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Objetivo: Analisar as caracterí­sticas espaço-temporais, cinemáticas e cinéticas da marcha em indiví­duos pós-AVC. Métodos: A amostra foi composta por 16 indiví­duos (10 do grupo Pós-AVC e 6 do grupo Controle). A análise das variáveis da marcha, a amplitude de movimento, o momento e a potência do tornozelo foram obtidas por meio do Qualysis Track Manager®, com 10 câmeras, filmando um percurso de 5 metros. Resultados: O grupo Pós-AVC apresentou uma velocidade, aproximadamente, 50% menor que o grupo Controle (p

Nuts are high-energy density foods and are associated with beneficial effects on health, including weight control. Effects on resting energy expenditure, respiratory quotient, and diet-induced thermogenesis are suggested mechanisms behind the effects of nuts consumption on weight control. Thus, we revised the randomised clinical trials that assessed acute and chronic nuts consumption effects on energy metabolism. Walnuts (22.1 g to 56 g) consumption appears to modulate energy metabolism markers differently depending on the dose and profile of the evaluated subject. In its turn, 56 g of high-oleic peanuts increased postprandial energy expenditure and thermic effect of food after three hours postprandial compared to consumption of conventional peanuts. Almonds, hazelnuts, peanuts, and a mix of nuts were the nuts studies in the chronic studies, which does not seem to influence energy metabolism markers. Further studies are needed to elucidate the effects of other types of nuts consumption on energy metabolism.

The projection of the Brazilian population for 2020 is of the order of approximately 211,5 million inhabitants, of which about 14% correspond to the age group equivalent to or above 60 years. The increase in the elderly population reflects a greater concern in relation to the perspectives and living conditions of these people. The Environmental Education in Communities project in partnership with the University of the Best Age (UMI) developed at the Catholic University Dom Bosco (UCDB), consisted of a university extension program that proposes an informal continuing education serving elderly people, allowing them to participate in the construction of new social and ethical values, develop skills and abilities for the conservation and use of natural resources. The work reports the activities developed by the Environmental Education in Communities project in partnership with UMI in the period from 2014 to 2019, dealing with a qualitative approach in the form of experience reporting through workshops, lectures, conversation circles, tours and participation in events. It is important to develop works on environmental issues, for the valorization of the elderly and their effective participation in Environmental Education activities, providing the socialization of life experiences and knowledge production.

Introdução: A alopecia Androgenética é caracterizada pela queda capilar, sendo mais acometida pelo público masculino, apresentando uma predisposição genética, outros fatores também podem aumentar a alopecia, como o estresse, alimentação, ansiedade, fumo e o álcool. Objetivo: Analisar o uso do laser de baixa potência associado a óleos essenciais para o tratamento da alopecia androgenética masculina. Metodologia: Trata-se de um estudo de revisão Integrativa da literatura, realizado através da busca de artigos disponibilizados nas bases de dados Biblioteca Virtual em Saúde (BVS): ScientificElectronic Library Online (SCIELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Publicações Médicas (PubMed). Conclusão: Concluiu-se que o uso do laser de baixa potência associado a óleos essenciais é eficaz para o tratamento da alopecia androgenética masculina, resultando no surgimento de novos fios já após as primeiras sessões.

Introdução: A dermatite seborreica é uma afecção que atinge o couro cabeludo, uma alteração crônica não contagiosa e recorrente, em que acontece inflamação nas áreas da pele onde há maior concentração de glândulas sebáceas. A carboxiterapia faz uso do gás carbônico (CO2), que é injetado no tecido subcutâneo melhorando a circulação e oxigenação dos tecidos. Objetivo: Avaliar a eficácia da carboxiterapia no tratamento da dermatite seborreica. Metodologia: Revisão integrativa de literatura, realizada no período agosto a outubro de 2020, nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval Sistem on-line (MedLine). Conclusão: Concluiu-se, com os resultados desta pesquisa, que a carboxiterapia é eficácia no tratamento da dermatite seborreia na fase inflamatória, pois gera vasodilatação e aumento da oxigenação do tecido, resultando em aumento da circulação e aumento do crescimento do cabelo.

Introduction: Dementia is a globally relevant health problem, which places a great burden on patients and their families. This study aimed to estimate the burden associated with Alzheimer's disease (AD) and other dementias in Brazil. Methods: In this descriptive study, we investigated the estimates obtained by the Global Burden of Disease study. We described the prevalence of AD and other dementias, years lived with disability (YLDs), age-standardized mortality, years of life lost (YLLs), and disability-adjusted life years (DALYs) among individuals aged 60 years or older between 2000 and 2016, with their respective 95% uncertainty intervals (95%UI). Results: During this period, the age-standardized prevalence of AD and other dementias per 100,000 people increased by 7.8%, from 961.7 (95%UI 828.3–1,117.5) to 1,036.9 (95%UI 882.0–1,219.5), with approximately 1.5 million people living with dementia in Brazil. The incidence increased by 4.5%. Similarly, all age-standardized rates had an upward trend (mortality: 3.1%; YLLs: 5.8%; YLDs: 7.9%; and DALYs: 6.3%). Mortality profiles increased with age in both years. Dementias were ranked fourth among the leading causes of death in people aged ≥70 years in 2000, rising to second place in 2016. In 2016, it also represented the second and third leading causes of disability among older women and men, respectively. Conclusion: Population growth and aging have resulted in an increased burden of AD and other dementias in Brazil. Preventive and early diagnostic measures are essential to mitigate the burden associated with these diseases. RESUMO Introdução: A demência é um problema de saúde globalmente relevante, com grande carga para os pacientes e suas famílias. Este estudo teve como objetivo estimar a carga associada à doença de Alzheimer (DA) e outras demências no Brasil. Métodos: Neste estudo descritivo, foram avaliadas as estimativas obtidas pelo estudo de Carga Global de Doença (Global Burden Disease). Descrevemos a prevalência de DA e outras demências, anos vividos com incapacidade (AVIs), mortalidade padronizada por idade, anos de vida perdidos por morte prematura (AVPs) e anos de vida perdidos ajustados por incapacidade (AVAIs), com respectivos intervalos de incerteza de 95% (95%II), em idosos com 60+ anos, entre 2000 e 2016. Resultados: No período, a prevalência padronizada por idade de DA e de outros tipos de demência aumentou 7,8%, de 961,7 (95%II 828,3–1.117,5) para 1.036,9 (95%II 882,0–1.219,5) por 100.000 pessoas, com aproximadamente 1,5 milhão de pessoas vivendo com demência no Brasil. Houve um aumento de 4,5% na incidência. Todas as taxas padronizadas por idade apresentaram tendência de aumento (mortalidade: 3,1%; AVPs: 5,8%; AVIs: 7,9%; e AVAIs: 6,3%). Os perfis de mortalidade demonstraram aumento com o envelhecimento, em ambos os anos. As demências ocuparam o quarto lugar entre as principais causas de morte em pessoas com 70+ anos em 2000, subindo para a segunda posição em 2016. Em 2016, também representou a segunda e terceira principais causas de incapacidade entre mulheres e homens mais velhos, respectivamente. Conclusões: O crescimento e envelhecimento populacional resultaram em aumento da carga de DA e de outras demências no Brasil. Medidas preventivas e de diagnóstico precoce são essenciais para atenuar a carga associada a essas doenças.

Introduction Invasive meningococcal disease (IMD) is an important public health concern. In developed countries, most IMD is caused by meningococcal serogroup B (MenB) and two protein-based MenB vaccines are currently available: the four-component vaccine 4CMenB (Bexsero, GSK) and the bivalent vaccine MenB-FHbp (Trumenba, Pfizer). Genes encoding the 4CMenB vaccine antigens are also present in strains belonging to other meningococcal serogroups. Methods To evaluate the potential of 4CMenB vaccination to protect adolescents against non-MenB IMD, we tested the bactericidal activity of sera from immunized adolescents on 147 (127 European and 20 Brazilian) non-MenB IMD isolates, with a serum bactericidal antibody assay using human complement (hSBA). Serum pools were prepared using samples from randomly selected participants in various clinical trials, pre- and post-vaccination: 12 adolescents who received two doses of 4CMenB 2 months apart, and 10 adolescents who received a single dose of a MenACWY conjugate vaccine (as positive control). Results 4CMenB pre-immune sera killed 7.5% of the 147 non-MenB isolates at hSBA titers ≥ 1:4. In total, 91 (61.9%) tested isolates were killed by post-dose 2 pooled sera at hSBA titers ≥ 1:4, corresponding to 44/80 (55.0%) MenC, 26/35 (74.3%) MenW, and 21/32 (65.6%) MenY isolates killed. Conclusion 4CMenB vaccination in adolescents induces bactericidal killing of non-MenB isolates, suggesting that mass vaccination could impact IMD due to serogroups other than MenB.

Juvenile ossifying fibroma is an uncommon, fast-growing benign neoplasm classified within the group of fibro-osseous lesions that directly affect the face and the jaws. Although it is not followed by metastasis, it usually presents a highly aggressive nature. It is histopathologically divided into two patterns: trabecular and psammomatoid. It can be differentiated through the age of the patients, anatomic location and behavior of the lesion. In this context, this paper reports on the findings of a rare pathology case: juvenile ossifying fibroma, focusing primarily on its clinical, medical imaging and histopathological features characteristics, in order to familiarize the dentist, provide correct diagnosis and the most appropriate treatment.

Parkinson’s disease (PD) is a neurodegenerative disease, which has an upward progression. In advanced stages, motor symptoms cause functional impairment to patients due to the degeneration of the substantia nigra. In early stages of PD, there is a sensory impairment, and patients report visual processing dysfunction. There is still no cure for PD, and early diagnosis is essential to slow disease progression. Given the good anatomical representation and organization of the visual system in the cerebral cortex, in this study, we propose a biomarker of PD using EEG signals, photic stimulation, partial directed coherence (PDC) to perform feature extraction, and machine learning (ML) techniques. Our goal is to classify participants into three distinct groups: PD patients who are medicated; patients with PD and drug deprivation; and healthy subjects. We were able to achieve outstanding results, above 99% of accuracy and kappa statistic up to 0.98 using random forests and feature selection techniques. Comparison with existing methods: Our approach was evaluated using several ML methods. As features, we initially used the electrodes, without explicitly extracting feature vectors over signal samples. The good results we obtained by using random forests made possible clinical applications for the early detection of PD and, consequently, better prognosis and patient’s quality of life.

Context The sirtuins (SIRT1 to SIRT7) constitute a family of highly conserved nicotinamide adenine dinucleotide–dependent proteins. When activated, sirtuins control essential cellular processes to maintain metabolic homeostasis, while lack of expression of sirtuins has been related to chronic disease. Objective The aim of this systematic review is to analyze the role of fat consumption as a modulator of human sirtuins. Data Sources This review was conducted according to PRISMA guidelines. Studies were identified by searches of the electronic databases PubMed/MEDLINE, Scopus, and Web of Science. Study Selection Randomized clinical trials assessing the effect of fatty acid consumption on sirtuin mRNA expression, sirtuin protein expression, or sirtuin protein activity were eligible for inclusion. Data Extraction Two authors screened and determined the quality of the studies; disagreements were resolved by the third author. All authors compared the compiled data. Results Seven clinical studies with 3 different types of interventions involving healthy and nonhealthy participants were selected. Only SIRT1 and SIRT3 were evaluated. Overall, the evidence from clinical studies to date is insufficient to understand how lipid consumption modulates sirtuins in humans. The best-characterized mechanism highlights oleic acid as a natural activator of SIRT1. Conclusion These results draw attention to a new field of interest in nutrition science. The possible activation of sirtuins by dietary fat manipulation may represent an important nutritional strategy for management of chronic and metabolic disease. Systematic Review Registration PROSPERO registration number CRD42018114456.

INTRODUCTION: Sternotomy in cardiac surgery is marked by postoperative pain. Analgesic drugs are widely used to relieve this symptom, however, with several adverse effects that vary according to the drug therapeutic class used. Therefore, the use of Transcutaneous Electrical Nerve Stimulation (TENS) appears as a noninvasive and easily applicable alternative for reducing the use of drugs in patients undergoing cardiac surgery. OBJECTIVE: To systematically review the effects of TENS in the treatment of pain in patients in the postoperative cardiac surgery and its repercussion on respiratory parameters. METHODOLOGY: Systematic review using the PICO methodology and keywords (TENS, pain, patients in the postoperative,cardiac surgery). Published studies that addressed the effects of TENS on the pain of patients after cardiac surgery were included and, as a secondary variable, its impact on respiratory parameters, published in Portuguese or English, in the years 2008 to 2019. Excluded nonrandomized studies, case reports, clinical observations and reviews. In addition, the Boolean operators “and” and “or” were used. RESULTS: The search initially resulted in 265 articles, of which 253 were excluded, 12 articles remained. At the end, 5 articles were included. The search initially resulted in 2165 articles. Of these, 2160 were excluded, of which 5 were selected. The samples ranged from 20 to 120 participants. Of the five studies selected, four demonstrated a reduction in the level of pain after cardiac surgery, varying its application from the first day to the third postoperative day. This reduction in pain favored a decrease in the use of drugs such as morphine. In addition, with the reduction of pain, there was an improvement in ventilatory muscle strength and lung volumes and capacities. CONCLUSION: It is concluded that TENS is a non-drug option that can be used as an adjunct in pain reduction and, consequently , improving respiratory muscle strength, lung volume and capacity , among other parameters, in patients undergoing cardiac surgery.

Este artigo tem como finalidade discutir as mídias digitais na formação docente para a Educação de Jovens e Adultos (EJA). O objetivo geral foi analisar a interação entre o uso das tecnologias da informação e comunicação nos momentos de formação continuada dos professores, a partir dos saberes constituídos na formação inicial e no planejamento do ensino da língua materna na EJA. As bases teóricas em que a pesquisa se ancora tem: Arroyo (2005), Coscarelli (2016), Dantas (2012) e Freire (2013) como principais respaldos. A opção pela pesquisa-ação e a realização de oficinas com os onze profissionais da EJA, constituiu a análise das informações coletadas, levando-nos à afirmação de que o letramento digital, apesar do desafio formativo, se constitui como uma das interfaces pedagógica de construção de saberes para a utilização das Tecnologias da Informação e Comunicação no processo de ensino e aprendizagem da língua materna na EJA.Este artigo tem como finalidade discutir as mídias digitais na formação docente para a Educação de Jovens e Adultos (EJA). O objetivo geral foi analisar a interação entre o uso das tecnologias da informação e comunicação nos momentos de formação continuada dos professores, a partir dos saberes constituídos na formação inicial e no planejamento do ensino da língua materna na EJA. As bases teóricas em que a pesquisa se ancora tem: Arroyo (2005), Coscarelli (2016), Dantas (2012) e Freire (2013) como principais respaldos. A opção pela pesquisa-ação e a realização de oficinas com os onze profissionais da EJA, constituiu a análise das informações coletadas, levando-nos à afirmação de que o letramento digital, apesar do desafio formativo, se constitui como uma das interfaces pedagógica de construção de saberes para a utilização das Tecnologias da Informação e Comunicação no processo de ensino e aprendizagem da língua materna na EJA.Este artigo tem como finalidade discutir as mídias digitais na formação docente para a Educação de Jovens e Adultos (EJA). O objetivo geral foi analisar a interação entre o uso das tecnologias da informação e comunicação nos momentos de formação continuada dos professores, a partir dos saberes constituídos na formação inicial e no planejamento do ensino da língua materna na EJA. As bases teóricas em que a pesquisa se ancora tem: Arroyo (2005), Coscarelli (2016), Dantas (2012) e Freire (2013) como principais respaldos. A opção pela pesquisa-ação e a realização de oficinas com os onze profissionais da EJA, constituiu a análise das informações coletadas, levando-nos à afirmação de que o letramento digital, apesar do desafio formativo, se constitui como uma das interfaces pedagógica de construção de saberes para a utilização das Tecnologias da Informação e Comunicação no processo de ensino e aprendizagem da língua materna na EJA.Letramento digital. Tecnologias da Informação e Comunicação. Educação de Jovens e Adultos. Formação de professores

Portugal is one of the countries with the highest tuberculosis (TB) burden in the European Union. Patients who are receiving antitumor necrosis factor (TNF) treatment should be screened and treated for latent tuberculosis infection (LTBI). This study aimed to evaluate the prevalence of LTBI and the number of active TB cases in patients with inflammatory bowel disease (IBD) treated with anti-TNF agents.This was a retrospective study from a Portuguese center that included patients with IBD who started anti-TNF treatment between 2013 and 2017. LTBI screening was considered positive in case of positive tuberculin skin test, positive/indeterminate interferon gamma release test, or history of exposure to TB irrespective of the results of the screening.One hundred and seventeen patients were included, 56% female, mean age 40 years; 91% had Crohn's disease; infliximab was initiated in 79%, adalimumab in 21%, and golimumab in 1%. Of these, 37 (32%) presented LTBI - tuberculin skin test was positive in 18 (49%) patients; interferon gamma release test was positive in 14 (38%) patients and undetermined in seven (19%); and there was a history of exposure in 12 (32%) patients. All patients screened with LTBI were on isoniazid for 9 months. During follow-up (mean 21.6 months), one patient under infliximab developed pleural TB 5 years after receiving treatment with isoniazid. None of the patients with negative LTBI screening developed active TB.In this sample of patients with IBD, the prevalence of LTBI before starting anti-TNF treatment was significant (32%), but only one patient had active TB after LTBI treatment.

Objectives: Myelopathy is a well-established long-term clinical manifestation of HTLV-1 infection. Besides motor dysfunction, cognitive impairment may be another consequence of HTLV-1 infection. Moreover, inflammatory markers may be associated with cognitive impairment in these patients. The present study compared the cognitive performance of HAM/TSP patients with healthy controls and investigated the associations between cognitive performance, proviral load and blood inflammatory markers. Methods: Eighty-three patients fulfilling diagnostic criteria for HAM/TSP were submitted to a comprehensive clinical, cognitive and functional evaluation, brain magnetic resonance imaging and determination of levels of IL-1β, IL-6, TNF-α, immunoglobulins and HTLV-1 proviral load in blood and cerebrospinal fluid. The control group was composed of 88 cognitively healthy subjects, matched for age, sex and educational level. Results: Compared to healthy subjects, HAM/TSP patients displayed significant global cognitive impairment and executive function deficits. HAM/TSP cognitive impairment was significantly associated with altered levels of IgM, IgG, IL-6 and TNF-α in blood. There was no association between HAM/TSP cognitive impairment and HTLV-1 proviral load. Conclusions: This study suggests cognitive impairment may be a long-term clinical manifestation of HTLV-1 infection, which seems to be linked to the persistent inflammatory activity that is found in the disease. Keywords: HTLV-1, Cognitive assessment, Tropical spastic paraparesis, Inflammation

Impacted and semi-impacted third molar surgery is a frequent dental procedure. Due to potentially major tissue manipulation during surgery, antibiotic prophylaxis may be indicated to prevent infection of the surgical wound. This study evaluated the surgical conditions of patients following extraction of impacted and semi-impacted third molars with or without prior antibiotic prophylaxis. Signs of infection and inflammation, postoperative pain level and efficacy of the prescribed drugs were recorded. This was a prospective, randomized, double blind clinical trial with split-mouth design. A total of 23 healthy (ASA I) volunteers with indication for bilateral mandibular third molar extraction were recruited, totaling 46 surgical procedures. One hour prior to the procedure, volunteers received 1g of amoxicillin or placebo and a drug for pain prevention and control. The surgical acts were performed by last-year dental students. Postoperative pain was assessed using a visual analogue scale and an 11-point box scale at selected postoperative intervals of 4 h, 12 h, and 24 h. After seven postoperative days, study volunteers were examined for clinical signs of infection and/or inflammation, such as pus, intra and extraoral swelling, trismus, heat, flushing and temperature change. There were only two cases of postoperative complications, one of intraoral edema (placebo group) and one of trismus (antibiotic prophylaxis group). There were no statistically significant differences for any of the indicative signs of infection. The pain scales revealed no differences between pain levels in both groups at all times evaluated, regardless of the pain scale used (P > 0.05). To conclude, the low infection rate observed in our study does not reflect any need for antibiotic prescription in systemically healthy patients. The adverse effects of antibiotics in addition to selection for resistant bacteria outweigh the benefits of antibiotic prophylaxis in healthy (ASA I) patients. La cirugía de terceros molares impactados y semi impactados es un procedimiento de rutina en odontología. Debido a su alto grado de manipulación tisular, se recomienda la profilaxis antibiótica para prevenir la infección de la herida quirúrgica. Sin embargo, su uso rutinario puede apoyar la prescripción indiscriminada de antibióticos y, en consecuencia, la selección de microorganismos resistentes. El objetivo del presente estudio fue evaluar las condiciones quirúrgicas de los pacientes después de la extracción de terceros molares impactados y semiimplantados realizados con y sin profilaxis antibiótica. En el postoperatorio se observó la presencia de signos de infección e inflamación, nivel de dolor postoperatorio y eficacia de los fármacos utilizados. Para ello, se incluyeron en el estudio 23 voluntarios sanos (ASA I), con indicación de extracción de terceros molares inferiores bilaterales, totalizando 46 cirugías. El estudio consistió en un ensayo clínico prospectivo, aleatorizado y doble ciego con un diseño de boca dividida. Una hora antes del procedimiento, el voluntario recibió la medicación (1g de amoxicilina o placebo), además de una prescripción para la prevención y control del dolor. Los procedimientos quirúrgicos fueron realizados por estudiantes que estaban en el último año del curso de odontología. El dolor postoperatorio se evaluó mediante una escala analógica visual y una escala de cuadro de 11 puntos, en los intervalos de tiempo de 4, 12 y 24 horas postoperatorias. Siete días después del procedimiento, el voluntario fue reevaluado para detectar signos clínicos de infección / inflamación, como presencia de pus, aumento de volumen intra y extraoral, trismo, calor, enrojecimiento y cambio de temperatura. Solo hubo dos casos de complicaciones postoperatorias, uno de edema intraoral después del uso de placebo y otro de trismo después del uso de antibióticos. No se encontraron diferencias estadísticamente significativas para ninguno de los signos indicativos de infección evaluados. Asimismo, los resultados obtenidos de las escalas de dolor aplicadas revelaron similitud entre los niveles de dolor para los dos tratamientos, en todos los momentos evaluados, independientemente de la escala de dolor utilizada (p> 0,05). A la vista de los resultados, se concluye que la baja tasa de infección que se presenta no concuerda con la necesidad de prescripción de antibióticos en pacientes sin deterioro sistémico de rutina. La tasa de efectos adversos de los antibióticos, sumada a la selección de bacterias resistentes, supera los beneficios de la profilaxis con antibióticos para pacientes sanos (ASA I). A cirurgia de terceiros molares inclusos e semi-inclusos é um procedimento rotineiro em odontologia. Devido ao seu elevado grau de manipulação tecidual, preconiza-se a profilaxia antibiótica com o intuito de evitar infecção na ferida cirúrgica. Entretanto, seu uso rotineiro pode sustentar a prescrição indiscriminada de antibióticos e, consequentemente, seleção de microrganismos resistentes. O objetivo do presente trabalho foi avaliar as condições cirúrgicas dos pacientes após extração de terceiros molares inclusos e semi-inclusos realizados com e sem profilaxia antibiótica. Foi observada, no pós-operatório, a presença de sinais de infecção e inflamação, nível de dor pós-operatória e eficácia dos fármacos utilizados. Para tal, foram incluídos no estudo 23 voluntários saudáveis (ASA I), com indicação de extração de terceiros molares inferiores bilaterais, totalizando 46 cirurgias. O estudo consistiu em um ensaio clínico prospectivo, randomizado e duplo cego, com delineamento do tipo split-mouth. Uma hora antes do procedimento o voluntário recebeu a medicação (1g de amoxicilina ou placebo), além de uma prescrição para prevenção e controle de dor. Os atos cirúrgicos foram realizados por alunos que estavam cursando o último ano do curso de odontologia. A dor pós-operatória foi avaliada por meio de uma escala analógica visual e uma escala de 11 pontos em caixa, nos intervalos de tempo de 4, 12 e 24 horas pós-operatórias. Sete dias após o procedimento, o voluntário foi reavaliado quanto aos sinais clínicos de infecção/inflamação, como presença de pus, aumento de volume intra e extraoral, trismo, calor, rubor e alteração de temperatura. Houve apenas dois casos de complicações pós-operatórios, sendo um de edema intraoral após uso de placebo e um de trismo após uso de antibiótico. Não foram encontradas diferenças estatisticamente significantes para nenhum dos sinais indicativos de infecção avaliados. Da mesma forma, os resultados obtidos a partir das escalas de dor aplicadas revelaram semelhança entre os níveis de dor para os dois tratamentos, em todos os tempos avaliados, independente da escala de dor utilizada (p>0,05). Diante dos resultados, conclui-se que o baixo índice de infeção apresentado não condiz com a necessidade de prescrição antibiótica para pacientes sem comprometimento sistêmico de forma rotineira. A taxa de efeitos adversos do antibiótico somado à seleção de bactérias resistentes, supera os benefícios da profilaxia antibiótica para pacientes saudáveis (ASA I).

The consumption of ultra-processed foods (UPF) has been associated with cardiometabolic risk factors. However, there is scarce literature on the association between UPF consumption, cardiovascular events, and cardiometabolic risk factors in subjects undergoing secondary care for cardiovascular diseases (CVD). Thus, we aimed to evaluate the association between UPF consumption, CVD, and cardiometabolic risk factors in subjects with established CVD. Baseline data from 2,357 subjects participating in a Brazilian multicenter study were analysed finding a mean UPF consumption of 18.7% of their energy intake. Higher figures of UPF consumption were founded associated with an increased presence of high waist circumference, overweight, peripheral arterial disease, and with a decreased odds of the simultaneous presence of coronary arterial disease, peripheral arterial diseases, and stroke when comparing among tertiles of UPF contribution to energy intake. These associations were observed when analyzing the whole sample and women but not men. Thus, these findings should help improve strategies for CVD patients in secondary care.

Infective Endocarditis (IE) is an infection of the endocardial surface of the heart that is caused by fungi, bacteria or viruses. The high mortality and morbidity rates of IE have encouraged the adoption of preventive strategies. This study investigated the knowledge on the prevention of IE among 2nd, 3rd and 4th-year undergraduate dental students at the Escola Superior São Francisco de Assis (ESFA) and among dentists working in the municipality of Santa Teresa, ES, Brazil. Objective: The rationale for this study was to identify the gaps in their knowledge and raise awareness on the topic. Methods: The study was previously approved by the Research Ethics Committee. The sample consisted of dental students who had completed the Pharmacology for Dentistry course at the ESFA, totaling 35 2nd-year students, 29 3rd-year students, and 36 4th-year students. Thirty dentists registered in the Regional Council of Dentistry of Espírito Santo state, who were working in the municipality of Santa Teresa, ES, Brazil, were also included. All participants were given a questionnaire containing six objective and four subjective questions to assess their knowledge regarding the definition of IE, high-risk patients, dental procedures known to cause bacteremia, recommended dosage regimens for high risk patients, and additional care in the assistance of these patients. The questionnaires’ responses were reviewed following the American Heart Association (AHA) guidelines for disease prevention published in 2007. Results: The analysis of the results revealed a low rate of correct responses among students and dentists. The questions with the lowest rate of correct responses were those addressing the identification of patients at high risk for heart conditions and the dental procedures known to cause bacteremia, with no significant differences between the four groups analyzed (P > 0.05). Third-year dental students presented a frequency of correct responses significantly lower than that of the other groups (P < 0.001), which did not differ from each other. To conclude, all participants demonstrated poor knowledge about the topic, particularly 3rd-year dental students. Conclusion: These results reinforce the need for informative measures to raise awareness and improve the quality of dental care provided to the population. RESUMO A Endocardite Infecciosa (EI) é definida como um processo infeccioso que envolve a superfície do endocárdio e que pode ser causada por fungos, bactérias ou vírus. Devido aos altos índices de mortalidade e morbidade associados a esta doença, as ações voltadas para a sua prevenção são de grande importância. Objetivo: O objetivo do presente trabalho foi avaliar o conhecimento de acadêmicos de odontologia matriculados no segundo, terceiro e quarto anos do curso na Escola Superior São Francisco de Assis (ESFA) e de profissionais de odontologia atuantes no município de Santa Teresa-ES em relação à prevenção de Endocardite Infecciosa, com o intuito de identificar os pontos falhos e promover uma maior divulgação acerca do assunto. Métodos: Após aprovação pelo Comitê de Ética em Pesquisa, foram incluídos alunos do curso de odontologia da ESFA que já haviam cursado a disciplina de farmacologia aplicada à odontologia, totalizando 35 alunos do segundo ano, 29 do terceiro ano e 36 do quarto ano. Também foram incluídos 30 cirurgiões-dentistas devidamente inscritos no CRO-ES e que atuam no município de Santa Teresa-ES. Todos os grupos responderam a um questionário formado por seis perguntas objetivas e quatro discursivas que avaliaram o nível de conhecimento quanto ao conceito da EI, grupos de pacientes considerados de alto risco para a doença, procedimentos odontológicos causadores de bacteremia, regimes posológicos recomendados para pacientes de risco e cuidados adicionais no atendimento destes pacientes. Os questionários foram corrigidos de acordo com as diretrizes publicadas em 2007 pela American Heart Association (AHA) para prevenção da doença. Resultados: Em virtude da análise dos resultados, pôde-se observar um baixo índice de acertos tanto por parte dos alunos quanto dos profissionais. As perguntas com os menores índices de acerto estavam relacionadas à identificação dos pacientes com condições cardíacas de alto risco e dos procedimentos odontológicos causadores de bacteremia, não havendo diferenças significativas entre os quatro grupos analisados (p>0,05). Ao comparar a quantidade total de acertos, alunos cursando o terceiro ano do curso de odontologia apresentaram um número significativamente menor em comparação com os demais grupos (p

Objective:To evaluate the association of dietary inflammatory index (DII®) with the occurrence of cardiovascular events, cardiometabolic risk factors and with the consumption of processed, ultra-processed, unprocessed or minimally processed foods and culinary ingredients.Design:This was a cross-sectional study that analysed the baseline data from 2359 cardiac patients. Data on socio-demographic, anthropometric, clinical and food consumption were collected. Energy-adjusted food intake data were used to calculate DII, and the foods were classified according to the NOVA classification. Furthermore, the patients were grouped according to the number (1, 2 or ≥ 3) of manifested cardiovascular events. The data were analysed using linear and multinomial logistic regression.Settings:Multicentre study from Brazil.Participants:Patients with established cardiovascular events from the Brazilian Cardioprotective Nutritional Program Trial evaluated at baseline.Results:Most of the patients were male (58·8 %), older adults (64·2 %) and were overweight (68·8 %). Patients in the third tertile of DII (DII > 0·91) had were more likely to have 2 (OR 1·27, 95 % CI: 1·01–1·61) and ≥ 3 (OR 1·39, 95 % CI: 1·07–1·79) cardiovascular events, with poor cardiometabolic profile. They also were more likely to consume a higher percentage of processed, ultra-processed and culinary ingredients foods consumption compared with the patients in the first DII tertile (DII ≤ 0·91).Conclusion:A more pro-inflammatory diet is associated with a greater chance of having 2 and ≥ 3 cardiovascular events and cardiometabolic risk factors and were more likely to consume processed, ultra-processed and culinary ingredients compared to those with a more anti-inflammatory diet.

Background Invasive meningococcal disease (IMD) is an acute, highly transmissible and potentially fatal disease caused by Neisseria meningitidis. Prompt antimicrobial therapy and prophylaxis are recommended, where penicillin or ciprofloxacin are the available choices. However, the emergence of resistant isolates of N. meningitidis poses a challenge for antimicrobial therapy. Objectives To describe the clinical, epidemiological and biological characteristics of six penicillin- and ciprofloxacin-resistant, culture-confirmed IMD cases reported in El Salvador, Central America, between 2017 and 2019. Methods Following the detection of six patients presenting with IMD in El Salvador, clinical data were collected and epidemiological action plans conducted. Isolates were subjected to antimicrobial susceptibility testing by broth microdilution and WGS for genotyping and molecular characterization analysis, including phylogeny comparison with global sequences available from public databases. Results A total of six IMD cases caused by N. meningitidis serogroup Y, resistant to both penicillin (MIC >8.0 mg/L) and ciprofloxacin (MIC 0.125 mg/L), were detected from 2017 to 2019. Genomic analysis showed that penicillin resistance was mediated by the production of β-lactamase ROB-1. Ciprofloxacin resistance was attributed to an amino acid substitution in DNA gyrase (T91I). All isolates were classified as ST3587, clonal complex 23, and were genetically highly similar, based on core-genome SNP analysis. Conclusions To the best of our knowledge, we report the first cases of MDR N. meningitidis causing IMD in Latin America. Our findings highlight the emergence of this potential public health threat, with a profound impact on the efficacy of IMD treatment and prophylaxis protocols.

Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.

As the most abundant neuropeptides in Central Nervous System, Substance P and Neuropeptide Y are arguably involved in the response to brain trauma. This study aims to characterize a new concept of multi-staged neuropeptide response to TBI. This study assessed Substance P, Neuropeptide Y, S100B, standard inflammatory parameters and ionic disturbance in TBI victims, with and without intracranial lesions, and healthy controls. In the group with intracranial lesions, blood samples were drawn until 6 h after initial trauma, at 48 h and 7 days post-TBI. An early increase in Substance P (mean 613.463 ± 49.055 SE 6 h post-TBI with brain contusions vs. 441.441 ± 22.572 SE pg/dL control group) is evident. Concerning TBI without intraparenchymatous lesions, an increase in substance P is also present (825.60 ± 23.690 SE pg/dL). Following an initial increase and subsequent fall in NPY levels (45.997 ± 4.96 SE 6 h post-TBI vs. 32.395 ± 4.056 SE 48 h post-TBI vs. 19.700 ± 1.462 SE pg/mL control group), a late increase in NPY is obvious (43.268 ± 6.260 SE pg/mL 7 day post-TBI). Post-traumatic hypomagnesemia (0.754 ± 0.015 SE 6 h post-TBI vs. 0.897 ± 0.021 SE mmol/L control group) and a peak in S100B (95.668 ± 14.102 SE 6 h post-TBI vs. 30.187 ± 3.347 SE pg/mL control group) are also present. A multi-staged neuropeptide response to TBI is obvious and represents a potential therapeutic strategy for the treatment of intraparenchymal lesions and cerebral edema following TBI.

Evidence from epidemiological and clinical studies suggests that nut consumption provides satiety and may contribute to the management of obesity. However, the effect of acute intake of nuts on appetite responses remains unclear. The objective of this study was to evaluate the acute effect of a shake containing 30 g of cashew nuts (Anacardium occidentale L.) and 15 g of Brazil nuts (Bertholletia excelsa H.B.K) on appetite responses in overweight subjects. This was a clinical, randomized, controlled, single-blind, cross-over, pilot study. On two non-consecutive test days, 15 subjects received a shake containing nuts, and a shake absent of nuts matched for energy and macronutrient content. Subjective appetite sensation was evaluated by visual analogue scales (VAS). Food intake was measured by weighing the lunch served at the end of each morning-test, which subjects ate ad libitum. Total energy intake was estimated by food records. This study is registered on the Brazilian Registers of Clinical Trials—ReBEC (protocol: U1111-1203-9891). We observed no significant difference in subjective appetite sensations between the groups. Food intake at lunch, as well as energy intake throughout the day also did not differ between the treatments. Our results suggest that the acute intake of a shake containing nuts was not able to enhance satiety, compared to a shake matched for energy and macronutrient content. Further studies are warranted to elucidate the satiety mechanisms of nuts intake.

Background: Motor functional neurological disorder (mFND) is a common and disabling condition. There are no evidence-based guidelines for treatment. Long-term outcome is often poor. This study describes the epidemiological profile, symptom pattern and outcome of patients admitted to the Belo Horizonte unit of the SARAH Network of Rehabilitation Hospitals from 1997 to 2018 with functional motor symptoms resulting from functional neurological disorder. Methods: This retrospective study reviewed data from 185 patients who met inclusion criteria for mFND. Diagnoses were made by multiple professionals in the presence of positive signs and excluding other neurological and systemic conditions. Results: 75.1% were women; 48.3% were receiving social security benefits. The youngest was 3 years old, the oldest 69. 23.8% were in wheelchairs, 77.2% had psychiatric disorders, 69.7% participated in rehabilitation programs and, among them, 70% improved. Conclusion: Participation in rehabilitation is beneficial for patients with mFND. Symptoms lasting for less than 30 days and aged less than 18 years had better outcomes (p

Yacon (Smallanthus sonchifolius (Poepp.) H. Rob) is a natural source of fructooligosaccharides (FOS) studied for its potential as a functional food for prevention and management of chronic diseases, in part associated with its positive impact on glycemic response and body weight. However, yacon beneficial effect on glucose response and food intake control are still controversial. We investigated the acute effect of yacon consumption on glycemic response, subjective appetitive sensations, and food intake in a crossover trial. Fifteen healthy adults consumed 350 mL of yacon (21 g of yacon flour with 7.4 g of FOS) or control shake, on two non-consecutive days (washout). Yacon shake did not affect glycemic response, appetite or food intake. However, it is possible that positive effects of yacon consumption may turn evident only after its chronic consumption. Further studies are needed to assess the long-term effect of yacon consumption on glucose response and body weight control.

Made available in DSpace on 2022-04-29T08:36:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Objective: Patterns of cytokine levels and their association with stroke severity, infarct size, and muscle strength are obscure. We aimed to analyze the immune mediators linked to T helper (Th)1, Th2, Th17, and regulatory T cell patterns and their association with stroke severity, infarct size, and muscle strength. Materials and methods: We included patients with acute stroke (n = 15) and healthy non-disabled individuals (n = 20) aged > 18 years. The dependent variables were stroke severity according to the National Institute of Health Stroke Scale (NIHSS), infarct size on computed tomography, handgrip strength by dynamometry, and global muscle strength according to the Medical Research Council (MRC) scale. The independent variables were the circulating cytokine levels. The cytokine levels were compared between the groups, and correlations between the clinical data were verified. Results: The stroke group had higher interleukin (IL)-6 (p < 0.0001) and IL-10 (p < 0.0001) levels, but lower tumor necrosis factor (TNF)-α (p = 0.036) levels than the control group. IL-10 and soluble tumor necrosis factor receptor (sTNF-RII) levels were correlated with each other (r = 0.533; p = 0.042) and infarct size (r = 0.653; p = 0.033 and r = 0.689; p = 0.018, respectively). MRC scores were positively and negatively correlated with handgrip strength of the affected side (r = 0.78; p = 0.001) and NIHSS scores (r = -0.87; p < 0.0001), respectively. Conclusions: Plasma levels of some cytokines were associated with changes in the acute phase of stroke, and IL-10 and sTNF-RII levels are potential biomarkers of infarct size. Department of Applied Physical Therapy Federal University of Triângulo Mineiro Department of Microbiology Immunology and Parasitology Federal University of Triângulo Mineiro Department of Neurology Psychology and Psychiatry Botucatu Medical School Clinics Hospital of the Federal University of Triângulo Mineiro Department of Neurology Psychology and Psychiatry Botucatu Medical School

The metabolic effects of cranberry and blueberry consumption on glycemic control have been evaluated in vitro and in animal models as well as in human studies, although findings have not been syste...

Background/Aims: Peritoneal protein loss (PPL) is associated with cardiovascular disease and mortality in peritoneal dialysis (PD). Controversial results have been published about the effect of paricalcitol in PPL among PD patients. This study intends to analyze the relationship between paricalcitol and PPL in PD. Methods: In a retrospective study, prevalent PD patients were divided into 2 groups: “with paricalcitol” and “without paricalcitol”. X2-test, Student’s t test, Pearson correlation coefficient and Logistic Regression analysis were applied. Results: Eighty-two patients were included. PPL was lower among patients medicated with paricalcitol (5.17 ± 1.71 vs. 6.79 ± 2.10 g/24 h, p = 0.0001). In multivariate analysis, paricalcitol and dialysate/plasma ratio of creatinine (D/P creatinine) were independently related to PPL (OR 4.270 [1.437–12.684], p = 0.009 and OR 0.205 [0.064–0.659], p = 0.008, respectively), adjusted for diabetes. Conclusion: Paricalcitol and D/P creatinine were independently related to PPL. Paricalcitol may have an effect on PPL in PD patients

Objectives Dietary total antioxidant capacity (dTAC) has been introduced as a useful tool to quantify the antioxidant content of a diet. However, few studies have evaluated the association of dTAC with cardiovascular disease (CVD) occurrence and cardiometabolic risk factors in people with established CVD events. Thus, we aimed to investigate the presence of an association between dTAC values, cardiovascular events, and cardiometabolic risk factors in individuals with previous CVD in a Brazilian multicenter study. Methods This study has a cross-sectional design. We evaluated baseline data from the Brazilian Cardioprotective Nutritional Program Trial. Sociodemographic, anthropometric, clinical, and food-consumption data were collected in face-to-face interviews. We estimated dTAC from the mean of two 24-h dietary recalls by values of ferric-reducing antioxidant power. Results We evaluated 2346 participants, most of whom were men (58.4%), older adults (64.2%), and overweight (68.6%), and had coronary artery disease (92.4%). The mean dTAC was equal to 5.6 (interquartile range, 3.9-7.8) mmol/1000 kcal. Participants in the third dTAC tertile (9.2 mmol/1000 kcal) had a 22%, 59%, and 69% lower chance, respectively, of having hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in comparison to the first tertile (3.4 mmol/1000 kcal). Conclusions The dTAC was inversely associated with hypertriglyceridemic waist phenotype, abdominal aortic aneurysm, and amputation due to arterial disease in individuals undergoing secondary care for CVD. Our results can guide strategies for the prevention of new CVD and its consequences.

This study responds to calls for further research on how the institutional context of code law rooted countries impeded or supported the adoption of International Financial Reporting Standards (IFRS). We contribute to the debate on whether the pre-IFRS Anglo-Saxon versus Continental European model persists under IFRS. The experiences of Brazil and Portugal with respect to IFRS are underexamined and allow a comparison of an advanced economy and an emerging market, thereby offering further research on this topic. This study also helps overcome the lack of research on IFRS implementation by unlisted firms. Findings reveal that as many as seven or eight years after formally adopting IFRS, full de facto international accounting convergence in Portugal and Brazil is not yet achieved. Evidence from both countries show a coercive isomorphism being exerted mainly by informal market forces rather than by formal supervisory mechanisms. This observation together with enduring professional resistance and a low level of professional development, most noticeably in Brazil, is consistent with the possibility of decoupling or loose coupling. The cultural traits that influenced the continental model adopted prior to IFRS are perpetuated in both countries, thereby suggesting that culture poses a major obstacle to the complete adoption of IFRS. BA16-BE06-B89C | Ana Paula Martins da Silva N/A

Clinical and endoscopic remissions constitute the therapeutic goals in ulcerative colitis (UC). Histological healing is currently not a target in UC. This study aims to determine the impact of the definition of endoscopic remission (Mayo endoscopic subscore [MSe] 0-1) and histological activity in the recurrence of UC and recurrence-free survival time.Patients with UC in clinical remission (partial Mayo score ≤ 1) and endoscopic remission (MSe ≤ 1) who underwent colonoscopy with biopsies between March 2010 and December 2013 were included. The validated Nancy score was used to evaluate histological activity, which considers inactivity if 0 to 1 and activity if 2 to 4. The recurrence-free time was evaluated and recurrence was defined as partial Mayo score ≥ 2, therapy to induce remission, hospitalization, or colectomy. Predictive factors associated with recurrence and time to recurrence were determined.Sixty patients were included; 58.3% (n = 35) were women, with a mean age of 52.7 years. MSe = 1 was observed in 46.7% (n = 28) and histological activity in 38.3% (n = 23). Clinical recurrence occurred in 31.7% (n = 19) of patients, with a cumulative risk of 17.1%/24.5%/26.7%/40.1% at 12/24/36/48 months, respectively. MSe = 1 (P = 0.02) and histological activity (P = 0.007) were significantly associated with recurrence. Of these, only histological activity (P = 0.03) was an independent predictive factor of recurrence. Patients with MSe = 1 (P = 0.02) and with histological activity (P = 0.01) had a significantly shorter recurrence-free time in univariate analysis. In multivariate analysis, only histological activity (P = 0.02) was an independent predictive factor of lower recurrence-free time.The presence of histological activity represents an independent predictive factor of recurrence and time to recurrence, which was not verified with MSe 0 to 1.

The aim of the present study was to investigate the relationship between serum phosphate levels, clinical parameters, body composition, and mortality.Multicenter longitudinal observational study of a cohort of 3552 patients in hemodialysis (HD) from 34 Nephrocare dialysis units in Portugal with 24 months of follow-up. Patients were divided into three groups depending on their serum phosphorus (3.5; 3.5-5.5;5.5 mg/dL). Statistical tests were performed with SPSS, version 20.0. A p 0.05 was considered significant.On the one hand, hypophosphatemia was significantly associated with better dialysis adequacy, higher age and overhydration. On the other hand, it was associated with lower albumin, protein intake, creatinine, hemoglobin, calcium, potassium, magnesium, body mass index (BMI), body cell mass index, fat tissue index and lean tissue index. These patients had lower survival rates compared with those with normo- and hyperphosphatemia. Hypophosphatemia was a predictor of death when adjusted for age, diabetes, HD vintage, gender, and Kt/V. Comparing the mortality predictors in hypo- and hyperphosphatemia, we found that low albumin, BMI, and high overhydration increased the mortality risk in the hypophosphatemic group, whereas in hyperphosphatemic patients data were not statistically significant.Currently, a high prevalence of hypophosphatemia exists in Portuguese HD patients. This condition is associated with worst nutritional and body composition parameters. In the context of additional indices of malnutrition (low albumin, low BMI or severe overhydration), hypophosphatemic patients presented higher mortality risk.

Objective Our objective was to perform a systematic review and meta-analysis of cohort studies evaluating the triglyceride-glucose (TyG) index as a tool for type 2 diabetes (T2D) prediction in adults and older adults. Methods Studies were identified in PubMed, Cochrane, Scopus, and Lilacs. Studies with cohort design, which evaluated the T2D incidence through the hazard ratio (HR) or relative risk (RR) or odds ratio values were included. Were included both studies that evaluated the incidence of T2D from tertiles, quartiles, quintiles, or single TyG index values. First, a meta-analysis only for studies that reported data in HR values was performed. Additionally, given the different association measurements used, the number of T2D cases, non-T2D cases, and the total number of participants were extracted from exposed and non-exposed groups when available. Then the risk ratio was calculated. A meta-analysis using the inverse variance method and the random-effects model was performed. Heterogeneity was assessed by I2 statistics and by inspecting funnel plots. Results Thirteen cohort studies with a total of 70,380 subjects, both sexes, adults, and older adults were included in the meta-analysis. Ten studies showed a significant association of the TyG index with T2D risk through HR estimative (overall HR: 2.44, 95% CI: 2.17–2.76). After estimating RR for nine studies, we also observed a significant association of the TyG index with T2D risk (RR: 3.12, 95 CI: 2.31–4.21). For all analyses, high heterogeneity was verified by I2 and visual inspection of funnel plots. Conclusions TyG index has a positive and significant association with T2D risk, suggesting that the TyG index may become an applicable tool to identify subjects with T2D risk. However, due to the high heterogeneity observed in overall HR and RR analysis, more studies could be necessary to confirm these results.

Purpose: Drawing on the experience of adoption of a model based on the International Financial Reporting Standards (IFRS) by Portuguese non-financial unlisted companies in 2010, called Sistema de Normalização Contabilística (SNC), this paper explores auditors’ perceptions regarding dimensions of relevance and suitability of the new accounting model to the Portuguese setting, major problems encountered, and the main engendered benefits. Methodology: An interpretative approach based on qualitative research methods was adopted, in which sixteen interviews with statutory auditors were conducted from a vantage point in 2017, seven years after the formal implementation of the IFRS-based model. Findings: Evidence suggests enduring problems but mostly a significant level of legitimation and institutionalization of the IFRS-based model: (i) the perceived motivations for SNC adoption are a good fit with the theoretically acknowledged motivations underlying accounting convergence; (ii) the principle-based standards and the fair value were largely perceived favorably; and (iii) the IFRS-based model brought about a number of benefits as expected ex ante. Implications: Findings shed light on the potential of the IFRS model to conform to countries whose accounting systems are remarkably disparate – as it was in Portugal – and offer an agenda for regulators and local and international policymakers. Originality and value: This study contributes to the accounting literature on IFRS adoption by providing empirical evidence from a European country that posited an a priori adverse context.

The consumption of food with MUFA has been associated with improvement of inflammation and oxidative stress in overweight individuals. In the present study, we evaluate the effect of high-oleic peanut intake within a hypoenergetic diet on inflammatory and oxidative status markers in overweight men. Sixty-four overweight men (BMI 26–35 kg/m2, 18–50 years old) participated in this randomised controlled study for 4 weeks, allocated into three groups: control (CT,n22), conventional peanut (CVP,n21) and high-oleic peanut (HOP,n21). They followed a hypoenergetic diet (−250 kcal/d; −1045 kJ/d) with or without 56 g of high-oleic or conventional peanuts. After the intervention, the inflammatory markers did not show significant changes in fasting concentrations or postprandial response among the experimental groups (P> 0·05). The activity of oxidative status markers remained unchanged after the intervention. However, in the CT, malondialdehyde showed lower concentration in comparison with the baseline (P= 0·020) and among the groups (P= 0·002). In the present study, the daily intake of high-oleic peanuts within a hypoenergetic diet did not modify the inflammatory markers and oxidative status in overweight men. More studies are needed to better understand the effect of high-oleic peanut intake on health outcomes.

Aim: to compare self-satisfaction and discomfort in the application of two types of chemical facial peeling. Methods: Randomized and controlled clinical trial consisting of 30 women with moderate facial hyperpigmentation randomly divided into 03 groups M- mandelic acid 30%, Group R - retinoic acid at 05%, L- mechanical face exfoliation. The evaluations were performed in the 1st and 6th weeks by blind investigator in relation to photography and evaluation of skin texture. They were evaluated through self-report: self-satisfaction by the GAIS scale, and the discomfort index. Results: There was a significant difference in the M and R groups compared to the L group in relation to the GAIS scale (Kruskal-Wallis test, p

Background The triglyceride-glucose index (TyG index) is a tool for insulin resistance evaluation, however, little is known about its association with coronary artery disease (CAD), which is the major cardiovascular death cause, and what factors may be associated with TyG index. Objective To evaluate the association between the TyG index and the prevalence of CAD phases, as well as cardiovascular risk factors. Methods The baseline data of patients in secondary care in cardiology from Brazilian Cardioprotective Nutritional Program Trial (BALANCE Program Trial) were analyzed. Anthropometric, clinical, socio-demographic and food consumption data were collected by trained professionals. The TyG index was calculated by the formula: Ln (fasting triglycerides (mg/dl) × fasting blood glucose (mg/dl)/2) and regression models were used to evaluate the associations. Results We evaluated 2330 patients, which the majority was male (58.1%) and elderly (62.1%). The prevalence of symptomatic CAD was 1.16 times higher in patients classified in the last tertile of the TyG index (9.9 ± 0.5) compared to those in the first tertile (8.3 ± 0.3). Cardiometabolic risk factors were associated with TyG index, with the highlight for higher carbohydrate and lower lipid consumption in relation to recommendations that reduced the chance of being in the last TyG index tertile. Conclusion The TyG index was positively associated with a higher prevalence of symptomatic CAD, with metabolic and behavioral risk factors, and could be used as a marker for atherosclerosis. Trial registration ClinicalTrials.gov identifier: NCT01620398. Registered 15 June, 2012

OBJECTIVES: Postprandial glycemic control is essential in both healthy and diabetic people, as hyperglycemia predisposes to complications associated with diabetes. The consumption of fiber-rich meals help to prevent and control undesirable glycemic changes. This study aimed to evaluate the effect of one-day consumption of chia on glycemic response and energy intake in healthy adults. METHODS: Single-blind, randomized, crossover design study involving healthy adults, normal weight (BMI 18.5–24.9 kg/m(2)), euglycemic (100 mg/dL), with no diabetes family history. They attended to the laboratory after 10–12 h fasting and received either 350 ml of a shake containing 10 g of chia flour (4.44 g of fiber) or 350 ml of a control shake (1.1 g of fiber)- similar in calories and macronutrients, containing 51 g of available carbohydrate - on two non-consecutive days (washout period). At each testing day, 60 minutes after shake intake a glucose solution (25 g) was provided. Capillary blood glucose was measured in fasting state (−60 min), immediately before (0 min), and 15, 30, 45, 60, 90, 120 minutes after glucose load. In addition, food intake was assessed 24-hour dietary recall was performed after each testing day. Habitual dietary intake was estimated using the semi-quantitative QFCA. The study was approved by the Local Ethics Committee. Repeated-measures ANOVA test was used to compare habitual dietary intake and consumption after shake. Two-way repeated measures ANOVA test followed by Bonferroni's post-hoc was used to assess the differences in postprandial blood glucose. Incremental area under the curve (AUC) of postprandial glycemia was calculated using the trapezoidal rule and paired sample t-test was used to compare them. All analyses were conducted using SPSS software. Statistical significance was set as p 0.05) nor food intake (p > 0.05) among adults (25 ± 1 years), euglycemic (87.88 ± 1.21 mg/dL), normal weight (21.06 ± 0.28 kg/m(2) and 23.23 ± 1.19% body fat percentual). CONCLUSIONS: The one-day consumption of chia flour did not affect the glycemic response and did not interfere in energy intake in healthy individuals. The long-term effect of chia should be assessed. FUNDING SOURCES: CNPq, CAPES, FAPEMIG, FUNARBE, DNS-UFV. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

The aim of the study was to investigate the effects of two pelvic floor exercise programs on lower urinary tract symptoms and quality of life in participants with multiple sclerosis.This is a prospective, single-blind, clinical trial.The study used a community rehabilitation program within a large metropolitan health service.Thirty women in moderate stage of multiple sclerosis were referred for outpatient rehabilitation.In a period of 6 mos, participants underwent a pelvic floor exercise program, associated or not with vaginal electrotherapy.The main outcomes are overactive bladder, perineal contraction, and quality of life.The findings showed benefits of both programs on overactive bladder and quality of life. Participants undergoing exercise plus electrotherapy presented greater improvement on contraction of the perineal musculature and quality of life.Six months of exercise provided benefits on lower urinary tract symptoms and quality of life in women with multiple sclerosis. Electrical stimulation potentiated the improvement on perineal musculature and quality of life. This trial was registered prospectively with the Clinical Trials Register, ID: BR-287q65 (http://www.ensaiosclinicos.gov.br/rg/RBR-287q65/).

Background: Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality. Methods: This was a prospective analysis conducted in an outpatient diabetic nephropathy clinic, enrolling 107 diabetic patients with stage 2&ndash, 3 CKD. Patients were divided into three groups according to their left ventricular mass index and relative wall thickness. Results: Multinomial regression analysis demonstrated that low Klotho and higher FGF-23 levels were linked to a greater risk of concentric hypertrophy. In the generalized linear model (GLM), Klotho, FGF-23 and cardiac geometry groups were statistically significant as independent variables of cardiovascular hospitalization (p = 0.007). According to the Cox regression model, fatal cardiovascular events were associated with the following cardiac geometric classifications, eccentric hypertrophy (p = 0.050), concentric hypertrophy (p = 0.041), and serum phosphate &ge, 3.6 mg/dL (p = 0.025), FGF-23 &ge, 168 (p = 0.0149), &alpha, klotho &lt, 313 (p = 0.044). Conclusions: In our population, Klotho and FGF23 are associated with cardiovascular risk in the early stages of CKD.

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P

La producción de insectos como fuente de nutrientes representa una alternativa de producción sostenible, atrayente y adecuada para satisfacer la creciente demanda de alimentos, especialmente para la nutrición animal. Estrategia nutricional que puede ser considerada principalmente por la industria alimentaria, ya que en comparación con otros alimentos de uso común como las harinas de origen animal y la harina de soja, puede aportar cantidades significativas de proteínas, lípidos, minerales, entre otros nutrientes. Estos insectos pueden ser alimentados con residuos agrícolas y desechos orgánicos, siendo esta una de las principales ventajas que refuerzan el uso de este ingrediente en la alimentación animal. Además, disminuyen costos de producción e intervienen en el desenvolvimiento de la microbiota benéfica, reducen la competencia por recursos alimenticios y actúan como inmunomoduladores. Actualmente, algunos estudios resaltan el uso de diversas harinas de insectos con la inclusión o sustitución total de las fuentes convencionales de proteína. Un ingrediente que ofrece resultados significativos de interés zootécnico, generando un impacto positivo en el sistema productivo, por lo cual merece destacarse. El objetivo de esta revisión de literatura es resaltar el uso de insectos en la nutrición animal, principalmente en la avicultura, como una alternativa económicamente viable para el productor en términos de reducción de costos sin afectar el desempeño productivo de los animales. En este sentido, destacar esta temática como una nueva perspectiva en la industria de la alimentación animal y el sector pecuario.