Production by Free and Sorghum Stalks Immobilized Cells of Pichia stipitis NCIM 3498

Groundnut shell (GS), after separation of pod, is readily available as a potential feedstock for production of fermentable sugars. The substrate was delignified with sodium sulfite. The delignified substrate released 670 mg/g of sugars after enzymatic hydrolysis (50 degrees C, 120 rpm, 50 hrs) using commercial cellulases (Dyadic Xylanase PLUS, Dyadic Inc. USA). The groundnut shell enzymatic hydrolysate (45.6 g/L reducing sugars) was fermented for ethanol production with free and sorghum stalks immobilized cells of Pichia stipitis NCIM 3498 under submerged cultivation conditions. Immobilization of yeast cells on sorghum stalks were confirmed by scanning electron microscopy (SEM). A maximum of ethanol production (17.83 g/L, yield 0.44 g/g and 20.45 g/L, yield 0.47 g/g) was observed with free and immobilized cells of P. stipitis respectively in batch fermentation conditions. Recycling of immobilized cells showed a stable ethanol production (20.45 g/L, yield 0.47 g/g) up to 5 batches followed by a gradual downfall in subsequent cycles.

Chaotic Patterns in Aeroelastic Signals

This work presents the analysis of nonlinear aeroelastic time series from wing vibrations due to airflow separation during wind tunnel experiments. Surrogate data method is used to justify the application of nonlinear time series analysis to the aeroelastic system, after rejecting the chance for nonstationarity. The singular value decomposition (SVD) approach is used to reconstruct the state space, reducing noise from the aeroelastic time series. Direct analysis of reconstructed trajectories in the state space and the determination of Poincare sections have been employed to investigate complex dynamics and chaotic patterns. With the reconstructed state spaces, qualitative analyses may be done, and the attractors evolutions with parametric variation are presented. Overall results reveal complex system dynamics associated with highly separated flow effects together with nonlinear coupling between aeroelastic modes. Bifurcations to the nonlinear aeroelastic system are observed for two investigations, that is, considering oscillations-induced aeroelastic evolutions with varying freestream speed, and aeroelastic evolutions at constant freestream speed and varying oscillations. Finally, Lyapunov exponent calculation is proceeded in order to infer on chaotic behavior. Poincare mappings also suggest bifurcations and chaos, reinforced by the attainment of maximum positive Lyapunov exponents. Copyright (C) 2009 F. D. Marques and R. M. G. Vasconcellos.

Análise faunística de himenópteros visitantes florais em fragmento de cerradão em Itirapina, SP

Bees are considered one of the most efficient pollinators. Therefore, they have Indisputable role in the plants reproduction, since they increase the quality and quantity of fruit and seeds, and thus they help the ecosystems maintenance. Cerrado is one of the most affected ecosystems due to the growth of human activities, drastically reducing its biodiversity. The faunistic analysis identifies the species and the size of the populations, and can also indicate the degree of environmental Impact on a particular area. Surveys on flower-visiting hymenoptera in a cerradao area, with 40ha, in the Experimental Station of Itiparina (SP), were conducted every fifteen days from March 2003 to February 2004. From 181 insects collected, the Apidae family was represented by the largest number of species and individuals. The species Apis mellifera (55.8%), Trigona spinipes (14.4%) and Exomalopsis (Exomalopsis) sp. (8.3%) were the most prevalent fit the area. Among the bees species collected, 30.8% were classified as sociable and 69.2% as solitary. Considering all hymenoptera collected, 59.7% preferred the morning period and 40.3% the afternoon period for foraging and/or visiting. The Diversity index (Shannon-Wiener) H was 1.6933, V(H) = 0.0123 and Uniformity index E = 0.5652, following pattern found in other areas of cerrado.

Políticas públicas ambientais no Brasil: mitigação das mudanças climáticas

Since the mid of 1980 an, discussed global climate change in the international sphere. This process resulted in the achievement of the United Nations Conference for Environment and Development UNCED, held in Rio de Janeiro in 1992, which resulted, among other documents, the Framework Convention of Climate Change - CMC. After five years, there was the establishment of the Kyoto Protocol - PK - which, unlike the Convention, set clearer standards on reducing emissions of gases effect of studying and targets to be achieved by countries which have issued more gas in the past, in the Annex I. The aim of this text is to analyze the ongoing federal public policies regarding mitigation of climate change in the country. To that end, it is based on analysis of official documentation. It analyzes policies before and after the adoption of the CMC in Brazil.

The Effects of a 785-nm AlGaInP Laser on the Regeneration of Rat Anterior Tibialis Muscle After Surgically-Induced Injury

Objective: This study aims to investigate the effects of low-level laser therapy (LLLT) on muscle regeneration. For this purpose, the anterior tibialis muscle of 48 male Wistar rats received AlGaInP laser treatment (785 nm) after surgically-induced injury. Background Data: Few studies have been conducted on the effects of LLLT on muscle regeneration at different irradiation doses. Materials and Methods: The animals were randomized into four groups: uninjured rats (UN); uninjured and laser-irradiated rats (ULI); injured rats (IN); and injured and laser-irradiated rats (ILI). The direct contact laser treatment was started 24 h after surgery. An AlGaInP diode laser emitting 75 mW of continuous power at 785 nm was used for irradiation. The laser probe was placed at three treatment points to deliver 0.9 J per point, for a total dose of 2.7 J per treatment session. The animals were euthanized after treatment sessions 1, 2, and 4. Mounted sections were stained with hematoxylin and eosin and used for quantitative morphological analysis, in which the number of leukocytes and fibroblasts were counted over an area of 4480 mu m(2). The data were statistically analyzed by analysis of variance (ANOVA) and the Bonferroni t-test. Results: Quantitative data showed that the number of both polymorphonuclear and mononuclear leukocytes in the inflammatory infiltrate at the injury site was smaller in the ILI(1), ILI(2), and ILI(4) subgroups compared with their respective control subgroups (IN(1), IN(2), and IN(4)) for sessions 1, 2, and 4, respectively (p < 0.05). On the other hand, the number of fibroblasts increased after the fourth treatment session (p < 0.05). With regard to the regeneration of muscle fibers following injury, only after the fourth treatment session was it possible to find muscle precursor cells such as myoblasts and some myotubes in the ILI(4) subgroup. Conclusion: During the acute inflammatory phase, the AlGaInP laser treatment was found to have anti-inflammatory effects, reducing the number of leukocytes at the injury site and accelerating the regeneration of connective tissue.

Intrahepatic Glissonian Approach for Pure Laparoscopic Left Hemihepatectomy

Background: Recent advances in laparoscopic devices and experience with advanced techniques have increased the indications for laparoscopic liver. Aim: The aim of this work was to present a video with technical aspects of a pure laparoscopic left hemi-hepatectomy (segments 2, 3, and 4) by using the intrahepatic Glissonian approach and control of venous outflow without hilar dissection or the Pringle maneuver. Patient and Method: A 63-year-old woman with a 5-cm solitary liver metastasis was referred for treatment. Four trocars were used. The left lobe was pulled upward and the lesser omentum was divided, exposing Arantius' ligament. This ligament is a useful landmark for the identification of the main left Glissonian pedicle. A small anterior incision was made in front of the hilum, and a large clamp was introduced behind the Arantius' ligament toward the anterior incision, allowing control of the left main sheath. Ischemic discoloration of the left liver was achieved and marked with cautery. The vascular clamp was replaced by a stapler. If ischemic delineation was coincident with a previously marked area, the stapler was fired. The left hepatic vein was dissected and encircled. Parenchymal transection and vascular control of the hepatic veins were accomplished with a Harmonic scalpel and an endoscopic stapling device, as appropriate. All these steps were performed without the Pringle maneuver and without hand assistance. Results: Operative time was 220 minutes with minimum blood loss. Hospital stay was 4 days. Pathology showed free surgical margins. The patient is alive with no signs of recurrence 18 months after the operation. Conclusion: Totally laparoscopic left hemihepatectomy is safe and feasible in selected patients and should be considered for patients with benign or malignant liver neoplasms. The described technique, with the use of the intrahepatic Glissonian approach and control of venous outflow, may facilitate laparoscopic left hemihepatectomy by reducing the technical difficulties in pedicle control and may decrease bleeding during liver transection.

A Comparison of Bimatoprost 0.03% Versus the Fixed-Combination of Latanotoprost 0.005% and Timolol 0.5% in Adult Patients With Elevated Intraocular Pressure: An Eight-Week, Randomized, Open-Label Trial

Introduction and Purpose: Bimatoprost and the fixed combination of latanoprost with timolol maleate are 2 medications widely used to treat glaucoma and ocular hypertension (OHT). The aim of the study is to compare the efficacy of these 2 drugs in reducing intraocular pressure (IOP) after 8 weeks of treatment in patients with primary open angle glaucoma (POAG) or OHT. Methods: In this randomized, open-label trial, 44 patients with POAG or OHT were allocated to receive either bimatoprost (1 drop QD) or latanoprost/timolol (1 drop QD). Primary outcome was the mean diurnal IOP measurement at the 8th week, calculated as the mean IOP measurements taken at 8:00 AM, 10: 00 AM, and 12: 00 PM Secondary outcomes included the baseline change in IOP measured 3 times a day, after the water-drinking test (performed after the last IOP measurement), and the assessment of side effects of each therapy. Results: The mean IOP levels of latanoprost/timolol (13.83, SD = 2.54) was significantly lower than of bimatoprost (16.16, SD = 3.28; P < 0.0001) at week 8. Also, the change in mean IOP values was significantly higher in the latanoprost/timolol group at 10:00 AM (P = 0.013) and 12:00 PM (P = 0.01), but not at 8: 00 AM (P = ns). During the water-drinking test, there was no signifi cant difference in IOP increase (absolute and percentage) between groups; however, there was a signifi cant decrease in mean heart rate in the latanoprost/timolol group. Finally, no signifi cant changes in blood pressure and lung spirometry were observed in either groups. Conclusions: The fixed combination of latanoprost/timolol was significantly superior to bimatoprost alone in reducing IOP in patients with POAG or OHT. Further studies with large sample sizes should be taken to support the superior efficacy of latanoprost/timolol, as well as to better assess its profile of side effects.

Suppression subtractive hybridization analysis reveals expression of conserved and novel genes in male accessory glands of the ant Leptothorax gredleri

Background: During mating, insect males eject accessory gland proteins (Acps) into the female genital tract. These substances are known to affect female post-mating behavior and physiology. In addition, they may harm the female, e. g., in reducing its lifespan. This is interpreted as a consequence of sexual antagonistic co-evolution. Whereas sexual conflict abounds in non-social species, the peculiar life history of social insects (ants, bees, wasps) with lifelong pair-bonding and no re-mating aligns the reproductive interests of the sexes. Harming the female during mating would negatively affect male fitness and sexual antagonism is therefore not expected. Indeed, mating appears to increase female longevity in at least one ant species. Acps are presumed to play a role in this phenomenon, but the underlying mechanisms are unknown. In this study, we investigated genes, which are preferentially expressed in male accessory glands of the ant Leptothorax gredleri, to determine which proteins might be transferred in the seminal fluid. Results: By a suppression subtractive hybridization protocol we obtained 20 unique sequences (USs). Twelve had mutual best matches with genes predicted for Apis mellifera and Nasonia vitripennis. Functional information (Gene Ontology) was available only for seven of these, including intracellular signaling, energy-dependent transport and metabolic enzyme activities. The remaining eight USs did not match sequences from other species. Six genes were further analyzed by quantitative RT-PCR in three life cycle stages of male ants. A gene with carboxy-lyase activity and one of unpredicted function were significantly overexpressed in accessory glands of sexually mature males. Conclusions: Our study is the first one to investigate differential gene expression in ants in a context related to mating. Our findings indicate that male accessory glands of L. gredleri express a series of genes that are unique to this species, possibly representing novel genes, in addition to conserved ones for which functions can be predicted. Identifying differentially expressed genes might help to better understand molecular mechanisms involved in reproductive processes in eusocial Hymenoptera. While the novel genes could account for rapidly evolving ones driven by intra-sexual conflict between males, conserved genes imply that rather beneficial traits might get fixed by a process described as inter-sexual cooperation between males and females.