Future perspectives in addressing the global issue of vitamin D deficiency.

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 µg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 µg for those aged 1-70 years and 20 µg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

Cheese-related listeriosis outbreak, Portugal, March 2009 to February 2012.

In Portugal, listeriosis has been notifiable since April 2014, but there is no active surveillance programme for the disease. A retrospective study involving 25 national hospitals led to the detection of an outbreak that occurred between March 2009 and February 2012. The amount of time between the start of the outbreak and its detection was 16 months. Of the 30 cases of listeriosis reported, 27 were in the Lisbon and Vale do Tejo region. Two cases were maternal/neonatal infections and one resulted in fetal loss. The mean age of the non-maternal/neonatal cases was 59 years (standard deviation: 17); 13 cases were more than 65 years old. The case fatality rate was 36.7%. All cases were caused by molecular serogroup IVb isolates indistinguishable by pulsed-field gel electrophoresis and ribotype profiles. Collaborative investigations with the national health and food safety authorities identified cheese as the probable source of infection, traced to a processing plant. The magnitude of this outbreak, the first reported food-borne listeriosis outbreak in Portugal, highlights the importance of having an effective listeriosis surveillance system in place for early detection and resolution of outbreaks, as well as the need for a process for the prompt submission of Listeria monocytogenes isolates for routine laboratory typing.

Nasal mites of Tyrannidae (Aves) in Brazil.

A total of 81 Tyraniidae birds were examined, 80 Pitangus sulphuratus (Linnaeus, 1766) (Great kiscadee), and one Machetornis rixosa (Vieilot, 1819) (Cattle tyrant), for collection of nasal mites, which were identified as Ptilonyssus spinosus (Brooks & Strandtmann, 1960) and Sternostoma longisetosae (Hyland, 1961) (Rhinonyssidae). This finding characterises the first report of P. spinosus and S. longisetosae in P. sulphuratus, and the first record of P. spinosus in M. rixosa, and expands the geographic distribution of these species. It is the first occurrence of S. longisetosae in the Neotropics, and the first citation of P. spinosus in the state of Rio Grande do Sul, Brazil.

Triacontyl p-coumarate: an inhibitor of snake venom metalloproteinases.

Snake venom metalloproteinases (SVMPs) participate in a number of important biological, physiological and pathophysiological processes and are primarily responsible for the local tissue damage characteristic of viperid snake envenomations. The use of medicinal plant extracts as antidotes against animal venoms is an old practice, especially against snake envenomations. Such plants are sources of many pharmacologically active compounds and have been shown to antagonize the effects of some venoms and toxins. The present study explores the activity of triacontyl p-coumarate (PCT), an active compound isolated from root bark of Bombacopsis glabra vegetal extract (Bg), against harmful effects of Bothropoides pauloensis snake venom and isolated toxins (SVMPs or phospholipase A(2)). Before inhibition assays, Bg or PCT was incubated with venom or toxins at ratios of 1:1 and 1:5 (w/w; venom or isolated toxins/PCT) for 30 min at 37°C. Treatment conditions were also assayed to simulate snakebite with PCT inoculated at either the same venom or toxin site. PCT neutralized fibrinogenolytic activity and plasmatic fibrinogen depletion induced by B. pauloensis venom or isolated toxin. PCT also efficiently inhibited the hemorrhagic (3MDH - minimum hemorrhagic dose injected i.d into mice) and myotoxic activities induced by Jararhagin, a metalloproteinase from B. jararaca at 1:5 ratio (toxin: inhibitor, w/w) when it was previously incubated with PCT and injected into mice or when PCT was administered after toxin injection. Docking simulations using data on a metalloproteinase (Neuwiedase) structure suggest that the binding between the protein and the inhibitor occurs mainly in the active site region causing blockade of the enzymatic reaction by displacement of catalytic water. Steric hindrance may also play a role in the mechanism since the PCT hydrophobic tail was found to interact with the loop associated with substrate anchorage. Thus, PCT may provide a alternative to complement ophidian envenomation treatments.

Karyotype diversity of four species of the incertae sedis group (Characidae) from different hydrographic basins: analysis of AgNORs, CMA3 and 18S rDNA.

A large number of genera in the tropical fish family Characidae are incertae sedis. Cytogenetic analysis was made of four of these species: Astyanax eigenmanniorum, Deuterodon stigmaturus, Hyphessobrycon luetkenii, and H. anisitsi, collected from various hydrographic basins: hydrographic system from Laguna dos Patos/RS, Tramandaí basin/RS and Tibagi River basin/PR. The first two species were collected in their type locality in the State of Rio Grande do Sul. The 2n = 48 karyotype was observed only in A. eigenmanniorum, while the other species had 2n = 50 chromosomes, with different karyotypic formulas. There was weak heterochromatin staining in the pericentromeric region of A. eigenmanniorum, D. stigmaturus and H. luetkenni chromosomes. In H. anisitsi, heterochromatin appeared to be more abundant and distributed in the pericentromeric and terminal regions of the chromosomes; three pairs showed more evident heterochromatic blocks. There were multiple Ag-NORs in all populations, visualized by FISH with an 18S rDNA probe. While D. stigmaturus and H. luetkenii had conserved AgNOR, CMA3 and 18S rDNA sites, the other two species showed intra- and interindividual variation at these sites. The karyotype variability was high, as is common in this group of fish. Different species arising from isolated hydrographic basins maintain an elevated level of karyotype differentiation, mainly with respect to chromosome structure, heterochromatin distribution and rDNA localization. This is the first report with cytogenetic data for D. stigmaturus and H. luetkenii.

Primary pleomorphic sarcoma of lung--11 year survival.

Primary sarcomas of the lung are uncommon, potentially aggressive neoplasms that need to be distinguished from other malignant pulmonary tumors and whose biological behavior is as yet not fully understood. Primary undifferentiated pleomorphic sarcoma was diagnosed in the right lung of a 66 year-old man, who has survived over 11 years after treatment with endobronchial tumor debulking by laser therapy and radiotherapy.

Desenvolvimento de Periplaneta australasiae Fabricius (Blattodea, Blattidae) em temperatura constante de 30º c e em temperatura ambiente de laboratório / Development of Periplaneta australasiae Fabricius (Blattodea, Blattidae) at a constant temperature of 30° c and at ambient laboratory temperature

Objetivou-se avaliar o desenvolvimento de ovos e ninfas de Periplaneta australasiae (Fabricius) à temperatura de 30 ± 0,2° C, umidade relativa 80 ± 15% e fotofase de 12h e em condições ambientais de laboratório, sem controle de temperatura e umidade relativa; visando à subsídios para medidas de prevenção e controle. As ootecas foram individualizadas em tubos de ensaio até a eclosão. As ninfas foram transferidas para cubas de vidro e alimentadas com ração comercial para coelhos e água ad libitum até a emergência das imagos. Avaliou-se, período de incubação, número de ovos/ ooteca, viabilidade de ovos, número de ninfas/ooteca, período ninfal, viabilidade de ninfas e período ovo/adulto. A diferença do período médio de incubação à temperatura de 30° C (38 dias) e no ambiente (44,5 dias) foi significativa (p < 0,0001); eclodiram, em média 18,1 ninfas/ooteca a 30° C e 21 ninfas/ooteca em condições ambientais (p = 0,006); o período médio de ninfa a 30° C foi de 155,9 dias e no ambiente 279,7 dias (p < 0,0001); a viabilidade de ninfas foi superior a 50%, tanto a 30° C (55,1%) quanto em condições de laboratório (57,2%); no período médio de ovo-adulto de P. australasiae, houve diferença significativa (p< 0,001) entre a temperatura de 30 °C (194,1 dias) e em condições ambientais de laboratório (337,3 dias). Em condições de laboratório, os períodos de incubação, de ninfa e de ovo-adulto de P. australasiae foram aumentados em relação à temperatura de 30° C, não ocorrendo, entretanto, perda nem redução de viabilidade em nenhuma das fases.

With the objective of obtaining standards of measurement for prevention and control, this study compared the development of the eggs and nymphs of Periplaneta australasiae (Fabricius) at a temperature of 30 ± 0.2° C, relative humidity 80 ± 15% and photoperiod of 12 hours versus ambient conditions in the laboratory without controls of temperature and RH. Single ootheca were maintained in test tubes until ecolosion, and nymphs were transferred to glass cubes and fed commercial rabbit ration and water ad libitum until emergence of the imagos. The incubation period, number of eggs/ ootheca, viability of the eggs, number of nymphs/ootheca, nymphal duration, viability of nymphs and duration of egg to adult were all evaluated. The mean difference in the incubation period between the temperature of 30° C (38 days) and ambient conditions (44.5 days) was significant (p < 0.0001); a mean of 18.1 nymphs/ootheca ecloded at 30° C, while 21 nymphs/ootheca ecloded under ambient conditions (p = 0.006); the mean nymphal period at 30° C was 155.9 days while for the ambient it was 279.7 days (p < 0.0001); nymphal viability was greater than 50% for both the 30° C laboratory (55.1%) and the ambient (57.2%); and the mean period from egg to adult of P. australasiae was significantly different (p < 0.001) between the 30° C temperature (194.1 days) and the ambient conditions of the laboratory (337.3 days). Under ambient conditions, the duration of nymphal incubation and egg to adult development of P. australasiae were increased relative to the temperature of 30° C without a reduction in viability in any of the stages.

Acclimation of Myrtus communis to contrasting Mediterranean light environments - effects on structure and chemical composition of foliage and plant water relations.

Leaf anatomical and chemical characteristics, water relations and stomatal regulation were studied in the shrub Myrtus communis growing under two contrasting Mediterranean light environments (full light versus 30% of full light) during the spring-summer period. These studies aimed to assess plant response to the combined effects of light and water availability. Foliar morphology, anatomy and chemistry composition acclimated positively to light conditions. Leaves of sun-exposed plants were thicker (38.7%) than those of shaded plants, mainly due to increased palisade parenchyma thickness, had a higher nitrogen concentration and stomatal density than the shade ones, which maximized foliar area (>SLA) and Chl/N molar ratio to improve light interception. Chlorophyll concentration per leaf area (Chl(a)) was always higher in sun leaves while, as expressed on dry mass (Chl(m)), significant differences were only apparent in September, shade leaves presenting higher values. During the summer period Chl(a) and Chl(m) markedly declined in sun leaves and remained unchanged in shade ones. The ratio of chlorophyll a/b was not affected either by the light intensity or by the season. Shade leaves presented generally a higher concentration of soluble carbohydrates per dry mass. No significant differences in starch concentration were apparent between sun and shade leaves and a gradual depletion occurred during the water stress period. Maximum stomatal conductances correlated positively with predawn water potential. Throughout the season, sun plants always presented higher leaf conductance to water vapour and lower minimum leaf water potentials, indicating an interaction of light-environment on these water relation parameters. Stomatal closure constitutes a mechanism to cope with diurnal and seasonal water deficits, sun plants presenting a more efficient control of water losses during water deficiency period. In addition, both sun and shade plants evidenced leaf osmotic adjustment ability in response to water stress, which was greater in sun ones.

[Nursing diagnoses by undergraduate students on hospitalized patients with neurological changes]. / Diagnósticos de enfermagem: atribuição feita por graduandos de enfermagem a pacientes internados com alterações neurológicas.

Diagnostic categories and patterns of human responses were identified in neurologic patients, assisted by nursing undergraduate students who attributed to them nursing diagnoses, according to NANDA's Taxinomy I. The majority of attributed diagnoses refer to the patterns Exchange, Move and Communicate and the minority to the patterns Choose, Receive and Feel. The non attribution of other diagnoses probably occurred due to the lack of emphasis given to them and to students' inexperience. Faculty determinations to develop in the students skills of analysis and synthesis confirm this positive experience.

[Evaluation of the surgical treatment of trapeziometacarpal arthroses]. / Avaliação do tratamento cirúrgico da artrose trapeziometacárpica.

The authors describe their experience, from July 1995 to December 1996, in the management of patients suffering from trapeziometacarpal degenerative arthrosis. Dell's classification is used for disease staging. The results of two different techniques are compared: 1) distal tenotomy of supranumerary insertions of abductor pollicis longus; and 2) trapeziectomy with tendon interposition arthroplasty and ligamentoplasty using the flexor carpi radialis.

[Experiences of a group of retired elderly: action research]. / La vivencia de un grupo de jubilados-anciano: investigación--acción.

The present study aims at comprehending the retired people through a group experience as well as allowing them to reflect about their condition. The authors utilized the research-action methodology, with 25 retired subjects who worked in the University, aging from 51 to 79 years old. The narratives related to their experiences were obtained through verbal interaction, group discussions and interviews. From the analysis of the experiences emerged questions associated to the retired-elderly interests, their physical and mental health, relationship, learning process, social environment and leisure.

[Urinary incontinence in the elderly: a proposal for nursing behavior]. / Incontinência urinária em idosos: proposta para a conduta da enfermeira.

The authors make it evident the Urinary Incontinence in elderly people showing up the prevalence, their motives and types. It is subsidize the evaluation of the historical, the physical exam, registry of the incontinence and also the exercises for the training of the bladder, the musculature, hygiene habits and also the manipulation of the catheters and the aspects of the environment looking for the restoration of the continence and/or to treat and to live with in the urinary incontinence. They distinguish that the nursing conduct is done interrelated with the medical team with homely cares and elderly investing in the self care for to improve the urinary incontinence and favouring the continence.

[The theme of death: an educational proposal]. / O tema da morte: uma proposta de educação.

The necessity of educating the Health Professionals to the theme Death is concerned has become so evident during our educational activities that we have striven for the construction of a knowledge body about death and dying. Therefore, the knowledge we have generating refers to the pedagogical aspect of the theme. The aim of this study was to focus such dimension as far as it describes and analyses our experience in educating nursing undergraduates to deal with situations involving death and dying. In particular, we try to developing our students in order to be able to provide care to the dead body in a proposal to transcend the technical aspect of this care. Bearing this educational purpose, we strive for a space that makes possible a formation in the perspective of leading the students to another existencial dimension when facing and understanding death.

[Estimation of fertility levels and trends using some indirect estimation methods]. / Avaliacao dos niveis e tendencias da fecundidade atraves de alguns modelos de mensuracao indireta.

PIP: Methods for the indirect estimation of fertility developed by Brass and Arriaga are described and applied to data from the Brazilian censuses from 1940 to 1980. The applicability of Arriaga's method for use with survey data is also considered^ieng