Bone mineral density in Brazilian men 50 years and older

Bone mineral density (BMD) in the lumbar spine (LSBMD), femoral neck (FNBMD) and whole body (WBBMD) and whole body tissue composition were evaluated in 288 Brazilian men 50 years and older, 80% white and 20% Mulattoes. Age was inversely correlated with WBBMD (r = -0.20) and FNBMD (r = -0.21) but not with LSBMD (r = 0.03). Body mass index and weight showed a strong positive correlation with WBBMD (r = 0.48 and 0.54), LSBMD (r = 0.37 and 0.45) and FNBMD (r = 0.42 and 0.48). Correlation with height was positive but weaker. No significant bone loss at the lumbar spine level was observed as the population aged. FNBMD and WBBMD decreased significantly only in the last decade (age 70-79) studied. BMD was higher for Brazilian men as compared to Brazilian women at all sites. No significant differences were observed between Brazilian and the US/European male population for BMD in the femoral neck. BMD measured by dual-energy X-ray absorptiometry in South American men is reported here for the first time. A decrease in FNBMD was detected only later in life, with a pattern similar to that described for the US/European male population.

Reduction of intraspecific aggression in adult rats by neonatal treatment with a selective serotonin reuptake inhibitor

Most studies suggest that serotonin exerts an inhibitory control on the aggression process. According to experimental evidence, this amine also influences growth and development of the nervous tissue including serotoninergic neurons. Thus, the possibility exists that increased serotonin availability in young animals facilitates a long-lasting effect on aggressive responses. The present study aimed to investigate the aggressive behavior of adult rats (90-120 days) treated from the 1st to the 19th postnatal day with citalopram (CIT), a selective serotonin reuptake inhibitor (20 mg/kg, sc, every 3 days). Aggressive behavior was induced by placing a pair of rats (matched by weight) in a box (20 x 20 x 20 cm), and submitting them to a 20-min session of electric footshocks (five 1.6-mA - 2-s current pulses, separated by a 4-min intershock interval). When compared to the control group (rats treated for the same period with equivalent volumes of saline solution), the CIT group presented a 41.4% reduction in the duration of aggressive response. The results indicate that the repeated administration of CIT early in life reduces the aggressive behavior in adulthood and suggest that the increased brain serotoninergic activity could play a role in this effect.

Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women

Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297), with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/Northeast (urban underdeveloped) and South/Southeast/Midwest (urban developed). The dependent variables were current body mass index (BMI) measured, BMI prior to childbearing (reported), and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI > or = 25 kg/m²) was higher among shorter women (<1.50 m) compared to normal stature women only in the urban developed region (P < 0.05). After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008) for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P <= 0.04). These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.

Female pelvic floor disorders – outcome after mesh-augmented procedures and studies on vaginal connective tissue

Pelvic floor disorders, such as urinary incontinence (UI) and pelvic organ prolapse (POP), are common disorders in women. Because of the prolonged life expectancy the prevalence of UI and POP and the probability of ending up in surgery are increasing. However, the pathophysiology behind these disorders is still unsolved. The aim of this thesis is to study possible alterations in the connective tissue in the vaginal wall in patients with and without POP. The long-term outcome and complications of mid-urethral slings (MUS) and mesh-augmented POP surgery were studied in heterogenic patient populations. More elastin and a slight increase in immunostaining of type III and V collagens in tissue samples were obtained from patients with POP compared to controls in whom type I collagen was more prominent. The studies assessing the mesh-augmented procedures revealed good efficacy and high patient satisfaction after a long-term follow-up. Patients operated on because of mixed incontinence and with BMI >30 kg/m² reported significantly more urinary symptoms and a lower quality of life than the patients operated on because of stress urinary incontinence and the ones with BMI ≤30 kg/m². The objective outcome was equal between the groups. Mesh exposure through vaginal mucosa occurred in 23 % of the patients after POP surgery, most of these being asymptomatic. There are alterations in connective tissues in patients with POP. Mid-urethral sling procedures produced good long-term cure rates and patient satisfaction. As to the prolapse surgery, in spite of relatively high exposure rate, mesh-augmented procedure proved to be safe and effective method for the correction of POP.

Seroprevalence of human herpesvirus 8 infection in children born to HIV-1- infected women in São Paulo, Brazil

Human herpesvirus-8 (HHV-8) appears to be transmitted mainly by sexual contact. However, several studies suggest that in developing countries the infection may be acquired early in life by routes other than sexual transmission. The present study estimated the seroprevalence of HHV-8 in Brazilian children born to HIV-1-infected mothers. The serum samples were collected in a cross-sectional cohort study from 99 children born to HIV-infected mothers (median age 3.27 years; range 1.5-13.8 years) attending the outpatient clinic of the Federal University of São Paulo. IgG antibodies to HHV-8 latency-associated nuclear antigen and lytic phase antigens were detected by immunofluorescence assays. The samples tested were collected from children aged 12 months or older to exclude the possibility of cross-placental antibody transport. The total prevalence of anti-lytic antibodies in this population (5/99; 5%) reveals that HHV-8 infection can occur during childhood. Children aged 1.5 to 2 years had a seroprevalence of 2% (1/50) and children aged 3.25 to 13.8 years had a seroprevalence of 8% (4/49). This difference was not statistically significant, probably because of the small size of the sample, but it suggests that HHV-8 infection occurs more commonly late in infancy. Further prospective studies are necessary to evaluate the timing and risk factors for primary HHV-8 infection in the pediatric population.

High frequency of mutation G377S in Brazilian type 3 Gaucher disease patients

Gaucher disease (GD), the most prevalent lysosome storage disorder, presents an autosomal recessive mode of inheritance. It is a paradigm for therapeutic intervention in medical genetics due to the existence of effective enzyme replacement therapy. We report here the analysis of GD in 262 unrelated Brazilian patients, carried out in order to establish the frequency of the most common mutations and to provide prognostic information based on genotype-phenotype correlations. Among 247 type 1 GD patients, mutation N370S was detected in 47% of all the alleles, but N370S/N370S homozygosity was found in only 10% of the patients, a much lower frequency than expected, suggesting that most individuals presenting this genotype may not receive medical attention. Recombinant alleles were detected at a high frequency: 44% of the chromosomes bearing mutation L444P had other mutations derived from the pseudogene sequence, present in 25% of patients. Three neuronopathic type 2 patients were homozygous for L444P, all presenting additional mutations (E326K or recombinant alleles) that probably lead to the more severe phenotypes. Six children, classified as type 1 GD patients, had a L444P/L444P genotype, showing that neuronopathic symptoms may only manifest later in life. This would indicate the need for a higher treatment dose during enzyme replacement therapy. Finally, mutation G377S was present in 4 homozygous type 1 patients and also in compound heterozygosity in 5 (42%) type 3 patients. These findings indicate that G377S cannot be unambiguously classified as mild and suggest an allele-dose effect for this mutation.

Immunoglobulin production is impaired in protein-deprived mice and can be restored by dietary protein supplementation

Most contacts with food protein and microbiota antigens occur at the level of the gut mucosa. In animal models where this natural stimulation is absent, such as germ-free and antigen-free mice, the gut-associated lymphoid tissue (GALT) and systemic immunological activities are underdeveloped. We have shown that food proteins play a critical role in the full development of the immune system. C57BL/6 mice weaned to a diet in which intact proteins are replaced by equivalent amounts of amino acids (Aa diet) have a poorly developed GALT as well as low levels of serum immunoglobulins (total Ig, IgG, and IgA, but not IgM). In the present study, we evaluated whether the introduction of a protein-containing diet in 10 adult Aa-fed C57BL/6 mice could restore their immunoglobulin levels and whether this recovery was dependent on the amount of dietary protein. After the introduction of a casein-containing diet, Aa-fed mice presented a fast recovery (after 7 days) of secretory IgA (from 0.33 to 0.75 mg/mL, while in casein-fed mice this value was 0.81 mg/mL) and serum immunoglobulin levels (from 5.39 to 10.25 mg/mL of total Ig). Five percent dietary casein was enough to promote the restoration of secretory IgA and serum immunoglobulin levels to a normal range after 30 days feeding casein diet (as in casein-fed mice - 15% by weight of diet). These data suggest that the defect detected in the immunoglobulin levels was a reversible result of the absence of food proteins as an antigenic stimulus. They also indicate that the deleterious consequences of malnutrition at an early age for some immune functions may be restored by therapeutic intervention later in life.

TNF-a and IL-10 levels in tracheobronchial lavage of ventilated preterm infants and subsequent lung function

The role of airway inflammation in ventilated preterm newborns and the risk factors associated with the development of chronic lung disease are not well understood. Our objective was to analyze the association of the airway inflammatory response in ventilated preterm infants by serial measurements of TNF-a and IL-10 in tracheobronchial lavage (TBL) with perinatal factors and lung function measured early in life. A series of TBL samples were collected from ventilated preterm infants (less than 32 weeks of gestational age) and concentrations of TNF-a and IL-10 were measured by ELISA. Pulmonary function tests were performed after discharge by the raised volume rapid compression technique. Twenty-five subjects were recruited and 70 TBL samples were obtained. There was a significant positive association between TNF-a and IL-10 levels and length of time between the rupture of the amniotic membranes and delivery (r = 0.65, P = 0.002, and r = 0.57, P < 0.001, respectively). Lung function was measured between 1 and 22 weeks of corrected age in 10 patients. Multivariable analysis with adjustment for differences in lung volume showed a significant negative association between TNF-a levels and forced expiratory flow (FEF50; r = -0.6; P = 0.04), FEF75 (r = -0.76; P = 0.02), FEF85 (r = -0.75; P = 0.03), FEF25-75 (-0.71; P = 0.02), and FEV0.5 (r = -0.39; P = 0.03). These data suggest that TNF-a levels in the airways during the first days of life were associated with subsequent lung function abnormalities measured weeks or months later.

ApoE polymorphisms and diarrheal outcomes in Brazilian shanty town children

A series of studies have shown that the heavy burdens of diarrheal diseases in the first 2 formative years of life in children living in urban shanty towns have negative effects on physical and cognitive development lasting into later childhood. We have shown that APOE4 is relatively common in shanty town children living in Brazil (13.4%) and suggest that APOE4 has a protective role in cognitive development as well as weight-for-height in children with heavy burdens of diarrhea in early childhood (64/123; 52%), despite being a marker for cognitive decline with Alzheimer’s and cardiovascular diseases later in life. APOE2 frequency was higher among children with heaviest diarrhea burdens during the first 2 years of life, as detected by PCR using the restriction fragment length polymorphism method, raising the possibility that ApoE-cholesterol balance might be critical for growth and cognitive development under the stress of heavy diarrhea burdens and when an enriched fat diet is insufficient. These findings provide a potential explanation for the survival advantage in evolution of genes, which might raise cholesterol levels during heavy stress of diarrhea burdens and malnutrition early in life.

IGF2, LEPR, POMC, PPARG, and PPARGC1 gene variants are associated with obesity-related risk phenotypes in Brazilian children and adolescents

Association studies of genetic variants and obesity and/or obesity-related risk factors have yielded contradictory results. The aim of the present study was to determine the possible association of five single-nucleotide polymorphisms (SNPs) located in the IGF2, LEPR, POMC, PPARG, and PPARGC1genes with obesity or obesity-related risk phenotypes. This case-control study assessed overweight (n=192) and normal-weight (n=211) children and adolescents. The SNPs were analyzed using minisequencing assays, and variables and genotype distributions between the groups were compared using one-way analysis of variance and Pearson's chi-square or Fisher's exact tests. Logistic regression analysis adjusted for age and gender was used to calculate the odds ratios (ORs) for selected phenotype risks in each group. No difference in SNP distribution was observed between groups. In children, POMC rs28932472(C) was associated with lower diastolic blood pressure (P=0.001), higher low-density lipoprotein (LDL) cholesterol (P=0.014), and higher risk in overweight children of altered total cholesterol (OR=7.35, P=0.006). In adolescents, IGF2 rs680(A) was associated with higher glucose (P=0.012) and higher risk in overweight adolescents for altered insulin (OR=10.08, P=0.005) and homeostasis model of insulin resistance (HOMA-IR) (OR=6.34, P=0.010). PPARGrs1801282(G) conferred a higher risk of altered insulin (OR=12.31, P=0.003), and HOMA-IR (OR=7.47, P=0.005) in overweight adolescents. PARGC1 rs8192678(A) was associated with higher triacylglycerols (P=0.005), and LEPR rs1137101(A) was marginally associated with higher LDL cholesterol (P=0.017). LEPR rs1137101(A) conferred higher risk for altered insulin, and HOMA-IR in overweight adolescents. The associations observed in this population suggested increased risk for cardiovascular diseases and/or type 2 diabetes later in life for individuals carrying these alleles.

Suomalaisten yliopistojen life science-alan spin-off-yritysten rahoitustilanne, -lähteet ja –riskit

Life science-ala on rahoituksellisesti erittäin haastava, koska tuotekehitysputket ovat 10-15 vuoden pituisia ja voivat vaatia suuria etupainotteisia investointeja. Monet life science-alan yritykset ovat niin Suomessa kuin kansainvälisestikin syntyneet suoraan yliopistosta niin sanottuina spin-off-yrityksinä. Yrityksen perustaminen tutkimustiedon pohjalle on yksi akateemisen yrittäjyyden muodoista. Tässä tutkimuksessa tutkitaan akateemista yrittäjyyttä life science-alalla Suomessa. Suomessa life science-alan osaaminen on kansainvälistä huippua ja alalle on syntynyt useita spin-off-yrityksiä viime vuosina. Aiemmat tutkimukset ovat keskittyneet erityisesti agentti-päämiesongelmiin akateemisessa yrittäjyydessä ja life science alaa puolestaan on käsitelty usein pelkästään yhtenä alana. Tutkimuksessa pyritään analysoimaan life science-alan eri painopiste-alueita tarkemmin rahoitusstrategisesta näkökulmasta, koska ala ei ole homogeeninen. Akateemisen yrittäjyyden agenttiongelmaa pyritään tarkoittamaan Suomen yliopistomaailmassa life science-alalta käsin. Tutkimus toteutetaan kvalitatiivisena haastattelututkimuksena ja sitä tukevana tilinpäätöstietojen analysointina. Tutkimuksen tulokset vahvistavat agentti-päämiesongelmien olemassaolon suomalaisessa yliopistomaailmassa. Ongelmien osapuolina ovat niin akateemikot, yliopiston innovaatiopalvelut kuin TEKES:kin. Yrittäjät kaipaavat kokonaisvaltaisempaa apua, koska kokevat alalla liiketoimintaosaamisen puuttuvan monin paikoin. Alan vaatimien runsaiden tuotekehityspanostusten vuoksi alan yritykset ovat pitkään raskaasti tappiollisia. Yritysten valitsemat rahoitusratkaisut vaihtelevat suuresti. Kaikki tutkitut yritykset pyrkivät kasvamaan nykyisten ydintuotteidensa mukana ja ovat jo jossain määrin hankkineet rahoitusta kasvustrategiaansa varten. Alan pääomaintensiivisyydestä johtuen ovat monet yritykset kuitenkin suunnittelemassa tai jo päätyneet tekemään yhteistyötä integroituen alalla joko vertikaalisesti tai horisontaalisesti. Tutkimuksen tulokset vahvistavat aiemman käsityksen, jonka mukaan life science-alan yrityksiä on vaikea arvioida ulkopuolelta pelkästään tilinpäätöstietojen pohjalta, koska alkuvaiheessa rahoituskierrokset ja tappiolliset vuoden seuraavat toisiaan ja toisaalta yrityksen arvo sitoutuu pitkiin tuotekehitysputkiin, jotka eivät välttämättä näy tilinpäätöksessä. Tulokset tuovat esille merkittäviä yritysten kokemia ongelmia rahoituksen saannissa life science-alalla Suomessa sekä akateemisen yrittäjyyden epäkohtia yritystoiminnan näkökulmasta. Näiden tekijöiden huomioonottaminen ja laajempi kansainvälinen vertailu voivat auttaa suomalaisia yrityksiä tällä vahvalla osaamisalalla eteenpäin.

Wellspring: an intrinsic case study of community-based education for adults living with cancer /

This paper presents education research as vital to addressing the issues faced by adults living with cancer. This qualitative study looked at philosophies of practice for cancer patient education. It was about understanding how values and beliefs shape the way program planners and managers operationalize their knowledge of adult education and how this has significant impact on meeting the needs of those touched by cancer. Improved technology has extended life expectancy, so that Canadians living with cancer, or even dying with cancer now spend less time in direct medical care. The notion of cancer as simply a medical concern is outdated. This study found that informational and support needs of adults living with cancer are often unmet, ignored or unknown. This research investigated a community-based education initiative that is inviting, accessible, and promotes a sense of hope. More specifically, this case study uncovered factors contributing to the success of Wellspring, a grass-roots cancer patient support centre which has been recognized nationally for its ability to effectively meet the diverse non-medical supportive care needs of as many cancer patients and caregivers as possible. Therefore, Wellspring was selected as a case study. Educating people to take charge of their own lives and supporting them in making informed decisions about their lifestyle choices made Wellspring part of a social action movement that focused on improving social attitudes toward people living with cancer. Results of this descriptive inquiry and philosophical inquiry evolved into data that was used to devise an organic model of community-based education that encompasses Adler's (1993) four dimensions of philosophy within a socio-cultural context.

The historical game-changes in the philosophy of devotion and caste as used and misused by the Bhagavad-gita

This thesis considers that the purport of the Bhagavadgita is to prioritize the philosophy of loving devotion to God (bhakti), not the propagation of color-coded-caste (varna system). The distinction between bhakti and caste becomes clear when one sees their effect on human life and on the society. Jnana and karma, two of the other polarities with which the Gita contends, finally support bhakti towards betterment, not deterioration, if done selflessly and with balance. Caste, however, is a totally different tension, which is always detrimental to the well-being of the person and the society. In the Gita, the devotees' mystical or emotional love of, God apprehends their ~ oneness with the Supreme God and with all beings, and transcends the pitiless segregation of the caste system, and opens the path of salvation to all irrespective of race, color, caste, class or gender in life. In spite of much opposition from orthodoxy, the bhakti movement spread allover India, and bhakti itself rose to the level of orthodoxy and has become the faith of millions of people especially of the south, and surprisingly, of even of those of the so called highest caste. And yet, caste still remains as an indelible mark of every Hindu, even after they change their religion. Although caste is less venomous now, it is still openly present in all walks of Indian life and shows up its ugly head at important moments such as marriage, elections for public office, admission to school or employment. True, bhakti is the antidote for. caste; but only real bhakti can remove caste completely, not mere lip-service to it. This thesis claims that bhakti is the deliberate major thrust of the teaching of the Gita while caste seems to be a contradiction of this thrust.

Longitudinal associations between passions and adjustment in adolescence: Positive mood and unstructured leisure activities as mediators

Passions are activities that people find important, like or enjoy, and on which they spend large amounts of time. Research examining passions in adolescence has been limited, despite a tendency for adolescents to explore their identity by trying new activities (Dworkin et aI., 2003). The purpose of the present study was to examine the association between adolescent passions and positive adjustment (psychological well-being, optimism, purpose in life, and low risktaking), as well as investigate possible underlying mechanisms for the link between passions and adjustment. High school students (N=2270, 48.7% female) from Southern Ontario completed questionnaires in grades 10, 11, and 12. Path analyses were conducted to examine cross-lag paths among all study variables. Passions predicted higher optimism and purpose, as well as lower negative risk-taking, over time, but these adjustment indicators in tum did not predict higher passions over time. Additionally, positive mood and unstructured leisure activities partially mediated these associations. Passions appears to be important for adolescent adjustment, and may serve as a protective factor or help to foster thriving.

ARTERIAL STIFFNESS IN CHILDREN WITH AND WITHOUT DEVELOPMENTAL COORDINATION DISORDER

The purpose of this study was to determine whether children with potential developmental coordination disorder (p-DCD) demonstrate increased arterial stiffness and thickness compared to age and school matched controls (mean age 14.7 yrs). We also assessed whether these measures differed by sex. Compliance, distensibility, and intima-media thickness (IMT) were measured at the common carotid artery for 28 children with p-DCD and 47 controls. ECG-R-wave-toe pulse wave velocity (PWV) was also measured for 29 children with p-DCD and 45 controls. We found that compared to controls males with p-DCD had significantly higher PWV (3.8±0.2 vs. 4.1±0.3, p=0.001) and lower distensibility (0.82± 0.19 vs. 0.70± 0.17, p=0.034) while females showed no significant differences (p=0.523 and p=0.123 respectively). As a result, it is apparent that sex differences exist with respect to arterial health within this population and that children with p-DCD may be more likely to develop cardiovascular disease later in life.