Racial inequality in perinatal outcomes in two Brazilian birth cohorts

This study aimed to estimate and compare racial inequality in low birth weight (LBW), preterm birth (PTB), and intrauterine growth restriction (IUGR) in two Brazilian birth cohorts. This was a cross-sectional study nested within two birth cohorts in Ribeirão Preto (RP) and São Luís (SL), whose mothers were interviewed from January to December 2010. In all, 7430 (RP) and 4995 (SL) mothers were interviewed. The maternal skin color was the exposure variable. Associations were adjusted for socioeconomic and biological covariates: maternal education, per capita family income, family economic classification, household head occupation, maternal age, parity, marital status, prenatal care, type of delivery, maternal pre-pregnancy BMI, hypertension, hypertension during pregnancy, and smoking during pregnancy collected from questionnaires applied at birth. Statistical analysis was done with the chi-squared test and logistic regression. In RP, newborns from mothers with black skin color had a higher risk of LBW and IUGR, even after adjusting for socioeconomic and biological variables (P<0.001). In SL, skin color was not a risk factor for LBW (P=0.859), PTB (P=0.220), and IUGR (P=0.062), before or after adjustment for socioeconomic and biological variables. The detection of racial inequality in these perinatal outcomes only in the RP cohort after adjustment for socioeconomic and biological factors may be reflecting the existence of racial discrimination in the RP society. In contrast, the greater miscegenation present in São Luís may be reflecting less racial discrimination of black and brown women in this city.

Birth by cesarean section and mood disorders among adolescents of a birth cohort study in northern Brazil

The increasing number of cesarean sections worldwide has encouraged research on the long-term effects of this birth type on the offspring's mental health. The objective of this study was to investigate whether there is an association between birth by cesarean section and the development of mood disorders (depression and bipolar disorders) in adolescents. A cohort study was carried out with 1603 adolescents from 18 to 19 years old who participated in the third phase of a birth cohort study in São Luís, MA, in 2016. Information on birth type and weight, prematurity, mother's age and schooling, parity, marital status, and smoking behavior during pregnancy, were collected at birth. The study outcomes were depression, bipolar disorder, and "mood disorder" construct. A Directed Acyclic Graph (DAG) was developed to select the variables for minimal adjustment for confounding and collision bias. Associations were estimated through propensity score weighting using a two-step estimation model, and confounders for cesarean birth were used in the predictive model. There was no significant association in the relationship between birth type and depression (95%CI: -0.037 to 0.017; P=0.47), bipolar disorder (95%CI: -0.019 to 0.045; P=0.43), and mood disorder (95%CI: -0.033 to 0.042; P=0.80) in adolescents of both sexes. Birth by cesarean section was not associated with the development of mood disorders in adolescents.

Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort

Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities. However, little is currently known about the association of the separate or concomitant use of alcohol and tobacco with infant motor and cognitive development. Thus, the objective of the present study was to investigate the association between maternal consumption of alcohol and/or tobacco during pregnancy and the motor and cognitive development of children starting from the second year of life. The study included 1006 children of a cohort started during the prenatal period (22-25 weeks of pregnancy), evaluated at birth and reevaluated during the second year of life in 2011/2013. The children were divided into four groups according to the alcohol and/or tobacco consumption reported by their mothers at childbirth: no consumption (NC), separate alcohol consumption (AC), separate tobacco consumption (TC), and concomitant use of both (ACTC). The Bayley Scale of Infant and Toddler Development Third Edition screening tool was used for the assessment of motor and cognitive development. Adjusted Poisson regression models were used to determine the association between groups and delayed development. The results indicated that only the ACTC group showed a higher risk of motor delay, specifically regarding fine motor skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol or tobacco consumption was not associated with delayed gross motor or cognitive development. However, the concomitant use of the two substances increased the risk of delayed acquisition of fine motor skills.

Body image dissatisfaction and symptoms of depression disorder in adolescents

The objective of this study was to evaluate the effect of body image dissatisfaction on symptoms of depressive disorder in adolescents. This is a cross-sectional study that included 2,162 adolescents ages 18-19 born in São Luís, Maranhão, Brazil, which was part of the joint RPS cohort (Brazilian birth cohorts of Ribeirão Preto-SP, Pelotas-RS, and São Luís-MA). Socioeconomic characteristics, nutritional status, mental health, and body image characteristics were evaluated. Body image was assessed by Stunkard's silhouettes scale. The presence of symptoms indicative of depressive disorder was investigated through a diagnostic interview MINI (Mini International Neuropsychiatric Interview). A theoretical model was built in a Directed Acyclic Graph (DAG) in order to investigate the relationship between the variables of the study. The relationship was estimated weighting the inverse probability of selection for the variables of adjustment: sex and nutritional status. Among the dissatisfied adolescents due to overweight, 66.54% were girls, 32.85% were overweight, and 11.99% were obese (P<0.01). There was a significant association between dissatisfaction due to overweight and symptoms of depressive disorder (P=0.01), and there was no evidence of the same association with dissatisfaction due to thinness. Therefore, only dissatisfaction due to overweight was associated with the symptoms of depressive disorder in the evaluated adolescents.

Is birth weight associated with pregestational maternal BMI? BRISA Cohort, Ribeirão Preto, Brazil

Given the increase of women with excess weight or obesity and its possible effects on birth weight, the present study aimed to investigate the association between pregestational maternal body mass index (BMI) and birth weight in a birth cohort from Ribeirão Preto, SP, Brazil. This was a prospective study conducted on 1362 mother-child pairs involving singleton births. The women were evaluated using standardized questionnaires during the second trimester of pregnancy and at the time of childbirth. Information about the newborns was obtained from their medical records. The dependent variable was birth weight, categorized as low, adequate, or high. The independent variable was pregestational maternal BMI, categorized as malnutrition, adequate weight, overweight, and obesity. A multinomial regression model was used to estimate the crude and adjusted relative risk (RR) of low and high birth weight. A high frequency of pregestational excess weight (39.6%) was detected and found to be independently associated with high birth weight (RR=2.13, 95%CI: 1.19-3.80 for overweight and RR=3.34, 95%CI: 1.80-6.19 for obese pregnant women). There was no association between pregestational malnutrition and low birth weight (RR=1.70; 95%CI: 0.81-3.55). The present data showed a high rate of women with excess pregestational weight, supporting the hypothesis that pregestational BMI may contribute to high birth weight babies and indicating the need for actions aiming to prevent excessive weight in women at reproductive age.

Metabolic profile during pregnancy in BRISA birth cohorts of Ribeirão Preto and São Luís, Brazil

During pregnancy, metabolic changes that develop in women may increase the risk of diseases and conditions that may also harm the life of the growing fetus. The aim of the present study was to identify and compare the metabolic profile (MP) during pregnancy in two birth cohorts in 2010 in the cities of Ribeirão Preto (RP) and São Luís (SL), Brazil. Pregnant women (1393 in RP and 1413 in SL) were studied; information was obtained through questionnaires in addition to anthropometric, biochemical, and blood pressure measurements. Data are presented as means and proportions. To compare the characteristics of pregnant women in both cities, chi-squared and Student's t-tests were applied, with 5% significance level. Ribeirão Preto presented higher mean values than SL for pre-gestational body mass index (24.5 vs 23 kg/m2, P<0.001), systolic (108.4 vs 102.8 mmHg, P<0.001) and diastolic (65.9 vs 61.8 mmHg, P<0.001) blood pressure, total cholesterol (226.3 vs 213.7 mg/dL, P<0.001) and fractions, and glycemia (84.5 vs 80.2 mg/dL, P<0.001), except for triglycerides (P=0.135). Women from RP also showed higher rates of pre-gestational overweight and obesity compared with SL (40.1 vs 25.8%). In the present study, pregnant women in RP had a worse gestational metabolic profile than those in SL, with higher pre-gestational excess weight, indicating that nutritional transition was more advanced in the more developed city.

Association of genitourinary infections and cervical length with preterm childbirth

A prospective cohort study was conducted on a convenience sample of 1370 pregnant women with a gestational age of 20 to 25 weeks in the city of Ribeirão Preto. Data on obstetrical history, maternal age, parity, smoking habit, and a history of preterm delivery was collected with the application of a sociodemographic questionnaire. Cervical length was determined by endovaginal ultrasound, and urine and vaginal content samples were obtained to determine urinary tract infection (UTI) and bacterial vaginosis (BV), respectively. The aim of this study was to verify the association of cervical length and genitourinary infections with preterm birth (PTB). Ultrasound showed no association of UTI or BV with short cervical length. PTB rate was 9.63%. Among the women with PTB, 15 showed UTI (RR: 1.55, 95%CI: 0.93-2.58), 19 had BV (RR: 1.22, 95%CI: 0.77-1.94), and one had both UTI and BV (RR: 0.85, 95%CI: 0.13-5.62). Nineteen (14.4%) PTB occurred in women with a cervical length ≤2.5 cm (RR: 2.89, 95%CI: 1.89-4.43). Among the 75 patients with PTB stratified as spontaneous, 10 showed UTI (RR: 2.02, 95%CI: 1.05-3.86) and 14 had a diagnosis of BV (RR: 1.72, 95%CI: 0.97-3.04). A short cervical length between 20 and 25 weeks of pregnancy was associated with PTB, whereas UTI and BV determined at this age were not associated with short cervical length or with PTB, although UTI, even if asymptomatic, was related to spontaneous PTB.

Changes on physiological parameters of tambaqui (Colossoma macropomum) fed with diets supplemented with Amazonian fruit Camu camu (Myrciaria dubia) / Alterações em parâmetros fisiológicos de tambaqui (Colossoma macropomum) alimentados com dietas suplementadas com fruta amazônica camu camu (Myrciaria dubia)

Abstract The physiological responses of juvenile tambaqui (Colossoma macropomum) fed commercial feed supplemented with different concentrations of camu camu (Myrciaria dubia) were evaluated. The design was completely randomized, with treatments arranged in a factorial design with three proportions of camu camu (15%, 30% and 45%) and a control treatment (100% commercial diet), with four replicates per treatment. A total of 96 tambaqui specimens were used, with a mean initial weight of 11.69 ± 2.68 g and a mean length of 7.06 ± 0.44 cm. After 30 days, hematological parameters, metabolic variables, growth and fish swimming performance were evaluated. The different proportions of camu camu in the diet did not cause significant changes to the tambaqui's hematological parameters during the feeding period, except for hemoglobin (Hb) concentration and mean corpuscular hemoglobin concentration (MCHC) after the 30th day, and hematocrit (Ht) after the swimming stress test, which increased significantly (p < 0.05). The significant increases in metabolic variables, such as cortisol, glucose, proteins and triglycerides, and in hematologic variables after the Ucrit test reflect, respectively, biochemical adaptations for maintenance of the energy mobilization process and a regulatory necessity in tissue oxygen demand during intense exercise. Fish fed 15% and 30% camu camu gained the most weight and achieved the best swimming performance, respectively. The results for camu camu concentrations above 30% suggest a saturation of its intrinsic properties in the diet at this level and a loss of nutrients from the commercial feed replaced by the fruit, reducing productive performance and nutritional assimilation.

Resumo As respostas fisiológicas de juvenis de tambaqui (Colossoma macropomum) alimentados com ração comercial suplementada com diferentes concentrações de camu camu (Myrciaria dubia) foram avaliados. As amostras analisadas foram inteiramente casualizadas, com os tratamentos arranjados em esquema fatorial com três proporções de camu camu (15%, 30% e 45%) e um tratamento controle (ração comercial 100%), com quatro repetições por tratamento. Um total de 96 amostras de tambaqui foram utilizadas, com um peso médio inicial de 11,69 ± 2,68 g e um comprimento médio de 7,06 ± 0,44 cm. Após 30 dias, foram avaliados os parâmetros hematológicos, variáveis ​​metabólicas, crescimento e desempenho natatório de peixes. As diferentes proporções de camu camu na dieta não causou alterações significativas nos parâmetros hematológicos dos tambaquis durante o período de alimentação, com exceção de hemoglobina (Hb) e concentração de hemoglobina corpuscular média (CHCM), após o 30º dia, e hematócrito (Ht), após o teste de natação de estresse, que aumentou de forma significativa (p <0,05). Os aumentos significativos nas variáveis ​​metabólicas, como o cortisol, glicose, proteínas e triglicerídeos, e nas variáveis ​​hematológicas após o teste Ucrit reflete, respectivamente, adaptações bioquímicas para a manutenção do processo de mobilização de energia e uma necessidade de regulamentação na demanda de oxigênio nos tecidos durante o exercício intenso. Os peixes alimentados com 15% e 30% de camu camu obtiveram mais peso e melhor desempenho natatório, respectivamente. Os resultados para as concentrações camu camu superiores a 30% indicam uma saturação das suas propriedades intrínsecas na dieta, a este nível e uma perda de nutrientes a partir da ração comercial substituído pelo fruto, reduzindo o desempenho produtivo e assimilação nutricional.

Freezing goat embryos at different developmental stages and quality using ethylene glycol and a slow cooling rate / Congelação de embriões caprinos em diferentes estádios de desenvolvimento e qualidade utilizando etileno glicol e taxa de resfriamento lenta

The efficiency of an alternative freezing protocol for goat embryos of different morphology and quality was tested. Fifty-eight embryos on Day 6-7 stage were transferred as fresh or after freeze-thawing (n=29/group). For freezing, embryos were placed into 1.5M ethylene-glycol solution for 10min. During this time, they were loaded in the central part of 0.25mL straw, separated by air bubble from columns containing PBS/BSA 0.4% plus 20% BFS. Straws were then frozen using a freezing machine from 20ºC to -6ºC at a cooling rate of 3ºC/min, stabilization for 15min (seeding after 5min), from -6 C to -32ºC at 0.6 C/min,and plunged into liquid nitrogen. Frozen embryos were thawed for 30s at 37ºC in a water bath. Embryos subjected to fresh transfer were maintained in holding medium (37ºC). Fresh and frozen-thawed embryos were transferred at day 7 post-estrus to 30 recipients. Kidding and kid born rates were similar (P> 0.05), respectively, for recipients receiving fresh (66.7% or 10/15; 55.2% or 16/29) or frozen-thawed (60% or 9/15; 51.7% or 15/29) embryos. The cryopreservation of goat embryos using slow-freezing protocol and 1.5MEG resulted in similar efficiency rates of fresh embryos.(AU)

Este estudo testou a eficiência de protocolo alternativo de criopreservação de embriões caprinos de diferentes qualidades morfológicas. Foram utilizados 58 embriões, coletados entre o sexto e o sétimo dia do ciclo estral (n=29/grupo). Embriões congelados passaram por solução 1,5M etilenoglicol por 10min e foram aspirados durante esse tempo para parte central de palheta 0,25mL, separada por bolhas de ar de colunas contendo PBS 0,4% BSA e 20% SFB. As palhetas foram congeladas em máquina de congelação de 20ºC a -6ºC, com taxa de resfriamento de 3ºC/min, estabilização por 15min (seeding após 5min), -6ºC a -32ºC a 0,6ºC/min, e imersas em nitrogênio líquido. Os embriões foram descongelados por 30s a 37ºC, em água. Embriões frescos foram mantidos em solução de manutenção (37ºC). Embriões frescos e congelados/descongelados foram transferidos para 30 receptoras no sétimo dia do ciclo estral. A taxa de partos e a de crias nascidas (respectivamente) foram similares (P>0,05) para receptoras recebendo embriões frescos (66,7% ou 10/15; 55,2% ou 16/29) ou congelados/descongelados (60,0% ou 9/15; 51,7% ou 15/29). O protocolo de criopreservação de embriões utilizado no presente estudo resultou em índices de eficiência semelhantes aos de embriões frescos.(AU)

Changes on physiological parameters of tambaqui (Colossoma macropomum) fed with diets supplemented with Amazonian fruit Camu camu (Myrciaria dubia)

Abstract The physiological responses of juvenile tambaqui (Colossoma macropomum) fed commercial feed supplemented with different concentrations of camu camu (Myrciaria dubia) were evaluated. The design was completely randomized, with treatments arranged in a factorial design with three proportions of camu camu (15%, 30% and 45%) and a control treatment (100% commercial diet), with four replicates per treatment. A total of 96 tambaqui specimens were used, with a mean initial weight of 11.69 ± 2.68 g and a mean length of 7.06 ± 0.44 cm. After 30 days, hematological parameters, metabolic variables, growth and fish swimming performance were evaluated. The different proportions of camu camu in the diet did not cause significant changes to the tambaqui's hematological parameters during the feeding period, except for hemoglobin (Hb) concentration and mean corpuscular hemoglobin concentration (MCHC) after the 30th day, and hematocrit (Ht) after the swimming stress test, which increased significantly (p 0.05). The significant increases in metabolic variables, such as cortisol, glucose, proteins and triglycerides, and in hematologic variables after the Ucrit test reflect, respectively, biochemical adaptations for maintenance of the energy mobilization process and a regulatory necessity in tissue oxygen demand during intense exercise. Fish fed 15% and 30% camu camu gained the most weight and achieved the best swimming performance, respectively. The results for camu camu concentrations above 30% suggest a saturation of its intrinsic properties in the diet at this level and a loss of nutrients from the commercial feed replaced by the fruit, reducing productive performance and nutritional assimilation.

Resumo As respostas fisiológicas de juvenis de tambaqui (Colossoma macropomum) alimentados com ração comercial suplementada com diferentes concentrações de camu camu (Myrciaria dubia) foram avaliados. As amostras analisadas foram inteiramente casualizadas, com os tratamentos arranjados em esquema fatorial com três proporções de camu camu (15%, 30% e 45%) e um tratamento controle (ração comercial 100%), com quatro repetições por tratamento. Um total de 96 amostras de tambaqui foram utilizadas, com um peso médio inicial de 11,69 ± 2,68 g e um comprimento médio de 7,06 ± 0,44 cm. Após 30 dias, foram avaliados os parâmetros hematológicos, variáveis metabólicas, crescimento e desempenho natatório de peixes. As diferentes proporções de camu camu na dieta não causou alterações significativas nos parâmetros hematológicos dos tambaquis durante o período de alimentação, com exceção de hemoglobina (Hb) e concentração de hemoglobina corpuscular média (CHCM), após o 30º dia, e hematócrito (Ht), após o teste de natação de estresse, que aumentou de forma significativa (p 0,05). Os aumentos significativos nas variáveis metabólicas, como o cortisol, glicose, proteínas e triglicerídeos, e nas variáveis hematológicas após o teste Ucrit reflete, respectivamente, adaptações bioquímicas para a manutenção do processo de mobilização de energia e uma necessidade de regulamentação na demanda de oxigênio nos tecidos durante o exercício intenso. Os peixes alimentados com 15% e 30% de camu camu obtiveram mais peso e melhor desempenho natatório, respectivamente. Os resultados para as concentrações camu camu superiores a 30% indicam uma saturação das suas propriedades intrínsecas na dieta, a este nível e uma perda de nutrientes a partir da ração comercial substituído pelo fruto, reduzindo o desempenho produtivo e assimilação nutricional.

Comportamento ingestivo e desempenho produtivo de cordeiros mantidos em pastagem tropical e recebendo diferentes suplementações / Ingestive behavior and productive performance of lambs maintained in tropical pasture receiving different supplements

Avaliaram-se os efeitos dos tipos de suplementação sobre o desempenho produtivo e o comportamento ingestivo diurno de cordeiros mestiços Santa Inês mantidos em pastagem de capim-aruana (Panicum maximum cv. Aruana) sobressemeado com aveia branca (Avena sativa L.) e azevém (Lolium multiflorum Lam.), em um delineamento inteiramente ao acaso, com três tratamentos e três repetições. Os cordeiros foram distribuídos aleatoriamente em três sistemas alimentares, com seis animais cada, sendo: PAST - cordeiros mantidos exclusivamente a pasto; SIL - cordeiros mantidos em pastagem recebendo suplementação (1,0% do peso vivo) com silagem de milho; CONC - cordeiros mantidos em pastagem recebendo suplementação (1,0% do peso vivo) com concentrado. Os cordeiros suplementados com concentrado apresentaram ganho de peso médio diário 37,5% superior aos mantidos em pastagem, mas não diferiram da suplementação com silagem de milho. O tempo de pastejo foi superior para os animais não suplementados quando comparados aos animais suplementados. Cordeiros mantidos a pasto e suplementados com silagem de milho ou concentrado ganham mais peso do que os cordeiros não suplementados.

The aim of this work was to evaluate the types of supplementation on performance and the diurnal feeding behavior of crossbred Santa Inês lambs maintained in aruana (Panicum maximum cv. Aruana) pasture grass overseeding with oat (Avena sativaL.) and Italian ryegrass (Lolium multiflorum Lam.) pasture in a completely randomized design with three treatments and three replications. The lambs were randomly assigned to three food systems of six animals each, PAST - lambs fed only pasture; SIL - lambs fed pasture and supplemented (1% of live weight) with corn silage; CONC - lambs fed pasture and supplemented with concentrate. Animals supplemented with concentrate presented average daily gain 37,5% higher, but did not differ from supplementation with corn silage. Grazing time was higher for non-supplemented animals compared with supplemented animals. Lambs maintained in pasture and supplemented with corn silage or concentrate gain more weight than non-supplemented lambs.

Why are the rates of cesarean section in Brazil higher in more developed cities than in less developed ones?

The objective of the present study was to investigate factors associated with cesarean sections in two cities located in different regions of Brazil and to determine factors that explain the higher cesarean section rate in the more developed city, Ribeirão Preto, compared to the less developed one, São Luís. Data from two cohort studies comprising 2846 women in Ribeirão Preto in 1994, and 2443 women in São Luís in 1997/1998 were used. Adjusted and non-adjusted risk estimates were calculated using a Poisson regression model. The cesarean section rate was 33.7 percent in São Luís and 50.8 percent in Ribeirão Preto. Adjusted analysis in a joint sequential model revealed a 51 percent higher risk of cesarean section in Ribeirão Preto compared to São Luís (prevalence rate ratio (PRR) = 1.51). Adjustment for category of hospital admission reduced the PRR to 1.09, i.e., this variable explained 82 percent of the difference in the cesarean section rate between the two cities. Adjustment for the variable "the same physician for prenatal care and delivery" reduced the PRR to 1.07, with the "physician" factor explaining 86 percent of the difference between rates. When simultaneously adjusted for the two variables, the PRR decreased to 1.05, with these two variables explaining 90 percent of the difference in the cesarean section rate between the two cities, and the difference was no longer significant. The difference in the cesarean section rate between the two Brazilian cities, one more and one less developed, was mainly explained by the physician factor and, to a lesser extent, by the category of hospital admission.

Do socioeconomic factors explain why maternal smoking during pregnancy is more frequent in a more developed city of Brazil?

The prevalence of smoking during pregnancy in Ribeirão Preto, a rich Brazilian city, was significantly higher (21.4 percent) than in São Luís (5.9 percent), a less developed city. To assess which variables explain the difference in prevalence of smoking during pregnancy, data from two birth cohorts were used, including 2846 puerperae from Ribeirão Preto, in 1994, and 2443 puerperae from São Luís, in 1997/98. In multivariable analysis, risk of maternal smoking during pregnancy was higher in São Luís for mothers living in a household with five or more persons (OR = 1.72, 95 percentCI = 1.12-2.64), aged 35 years or older (OR = 1.98, 95 percentCI = 0.99-3.96), who had five or more children (OR = 2.10, 95 percentCI = 1.16-3.81), and whose companion smoked (OR = 2.20, 95 percentCI = 1.52-3.18). Age of less than 20 years was a protective factor (OR = 0.55, 95 percentCI = 0.33-0.92). In Ribeirão Preto there was association with maternal low educational level (OR = 2.18, 95 percentCI = 1.30-3.65) and with a smoking companion (OR = 3.25, 95 percentCI = 2.52-4.18). Receiving prenatal care was a protective factor (OR = 0.24, 95 percentCI = 0.11-0.49). Mothers from Ribeirão Preto who worked outside the home were at a higher risk and those aged 35 years or older or who attended five or more prenatal care visits were at lower risk of smoking during pregnancy as compared to mothers from São Luís. Smoking by the companion reduced the difference between smoking rates in the two cities by 10 percent. The socioeconomic variables in the model did not explain the higher prevalence of smoking during pregnancy in the more developed city.

Early life, current socioeconomic position and serum lipids in young adulthood of participants in a cohort study initiated in 1978/1979

The association between socioeconomic position (SEP) and serum lipids has been little studied and the results have been controversial. A total of 2063 young adults born in 1978/79 were evaluated at 23-25 years of age in the fourth follow-up of a cohort study carried out in Ribeirão Preto, SP, Brazil, corresponding to 31.8 percent of the original sample. Total serum cholesterol (TC), triglycerides, high-density cholesterol (HDL cholesterol) and low-density cholesterol (LDL cholesterol) were analyzed according to SEP at birth and during young adulthood. SEP was classified into tertiles of family income and a cumulative score of socioeconomic disadvantage was created. TC was 11.85 mg/100 mL lower among men of lower SEP in childhood (P < 0.01) but no difference was found in women, whereas it was 8.46 lower among men (P < 0.01) and 8.21 lower among women of lower SEP in adulthood (P < 0.05). Individuals of lower SEP had lower LDL and HDL cholesterol, with small differences between sexes and between the two times in life. There was no association between SEP and triglyceride levels. After adjustment of income at one time point in relation to the other, some associations lost significance. The greater the socioeconomic disadvantage accumulated along life, the lower the levels of TC, LDL and HDL cholesterol (P < 0.05). The socioeconomic gradient of TC and LDL cholesterol was inverse, representing a lower cardiovascular risk for individuals of lower SEP, while the socioeconomic gradient of HDL cholesterol indicated a lower cardiovascular risk for individuals of higher SEP.

Quantitative determination by HPLC of ent-kaurenoic and grandiflorenic acids in aerial parts of Wedelia paludosa D.C.

There are several reports of biological activity for kaurenoic acid (1), which is found in the aerial parts of Wedelia paludosa D.C., a herbaceous plant of the Asteraceae family abundant in Brazil, and that contains grandiflorenic acid (2) also. Both of these diterpenes were shown to cause lysis of trypomastigotes of the protozoa Trypanosoma cruzi, the causative agent of Chagas' disease (American trypanosomiasis). This paper reports the quantitative determination of these diterpene acids in the aerial parts of W. paludosa by an isocratic RP-HPLC method employing 60 percent acetonitrile in water and UV detection (220 nm). Kaurenoic acid (1) was found to be more abundant (0.85 ± 0.08 percent) while the amount of grandiflorenic acid (2) determined was almost three times lower (0.32 ± 0.02 percent). No significant seasonal variation was observed for these compounds in W. paludosa growing in Belo Horizonte (MG, Brazil) what points out to the aerial parts of this species are a good source of these biologically active diterpenes along all the year.

Similia similibus curentur: notaçäo histórica da medicina homeopática / Similia Similibus curentur: historical backgrounds of homeopathic medicine

A história da medicina homeopática foi discutida neste artigo, abordando-se as concepçöes de Hipócrates, Galeno, Paracelso e Hahnemann. Pretendemos dar uma idéia da evoluçäo da ciência médica de um modo geral, incluindo, neste contexto, o surgimento gradativo das idéias que levaram Hahnemann a criar a homeopatia.

Ventriculectomia parcial em criança: técnica de Batista / Partial ventriculectomy in a child: the Batista Operation

Criança com dois anos e seis meses de idade, apresentando cardiomiopatia dilatada idiopática, classe funcional III-IV (New York Heart Association - NYHA) e indicaçäo de transplante cardíaco, foi submetida à ventriculectomia radioisotópica (Gated Blood Pool) revelaram fraçäo de ejeçäo de ventrículo esquerdo (FEVE) de 13 'por cento' e 20 'por cento', respectivamente. Após a cirurgia, que consistiu na remoçäo de uma parte do músculo da parede lateral do ventrículo esquerdo, a FEVE foi para 50 'por cento' pelo ECO e 30 'por cento' pela ventriculografia radioisotópica. A criança recebeu alta hospitalar no 16§ pós-operatório em classe funcional I (NYHA).

Perspectivas para a moléstia de Chagas às portas do século XXI / Perspectives for Chagas Disease at the Doors of the 21st Century

A moléstia de Chagas é um dos mais graves problemas de saúde dos países latino-americano, afetuados, principalmente, a populaçäo rural submetida à miséria, característica do subdesenvolvimento econômico. Esta é uma irrefutável realidade, que vem sendo apontada há muito, mas para a qual näo se dá o devido valor. Com a proximidade do século XXI e do 3o. milênio, rendemo-nos a reflexäo profunda sobre o papel da ciência na vida do ser humano nos anos vindouros. Reflexäo que está necessariamente atreladao subdesenvolvimento sócio-econômico e às enfermidades infecto-parasitárias, que tolhem o homem em muito, no mister de contruir sua vida com plenitude. No presente artigo, discutiremos alguns dos caminhos que se anunciam par o entendimento e controle da enfermidade de Chagas que, após 84 anos de seu descobrimento, continua como nefasto flagelo de nosso sofrido povo.