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The objective of this study was to evaluate the nutrient intake and performance of feedlot lambs using 2 roughage to concentrate ratios and 2 types of soybean, whole (WS) or thermally processed (PS). Twenty male noncastrated market lambs weighting 23.26 ± 2.18 kg were used. The design was completely randomized in a factorial arrangement of 2 × 2. Diets were formulated with 50:50 and 20:80 of roughage to concentrate ratio on DM, and the thermal processing was realized in an autoclave at 120°C during 1 h. The end of the experimental period was determined by animal BCS, that is, the animals were slaughtered with a BCS between 3 and 3.5. The animals fed with 50% of roughage spent more time consuming feed (P < 0.01) and ruminating (P < 0.01). Thermally processed soybean provided more time consuming (P < 0.05) and less leisure time (P < 0.05) compared with WS. Diet with 20% of roughage provided increased ADG (P < 0.01) and better feed conversion (FC; P < 0.01). The utilization of PS resulted in decreased feedlot period (FP; P< 0.01), increased ADG (P < 0.05), decreased DMI (P < 0.01), and consequently better FC (P < 0.01). Diet with PS decreased the intake of ADF (P < 0.01). There was interaction between the roughage to concentrate ratio and soybean, wherein the diet with 50% of roughage and WS provided increased intake of NDF (P < 0.05). The use of thermally processed soybean provided better performance of lambs, and when this feed is associated with higher concentrate proportion, it reduces the intake of fibrous fraction of the diet.

Ethnopharmacological Relevance: The species Sparattosperma leucanthum (Vell.) K. Schum is used in Brazilian folk medicine to treat rheumatism, throat ulcers, stomatitis, syphilis, bladder stones and as blood cleanser. The aim of this study was to evaluate the potential, in vitro and in vivo, of the extracts of leaves from Sparattosperma leucanthum to treat hyperuricemia and inflammation in the gouty arthritis model., Materials and Methods: Ethyl acetate extract (SLE), methanolic extract (SLM) and aqueous extract (SLW) were evaluated in vitro on XO inhibitory activity and in vivo in an experimental model with oxonate-induced hyperuricemia in mice which was used to evaluate anti-hyperuricemic activity and liver xanthine oxidase (XOD) inhibition. Anti-inflammatory activity was also investigated on MSU crystal-induced paw edema model., Results: Sparattosperma leucanthum crude extracts showed expressive results on urate-lowering activity in blood. SLW at the dose of 125 mg/kg has proved to be active in reducing hyperuricemia and was capable to inhibit the hepatic xanthine oxidase enzyme (XOD). SLM showed anti-hyperuricemic activity on all doses tested; however, this extract showed activity on the XOD only at the dose of 500 mg/kg. SLE, at the three evaluated doses, has proved to be active in reducing hyperuricemia in vivo and was able to inhibit XO activity in vitro at the concentration of 100 µg/mL. This extract was also able to inhibit XOD activity in vivo at the doses of 250 mg/kg and 500 mg/kg. SLE (125 and 250 mg/kg) and SLW (500 mg/kg) showed significant anti-inflammatory activity on monosodium urate crystal-induced paw edema model., Conclusions: The ethyl acetate, methanolic and aqueous extracts of Sparattosperma leucanthum showed significant results on evaluated models and therefore may be important agents for the treatment of gouty arthritis and hyperuricemia., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: Breast cancer is the most common cause of death from cancer in women in less developed regions. Therefore, the objective of this study was to provide data on the temporal trends in female breast cancer mortality between 1990 and 2011 and to evaluate its association with the social inequalities present in Brazil., Methods: Breast cancer mortality data and estimates for the resident population were obtained from the Brazilian National Health Service database for the 1990-2011 period. Age-standardized mortality rates were calculated (20-39, 40-49, 50-69 and ≥70 years) by direct standardization using the 1960 standard world population. Trends were modeled using joinpoint regression model and linear regression. The Social Exclusion Index and the Human Development Index were used to classify the 27 Brazilian states. Pearson's correlation was used to describe the association between the Social Exclusion Index and the Human DeveIopment and the variations in mortality rates in each state., Results: Age-standardized mortality rates in Brazil were found to be stable (annual percent change [APC] = 0.3; 95% CI: -0.1 - 0.7) between 1994 and 2011. Considering the Brazilian states, significant decreases in mortality rates were found in Rio Grande do Sul, Rio de Janeiro and São Paulo. Increases in mortality rates were most notable in the states of Maranhão (APC = 11.2; 95 %CI: 5.8 - 16.9), Piauí (APC = 9.8; 95% CI: 7.6 - 12.1) and Paraíba (APC = 9.3; 95% CI: 6.0 - 12.8). There was a statistically significant correlation between Social Exclusion Index and a change in female breast cancer mortality rates in the Brazilian states between 1990 and 2011 and between Human Development Index and mortality between 2001 and 2011., Conclusions: Female breast cancer mortality rates are stable in Brazil. Reductions in these rates were found in the more developed states, possibly reflecting better healthcare.

This study was carried out with the aim of evaluating the effects of mineral oil application on eggshells and the use of plastic packages with lids on the physical-chemical and microbiological quality and biogenic amine contents of eggs stored under refrigeration for up to 125 d. A total of 1,920 eggs from 46-wk-old Hyline W36 laying hens were randomly distributed into 4 groups soon after classification: (i) 480 eggs were stored in pulp carton tray packages; (ii) 480 eggs were stored in plastic packages with lids; (iii) 480 eggs were stored in carton packages after the application of mineral oil; and (iv) 480 eggs were stored in plastic packages with lids after the application of mineral oil. The internal quality was measured by Haugh units, by the counts of mesophilic and psychrotrophic microorganisms, by the most probable number of total and thermal-tolerant coliforms, by the counts of molds and yeasts, by the analysis of Salmonella spp. and Staphylococcus spp., and by the levels of biogenic amines in the egg yolk and albumen. The application of mineral oil to the eggshell resulted in higher Haugh unit values throughout storage, and the use of plastic packages altered the internal quality. The application of mineral oil and the use of packaging had no effects on the microbiological and biogenic amine results. Microbiological analyses showed the absence of Salmonella spp., Staphylococcus aureus, thermal-tolerant coliforms, and fungi. However, the highest counts of mesophilic (1.1 × 10(7) cfu/g) and psychrotrophic (6.7 × 10(7) cfu/g) microorganisms were recorded. The highest values of biogenic amines detected and quantified were putrescine (2.38 mg/kg) and cadaverine (7.27 mg/kg) in the egg yolk and putrescine (1.95 mg/kg), cadaverine (2.83 mg/kg), and phenylethylamine (2.57 mg/kg) in the albumen. Despite these results, the biogenic amine levels recorded were considered low and would not be harmful to consumer health., (©2014 Poultry Science Association Inc.)

Apobaetis Day, 1955 species are known for their small size and preference for sandy stream substrate. Species which possess such habitat preference commonly possess long and slender legs and claws, but, in Apobaetis, the length of the tarsal claw rarely is so long that it exceeds the length of tarsus, occurring only in two species: A. lakota McCafferty, 2000 from USA and A. hamadae Cruz, Boldrini & Salles, 2011 from Brazil. In the present study, two new species with tarsal claws that exceed the length of the tarsi are described: Apobaetis pucupi sp. nov. from southeast Brazil and Apobaetis kethepiali sp. nov. from northernmost Brazil. Additionally, a new key for nymphs of Apobaetis is proposed.

This study follows the left ventricular (LV) hypertrophy in rats undergoing aerobic training alone (A), resistance training alone (R), or combined resistance and aerobic training (RA) (usually referred as concurrent training) program. A sedentary control group (C) was included. LV remodeling was evaluated using electron and light microscopy. The LV weight to body weight (LVW: BW) increased 11.4% in A group, 35% in the R group, and 18% in the RA group compared to the C group. The LV thickness increased 6% in the A group, 17% in the R group, and 10% in the RA group. The LV internal diameter increased 19% in the A group, 3% in the R group, and 8% in the RA group compared with the C group. The cross-sectional area of cardiomyocyte increased by 1% with the A group, 27% with R group, and 12% with RA training. The capillary density increased by 5.4% with A training, 11.0% with R training, and 7.7% with RA training compared with the C group. The volume fraction of interstitial collagen increased by 0.4% with training A, increased by 2.8% with R training, and 0.9% with RA training. In conclusion, except for the LV internal diameter, which increased more in the A group, the cardiac parameters increased more in the R group than in the other groups and in RA group than in A group. Collagen density increased from 5.4 ± 0.8% in the C group to 5.8 ± 0.6% in the A group (n. s.) (P > 0.05), to 8.2 ± 0.7% in the R group (P < 0.05), and to 6.3 ± 0.4% in the RA group (P < 0.05). These results demonstrate a significant increase for collagen content in the LV with R and RA exercise, but the increase was higher with R training alone than with RA training., (© 2014 Wiley Periodicals, Inc.)

Introduction:  Benign idiopathic tonsillar hypertrophy (HBI) may affect a child's quality of life and sleep. Several studies have sought to relate the clinical features of HBI with the infectious and/or immunologic changes that occur., Objective:  To increase the knowledge of the etiology of HBI., Data Synthesis:  From 2012 to 2013 we conducted a retrospective observational study of 101 children with HBI who underwent tonsillectomies at Ambulatory ENT General Hospital of the East Zone of São Paulo City, a region with a poor socioeconomic population. Preoperative serologic results were available to confirm mononucleosis, cytomegalovirus, anti-streptolysin O (ASLO) and immunoglobulins. The mean patient age was 5.8 years (55% male, 45% female). Using the Mann-Whitney U test, we identified significant gender differences in the parameters of immunoglobulins (Ig) M (IgM), IgA, and IgE. Forty-seven percent of the patients had increased ASLO levels, and 37% had increased IgE levels., Conclusion:  An evaluation of a patient's serologic parameters and laboratory results may be relevant to the etiology and prevention of HBI. Based on the results obtained from the study sample, the identification of etiologic agents and causative factors remain a public health challenge that affects the quality of life of children.

Despite its wide, almost worldwide distribution, the mayfly genus Cloeon Leach, 1815 (Ephemeroptera: Baetidae) is restricted in the Western hemisphere to North America, where a single species is reported. In the Neotropics, except for some species wrongly attributed to the genus in the past, there are no records of Cloeon. Recently, however, specimens of true Cloeon were collected along the coast of Espírito Santo, Southeastern Brazil. In order to verify the hypothesis that this species was recently introduced to Brazil, our aim was to identify the species based on morphological and molecular characters and to confirm the presence of true representatives of the genus in the Neotropics. Our results revealed that the specimens found in Brazil belong to the Afrotropical species C. smaeleni Lestage, 1924. The identity of the species, its distribution, along with its previous absence in regularly sampled sites, is a clear sign that the specimens of C. smaeleni found in Espírito Santo are introduced, well established, and that the colonization took place very recently.

Objectives: To evaluate trends in breast cancer mortality in urban centers and rural areas of Brazil., Methods: Ecological time-series study using data on breast cancer deaths and census. Mortality trends were analyzed using change-point regression: 1980-2010., Results: A declining trend was found in five urban centers: São Paulo (APC = -1.7%), Porto Alegre (APC = -1.6%), Belo Horizonte (APC = -1.2%), Rio de Janeiro and Recife (APC = -0.9%). An increasing was found in: Porto Velho (APC = 9.0%), Teresina (APC = 4.6%), João Pessoa (APC = 1.6%), Belém (APC = 0.8%) and Fortaleza (APC = 0.5%). In the majority of rural areas, mortality continues to rise, with the exception of some areas in the southern., Conclusion: Disparities in breast cancer mortality were found across the country, with increasing trends occurring predominantly in the north and northeastern regions. One of the reasons for this disparity may be that access to treatment is more difficult for patients living in rural areas and in the north of Brazil., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The objective of this study was to evaluate the correlation between the levels of bioactive amines and the microbiological quality of liquid pasteurized egg stored under refrigeration. Pasteurized whole egg liquid was obtained from 2 types of different raw materials, fresh eggs, and commercial fertile eggs. They were stored under refrigeration over a period of 21 d. The treatments were arranged in a completely randomized split plot, with the plots being the 2 types of liquid pasteurized egg, and the subplots being the 4 storage periods (1, 7, 14, and 21 d). The storage period did not contribute to the increase (P > 0.05) of contamination by mesophilic aerobic microorganisms and total coliforms in commercial liquid pasteurized egg. However, for fertile eggs, the storage period led to an increase (P < 0.05) in the numbers of microorganisms. Levels of the amines putrescine, cadaverine, and tyramine were detected only in fertile liquid pasteurized egg, and the storage period contributed to the increase (P < 0.05) in the levels of these amines. There was a high correlation between total coliform most probable number and cadaverine levels, and a moderate correlation between the numbers of aerobic mesophilic microorganisms and tyramine levels. It was concluded that the most contaminated liquid pasteurized eggs were the fertile liquid pasteurized eggs and this caused the highest levels of bioactive amines in them compared with all the eggs that had been subjected to pasteurization and refrigerated storage.

Background: The obesity has achieved an alarming increase in recent years, which led this disease to global epidemic condition., Aim: To evaluate the nutritional status as well as the quality of life of obese patients undergoing bariatric surgery., Methods: A transversal study was conducted with obese adults of both genders who underwent bariatric surgery by Fobi-Capella technique for at least 30 days. It was evaluated: age, gender, marital status, occupation, weight before surgery, current weight, height, preoperative and current BMI, weight loss and loss of excess weight percentages, presence of clinical manifestations and food intolerances., Results: The sample consisted of 70 patients, being 81.4% female, 37.1% aged 30 to 39 years, 58.6% were married, 41.4% have undergone the bariatric surgery in the last 12 months. It was observed a reduction in BMI from 37.2 kg/m2 (one to three months) to 28.9 kg/m2 (>12 months) and consequent increase in weight loss and loss of excess weight percentages. The most frequent clinical manifestation was alopecia (62.9%). The most reported food intolerance was on the red meat (24%). According to the Baros questionnaire, 50% of patients were classified as having good quality of life., Conclusion: The operation of Fobi-Capella proved to be effective in promoting gradual and lasting weight loss. Quality of life was considered good in most patients, indicating that the operation had a positive impact on their lives.

Sheep of the Pantaneiro breed and seven other breeds, raised in the State of Mato Grosso do Sul, Brazil, were genotyped using eight microsatellite loci. The aim of the present study was to determine the genetic variability, phylogenetic relationship, and patterns of gene introgression and miscegenation among the animals surveyed, to obtain information about the genetic structure of locally adapted sheep in Mato Grosso do Sul. A total of 195 animals were used for genetic analysis. The Pantaneiro breed had the largest average number of alleles/locus (9.25), and higher allelic richness (6.95), while the Dorper population had the lowest values for these parameters (4.88 and 3.86, respectively). Analysis of genetic distance values and genetic structure between populations made it possible to characterize these animals with regard to distinct genetic groups. Average expected heterozygosity ranged from 0.72 (Pantaneiro) to 0.55 (Dorper), while average observed heterozygosity ranged from 0.63 (White Dorper) to 0.54 (Dorper). On the basis of the statistical parameters evaluated, it was possible to demonstrate that when compared to other populations, the Pantaneiro breed represented a reservoir of genetic diversity with rare and useful alleles for genetic improvement, emphasizing the importance of preserving the breed.

This documentary, qualitative, descriptive study has the objective to analyze images and representations of the female body and their relation to drug use in the content of articles published in four magazines with national circulation (Veja, Isto E, Boa Forma, Claúdia). The articles selected were submitted to the technique of content analysis, with three thematic groups identified: the body as an incentive to use drugs; risks to the body resulting from drug use; and the search for the perfect body through drug use. The data showed that the media reproduces rigid aesthetic standards, exposing women to social and health offenses that stimulate drug use, either autonomously or by prescription. The search for beauty and the appeal to feminine eroticism, published through the communication channels analyzed limit the social importance of women by using images that link them to the status of sexual object.

Studies have determined the effects of joint immobilization on the articular cartilage of sedentary animals, but we are not aware of any studies reporting the effects of joint immobilization in previously trained animals. The objective of the present study was to determine whether exercise could prevent degeneration of the articular cartilage that accompanies joint immobilization. We used light microscopy to study the thickness, cell density, nuclear size, and collagen density of articular cartilage of the femoral condyle of Wistar rats subjected to aerobic physical activity on an adapted treadmill five times per week. Four groups of Wistar rats were used: a control group (C), an immobilized group (I), an exercised group (E), and an exercised and then immobilized group (EI). The right knee joints from rats in groups I and EI were immobilized at 90 °C of flexion using a plastic cast for 8 weeks. Cartilage thickness decreased significantly in group I (mean, 120.14 ± 15.6 μm, P < 0.05), but not in group EI (mean, 174 ± 2.25), and increased significantly in group E (mean, 289.49 ± 9.15) compared with group C (mean, 239.20 ± 6.25). The same results were obtained for cell density, nuclear size, and collagen density (in all cases, P < 0.05). We concluded that exercise can prevent degenerative changes in femoral articular cartilage caused by immobilization of the knee joint., (© 2013 Anatomical Society.)

The physicochemical and microbiological qualities of commercial eggs produced by layer hens of different ages (approximately 30 and 60 wk old) were submitted to storage under room temperature or refrigeration for 28 d. A total of 600 eggs were subjected to microbiological analyses of their inner contents and another 600 to a determination of Haugh units (HU) and bioactive amine content. A decrease in the quality of the inner contents of the eggs was observed during the experiment, mainly in the eggs from the 60-wk-old layers, which presented the worst HU values when stored at room temperature (P < 0.05). Microbiological analyses showed an absence of Salmonella spp., Staphylococcus aureus, and coliforms, either total or thermal-tolerant; however, low counts of other Staphylococcus species, Enterobacter spp., Pseudomonas spp., mesophilic aerobic bacteria, and fungi were also recorded. The chromatographic analysis of bioactive amines detected the presence of phenylethylamine in all albumens (38.0 mg/kg) and spermidine in the yolks (1.02 mg/kg). It was concluded that the age of the hens and the time and temperature of storage influenced the quality parameters of the eggs (P < 0.05). Furthermore, despite the low levels of microbial contamination found, phenylethylamine was detected in the albumen. It was not possible to establish index of quality of eggs using bioactive amines present in the yolk and albumen of eggs.

The aerial parts of Lychnophora trichocarpha Spreng. (Asteraceae) are used macerated in water or ethanol to treat inflammation, pain, rheumatism, contusions, bruises and insect bites in Brazilian traditional medicine. In this study, anti-inflammatory activity of ethanol extract from aerial parts of L. trichocarpha and its ethyl acetate fraction was investigated. Sesquiterpene lactones, lychnopholide (Lyc) and eremantholide C (EreC), isolated of ethyl acetate fraction, were also assayed for in vitro and in vivo anti-inflammatory activity. Topical treatment with ointments containing ethanol extract, its ethyl acetate fraction and sesquiterpene lactones significantly reduced carrageenan-induced mice paw oedema. In vitro assays demonstrated that Lyc inhibited interferon -γ/lipopolysaccharide -stimulated nitric oxide (NO) production in J774A.1 macrophages and increased production of IL-10 anti-inflammatory cytokine. The reduction of tumor necrosis factor-α (TNF-α) production by EreC was accompanied by an increased production of IL-10 in a concentration-dependent manner in J774A.1 macrophages. The anti-inflammatory effect of Lyc seems to involve the inhibition of production of NO and increased production of IL-10. The mechanism of the effect of EreC on the reduction of carrageenan-induced paw oedema may be attributed to inhibition of production of TNF-α and stimulation of IL-10 production. The results corroborate the use of ethanol extract from Lychnophora trichocarpha in folk medicine for anti-inflammatory action and indicate that the topical route is suitable for use., (Copyright © 2012 John Wiley & Sons, Ltd.)

The increased use of orofacial fillers in cosmetic procedures has led to new diagnostic challenges for dentists and oral pathologists. Here, we describe a case with multiple oral foreign body granulomas, which were formed after a polymethylmetacrylate injection for cosmetic purposes., (Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Ethnopharmacological Relevance: The ethanolic extract of Lychnophora trichocarpha Spreng. is used in Brazilian folk medicine to treat bruise, pain and inflammatory diseases., Aim of the Study: The present study aimed at investigating whether ethanolic extract of L. trichocarpha, its ethyl acetate fraction and its main bioactive compounds could be useful to treat gouty arthritis by countering hyperuricemia and inflammation., Materials and Methods: L. trichocarpha ethanolic extract (LTE), ethyl acetate fraction from ethanolic extract (LTA) and isolated compounds were evaluated for urate-lowering activity and liver xanthine oxidase (XOD) inhibition in oxonate-induced hyperuricemic mice. Anti-inflammatory activity in monosodium urate crystal-induced paw oedema, an experimental model of gouty arthritis, was also investigated., Results: Crude ethanolic extract and its ethyl acetate fraction showed significant urate-lowering effects. LTE was also able to significantly inhibit liver xantine oxidase (XOD) activity in vivo at the dose of 250mg/kg. Luteolin, apigenin, lupeol, lychnopholide and eremantholide C showed the anti-hyperuricemic activities among tested compounds. Apigenin also showed XOD inhibitory activity in vivo. Luteolin, lychnopholide, lupeol and eremantholide C, in turn, did not shown significant inhibitory activity towards this enzyme, indicating that this mechanism is not likely to be involved in urate-lowering effects of those compounds. LTE, LTA, lupeol, β-sitosterol, lychnopholide, eremantholide, luteolin and apigenin were also found to inhibit monosodium urate crystals-induced paw oedema in mice., Conclusions: Ethanolic extract of Lychnophora trichocarpha and some of its bioactive compounds may be promising agents for the treatment of gouty arthritis since they possesses both anti-hiperuricemic and anti-inflammatory properties., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To assess whether depression symptoms, poor sleep and dry skin bother explain association between pruritus and the burden of kidney disease in maintenance hemodialysis (MHD) patients., Methods: Cross-sectional study of 980 patients from a prospective study in dialysis units of Salvador, Brazil (PROHEMO). The Kidney Disease Quality of Life Short Form was used to determine scores of kidney disease burden (KDB) and sleep with higher scores indicating lower perceived burden and better sleep quality, respectively. The Center for Epidemiological Studies Depression Scale was used for depression symptoms., Results: Prevalence of severe pruritus (very much or extreme) was 19.4%. Significantly (P < 0.001) lower mean KDB score by 11.44 points was observed for patients with severe pruritus (34.18 ± 27.51) than for those with no pruritus (45.62 ± 30.73). Severe pruritus was associated with poorer sleep quality, higher odds of dry skin bother and higher depression symptoms score. Association of pruritus with KDB score was virtually eliminated after adjustment for sleep, dry skin bother and depression symptoms., Conclusions: This study shows strong associations of severe pruritus with higher depression symptoms, poorer sleep and dry skin bother among MHD patients. The results support special attention to MHD patients with pruritus who often face high psychological burden.

Extenders with a defined composition containing only components with clearly protective effects on sperm during storage would be an advantage. The aims of the present work were to assess whether caseinate, improves cooled and frozen equine semen quality. Semen from six stallions were suspended with four different cooling extenders C1) Kenney extender; C2) 0.6 % caseinate; C3) 2.7 % caseinate ; and C4) C1 + 2.1 % caseinate, and frozen extenders: F1) INRA 82 extender; F2) 1.35 % caseinate; and F3) 2.7 % caseinate. Although there was no significant difference between the motility rate among the cooled (C1:45.0, C2:36.7, C3:38.3 and C4:48.3) and frozen extenders (F1:16.9, F2:21.1 and F3:18.6), significant higher values of sperm velocity variables were observed with the 1.35 % caseinate extender compared to the control (VSL: 40.8 x 18.9 and VAP: 46.8 x 25.0 µm/s), respectively. Caseinate seemed to be responsible for sperm protection during preservation and showed to be as efficient as milk.

The concentrations of metals in tissues of Callinectes danae were evaluated, aiming to determine the bioaccumulation process of this species. Gills presented the highest mean concentrations for most metals, except for Hg (

Context: Non-alcoholic fatty liver disease (NAFLD), hepatic manifestation of metabolic syndrome, has been considered the most common liver disease nowadays, which is also the most frequent cause of elevated transaminases and cryptogenic cirrhosis. The greatest input of fatty acids into the liver and consequent increased beta-oxidation contribute to the formation of free radicals, release of inflammatory cytokines and varying degrees of hepatocytic aggression, whose histological expression may vary from steatosis (HS) to non-alcoholic steatohepatitis (NASH). The differentiation of these forms is required by the potential risk of progression to cirrhosis and development of hepatocellular carcinoma., Objective: To review the literature about the major risk factors for NAFLD in the context of metabolic syndrome, focusing on underlying mechanisms and prevention., Method: PubMed, MEDLINE and SciELO data basis analysis was performed to identify studies describing the link between risk factors for metabolic syndrome and NAFLD. A combination of descriptors was used, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, metabolic syndrome and risk factors. At the end, 96 clinical and experimental studies, cohorts, meta-analysis and systematic reviews of great impact and scientific relevance to the topic, were selected., Results: The final analysis of all these data, pointed out the central obesity, type 2 diabetes, dyslipidemia and hypertension as the best risk factors related to NAFLD. However, other factors were highlighted, such as gender differences, ethnicity, genetic factors and the role of innate immunity system. How these additional factors may be involved in the installation, progression and disease prognosis is discussed., Conclusion: Risk factors for NAFLD in the context of metabolic syndrome expands the prospects to 1) recognize patients with metabolic syndrome at high risk for NAFLD, 2) elucidate pathways common to other co-morbidities, 3) determine risk factors associated with a worse prognosis, 4) develop therapeutic strategies with goal of reducing risk factors, 5) apply acquired knowledge in public health policies focusing on preventive strategies.

Studies on the collagen system of the human myocardium are still limited compared to those on small laboratory animals. The aim of this work was to observe the collagen tissue of the myocardium of the human heart as a function of age. The types of collagen, as well as the density of collagen tissue and the diameter of collagen fibrils, were examined. Fragments of the left ventricular wall from 15 hearts, 5 from children, 5 from young adults, and 5 from elderly individuals, were analyzed by using the Picrosirius-polarization method and by transmission electron microscopy (TEM). The results showed the presence of collagen type III and collagen type I, both in the endomysium and perimysium of the 3 groups studied. Measurements of collagen content in myocardial tissue displayed that both endomysial and perimysial collagen increase in number and thickness in the adult and elderly. These histochemical results coincided with the observations obtained with the electron microscope in showing an increase in the number of collagen fibrils with a large diameter in the adult and elderly hearts. The present results on cardiac collagen may be important for assessing the pathogenesis of several cardiopathies in the hearts of children, young adults, and the elderly.

Purpose: To translate and adapt the ABEL--Auditory Behavior in Everyday Life--questionnaire into Brazilian Portuguese, and to establish the profile of auditory behavior in a group of children who use hearing aids., Methods: The ABEL questionnaire was translated and back translated. This version was compared to the original version regarding semantic equivalence, generating a new version in Portuguese. After that, 31 parents of children fitted with hearing aids answered an anamnesis and the Portuguese version of the ABEL questionnaire. The scores obtained were related to the variables investigated in the anamnesis., Results: Differences were found in the analysis of the aural-oral score for the variables degree of hearing loss and time of daily use of the hearing aid: children with milder degrees of hearing loss and/or children who use the hearing aid for longer periods showed better performances. There were also differences in total and auditory awareness scores for the variable time of daily use of the hearing aid, indicating that children who user their hearing aids for longer periods daily showed better performances., Conclusion: There was consistency between the versions generated during the translation of the questionnaire, allowing the formulation of its final version in Portuguese. Children with lower degrees of hearing loss and/or who use their hearing aids for longer periods have their daily activities less affected by the hearing loss. The ABEL questionnaire is an appropriate instrument to detail the development of auditory behaviors in children who use hearing aids.

Barbosa, LF, de Souza, MR, Corrêa Caritá, RA, Caputo, F, Denadai, BS, and Greco, CC. Maximal lactate steady-state independent of recovery period during intermittent protocol. J Strength Cond Res 25(12): 3385-3390, 2011-The purpose of this study was to analyze the effect of the measurement time for blood lactate concentration ([La]) determination on [La] (maximal lactate steady state [MLSS]) and workload (MLSS during intermittent protocols [MLSSwi]) at maximal lactate steady state determined using intermittent protocols. Nineteen trained male cyclists were divided into 2 groups, for the determination of MLSSwi using passive (VO(2)max = 58.1 ± 3.5 ml·kg·min; N = 9) or active recovery (VO(2)max = 60.3 ± 9.0 ml·kg·min; N = 10). They performed the following tests, in different days, on a cycle ergometer: (a) Incremental test until exhaustion to determine (VO(2)max and (b) 30-minute intermittent constant-workload tests (7 × 4 and 1 × 2 minutes, with 2-minute recovery) to determine MLSSwi and MLSS. Each group performed the intermittent tests with passive or active recovery. The MLSSwi was defined as the highest workload at which [La] increased by no more than 1 mmol·L between minutes 10 and 30 (T1) or minutes 14 and 44 (T2) of the protocol. The MLSS (Passive-T1: 5.89 ± 1.41 vs. T2: 5.61 ± 1.78 mmol·L) and MLSSwi (Passive-T1: 294.5 ± 31.8 vs. T2: 294.7 ± 32.2 W; Active-T1: 304.6 ± 23.0 vs. T2: 300.5 ± 23.9 W) were similar for both criteria. However, MLSS was lower in T2 (4.91 ± 1.91 mmol·L) when compared with in T1 (5.62 ± 1.83 mmol·L) using active recovery. We can conclude that the MLSSwi (passive and active conditions) was unchanged whether recovery periods were considered (T1) or not (T2) for the interpretation of [La] kinetics. In contrast, MLSS was lowered when considering the active recovery periods (T2). Thus, shorter intermittent protocols (i.e., T1) to determine MLSSwi may optimize time of the aerobic capacity evaluation of well-trained cyclists.

Objectives: The purpose of this study was to evaluate the effect of Chamomilla recutita on the healing of ulcers in rats., Study Design: A 5-mm wound was inflicted on the tongue of 36 rats. Treatment group animals were treated topically with 0.04 mL/day of chamomile ointment, whereas control group animals were not treated. Animals were sacrificed after 3, 7 or 10 days. Semi-quantitative analysis of the degree of inflammation, fibroblast count and wound size was performed, as well as histometric analysis of re-epithelialization and percentage of collagen fibers of the lesion., Results: Animals treated with chamomile showed the best results regarding epithelialization and percentage of collagen fibers after 10 days. As expected, time had a statistically significant effect (p < 0.05) on fibroblast count, epithelialization, inflammation and wound size; animals sacrificed at 3 days showed the worst results., Conclusions: Chamomile stimulated re-epithelialization and the formation of collagen fibers after 10 days of treatment; it did not, however, influence inflammation or fibroblast count.

We report an unusual case of verruciform xanthoma in a patient with neurofibromatosis and some clinical features of oral lichen planus., (Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The effects of different dietary lipids on the fatty acid profiles of eggs produced by 20- and 54-wk-old Dekalb laying hens were investigated. The 4 treatments were based on the lipid source added to the diet: soybean oil, sunflower oil, linseed oil, or control (no added oil). The experimental design was a simple random-sample design using a 4 × 2 factorial arrangement (4 treatments and 2 ages). The fatty acid composition of the yolks of eggs produced by the laying hens was analyzed. The fatty acid profiles found in the egg yolks were the same as those provided in each diet. Eggs laid by hens fed the diet containing soybean oil had a large amount of n-6 polyunsaturated fatty acids (PUFA), whereas eggs laid by hens fed the diet containing linseed oil had the highest percentage of n-3 PUFA. A decrease in PUFA deposition in egg yolks was observed as the laying hens got older. Eggs of hens fed the diet containing linseed oil presented an n-6:n-3 ratio of 2.01 in younger chickens and 2.17 in older ones. The trans fat percentages found in the egg yolks of all treatments were very low. It was concluded that the quantity of fatty acids present in the egg yolk may be altered according to the source of lipids in the diets; the addition of linseed oil to the ration of laying hens resulted in the production of n-3-enriched eggs and excellent n-6:n-3 ratios, and the egg yolks had insignificant amounts of trans fat, irrespective of the different lipid sources added to the diets or the age of the chickens.

The population ageing is a challenge for health professionals. This study seek to evaluate the functional capacity and to identify the factors associated to the dependence for the activities of daily life (ADL) and activities instrumental of daily life (AIDL), and also to describe the socioeconomic, demographic and health profile of the elderly. A transverse study was carried out with seniors assisted by Family Health teams of the District East Sanitary of Goiania (GO). A questionnaire was applied to obtain socioeconomic and demographic date, factors related to the health and scales of the functional evaluation. For analyses it was used Square-Qui Test considering the level of significance of 5%. The sample was composed by 388 elderly, 57.5% with age varying from 60 to 69 years, 58.5% female, 39.7% illiterate, 77.3% with income ≤ 2 minimum wages and 70.9% bearers of chronic diseases. It was verified that 34.8% needed help in one or more ADL and 60.6% in AIDL. The factors more frequently associated at dependence in both activities were: balance and mobility debilitated, depression, cognitive deficit and age ≥ 80 years. These results denote that the elderly are living aging characterized by comorbidities and dependence to accomplish daily activities.

Thirty-eight strains of Shiga toxin-producing Escherichia coli (STEC) were characterised in terms of biochemical properties, enterohaemolysin production and plasmid carriage. A wide variation in the biochemical properties was observed among the STEC, with 14 distinct biotypes identified. Biotype 1 was the most common, found in 29% of the strains. Enterohaemolysin production was detected in 29% of the strains. Most of the bacterial strains (95%) carried one or more plasmids and considerable heterogeneity in size and combinations was observed. Seven distinct plasmid profiles were identified. The most common profile, characterised by the presence of a single plasmid of ~90 kb, was found in 50% of these strains. These data indicate extensive diversity among STEC strains. No correlation was found among biotype, serotype, enterohaemolysin production and plasmid profile.

The objective of this study was to investigate the possibility of using bioactive amines as an index of quality of fresh and stored eggs. Large white eggs from 24-wk-old Dekalb layers were randomly distributed in 3 groups: (i) 10 freshly laid eggs, (ii) 60 eggs stored at 25 +/- 1 degrees C and 60% RH for 30 d, and (iii) 50 eggs stored at 6 +/- 1 degrees C and 60% RH for 50 d. The eggs were weighed and the internal quality was evaluated by Haugh units (HU), pH of albumen, total solids, total volatile bases, and bioactive amines in the albumen and yolk. The fresh eggs had, on average, 56.85 g, 98.55 HU, albumen pH of 8.02, total solids of 12.17 g/100 g in the albumen and 52.43 g/100 g in the yolk, and absence of volatile bases. None of the 10 amines investigated were detected in the albumen; however, the yolk contained 0.37 mg/kg of spermidine. Throughout storage, there was a significant decrease in the weight of the egg and HU and a significant increase in the pH and in the total solids of the albumen. The decrease in HU and the increase in the total solids of the albumen were faster at 25 +/- 1 degrees C compared with 6 +/- 1 degrees C. At 50 and 30 d of storage at 6 +/- 1 and 25 +/- 1 degrees C, respectively, significant levels of total volatile bases were detected. The levels of spermidine in the yolk increased significantly at the 40th and 15th days of storage at 6 +/- 1 and 25 +/- 1 degrees C, respectively. At these storage times, the presence of putrescine and agmatine was also detected. Therefore, the presence of other amines besides spermidine or spermidine levels higher than 1.0 mg/kg in the yolk could be used as an index of quality of fresh eggs and throughout storage.

Aim: To evaluate the associations between maternal psychological status and intended breastfeeding duration., Methods: A total of 852 pregnant women who attended antenatal care between September 1997 and August 2000 in 12 health units and five hospitals in Jundiaí city, Brazil, were included in the study. Psychological measures (stress and distress) were obtained at a gestational age from 30 to 36 weeks, using standardized scales, questionnaires and inventories. Psychological factors specifically related to breastfeeding assessed their worries, concerns, and support when breastfeeding. Multiple linear regression analysis identified the associations between the outcome "intended duration of breastfeeding" and psychological status of the mothers, controlling for toxic exposure, socioeconomic, demographic, obstetric and nutritional factors., Results: There were negative associations between the outcome and distress, "concerned about body's changes", and work outside home, and a positive association between the outcome and marital status (p < or = 0.03)., Conclusion: Early identification of distress in pregnant women and a more attentive encouragement to breastfeed is probably one of the steps to improve intended breastfeeding duration.

In the present study, lactic acid bacteria (LAB) from the cecum of chickens bred either under intensive (commercial broilers) or extensive (free-range) conditions were isolated, identified and some of their probiotic characteristics determined. The LAB identified by 16S-23S rRNA PCR-ARDRA were mainly of Lactobacillus species and to a lesser extent of Enterococcus spp. for all animals. Free-range chickens showed a higher presence of Lactobacillus acidophilus while Lactobacillus reuteri and Lactobacillus johnsonii were more frequently recovered from commercial broilers. Lactobacillus crispatus was found only in commercial broilers, Lactobacillus vaginalis and Lactobacillus agilis only in free-range chickens and Lactobacillus salivarius in both types. Enterococcus isolates from ceca of commercial broilers showed a higher resistance to antimicrobial drugs. Lactobacillus isolates from free-range chickens presented a higher frequency of in vitro antagonistic activity against selected pathogens than from commercial broilers. All LAB isolates had predominantly non-hydrophobic surfaces, but with variations depending on age of the chickens and breeding conditions. Animal breeding caused variation on composition, antimicrobial susceptibility, antagonistic activity and surface hydrophobicity of LAB from chicken cecum. LAB isolates from ceca of free-range chickens have potential as probiotic agents, which may be used in the future as replacing the use of antimicrobials as growth promoters.

Background: The use of lactic acid bacteria as vehicles to delivery antigens to immunize animals is a promising issue. When genetically modified, these bacteria can induce a specific local and systemic immune response against selected pathogens. Gastric acid and bile salts tolerance, production of antagonistic substances against pathogenic microorganisms, and adhesive ability to gut epithelium are other important characteristics that make these bacteria useful for oral immunization., Results: Bacteria isolated on de Man, Rogosa and Sharpe medium (MRS) from different gastrointestinal portions of broiler chicks were evaluated for their resistance to artificial gastric acid and bile salts, production of hydrogen peroxide, and cell surface hydrophobicity. Thirty-eight isolates were first typed at species level by PCR amplification of 16S-23S rRNA intergenic spacers using universal primers that anneal within 16S and 23S genes, followed by restriction digestion analyses of PCR amplicons (PCR-ARDRA). An expression cassette was assembled onto the pCR2.1-Topo vector by cloning the promoter, leader peptide, cell wall anchor and terminator sequences derived from the laminin binding S-layer protein gene of L. crispatus strain F5.7 (lbs gene). A sequence encoding the green fluorescent protein (GFP) was inserted as reporter gene, and an erythromycin resistance gene was added as selective marker. All constructs were able to express GFP in the cloning host E. coli XL1-Blue and different Lactobacillus strains as verified by FACS and laser scanning confocal microscopy., Conclusion: Lactobacillus isolated from gastrointestinal tract of broiler chickens and selected for probiotic characteristics can be genetically modified by introducing an expression cassette into the lbs locus. The transformed bacteria expressed on its cell wall surface different fluorescent proteins used as reporters of promoter function. It is possible then that similar bacterial model expressing pathogen antigens can be used as live oral vaccines to immunize broilers against infectious diseases.

Many people in the world are affected by hyperlipidemia, which is a known risk factor for atherosclerotic disease. On the other hand, periodontitis, a prevalent oral disease, has been connected to several systemic health changes, including an altered lipid metabolism. Transient and recurrent bacteremias, which may be caused by periodontal infection, induce an intense local and systemic inflammatory response, leading to changes in the whole body. The aim of the present study was to verify the relationship between severe and moderate periodontal disease and blood lipid levels. Sixty individuals seen at the clinics of the University of Taubaté, São Paulo, over 20 years old, were divided into two groups, with and without periodontitis, and paired according to sex and age. Their levels of total cholesterol, tryglicerides and fractions were determined. Variables related to high cholesterol levels, including age, sex and body mass index, were evaluated. The values recommended by the Brazilian Society of Cardiology were considered to classify lipidemia. The results showed that mean levels of cholesterol (192.1 mg/dl +/- 40.9) and triglycerides (153.5 mg/dl +/- 105.6) in individuals with periodontitis were higher than, but not statistically different from, those of individuals without periodontitis (186.1 mg/dl +/- 35.4 and 117.5 mg/dl +/- 68, respectively). Therefore, this study has demonstrated that there is no significant relationship between periodontal disease, regardless of its intensity, and blood lipid levels in the studied population.

Patients undergoing liver transplantation (LT) often experience dietary restrictions that may influence their nutritional status. With the objective of comparing the status of liver transplant patients pre- versus in the early and late postoperative periods, a retrospective study evaluated 33 adults (63.6% men and 36.4% women) mean age 47 years for body mass index (BMI), current body weight/ideal body weight (%CBW/IBW), current body weight/usual body weight (%CBW/UBW), adequacy of tricipital skin fold (%TSF), generalized adipose reserve (%F), adequacy of mid-upper arm muscle circumference (%MMC), and serum albumin. The elapsed time between nutritional evaluation and LT was 446 days for the pre-LT group, 31 for the early post-LT group, and 244 for the late post-LT group; 30.3% were Child C and 63.6% B in the pre-LT phase. The median value to %TST in pre-LT, early LT, and late LT were 91.7%, 70.8%, and 78.0%, respectively. The analysis of mean value of %F was 25.9% in the pretransplant, 23.3% in early postoperative, and 25.3% in late postoperative stages %MMC was 85.5% for pretransplant patients, it was 86.6% in the early versus 89.9% in the late stages. While BMI was 24.9 kg/m(2) in the preoperative 22.9 kg/m(2) in early, and 24.2 kg/m(2) in late phases. Similarly, concerning %CBW/UBW the mean values were 96.2% in the preoperative group, 64.1% in early, and 101.9% in late groups. The %CBW/IBW mean values were 113.9% in the pre- versus 104.6% in the early and 111.2% in the late periods. The values of serum albumin and %CBW/UBW were statistically different for Child B,C as well as when the patients were not classified by the Child criteria. There was a deterioration in status from pretransplant period to early postoperative with improvement in the late period.

This study compared the nutritional and psychological status of 855 pregnant adolescents and non-adolescents and assessed their relationships at three interviews (gestational age < or = 16 weeks, 20-26 weeks, and 30-36 weeks). The instruments used were: anthropometry, state-trait anxiety inventories (STAI), general health questionnaire (GHQ), and perceived stress scale (PSS). More adolescents were thinner, had higher scores of the trait anxiety inventory (TAI), wished to abort their children, and were worried about changes in their bodies than non-adolescents. Multiple linear regression analyses (controlling for toxic exposure, socioeconomic, demographic and obstetric factors) detected negative associations between weight gain in the first interview and distress (GHQ) for both the groups of women and weight gain in the second interview and the variable "worry about body's change" for the non-adolescent group. The negative associations between body mass index and chronic anxiety (TAI) were present in the three interviews for non-adolescents. This study detected a relationship between the nutritional and the psychological status of pregnant women, although there were more associations for non-adolescents.

Undernutrition is a worldwide problem affecting millions of unborn and young children during the most vulnerable stages of brain development. Total restriction of protein during the perinatal period of life can alter the development of the mammalian fetus and have marked repercussions on development of the central nervous system (CNS). The brain is vulnerable to undernutrition with altered morphologic and biochemical maturation, leading to impaired functions. The focus of this study is to investigate [U-14C]glycine metabolism in undernourished rats submitted to pre- and postnatal protein deprivation (diet: 8% protein with and without addition of L-methionine; control group: 25% protein). Although undernutrition produced a reduction in cerebellar weight and alterations in the DNA concentration, the present study shows that glycine metabolism in this structure is partially protected because the undernourished group with L-methionine did not show modifications in glycine metabolism at all ages studied. However, L-methionine deficiency alters glycine metabolism at 7 and 21 days, but in the adult age both undernourished groups presented no differences in oxidation to CO2, conversion to lipids and incorporation into protein from glycine, compared to the control group., (Copyright (c) 2004 S. Karger AG, Basel.)

Preservative efficacy testing is based on a sample inoculation using a microbial suspension with a determined amount of colony-forming units (CFU). After that, the number of survivors is investigated by periodic evaluations, and the results are compared with specifications. When liquid cosmetics are evaluated, it is easy to obtain homogeneity between the inoculum and the sample, but for a powder sample it cannot be guaranteed. In this context, freeze-dried microorganisms could be used to help the homogenization. In this research, the preservative efficacy is evaluated using a powdered eye shadow. The microorganisms used were Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, and Aspergillus niger. The challenge tests were performed in samples with (P) or without (NP) added preservative. The methods used to evaluate the results were the ones described in the official compendia and in the cosmetics guides of international associations, also using linear regression in calculating the D-value. The results showed that it is possible to use freeze-dried microorganisms instead of suspension to evaluate the preservative efficacy of cosmetic solids. The microorganism stability was verified by the determination of the microbial load and the minimum inhibitory concentration after freeze-drying and during the following six months.

During the last three decades, Brazilians have relied almost exclusively on two contraceptive methods, the pill and female sterilization, with sterilization use increasing over time. Until a new law was passed in 1997, sterilization was virtually illegal and not covered by either public or private health insurance. It was, however, frequently provided in public and private hospitals in conjunction with a cesarean section. The new law regulating sterilization provided for reimbursement for interval sterilizations by public health insurance, but placed restrictions on availability intended to reduce the use of cesareans. These restrictions included the prohibition of postpartum sterilizations. This paper focuses on women's sterilization intentions during pregnancy and their experiences postpartum. In a prospective study of 1612 pregnant women carried out in four Brazilian cities, there was substantial demand for postpartum sterilization in both the private and public sectors among women who wanted no more children. However, public patients were much less likely to be sterilized than private patients. Thus, the new law may not have reduced inequities in access or, paradoxically, the incentive for unnecessary cesarean sections.

Background: In severe forms of cirrhosis reduced liver synthesis of thrombopoietin (Tpo) can contribute to thrombocytopenia. In the hepatosplenic form of schistosomiasis, portal hypertension is the most evident clinical complication, although a deficiency of protein synthesis may be detected early. Our aim was to determine, for the first time in schistosomiasis, Tpo serum concentrations in patients with chronic forms of the disease., Method: Twenty-four patients with the pure form of schistosomiasis were studied; 13 had the hepatosplenic form (HE, with portal hypertension) and 11 had the hepatointestinal form (HI, without portal hypertension). Patients were HBsAg, anti-HBc and anti-HCV negative, and reported alcohol ingestion below 160 g/week., Results: The Tpo serum concentration, determined in 10 healthy volunteers, varied from undetectable (< 15 pg/mL) to 489 pg/mL (median 208 pg/mL). The HE and HI groups differed (p = 0.004) in regard to the prothrombin index, thrombocytemia and gamma-glutamyltransferase but not in regard to Tpo (p = 0.622). No significant correlation was found between Tpo and the other parameters (p > 0.05)., Conclusions: The results suggest that Tpo serum concentration does not mirror and/or has no significant participation in the mechanisms responsible for the thrombocytopenia observed in schistosomiasis patients with splenomegaly and portal hypertension.

Background: Liver disorders are the major manifestations of schistosomiasis mansoni. Factors that account for increased concentrations of cholestasis-indicating enzymes in the hepatosplenic form of the disease are unknown., Objective: To assess the correlation between increased gamma-glutamyltransferase serum levels and both the parasitic load and ultrasound alterations in patients with schistosomiasis., Patients and Methods: Twenty-five patients with the chronic form of schistosomiasis were assessed for the presence or absence of increased enzymatic levels, for the parasitic load (low x medium/high) and for ultrasound parameters. Furthermore, analysis of prothrombin time and a platelet count were performed., Results: Of the 25 patients, 13 showed increased gamma-glutamyltransferase plasma levels. No significant correlation was found between increased gamma-glutamyltransferase levels and the parasitic load, or between increased enzyme levels and ultrasound alterations. Nor did the prothrombin index or the platelet count differ between the two groups (normal gamma-glutamyltransferase levels and increased gamma-glutamyltransferase levels)., Conclusion: The parasitic load explains no rise in gamma-glutamyltransferase plasma levels in patients with the chronic form of schistosomiasis, and conventional ultrasound is not a sensitive method to detect the alteration suggested by the increased enzyme level in those patients.

Objective: To assess and compare the preferences of pregnant women in the public and private sector regarding delivery in Brazil., Design: Face to face structured interviews with women who were interviewed early in pregnancy, about one month before the due date, and about one month post partum., Setting: Four cities in Brazil., Participants: 1612 pregnant women: 1093 public patients and 519 private patients., Main Outcome Measures: Rates of delivery by caesarean section in public and private institutions; women's preferences for delivery; timing of decision to perform caesarean section., Results: 1136 women completed all three interviews; 476 women were lost to follow up (376 public patients and 100 private patients). Despite large differences in the rates of caesarean section in the two sectors (222/717 (31%) among public patients and 302/419 (72%) among private patients) there were no significant differences in preferences between the two groups. In both antenatal interviews, 70-80% in both sectors said they would prefer to deliver vaginally. In a large proportion of cases (237/502) caesarean delivery was decided on before admission: 48/207 (23%) in women in the public sector and 189/295 (64%) in women in the private sector., Conclusions: The large difference in the rates of caesarean sections in women in the public and private sectors is due to more unwanted caesarean sections among private patients rather than to a difference in preferences for delivery. High or rising rates of caesarean sections do not necessarily reflect demand for surgical delivery.

Yellow fever (YF) is frequently associated with high severity and death rates in the Amazon region of Brazil. During the rainy seasons of 1998 and 1999, 23 (eight deaths) and 34 (eight deaths) human cases of YF were reported, respectively, in different geographic areas of Pará State; most cases were on Marajó Island. Patients were 1 to 46 years of age. Epidemiologic and ecological studies were conducted in Afuá and Breves on Marajó Island; captured insects yielded isolates of 4 and 11 YF strains, respectively, from Haemagogus janthinomys pooled mosquitoes. The cases on Marajó Island in 1999 resulted from lack of vaccination near the focus of the disease and intense migration, which brought many nonimmune people to areas where infected vectors were present. We hypothesize that YF virus remains in an area after an outbreak by vertical transmission among Haemagogus mosquitoes.

Sufferers of schistosomiasis mansoni can evolve a clinical form of the disease associated with portal hypertension. To differentiate this form, routine clinical tests and biological indices were evaluated. In all, 54 HBsAg- and HCV-negative patients were studied, 42 with schistosomiasis and 12 normal volunteers. Using clinical criteria, ultrasonography, and endoscopy, the schistosomiasis patients were classified into two groups: mild chronic form (MS, N = 14) and chronic form associated with portal hypertension (PH, N = 28). The laboratory parameters of the MS group did not differ from the controls. The PH group differed from the others in prothrombin index, thrombocytemia, gamma-glutamyltransferase, serum alpha2-macroglobulin, and the calculated indices. ROC plot cutoff levels verified that isolated thrombocytemia was the most efficient marker for discrimination of the PH and MS forms. Thrombocytemia of 130 x 10(9) platelets/liter discriminated the groups with an 86% accuracy when all patients were analyzed and 96% when only schistosomiasis patients who did not consume alcohol were included.

The ethanolic extract from the stem of Brosimum potabile afforded (-)-centrolobin (1), isolated for the first time in this genus. The identification of this compound included COSY and NOESY two-dimensional NMR data.

We present the case of a 8-years-old boy, admitted with a history of headache, nausea and vomiting. Cerebral angiography showed a non-vascular mass on frontal lobe. The patient underwent craniotomy and the lesion was removed. Neuropathological study revealed that the tumor was a ganglioglioma. The patient received pos-operative radiotherapy. On follow-up, 16 years after, a computed tomographic scan showed a recurrence of the tumor, and a second surgery revealed a glioblastoma multiform. Gangliogliomas are rare tumors of the central nervous system containing neoplastic ganglion cells and low grade neoplastic glial cells. The malignant degeneration occurs only in the glial component, so the prognosis of these tumors is related to the grade of that component.

The purpose of this article is to describe health conditions in a pan-mining community, in particular the interaction of mercury contamination with other health problems. This study was carried out in a panning mine located on Rato Creek, a tributary of the Tapajó s River Basin in the municipality of Itaituba, State of Par The study population consisted of 223 individuals. An epidemiological questionnaire was applied, medical treatment was given, and biological specimens were collected. Testing of fecal samples showed that 96.1% of the individuals had parasites and 66.4% were anemic. Prevalence of hepatitis B virus was 85.0%, and 11 individuals (6.0%) were virus carriers (HBsAg positive). Of 186 patients tested for malaria, 65 individuals (35.0%) had the infection, of whom 34 (52.3%) were asymptomatic. Prevalence of syphillis was 41.6%. Urine mercury levels were measured in 173 individuals. Some 16 (9.2%) of those tested had mercury levels between 10 and 19 ug/l, while 9 patients (5.2%) had levels above 20 ug/l. An overview of general health conditions showed a combination of problems in individuals, who lacked adequate diagnosis, in addition to a high level of self-medication, given the absence of health facilities. In addition, these individuals are threatened by critical levels of mercury contamination. In conclusion, this article gives a general overview of health conditions in these pan-mining communities, demonstrating the multicausal nature of health conditions in the Amazon region, a fact which should be considered when planning appropriate strategies for clinical treatment.

We studied by magnetic resonance imaging the incidence of associated malformations in a group of 38 patients with diagnosis of spina bifida followed in our outpatient clinic. Twenty-two children were born with spina aperta and 16 with spina bifida occulta. Tethered cord was found in the majority of patients of both groups. Syringomyelia was found in 13 patients. The craniocervical region was studied in 11 patients with the diagnosis of spina bifida aperta; Chiari malformation was found in 8. The results point to the fact that asymptomatic malformations detected by MRI techniques are frequent in patients with spina bifida.