Association of Val16Ala Polymorphism of Manganese Superoxide Dismutase (MnSOD) with Food Intake and Cardiometabolic Risk Factors in the Elderly in Primary Care in Porto Alegre.

BACKGROUND: The aging process causes physiological changes on its own. The combination of an unhealthy lifestyle with the presence of genetic polymorphisms, such as the Val16Ala of the antioxidant enzyme manganese-dependent superoxide dismutase (MnSOD) may contribute to a greater occurrence of cardiometabolic risk factors. OBJECTIVE: This study aimed to verify the association of Val16Ala-MnSOD polymorphism with food intake, caloric expenditure, and cardiometabolic risk factors in the elderly. METHODS: A cross-sectional study with a sample size of 270 elderly individuals assisted in primary health care in the city of Porto Alegre, RS, Brazil. Val16Ala polymorphism, glucose, lipid profile, insulin, HOMA-IR, blood pressure, waist circumference, PCR-us, IL-6, food consumption, and caloric expenditure were evaluated. RESULTS: The average age of the elderly was 68.6 ± 7.6 years. There were statistically significant differences regarding the consumption of two or more servings of fruits and vegetables daily between the elderly VV versus AV (P=0.017). There were also statistically significant differences regarding the consumption of two or more daily servings of legumes and eggs between the elderly AA versus VV (P=0.002). The median of insulin was higher in the elderly AA versus AV (P=0.025) and the median of HOMA-IR was higher in the elderly VV versus AV (P=0.029). AA elderly individuals had higher means of high-density lipoprotein (HDL-c), compared to AV (P=0.029). CONCLUSION: The results suggest that Val16Ala -MnSOD polymorphism is associated with the consumption of fruits, vegetables, legumes, and eggs, as well as with cardiometabolic risk factors in the elderly.

Can Virtual Assistants Perform Cognitive Assessment in Older Adults? A Review.

Community-dwelling older adults have raised the scientific community's interest during the COVID-19 era as their chronic conditions might be aggravated by the consequences of confinement. Digital devices in this field to monitor cognitive impairment are an emerging reality of an innovative nature. However, some groups may not have benefited from these developments as much as, for example, younger people. The aim of this manuscript is to carry out a review on the development of digital devices, and specifically virtual assistants, for the detection of cognitive impairment in older adults. After a screening process, eight studies were found under the given criteria, and this number was even smaller for those using virtual assistants. Given the opportunities offered by virtual assistants through techniques such as natural language processing, it seems imperative to take advantage of this opportunity for groups such as older adults.

Idade, sexo, raça/etnia são fatores intrínsecos associados à perda de massa muscular: uma revisão sistemática / Age, sex, race/ethnicity are factors associated with loss of muscle mass intrinsic: a review systematic

Fatores intrínsecos podem estar envolvidos com a perda de massa muscular ou com a sarcopenia em humanos, como por exemplo, idade, sexo e raça. O objetivo dessa revisão foi verificar se idade, sexo e raça/etnia estão associados a perda de massa muscular ou sarcopenia. Realizou-se uma busca no mês de agosto de 2015 nas bases de dados Web of Science, Embase, PubMed e LILACS, com o intuito de identificar estudos que investigaram a perda de massa muscular e/ou sarcopenia em amostras compostas por homens e mulheres com idade acima de 18 anos, diferentes grupos étnicos, nos idiomas português e inglês, entre os anos de 2005 e 2015. Os critérios de elegibilidade foram os seguintes: indivíduos com idade igual ou superior a 18 anos; homens e mulheres de diferentes raças/etnias, onde o desfecho final deveria consistir na associação entre sarcopenia e/ou perda de massa muscular com sexo, idade e raça/etnia. 136 artigos relacionados ao tema foram capturados, porém apenas sete estudos foram incluídos, pois preencheram os critérios de inclusão. Os resultados demonstram que mulheres negras apresentam significativamente maior massa livre de gordura e índice de massa livre de gordura do que mulheres brancas, porém essas variáveis são semelhantes entre homens negros e brancos. Homens e mulheres negras apresentam significativamente perda mais precoce de massa muscular quando comparada com brancos. Idosos negros (homens e mulheres) também apresentam uma redução de força muscular quando comparados com idosos brancos. Para ambos os sexos, após o ponto de corte de 27 anos de idade a massa muscular começa a declinar, porém Afro-Americanos apresentaram os maiores valores de massa muscular, seguidos por brancos, hispânicos e asiáticos. Sexo e idade são fatores intrínsecos que podem afetar a massa muscular, no entanto a raça/etnia pode modular de forma diferente essa perda ao longo do processo de envelhecimento....(AU)

Intrinsic factors may be involved with muscle loss or sarcopenia in humans, such as age, sex and race. The objective of this review was to determine whether age, gender and race / ethnicity are associated with muscle mass loss or sarcopenia. Carried out a search during August 2015 in the databases Web of Science, Embase, PubMed and LILACS, in order to identify studies that investigated the muscle mass loss and/or sarcopenia in samples with men and women with age above 18 years, different ethnic groups, in Portuguese and English, between 2005 and 2015. The eligibility criteria were as follows: individuals aged over 18 years; men and women of different races/ethnicities, where the final outcome should be the association between sarcopenia and/or muscle mass loss with age, sex and race/ethnicity. 136 papers related to the topic were captured, but only seven studies were included because it fulfilled the inclusion criteria. The results show that black women have significantly higher fat free mass and free fat mass index than white women, but these variables are similar between black and white men. Black men and women have significantly earlier muscle mass loss compared to whites. Black elderly (men and women) also showed a reduction in muscle strength when compared with white elderly. For both sexes, after the cut-off point of 27 years old muscle mass begins to decline, but African-Americans had the highest muscle mass, followed by white, Hispanic and Asian. Gender and age are intrinsic factors that can affect muscle mass, however race/ethnicity may modulate differently this loss during the aging process....(AU)

Inflammation, Oxidation, Caloric Expenditure and Cognitive Impairment in Brazilian Elderly Assisted at Primary Care.

Cognitive impairment (CI) has a multifactorial etiology. Some studies have suggested that inflammatory, oxidative and antioxidant status and physical activity are associated with CI. However, the evidence on this subject is still controversial. The goal of this study was to verify the association of caloric expenditure by physical activity, oxidative, antioxidant power and inflammatory biomarkers with CI in older adults. We performed a cross-sectional study of 424 elderly (224 with normal cognitive function and 200 with CI) patients from the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil. The variables investigated were sociodemographic, biochemical, inflammatory (hs-CRP, IL-6), oxidative (TBARS, AOPP), antioxidant power (FRAP) biomarkers, energy expenditure, and cognitive function. The instruments used were the Minnesota Leisure Time Physical Activity Questionnaire + Compendium of Physical Activities, classification of energy costs of human physical activities (for physical activity evaluation and measurement of energy expenditure in METs), and a battery of neuropsychiatric instruments (for cognitive ability assessment). We found statistically significant differences only with respect to HDL-c and age (higher averages in the CI group; P<0.05). We observed no differences between the groups with respect to biochemical, inflammatory, oxidative and FRAP biomarkers or caloric expenditure. Logistic regression showed that HDL-c (OR=1.02 [IC=95%; 1.01-1.04]; P=0.011), and age (OR=1.05 [IC=95%; 1.02-1.08]; P=0.004) are independent factors associated with CI. Our results suggest that the biochemical (except HDL-c), inflammatory, oxidative, and FRAP biomarkers investigated and caloric expenditure are not associated with CI in the elderly assisted at primary care.

Chá verde (Camellia sinensis) e suas propriedades funcionais nas doenças crônicas não transmissíveis / Green tea (Camellia sinensis) and its functionals properties on transmissible chronic diseases

Objetivos: fazer uma revisão sobre as principais propriedades do chá verde para a saúde humana.Fonte de dados: artigos científicos das bases de dados Medline/Pubmed e SciELO.Síntese dos dados: o chá é a bebida mais consumida no mundo depois da água. Devido ao seu processo de produção, o chá verde contém mais catequinas do que o chá preto ou chá oolong. Existem evidências científicas de que as catequinas são in vitro e in vivo potentes antioxidantes. Recentes estudos em humanos sugerem que o chá verde pode contribuir para a redução do risco de doenças cardiovasculares e algumas formas de câncer, bem como promover outros benefícios à saúde, tais como efeito hipoglicemiante, controle do peso corporal, proteção contra os raios ultravioleta e manutenção da densidade mineral óssea. O crescente interesse em seus benefícios levou à inclusão do chá verde no grupo de bebidas com propriedades funcionais. Entretanto, é muito importante ressaltar que o chá verde também pode apresentar efeitos adversos.Conclusões: apesar de todas as evidências promissoras sobre as propriedades funcionais do chá verde nas doenças crônicas não transmissíveis, investigações adicionais são necessárias para a compreensão da sua real contribuição para a saúde humana.

Aims: To review the main properties of green tea to human health. Source of data: Articles from Medline/Pubmed and SciELO databases. Summary of findings: Tea is the most consumed beverage in the world after water. Due to its production process, green tea contains more catechins than black tea or oolong tea. There is scientific evidence that the catechins are in vitro and in vivo potent antioxidants. Recent human studies suggest that green tea can help reduce the risk of cardiovascular disease and some forms of cancer, as well as promote other health benefits such as hypoglycemic effect, body weight control, protection against ultraviolet rays and maintenance of bone mineral density. The growing interest in their benefits led to the inclusion of green tea in the group of beverages with functional properties. However, it is very important to note that green tea can also present adverse effects. Conclusions: Despite all the promising evidence about functionals properties of green tea on non-transmissible chronic diseases, further investigations are necessary to fully understand its real contribution to human health.

Análise de indicadores éticos do uso de animais na investigação científica e no ensino em uma Amostra Universitária da Área da Saude e das Ciências Biológicas / Analysis of ethics indicators of animal use in scientific investigation and education among universitary sample fron Health Area and Biological Sciences

Objetivos: investigar, em uma amostra universitária, indicadores éticos envolvidos no uso de animais e no ensino. Métodos: foi distribuído um questionário aos alunos do primeiro semestre dos cursos da área da saúde (Medicina, Enfermagem, Odontologia Nutrição, Fisioterapia, Farmácia e Educação Física) e das Ciências Biológicas para prenchimento em aula. As variáveis investigadas foram: idade, gênero, curso, indicadores de interesse pelo tema "ética animal" e indicadores éticos do uso de animais na pesquisa científica e no ensino. Os dados foram digitados e analisados no programa estatístico SPSS versão 11.5. Os resultados foram apresentados de forma descritiva. Resultados: um total de 363 alunos respondeu aos questionários. A média de idade foi 19,59±3,17 anos, sendo 69,3% do gênero feminino. A maioria dos alunos pesquisados tinha algum conhecimento prévio sobre o tema; não havia participado de aulas práticas com animais na graduação, mas havia participado ainda no ensino médio; levaria em consideração dor/sofrimento das cobaias, o bem-estar e o número delas tanto no ensino quanto na pesquisa; têm interesse pelo tema e participaria de um curso de extensão sobre o mesmo. Com grande frequência, os alunos posicionaram-se a favor da substituição dos animais nas atividades de ensino. Conclusões: os alunos são sensíveis quanto à utilização de animais na pesquisa e no ensino. Estes achados são importantes no contexto da ética animal, sendo que sua divulgação poderá subsidiar a reflexão sobre a utilização eticamente adequada de seres sensientes.

Hematological and nutritional parameters in apparently healthy elderly individuals

A non-probabilistic study in an elderly free living community was performed. The first analysis was cross-sectional in design and the additional analysis, a case-control design. In the first analysis, 745 subjects were enrolled. Additional analyses, made in 46 apparently healthy elderly subjects (AHE) and 33 young adults (YA) included: clinical, hematological and biochemical analyses, 24-hours nutritional recall and diet frequency questionnaire. The AHE were selected using the Senieur test protocol. To avoid selection bias in the AHE sample, additional analysis comparing cultural, socioeconomic, and health variables were compared between AHE and non-selected elderly with same dysfunction or morbidity (DE). The prevalence of AHE was 6.17 percent (n=46) among whom 4.3 percent were anemic. There were no statistically differences in hematocrit, hemoglobin, leukocytes and vitamin B12 levels between AHE and YA groups. Mean values of MCV, RDW, eosinophils, folate and ferritin were higher in the AHE than the YA group. On the other hand, platelets were higher in the YA group. No statistically significant difference occurred between the AHE and DE groups when nutritional indicators were compared. The comparison between nutritional indicators of anemic and non-anemic apparently healthy elderly people showed statistically significant differences in vitamin B12 and protein intake, which were lower in the anemic elderly. The results suggest independent biological differences between hematological parameters of elderly and young individuals.

Foi realizado um estudo não probabilístico em idosos que vivem na comunidade. A primeira análise teve um delineamento transversal e análises adicionais um delineamento caso-controle. Na primeira análise foram incluídos 745 indivíduos. Análises adicionais foram feitas em 46 idosos saudáveis (HE) e em 33 adultos jovens (YA) incluindo: análises clínicas, hematológicas e bioquímicas, recordatório nutricional de 24 horas e questionário de freqüência dietética. Os idosos saudáveis foram selecionados através do uso do protocolo Seniour. Para evitar viés de seleção na amostra HE, uma análise adicional comparando variáveis culturais, socioeconômicas e saúde com a dos idosos não selecionados (DE). A prevalência de HE foi de 17 por cento (n=46) sendo que, entre estes, 4,3 por cento estavam anêmicos. Não ocorreram diferenças estatísticas de hematócrito, hemoglobina, leucócitos, neutrófilos e vitamina B12 entre os grupos AHEe YA. Níveis médios de MCV, RDW, eosinofilos folato and ferritina foram mais altos no grupo AHE do que no YA. Ao contrário, as plaquetas foram mais altas no grupo YA. Não ocorreram diferenças significativas entre os grupos AHE e DE quando os indicadores nutricionais foram comparados. A comparação entre indicadore nutricionais de idosos anêmicos e não-anêmicos em idosos aparentemente saudáveis mostrou diferenças significativas na ingestão de vitamina B12 e de proteína, que foi mais baixa nos idosos anêmicos. Os resultados sugerem diferenças biológicas independentes entre os parâmetros hematológicos de idosos e jovens.

Association among oxidized LDL levels, MnSOD, apolipoprotein E polymorphisms, and cardiovascular risk factors in a south Brazilian region population.

Oxidized LDL (ox-LDL) is involved in the initiation and progression of atherosclerosis. Many factors can affect the LDL oxidation such as oxidative stress. The present study tested whether ox-LDL levels would be associated with apolipoprotein E (APOE), manganese superoxide dismutase (MnSOD) Ala16Val polymorphisms, and classic cardiovascular risk factors. ox-LDL levels were measured by thiobarbituric acid-reactive substances and both polymorphisms were determined by polymerase chain reaction/restriction fragment length polymorphism in a sample of 252 subjects (70 men, 182 women, mean age, 54-85 years). Subjects with ox-LDL >or=0.5 nmol/mg apoprotein were considered the high level group (HLG, N = 82) and subjects with ox-LDL <0.5 nmol/mg apoprotein were considered the expected level group (ELG, N = 170). Classic risk factors were also evaluated. The results showed that diabetes mellitus was more prevalent in HLG, whereas other cardiovascular risk factors were similar between groups. The APOE genotype frequencies did not differ between HLG and ELG subjects. However, AA genotype from MnSOD polymorphism was more frequent in ELG (chi(2) = 8.48; P = 0.014). AV and VV subjects from ELG present highest ox-LDL levels (OR = 3.61; CI95% = 1.42-9.17) than AA. Additional analysis did not find gene-gene interactions associated with ox-LDL levels. Multivariate analysis showed that diabetes and the MnSOD polymorphism were independent factors associated with higher ox-LDL levels in HLG. The results suggest that an important framework on modulation of the redox status influenced by genetic polymorphisms could affect the cardiovascular homeostasis.

Hipoglicemia / Hypoglycemia

A hipoglicemia é um distúrbio bastante comum e que deve ter um manejo rápido e apropriado, assim que diagnosticado. Pretendemos, com este artigo, revisar os principais aspectos clínicos e laboratoriais da hipoglicemia, bem como seu tratamento, proporcionando um melhor manejo deste distúrbio

Pneumonia no idoso / Pneumonia in elderly

A incidência de pneumonia é maior nos pacientes idosis e estes apresentam maior índice de morbi-mortalidade. O estado geral debilitado, as doenças concomitantes e o diagnóstico tardio contribuem para uma alta taxa de complicaçöes. Neste artigo de revisäo säo focalizados aspectos característicos de pneumonia no idoso