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Objectives: To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. Materials and methods: The 50 panoramic images were selected and divided into two groups, according to the children's age: 8–9 (Group 1; n = 25) and 6–7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. Results: Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). Conclusion: The bone trabeculate pattern in 6–9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI. [ABSTRACT FROM AUTHOR]

Introduction: Oxidative stress is closely related to the pathophysiology of gestation, where the placenta is susceptible to oxidative damage, contributing to the onset of gestational complications. Currently, few studies evaluate the use of oxidative markers for prediction of risk of gestational complications. However, there are some reports that suggest these biomarkers as potential prognostic biomarkers. Therefore, the objective of this study was to compare the biomarkers of oxidative stress from gestations with and without complications, and also evaluate the delta of variation in these markers from the first gestational trimester. Material and Methods: A total of 45 pregnant women were evaluated during the three gestational trimesters, of whom 15 developed gestational complications by the end of gestation. The evaluated oxidative damage markers were thiobarbituric acid reactive substances and nitric oxide dosage. Evaluation of the antioxidant system was performed by the quantification of vitamin C, sulfhydryl groups, total antioxidant capacity, plasmatic iron reduction ability, the evaluation of catalase and delta-aminolevulinate dehydratase enzymatic activity. Results: According to the results, the markers of oxidative damage are increased, and the antioxidant profile decreased, in the third trimester of complicated pregnancies as compared to uncomplicated pregnancies. Moreover, the delta of variation in both oxidative damage markers and antioxidants was higher in complicated gestations as compared to uncomplicated gestations, thus suggesting a higher oxidative stress in pregnancies with complications. Conclusions: Oxidative stress parameters appear altered in pregnant women with gestational complications. The markers to oxidative stress can be possible biomarkers, helping in understanding mechanisms underlying the associations between complications during pregnancy and various health outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To describe the process of implementing a palliative care team (PCT) in a Brazilian public tertiary university hospital and compare this intervention as an active in-hospital search (strategy I) with the Emergency Department (strategy II). Methods: We described the development of a complex Palliative Care Team (PCT). We evaluated the following primary outcomes: hospital discharge, death (in-hospital and follow-up mortality) or transfer, and performance outcomes-Perception Index (difference in days between hospitalization and the evaluation by the PTC), follow-up index (difference in days between the PTC evaluation and the primary outcome), and the in-hospital stay. Results: We included 1203 patients—strategy I (587; 48.8%) and strategy II (616; 51.2%). In both strategies, male and elderly patients were prevalent. Most came from internal medicine I (39.3%) and II (57.9%), p < 0.01. General clinical conditions (40%) and Oncology I (27.7%) and II (32.4%) represented the majority of the population. Over 70% of all patients had PPS 10 and ECOG 4 above 85%. There was a reduction of patients identified in ICU from I (20.9%) to II (9.2%), p < 0.01, reduction in the ward from I (60.8%) to II (42.5%), p < 0.01 and a significant increase from I (18.2%) to II (48.2%) in the emergency department, p < 0.01. Regarding in-hospital mortality, 50% of patients remained alive within 35 days of hospitalization (strategy I), while for strategy II, 50% were alive within 20 days of hospitalization (p < 0.01). As for post-discharge mortality, in strategy II, 50% of patients died 10 days after hospital discharge, while in strategy I, this number was 40 days (p < 0.01). In the Cox multivariate regression model, adjusting for possible confounding factors, strategy II increased 30% the chance of death. The perception index decreased from 10.9 days to 9.1 days, there was no change in follow-up (12 days), and the duration of in-hospital stay dropped from 24.3 to 20.7 days, p < 0.01. The primary demand was the definition of prognosis (56.7%). Conclusion: The present work showed that early intervention by an elaborate and complex PCT in the ED was associated with a faster perception of the need for palliative care and influenced a reduction in the length of hospital stay in a very dependent and compromised old population. [ABSTRACT FROM AUTHOR]

Immigration can improve economic status and access to education compared to the country of origin, but it challenges access to health and preventive care. Assess Brazilian immigrants' overall health conditions and dietary intake in New Jersey (US). This pilot study assessed health conditions and dietary intake. Brazilians immigrants were interviewed through their communities. Trained dietitians interviewed them using a questionnaire and three days of 24H recall. Dietary intake was analyzed using the Nutrition Data System for Research software. A sample of 118 individuals completed the protocol, majority female and overweight/obese, living in the US for 11.3 years with 21.1% declaring having Noncommunicable Diseases. The average number of daily meals was 2.20 ± 1.04. Energy intake does not correlate with time in the US. Obesity, dyslipidemia, and hypertension are the most prevalent Noncommunicable Diseases, demanding interventions that include managing saturated fat, cholesterol, and sodium intake. [ABSTRACT FROM AUTHOR]

Background: Despite the well-known role of parents as caregivers, few studies have addressed their health outcomes related to the Zika virus epidemic. Methods: A cross-sectional study was carried out with 146 primary caregivers of children 15–26 months of age, with laboratory and/or clinical evidence of Zika infection between August and October 2017 in three Brazilian municipalities: João Pessoa and Campina Grande in the state of Paraíba and Fortaleza in the state of Ceará. Caregivers reported on their child's life and health, family circumstances and underwent screening for stress using the Parenting Stress Index-Short Form. Children were evaluated for developmental delays and clinical outcomes. Differences in the prevalence of risk factors between caregivers with high or clinically relevant stress and those with normal stress were evaluated. Results: Of the 146 participants, 13% (n = 19) were classified as having high or clinically relevant stress, all of them mothers. The two risk factors significantly and independently associated with high levels of stress, compared with individuals with normal stress levels, were "reporting difficulty in covering basic expenses" (adjusted OR 3.6 (95% CI 1.1–11.8; p = 0.034)) and "having a child with sleep problems" (adjusted OR 10.4 (95% CI 1.3–81.7; p = 0.026)). Conclusions: Some factors seem to contribute significantly more than others to the level of stress experienced by caregivers of children with evidence of Zika virus congenital infection. Interventions and preventive strategies should also target caregivers, who in turn will be able to respond to the unique characteristics of their child. [ABSTRACT FROM AUTHOR]

Patients with inflammatory bowel disease (IDB) may have higher levels of sexual dysfunction than the general population. We aimed to study the prevalence of sexual disorders in a sample of Brazilian male and female patients with IDB and its association with depression, epidemiological and clinical data. This was a cross sectional study of 192 individuals (40 females with IDB, 40 males with IDB and 112 healthy controls). Male patients and controls answered the IIEF-5 (International Index of Erectile Function-5) and female patients the FSFI (Female Sexual Function Index). Beck Depression Inventory-II was used to access depression. Epidemiological, clinical and treatment data was collected from medical charts. We found that male and female patients with IDB had more sexual dysfunction than controls. Age was the only factor, when considering the various demographics, depression, IDB type, and treatments, that was significantly associated with sexual dysfunction in IBD patients, and this pattern was only detected in males. Taking into account the multi-faceted nature of this disease and how IDB symptoms interfere with sexual functioning, a multidisciplinary approach may be useful to improve the quality of life of patients with IDB. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the knowledge, comfort and attitudes of physiotherapy students towards human sexuality. An observational, cross-sectional study was conducted in four universities. Physiotherapy students (n = 248) enrolled in an undergraduate degree program were invited to participate and 203 (82%) were included. Students were enrolled in the first (29%), second (22%), third (33%) and fourth (16%) years of the undergraduate degree program. The instrument used was the Scale of Knowledge, Comfort and Attitudes of Physiotherapy Students towards Human Sexuality. Results indicated that students enrolled in the first year of the program reported less knowledge then students in the third (p ≤ 0.001) and fourth years (p ≤ 0.001). Students enrolled in the second year reported less knowledge than the students in the third (p = 0.007) and fourth years (p = 0.002). Students enrolled in the fourth year of the program reported more discomfort compared with students enrolled in the first year (p = 0.049). Additionally, female students showed more discomfort, especially when issues are related to male patients. These findings highlight the importance of a change in the physiotherapy curriculum to better prepare future physiotherapists in delivering holistic treatment. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the sensitivity and responsiveness to change for the Brazilian version of the Child Perceptions Questionnaire (CPQ8–10) after dental caries treatment.Subject and methods: Thirty children aged 8 to 10 years old with untreated dental caries were randomly selected from public schools. They responded to the CPQ8–10 before and 1 month after finishing treatment for dental caries. Sensitivity was assessed by determining distribution changes using paired t-tests and Wilcoxon signed-rank tests. Responsiveness to change was evaluated by effect size (ES) and standardized response mean (SRM). Minimally important differences (MIDs) were also evaluated.Results: Mean/median pre-treatment values for the total CPQ8–10 score and subscales were significantly higher than the post-treatment values (p < 0.05). ES was large (effect size ≥ 0.8) for the total CPQ8–10 score and oral symptoms (OS), functional limitations (FL) and emotional wellbeing (EW) subscales and moderate (effect size 0.3–0.7) for the social wellbeing (SW) subscale. SRM values were moderate (0.3–0.7) for the total CPQ8–10 score and FL, EW and SW subscales and high (≥ 0.8) for the OS subscale. MID values for the total CPQ8–10 score and all subscales were lower than the mean score change.Conclusion: The Brazilian version of the CPQ8–10 is sensitive and responsive enough to detect changes brought about by dental caries treatment. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the effects of acute l-arginine ( l-arg) supplementation on peripheral vasodilatation and muscle performance in older women. Methods: In a double-blind, randomized, placebo-controlled study, 20 elderly women were randomly assigned in a double-blind fashion to either an l-arg (ARG, N = 10) or placebo (PLA, N = 10) group. During the first visit, both groups underwent a Doppler ultrasound exam (to assess the femoral artery vasodilatation) at rest (baseline), and immediately before and after the isokinetic strength test (performed at 80 min after supplementation). On the second and third visits, the groups completed a battery of muscle performance tests (to assess the isometric and functional strength), initiated at the same time point (80 min after supplementation). Results: The femoral artery blood flow (ARG: 443.9 ± 42.8 vs. PLA: 373.1 ± 40.8 ml/min; P > 0.05) and area (ARG: 0.45 ± 0.03 vs. PLA: 0.41 ± 0.02 cm; P > 0.05) were similar between the groups at basal conditions, and they remained unchanged after supplementation. Following exercise, blood flow increased ~160 % above the basal level, and there was no significant ( P > 0.05) difference between the ARG and PLA groups. Additionally, there were no significant ( P > 0.05) differences between the ARG and PLA groups for any strength variable (isokinetic, isometric, and functional). Conclusion: These results show that acute l-arg supplementation provides no ergogenic effect on blood flow and muscle performance in older women. [ABSTRACT FROM AUTHOR]

Previous studies suggested that threat biases underlie familial risk for emotional disorders in children. However, major questions remain concerning the moderating role of the offspring gender and the type of parental emotional disorder on this association. This study addresses these questions in a large sample of boys and girls. Participants were 6-12 years old (at screening) typically developing children participating in the High Risk Cohort Study for Psychiatric Disorders ( n = 1280; 606 girls, 674 boys). Children were stratified according to maternal emotional disorder (none; mood disorder; anxiety disorder; comorbid anxiety/mood disorder) and gender. Attention biases were assessed using a dot-probe paradigm with threat, happy and neutral faces. A significant gender-by-parental emotional disorder interaction predicted threat bias, independent of anxiety and depression symptoms in children. Daughters of mothers with an emotional disorder showed increased attention to threat compared with daughters of disorder-free mothers, irrespective of the type of maternal emotion disorder. In contrast, attention bias to threat in boys only occurred in mothers with a non-comorbid mood disorder. No group differences were found for biases for happy-face cues. Gender and type of maternal emotional disorder predict attention bias in disorder-free children. This highlights the need for longitudinal research to clarify whether this pattern of threat-attention bias in children relates to the risk of developing anxiety and mood disorders later in life. [ABSTRACT FROM AUTHOR]

Purpose: Protein-restricted diet during pregnancy is related to oxidative stress and, as a consequence, damage to nephrogenesis. We investigated the effects of vinifera grape skin extract (ACH09)-derived polyphenols on preserving renal morphology of maternal protein-restricted 1-day-old offspring. Methods: Female C57/Bl-6 mice were fed two different isocaloric diets: control diet (19.3 % protein) and low-protein diet (6 % protein) with access to water or to the extract dissolved in drinking water (19.3 % protein plus ACH09 200 mg kg day and 6 % protein plus ACH09 200 mg kg day) throughout gestation. Renal morphology-glomerular number N[glom]; renal maturity-vascular glomeruli and avascular glomeruli ratio (v-N[glom]/a-N[glom]); medullar and cortical volumes, as well as mean glomerular volume, were analyzed in male offspring. Hepatic superoxide dismutase and catalase (CAT) activities were evaluated, and renal lipid peroxidation levels were measured. Results: Maternal protein restriction affected birth weight and naso-anal length in low-protein offspring compared to control and ACH09 restored both parameters. Protein restriction increased lipid peroxidation in kidney and liver and reduced CAT activity in low-protein group compared to control. Supplementation with ACH09 reduced the kidney oxidative damage and restored the antioxidant activity of CAT. ACH09 prevented glomerular loss and renal immaturity in the offspring. Conclusion: The treatment of low-protein-fed dams during pregnancy with ACH09 provides protection from early-life deleterious renal morphological changes. The protective effect of ACH09 may involve antioxidant action and vasodilator effect of the extract. [ABSTRACT FROM AUTHOR]

Child maltreatment has frequently been associated with impaired social skills and antisocial features, but there are still controversies about the effect of each type of maltreatment on social behaviour. The aim of this study was to compare the social functioning and psychopathic traits of maltreated adolescents (MTA) with a control group (CG) and to investigate what types of maltreatments and social skills were associated with psychopathic traits in both groups. The types and intensity of maltreatment were evaluated through the Childhood Trauma Questionnaire (CTQ) in 107 adolescents, divided into the MTA group ( n = 66) and non-maltreated youths ( n = 41), our CG. The Hare Psychopathy Checklist: Youth Version (PCL: YV) and a detailed inventory for evaluation of social skills in adolescents were also applied in all individuals. MTA presented more psychopathic traits than the CG, in all domains measured by PCL: YV, independently of IQ levels and the presence of psychiatric disorders. Interestingly, the groups did not differ significantly from each other on indicators of social skills. Multiple regression analysis revealed that emotional neglect was the only maltreatment subtype significantly associated with psychopathic traits, more specifically with the PCL: YV interpersonal factor (F1), and that some social skills (empathy, self-control and social confidence) were related to specific psychopathic factors. The results highlight that emotional neglect may be more detrimental to social behaviours than physical and sexual abuse, and that neglected children require more specific and careful attention. [ABSTRACT FROM AUTHOR]

Purpose: Oxidative stress is closely related to cognitive impairment, and the antioxidant system may be a potential therapeutic target to preserve cognitive function in older adults. Selenium plays an important antioxidant role through selenoproteins. This controlled trial aimed to investigate the antioxidant and cognitive effects of the consumption of Brazil nuts, the best selenium food source. Methods: We enrolled 31 older adults with mild cognitive impairment (MCI) who were randomly assigned to ingestion of Brazil nuts or to the control group. Participants of the treatment group consumed one Brazil nut daily (estimated 288.75 µg/day) for 6 months. Blood selenium concentrations, erythrocyte glutathione peroxidase (GPx) activity, oxygen radical absorbance capacity, and malondialdehyde were evaluated. Cognitive functions were assessed with the CERAD neuropsychological battery. Results: Eleven participants of the treated group and nine of the control group completed the trial. The mean age of the participants was 77.7 (±5.3) years, 70 % of whom were female. We observed increased selenium levels after the intervention, whereas the control group presented no change. Among the parameters related to the antioxidant system, only erythrocyte GPx activity change was significantly different between the groups ( p = 0.006). After 6 months, improvements in verbal fluency ( p = 0.007) and constructional praxis ( p = 0.031) were significantly greater on the supplemented group when compared with the control group. Conclusion: Our results suggest that the intake of Brazil nut restores selenium deficiency and provides preliminary evidence that Brazil nut consumption can have positive effects on some cognitive functions of older adults with MCI. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the effects of neonatal malnutrition on the microbicidal response and viability of in vitro macrophages infected with Staphylococcus aureus sensitive/resistant to methicillin. Methods: Male Wistar rats ( n = 24) were divided into two distinct groups: nourished (rats breast-fed by mothers undergoing diet with 17 % casein) and malnourished (rats breast-fed by mothers undergoing diet with 8 % casein). Macrophages were recovered after surgical tracheostomy procedure by collecting bronchoalveolar lavage. Four systems were established: negative control, composed only by phagocytes; positive control, macrophages plus lipopolysaccharide; and two test systems, macrophages plus Staphylococcus aureus sensitive and resistant to methicillin. Plates were incubated at 37 °C for 24 h. After this period, tests for the analysis of cell viability and microbicidal response were performed. In the statistical analysis, the Student's t and ANOVA tests were used, accepting p < 0.05. Results: The neonatal malnutrition impaired the animals' body weight. There was a lower expression of the inducible nitric oxide enzyme (iNOS), nitric oxide production, and viability of macrophages infected with methicillin-resistant Staphylococcus aureus. However, increased production of superoxide anion in the malnourished group was detected. Conclusion: Neonatal malnutrition focusing on critical periods of development promoted lower expression of iNOS, nitric oxide production, cell viability, and exacerbated reactive oxygen species production. The high levels of reactive oxygen species may favor the onset of serious and systemic infections with fatal outcome if associated with methicillin-resistant Staphylococcus aureus. [ABSTRACT FROM AUTHOR]

Purpose: Lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria might be an inflammation trigger in adipose tissue. It has recently been proposed that there is a link between adipose tissue distribution and blood LPS. However, the number of studies on this topic is scarce, and further investigation in humans is required. In this study, we explored the association between plasma LPS concentrations and body fat distribution, as well as the biochemical parameters that may indicate the presence of metabolic disorders. Methods: Sixty-seven young adult men with body mass index of 26-35 kg/m were evaluated. Anthropometry, body composition and body fat distribution, blood pressure, energy expenditure, physical activity level, dietary intake, and biochemical parameters were assessed. Results: Men with median plasma LPS ≥ 0.9 EU/mL presented higher sagittal abdominal diameter, trunk fat percentage, and android fat percentage, and mass, insulin and alanine aminotransferase concentrations, homeostasis model assessment of insulin resistance (HOMA-IR), and beta cell dysfunction (HOMA-B) than those with lower plasma LPS. LPS correlated positively with the trunk fat percentage, and android fat percentage, and mass, insulin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase concentrations, as well as HOMA-IR and HOMA-B. Conclusion: Our results suggest that a higher plasma LPS concentration is associated with a less favorable phenotype as characterized by higher central adiposity, higher values of HOMA-IR, and beta cell function impairment in overweight/obese men. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is a risk factor for psychosocial impairment and psychiatric symptoms. Children and adolescents on dialysis frequently have compromised daily life activities and a worse quality of life (QoL) compared with healthy peers. However, few studies have investigated these aspects of CKD in pediatric pre-dialysis CKD patients. Therefore, we have analyzed resilience, QoL and anxiety and depressive symptoms in children and adolescents with pre-dialysis CKD and compared these to the values of healthy controls. Methods: Demographic and clinical data were collected from 28 children and adolescents with pre-dialysis CKD and 28 healthy sex- and age-matched controls. Psychological assessment of the participants was performed using the Wagnild and Young Resilience Scale, Pediatric Quality of Life (QoL) Inventory 4.0 , Child Depression Inventory and Self-report for Childhood Anxiety Related Disorders scales. Results: Of the 56 children enrolled in our study, the CKD patients were referred to mental health professionals more frequently than the controls. Patients exhibited higher scores for separation anxiety and a higher frequency of clinically significant depressive symptoms. They also had lower overall QoL scores, as well as poorer scores for the psychological, educational and psychosocial subdomains of QoL instruments. There was a negative correlation between anxiety and depressive symptoms and all domains of QoL. Resilience was similar in both groups, but lower in patients with significant depressive symptoms. No significant association was found between clinical or laboratory findings and psychological variables in CKD patients. Conclusion: Although patients and controls exhibited similar scores of resilience, CKD negatively impacted the QoL of pediatric patients, contributing to a higher frequency of depression and separation anxiety. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is a significant complication in patients with cancer, and nephrotoxic drugs are among the most common causes of AKI. To date, there is no study evaluating the potential role of renal biomarkers in children receiving nephrotoxic chemotherapy. Methods: A prospective study was conducted in children receiving methotrexate (MTX) or platinum-based treatment. Urinary kidney injury molecule-1 (KIM-1) was measured 24 h after the initiation of the chemotherapy infusion, and serum creatinine (sCr) was measured prior to drug infusion and at 24, 48, 72, and 96 h, 1 and 2 weeks, and 3 months post-initiation of treatment. Results: A total of 64 children were evaluated, of whom 21 (32.8 %) developed AKI. The majority had AKI stage 1 ( n = 12, 57.1 %) and only one developed AKI stage 3. Median values of urinary KIM-1 were higher in patients with AKI than in those without AKI [10.7, interquartile range (IQR) 1.6-17.9 vs. 4.3 (IQR 1.3-6.1) ng/mg creatinine; p < 0.01]. Urinary KIM-1 showed good discrimination for AKI in patients receiving nephrotoxic chemotherapy, with an area under the receiver operator characteristic curve for AKI up to 1 week later of 0.82 (95% confidence interval 0.66-0.95). Even when measured only 24 h after drug infusion, urinary KIM-1 still showed good discrimination to predict persistent renal impairment three months later. Conclusion: Urinary KIM-1 measured 24 h after the start of drug infusion has the potential to detect early AKI in pediatric patients treated with MTX or platinum-class drugs. [ABSTRACT FROM AUTHOR]

Summary: The present study investigates the effects of vitamin D on muscle function in postmenopausal women. It has been shown that vitamin D supplementation in postmenopausal women with hypovitaminosis D provides significant protective factor against sarcopenia, with significant increases in muscle strength and control of progressive loss of lean mass. Introduction: We aimed to evaluate the effect of supplementation of vitamin D (VITD) alone on muscle function in younger postmenopausal women. Methods: In this double-blind, placebo-controlled clinical trial, 160 Brazilian postmenopausal women were randomized into two groups: VITD group consisting of patients receiving vitamin D3 1000 IU/day orally ( n = 80) or placebo group ( n = 80). Women with amenorrhea for more than 12 months and age 50-65 years, with a history of falls (previous 12 months), were included. The intervention time was 9 months, with assessments at two points, start and end. Lean mass was estimated by total-body dual-energy X-ray absorptiometry (DXA) and muscle strength by handgrip strength and chair rising test. The plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by high-performance liquid chromatography (HPLC). Statistical analysis was by intention to treat (ITT), using ANOVA, Student's t test, and Tukey's test. Results: After 9 months, average values of 25(OH)D increased from 15.0 ± 7.5 to 27.5 ± 10.4 ng/ml (+45.4 %) in the VITD group and decreased from 16.9 ± 6.7 to 13.8 ± 6.0 ng/ml (−18.5 %) in the placebo group ( p < 0.001). In the VITD group, there was significant increase in muscle strength (+25.3 %) of the lower limbs by chair rising test ( p = 0.036). In women in the placebo group, there was considerable loss (−6.8 %) in the lean mass ( p = 0.030). Conclusion: The supplementation of vitamin D alone in postmenopausal women provided significant protective factor against the occurrence of sarcopenia, with significant increases in muscle strength and control of progressive loss of lean mass. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Trauma Symptom Checklist for Children (TSCC) were examined in 124 children and adolescents aged 8-16 years. Principal Component Analysis was performed to investigate the principal components of the TSCC, and Confirmatory Factor Analysis was conducted to test the dimensional structure of the TSCC. Results confirmed a six-factor structure, which fitted well with the data. Cronbach's alpha coefficients for the scales of TSCC yielded evidence for good internal reliability, with values ranging from 0.64 to 0.85. Strong evidence of convergent validity was observed through correlations with the Child Depression Inventory and Child Behavior Checklist. The preliminary results suggest that the TSCC is reliable and showed adequate evidence of validity. [ABSTRACT FROM AUTHOR]

Summary: Predictors of bone mineral density (BMD) loss are additional tools in the management of osteoporosis in premenopausal women with systemic lupus erythematosus (SLE). This study provides original evidence that N-terminal propeptide of type 1 collagen (P1NP), the most specific bone formation marker, is a predictor of BMD loss in this group of women. Introduction: SLE is associated with a high risk of low bone mass/fractures but this risk is still controversial in premenopausal women. Our aim was to determine the 1 year incidence of BMD loss in premenopausal SLE women and the value of bone turnover markers as predictors of this complication. Methods: This study enrolled a convenience sample of 63 premenopausal SLE patients. BMD was evaluated by dual X-ray absorptiometry at lumbar spine and hip at baseline and after 12 months. BMD changes above the least significant change were considered significant. Serum levels of P1NP and CTX (electrochemiluminescence), OPG, and RANKL (ELISA) were determined at baseline. Results: Mean age was 31.1 ± 6.8 years, and disease duration was 5.25 ± 3.8 years. 36.5 % of patients presented BMD loss and 17.5 % BMD gain at lumbar spine and/or hip. Patients were divided in three groups: BMD loss (BL), no BMD change (NC), and BMD gain (BG). Patients with BL and NC received similar cumulative/mean/maximum glucocorticoid doses during the study, but patients with BG received lower doses ( p < 0.05). Baseline P1NP levels were different in the groups (BL: 36.95 ± 23.37 vs. NC: 54.63 ± 30.82 vs. BG: 84.09 ± 43.85 ng/mL; p = 0.031 BL vs. NC, p < 0.001 BL vs. BG, and p = 0.039 NC vs. BG). There was no difference in CTX, OPG, or RANKL levels. After multivariate analysis, P1NP remained as an independent risk factor for BMD loss ( p < 0.03). Conclusions: This study provides original evidence that lower levels of P1NP, the most specific bone formation marker, are predictive of BMD loss over 12 months in premenopausal SLE patients. [ABSTRACT FROM AUTHOR]

Summary: We ascertained the incidence and predictors of radiographic vertebral fracture in a Brazilian elderly cohort, since no data in this field have been reported in low-income countries. This is the first population-based study to demonstrate the high frequency of vertebral fracture in elderly Latin Americans. Age, prior fracture, BMD, and bone turnover were predictors of fracture. Introduction: Vertebral fractures are associated with increased future fracture risk and mortality. No data on incidence of osteoporotic vertebral fracture have been reported in low-income countries where the population's aging has been faster. Thus, we sought to describe the incidence and risk factors for radiographic vertebral fracture in a longitudinal prospective Brazilian population-based elderly cohort. Methods: 707 older adults (449 women and 258 men) were evaluated with spinal radiographs obtained at baseline and after a mean follow-up of 4.3 ± 0.8 years. New vertebral fracture was defined as distinct alteration in the morphology of vertebrae resulting in higher grade of deformity on the second radiograph when compared to the baseline radiograph. Clinical questionnaire, bone mineral density (BMD), and laboratory tests were performed at baseline. Multivariate Poisson regression models were used to identify independent predictors of fracture. Results: The age-standardized incidence of vertebral fracture was 40.3/1,000 person-years in women and 30.6/1,000 in men. In women, three models of risk factors for fracture were fitted: (1) age (relative risks (RR) 2.46, 95 % confidence interval (CI) 1.66-3.65), previous osteoporotic fracture (RR 1.65, 95 % CI 1.00-2.71), and lumbar spine BMD (RR 1.21, 95 % CI 1.03-1.41); (2) age (RR 2.25, 95 % CI 1.52-3.34) and femoral neck BMD (RR 1.42, 95 % CI 1.11-1.81); (3) age (RR 2.11, 95 % CI 1.41-3.15) and total hip BMD (RR 1.56, 95 % CI 1.21-2.0). In men, the highest quartile of cross-linked C-telopeptide (CTx) (RR 1.96, 95 % CI 0.98-3.91) and prior fracture (RR 2.10, 95 % CI 1.00-4.39) were predictors of new vertebral fracture. Conclusions: This is the first population-based study to ascertain the incidence of vertebral fracture in elderly Latin Americans, confirming the high frequency of the disorder. Age, prior fracture, BMD, and bone turnover were predictors of the short-term incidence of vertebral fracture. [ABSTRACT FROM AUTHOR]

In the era of highly active antiretrovirals, people living with HIV (PLWH) have resumed sexual activity in the context of longer and healthier lives, and thus the chances of transmitting the HIV virus, as well as the potential to be re-infected also increase. HIV treatment optimism has been found to be associated with sexual risk behaviors among PLWH in different settings. A cross sectional survey was conducted to examine the relationship between treatment optimism, safer sex burnout and consistent condom use as well as variables associated with treatment optimism in a sample of PLWH on antiretrovirals (ARVs) in Rio de Janeiro, Brazil (n = 604). Seventy-two percent of participants always used a condom in the last 6 months. Homosexual, bisexual, transexual persons were less likely to use condoms consistently than heterosexuals (AOR .58 CI .42-.78). Those who were treatment optimistic (AOR .46 CI .25-.88) were more likely not use a condom consistently in the past 6 months, as were participants who reported safer sex burnout (AOR .58 CI .36-.90). Sexual orientation, safer sex burnout, and lower education levels were significantly associated with higher treatment optimism in multivariate analysis. Study findings highlight the need to address psychosocial factors such as treatment optimism and safer sex burnout associated with lower consistent condom use among PLWH in Rio de Janeiro, Brazil. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional study.Objectives:To validate heart rate (HR) indexes for the evaluation of energy expenditure during wheelchair propulsion in people with spinal cord injury (SCI).Setting:SARAH Rehabilitation Hospital Network-Brasilia, Brazil.Methods:Forty-eight men aged 29.0±7.8 years with a SCI between C6 and L3 causing complete motor impairment were enrolled in the study. The assessment consisted of 5 min of rest while seated in the wheelchair, followed by 5 min of wheelchair propulsion at a self-selected comfortable speed. The main outcomes measured were oxygen consumption, HR, physiological cost index (PCI), total heart beat index (THBI) and propulsion cardiac cost index (PCCI).Results:Using oxygen uptake as gold standard, the highest correlations were found between this and PCCI (r=0.59, P<0.001, 95% confidence interval (CI) 0.36-0.75) and THBI (r=0.58, P<0.001, 95% CI 0.36-74.0), independently of the injury level. The PCI had the lowest correlation coefficient (r=0.38, P<0.01, 95% CI 0.11-0.60). Spearman correlation analysis showed that the indexes mostly associated with lesion level were PCCI (ρ=−0.531; P<0.001; 95% CI −0.708 to −0.291) and THBI (ρ=−0.524; P<0.001; 95% CI −0.704 to −0.282).Conclusions:Both THBI and PCCI seem to be valid measures for assessing energy expenditure. Both indexes showed a coherent correlation with the spinal injury level. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional study.Objectives:To measure the reproducibility and responsiveness of heart rate indexes in measuring energy expenditure during wheelchair locomotion of adults with spinal cord injury (SCI).Setting:SARAH Rehabilitation Hospital Network-Brasilia, Brazil.Methods:The study consecutively enrolled 35 individuals with SCI. Volunteers propelled their wheelchairs at a self-selected and comfortable velocity around a circular track. The first assessment day was a responsiveness study, in which three tests were performed, with the wheelchair weight increased randomly during the last two tests. On the second assessment day, the test was conducted without extra weight (that is, baseline conditions) for reproducibility analyses.Results:All indexes demonstrated reproducibility on all statistical analyses. The Propulsion Cardiac Cost Index (PCCI) had a lower variation coefficient than the Physiological Cost Index (PCI; 8.5%, 95% confidence interval (CI) 5.8-11.2 vs 24.2%, 95% CI 16.0-32.4) and lower effect size than the Total Heart Beat Index (THBI; 0.16 vs 0.26). The PCCI also had the best responsiveness results on all statistical tests. The PCCI correlation was the largest (r=0.63, P<0.01, 95% CI 0.43-0.83, followed by PCI (r=0.53, P<0.01, 95% CI 0.34-0.72) and then the THBI (r=0.50, P<0.01, 95% CI 0.29-0.71).Conclusions:All three indexes were reproducible and responsive. However, the PCCI gave better statistical results. This index may be useful in functional diagnosis and follow-up of rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Previously, it was showed that vegan diet improves the metabolism of triglyceride-rich lipoproteins by increasing the plasma clearance of atherogenic remnants. The aim of the current study was to investigate this metabolism in lacto-ovo vegetarians whose diet is less strict, allowing the ingestion of eggs and milk. Transfer of lipids to HDL, an important step in HDL metabolism, was tested in vitro. Methods: Eighteen lacto-ovo vegetarians and 29 omnivorous subjects, all eutrophic and normolipidemic, were intravenously injected with triglyceride-rich emulsions labeled with C-cholesterol oleate and H-triolein. Fractional clearance rates (FCR, in min) were calculated from samples collected during 60 min. Lipid transfer to HDL was assayed by incubating plasma samples with a donor nanoemulsion labeled with radioactive lipids. Results: LDL cholesterol was lower in vegetarians than in omnivores (2.1 ± 0.8 and 2.7 ± 0.7 mmol/L, respectively, p < 0.05), but HDL cholesterol and triglycerides were equal. Cholesteryl ester FCR was greater in vegetarians than in omnivores (0.016 ± 0.012, 0.003 ± 0.003, p < 0.01), whereas triglyceride FCR was equal. Cholesteryl ester transfer to HDL was lower in vegetarians than in omnivores (2.7 ± 0.6, 3.5 ± 1.5 %, p < 0.05), but free cholesterol, triglyceride and phospholipid transfers and HDL size were equal. Conclusion: Similarly to vegans, lacto-ovo vegetarian diet increases remnant removal, as indicated by cholesteryl oleate FCR, which may favor atherosclerosis prevention, and has the ability to change lipid transfer to HDL. [ABSTRACT FROM AUTHOR]

Purpose: A meal replacement may be an effective strategy in the management of obesity to increase antioxidant intake, attenuating oxidative stress and inflammation. In the present study, we investigated the efficacy of a new nutritional supplement to reduce metabolic risk parameters in obese women. Methods: In a randomized controlled crossover study (2 × 2), 22 women (percentage body fat 40.52 ± 3.75 %; body mass index-BMI 28.72 ± 2.87 kg/m; 35.04 ± 5.6 years old) were allocated into two treatments: hypocaloric diet and drink containing 'Human Ration' (HR) consumption (CRHR), and hypocaloric diet and control drink consumption (CR). The study consisted of 2 periods of 5 weeks with 1 week of washout in two orders (CR → CRHR and CRHR → CR). Caloric restriction was 15 %, based on estimated energy requirement. Anthropometric, clinical and metabolic risk parameters were assessed at baseline and at the end of each period. Results: Some metabolic risk factors were favorably modulated in both interventions: reduction in body weight (CR −0.74 ± 1.27 kg; p = 0.01; CRHR −0.77 ± 1.3 kg; p = 0.02), body mass index (BMI) (CR −0.27 ± 0.51 kg/m; p = 0.02; CRHR −0.30 ± 0.52 kg/m; p = 0.01) and HOMA-IR (CR −0.35 ± 0.82; p = 0.02, CRHR −0.41 ± 0.83; p = 0.03). However, CRHR reduced waist circumference (−2.54 ± 2.74 cm; p < 0.01) and gynoid fat (−0.264 ± 0.28 g; p < 0.01), and increased HDL-c levels (0.08 ± 0.15 mmol/l; p = 0.04). Conclusion: Associated with hypocaloric diet, the intake of a nutritional supplement rich in phytochemicals as a breakfast substitute for 5 weeks had no additional effect on weight reduction than caloric restriction alone, but increased central lipolysis and improved the lipoprotein profile. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of two dietary patterns in which carbohydrates and proteins were eaten mostly at lunch or dinner on body weight and composition, energy metabolism, and biochemical markers in overweight/obese men. Methods: Fifty-eight men (30.0 ± 7.4 years; 30.8 ± 2.4 kg/m) followed a covert hypocaloric balanced diet (−10 % of daily energy requirements) during 8 weeks. Subjects were randomly assigned to three groups: control diet (CT); diurnal carbohydrate/nocturnal protein (DCNP); and nocturnal carbohydrate/diurnal protein (NCDP). Main analyzed outcomes were weight loss, body composition, diet-induced thermogenesis (DIT), and glucose/lipid profile. Results: In all groups, a significant decrease in body weight, BMI, and fat mass (kg and %) was verified, without differences between groups. Interestingly, within group analyses showed that the fat-free mass (kg) significantly decreased in NCDP and in CT after 8-week intervention, but not in DCNP. A detrimental increase in fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA) was verified only in DCNP, while NCDP and CT groups presented a non-significant reduction. Moreover, significant differences between DCNP and the other groups were detected for fasting insulin and HOMA. After the adjustments, NCDP presented a significantly higher DIT and energy expenditure after lunch, compared with DCNP, but after dinner, there were no differences among groups. Conclusion: Eating carbohydrates mostly at dinner and protein mostly at lunch within a hypocaloric balanced diet had similar effect on body composition and biochemical markers, but higher effect on DIT compared with control diet. Moreover, eating carbohydrates mostly at lunch and protein mostly at dinner had a deleterious impact on glucose homeostasis. [ABSTRACT FROM AUTHOR]

Summary: Sarcopenia is an aging syndrome that can be characterized by many criteria adjusted or not by fat mass. This study suggested that the optimal criteria should be selected according to body mass index (BMI) in older men and identified age, BMI, race, smoking, physical activity, hip bone mineral density (BMD) as risk factors for this syndrome. Introduction: This study aims to analyze the prevalence of sarcopenia and associated risk factors using appendicular skeletal mass (ASM)/height and ASM adjusted for total fat mass criteria in older men from community. Methods: Three hundred ninety-nine men were included and answered a questionnaire about lifestyle and medical history. Individuals were classified by their BMI using the classification adjusted by age. Body composition and bone mineral density were measured by dual X-ray absorptiometry. Sarcopenia was classified according to both criteria. Logistic regression models were used to analyze risk factors associated with sarcopenia. Results: The mean BMI was 26.46 kg/m: 12.5 % underweight, 43.6 % normal, and 43.9 % overweight/obese. Fifty-four (13.5 %) were considered sarcopenic by ASM/height and 79 (19.8 %) by ASM adjusted for fat ( p = 0.001). Fifty-one (12.8 %) individuals had discordant sarcopenia classification: 13 were classified only by ASM/height and 38 only by ASM adjusted for fat. Of the 13 subjects classified as sarcopenic only by ASM/height, 84.6 % (11/13) were underweight and solely one (7.7 %) was considered overweight/obese. In contrast, of those 38 older men classified as sarcopenic only by ASM adjusted for fat, none were underweight and 53 % (20/38) were overweight/obese. Subjects classified as sarcopenic according to both criteria had the same risk factors in the final model analyses (age, BMI, race, smoking, physical activity, hip BMD; p < 0.05). Conclusion: This study suggested that the optimal criteria for sarcopenia should be selected according to BMI in community-dwelling older men. [ABSTRACT FROM AUTHOR]

Purpose: Failure to control blood pressure (BP) despite the use of three or more drugs characterizes resistant hypertension (RHTN). Impaired endothelial function is associated with this condition and phosphodiesterase-5 inhibitors (PDE5i)—inhibiting cGMP breakdown—reduce BP in RHTN patients. We hypothesized that acute administration of PDE5i could ameliorate hemodynamic, endothelial parameters and left ventricular diastolic function (LVDF) in RHTN patients. Also, an exploratory analysis was performed to assess the influence of the T-786C endothelial NO synthase polymorphism on those responses. Methods: Subjects ( n = 26) underwent a 6-month clinical screening for RHTN diagnosis. Increasing doses of oral sildenafil were given at 30 min intervals (37.5, 50 and 100 mg) while continuous non-invasive hemodynamic measures were assessed. LVDF, flow mediated dilation (FMD), nitrite and cGMP levels were also determined. Results: Mean arterial pressure and total peripheral resistance decreased in all patients (84.17 ± 21.04 to 75 ± 17.21 mmHg; 1149 ± 459.7 to 1037 ± 340 dyn.s/cm −5, respectively). Likewise, sildenafil improved diastolic dysfunction parameters (Left atrial volume: 25 ± 5.8 to 20 ± 4.4; IVRT: 104 ± 19.33 to 88 ± 15.22; E/e’ septal: 9.7 ± 3.8 to 7.9 ± 2.9; E/e’ lateral: 7.7 ± 3.4 to 6.4 ± 3.2). No statistical changes were found in FMD, nitrite and cGMP with PDE5i. Conclusion: Our data suggest PDE5i acutely improves diastolic function and hemodynamic profile in RHTN subjects, despite unchanging endothelial dysfunction. [ABSTRACT FROM AUTHOR]

School bullying is frequent and is associated with a broad spectrum of psychiatric problems. The aims of this study were to examine the prevalence of bullying behaviors in a large sample of Brazilian children and adolescents and to investigate the association between bullying behaviors and DSM-IV anxiety symptomatology. This cross-sectional study involved completion of a questionnaire about bullying behaviors and their frequency and the Screen for Child Anxiety-Related Emotional Disorders (SCARED) that is a self-report screening tool for childhood anxiety disorders by 2,355 students. A total of 22.9 % of the sample reported frequent involvement in bullying, as a bully (7.6 %), as a victim (5.7 %), or as a bully-victim (9.6 %). In general, our findings showed that students involved in bullying behaviors, as victims or bully-victims, were more likely to have higher scores in SCARED total and its subscales than bullies and than uninvolved students. The prevalence of bullying behaviors among Brazilian youth is about average when compared with previous samples described in the literature. Victims and bully-victims, but no bullies, are groups associated with higher anxiety symptomatology. [ABSTRACT FROM AUTHOR]

Summary: The task of standing up from a chair forms a part of daily life for all independent individuals. However, this task becomes more difficult with advancing age. Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up. Introduction: This study aims to evaluate postural balance during the transition from sitting to standing and its relationship with knee extensor and flexor strength among women with and without postmenopausal osteoporosis. Methods: Assessments were made on 126 women (aged 55-65 years), divided into osteoporosis and control groups according to lumbar bone density. Their balance during the task of standing up from a chair was evaluated using the Balance Master® device. Knee muscle strength was evaluated using an isokinetic dynamometer (Biodex®), in concentric/concentric mode, at a velocity of 60°/s. Spearman's correlation between the variables of muscle strength and postural balance was evaluated. Subsequently, to evaluate the association of each balance variable with the group and with muscle strength, multiple linear regression models were fitted. The significance level was set at 0.05. Results: There was a difference in knee muscle strength between the groups ( P < 0.05). However, independent of the muscle strength values, there were no differences in relation to weight transfer times ( P = 0.556) or center of gravity sway velocity ( P = 0.952). Transfer time diminished with increasing extensor strength ( P = 0.025). The center of gravity sway velocity tended to increase with increasing extensor strength ( P = 0.013) and was the same in the two groups ( P = 0.264). Conclusion: Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up. [ABSTRACT FROM AUTHOR]

Study design:Experimental, controlled, animal study.Objectives:To evaluate the influences of antidepressant treatment, treadmill gait training and a combination of these therapies in rats with experimental, acute spinal cord injury (SCI).Setting:Brazil.Methods:48 Wistar rats were given standardized SCI; rats were then randomly assigned to four treatment groups: (1) motor rehabilitation therapy for 1 hour daily (gait training); (2) daily treatment with the antidepressant, fluoxetine (0.3 ml per 100 g intraperitoneally), beginning 24 h after the trauma; (3) combined fluoxetine treatment and gait training, or (4) untreated (controls). Neurological recovery was tested with the Basso, Beattie and Bresnahan (BBB) scale at 2, 7, 14, 21, 28 ,35 and 42 days after injury. Moreover, on day 42, all rats underwent a motor-evoked potential test (MEP); then, after euthanasia, histopathological evaluation was conducted in the area of SCI.Results:Based on the BBB scale, the combined treatment group showed significantly greater improvement compared with the other three groups, from the 14th to the 42nd day of observation. The MEP revealed that all treated groups showed significant improvement compared with the control group (P<0.02 for latency and P<0.01 for amplitude).Conclusion:Our results indicated that a combination of antidepressant and treadmill gait training was superior to either treatment alone for improving functional deficits in rats with experimental, acute SCI. [ABSTRACT FROM AUTHOR]

Background: In this study we applied the pediatric version of the RIFLE criteria (pRIFLE) to an at-risk hospital population, analyzed the incidence and association of acute kidney injury (AKI) with mortality and length of stay in both the intensive care unit (ICU) and the hospital, and evaluated the applicability of pRIFLE as a prognostic tool in the ICU. Methods: This study was a prospective single-center cohort study in which 126 patients were enrolled. The affected group included patients who were diagnosed with AKI. Subgroups of the diagnosed patients were established according to their maximum pRIFLE strata, which were defined as the worst pRIFLE score attained during the study period. Results: Fifty-eight (46 %) of our patients developed AKI. The lengths of stay in the ICU and in the hospital were longer in the affected group than in the unaffected group. The advanced strata of pRIFLEmax were associated with longer stays in the ICU and hospital and higher median Pediatric Index of Mortality II scores. The hospital mortality rate of AKI patients was 12-fold higher than that of the patients without AKI (36 vs. 3 %). Conclusion: The incidence of AKI in this population was both significant and directly associated with hospital mortality and the length of stay in the ICU and hospital. The pRIFLE classification facilitated the definition of AKI, indicating that it a significant prognostic predictor. [ABSTRACT FROM AUTHOR]

Background: Many studies have indicated a role for cytokines in chronic kidney disease (CKD). The aim of this study was to evaluate plasma and urinary levels of monocyte chemoattractant protein-1 (MCP-1/CCL2), transforming growth factor-beta1 (TGF-β1), and interleukin-8 (IL-8/CXCL8) in pediatric patients with CKD stages 2-4. Methods: Cytokines were measured in 37 healthy controls and in 42 CKD patients by enzyme-linked immunoassay. Patients were divided into groups according to CKD etiology: glomerular disease (group 1, n = 11) and congenital anomalies of the kidney and urinary tract (group 2, n = 31). Urinary cytokine measurements were standardized for creatinine. Results: Plasma and urinary levels of MCP-1/CCL2 were significantly higher in both CKD groups compared to the control group. Between the two CKD groups, only urinary MCP-1/CCL2 levels were significantly different, with MCP-1/CCL2 levels higher in group 1 patients. Plasma and urinary levels of IL-8/CXCL8 and TGF-β1 were undetectable in the control group but comparable between the two CKD groups. In group 1 patients, urinary MCP-1/CCL2 levels were negatively correlated to serum albumin levels and positively correlated to the levels of total cholesterol and triglycerides. In group 2 patients, urinary levels of IL-8/CXCL8 were negatively correlated with the estimated glomerular filtration rate and positively correlated with body mass index. Conclusions: Differences in cytokine profiles may be related to CKD etiology and other disease-associated alterations. [ABSTRACT FROM AUTHOR]

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Aim: To verify whether moderate physical training affects the muscle fibre composition of adult rats subjected to a low protein diet during the perinatal period. Methods: Male Wistar rats were divided into two groups according to their mother's diet during gestation and lactation: control (17% casein, C) and low-protein (8% casein, LP). On postnatal day 60, half of each group was submitted to moderate physical training (8 weeks, 5 days/week, 60 min/day, at 70% of VO, T) or not. After the physical training period, soleus and extensor digitorum longus (EDL) muscles were removed. Myofibrillar ATPase staining was used to classify muscle fibres as type I, IIa, IIb, and intermediate. Results: In the EDL muscle, LP rats showed no changes in the fibre type proportion. Both the C + T and LP + T groups showed a higher percentage of fibres of type IIa, and a lower proportion of fibres of type IIb. In the soleus muscle, LP animals showed a reduction in the proportion of fibre types I and intermediate. C + T rats showed an increase in the fibre type I and IIa. In the LP + T rats, the proportions of the fibre types remained similar to control rats. Conclusions: Moderate physical training acts as a positive environmental stimulus that reverts the effects of a perinatal low-protein diet on the proportion of fibre types in skeletal muscle. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives:This study aimed to assess the burden and quality of life (Qol) of primary caregivers of children/adolescents with meningomyelocele, taking into account the relationship to anxiety and depression symptoms.Methods:A cross-sectional approach was taken to analyze the health-related Qol and burden using the Short Form-36 Survey (SF-36) and the Caregiver Burden Scale (CBS), respectively. Depressive and anxiety symptoms were investigated using the Beck Inventories. The Heckman two-step method was used to deal with the selection bias problem.Results:A total of 43 primary caregivers were enrolled in the study. Most of the caregivers were mothers with preliminary education, living in consensual union. Lower scores in general health and vitality were reported in the SF-36. The mean global CBS score was 2.2. Majority of the volunteers (55.8%) were considered non-depressive. There were both positive and negative correlations between the scores of both Beck Inventories and most dimensions of the CBS and SF-36. The Heckman method showed a higher burden among caregivers who had children with fecal incontinence, were living together with a partner, were unemployed and had lower income (P<0.05).Conclusion:The primary caregivers of children and adolescents with myelomeningocele reported burden and a lower Qol. There were more anxiety and depression symptoms in subjects with higher burden and impaired Qol. Caregivers had a higher burden if they were living together with a partner, were unemployed, had low income and had care recipients with fecal incontinence. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest that cytokines modulate bone turnover. Idiopathic hypercalciuria (IH) seems to be associated with bone mineral loss. Therefore, the aim of this study was to assess cytokines involved in bone turnover in patients with IH. Methods: Plasma and spot-urine levels of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), transforming growth factor β1 (TGF-β1), and monocyte chemoattractant protein (MCP-1) were measured in 70 children and adolescents with IH and in 37 healthy controls. Patients with IH were subdivided according to their calciuria at the time of sample collection: ≥4 mg/kg/day (persistent IH, n=27) and below 4 mg/kg/day (controlled IH, n=43). Cytokines were determined by enzyme-linked immunoassay. Results: Plasma and urinary concentrations of IL-1β, IL-6, IL-8, and TNF-α were undetectable in all groups. No differences were found between controlled and persistent hypercalciuria for plasma and urinary levels of MCP-1 and TGF-β1. On the other hand, MCP-1 levels were significantly higher in both subgroups of IH in comparison to healthy controls. Furthermore, urinary MCP-1 levels of IH patients correlated positively with bone mineral content ( p=0.013). Conclusion: Although cytokine measurements did not allow the differentiation between persistent and controlled IH, our findings suggest that MCP-1 might play a role in patients with IH. [ABSTRACT FROM AUTHOR]

Purpose: Adipocytes and osteoblasts were derived from a common progenitor, and canola oil intake may have an adipogenic and osteogenic effect. Thus, our objective was to evaluate the effect on adipocyte, lipid profile, glucose homeostasis, and bone of canola oil as main lipid source on the diet during development. Methods: After weaning, rats were divided into two groups ( n = 10 per group): control (S) and experimental (C) diets containing 7 mL/100 g soybean or canola oil, respectively. At 60 days, body composition, liver and intra-abdominal fat mass, adipocyte morphology, serum analysis, femur and lumbar vertebras density by dual-energy X-ray absorptiometry and computed tomography were determined. Differences were considered significant with P < 0.05. Results: C group showed the following: lower liver (−12%) and intra-abdominal fat mass (−19%) area of adipocyte (−60%), cholesterol (−33%), insulin (−22%), lower total body (−9%) and spine (−33%) bone mineral content and bone area (−7 and −24%, respectively), femur mass (−9%), width of the diaphysis (−6%), femur (−10%) and lumbar vertebrae bone mineral density (−9%), and radiodensity of femoral head (−8%). Conclusions: The lower intra-abdominal adiposity could have more beneficial effects in a short term, since it can be associated with a better insulin sensitivity and lipid profile, than the small reduction in femur and lumbar vertebra density. However, it has to be considered the incremental effect of this reduction along the aging process. [ABSTRACT FROM AUTHOR]

Background: There is no consensus regarding the accuracy of bioimpedance for the determination of body composition in older persons. Objective: This study aimed to compare the assessment of lean body mass of healthy older volunteers obtained by the deuterium dilution method (reference) with those obtained by two frequently used bioelectrical impedance formulas and one formula specifically developed for a Latin-American population. Design: A cross-sectional study. Participants: Twenty one volunteers were studied, 12 women, with mean age 72±6.7 years. Setting: Urban community, Ribeirão Preto, Brazil. Measurement: Fat free mass was determined, simultaneously, by the deuterium dilution method and bioelectrical impedance; results were compared. In bioelectrical impedance, body composition was calculated by the formulas of Deuremberg, Lukaski and Bolonchuck and Valencia et al. Results: Lean body mass of the studied volunteers, as determined by bioelectrical impedance was 37.8±9.2 kg by the application of the Lukaski e Bolonchuk formula, 37.4±9.3 kg (Deuremberg) and 43.2±8.9 kg (Valencia et. al.). The results were significantly correlated to those obtained by the deuterium dilution method (41.6±9.3 Kg), with r=0.963, 0.932 and 0.971, respectively. Lean body mass obtained by the Valencia formula was the most accurate. Conclusion: In this study, lean body mass of older persons obtained by the bioelectrical impedance method showed good correlation with the values obtained by the deuterium dilution method. The formula of Valencia et al., developed for a Latin-American population, showed the best accuracy. [ABSTRACT FROM AUTHOR]

Children with idiopathic hypercalciuria (IH) may have a reduced bone mineral density (BMD), which could impact on bone health in adulthood. There is currently no strong evidence for a preferred treatment of such children. The aim of our study was to evaluate the BMD z-score before and after treating children and adolescents with IH with potassium citrate and thiazides. The study consisted of a historical cohort of 80 pediatric patients who were evaluated between October 1989 and November 2010. Bone scanning and densitometry measurements were made with dual-emission X-ray absorptiometry. Lumbar-spine BMD (g/cm) and BMD z-score were evaluated before and after treatment. The t test and Mann-Whitney U test were used for statistical analysis. Forty-three boys and 37 girls were followed for a median time of 6.0 years. Median calcium excretion before and after treatment was 5.0 and 2.6 mg/kg/24 h, respectively. The BMD z-score changed significantly from −0.763 ± 0.954 (mean ± SD) to −0.537 ± 0.898 ( p < 0.0001) before and after treatment, respectively. The BMD z-score of the patients improved with treatment, suggesting a beneficial effect and potential need for treatment. However, the lack of a control group points to the need for future studies to corroborate this outcome. [ABSTRACT FROM AUTHOR]

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Objective: The objective of this study was to assess factors associated with the diet quality of brazilian older adults. Design: Cross-sectional study. Setting: City of Carlos Barbosa, Brazil. Participants: 228 participants aged 60 and older. Measurements: A questionnaire with questions on socioeconomic and behavioral variables and health characteristics was used. The body mass index was calculated and the waist circumference was measured to provide information in respect to abdominal fat accumulation. Dietary data were collected via 24-hour recall and the diet quality was assessed using the Healthy Eating Index, an instrument that attributes scores to the diet according to the adequacy of intake of the main food and nutrient groups. Participants were divided into three categories, according to the Healthy Eating Index scores: under 51 - poor diet; between 51 and 80 - diet that needs improvement; over 80 - good diet. The evaluation employed the analysis of variance, t test and non-conditional logistic regression to assess the association between the Healthy Eating Index and the other variables. Results: Most participants (80.9%) presented diet that needs improvement and the marital status showed an independent association with the Healthy Eating Index - married individuals showed higher odds of presenting good diet. Conclusion: The results of this study suggest that, in general, the diet quality of this group needs improvement and that the marital status is a factor that can be considered for the development of activities to promote health and healthy food intake habits. [ABSTRACT FROM AUTHOR]

Insomnia is a frequent climacteric symptom. This pilot, double-blind, randomized placebo-controlled trial compared estradiol associated with trimegestone or placebo in 12 women with perimenopausal insomnia. The Pittsburgh Sleep Quality Index (PSQI) was administered, and polysomnography was performed at baseline and after 28 days. Sleep efficiency and median score of the PSQI improved significantly in the hormone therapy group (HT) ( p = 0.041 and p = 0.027, respectively) and not in placebo group. Perimenopausal insomnia improved after short-term HT. [ABSTRACT FROM AUTHOR]

im: To investigate the effects of a neonatal low-protein diet on the morphology of myotubes in culture and the expression of key proteins that regulate myogenesis in young and adult rats. Methods: Male Wistar rats ( n = 18) were suckled by mothers fed diets containing 17% protein (controls, C) or 8% protein (undernourished, UN). All rats were fed a normal protein diet after weaning. Muscles were removed from the legs of 42-, 60- and 90-day-old rats. Muscle cells were cultured to assess cell number, morphology and the expression of major proteins involved in myogenesis (Pax7, cadherins, β1 integrin, IL-4Rα and myogenin) by western blotting. IL-4 levels in culture supernatants were measured by ELISA. Results: Offspring from mothers fed a low-protein diet showed a lower body weight gain. Cell number and myotube expansion were reduced in cultured muscle cells from UN, but the expression of myogenic marker proteins was unaltered. Conclusions: Dietary restriction during lactation had no impact on the synthesis of myogenic marker proteins, and myocyte differentiation occurred normally in the muscles of offspring aged 42, 60 or 90 days. Nevertheless, the number and morphology of the myotubes are altered. [ABSTRACT FROM AUTHOR]

Background: There are substantial evidences suggesting that probiotics can protect the gastrointestinal tract against inflammatory or infectious episodes. The effects of oral treatment with viable or heat-killed cells of Saccharomyces boulardii ( Sb) on bacterial translocation, intestinal permeability, histological aspect of the ileum, and some immunological parameters were evaluated in a murine intestinal obstruction (IO) model. Results: Bacterial translocation and intestinal permeability in the IO group were significantly higher when compared to a Sham group ( p < 0.05). Pretreatment with both viable and heat-killed S. boulardii prevented these increases, and the data obtained for IO + Sb and IO + heat-killed Sb groups were similar to those observed in the Sham group ( p > 0.05). Histological analysis showed preservation of the ileum mucosa in mice that received both forms of the yeast when compared to the lesions observed in the IO group. The levels of serum interleukin (IL)-10 and intestinal secretory immunoglobulin A (sIgA) were higher in the animals that received both yeast treatments when compared to those from IO and Sham groups. Conclusion: Oral treatment with viable or heat-killed cells of S. boulardii maintained intestinal integrity and modulated the immune system in a murine IO model, preventing bacterial translocation and intestinal lesions. [ABSTRACT FROM AUTHOR]

Purpose: Adverse drug events (ADEs) are harmful and occur with alarming frequency in critically ill patients. Complex pharmacotherapy with multiple medications increases the probability of a drug interaction (DI) and ADEs in patients in intensive care units (ICUs). The objective of the study is to determine the frequency of ADEs among patients in the ICU of a university hospital and the drugs implicated. Also, factors associated with ADEs are investigated. Methods: This cross-sectional study investigated 299 medical records of patients hospitalized for 5 or more days in an ICU. ADEs were identified through intensive monitoring adopted in hospital pharmacovigilance and also ADE triggers. Adverse drug reactions (ADR) causality was classified using the Naranjo algorithm. Data were analyzed through descriptive analysis, and through univariate and multiple logistic regression. Results: The most frequent ADEs were ADRs type A, of possible causality and moderate severity. The most frequent ADR was drug-induced acute kidney injury. Patients with ADEs related to DIs corresponded to 7% of the sample. The multiple logistic regression showed that length of hospitalization (OR = 1.06) and administration of cardiovascular drugs (OR = 2.2) were associated with the occurrence of ADEs. Conclusion: Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied, which reduces patient safety. The number of ADEs related to drug interactions was small, suggesting that clinical manifestations of drug interactions that harm patients are not frequent in ICUs. [ABSTRACT FROM AUTHOR]

Purpose: The antihypertensive effects of angiotensin-converting enzyme inhibitors (ACEi) are explained, at least in part, by enhanced bradykinin-dependent nitric oxide (NO) formation and decreased angiotensin II-induced oxidative stress and vasoconstriction. We examined for the first time whether treatment with enalapril increases the plasma levels of markers of NO formation and decreases oxidative stress in mild to moderate hypertensive patients. Methods: Eighteen untreated hypertensive patients were treated with enalapril 10 mg/day ( n = 10) or 20 mg/day ( n = 8) for 60 days. Eighteen normotensive healthy controls were followed for the same period. Venous blood samples were collected at baseline and after 30/60 days of treatment with enalapril. Plasma NOx (nitrites + nitrates) concentrations were determined by using the Griess reaction. Plasma nitrite and whole blood nitrite concentrations were determined by using an ozone-based chemiluminescence assay. Plasma thiobarbituric acid-reactive species (TBARS) and 8-isoprostane concentrations were determined by a fluorimetric method and by ELISA, respectively. Results: Treatment with enalapril decreased blood pressure in hypertensive patients. However, we found no significant changes in plasma NOx, nitrite, whole blood nitrite, and in the levels of markers of oxidative stress in both normotensive controls and hypertensive patients treated with enalapril. Conclusions: Our data show that enalapril 10-20 mg/day does not affect the concentrations of relevant markers of NO formation or markers of oxidative stress in mild to moderately hypertensive subjects, despite satisfactory blood pressure control. Our findings do not rule out the possibility that ACEi may produce such effects in more severely hypertensive patients treated with higher doses of ACEi. [ABSTRACT FROM AUTHOR]

Childhood hypertension has classically been recognized as a secondary disease. However, primary hypertension also occurs in children. The aim of this study was to compare clinical features of pediatric patients with elevated blood pressure, which were referred to an outpatient tertiary unit, and to detect variables associated with the identification of primary hypertension. The records of 220 patients with hypertension followed between 1996 and 2006 were analyzed. The variable of interest was primary hypertension. Logistic regression analysis was applied to identify clinical variables that were independently associated with primary hypertension. Of 220 patients, 33 (15%) had primary hypertension, and 187 (85%) exhibited secondary hypertension. No statistically significant differences were detected in gender, race, age at diagnosis, and systolic/diastolic blood pressure levels between both groups. After adjustment, four variables at baseline remained independently associated with primary hypertension: absence of signs/symptoms (OR 18.87, 95% CI 6.32-56.29), normal serum creatinine (OR 0.02, 95% CI 0.00-0.27), family history of hypertension (OR 3.03, 95% CI 1.04-8.79), and elevated body weight (OR 1.06, 95% CI 1.02-1.10). The absence of signs/symptoms, normal serum creatinine, family history of hypertension, and overweight/obesity at admission are clues to diagnose primary hypertension in childhood. [ABSTRACT FROM AUTHOR]