The role of nutritional profile in the orexigenic neuropeptide secretion in nonalcoholic fatty liver disease obese adolescents

Background Little progress has been made to identify the central neuroendocrine pathway involved in the energy intake control in nonalcoholic fatty liver disease (NAFLD) patients. Objective To assess the influence of orexigenic neuropeptides in the nutritional aspects of NAFLD obese adolescents submitted to a long-term interdisciplinary approach. Methods Fifty adolescents aged 15-19 years, with body mass index at least 95th percentile, consisting of 25 patients without NAFLD and 25 with NAFLD. The NAFLD diagnosis was determined by ultrasonography. Blood samples were collected to analyze glycemia, hepatic transaminases, and lipid profile. Insulin resistance was estimated by Homeostasis Model Assessment Insulin Resistance Index. Neuropeptide Y (NPY) and agouti related protein concentrations were measured by enzyme-linked immunosorbent assay. Analyses of food intake were made by 3 days recordatory inquiry. Results At baseline conditions, the patients with NAFLD had significantly higher values of body mass, body mass index, visceral fat, triglycerides, VLDL-C, and hepatic transaminases. After the long-term intervention, they presented a significant reduction in these parameters. In both the groups, it was observed a significant decrease in energy intake, macronutrients and dietetic cholesterol. Only the patients with NAFLD presented a positive correlation between the saturated fatty acids intake and the orexigenic neuropeptides NPY and agouti related protein, and carbohydrate with NPY. Indeed, it was observed a positive correlation between energy intake, lipid (%) and saturated fatty acids with visceral fat accumulation. Conclusion Our findings showed an important influence of diet composition in the orexigenic system, being essential consider that the excessive saturated fatty acids intake could be a determinant factor to increase nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 22:557-563 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Effect of Acute and Chronic Physical Exercise on Patients with Periodic Leg Movements

ESTEVES, A. M., M. T. DE MELLO, M. PRADELLA-HALLINAN, and S. TUFIK. Effect of Acute and Chronic Physical Exercise on Patients with Periodic Leg Movements. Med. Sci. Sports Exerc., Vol. 41, No. 1,. pp. 237-242, 2009. Purpose: Nonpharmacological interventions may lead to an improvement in sleep quality. The objective of our study was to evaluate the effects of acute intensive exercise and chronic exercise on sleep patterns in patients with periodic leg movements (PLM). Methods: The study involved acute and chronic exercise. The acute intensive exercise group consisted of 22 volunteers who underwent a maximum effort test and a polysomnography (PSG) on the same night. The chronic exercise group included. 11 patients who performed 72 physical training sessions undergoing three PSG studies on the night of sessions 1, 36, and 72. Blood samples were collected from both acute and chronic groups for beta-endorphin dosage. Results: Our results showed that both forms of physical exercise lowered PLM levels. The acute physical exercise increased sleep efficiency, rapid eye movement (REM) sleep, and reduced wake after sleep onset, whereas the chronic physical exercise increased sleep efficiency, REM sleep, and reduced sleep latency. We also found a significant negative correlation between beta-endorphin release after acute intensive exercise and PLM levels (r = -0.63). Conclusion: Physical exercise may improve sleep patterns and reduce PLM levels. The correlation between beta-endorphin release after acute intensive exercise and PLM levels might be associated with the impact physical exercise has on the opiodergic system. We suggest that physical exercise may be a useful nonpharmacological treatment for PLM.

Evaluation of the buccal vestibule-palatal diffusion of 4% articaine hydrochloride in impacted maxillary third molar extractions

Aims: The aim of this study was to evaluate the vestibular-palatal diffusion of 4% articaine with epinephrine 1: 100,000 and 1: 200,000, in impacted maxillary third molar extractions, without palatal injection. Materials and Method: Two hundred teeth were selected from patients age 15 to 46. Patients were divided into 4 groups: 1A, were anesthetized with 4% articaine 1: 100,000 and the surgery was initiated 5 minutes following anesthesia. 1B, used 4% articaine 1: 100,000 but the surgery was started 10 minutes after anesthesia. 2A, used 4% articaine 1: 200,000 the surgery was started 5 minutes after. 2B, used 4% articaine 1: 200,000 but 10 minutes was allowed for anesthetic diffusion before the initiation of in groups (50 extractions each) only buccal vestibule anesthesia was initially administered (i.e. no palatal injections were used). Results: The rate of sufficient vestibule-palatal diffusion, as determined by the lack of necessity of supplemental palatal anesthesia, was: 1A(84%), 1B(98%), 2A(78%), 2B(82%). Chi-square (X2) and residual analyses showed that a higher vestibule-palatal diffusion was obtained using 4% articaine 1: 100,000 with a period of 10 minutes (p<0.05). Conclusions: Most of the extractions could be performed only with vestibule anesthesia. However, vasoconstrictor concentration and the time interval between administration of the anesthetic and initiation of surgery did influence buccal vestibule-palatal diffusion of 4% articaine in the extraction models used.

Morphological, Morphometrical and Histochemical Study of the Lining and Glandular Epithelia of the Tongue of the Bullfrog Rana catesbeiana

The dorsal surface of the tongue of the bullfrog, Rana catesbeiana, has simple columnar epithelium with a few ciliated cells and goblet cells. The entire surface is covered with numerous filiform papillae and few fungiform. Filiform papillae have a simple columnar epithelium with secretory cells, while the fungiform have a sensory disc on their upper surface the lined by a stratified columnar epithelium with basal, peripheral, glandular and receptor cells. Over the dorsal lingual surface there are numerous winding tubular glands, which penetrate deeply into the muscle of the tongue, mingling with the fibers. The gland epithelium is cylindrical with secretory and supporting cells. The first are absolute on the basis of the gland and the latter are rare in the upper third. The ventral surface of the tongue is lined by a stratified epithelium, with the presence of goblet cells, with ciliated cells among them. Morphometrically, lingual glands varies in length, according to their location: shorter in the anterior region of the tongue (330 mu m) than in the posterior region (450 mu m). Secretory cells of the anterior lingual glands are smaller (1457.7 mm(3)) than the posterior ones (2645.9 mu m(3)). The same can be said of the cell nuclei, 130.0 mu m(3) for the anterior glands and 202.3 mu m(3) for the posterior ones. Secretory cells of the lingual glands contain substances rich in protein and neutral mucopolysaccharides, which characterize the seromucous type. Goblet cells of the dorsal and ventral surface epithelia secrete neutral mucopolysaccharides and proteins, and can be characterized as type G1 cells, and the supporting cells of the superficial glands of the fungiform papillae secrete a mucus rich in neutral mucopolysaccharides, sulfomucins and sialomucins.

Benzedeiras de Maruípe: uma prática de cuidado humano em extinção

Estudo realizado com benzedeiras de uma área de saúde do município de Vitória - ES, objetivando identificá-las, conhecer suas histórias de vida e o interesse das mesmas em articularem-se com os profissionais das unidades básicas de saúde locais. Por se tratar de uma região marcada pela violência advinda do tráfico de drogas, tornou-se impossível identificar o universo dessas mulheres, face à impossibilidade de acesso a alguns desses bairros; assim posto, nossa amostra ficou limitada a cinco benzedeiras. A coleta de material do estudo se deu através de entrevistas e observações registradas em um diário de campo. O material transcrito e os apontamentos do diário de campo possibilitaram a narrativa de inspiração cartográfica deste estudo. Essas benzedeiras são mulheres entre 64 a 88 anos de idade, residem em locais inóspitos e em moradias humildes. Algumas benzem apenas crianças, outras todos aqueles que as procuram, inclusive para benzimento de seus animais. Nenhuma delas cobra e tão pouco aceita agradecimento pela atenção prestada, pois segundo elas, o agradecimento deve ser dirigido a Deus. São mulheres humildes, todas moradoras antigas da área, ora reconhecidas como importantes pelo dom que têm, ora rechaçadas como demoníacas por grupos religiosos. No tocante a uma aproximação com as equipes locais de saúde, todas as benzedeiras se mostraram avessas à ideia, no entendimento de que tal aproximação significaria uma demanda de benzimentos aumentada e obrigatória, o que contraria a lógica da atenção prestada pelas mesmas, que só benzem de acordo com a conveniência: sentindo-se bem, praticam o benzimento; estando desvitalizadas, evitam benzer. Por se tratar de mulheres idosas, as benzedeiras encontram-se ameaçadas de extinção, visto que aprender o oficio não tem sido objeto de interesse das novas gerações.

A experiência de mulheres e a decisão pelo aborto provocado em uma região do Espírito Santo, Brasil

O escopo deste trabalho buscou compreender as percepções de mulheres que passaram pela decisão do aborto provocadona Microrregião de São Mateus (norte do estado do Espírito Santo, Brasil), a partir do percurso e das interações que se sustentaram nesse processo. Foram realizadas entrevistas com roteiro semiestruturado com sete mulheres sobre essa experiência no ambiente domiciliar dos sujeitos do presente estudo. Os dados foram colhidos em entrevistas abertas e foram analisados à luz do referencial teórico de autores que discorrem acerca do tema e também acerca da ciência bioética.O estudo apresenta seis categorias: O aborto na perspectiva da decisão íntima; o aborto como fonte de revelações de sentimentos; o contemplar peremptório da atitude;técnicas empregadas na intencionalidade e no ato de abortar; sustentando a decisão pelas relações comunitárias; e conteúdos e confidências femininas. A experiência das mulheres foi marcada poruma diversidade de sentimentos, como tristeza, culpa, arrependimento, desespero e dor emocional, todavia, também, pelo alívio com o fim da gravidez e do risco de morte. Angústia adicional foi condicionadaa partir da percepção de fatores contribuintes da decisão, como falta de condições financeiras, falta de apoio da família ou do parceiro e instabilidade no relacionamento com parceiro. Este estudo também sinalizou que o caráter cultural e histórico da gestação, no sentido da norma social, faz-se presente nas mulheres que vivenciam o aborto provocado; demonstrou que as mulheres do presente estudo encontram-se à margem das políticas públicas e de saúde; assinalou que os programas de planejamento familiar ou de saúde reprodutiva deveriam ser estruturados de forma a ajudar também a lidar com problemas de destituição social, econômica e educacional dessa população vulnerada, no sentido de que essas mulheres ultrapassem a proteção social básica e sejam amparadas por serviços de saúde, que constituam espaços equânimes de escuta, orientação e resolução.

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients

We have studied the cardiac chronotropic responses to the Valsalva maneuver and to dynamic exercise of twenty chronic chagasic patients with normal left ventricular function and no segmental wall abnormalities by two-dimensional echocardiogram. The absolute increase in heart rate of the patients (Δ = 21.5 ± 10 bpm, M±SD) during the maneuver was significantly diminished when compared to controls (Δ = 31.30 ± 70, M±SD, p = 0.03). The minimum heart rate (58.24 ± 8.90 vs. 62.80 ± 10, p = 0.68) and the absolute decrease in heart rate at the end of the maneuver (Δ = 38.30 ± 13 vs. Δ = 31.47 ± 17, p = 0.10) were not different from controls. The initial heart rate acceleration during dynamic exercise (Δ = 12 ± 7.55 vs. Δ = 19 ± 7.27, M±SD, p = 0.01) was also diminished, but the heart rate recovery during the first ten seconds was more prominent in the sero-positive patients (Median: 14, Interquartile range: (9.75-17.50 vs. 5(0-8.75, p = 0.001). The serum levels of muscarinic cardiac auto-antibodies were significantly higher in the chagasic patients (Median: 34.58, Interquartile Range: 17-46.5, Optical Density) than in controls (Median: 0, Interquartile Range: 0-22.25, p = 0.001) and correlated significantly and directly (r = 0.68, p = 0.002) with early heart rate recovery during dynamic exercise. The results of this investigation indirectly suggest that, the cardiac muscarinic auto-antibodies may have positive agonist effects on parasympathetic heart rate control of chagasic patients.

Comparison of vigilance methods in three houses with different Triatoma infestans densities

Através da prova de 7 dias foi estudado o grau de resistência do Plasmodium falciparum à cloroquina, amodiaquina e sulfadoxina-pirimetamina em Porto Velho, Estado de Rondônia, Brasil. Não se observaram diferenças significativas nas médias de parasitas nos dias de seguimento e nas proporções de resistência entre os três medicamentos testados, fazendo com que os autores recomendem a manutenção das 4-aminoquinoleínas como drogas a serem usadas atualmente em infecções não graves por P. falciparum na área de Porto Velho.

Diagnóstico laboratorial dos protozoários entéricos oportunistas em Goiânia, GO

A criptosporidiose, isosporíase, ciclosporíase e as microsporidioses tornaram-se comuns em pacientes imunocomprometidos. O diagnóstico destas doenças é importante, pois produzem quadro clínico semelhante, mas possuem manejo terapêutico e prognóstico diferente. Visando avaliar a situação do diagnóstico destes parasitas, foram mapeados os laboratórios da rede do SUS e as unidades de saúde no município de Goiânia, GO.

Human pseudomyiasis caused by Eristalis tenax (Linnaeus) (Diptera: Syrphidae) in Goiás

The objective of the present work was to register the first proven cases of human pseudomyiasis due to Eristalis tenax in Goiás State, Brazil, underscoring their clinical manifestations and direct relationship with hygiene. The taxonomic identification of the instars was done according to the descriptions and keys presented by James (1947), Hartley (1961) and Guimarães & Papavero (1999). Two cases were observed. In both cases there was no evidence of apparent mental disturbance. The clinical picture of these cases was self limited. The water supply, sewer system, socioeconomic level and habits of the suspect species of the flies are criteria that should be investigated.

Diagnóstico laboratorial de enteroparasitoses oportunistas, com ênfase nas microsporidioses humanas, em Goiânia-GO

Os microsporídios são protozoários, emergentes e oportunistas, responsáveis por patologias de alta morbi-mortalidade, principalmente em indivíduos com distúrbios imunes. Este estudo visa determinar o perfil clínico-laboratorial destes agentes. No total, foram avaliados 723 pacientes divididos em dois grupos: I) Indivíduos imunodeprimidos/imunossuprimidos; II) Indivíduos aparentemente imunocompetentes. Estes, após livre e esclarecido consentimento, foram entrevistados e cederam amostras fecais, sendo todas submetidas a técnicas de HPJ, Rugai, Faust e colorações específicas para coccídios e microsporídios. A freqüência de microsporídios foi 1,3% (5/393) no grupo I, enquanto no outro grupo foi quatro vezes menor. A ocorrência de outras enteroparasitoses oportunistas também foi maior no grupo I. Conclui-se, por um lado, que estes agentes estão em nosso meio, e por outro, necessitamos aprimorar o diagnóstico clínico e laboratorial, para definir a distribuição geográfica destes agentes no Estado de Goiás e no Brasil.

Rational approximations of sectional category and Poincaré duality

Félix, Halperin, and Lemaire have shown that the rational module category Mcat and the rational Toomer invariant coincide for simply connected Poincaré duality complexes. We establish an analogue of this result for the sectional category of a fibration.