Características evidenciadas em recém-nascidos de gestantes hipertensas e diabéticas: revisão sistemática da literatura / Characteristics evidenced in newborns of hypertensive and diabetic pregnant women: systematic review of the literature

Objetivo: evidenciar quais são as repercussões no leito vascular e as características dos neonatos de gestantes com Síndromes Hipertensivas Gestacionais e/ou Diabetes Mellitus Gestacional. Método: trata-se de uma revisão sistemática de literatura, as buscas da pesquisa foram realizadas no mês de julho do ano de 2017, nas bases de dados da Literatura Latino-Americana do Caribe em Ciências da Saúde e na National Library of Medicine. Os dados foram tabulados em planilhas do Excel, sendo aplicada a análise de conteúdo. Resultados: os recém-nascidos de mães hipertensas estiveram relacionados a prematuridade e baixo peso para a idade gestacional, enquanto os recém-nascidos de mães diabéticas são relacionados a uma maior idade gestacional ao nascimento e peso considerado grande para a idade gestacional. Considerações finais: salienta-se a importância do acompanhamento através do pré-natal desde os primórdios da gestação, como medida protetiva à saúde materno-infantil.

Objective: investigate the repercussions in the vascular bed and the characteristics of the neonates of pregnant women with Hypertensive Syndromes in Pregnancy and/or Gestational Diabetes Mellitus. Methods: it is a systematic review of the literature, the research searches were carried out in July of the year 2017, in the databases of Latin American Literature of the Caribbean in Health Sciences and National Library of Medicine. Data were tabulated in Excel spreadsheets, and content analysis was applied. Results: newborns of hypertensive mothers were related to prematurity and low birth weight for gestational age, while the newborns of diabetic mothers are related to a higher gestational age at birth and a heaviest for gestational age. Final considerations: importance of follow-up through prenatal care from the earliest stages of gestation, as a protective measure for maternal and child health.

Association between anthropometric markers and asthma control, quality of life and pulmonary function in adults with asthma.

BACKGROUND: The role of abdominal fat and body fat (BF) in the evaluation of nutritional status in asthma has been considered recently. The present study aimed to evaluate the association between different anthropometric markers and asthma control, pulmonary function and quality of life. A secondary objective was to determine the agreement between the anthropometric markers with respect to assessing obesity in adults with asthma. METHODS: This cross-sectional study enrolled adult asthma patients attending an outpatient asthma clinic in southern Brazil. Patients were evaluated regarding sociodemographic data, lung function, asthma control, nutritional status and health-related quality of life (Asthma Quality of Life Questionnaire; AQLQ). Nutritional status was classified by body mass index (BMI), waist circumference (WC) and BF. RESULTS: The mean (SD) age of the 198 patients was 56.2 (14.8) years. The prevalence of uncontrolled asthma among subjects who were overweight as diagnosed by their BMI was 64.6% higher than in those who were normal weight. An increase in a measure of BMI (1 kg m-2 ) decreases approximately 44-59% of symptoms, activity limitations and emotional function domains of the AQLQ, whereas an increase in a measure in WC (1 cm) decreases approximately 24-30% of the same domains. Agreement between BMI and BF was 0.566 and that between BMI and WC was 0.597 by Kendall's Tau-b test. CONCLUSIONS: The prevalence of uncontrolled asthma is greater in overweight subjects than in normal weight subjects. WC and BMI were negatively associated with symptoms, activity limitations and emotional function domains of the AQLQ. BMI appears to be sufficient to diagnose the nutritional status of subjects with asthma in this population.

Associação da ocorrência do ectima contagioso (ORF vírus) em ovinos com os cuidadores desses animais / Occurrence of the Association contagious ecthyma (ORF virus) in sheep with these animals' caregivers

A enfermidade ectima contagioso está difundida em todo o estado de São Paulo. Foram amostrados 42 (8,64%) cuidadores de animais e 444 (91,36%) ovinos (n=486). A prevalência de reagentes para vírus-neutralização foi de 67% (IC95%=62-71%) nos ovinos, e em seus cuidadores de 76% (IC95%=63-89%), sendo P=0,22, ou seja, não houve diferença estatística significativa entre as espécies. A distribuição dos títulos teve diferença estatística significativa entre as espécies, com P=0,0048. As variações de titulação foram de 0,6 a 2,1 tanto nos ovinos quanto nos seus cuidadores. Dentre os 42 cuidadores de ovinos participantes do estudo, 32 apresentaram títulos de anticorpos expressos por log10 acima de 0,6.(AU)

These diseases are all widespread in the State of São Paulo. 42 (8.64%) animal caregivers and 444 (91.36%) sheep (n=486) were sampled. The reagents Prevalence paragraph virus neutralization was 67% (95% CI = 62-71%) in sheep and 76% (95% CI = 63-89%) for caregivers, with P=0.22 not being a statistically significant difference between the species. One of the distribution titles had significant difference between statistics as species with P=0.0048. The titration variations were 0.6 to 2.1, both in sheep and their caregivers. Among the 42 sheep caregivers participating in the study, 32 had antibody securities denominated in log10 above 0.6.(AU)

Seasonal variability of the essential oil of Hesperozygis ringens (Benth.) Epling.

This study was developed to evaluate the effect of seasonality on the yield and chemical composition of the essential oil (EO) of Hesperozygis ringens (Benth.) Epling, a native species from the Brazilian Pampa. Leaves were collected from four specimens of a single population in each of the four seasons for a year and were extracted in triplicate by hydro-distillation for 2 hours. The yield of EO (% w/w) was calculated on fresh weight basis (FWB), and the 16 oil samples were analyzed by gas chromatography coupled to mass spectrometry (GC-MS) and gas chromatography with flame ionization detector (GC-FID). Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA) were used as statistical tools to evaluate differences in chemical composition. The highest yields were obtained in autumn, spring and summer (2.32-4.38%), while the lowest yields were detected in winter, ranging from 1.15 to 1.91%. Oxygenated monoterpenoids were the predominant class of chemical constituents in the EO obtained in all seasons, showing the highest contents in autumn and summer, and pulegone was identified as a major compound, whose contents varied between 54.13 and 81.17%. The EO samples were divided into three chemical groups by HCA and PCA and were assigned to the same group, except for the three samples gathered in winter. The results showed a seasonal influence on the yield and chemical composition of the EO.

Seasonal variability of the essential oil of Hesperozygis ringens (Benth.) Epling. / Variabilidade sazonal do óleo essencial de Hesperozygis ringens (Benth.) Epling.

Abstract This study was developed to evaluate the effect of seasonality on the yield and chemical composition of the essential oil (EO) of Hesperozygis ringens (Benth.) Epling, a native species from the Brazilian Pampa. Leaves were collected from four specimens of a single population in each of the four seasons for a year and were extracted in triplicate by hydro-distillation for 2 hours. The yield of EO (% w/w) was calculated on fresh weight basis (FWB), and the 16 oil samples were analyzed by gas chromatography coupled to mass spectrometry (GC-MS) and gas chromatography with flame ionization detector (GC-FID). Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA) were used as statistical tools to evaluate differences in chemical composition. The highest yields were obtained in autumn, spring and summer (2.32-4.38%), while the lowest yields were detected in winter, ranging from 1.15 to 1.91%. Oxygenated monoterpenoids were the predominant class of chemical constituents in the EO obtained in all seasons, showing the highest contents in autumn and summer, and pulegone was identified as a major compound, whose contents varied between 54.13 and 81.17%. The EO samples were divided into three chemical groups by HCA and PCA and were assigned to the same group, except for the three samples gathered in winter. The results showed a seasonal influence on the yield and chemical composition of the EO.

Resumo Este estudo foi desenvolvido a fim de avaliar o efeito da sazonalidade no rendimento e composição química do óleo essencial (OE) de Hesperozygis ringens (Benth.) Epling., uma espécie nativa do Pampa brasileiro. Folhas foram coletadas de quatro indivíduos de uma mesma população, em cada uma das quatro estações de um ano, e foram extraídas em triplicada por hidrodestilação durante 2 horas. O rendimento do OE (% m/m) foi calculado considerando a base fresca (BF) e as 16 amostras de óleo foram analisadas por cromatografia gasosa acoplada à espectrometria de massas (CG-EM) e cromatografia gasosa com detector de ionização de chamas (CG-DIC). Análise Hierárquica de Cluster (AHC) e Análise de Componentes Principais (ACP) foram utilizadas como ferramentas estatísticas para avaliar as diferenças na composição química. Os maiores rendimentos foram obtidos no outono, primavera e verão (2,32-4,38%), enquanto que os menores foram detectados no inverno, variando de 1,15 até 1,91%. Os monoterpenoides oxigenados foram a classe predominante dos constituintes do OE obtido em todas as estações, apresentando os maiores teores no outono e no verão, e a pulegona foi identificada como o constituinte majoritário, cujos teores variaram entre 54,13 e 81,17%. As amostras de OE foram divididas em três grupos químicos por AHC e ACP e foram classificadas no mesmo grupo, com exceção de três amostras coletadas no inverno. Os resultados demonstraram influência sazonal no rendimento e na composição química dos OE.

Effect of (+)-dehydrofukinone on GABAA receptors and stress response in fish model.

(+)-Dehydrofukinone (DHF) is a major component of the essential oil of Nectandra grandiflora (Lauraceae), and exerts a depressant effect on the central nervous system of fish. However, the neuronal mechanism underlying DHF action remains unknown. This study aimed to investigate the action of DHF on GABAA receptors using a silver catfish (Rhamdia quelen) model. Additionally, we investigated the effect of DHF exposure on stress-induced cortisol modulation. Chemical identification was performed using gas chromatography-mass spectrometry and purity was evaluated using gas chromatography with a flame ionization detector. To an aquarium, we applied between 2.5 and 50 mg/L DHF diluted in ethanol, in combination with 42.7 mg/L diazepam. DHF within the range of 10-20 mg/L acted collaboratively in combination with diazepam, but the sedative action of DHF was reversed by 3 mg/L flumazenil. Additionally, fish exposed for 24 h to 2.5-20 mg/L DHF showed no side effects and there was sustained sedation during the first 12 h of drug exposure with 10-20 mg/L DHF. DHF pretreatment did not increase plasma cortisol levels in fish subjected to a stress protocol. Moreover, the stress-induced cortisol peak was absent following pretreatment with 20 mg/L DHF. DHF proved to be a relatively safe sedative or anesthetic, which interacts with GABAergic and cortisol pathways in fish.

Effect of (+)-dehydrofukinone on GABAA receptors and stress response in fish model

(+)-Dehydrofukinone (DHF) is a major component of the essential oil of Nectandra grandiflora (Lauraceae), and exerts a depressant effect on the central nervous system of fish. However, the neuronal mechanism underlying DHF action remains unknown. This study aimed to investigate the action of DHF on GABAA receptors using a silver catfish (Rhamdia quelen) model. Additionally, we investigated the effect of DHF exposure on stress-induced cortisol modulation. Chemical identification was performed using gas chromatography-mass spectrometry and purity was evaluated using gas chromatography with a flame ionization detector. To an aquarium, we applied between 2.5 and 50 mg/L DHF diluted in ethanol, in combination with 42.7 mg/L diazepam. DHF within the range of 10-20 mg/L acted collaboratively in combination with diazepam, but the sedative action of DHF was reversed by 3 mg/L flumazenil. Additionally, fish exposed for 24 h to 2.5-20 mg/L DHF showed no side effects and there was sustained sedation during the first 12 h of drug exposure with 10-20 mg/L DHF. DHF pretreatment did not increase plasma cortisol levels in fish subjected to a stress protocol. Moreover, the stress-induced cortisol peak was absent following pretreatment with 20 mg/L DHF. DHF proved to be a relatively safe sedative or anesthetic, which interacts with GABAergic and cortisol pathways in fish.

Effect of oil overlay on inhibition potential of roscovitine in sheep cumulus-oocyte complexes.

Inhibitors of cyclin-dependent kinases, as roscovitine, have been used to prevent the spontaneous resumption of meiosis in vitro and to improve the oocyte developmental competence. In this study, the interference of oil overlay on the reversible arrest capacity of roscovitine in sheep oocytes as well as its effects on cumulus expansion was evaluated. For this, cumulus-oocyte complexes (COCs) were cultured for 20 h in TCM 199 with 10% foetal bovine serum (Control) containing 75 µm roscovitine (Rosco). Subsequently, they were in vitro matured (IVM) for further 18 h in inhibitor-free medium with LH and FSH. The culture was performed in Petri dishes under mineral oil (+) or in 96 well plates without oil overlay (-) at 38.5°C and 5% CO2 . At 20 and 38 h, the cumulus expansion and nuclear maturation were evaluated under stereomicroscope and by Hoechst 33342 staining, respectively. No group presented cumulus expansion at 20 h. After additional culture with gonadotrophins, a significant rate of COCs from both Control groups (+/-) exhibited total expansion while in both Rosco groups (+/-) the partial expansion prevailed. Among the oocytes treated with roscovitine, 65.2% were kept at GV in the absence of oil overlay while 40.6% of them reached MII under oil cover (p < 0.05). This meiotic arrest was reversible, and proper meiosis progression also occurred in the Control groups (+/-). So, the culture system without oil overlay improved the meiotic inhibition promoted by roscovitine without affecting the cumulus expansion rate or the subsequent meiosis progression.

Conceptualizing and measuring potentially inappropriate drug therapy.

WHAT IS KNOWN AND OBJECTIVE: Elderly people are the principal consumers of prescription drugs. The more the medication used by the patient, the greater the likelihood there is of the patient being subjected to potentially inappropriate drug therapy (PIDT). PIDT has been measured in the literature with both implicit and explicit tools. The purpose of this review was to assess the use of tools to detect PIDT in various studies and to determine which terms are used to refer to PIDT in practice. METHODS: A systematic review was conducted according to the following steps: the first was identification. In this step, studies were selected from different combinations of the descriptors 'aged', 'elderly', 'inappropriate prescribing' and 'drug utilization' in three different languages, using the Embase, Medline, Scielo, Scopus and Web of Science databases. Second, the papers that satisfied the inclusion criteria for data extraction were carefully examined by three evaluators to determine the tools used and terms that referred to PIDT. RESULTS AND DISCUSSION: From the combinations of keywords, 8610 articles were found. At the end of the selection process, 119 of the articles complied with the specified criteria. The degree of agreement among evaluators was moderate for the study titles (κ1  = 0·479) and substantial for abstracts (κ2  = 0·647). With respect to the PIDT evaluation criteria used by the studies, 27·7% used two criteria. Of the 27 evaluation criteria identified, the Beers criteria were used by 82·3% of the studies. More than 50 different terms to identify PIDT were found in the literature. WHAT IS NEW AND CONCLUSION: This review is the first study to conceptualize and discuss terms that refer to PIDT. At present, there is no consensus regarding terms used to refer to PIDT, with over 50 different terms currently in use. This review shows an increase in the number of articles aimed at evaluating PIDT using implicit and explicit tools.

Larvicidal activity of Brazilian plant essential oils against Coenagrionidae larvae.

Odonate larvae can be serious pests that attack fish larvae, postlarvae, and fingerlings in fish culture tanks, causing significant loss in the supply and production of juveniles. This study reports a screen of the essential oils (EOs) of Nectandra megapotamica (Sprengel) Mez, Nectandra grandiflora Nees, Hesperozygis ringens (Bentham) Epling, Ocimum gratissimum L., Aloysia gratissima (Gillies & Hooker) Troncoso, and Lippia sidoides Chamisso against Coenagrionidae larvae. In addition, the most effective EO and its 50% lethal concentration (LC50) and chemical analysis are described. The larvae of Acanthagrion Selys, Homeoura Kennedy, Ischnura Charpentier, and Oxyagrion Selys were used to assess the EO effects. EO obtained from H. ringens, O. gratissimum, and L. sidoides showed the highest larvicidal effects at 19 h of treatment. The major constituents of the EO of H. ringens include pulegone and limonene, while eugenol and Z-beta-ocimene predominate in the EO of O. gratissimum, and carvacrol and rho-cymene were the major compounds of the EO of L. sidoides. Leaf EOs from H. ringens, O. gratissimum, and L. sidoides showed activity against Coenagrionidae larvae at similar concentrations with LC50s of 62.92, 75.05, and 51.65 microl liter(-1), respectively, and these were considered the most promising treatments.

Ocorrência de Campylobacter em carne de frango, fezes de frango e humanas e pesquisa dos genes cdt / Occurrence of Campylobacter in poultry, meat chicken and human feces, and cdt GENES research

Foram coletadas 100 amostras de conteúdo fecal de aves de corte, 100 de produtos de frango (coxa, sobrecoxa, asa, dorso, carne moída e fígado) e 100 de fezes de humanos, e analisadas para pesquisa de Campylobacter. Realizou-se a determinação da espécie e da presença dos genes cdt, responsáveis pela codificação da toxina citoletal distensiva (CDT), através da técnica da PCR. A bactéria foi isolada de 61% das amostras de fezes de frango, 20% de produtos de frango e 3% de fezes de humanos. A maioria dos isolados foi determinada como C. jejuni . Destes, 93,5% apresentaram os genes para a toxina CDT. Apesar de a ocorrência de Campylobacter em fezes de humanos ter sido baixa, a prevalência em frangos de corte e produtos de frango foi elevada, fato que, aliado à presença dos genes cdt na maioria dos isolados, representa risco potencial para os consumidores. Esses resultados são indicativos da necessidade de medidas preventivas no sistema de produção e de boas práticas de fabricação na indústria, de forma a minimizar a contaminação dos produtos e diminuir o risco para os consumidores.

A hundred chicken fecal samples, a hundred samples of retail poultry products and a hundred samples of human feces were collected and tested for the presence of Campylobacter. The species identification and the analysis for the presence of cdt genes, responsible for encoding the cytolethal distending toxin, were performed by PCR. Campylobacter was found in 61% of the chicken fecal samples, in 20% of the poultry products and in 3% of the human feces. Most isolates were identified as C. jejuni. In 93.5% of these isolates, the cdt genes have been detected. Despite the occurrence of Campylobacter in feces of humans has been low, the prevalence in broilers and poultry products was high, which, combined with the presence of cdt genes in most isolates, represents a potential risk to consumers. These results suggest there is a need for preventive measures in the production system and good manufacturing practices in the industry so as to minimize contamination of products and reduce the risk to consumers.

Trypanosoma cruzi-cardiomyocytes: new contributions regarding a better understanding of this interaction.

The present paper summarizes new approaches regarding the progress done to the understanding of the interaction of Trypanosoma cruzi-cardiomyocytes. Mannose receptors localized at the surface of heart muscle cell are involved in binding and uptake of the parasite. One of the most striking events in the parasite-heart muscle cells interaction is the disruption of the actin cytoskeleton. We have investigated the regulation of the actin mRNA during the cytopathology induced in myocardial cells by the parasite. T. cruzi invasion increases calcium resting levels in cardiomyocytes. We have previously shown that Ca2+ ATPase of the sarcoplasmic reticulum (SERCA) is involved in the invasion of T. cruzi in cardiomyocytes. Treating the cells with thapsigargin, a drug that binds to all SERCA ATPases and causes depletion of intracellular calcium stores, we found a 75% inhibition in the T. cruzi-cardiomyocytes invasion.

An epidemic of renal failure among Australian Aboriginals.

OBJECTIVE: To define recent trends (1993-1996) in incidence of endstage renal disease (ESRD) among Australian Aboriginal people in the Top End of the Northern Territory (NT). DESIGN: Analysis of hospital and clinical records of the Darwin-based ESRD treatment program from 1993 to 1996 and comparison with data accumulated since 1978. PARTICIPANTS: All people entering the ESRD treatment program from 1978 to 1996. MAIN OUTCOME MEASURES: Number of patients treated for ESRD; their ethnicity, age and sex; comorbidities in Aboriginal patients; treatment methods and outcomes. RESULTS: More Aboriginal people presented with ESRD between 1993 and 1996 (87) than in the previous 15 years of the program (68). The incidence of ESRD in Aboriginals reached 838 per million in 1996, and is doubling every 4 years. Aboriginal people presenting with ESRD are younger than non-Aboriginal people with ESRD, and, in contrast to non-Aboriginals, ESRD rates are higher in women than men. The numbers and proportions of Aboriginal ESRD patients who have hypertension, type 2 diabetes and cardiac disease are rising. Haemodialysis remains the most common form of treatment, and the number of dialysis treatments is doubling every 2.5 years. Only 9% of Aboriginal patients entering the program in 1993-1996 were treated with chronic ambulatory peritoneal dialysis and only 3% received transplants. Despite their younger age, survival of Aboriginal people on dialysis is low (median 3.3 years v. 6.5 years in non-Aboriginals), and graft survival after transplant is poor (37% at 5 years v. 88% in non-Aboriginals). Survival has not improved in the past 4 years, with fewer deaths from infection offset by more deaths from cardiovascular disease. CONCLUSIONS: The predicted doubling of ESRD incidence among Aboriginal people by the year 2000 will add an enormous burden to limited resources. Risk factors for renal disease underlie all the excess morbidity and mortality in NT Aboriginal adults, and arise out of accelerated lifestyle changes and socioeconomic disadvantage. Better living conditions and education, robust and integrated primary healthcare programs, and systematic screening for early renal disease and treatment of those with established disease are all matters of urgency.

Excessive rates of childhood mortality in the Northern Territory, 1985-94.

OBJECTIVES: To estimate the post-infant/childhood mortality rate (1-14 years) in the Northern Territory (NT) of Australia. METHODS: A retrospective study of post-infant death in the 10 years 1985-94 inclusive in the NT. RESULTS: Two hundred and forty-four deaths were identified. Compared to a non-Aboriginal, an Aboriginal child was twice as likely to die from accidents, 11 times more likely to die from infection and 3.2 times more likely to die from all causes. Road traffic accidents were the leading cause of accident mortality in Aboriginal children. All children who died in collisions or rollovers were unrestrained. Drowning was the major cause of death amongst non-Aboriginal children aged 1-4 years; none of the residential pools in which drowning occurred had fencing which complied with the recommended Australian fencing standards. Mortality rates from infection were highest in Aboriginal children aged 1-4 years. The overall mortality rate decreased over the 10-year period with a significant reduction in non-Aboriginal but not in Aboriginal children. CONCLUSIONS: NT children aged 1-14 years have higher mortality rates than their Australian counterparts and these are significantly higher in Aboriginal compared to non-Aboriginal children. Legislation and enforcement of isolation pool fencing, car seat restraints and safer driving on rural roads could have a significant impact on reducing accident mortality.

Home oxygen management of neonatal chronic lung disease in Western Australia.

OBJECTIVE: To describe the course and management of infants with neonatal chronic lung disease who were discharged home on low-flow supplemental oxygen. METHODOLOGY: Retrospective case series in Western Australia. RESULTS: Fifty-six neonates born in the 6 year period 1987-92 inclusive were discharged home on supplemental oxygen. The median gestational age was 27 weeks (range 22-40), median birthweight 865 g (range 450-3350), median oxygen flow rates 125 mL/min (range 30-850). The median corrected age at discharge was 1 month (range term-9.5) and this had decreased throughout the study period. Acute hospital readmissions were common (36 of 56, 64%). The majority of these admissions were for wheezing illnesses. Three infants died. The median corrected age at weaning from day oxygen was 4 months (range term-33) and from night oxygen was 6 months (range 2-38). Monitoring of oxygen saturation in air, in low-flow oxygen and in the overnight sleep study were important non-invasive guides in deciding when patients were ready for discharge, reducing the oxygen flow rate and when oxygen could be ceased, respectively. CONCLUSIONS: The home oxygen programme enables infants with neonatal chronic lung disease to be discharged home earlier, is safe, and well accepted by parents and community health care workers.