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Aim: To study the relationship between the ACTN3 R577X polymorphism and oxygen uptake (VO2) before and after exercise training. Methods: Police recruits (N = 206, 25 ± 4 y) with RR (n = 75), RX (n = 97), and XX (n = 33) genotypes were selected. After baseline measures, they underwent 18 wk of running endurance training. Peak VO2 was obtained by cardiopulmonary exercise testing. Results: Baseline body weight was not different among genotypes. At baseline, XX individuals displayed higher VO2 at anaerobic threshold, respiratory compensation point, and exercise peak than did RR individuals (P < .003). Endurance training significantly increased VO2 at anaerobic threshold, respiratory compensation point, and exercise peak (P < 2 x 10-6), but the differences between XX and RR were no longer observed. Only relative peak VO2 exercise remained higher in XX than in RR genotype (P = .04). In contrast, the increase in relative peak VO2 was greater in RR than in XX individuals (12% vs 6%; P = .02). Conclusion: ACTN3 R577X polymorphism is associated with VO2. XX individuals have greater aerobic capacity. Endurance training eliminates differences in peak VO2 between XX and RR individuals. These findings suggest a ceiling-effect phenomenon, and, perhaps, trained individuals may not constitute an adequate population to explain associations between phenotypic variability and gene variations. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify factors associated with the increased bleeding in patients during the postoperative period after cardiac surgery. Background: Bleeding is among the most frequent complications that occur in the postoperative period after cardiac surgery, representing one of the major factors in morbidity and mortality. Understanding the factors associated with the increased bleeding may allow nurses to anticipate and prioritise care, thus reducing the mortality associated with this complication. Design: Prospective cohort study. Methods: Adult patients in a cardiac hospital who were in the postoperative period following cardiac surgery were included. Factors associated with the increased bleeding were investigated by means of linear regression, considering time intervals of 6 and 12 hr. Results: The sample comprised 391 participants. The factors associated with the increased bleeding in the first 6 hr were male sex, body mass index, cardiopulmonary bypass duration, anoxia duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative period. Predictors in the first 12 hr were body mass index, cardiopulmonary bypass duration, metabolic acidosis, higher heart rate, platelets and the activated partial thromboplastin time in the postoperative. Conclusions: This study identified factors associated with the increased postoperative bleeding from cardiac surgery that have not been reported in previous studies. The nurse is important in the vigilance, evaluation and registry of chest tube drainage and modifiable factors associated with the increased bleeding, such as metabolic acidosis and postoperative heart rate, and in discussions with the multiprofessional team. Relevance to clinical practice: Knowledge of the factors associated with the increased bleeding is critical for nurses so they can provide prophylactic interventions and early postoperative treatment when needed. [ABSTRACT FROM AUTHOR]

Objective To investigate the influence of educational activity in the school environment based on prescriptive and subjective oral health indicators. Methods Cross-sectional, comparative study involving students between 9 and 12 years of age, from schools that have educational activities and those that do not, designated schools A and B. The oral health indicators used were the Simplified Oral Hygiene Index ( OHI-S) and the Community Periodontal Index ( CPITN). Knowledge and attitudes with regard to oral health were evaluated using a structured questionnaire. Results A total of 289 schoolchildren took part, 50.5% from school A and 49.5% from school B, in the town of Montes Claros, in the Brazilian state of Minas Gerais. In school A, the schoolchildren's OHI-S was satisfactory for 9.6%, normal for 78.8% and deficient for 11.6%, while in school B, the respective percentages were 3.5%, 17.5% and 79% (chi-squared, P < 0.001). The students in school A showed better CPITN results, namely lack of bleeding for 61.6%, the presence of bleeding for 29.5% and presence of tartar for 8.9%, while in school B, the respective results were 25.2%, 45.5% and 29.4% (chi-squared, P < 0.001). Students in school A achieved more correct answers in questions that evaluated knowledge of oral health. The account of daily use of dental floss in school A was 21.7% and in B, 3.6% (chi-squared, P < 0.001). Conclusion It is believed that educational activity in the school environment had a positive effect on oral health conditions, the consolidation of knowledge and incorporation of oral hygiene habits. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the impact of oral conditions on functional limitations among preschoolers. A preschool-based, cross-sectional study was carried out with 843 preschoolers in Campina Grande, Brazil. Parents/caregivers answered a questionnaire addressing socio-demographic characteristics and perceptions regarding the general/oral health of their children as well as the Brazilian version of the Early Childhood Oral Health Impact Scale. The nonparametric Kruskal-Wallis test followed by Mann-Whitney test (α = 5%) was used to compare mean children's quality-of-life scores for each independent variable. Poisson regression analysis was used to test associations between the independent and dependent variables (difficulties eating, drinking and speaking) (α = 5%). The multivariate regression model involved a hierarchical approach with four levels (distal to proximal determinants): (i) socio-demographic aspects; (ii) health perceptions; (iii) oral conditions; and (iv) pain conditions. The prevalence of negative impact on function was 24·7% for eating/drinking and 8·0% for speaking. Significant associations were found between toothache and negative impact on eating/drinking ( PR = 5·38; 95% CI: 3·20-9·02) as well as between high severity dental caries and negative impact on speaking ( PR = 14·91; 95% CI: 1·98-112·32). Dental caries, traumatic dental injury and malocclusion were not significantly associated with a negative impact on eating or drinking. However, toothache was an indicator of negative impact on eating/drinking and dental caries severity was an indicator of negative impact on speaking. [ABSTRACT FROM AUTHOR]

Background Alcoholic subjects manifest important deficits in frontal executive function, yet maintain cognitive mental status within normal range. Methods This study searched for volumetric measurements of segmented brain structures obtained from magnetic resonance imaging ( MRI) that would predict executive functions and cognitive mental status in alcoholic subjects. The frontal assessment battery ( FAB) and the Mini-Mental State Examination ( MMSE) were applied to alcoholic subjects who underwent MRI. Cortical and subcortical segmentation and corrections were performed using FreeSurfer. Multiple linear regressions analyses having volumetric measures of segmented brain structures as predictors for FAB or MMSE scores as dependent measures were conducted. Sixty alcoholic subjects, 52 males, mean age of 47.2 ± SD 10.4 years, with heavy use of alcohol (mean 284.4 ± SD 275.9 g of alcohol/d) over a long time (mean 32.4 ± SD 11.1 years), showed FAB 11.1 ± SD 3.2 and MMSE of 25.2 ± SD 4.1. Results Multiple regression analyses having left and right side of each segment as predictors showed that gray matter volumes of rostral middle frontal cortex and cerebellar cortex ( p < 0.001), in which only the left side of these structures showed significant partial effects in the full model ( p < 0.05), showed to predict FAB performance. They were even more predictive when considered together ( p < 0.001), in which both left rostral middle frontal cortex ( p < 0.05) and left cerebellar cortex ( p < 0.01) predictors had significant partial effects in the full model. None of brain structures was predictive of MMSE performance. Conclusions We have concluded that volumetric measurements of left rostral middle frontal and cerebellar cortices seem to be able to predict the frontal executive performance but not the cognitive mental status in alcoholic subjects. [ABSTRACT FROM AUTHOR]

Background The high amounts of phytic acid present in diets from developing countries are considered as important inhibitors of zinc ( Zn) absorption. The present study aimed to assess the fractional absorption of Zn from a meal containing common Brazilian foods using the stable isotope technique. Methods Twelve men, aged 19-42 years, were fed a healthy experimental diet comprising lettuce, tomato, French fries, steak with onions, rice, beans, papaya, orange, pineapple, and passion fruit juice. Each subject received one intravenous dose of enriched 70 Zn, and the lunch was extrinsically labelled with enriched 67 Zn. Urinary 67 Zn and 70 Zn enrichments were assessed by inductively coupled plasma mass spectrometry. Results The labelled meal phytate : Zn molar ratio was very divergent with respect to chemically determined and calculated data. Subjects presented a normal Zn nutritional status before and after the study. The mean Zn absorption from the labelled meal was 30% (range 11-47%). Conclusions According to the World Health Organization parameters, the results denote a moderate/high Zn bioavailability in the evaluated meal, with a variability in the absorption percentage that is similar to other studies. The data show that a typical Brazilian meal, with an adequate energy amount and a balanced macronutrient distribution, presents a Zn bioavailability in accordance with the worldwide recommended standard. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine the relationship between the daily frequency of self-monitoring of blood glucose and glycaemic control, demographic and socio-economic status in patients with Type 1 diabetes under routine clinical care in Brazil. Methods This was a cross-sectional, multi-centre study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data were obtained from 3176 patients, aged 22 ± 11.8 years, of whom 56.3% were female and 57.4% were Caucasian. The mean time since diabetes diagnosis was 11.7 ± 8.1 years. Results The prevalence of self-monitoring of blood glucose was 88.5%. There was a significant increase in self-monitoring frequency associated with female gender, lower ages, more intensive diabetes management and higher socio-economic status. A correlation between HbA1c levels and the daily frequency of self-monitoring was observed ( rs = -0.13; P = 0.001). The mean HbA1c levels were related to the daily frequency of self-monitoring ( P < 0.001) without additional benefit to patients who performed self-monitoring more than four times daily (9.2, 11.2, 10.2,15.2 and 15% for one, two, three, four, five or more self-monitoring tests daily, respectively; P < 0.0001). Conclusions The majority of our patients (88.5%) performed three or more self-monitoring tests daily, with more frequent testing reported by females, younger patients, those on intensive insulin regimens and of higher socio-economic status. No additional benefit was found in patients who performed self-monitoring more than four times daily. The diabetes care team must improve patients' education regarding self-monitoring of blood glucose and its benefits. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse mastication and the sense of taste in 39 patients submitted to cancer treatment in different areas of the body and to compare these variables with those of 44 control individuals within the same age range. The following aspects were assessed: dental status ( DMFT); stimulated and non-stimulated salivary flow; sense of taste (salty, sweet, bitter and sour); and masticatory performance ( MP), through the calculation of X50. Logistic regression models were established to test the association between the independent variables and cancer treatment. Cancer patients had lesser stimulated salivary flow, a smaller number of teeth and occlusal units, worse MP, higher salty, sweet and sour taste scores and a lower bitter taste score ( P < 0·05). A significant positive correlation was found between MP and the DMFT index in both groups ( P < 0·05), meaning that a lower DMFT index value denoted a smaller X50 value (better masticatory performance). The logistic regression model revealed that patients who had undergone cancer treatment had a greater probability of exhibiting a smaller number of teeth, higher salty and smaller bitter taste scores ( P < 0·05). It was concluded that patients who were submitted to cancer treatment presented oral physiology alterations when compared with control subjects at the same age range. [ABSTRACT FROM AUTHOR]

What is known and Objective: Some antimicrobial agents are active in vitro against Leptospiras. The use of penicillins at the late stage of leptospirosis is still controversial. We aimed to evaluate the use of penicillin in patients with leptospirosis-associated acute kidney injury (AKI). Methods: A retrospective study was conducted of patients with leptospirosis admitted to two hospitals in Fortaleza city, Brazil, between 1985 and 2008. AKI was defined according to the RIFLE and AKIN classifications. Patients were divided in two groups according to whether they were treated with a penicillin or not. Results: Two hundred and eighty-seven patients were included, with an average age of 36·8 ± 15·6 years and mostly male (80·8%). One hundred and twelve patients (39%) received a penicillin. Patients treated with a penicillin were younger (32 ± 14 years vs. 39 ± 16 years, P = 0·0002) and had a shorter hospital stay (8·4 ± 5·0 vs. 11 ± 7·7 days, P < 0·0001). There was no difference in the onset of symptoms before hospital admission between the two groups (6·5 ± 3·0 vs. 7·7 ± 4·7, P = 0·33). Systolic blood pressure was lower in the penicillin group (111 ± 21 vs. 119 ± 22 mmHg, P = 0·04). AKI, need of dialysis and renal recovery at the time of hospital discharge were more frequent in patients who did not use a penicillin ( P < 0·05). Mortality was similar in both groups (11·6% vs. 13·7%, P = 0·60). Conclusion: Treatment of leptospirosis with antibiotics, including the penicillin, remains controversial. The main benefit of using penicillin in the present study was a reduction in the length of hospital stay and fewer complications, such as AKI, but its use was not associated with a decrease in mortality. On balance of risks and benefits, we recommend the use of penicillin in late-stage leptospirosis. [ABSTRACT FROM AUTHOR]

Study design:Prospective clinical study.Objectives:This study aimed to translate, adapting to Brazilian version in Portuguese, validate and measure inter and intra-examinator reliability and internal consistency of the Thoracic-Lumbar Control Scale instrument.Setting:State University of Campinas, São Paulo, Brazil.Methods:This instrument was translated to Brazilian Portuguese by a bilingual translator, and it was retranslated to English for conflict correction and cultural adaptation. Two physiotherapists were previously trained to standardize the scale administration. In all, 22 patients were selected and initially assessed through FIM and American Spinal Injury Association (ASIA) instruments. Furthermore, they were evaluated through the Thoracic-Lumbar Control Scale by two examiners and revaluated 1 week after by only one examinator.Results:The Brazilian Portuguese version of Thoracic-Lumbar Control Scale showed excellent intra and inter-examinator reliability (0.961 and 0.986), high value of internal consistence (0.934) and significant correlation with ASIA sensory score (r=0.83, P=0.001).Conclusions:The Brazilian Portuguese version of Thoracic-Lumbar Control Scale is a valid and efficient instrument to assess trunk control of after-spinal cord injury patients, which certifies its replicability by other neurology professionals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare mothers' actual observations of signs and symptoms associated with the eruption of primary incisors in their infants with their own recollections of the same period after eruption was completed. Methods: A comparative study was carried out with 45 non-institutionalized infants and their mothers. Oral clinical exams were performed daily for detection of tooth eruption. The mothers were also interviewed daily about signs and symptoms they thought were associated with teething in the previous 24 hours. One week after the data collection was done, the mothers answered the same questionnaire. Descriptive analysis and the McNemar test (P<.05) were performed. Results: Statistically significant differences were found between the prospective and retrospective studies. Increased salivation (P<.04) and runny nose (P<.001) were reported less often and fever was reported more often (P<.001) in the retrospective evaluation. Conclusions: Mothers reported similar manifestations of sleep disturbance, diarrhea, loss of appetite, and irritability in the prospective and retrospective studies. Increased salivation and runny nose were more frequently reported in the prospective study, whereas fever was reported 5 times more often in the retrospective study. [ABSTRACT FROM AUTHOR]