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BACKGROUND: Individuals undergoing bariatric surgery often have inadequate protein intake, which can cause loss of lean body mass, low level of physical activity and sarcopenia. The whey protein supplement is the most suitable in this situation, however there is a low adherence to long-term use due to the palatability and monotony of the recipes. The aim this study was to analyze the acceptability of recipes containing whey-based protein supplements in individuals undergoing bariatric and metabolic surgery. METHODS: An on-demand sampling was performed, through a prospective, experimental study, with individuals undergoing bariatric surgery, treated by a multidisciplinary team, in a clinic located in São Paulo, Brazil. The study excluded: individuals with possible changes in taste during the sensory testing period. The study was divided into selection of recipes containing whey proteins, recruitment of tasters, sensory and chemical analysis of the recipes. RESULTS: The sample consisted of 40 tasters, adults, and elderly, who underwent bariatric and metabolic surgery, with a median of eight years of surgery, who had previously consumed a supplement. These individuals were subjected to sensory analysis of six recipes with fresh and minimally processed foods, plus protein supplement. All recipes had food acceptance above 78% and the chemical analysis of the recipes showed an average of 13 g of protein per serving. CONCLUSION: There was favorable acceptance of recipes with whey proteins, which places them as good dietary alternatives for the prevention of sarcopenia and weight relapse in individuals undergoing bariatric and metabolic surgery.
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Cirurgia Bariátrica , Obesidade Mórbida , Sarcopenia , Adulto , Humanos , Idoso , Proteínas do Soro do Leite , Estudos Prospectivos , Brasil , Obesidade Mórbida/cirurgiaRESUMO
OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.
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Demência , Deficiência de Vitamina D , Idoso , Idoso de 80 Anos ou mais , Humanos , Fosfatase Alcalina , Cálcio , Estudos Transversais , Demência/complicações , Hormônio Paratireóideo , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Pessoas AcamadasRESUMO
SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.
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Objetivo: identificar por meio de uma revisão narrativa de literatura as patologias mais recorrentes em indivíduos com Síndrome de Down. Método: trata-se de uma revisão narrativa. Realizou-se um levantamento da literatura no Portal Pubmed e nas bases de dados de publicações científicas indexadas: Scientific Eletronic Library Online (Scielo), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de Dados de Enfermagem (BDENF) e Cumulative Index to Nursing and Allied Health Literature (CINAHL) e Portal PubMed, usando os descritores "Down's syndrome", "Pathologies", "Trisomy 21", "Intellectual Disability", "Clinical manifestations". Resultados: foram encontrados 696 artigos, dos quais 24 foram analisados na íntegra, destes, foram selecionados 9 artigos que compuseram a amostra desta revisão. A maioria dos estudos selecionados mensurou as características fenotípicas peculiares nos indivíduos com essa anomalia, a saber: olhos oblíquos, orelhas baixas, braquidactilia, hipotonia, baixa estatura, braquicefalia, fissuras oblíquas na pálpebra, epicanto, manchas de Brushfield na íris, dentre outras. Conclusão: torna-se necessária uma atenção e acompanhamento regular dos profissionais de saúde acerca das patologias malignas, doenças autoimunes e inflamatórias que acometem as pessoas com SD.
Objective: to identify through a narrative literature review the most recurrent pathologies in individuals with Down syndrome. Method: this is a narrative review. A survey of literature was conducted on the Pubmed Portal and in the databases of indexed scientific publications: Scientific Electronic Library Online (Scielo), Latin American and Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed Portal, using the descriptors "Down's syndrome", "Pathologies", "Trisomy 21", "Intellectual Disability" , "Clinical manifestations". Results: 696 articles were found, of which 24 were fully analyzed, of which 9 articles were selected that comprised the sample of this review. Most of the selected studies measured the peculiar phenotypic characteristics in individuals with this anomaly, namely: oblique eyes, low ears, brachydactyly, hypotonia, short stature, brachycephaly, oblique clefts in the eyelid, epicant, Brushfield spots on the iris, among others. Conclusion: it is necessary to have regular attention and follow-up of health professionals about malignant pathologies, autoimmune and inflammatory diseases that affect people with DS.
Objetivo: identificar a través de una literatura narrativa revisar las patologías más recurrentes en individuos con síndrome de Down. Método: esta es una revisión narrativa. Una encuesta de literatura se realizó en el Portal Pubmed y en las bases de datos de publicaciones científicas indexadas: Biblioteca Electrónica Científica en Línea (Scielo), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Base de Datos de Enfermería (BDENF) e Índice Acumulativo de Literatura de Enfermería y Salud Aliada (CINAHL) y PubMed Portal, utilizando los descriptores "Síndrome de Down", "Patologías", "Trisomy 21", "Discapacidad Intelectual" , "Manifestaciones clínicas". Resultados: se encontraron 696 artículos, de los cuales 24 fueron analizados en su totalidad, de los cuales se seleccionaron 9 artículos que comprendían la muestra de este examen. La mayoría de los estudios seleccionados midieron las peculiares características fenotípicas en individuos con esta anomalía, a saber: ojos oblicuos, orejas bajas, braquidactilia, hipotonía, estatura baja, braquicefalia, hendiduras oblicuas en el párpado, epicante, manchas de Brushfield en el iris, entre otros. Conclusión: es necesario tener atención regular y seguimiento de los profesionales de la salud sobre patologías malignas, enfermedades autoinmunes e inflamatorias que afectan a las personas con DS.
Assuntos
Síndrome de Down , Sinais e Sintomas , Trissomia , Deficiência IntelectualRESUMO
Introduction: One of the primary causes of community-acquired bacteremia also associated with nosocomial infections is Staphylococcus aureus, which is responsible for a high percentage of complications leading to high morbidity and mortality rates. The systemic inflammatory response syndrome (SIRS) criteria have been traditionally used to evaluate the presence of sepsis; however, recent evidence questions its predictive value due to its low sensitivity and specificity. In 2016, new criteria for sepsis were published and a new tool emerged, quick SOFA (qSOFA), for the rapid evaluation of infection in emergency services. Objective: To compare the qSOFA and SRIS tools for the prediction of bacteremia caused by S. aureus. Materials and methods: We conducted an observational study in patients with S. aureus bacteremia to evaluate their phenotypic resistance patterns, some special features (sociodemographic characteristics, clinical and paraclinical values), complications, and mortality. The results of the qSOFA and SIRS scales were analyzed to identify which of them could better predict the presence of S. aureus bacteremia. Results: Twenty-six bacteremic patients were identified. Staphylococcus aureus was the second most frequently isolated bacteria. The results evidenced a mortality rate of 50% (13 cases) and a prevalence of 30% of MRSA. For the clinical scores evaluated, the qSOFA scale was positive in 30.8% of the patients, and the SIRS scale, in 92.3%. Discussion: The mortality rate for the population under study was high and the qSOFA tool had a lower diagnostic yield compared to the classic criteria for SIRS.
Introducción. Staphylococcus aureus es una de las principales causas de bacteriemia, adquirida en la comunidad o asociada con la atención en salud, la cual presenta un gran porcentaje de complicaciones y elevadas tasas de morbilidad y mortalidad. Los criterios SRIS (Systemic Inflammatory Response Syndrome) se han usado tradicionalmente con el fin de establecer la presencia de sepsis; sin embargo, recientemente se ha cuestionado su valor predictivo dada su baja sensibilidad y especificidad. En el 2016, apareció la escala qSOFA (quick Sequential Organ Failure Assessment), como una nueva herramienta para la evaluación rápida de las infecciones en los servicios de urgencias. Objetivo. Comparar las herramientas qSOFA y SRIS para la predicción de la bacteriemia por S. aureus. Materiales y métodos. Se hizo un estudio observacional sobre el comportamiento clínico de pacientes con bacteriemia por S. aureus para evaluar el perfil de resistencia fenotípica, algunas características sociodemográficas, clínicas y de laboratorio, las complicaciones y la mortalidad, así como los resultados de las evaluaciones con la escala qSOFA y los criterios SRIS, para establecer cuál podría predecir mejor la presencia de bacteriemia por S. aureus. Resultados. Se seleccionaron 26 pacientes con bacteriemia, en cuyas muestras S. aureus había sido el segundo germen más frecuentemente aislado. Se encontró una mortalidad del 50 % (13 casos) y una prevalencia del 30 % de S. aureus resistente a meticilina (SARM). Según los puntajes clínicos obtenidos, la escala qSOFA fue positiva en 30,8 % de los pacientes y los criterios SRIS lo fueron en el 92,3 %. Discusión. Se encontró una elevada mortalidad en la población analizada. La escala qSOFA fue menos efectiva para el diagnóstico que los criterios clásicos de reacción inflamatoria sistémica.
Assuntos
Bacteriemia/complicações , Bacteriemia/diagnóstico , Escores de Disfunção Orgânica , Sepse/complicações , Sepse/diagnóstico , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Introducción. Staphylococcus aureus es una de las principales causas de bacteriemia, adquirida en la comunidad o asociada con la atención en salud, la cual presenta un gran porcentaje de complicaciones y elevadas tasas de morbilidad y mortalidad. Los criterios SRIS (Systemic Inflammatory Response Syndrome) se han usado tradicionalmente con el fin de establecer la presencia de sepsis; sin embargo, recientemente se ha cuestionado su valor predictivo dada su baja sensibilidad y especificidad. En el 2016, apareció la escala qSOFA (quick Sequential Organ Failure Assessment), como una nueva herramienta para la evaluación rápida de las infecciones en los servicios de urgencias. Objetivo. Comparar las herramientas qSOFA y SRIS para la predicción de la bacteriemia por S. aureus. Materiales y métodos. Se hizo un estudio observacional sobre el comportamiento clínico de pacientes con bacteriemia por S. aureus para evaluar el perfil de resistencia fenotípica, algunas características sociodemográficas, clínicas y de laboratorio, las complicaciones y la mortalidad, así como los resultados de las evaluaciones con la escala qSOFA y los criterios SRIS, para establecer cuál podría predecir mejor la presencia de bacteriemia por S. aureus. Resultados. Se seleccionaron 26 pacientes con bacteriemia, en cuyas muestras S. aureus había sido el segundo germen más frecuentemente aislado. Se encontró una mortalidad del 50 % (13 casos) y una prevalencia del 30 % de S. aureus resistente a meticilina (SARM). Según los puntajes clínicos obtenidos, la escala qSOFA fue positiva en 30,8 % de los pacientes y los criterios SRIS lo fueron en el 92,3 %. Discusión. Se encontró una elevada mortalidad en la población analizada. La escala qSOFA fue menos efectiva para el diagnóstico que los criterios clásicos de reacción inflamatoria sistémica.
Introduction: One of the primary causes of community-acquired bacteremia also associated with nosocomial infections is Staphylococcus aureus, which is responsible for a high percentage of complications leading to high morbidity and mortality rates. The systemic inflammatory response syndrome (SIRS) criteria have been traditionally used to evaluate the presence of sepsis; however, recent evidence questions its predictive value due to its low sensitivity and specificity. In 2016, new criteria for sepsis were published and a new tool emerged, quick SOFA (qSOFA), for the rapid evaluation of infection in emergency services. Objective: To compare the qSOFA and SRIS tools for the prediction of bacteremia caused by S. aureus. Materials and methods: We conducted an observational study in patients with S. aureus bacteremia to evaluate their phenotypic resistance patterns, some special features (sociodemographic characteristics, clinical and paraclinical values), complications, and mortality. The results of the qSOFA and SIRS scales were analyzed to identify which of them could better predict the presence of S. aureus bacteremia. Results: Twenty-six bacteremic patients were identified. Staphylococcus aureus was the second most frequently isolated bacteria. The results evidenced a mortality rate of 50% (13 cases) and a prevalence of 30% of MRSA. For the clinical scores evaluated, the qSOFA scale was positive in 30.8% of the patients, and the SIRS scale, in 92.3%. Discussion: The mortality rate for the population under study was high and the qSOFA tool had a lower diagnostic yield compared to the classic criteria for SIRS.
Assuntos
Staphylococcus aureus , Infecção Hospitalar , Bacteriemia , Síndrome de Resposta Inflamatória Sistêmica , Staphylococcus aureus Resistente à Meticilina , Escores de Disfunção OrgânicaRESUMO
RESUMEN Fundamento: la luxofractura de Monteggia es una lesión traumática infrecuente de manera general, aún cuando se trata de una de sus lesiones equivalentes. Objetivo: mostrar la evolución clínica de una paciente con una inusual luxofractura de fractura de Monteggia. Presentación de caso: paciente de 37 años, mestiza, sin antecedentes mórbidos de salud, la cual sufrió caída de sus pies en el baño de su casa con apoyo en el antebrazo y muñeca, es llevada al servicio de urgencias de Ortopedia y Traumatología por presentar dolor e inflamación a nivel del antebrazo derecho, en específico en el codo y uniones del tercio medio y distal. Debido a la naturaleza de la lesión traumática, necesitó de tratamiento quirúrgico consistente en la reducción de la cúpula radial y fijación de ambas fracturas en el cúbito. Conclusiones: la luxofractura de Monteggia es una afección traumática infrecuente y en especial las equivalentes a las fracturas tipo 1, que ocurren por lo general en niños.
ABTRACT Background: Monteggia's fracture is generally an uncommon traumatic injury, even more when it is one of its equivalent injuries. Objective: to show the evolution of a patient with an uncommon Monteggia's fracture. Case report: a 37 year-old black, woman, without health antecedents, who suffered a fall from her own feet in her bathroom, was taken to emergency room of Orthopedic and Traumatology complaining of pain, swelling and limitation of movement of the right elbow and distal. Because of the lesion features, surgical treatment was needed by open reduction and internal fixation of both fractures of the ulna. Conclusions: Monteggia's fracture is an unusual lesion, even more some equivalent type 1 lesions which occur more common in children than adults.
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Large numbers of parasites are found in various organs of anuran amphibians, with parasite intensities thought to modulate the host's Darwinian fitness traits. Interaction between the anuran hosts and their multiple parasites should modulate the host's phenotypic characteristic, such as those associated with high energetic demand (such as calling effort and locomotor performance), energy balance (standard metabolic rate), and morphological plasticity (as indicated by organ masses). The present study investigated the impact of parasite intensities on the behavioral, physiological, and morphological traits of wild adult male Rhinella icterica (Anura: Bufonidae). We tested as to whether individuals with higher parasite intensities would present: 1) lower vocal calling effort in the field, as well as poorer locomotor performance and body-condition index; and 2) higher standard metabolic rates and internal organ masses. Measurements included: calling effort in the field; standard metabolic rate; locomotor performance; parasite intensity; internal organ masses (heart, liver, kidneys, intestines, stomach, lungs, hind limb muscle, and spleen); and the body-condition index. Results showed a negative association of parasite intensities with locomotor performance, and standard metabolic rate of R. icterica. A positive association between parasite intensities and relative organ masses (heart, intestines and kidneys) was also evident. Toads with higher pulmonary and intestinal parasites intensities also showed higher total parasite intensities.
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Resumen El objetivo de esta investigación fue determinar si una muestra de policías penitenciarios, en Costa Rica, experimenta estrés laboral y si está relacionado con la presencia de estrés, depresión, ansiedad, burnout y otras características personales y ocupacionales. Además, se determina si hay diferencias entre hombres y mujeres con respecto a la presencia de tales factores. La Escala de Depresión, Ansiedad y Estrés (DASS), la Escala de Estrés Laboral para Oficiales Correccionales (EELOC), y el Cuestionario Breve de Burnout (CBB) fueron administrados a 66 oficiales correccionales de diferen tes prisiones en Costa Rica. Conclusiones: El estrés laboral está significativamente relacionado con la presencia de estrés, ansiedad y depresión, pero no relacionado con la presencia de burnout. No se encontraron diferencias entre hombres y mujeres en ninguna variable. Es importante saber cómo el ambiente de trabajo afecta las vidas de los oficiales con el fin de mejorar las condiciones de trabajo que podrían tener efectos negativos sobre el desempeño en el trabajo y la salud, así como proporcio nar información para los psicólogos policiales, que están a cargo de proveer servicios clínicos y de consejería a los oficiales correccionales.
Abstract The aim of this study was to establish whether a sample of correctional officers in Costa Rica expe rience workplace stress and if workplace stress is related to the presence of stress, depression, anxie ty, burnout and other various personal and occupational characteristics. Additionally, whether there are differences between men and women regarding the presence of such factors are explored. The Depression, Anxiety and Stress Scale (DASS), Work Stress Scale for Correctional Officers (WSSCO) and Brief Questionnaire on Burnout (CBB) were administered to 66 correctional officers from di fferent prisons in Costa Rica. Conclusions: Workplace stress is significantly related to the presence of stress, anxiety and depression, but not related to the presence of burnout. No differences between men and women were found on any variable. It is important to know how the work environment affects the lives of the officers, in order to improve the working conditions that could have negative effects on the job performance and health of the officers, as well to provide information for police psychologists who are in charge of providing clinical and counseling services to correctional officers.
Assuntos
Ansiedade , Prisões/tendências , Condições de Trabalho , Riscos Ocupacionais , Polícia Judiciária , Estresse Ocupacional , Direitos Civis/psicologia , Costa RicaRESUMO
El eritema nodoso es la paniculitis más frecuente que afecta la grasa subcutánea. La gran mayoría de los casos son idiopáticos, pero también se encuentran infecciones, sarcoidosis, embarazo y ciertos medicamentos, como otras causas importantes. Entre las infecciones, la más frecuente es la estreptocóccica; mientras que las infecciones micóticas junto con las virales, parasitariasy otras bacterianas, corresponden a menos de 1 % de las causas. Son pocos los casos reportados de infecciones micóticas asociadas a síntomas reumatológicos, pero hasta ahora, el más común es el eritema nodoso. La mayor cantidad de estos casos corresponden a infecciones por dermatofitos; entre éstos, el más relevante es Trichophyton mentagrophytes, causando principalmente el querionde Celso.El eritema nodoso también se ha visto asociado a infecciones micóticas invasivas como la aspergilosis,histoplasmosis, coccidioidomicosis y esporotricosis. Su tratamiento tiene dos objetivos: tratar la enfermedad subyacente y realizar un manejo sintomático de las lesiones cutáneas y los síntomas asociados. Está claro quelas lesiones en piel son autolimitadas y los nódulos curan espontáneamente sin dejar cicatriz ni atrofia.
Erythema nodosum (EN) is the panniculitis thatmost frequently affects subcutaneous fat. Most cases are idiopathic but infections, sarcoidosis,pregnancy and certain medications are other important causes. Among infections, streptococcusis most frequent; mycotic and viral infections,parasitic and other bacterias, correspond to lessthan 1% of the causes. The reports of mycotic infectionsassociated to rheumatologic symptomsare few, but to date, the most common is EN. The majority of these cases correspond to dermatophyticinfections, among which the most relevant is Trichophyton mentagrophytes, most commonlycausing Kerion of Celsi. EN has also been seen inassociation with invasive mycotic infections likeaspergillosis, hystoplasmosis, coccidiodomycosisand sporotrichosis. Treatment of EN has two objectives: treating the underlying disease andsymptomatic control of skin lesions and associated symptoms. It is clear that skin lesions are self limited and nodules heal spontaneously withoutleaving scar or atrophy.
Assuntos
Humanos , Eritema Nodoso , Estruturas Fúngicas , Fungos/virologia , PaniculiteRESUMO
Since 1983, several recombinant antibodies have been expressed in important agronomic plant species. However, to date no evaluation has been published about prolonged antibody stability within plant tissues under cryo-preservation conditions. This current report presents an approach to the KDEL-plantibody HB-01 (PHB-01) stability in frozen tobacco leaves by presenting scientific evidence about the stability of a plantibody to a prolonged low temperature exposure in this biological source. Results clearly show that the PHB-01 amount is maintained during the storage of tobacco leaves at -20 degrees C for 90 days. The PHB-01 recovery was not affected by any irreversible physical and/or chemical change produced in tobacco leaves after this cryo-preservation time. The amount of total soluble proteins in the clarified extract decreased in proportion with the storage time and the PHB-01 molecules isolated from frozen leaf extracts were highly pure, >95%, according to an SDS-PAGE assessment under reducing conditions. Low temperature exposure of tobacco leaves did not reveal visible changes in frozen leaves, which is essential for the further extractability of proteins. The PHB-01 is stable in tobacco leaves at -20 degrees C during 90 days, which offers the possibility to overcome problems associated with detrimental climate conditions and optimize purification capabilities.
Assuntos
Anticorpos Anti-Hepatite B/biossíntese , Antígenos de Superfície da Hepatite B/imunologia , Nicotiana/metabolismo , Folhas de Planta/metabolismo , Animais , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais/genética , Anticorpos Monoclonais/imunologia , Criopreservação , Eletroforese em Gel de Poliacrilamida , Congelamento , Anticorpos Anti-Hepatite B/genética , Anticorpos Anti-Hepatite B/imunologia , Vacinas contra Hepatite B/biossíntese , Vacinas contra Hepatite B/imunologia , Camundongos , Folhas de Planta/genética , Plantas Geneticamente Modificadas , Engenharia de Proteínas/métodos , Estabilidade Proteica , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/imunologia , Reprodutibilidade dos Testes , Tecnologia Farmacêutica/métodos , Fatores de Tempo , Nicotiana/genéticaRESUMO
OBJETIVO:Comparar os efeitos de dois protocolos de um programa de intervenção nutricional sob o risco cardiovascular em pacientes hipertensos e com excesso de peso em uso de medicamentos usual. Os pacientes foram acompanhados no Ambulatório de Hipertensão e Metabologia Cardiovascular, Universidade Federal de São Paulo. MÉTODOS:A população do estudo foi constituída por 63 pacientes hipertensos e com excesso de peso [índice de massa corporal >27 e <39kg/m²], com a média de idade de M=55,7, DP=6,1 anos; 12 homens e 51 mulheres, divididos em dois grupos de acordo com a freqüência das visitas, a cada cinco semanas (G35 n=25) ou a cada duas semanas (G14 n=38), durante 20 semanas. Os dois grupos foram submetidos a um programa de intervenção nutricional que englobou atendimentos em grupos, nos quais foram abordados conceitos de alimentação saudável. No início e no término do período do estudo, todos os pacientes foram submetidos a medidas de pressão arterial, avaliação antropométrica e avaliação laboratorial para cálculo do Risco Coronariano de Framingham. RESULTADOS:Ao término do estudo, foi observada redução no índice de massa corporal, na circunferência da cintura (M=102,9, DP=9,7cm vs M=101,8, DP=7,6cm NS), na pressão arterial sistólica (M=139,7, DP=12,4mmHg vs M=134,8, DP=8,2mmHg NS), no colesterol total sérico (M=192,9, DP=35,7mg/dL vs M=195,2, DP=37,8mg/dL NS), no consumo energético referido (M=1759,5, DP=385,8Kcal vs M=1858,7, DP=452,8kcak NS) e no RCF (M=11,1, DP=6,1 vs M=9,4, DP=3,5 NS). CONCLUSÃO:A intervenção nutricional educativa de curto prazo, se mostrou eficaz para redução do risco cardiovascular em pacientes hipertensos e com excesso de peso. Em relação a freqüência das visitas, pôde-se verificar que a visita mensal já produz resultados positivos no sentido de modificar os hábitos alimentares e reduzir o risco cardiovascular.
OBJECTIVE:To evaluate and compare the effects of two study protocols with a program of educational nutrition intervention on CARDIOVACULAR risk in overweight hypertensive patients maintained on their usual medication. Patients were followed at Hypertension and Metabology Division of Federal University of São Paulo. METHODS: Sixty tree overweight [body mass index >27 e <39kg/m²] hypertensive patients, age M=55,7 (Standard deviation - SD=6,1) years old, 12 men and 51 women, were divided into two groups according to visit intervals, either every five weeks (G35 n=25) or every two weeks (G14 n=38), during twenty weeks. The two groups were submitted to an educational program aiming to improve the quality of their diet and to promote changes in their alimentary habits. Before and at the end of the study period, all patients were submitted to blood pressure determinations, to anthopometric measurements and to laboratorial evaluation for the calculation of Framingham coronary risk. RESULTS:At the end of the study significant and similar changes in body mass index, waist circumference (102,9, SD=9,7 vs 101,8, SD=7,6 NS), systolic blood pressure (139,7, SD=12,4 vs 134,8, SD=8,2 NS), total cholesterol (192,9, SD=35,7 vs 195,2, SD=37,8 NS), energy intake (1759,5, SD=385,8 vs 1858,7, SD=452,8 NS) and Framingham coronary risk (11,1, SD=6,1 vs 9,4, SD=3,5 NS) we observed in G14 and G35 groups respectively. CONCLUSION: A short program of nutritional intervention was shown to be useful to reduce coronary risk in overweight hypertensive patients despite a very small change in body weight. A higher frequency of visits did not achieve better results, with a monthly visit being enough for positive changes although with a higher rate of drop outs.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Doenças Cardiovasculares/prevenção & controle , Educação Alimentar e Nutricional , Fatores de Risco , Hipertensão/prevenção & controleRESUMO
This paper evaluates the immunopurification behavior of a plantibody HBsAg specific plantibody coupled to Sepharose CL-4B at different ligand densities. Results show no significant differences in the adsorption and elution capacities, and rHBsAg recovery of immunosorbents at 3.43, 4.45, and 5.31 mg/mL of ligand densities compared to its mouse-derived mAb counterpart consistently used in the rHBsAg purification process. Therefore, plantibody ligand densities higher than 3.43 mg/mL do not improve the immunopurification behavior of this immunosorbent, but increase the antibody consumption and the Hepatitis B vaccine cost. Immunosorbent of 2.23 mg/mL of ligand density demonstrated a poor performance. The IgG leached detectable level never exceeded the approved limit (3 ng IgG/microg rHBsAg). Values close to this limit were only observed at the ligand density of 5.31 and 2.27 mg/mL. In the case of the ligand density of 2.23 mg/mL the IgG leached value was high (2.90 ng IgG/microg rHBsAg) due to a low level of eluted antigen. In conclusion, it supports feasibility of using this plantibody at 3.43 mg/mL of ligand density for large-scale immunopurification of rHBsAg for human use, avoiding the biosafety and ethical concerns of the massive use of animals for this purpose.