Relationship of thyroid function with body fat, waist circumference, sub-cutaneous and visceral adipose tissue in eu-thyroid female subjects

Background: The relationship between thyroid function, body weight and central obesity in euthyroid individuals has been given a great medical concern. Central abdominal adiposity can be divided into adipose tissue present in subcutaneous areas (SCAT) and visceral areas (VAT). The type of adiposity may be implicated in the associations of thyroid function parameters with obesity. The aim of the present study was to evaluate thyroid function and its possible relationship with BMI, body fat percent, waist circumference, SCAT and VAT in eu-thyroid female subjects.Methods: Randomly selected eu-thyroid female subjects were included in this study. Their BMI was estimated by metric method, body fat percent was measured by Harpenden skin fold caliper. Ultrasound (US) was used to assess regional adiposity. Serum TSH was measured from fasting serum sample by Enzyme-linked-immuno-sorbant (ELISA) Assay. Data was analysed by SPSS (version 18).Results: A positive linear association was found between serum TSH level and BMI, body fat percent, waist circumference and VAT. (r=0.342, p <0.002, r=0.628, p <0.00, r=0.289, p <0.009, r=0.375, p <0.000). No significant association was found with SCAT and TSH. There is gradual increase in serum TSH values among three BMI groups i.e. normal weight (BMI <23 kg/m2), over-weight (BMI 23.00-24.99 kg/m2), and obese (BMI >25 kg/m2) females. Body fat percentage, BMI and VAT were found to be significant independent predictors of TSH.Conclusions: Selective reduction of visceral fat may induce greater beneficial effects on the parameters of thyroid hormones than subcutaneous fat reduction.

Worries and Concerns about Taking Medicine, and Related Factors in Older Patients Undergoing Polypharmacy / 日本プライマリ・ケア連合学会誌

Introduction: Worries and concerns about taking medicine, and related factors in older patients undergoing polypharmacy were investigated.Methods: Participants (N = 9) aged 65 years or older with chronic diseases who were prescribed more than six types of medicine were selected for this survey. Qualitative data obtained by semi-structured interviews were analyzed by Steps Coding and Theorization (SCAT). Components and concepts are indicated by "" and ' ', respectively.Results: Worries about taking medicine were affected by "lack of support from medical staff providing polypharmacy", and by "negative experiences and lack of understanding about medicine". "Behaviors for coping with worries", which were composed of "self-control in taking medicine" and "asking advice from the prescribing physician", dispelled worries. Participants that had never been worried had "received adequate support from staff involved in polypharmacy" and had "positive attitudes about polypharmacy".Conclusion: Worries about taking medicine among older patients undergoing polypharmacy were solved through self-control. Moreover, medical staff involved in polypharmacy should conduct activities to initiate communication with such patients.

Medical Students Learning from a Problem Based Learning (PBL) Style In-home Care Course: A Qualitative Analysis of the Reports / 日本プライマリ・ケア連合学会誌

<p><b>Introduction: </b>The University of Tsukuba has a one-week in-home care course combining a problem-based learning style tutorial and lectures in the comprehensive community-based learning curriculum for 2^nd year students. This study aimed to investigate what medical students are learning concretely from this course.</p><p><b>Methods: </b>We performed a qualitative date analysis of the contents of all 111 student course reports written in the free description using a modified Steps Coding and Theorization method employing the framework of patient-centered clinical method (PCCM).</p><p><b>Results: </b>Medical students learned with keen interest based on their experiences and in the framework of PCCM such as 'Exploring health, disease and the illness experience', 'Understanding the whole person'. These processes led to the awareness of responsibility as a physician.</p><p><b>Conclusion: </b>The in-home care course in the classroom may provide medical students with an opportunity to become aware of their responsibility as a physician.</p>

Gastrointestinal parasites of maned wolf (Chrysocyon brachyurus, Illiger 1815) in a suburban area in southeastern Brazil / Parasitas gastrointestinais de lobo-guará (Chrysocyon brachyurus, Illiger 1815) em uma área suburbana no sudeste do Brasil

AbstractWe examined 42 maned wolf scats in an unprotected and disturbed area of Cerrado in southeastern Brazil. We identified six helminth endoparasite taxa, being Phylum Acantocephala and Family Trichuridae the most prevalent. The high prevalence of the Family Ancylostomatidae indicates a possible transmission via domestic dogs, which are abundant in the study area. Nevertheless, our results indicate that the endoparasite species found are not different from those observed in protected or least disturbed areas, suggesting a high resilience of maned wolf and their parasites to human impacts, or a common scenario of disease transmission from domestic dogs to wild canid whether in protected or unprotected areas of southeastern Brazil.

ResumoForam examinadas 42 fezes de lobo-guará em uma área desprotegida e perturbada do Cerrado no sudeste do Brasil. Nós identificamos seis táxons de helmintos endoparasitas, sendo o Filo Acantocephala e a Família Trichuridae os mais prevalentes. A alta prevalência da Família Ancylostomatidae indica uma possível transmissão por cães domésticos, que são abundantes na área de estudo. No entanto, nossos resultados indicam que as espécies de endoparasitas encontradas não são diferentes daquelas observadas em áreas protegidas ou menos perturbadas, o que sugere uma alta resiliência do lobo-guará e seus parasitas aos impactos humanos ou um cenário comum de transmissão de doenças de cães domésticos para um canídeo selvagem, seja em áreas protegidas ou desprotegidas do sudeste do Brasil.

Patients' impressions about physicians working short-term in community clinics : A qualitative analysis of individual patient interviews / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : To reveal patients' impressions of physicians working short-term in community clinics, and to explore methods for physicians to work short-term in community clinics.<br><b>Methods</b> : We conducted a qualitative analysis of recordings of individual interviews performed on patients in community clinics using a partially revised SCAT (Steps for Coding and Theorization) method.<br><b>Results</b> : Patients indicated that they felt reassured by the constant presence of a chief physician at community clinics. They expected care within the scope of primary care, but were not expecting every element within this scope to be met. Patients had the attitude of accepting the current situation and were selecting how to receive medical care from the available options based on their personal priorities.<br><b>Conclusion</b> : Physicians working short-term in community clinics were satisfying a portion of the patients' needs. Providing care within the scope of primary care and taking the initiative in getting to know patients are essential elements for physicians working short-term in community clinics.

Conmoción cerebral asociado a un traumatismo craneoencefálico en los deportistas / Concussion associated with head trauma in athletes

Recientemente se ha puesto más atención en todo el mundo a las conmociones cerebrales que ocurren durante la práctica del deporte, a nivel escolar, amateur o profesional. La conmoción cerebral se define como una alteración repentina y transitoria en la conciencia inducida por fuerzas biomecánicas traumáticas de transmisión directa o indirectamente al cerebro. Este tipo de lesiones ocurren más comúnmente en deportes de contacto, como el boxeo, el fútbol americano y el soccer, luchas, hockey, entre otros. Se debe sospechar conmoción cerebral en cualquier deportista que sufra un traumatismo craneoencefálico, haya perdido o no el estado de conciencia. Estos deportistas, no deben regresar a la práctica deportiva de manera inmediata, y se recomiendan unos días de descanso mental y físico, para su total recuperación. Se deben evitar los traumatismos en la cabeza de manera repetitiva, ya que existe evidencia que en algunos deportistas puede producir un estado de encefalopatía traumática crónica. En la presente revisión se abordan las diferentes definiciones de conmoción cerebral, su manejo y sus consecuencias a largo plazo. Asimismo, se anexa la versión en español de la herramienta de evaluación de conmoción, Sport Concussion Assessment Tool 2 (SCAT2).

Recently, there has been increased attention to concussions that occur during sports activities, both at school level or amateur and professional level. Concussion is defined as a sudden and transient alteration of consciousness induced by traumatic biomechanical forces transmitted directly or indirectly to the brain. Such injuries most commonly occur in contact sports such as boxing, football, soccer, wrestling, hockey, among others. Concussion should be suspected in any athlete who suffers a head injury, whether or not it is associated to loss of consciousness. These athletes should not return to their sports activities immediately, and a few days of mental and physical leave are recommended in order to ensure full recovery. Repeat head injuries should be avoided, since there is evidence that in some athletes they can lead to chronic traumatic encephalopathy. The present review focuses on the different definitions of concussion, management and long-term consequences. It also contains the Spanish version of the Sport Concussion Assessment Tool 2 (SCAT2).

Jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) food habits in a mosaic of Atlantic Rainforest and eucalypt plantations of southeastern Brazil / Hábitos alimentares do jaguarundi (Puma yagouaroundi) (Carnivora, Felidae) em mosaico de Floresta Atlântica e reflorestamento de eucalipto no sudeste do Brasil

Food habits of jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) were studied between November 2000 and November 2001, in a 24.9 km² area of secondary Atlantic Rainforest and eucalypt plantation, in the Serra de Paranapiacaba, São Paulo State, Brazil. Analyses of 26 fecal and regurgitate samples, obtained over a stretch of 570.1 km, showed the consumption of 19 prey items and 74 prey occurrences. Small mammals were the most frequent food item (42.5 percent), followed by birds (21 percent), reptiles (14 percent) and medium-sized mammals (3 percent). The percent occurrence (PO) suggests that the diet consisted mainly of small rodents (30 percent) and birds (21 percent). We recorded for the first time the predation of Viperidae snakes by P. yagouaroundi. Although having a large list of items and range of dietary niche breadths (Bsta = 0.76), our data show that jaguarundi prey mainly on small vertebrates (mammals, birds or reptiles), and even in tall tropical forests or eucalypt plantations, it preys mostly on animals that come to, or live on, the ground.

A dieta de uma população de jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) foi estudada entre novembro de 2000 e novembro de 2001, em 24,9 km² de mosaico de Mata Atlântica secundária e reflorestamento de eucalipto na Serra de Paranapiacaba, São Paulo, Brasil. A análise das 26 amostras fecais e regurgitadas, obtidas em 570.1 km de percurso, indicou o consumo de 19 itens alimentares em um total de 74 ocorrências de presas. Pequenos mamíferos foram os itens mais frequentemente encontrados na dieta (42,5 por cento), seguidos por aves (21 por cento), répteis (14 por cento) e mamíferos de tamanho médio (3 por cento). A porcentagem de ocorrência (PO) sugere que a dieta concentra-se, principalmente, em pequenos roedores (30 por cento) e aves (21 por cento). Foi também registrada a predação sobre serpentes da família Viperidae. A amplitude de nicho alimentar padronizada (Bsta = 0,76) mostra uma dieta generalista, entretanto, os dados sugerem que o jaguarundi consome principalmente pequenos vertebrados (mamíferos, aves ou répteis), sobretudo, espécies terrestres.

Jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) food habits in a mosaic of Atlantic Rainforest and eucalypt plantations of southeastern Brazil

Food habits of jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) were studied between November 2000 and November 2001, in a 24.9 km² area of secondary Atlantic Rainforest and eucalypt plantation, in the Serra de Paranapiacaba, São Paulo State, Brazil. Analyses of 26 fecal and regurgitate samples, obtained over a stretch of 570.1 km, showed the consumption of 19 prey items and 74 prey occurrences. Small mammals were the most frequent food item (42.5%), followed by birds (21%), reptiles (14%) and medium-sized mammals (3%). The percent occurrence (PO) suggests that the diet consisted mainly of small rodents (30%) and birds (21%). We recorded for the first time the predation of Viperidae snakes by P. yagouaroundi. Although having a large list of items and range of dietary niche breadths (Bsta = 0.76), our data show that jaguarundi prey mainly on small vertebrates (mammals, birds or reptiles), and even in tall tropical forests or eucalypt plantations, it preys mostly on animals that come to, or live on, the ground.

A dieta de uma população de jaguarundi (Puma yagouaroundi) (Geoffroy, 1803) (Carnivora, Felidae) foi estudada entre novembro de 2000 e novembro de 2001, em 24,9 km² de mosaico de Mata Atlântica secundária e reflorestamento de eucalipto na Serra de Paranapiacaba, São Paulo, Brasil. A análise das 26 amostras fecais e regurgitadas, obtidas em 570.1 km de percurso, indicou o consumo de 19 itens alimentares em um total de 74 ocorrências de presas. Pequenos mamíferos foram os itens mais frequentemente encontrados na dieta (42,5%), seguidos por aves (21%), répteis (14%) e mamíferos de tamanho médio (3%). A porcentagem de ocorrência (PO) sugere que a dieta concentra-se, principalmente, em pequenos roedores (30%) e aves (21%). Foi também registrada a predação sobre serpentes da família Viperidae. A amplitude de nicho alimentar padronizada (Bsta = 0,76) mostra uma dieta generalista, entretanto, os dados sugerem que o jaguarundi consome principalmente pequenos vertebrados (mamíferos, aves ou répteis), sobretudo, espécies terrestres.