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Made available in DSpace on 2020-12-10T20:00:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-15 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) BACKGROUND Toll-like receptor-2 (TLR2) is responsible for recognizing Helicobacter pylori (H. pylori) and activating the immune response. Polymorphisms in TLR2 may modulate gastric carcinogenesis. AIM To evaluate whether the TLR2 19216T/C (rs3804099) and TLR2 -196 to -174 ins/del (rs111200466) polymorphisms contribute to gastric carcinogenesis in the Brazilian population, and to determine the influence of both polymorphisms and H. pylori infection on TLR2 mRNA expression. METHODS DNA was extracted from 854 peripheral blood leukocyte or gastric tissue samples [202 gastric cancer (GC), 269 chronic gastritis (CG), and 383 control/healthy (C)] and genotyped by allele-specific PCR or restriction fragment length polymorphism (RFLP)-PCR. Quantitative polymerase chain reaction by TaqMan(R) assay was used to quantify TLR2 mRNA levels in fresh gastric tissues (48 GC, 36 CG, and 14 C). RESULTS Regarding the TLR2 -196 to -174 polymorphism, the ins/del and del/del genotypes were associated with a higher risk of GC by comparison with the C in all of the analyzed inheritance models (codominant, dominant, recessive, overdominant and log-additive; P < 0.0001). Similarly, an increased risk was observed when comparing the GC and CG groups [codominant (P < 0.0001), dominant (P < 0.0001), recessive (P = 0.0260), overdominant (P < 0.0001) and log-additive (P < 0.0001)]. In contrast, TLR2 19216T/C was associated with a protective effect in the GC group compared to the C group [dominant (P = 0.0420) and log-additive (P = 0.0300)]. Regarding the association of polymorphisms with H. pylori infection, individuals infected with H. pylori and harboring the TLR2 -196 to -174 ins/del polymorphism had an increased risk of gastric carcinogenesis [codominant (P = 0.0120), dominant (P = 0.0051), overdominant (P = 0.0240) and log-additive (P = 0.0030)], while TLR2 19216T/C was associated with a protective effect [codominant (P = 0.0039), dominant (P < 0.0001), overdominant (P = 0.0097) and log-additive (P = 0.0021)]. TLR2 mRNA levels were significantly increased in the GC group (median RQ = 6.95) compared to the CG group (RQ = 0.84, P < 0.0001) and to the normal mucosa group (RQ = 1.0). In addition, both H. pylori infection (P < 0.0001) and the presence of the polymorphic TLR2 -196 to -174del (P = 0.0010) and TLR2 19216 C (P = 0.0004) alleles influenced TLR2 mRNA expression. CONCLUSION The TLR2 -196 to -174 ins/del and TLR2 19216 T/C polymorphisms are strongly associated with GC. TLR2 mRNA expression levels are upregulated in neoplastic tissues and influenced by both the presence of H. pylori and variant genotypes. Univ Sagrado Coracao, Dept Grad Level Res, BR-17011970 Bauru, SP, Brazil Sao Jose do Rio Preto Sch Med, Dept Mol Biol, BR-15090000 Sao Jose Do Rio Preto, SP, Brazil Sao Paulo State Univ, Dept Biol, Rua Cristovao Colombo 2265, BR-15054000 Sao Jose Do Rio Preto, SP, Brazil Sao Paulo State Univ, Dept Biol, Rua Cristovao Colombo 2265, BR-15054000 Sao Jose Do Rio Preto, SP, Brazil FAPESP: 2013/14022-6 FAPESP: 2014/177161

The effects of magnesium (Mg) supplementation on vascular function have been evaluated in some randomized controlled trials (RCT) but their results are conflicting. A systematic review and meta-analysis were conducted to summarize the effects of oral Mg supplementation on vascular function in RCT. The databases MEDLINE (PubMed), Embase, Web of Science and Cochrane Library were accessed from inception to May 27, 2019. Intergroup differences (treatment vs. control group) related to changes in flow-mediated dilation (FMD) and pulse wave velocity (PWV), expressed as mean and standard deviation, were used to evaluate the effect of Mg supplementation on these outcomes. The results of the meta-analysis were expressed using a random-effects model. The heterogeneity between studies was evaluated using the I2 statistic. The oral supplementation of Mg had no significant effect on FMD (mean difference 2.13; 95% CI − 0.56, 4.82; p = 0.12) and PWV (mean difference − 0.54, 95% CI − 1.45, 0.36, p = 0.24). Heterogeneity for both outcomes (FMD and PWV) was high (I2 = 99%, p

Resumo O medo de cair é um fator de risco de queda. Também tem sido associado ao declínio funcional, diminuição da qualidade de vida e aumento do isolamento social na população idosa. Este estudo teve como objetivo analisar preditores do medo de cair em pessoas idosas portuguesas residentes na comunidade. Foi desenvolvido um estudo transversal com uma amostra de conveniência de 98 participantes (57,1% mulheres; média etária 74,07 ± 8,74 anos). O protocolo de coleta de dados incluiu um questionário sociodemográfico e de saúde, a Escala de Confiança no Equilíbrio específica para a Atividade, a Escala de Ansiedade e Depressão Hospitalar, a Escala Breve de Redes Sociais de Lubben, o Timed Up and Go, e o Teste de Sentar e Levantar Cinco Vezes. Os dados foram analisados com recurso à estatística descritiva e inferencial. Os resultados indicam que no gênero feminino (p = 0.01), a percepção de saúde física boa (p = 0.01) e moderada (p = 0.02) e os sintomas de depressão (p ≈ 0.00) são preditores do medo de cair. Controlar estes preditores é um aspecto fundamental para a promoção da independência das pessoas idosas, minimizando as consequências associadas ao medo de cair.

Resumo Objetivo Comparar estrutura e processo de trabalho na Atenção Básica para implantação da teleconsulta médica em municípios de diferentes regiões e portes populacionais (mil habitantes: 100). Métodos Estudo transversal, com análise descritiva e bivariada, sobre dados de 2017-2018, para avaliar disponibilidade de computador com internet, câmera, microfone e caixa de som, e processo de trabalho das equipes (utilizar Telessaúde, central de regulação e fluxo de comunicação). Resultados Analisadas 30.346 UBS e 38.865 equipes, a presença de equipamentos para teleconsulta entre UBS variou de 1,2% em municípios grandes do Norte a 26,7% em municípios pequenos do Sul. O processo de trabalho variou de 10,7% em municípios pequenos do Norte a 39,5% em municípios grandes do Sul. Comparados ao Sul, municípios médios do Norte (OR=0,14 - IC95% 0,11;0,17) e do Nordeste (OR=0,21 - IC95% 0,18;0,25) tiveram menores chances de dispor dos equipamentos necessários. Conclusão Significativas desigualdades regionais recomendam investimentos em Saúde Digital. Resumen Objetivo Comparar estructura y proceso de trabajo en atención primaria para implementar la teleconsulta médica en municipios de diferentes regiones y tamaños (mil habitantes: 100). Métodos Estudio transversal, con análisis descriptivo y bivariado, datos de 2017-2018 para evaluar la disponibilidad de computadora con internet, cámara, micrófono, altavoz y proceso de trabajo (uso de Telesalud, centro de regulación central y flujo de comunicación). Resultados Se analizaron 30.346 unidades y 38.865 grupos. La presencia de equipos de teleconsulta osciló entre 1,2% en los grandes municipios del Norte y 26,7% en pequeños municipios del Sur. El proceso de trabajo osciló entre 10,7% en pequeños municipios del Norte y 39,5% en grandes municipios del Sur. En comparación con el Sur, municipios medianos del Norte (OR=0,14 - IC95% 0,11;0,17) y Nordeste (OR=0,21 - IC95% 0,18;0,25) tenían menos probabilidades de contar con los equipos necesarios. Conclusión: Existe la necesidad de inversiones en Salud Digital, con desigualdades regionales relevantes. Abstract Objective To compare the structure and the work process in Primary Care for implementing medical teleconsultation in municipalities in different regions and with different population sizes (100,000 inhabitants). Methods Cross-sectional study, with descriptive and bivariate analysis, using data from 2017-2018 to assess the availability of computers with internet access, webcam, microphone, speaker, as well as to assess the work processes (use of Telehealth, service supply and demand control center, and communication flow). Results 30,346 primary health centers and 38,865 teams were evaluated. Presence of teleconsultation equipment in the health centers ranged from 1.2% in large northern municipalities to 26.7% in small southern municipalities. Established work process ranged from 10.7% in small northern municipalities to 39.5% in large southern municipalities. Compared to the South, medium-sized municipalities in the North (OR=0.14 - 95%CI 0.11;0.17) and Northeast (OR=0.21 - 95%CI 0.18;0.25) regions were less likely to have the necessary equipment. Conclusion Significant regional inequalities call for investments in Digital Health.

Resumo Fundamento: Diversos índices antropométricos têm sido propostos para determinar a associação entre excesso de peso e fatores de risco cardiovascular. Objetivo: Avaliar a relação entre adiposidade corporal e reatividade microvascular em pacientes hipertensos sob terapia anti-hipertensiva. Métodos: Pacientes hipertensos tratados de 40 a 70 anos foram submetidos à avaliação de índices antropométricos: conicidade (IC), adiposidade corporal (IAC), adiposidade visceral (IAV) e relação cintura-estatura (RCE). Os participantes foram divididos pelos tercis de percentual de gordura (%G) obtido pela bioimpedância elétrica (BIA) e submetidos a teste de reatividade microvascular (laser speckle contrast image), medida da velocidade da onda de pulso (VOP). O valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: A variação da área sob a curva (ASC) da perfusão cutânea foi inferior no tercil superior (97 ± 57% vs. 67 ± 36%; p = 0,027). O %G apresentou correlação significativa com RCE (r = 0,77; p < 0,001), IAV (r = 0,41; p = 0,018), IC (r = 0,60; p < 0,001) e IAC (r = 0,65; p < 0,001) nos homens e somente com RCE (r = 0,55; p < 0,001) e IAC (r = 0,60; p < 0,001) nas mulheres. Na regressão linear, a ASC mostrou associação independente com o %G (β =–3,15; p = 0,04) nas mulheres e com a glicemia (β = –1,15; p = 0,02) nos homens. Não houve diferença nas medidas de VOP. Conclusão: Os índices antropométricos de obesidade foram mais associados ao %G nos homens. A maior adiposidade corporal foi relacionada com menor reatividade microvascular, o que foi mais evidente nas mulheres. Não houve diferença na rigidez arterial, o que pode ter sido influenciado pelo tratamento anti-hipertensivo. Abstract Background: Several anthropometric indexes have been proposed to determine the association between overweight and cardiovascular risk factors. Objective: To evaluate the relationship between body adiposity and microvascular reactivity in hypertensive patients under antihypertensive therapy. Methods: Treated hypertensive patients aged 40 to 70 were submitted to evaluation of anthropometric indexes: conicity (CI), body adiposity (BAI), visceral adiposity (VAI) and waist-to-height ratio (WHtR). Participants were divided by the terciles of fat percentage (%F) obtained by bioelectrical impedance. The patients underwent microvascular reactivity test (Laser Speckle Contrast Image) and pulse wave velocity (PWV) measurement. The p value

It is often overlooked that even food production is linked to the ecology of plants and animals. Living organisms respond to environmental short- and long-term variability: acknowledging this may help in the ultimate goal of valorizing a territory/product. We investigated acorns of the two main Quercus species of the Portuguese Montado, a main feed of the renown black Iberian pig. We tested their responses to an aridity gradient by morphological parameters and isotopic signature. Q. rotundifolia and Q. suber acorns did not differ morphologically, even if a higher variability in all parameters was observed in acorns of Q. suber. According to the site-specific Aridity Index, correlations are indicative to higher weight and length only in Q. suber acorns from more arid sites. As for isotopic composition, there were no differences in nitrogen or carbon (&delta, 15N and &delta, 13C) between the two species. However, combining the samples and testing for association with the Aridity Index, we found that more arid sites lead to a 15N enrichment. This result, combined with the positive correlation between AI and acorns length, support the use of acorns as a tool, their isoscapes of nitrogen being a stepping stone for the provenance of the black Iberian pig.

The essential branched chain amino acids (BCAAs) valine, leucine, and isoleucine, are widely studied because of their effects on immunity and metabolism. Mesenchymal stem cells (MSCs) are a type of cell also studied due to their immunomodulatory properties. Since both BCAAs and MSCs have immunomodulatory capacity, the objective of this study was to evaluate the influence of BCAAs on some immunomodulatory aspects of MSCs.MSCs were cultivated in BCAA-supplemented media to evaluate metabolic activity, including cell cycle, proliferative nuclear cell antigen, peroxisome proliferator-activated receptor gamma coactivator 1-alpha, avian myelocytomatosis viral oncogene homolog, peroxisome proliferator activated receptor gamma, nuclear factor kappa B (NFкB), and signal transducers and activators of transcription 3 (STAT-3) expression. Additionally, some inflammatory mediators' synthesis, such as interleukin (IL) 1-beta, IL-10, granulocyte-macrophage colony-stimulating factor, transforming growth factor beta, nitric oxide, and prostaglandin ESupplementation with BCAA led not only to increased MSC proliferation with more cells in the S, G2, and M cycle phases, but also to increased metabolic activity. BCAA supplementation also altered the immunomodulatory capacity of MSCs by decreasing the p-NFкB/NFкB and increasing the p-STAT-3/STAT-3 gene expression ratios, in addition to increasing synthesis of the antiinflammatory mediators transforming growth factor beta and prostaglandin EBCAA supplementation affected some immunoregulatory aspects of MSCs.

In the last decade, mesenchymal stem cells (MSCs) have been gaining attention due their ability to influence the function of other cells as well as modulate the inflammatory response. This occurs via their immunomodulatory functions, acting through direct cell-cell interaction or by releasing a broad spectrum of bioactive factors such as cytokines and growth factors. In addition, prostaglandins are arachidonic acid metabolites that play a key role in the generation and modulation of the inflammatory response. Among the bioactive prostaglandins, PGF2α is able to stimulate cell proliferation as well as act to inhibit progenitor cell differentiation, but no information about this prostaglandin's action on the immunoregulatory function of MSCs has been reported. In this study we evaluate important aspects of the influence of PGF2α analog (17-phenyl-trinor PGF2α), which is a potent prostaglandin FP receptor agonist, on some mechanisms that control the main functions of MSCs. C3H10T1/2, a mesenchymal stem cell linage, was stimulated with PGF2α under inflammatory conditions trigged by LPS in order to investigate PGF2α inflammatory parameters as well as its ability to immunoregulate macrophages and lymphocytes. PGF2α has the ability to increase proliferation tax without altering the cell viability of LPS-stimulated MSCs, while also diminishing the phosphorylation of NFκB transcription factor leading to attenuation of IL-1β and GM-CSF production. Additionally, MSC-s conditioned media from cells stimulated with PGF2α was able to increase the lymphocytes' IL-10 production. Overall, this study implied that PGF2α are able to modify some properties of MSCs.

Background The study tested the hypothesis that habitat and sex influence the composition of meat lipid fraction. Therefore, this study aims to characterize the effects of habitat and sex on feral fallow deer (Dama dama) tenderloin (psoas major muscle) intramuscular fat composition. Results Fallow deer meat from the Atlantic forest presented higher total cholesterol and total monounsaturated fatty acids contents, while fallow deer meat from Montado presented significantly higher proportion of total branched chain fatty acids, n-6 polyunsaturated fatty acids and dimethyl acetals. Regarding the sex influence on meat's fatty acid composition, it was observed that female fallow deer displayed higher contents of total saturated fatty acids than their male counterparts. Conclusion Independently of the habitat the feral fallow deer's meat can be classified as extra lean. However, the high peroxidability index and the low total vitamin E content suggests that it is prone to lipid peroxidation. © 2020 Society of Chemical Industry.

Resumo A trajetória profissional ocupa espaço significativo na vida das pessoas na atualidade. Com base nesta premissa, procurou-se compreender o sentido de comunidade no contexto de trabalho de uma equipe multiprofissional hospitalar. Trata-se de uma pesquisa qualitativa, realizada por meio de entrevistas semiestruturadas, das quais participaram oito profissionais do ambulatório de hematologia e oncologia pediátrica de um hospital público do sul do Brasil, de abril a junho de 2015. As entrevistas foram analisadas à luz das Práticas Discursivas. Estabeleceram-se quatro categorias, decorrentes dos componentes teóricos do sentido de comunidade. Os resultados indicam que os elementos pertencimento; influência; integração e satisfação das necessidades; e ligações emocionais compartilhadas estavam presentes nos discursos da equipe. Houve proximidade entre as narrativas das participantes e o conceito de comunidade para a caracterização do contexto de trabalho e das relações desenvolvidas. Contudo, também foram notados indícios de tensionamento hierárquico nas relações, a valorização de práticas individualistas, o conflito não externalizado e a dificuldade de lidar com as diferenças. Conclui-se que há necessidade de maior investimento na valorização e integração dos diferentes profissionais implicados no processo de promoção de saúde e no fomento do sentido de comunidade nas equipes hospitalares. Abstract The career path plays a significant role in the lives of people nowadays. Based on this premise, we sought to understand the meaning of community in the work context of a multiprofessional hospital team. The qualitative research was conducted through semi-structured interviews with eight professionals of the outpatient hematology and pediatric oncology services at a public hospital in the Southern region of Brazil, from April to June 2015. The interviews were analysed using Discursive Practices. We established four categories, which originated from the theoretical components of the meaning of community. The results indicate that the elements of belonging; influence; integration and satisfaction of needs; and shared emotional bonds were present in the discourses of the team. There was a proximity among the narratives of the participants and the concept of community in order to characterize the contexts of the work and of the relationships developed. However, we also noticed signs of hierarchical tensions in the relationships, the validation of individualist practices, non-externalized conflicts, and the difficulty to deal with differences. We concluded that there is a need for higher investments in the validation and integration of the different professionals implicated in the process of promotion of health and of the meaning of community among Brazilian teams. Resumen La trayectoria profesional ocupa un espacio significativo en la vida de las personas en la actualidad. Con base en esta premisa, se buscó comprender el sentido de comunidad en el contexto de trabajo de un equipo multidisciplinario hospitalario. Se trata de una investigación cualitativa, realizada por medio de entrevistas semiestructuradas, de las cuales participaron ocho profesionales del servicio de hematología y oncología pediátrica de un hospital público del sur de Brasil, entre abril y junio del 2015. Las entrevistas se analizaron a la luz de las Prácticas Discursivas. Se establecieron cuatro categorías, derivadas de los componentes teóricos del sentido de comunidad. Los resultados indican que los elementos pertenencia; influencia; integración y satisfacción de las necesidades; y vínculos emocionales compartidos, estaban presentes en los discursos del equipo. Se constató semejanza entre los relatos de los participantes y el concepto de comunidad para la caracterización del contexto de trabajo y las relaciones desarrolladas. Sin embargo, también se observaron indicios de tensión en las relaciones jerárquicas, la valoración de prácticas individualistas, el conflicto no exteriorizado y dificultad de lidiar con las diferencias. Se concluyó que es necesario invertir con más fuerza en la valoración e integración de los diferentes profesionales involucrados en el proceso de promoción de la salud y en el fomento del sentido de comunidad en los equipos hospitalarios.

Endothelial dysfunction is a surrogate marker of cardiovascular risk. Resveratrol is known to improve endothelial function in animals, however, clinical trials are limited. We hypothesized that the acute trans-resveratrol supplementation improves endothelial function in treated hypertensive patients with endothelial dysfunction. Twenty-four hypertensive patients between 45 and 65 years-old with baseline endothelial dysfunction were enrolled in a randomized, cross-over, double-blind, placebo-controlled trial. Individuals received either a single dose of trans-resveratrol (300 mg) or placebo and were crossed-over after a one-week washout period. Blood pressure (BP) measurements, aortic systolic blood pressure (SBP) and brachial flow-mediated dilation (FMD) were performed before and 1.5 hours after the intervention. FMD was significantly increased in women (4.2 ± 0.5 vs 7.1 ± 1.3%, p = 0.026) but not in men (4.4 ± 0.9 vs 4.9 ± 0.8%, p = 0.588) in the trans-resveratrol group. There was no statistical difference between baseline and final values of brachial BP and also no changes in aortic SBP. Patients with higher low-density lipoprotein (LDL) cholesterol had better FMD response to trans-resveratrol than patients with lower LDL cholesterol (7.4 ± 1.2 vs 4.3 ± 1.0%, p = 0.004). Our study demonstrated that the acute supplementation of trans-resveratrol promoted an improvement in endothelial function, especially in women and those with higher LDL-cholesterol, despite no changes in BP. List of Abbreviation: Aix: augmentation index; AP: augmentation pressure; BP: blood pressure; BMI: body Mass Index; CVD: cardiovascular disease; FMD: flow-mediated dilation; FRS: Framingham Risk Score; HDL: high-density lipoprotein; LDL: low-density lipoprotein; NO: nitric oxide; SPSS: Statistical Package for Social Sciences; ROS: reactive oxygen species; SBP: systolic blood pressure; TG: triglycerides.

Resumo: Este estudo teve como objetivo descrever as características da vítima, da violência, do agressor e do atendimento recebido por mulheres (12 anos acima) em um hospital da rede pública de Fortaleza-CE entre 2010 e 2013. Buscou-se, ainda, identificar as consequências da violência e o desfecho da gestação (continuidade ou interrupção), além de realizar uma análise comparativa das vítimas adolescentes e adultas. Elaborou-se um formulário específico de investigação (36 questões), preenchido com base em três formulários utilizados no hospital. No total, foram analisados 112 formulários, dos quais 51 pertenciam a adolescentes e 61 a adultas. Os dados foram analisados por meio de estatísticas descritivas e inferenciais no Statistical Package for Social Science – SPSS, versão 19. As vítimas eram em sua maioria adultas, de raça/cor parda, heterossexual, solteira e estudante. A violência sexual mais praticada foi o estupro e por agressor desconhecido por parte das vítimas. A gravidez foi a consequência da violência sexual mais frequente, tendo as mulheres adolescentes mais vezes optado pela continuidade da gestação. A evolução do atendimento não ficou clara em muitos casos, devido à fragilidade de preenchimento das fichas analisadas. Ressalta-se a importância do estudo que, ao incluir diversas perspectivas acerca da violência sexual (vítima, violência, agressor e atendimento), pode contribuir para a elaboração e estruturação de políticas públicas.

The Falls Efficacy Scale-International (FES-I) is a highly reliable instrument to assess fear of falling among older population. This study aimed to develop a European Portuguese version of the FES-I (FES-I(P)) and analyse its psychometric properties in terms of internal consistency, test-retest reliability, concurrent and convergent validity. A cross-sectional study was conducted. Data collection integrated a socio-demographic questionnaire which included falls history and presence/absence of fear of falling, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential statistical analyses were performed. A total of 100 Portuguese community-dwelling older people (74.27±8.7years old) have participated in the study. From these, 82 have participated in the reliability study. The FES-I(P) had excellent internal consistency (α=0,978) and test-retest reliability (ICC2,1=0,999). A significant negative correlation was found between the FES-I(P) and the ABC (rs=-0.85; p

The reduction of the functional capacity in older people is the result of physical, psychological and functional changes related to the ageing process, compromising the performance of daily life activities. Assessing their functional capacity and their self-care profile can facilitate the planning of targeted strategies related to stimulation, as well as cognitive and motor rehabilitation. This study aims to evaluate and analyse the functional capacity, as well as the level of dependence in self-care of older people in senior care centres. This is a transversal exploratory study, quantitative in nature. The sample was comprised of 313 participants, randomly selected from a set of senior care centres, with an average age of 83.41 (SD=7.14) years, recruited from the interior North of Portugal. The data collection instruments included the Barthel Index, the Lawton and Brody Scale, the Evaluation Form of Dependence in Self-care, the Self-care of Home Dwelling Elderly (self-care subscale profiles) and a questionnaire on demographic data. The elderly showed several levels of dependence on different self-care items. It was possible to observe that the staff often replaces the elderly in many of the tasks that could still be performed by them, and thus aggravates their levels of dependence. The link observed between functional capacity and self-care profiles highlights the need to focus on the notion of a healthy and active ageing process, especially in some profiles. The monitoring of the functional capacity and the self-care profile can provide knowledge concerning the potential for autonomy and individual needs, thus enabling targeted and more responsive interventions for the individual and the real needs of older people. info:eu-repo/semantics/publishedVersion

Objective: to assess whether the health condition of an elderly person can serve as a mediating factor between the cognitive state and general self-esteem of the institutionalized elderly. Method: a quantitative, cross-sectional correlational study was performed, based on the path analysis technique.The following instruments were used for data collection: the Mini-Mental State Examination, the Tinetti Performance Oriented Mobility Assessment, the Mini Nutritional Evaluation and the Rosenberg Self-Esteem Scale. Results: the sample was composed of 312 elderly patients of both genders (112 men and 200 women), with an average age of 83.39 (+7.09) years. Most of the elderly persons were widowed, with a low educational level, and had been institutionalized in Residential Care Facilities for the Elderly for on average 54.6 (+51.69) months. The mediating factor of health condition renders the link between the cognitive state and self-esteem of the elderly null. However, the analysis of the decomposition of the effects showed a significant indirect effect between the cognitive state and health condition. The total effect of cognitive state on the health condition of the elderly is significant, positive and direct. Conclusion: based on the results of this study we maintain that cognitive changes can affect the nutritional state and physical balance of the institutionalized elderly.

The concept of self-care in the elderly has been frequently associated with autonomy, independence and personal accountability. Self-care practices are a result of individual lifestyles and paths adapted to the circumstances and expectations of the elderly. Based on the model by Backman and Hentinen (1999), the present study attempts to categorically describe the types of self-care of the elderly. This is an exploratory study, transversal, of a quantitative nature. The sample was comprised of 313 participants, randomly selected among Elderly Care Centres in the interior North of Portugal. The Portuguese version of Self-care of Home Dwelling Elderly was used for data collection. The results call for a replication of the study, using the theoretical derivation of the four self-care profiles (responsible, formally guided, independent and abandoned). POCI-01-0145-FEDER-007746 UID/IC/4255/2013 info:eu-repo/semantics/publishedVersion

Based on results of two intervention projects with professionals working with drug users in Sorocaba, São Paulo, the article discusses the possibilities of health promotion in the field of mental health, understood as a form of resistance to the regulatory powers of official policies. The projects proved to be promising for the construction of autonomy of these workers. The guiding principles of humanized care in health care and respect for human rights of drug users proved to be important tools for these interventions as were university extramural activities.

This article aims to review glutamine metabolism and its effects on the immune response. Selected topics are addressed, particularly the effect of glutamine on cell survival and proliferation, as well as its importance in some biochemical pathways. The impact of glutamine on muscle, intestine, and liver metabolism are described, and a special section about glutamine regulation of the immune response is included. In this context, the modulation of glutamine on relevant signaling pathways as nuclear factor kappa B (NF-kB), mitogen-activated protein kinases (MAPKs), and heat shock protein and the influence of this amino acid on cell migration and adhesion molecules are highlighted. Some important immune response pathways modulated by glutamine were described as its action in critically ill patients. In summary, this review describes some important actions of glutamine, and a range of reactions and modulatory effects in different organs, which may inform new therapeutic strategies. However, further studies are necessary to provide information about glutamine use, especially about situations in which it can be better used as well as fine-tuning dose and administration.

Protein malnutrition (PM) is a major public health problem in developing countries, affecting the inflammatory response and increasing susceptibility to opportunistic infections. For this reason, an adequate nutritional intervention can improve the quality of life of patients. Glutamine (GLN) is a nonessential amino acid, but can be considered "conditionally essential" for macrophage function in stress situations, in which it plays a role in the improvement of the inflammatory response. Concerning this issue, in the current study, it was of interest to evaluate some biological aspects of peritoneal cells from a protein malnutrition (PM) mouse model challenged with lipopolysaccharide (LPS) and treated intravenously with GLN. Two-month-old male Balb/c mice were subjected to a low-protein diet (2 % protein) and stimulated intravenously with LPS 1 h prior to the injection of 0.75 mg/kg GLN. Malnourished animals showed a reduced number of total peritoneal cells. Malnourished animals stimulated with LPS or LPS plus GLN did not show differences in peritoneal cell counts; however, the control group showed increased cellularity after LPS stimulus, which was reversed after GLN injection. Further, in the animals from both groups stimulated with LPS, GLN decreased the circulating levels of TNF-α and the levels of TNF-α produced by peritoneal cells; additionally, GLN decreased the IL-10 circulating levels in the malnourished animals stimulated with LPS. In addition, peritoneal cells of the control and malnourished groups stimulated with LPS showed a negative modulation of the NFkB signaling pathway after GLN injection. In conclusion, this study shows that GLN has the capacity to reduce TNF-α synthesis as well as to act as a negative regulator of NFkB phosphorylation, leading to a positive outcome in the control of TNF-α production.

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

Esse artigo discute os desafios da prevenção em tempos de crescimento de casos de Aids entre jovens. Opiniões e práticas de estudantes no ensino médio, coletadas em pesquisa realizada de 2013-2017, indicaram que estavam incorporando o discurso preventivo e que a religiosidade tem efeito em crenças e valores antes da iniciação sexual, mas pode interferir negativamente no uso de preservativo desde a primeira relação. Sustentar o direito à prevenção dependerá de ampliarmos a compreensão pública sobre como a religiosidade vivida difere da política-religiosa. Sugere-se monitorar o efeito da retomada de discursos morais que remontam à ditadura civil-militar e da possível descontinuidade de programas de prevenção bem-sucedidos junto aos jovens desde os anos 1990. É urgente compreender a dinâmica entre velhos e novos discursos que estruturam a sexualização (frequentemente via redes sociais) assim como o acesso à recomendada “prevenção combinada” das Infecções Sexualmente Transmissíveis (IST/Aids). Este artículo discute los desafíos de la prevención en tiempos de aumento de casos de Sida entre jóvenes. Opiniones y prácticas de estudiantes en la enseñanza media, recolectadas en un estudio realizado entre 2013-2017, indicaron que incorporaron el discurso preventivo y que la religiosidad tiene efecto en creencias y valores antes de la iniciación sexual, pero que puede interferir negativamente en el uso del preservativo desde la primera relación. Mantener el derecho a la prevención dependerá de que ampliemos la comprensión pública sobre cómo la religiosidad vivida difiere de la política-religiosa. Se sugiere el monitoreo del efecto de la reanudación de discursos morales que remiten a la dictadura civil-militar y de la posible discontinuidad de programas de prevención exitosos con los jóvenes desde la década de 1990. Es urgente comprender la dinámica entre viejos y nuevos discursos que estructuran la sexualización (frecuentemente vía redes sociales) así como el acceso a la recomendada “prevención combinada” de las Infecciones de Transmisión Sexual (ITS)/Sida. This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the disease among young people. A study was conducted between 2013 and 2017 to explore the sexual behavior of high school students and their opinions regarding sexuality. The findings show that students have adopted the prevention discourse and that religiosity influences beliefs and values relating to sexual initiation, negatively affecting condom use from the onset of sexual activity. To ensure the right to prevention is upheld, it will be necessary to broaden public understanding about how religion as it is actually lived differs from religious politics. The effects of the reversion to moral discourses reminiscent of the military dictatorship and possible discontinuity of successful longstanding prevention programs targeting young people should be monitored. There is an urgent need to understand the dynamic between the old and new discourses that shape sexualization (often via social media) and access to “combination prevention” of Sexually Transmitted Infections (STI)/Aids.

Ticks are ectoparasites of worldwide distribution that affect vertebrates and can transmit pathogens to animals and humans. The Zoological Park Foundation of São Paulo (FPZSP) is located in a Conservation Unit in one of the most important remaining fragments of the Atlantic Rainforest biome in the suburbs of São Paulo, Brazil. The FPZSP houses more than 3,000 wild animals on exhibit, in breeding programs and in environmental education programs, and also attracts migratory birds and free-roaming wildlife. This study focused on identifying the diversity of tick species that infest captive and free-roaming animals at the FPZSP. The collection of ticks kept at the FPZSP contains 523 specimens that were collected from different host species between 1990 and 2017. Ten tick species were found. In addition, Amblyomma aureolatum (Pallas) was found on stray cats living in the Atlantic forest fragment in the FPZSP. This study reveals a low occurrence of parasitism in captive animals and a high diversity of tick species collected from hosts in this Atlantic forest fragment, contributing information about host-parasite relationships and potential vectors of zoonotic diseases, since the vectors of Brazilian spotted fever, A. aureolatum and Amblyomma sculptum Berlese, were found in some hosts. Resumo Os carrapatos são ectoparasitas da classe Arachnida, conhecidos como importantes vetores de agentes infecciosos para animais e humanos. A Fundação Parque Zoológico de São Paulo (FPZSP) localizada em uma Unidade de Conservação do bioma Mata Atlântica e inserida na cidade de São Paulo, mantém mais de 3.000 animais selvagens cativos, abrigando ainda diversas espécies silvestres nativas da Mata Atlântica. Devido à importância do conhecimento dos carrapatos que parasitam a fauna selvagem, o objetivo deste trabalho foi identificar a coleção de carrapatos da FPZSP e analisar a diversidade desses parasitas em animais cativos e de vida livre. O acervo de carrapatos mantidos pela FPZSP contém 523 exemplares que foram coletados de diferentes espécies hospedeiras, desde 1990 até 2017. Dez espécies de carrapatos foram encontradas. Além dos animais silvestres, foram encontrados Amblyomma aureolatum (Pallas) em gatos domésticos errantes que circulam nas áreas da FPZSP. Este trabalho demonstra a baixa ocorrência de parasitismo em animais cativos e a alta diversidade de carrapatos nos hospedeiros deste fragmento de Mata Atlântica, contribuindo com informações sobre a relação parasita-hospedeiro e potenciais vetores de doenças zoonóticas, já que os vetores da Febre Maculosa Brasileira A. aureolatum e Amblyomma sculptum Berlese, foram encontrados em alguns hospedeiros.