Excessive gain in body mass index-for-age Z-score and associated factors: a cohort study in female adolescents.

OBJECTIVE: To evaluate the occurrence of excessive gain in body mass index-for-age Z-score (BMI/AZ) and its associated factors in adolescent girls. METHODOLOGY: This is a cohort study conducted between 2007 and 2012 with 382 girls between 10 and 18 years of age attending public schools in Recife, Pernambuco, Brazil. Excessive gain in BMI/AZ (EGBMI/AZ) at follow-up was considered if the adolescent had a BMI/AZ >0.63 between follow-up and baseline. RESULTS: In 2007, 33.5% of girls were overweight, and at the end of the study this prevalence was 26.2%, with no statistically significant differences. Of the 382 girls evaluated in the cohort, 33% showed EGBMI/AZ. In 2007, 95% of these girls were normal weight or underweight, and in 2012, 60% were classified as overweight. After adjusting for possible confounding factors, three variables remained independently associated with EGBMI/AZ: underweight, normal weight and maternal overweight. CONCLUSIONS: Both underweight and normal weight were associated with EGBMI/AZ, and this could be due to a physiological protection for the occurrence of menarche. In fact, maternal overweight has considerable influence on adolescents' nutritional status because of exposure to an obesogenic environment.

Early menarche in normal-weight girls and its association with excess weight, abdominal obesity and metabolic changes at the end of sexual maturation.

BACKGROUND/OBJECTIVES: The objective of this study was to assess whether early menarche in normal-weight girls is associated with excess weight, abdominal obesity and metabolic changes at the end of sexual maturation. SUBJECTS/METHODS: This is a cohort study of 255 normal-weight girls aged 10-18 years attending public schools in the city of Recife, Pernambuco, Northeast of Brazil. The following data were collected in 2007 and 2012: anthropometric; lifestyle, socioeconomic and demographic data; lipid profile; and self-assessed sexual maturation. RESULTS: Eighty-four girls (32.9%) had early menarche. The socioeconomic level and time spent using a computer increased during this 5-year period, whereas the time spent watching television decreased. The prevalences of excess weight and abdominal obesity were 19.2% and 9.8%, respectively. The anthropometric and laboratory variables of girls with and without early menarche did not differ. CONCLUSIONS: These findings suggest that early menarche did not influence weight, abdominal obesity and serum lipids in the final stage of sexual maturation.

Body fat assessment by bioelectrical impedance and its correlation with anthropometric indicators / Evaluación de la grasa corporal por impedancia bioeléctrica y su correlación con indicadores antropométricos

Introduction: Since the excess of body fat is associated with higher morbid-mortality rates (mainly in adults), precise, reliable, cost-effective, and broadly applicable methods are necessary for its assessment in population-based studies and in clinical practice. Objective: To evaluate the correlation between body fat estimated either by bioelectrical impedance or by the sum of skinfold thicknesses and anthropometric indicators of fat distribution. Methods: A cross-sectional study was conducted enrolled 348 undergraduate students (median 21 years), from the Federal University of Pernambuco, Northeast Brazil. Results: 262 of the subjects were women. Mean body fat assessed by bioelectrical impedance was 22.3 ± 6.2% in women and 15.2 ± 4.2% in men. Body fat obtained by the sum of skinfold thicknesses was similar to that assessed by bioelectrical impedance only in men. A strong correlation was observed between body fat assessed by bioelectrical impedance and that assessed by the sum of the skinfold thicknesses, waist circumference and waist-to-height ratio. Regarding the conicity index, there was a moderate correlation for men and a weak correlation for women. Conclusions: The sum of skinfold thicknesses surrogate of body fat percentage and can be used to assess body fat when BIA is not available in the field. Additional information about central fat distribution can be supply by measuring the waist circumference or waist-to-height ratio (AU)

Introducción: Desde que el exceso de grasa corporal se asocia con mayores tasas de morbi-mortalidad (sobre todo en los adultos), los métodos precisos y fiables, rentables, y aplicables en términos generales son necesarios para su evaluación en estudios basados en población y en la práctica clínica. Objetivo: Evaluar la correlación entre la grasa corporal estimada, ya sea por impedancia bioeléctrica o por la suma de pliegues cutáneos y los indicadores antropométricos de la distribución de la grasa. Métodos: Un estudio transversal se realizó con 348 estudiantes, con una edad promedio de 21 años, de la Universidad Federal de Pernambuco, nordeste de Brasil. La grasa corporal se evaluó mediante impedancia bioeléctrica y la suma de pliegues cutáneos. Circunferencia de la cintura, la relación cintura-altura y el índice de conicidad fueron utilizados como indicadores centrales de distribución de grasa Resultados: 262 de los sujetos eran mujeres. Media de la grasa corporal por impedancia bioeléctrica evaluados fue de 22,3 ± 6,2% en mujeres y 15,2 ± 4,2% en los hombres. Grasa corporal obtenida mediante la suma de pliegues cutáneos fue similar a la evaluada por impedancia bioeléctrica sólo en los hombres. Una fuerte correlación se observó entre la grasa corporal evaluada por impedancia bioeléctrica y espesores de los evaluados por la suma de los pliegues cutáneos, circunferencia de la cintura y relación cintura-altura. En cuanto al índice de conicidad, se observó una correlación moderada para los hombres y una correlación débil para las mujeres. Conclusiones: La suma de pliegues cutáneos se puede utilizar para evaluar la grasa corporal en la ausencia de la impedancia bioeléctrica. Información adicional sobre la distribución de la grasa central puede ser la oferta mediante la medición del circunferencia de la cintura o la relación cintura-altura (AU)

Risk factors associated with hepatic steatosis: a study in patients in the Northeast Brazil.

INTRODUCTION: Although there are several studies in the international literature regarding hepatic steatosis, few large-scale studies of risk factors are available. OBJECTIVE: To verify potential risk factors associated with hepatic steatosis, such as: alcohol consumption, overweight, dyslipidemia, hypertension, and type 2 diabetes mellitus. METHODS: This is a case series study including a control group (without hepatic steatosis), carried out at the gastroenterology outpatient clinic in Northeast Brazil. The sample was composed of 219 patients with hepatic steatosis and 82 without the disease. RESULTS: There was an association between hepatic steatosis and socioeconomic status. Prevalence Ratio (PR) for family income ≤ 2 minimum wage was (PR = 1.35 CI 95%, 1.18-1.54) and education level < primary education (PR = 1.44, CI 95%,1.27-1.64). Regarding anthropometric and clinical characteristics and lipid profile, there was an association with overweight (PR = 1.59, CI 95%, 1.38-1.83), abdominal circumference in the range of very high risk (PR = 2.28, IC 95%,1.68-3.09), hypertension (PR = 1.30, CI 95%, 1.15-1.48) and type 2 diabetes mellitus (PR = 1.23, CI 95%, 1.07-1.64), low HDL-cholesterol (PR = 1,96, CI 95%, 1.55-2.48), hypertriglyceridemia (PR = 2.10, CI 95%, 1.64-2.68). In the regression model three variables remained independently associated to hepatic steatosis, abdominal circumference in the range of very high risk (PRadjusted = 1.74), low HDL-cholesterol (PRadjusted = 1.39) and overweight (PRadjusted = 1.28). CONCLUSION: The results showed an association of hepatic steatosis with some risk factors, being abdominal circumference (very high risk) the most strongly associated, followed by low HDL-cholesterol and overweight.

Risk factors associated with hepatic steatosis; a study in patients in the Northeast Brazil / Factores asociados a la esteatosis hepática; un estudio en pacientes del nordeste brasileño

Introduction: Although there are several studies in the international literature regarding hepatic steatosis, few large-scale studies of risk factors are available. Objective: To verify potential risk factors associated with hepatic steatosis, such as: alcohol consumption, overweight, dyslipidemia, hypertension, and type 2 diabetes mellitus. Methods: This is a case series study including a control group (without hepatic steatosis), carried out at the gastroenterology outpatient clinic in Northeast Brazil. The sample was composed of 219 patients with hepatic steatosis and 82 without the disease. Results: There was an association between hepatic steatosis and socioeconomic status. Prevalence Ratio (PR) for family income < 2 minimum wage was (PR = 1.35 CI 95%, 1.18-1.54) and education level < primary education (PR = 1.44, CI 95%,1.27-1.64). Regarding anthropometric and clinical characteristics and lipid profile, there was an association with overweight (PR = 1.59, CI 95%, 1.38-1.83), abdominal circumference in the range of very high risk (PR = 2.28, IC 95%,1.68-3.09), hypertension (PR = 1.30, CI 95%, 1.15-1.48) and type 2 diabetes mellitus (PR = 1.23, CI 95%, 1.07-1.64), low HDL-choles-terol (PR = 1,96, CI 95%, 1.55-2.48), hypertriglyceridemia (PR = 2.10, CI 95%, 1.64-2.68). In the regression model three variables remained independently associated to hepatic steatosis, abdominal circumference in the range of very high risk (PRadjusted = 1.74), low HDL-cholesterol (PRadjusted = 1.39) and overweight (PRadjusted = 1.28). Conclusion: The results showed an association of hepatic steatosis with some risk factors, being abdominal circumference (very high risk) the most strongly associated, followed by low HDL-cholesterol and overweight (AU)

Introducción: Aunque hay varios estudios en la literatura internacional sobre la esteatosis hepática, pocos estudios a gran escala de factores de riesgo están disponibles. Objetivo: Verificar potenciales factores de riesgo asociados a la esteatosis hepática como: consumo de alcohol, exceso de peso, dislipidemia, hipertensión arterial y diabetes mellitus tipo 2. Método: Estudio del tipo serie de casos, incluyendo un grupo control (sin esteatosis hepática), realizado en el ambulatorio de gastroenterología de un hospital universitario en el nordeste brasileño, compuesto por 219 pacientes con esteatosis hepática y 82 sin la enfermedad. Resultados: Hubo asociación entre la esteatosis hepática y condiciones socioeconómicas, el renta familiar < 2 salarios mínimos presentó Razón de Prevalencia (RP) = 1,35, IC 95%, 1,18-1,54) y escolaridad < 1o grado (RP = 1,44, IC 95%, 1,27-1,64). Respecto a las características antropométricas, clínicas y perfil lipídico, hubo asociación con exceso de peso (RP = 1,59, IC 95%, 1,38-1,83), circunferencia abdominal en el intervalo de muy alto riesgo (RP = 2,28, IC 95%, 1,68-3,09), hipertensión arterial (RP = 1,30, IC 95%, 1,15-1,48) y diabetes mellitus (RP = 1,23, IC 95%, 1,07-1,64), high density lipoprotein cholesterol-HDLc bajo (RP = 1,96, IC 95%, 1,55-2,48), triglicéridos-TG elevado (RP = 2,10, IC 95%, 1,64-2,68). En el modelo de regresión con factores de riesgo para la esteatosis hepática, se constató que tres variables permanecieron independientemente asociadas, circunferencia abdominal en el intervalo de muy alto riesgo (RP ajustada = 1,74), high density lipoprotein cholesterol-HDLc bajo (RP ajustada = 1,39) y exceso de peso (RP ajustada = 1,28). Conclusión: los resultados muestran una asociación de la EH con algunos factores de riesgo, destacándose la circunferencia abdominal en el intervalo de muy alto riesgo seguidos por el high density lipoprotein cholesterol-HDLc bajo y el exceso de peso (AU)

Body fat assessment by bioelectrical impedance and its correlation with anthropometric indicators.

INTRODUCTION: Since the excess of body fat is associated with higher morbid-mortality rates (mainly in adults), precise, reliable, cost-effective, and broadly applicable methods are necessary for its assessment in population-based studies and in clinical practice. OBJECTIVE: To evaluate the correlation between body fat estimated either by bioelectrical impedance or by the sum of skinfold thicknesses and anthropometric indicators of fat distribution. METHODS: A cross-sectional study was conducted enrolled 348 undergraduate students (median 21 years), from the Federal University of Pernambuco, Northeast Brazil. RESULTS: 262 of the subjects were women. Mean body fat assessed by bioelectrical impedance was 22.3 ± 6.2% in women and 15.2 ± 4.2% in men. Body fat obtained by the sum of skinfold thicknesses was similar to that assessed by bioelectrical impedance only in men. A strong correlation was observed between body fat assessed by bioelectrical impedance and that assessed by the sum of the skinfold thicknesses, waist circumference and waist-to-height ratio. Regarding the conicity index, there was a moderate correlation for men and a weak correlation for women. CONCLUSIONS: The sum of skinfold thicknesses surrogate of body fat percentage and can be used to assess body fat when BIA is not available in the field. Additional information about central fat distribution can be supply by measuring the waist circumference or waist-to-height ratio.

Embryo production in superovulated goats treated with insulin before or after mating or by continuous propylene glycol supplementation.

Seventeen adult and cyclic Moxoto goats were synchronized using 60 mg MPA vaginal sponge for 11 days and 50 mug cloprostenol, 48 h before sponge removal, and superovulated with 120 mg pFSH i.m. in decreasing doses at 12 h intervals for three consecutive days. In seven goats, 0.2 IU/kg BW/day of long acting insulin was subcutaneously injected at same time as pFSH, and in the other five goats, the same dose of insulin was injected for three consecutive days starting 24 h after mating. Finally, five goats were supplemented with an oral dose of 80 ml/goat/day of propylene glycol continuously during the experiment. The animals were flushed at 7 days after mating and the embryos were classified based on International Embryo Transfer Society criteria. Blood samples were collected every 3 days for insulin assay. Administration of insulin raised the insulin levels of the goats (p < 0.05), whereas in the group treated with propylene glycol, insulin rate was different only between FSH treatment and after mating (p < 0.05). Similar rates of recovery for total (80.05 +/- 9.78%) or transferable structures (61.03 +/- 15.13%) were obtained. Treatment was not influenced (p > 0.05) by responsiveness to superovulation, which averaged 64%. By contrast, insulin treatments were shown to increase the number of embryos considered excellent with respect to goats supplemented with propylene glycol (p < 0.05). When insulin was given before mating, a strong relationship (r = 0. 90) (p < 0.05) between number of transferable embryo and ovulations was observed in the animals. In conclusion, superovulated goats treated with low doses of exogenous insulin resulted in an enhancement in embryo quality, which was related to changes in circulating insulin concentrations.

Oral glutamine in addition to parenteral nutrition improves mortality and the healing of high-output intestinal fistulas.

OBJECTIVE: Anastomotic leakage is one of the most important causes of morbidity and mortality in gastrointestinal surgery. We investigated the effect of oral glutamine on the healing of high-output intestinal fistula. SETTING: A tertiary Universitary Hospital of the University of Mato Grosso, Cuiaba, Brazil. PATIENTS AND METHODS: 28 patients (25 males and 3 females; median age = 45 [18-71] years old) admitted with high output post-operative small bowel fistulas (median volume in 24 h: 850 [600-2,200] mL) during a 4 years period were retrospectively studied. INTERVENTIONS: In the first two years 19 (67.9%) patients received only TPN as the initial nutritional support. In the last two years however, due to a change in the protocol for the nutritional support in cases of intestinal fistula 9 patients (32.1%) received oral glutamine (0.3 g/kg/day; 150 mL/day) in addition to TPN. Endpoints of the study were mortality, resolution of the fistula, and length of hospital stay (LOS). RESULTS: The overall mortality was 46.4% (13 patients). Fistula closure was observed in all other 15 patients (53.6%) that survived. In the subset of survived patients LOS was similar in those who received or not received glutamine. The multivariate regression analysis showed that resolution of the fistula was 13 times greater in patients that received oral glutamine (OR = 13.2 (95% CI = 1.1-160.5); p = 0.04) and 15 times greater in non-malnourished patients (OR = 15.4 [95% CI = 1.1-215.5]; p = 0.04). CONCLUSIONS: We conclude that oral glutamine accelerated the healing and diminished the mortality in this series of patients with post-operative high-output intestinal fistula receiving TPN.

[Height deficit in school aged children: a multivariate analysis of possible risk factors, Pernambuco-1997]. / Deficit estatural em crianças em idade escolar: uma análise multivariada de possíveis fatores de risco, Pernambuco--1997.

The nutritional status and some risk factors in 894 school children (ages 6 to 12) in the State of Pernambuco, Brazil, were analyzed based on the data collected by the Second State Research on Nourishment, Health and Nutrition carried out in 1997. The cutoff point used in the nutritional evaluation was the limit referring to -2 score-Z, being the NCHS the reference standard. The prevalence of stunting in the state was of 16.9%. Rural areas were more affected, reaching 27.1%. Bivariate analysis showed that the low socioeconomic level of the children and their families is associated with the occurrence of stunting. The logistic regression model pointed the variables: residence location, gender, access to treated potable water, low education, and per-capita income as the main determinants in stunting. The conjunct analysis of all the factors that explain the malnutrition found among the school children studied showed that the probability of a school-aged child to present height deficit varied from 1.5 to 60.3% depending on the risk factors taken into account, therefore showing different epidemiological "scenarios." The study also concluded that in the State of Pernambuco the height deficit constitutes a public health problem especially for school children in rural areas, showing two very different epidemiologic realities between urban and rural areas.

Birth of normal kids after microinjection of pronuclear embryos in a transgenic goat (Capra hircus) production program in Brazil

This pilot project was designed to determine if normal kids could be produced after microinjection in pronuclear embryos and subsequent transfer to recipients in a transgenic goat program in Brazil. Twelve donors of the Saanen breed and 17 recipients of an undefined breed were used. The estrus of both donors and recipients was synchronized by a standard progestagen treatment and superovulation obtained by six pFSH injections. Donors in estrus were mated with fertile Saanen bucks. Zygotes were recovered surgically by flushing oviducts. The recovered zygotes with visible pronuclei were microinjected with 500 to 1000 copies of the human G-CSF gene. Two or four embryos were surgically transferred into the oviducts of recipients. One recipient became pregnant and two kids were born. No transgenic goat was identified after PCR analysis. Even though transgenic goats were not obtained, this experiment establishes the basis of a synchronization and superovulation regimen for use in goats raised in Brazil, for the purpose of collecting and manipulating the pronuclear embryos. This project also showed that microinjected one-cell goat embryos can survive to produce live young following surgical transfer

Birth of normal kids after microinjection of pronuclear embryos in a transgenic goat (Capra hircus) production program in Brazil.

This pilot project was designed to determine if normal kids could be produced after microinjection in pronuclear embryos and subsequent transfer to recipients in a transgenic goat program in Brazil. Twelve donors of the Saanen breed and 17 recipients of an undefined breed were used. The estrus of both donors and recipients was synchronized by a standard progestagen treatment and superovulation obtained by six pFSH injections. Donors in estrus were mated with fertile Saanen bucks. Zygotes were recovered surgically by flushing oviducts. The recovered zygotes with visible pronuclei were microinjected with 500 to 1000 copies of the human G-CSF gene. Two or four embryos were surgically transferred into the oviducts of recipients. One recipient became pregnant and two kids were born. No transgenic goat was identified after PCR analysis. Even though transgenic goats were not obtained, this experiment establishes the basis of a synchronization and superovulation regimen for use in goats raised in Brazil, for the purpose of collecting and manipulating the pronuclear embryos. This project also showed that microinjected one-cell goat embryos can survive to produce live young following surgical transfer.

A mammalian telomerase-associated protein.

The telomerase ribonucleoprotein catalyzes the addition of new telomeres onto chromosome ends. A gene encoding a mammalian telomerase homolog called TP1 (telomerase-associated protein 1) was identified and cloned. TP1 exhibited extensive amino acid similarity to the Tetrahymena telomerase protein p80 and was shown to interact specifically with mammalian telomerase RNA. Antiserum to TP1 immunoprecipitated telomerase activity from cell extracts, suggesting that TP1 is associated with telomerase in vivo. The identification of TP1 suggests that telomerase-associated proteins are conserved from ciliates to humans.

Frequência de hemoglobinopatia S detectada no Instituto Adolfo Lutz Central e sua importãncia em saúde pública / Frequency of hemoglobinopathie S detected in Adolfo Lutz Institute and its importance on Public Health

A incidência de hemoglobia S foi investigada em 1575 amostras de sangue periférico da rotina hematológica do IAL de março a junho de 1994, através da pesquisa de células falciformes nos esfregaços sanguíneas corados por Leishman, pela prova de falcização com metabissulfito de sódio. No esfregaço de sangue periférico foi observada a presença de células falciformes em 21 lâminas (1,33%). A frequência de positividade nos testes de solubilidade e prova de falcização foi de 3,05% (48 casos), sendo todos confirmados por eletroforese de hemoglobina em acetato de celulose pH 8,6 e em gel de ágar citrato pH 6,2, onde observou-se 2,92% de HbAs e 0,06% de HbSC. Devido a grande miscigenação racial da população brasileira o diagnóstico laboratorial da hemoglobinopatia S torna-se de vital importância em termos de Saúde Pública.

[Nutrition and development]. / Nutrição e desenvolvimento.

Discussions on development and nutrition frequently have a double focus: one that considers nutritional status as a reflection of development, and another that admits that nutrition strongly influences the level and rhythm of development. The authors view nutrition as a decisive factor for adequate social and economic development, specifying the fact that nutritional interventions might contribute to significant improvements in individual classroom performance, productivity at the workplace, and resistance to infections. The implications of malnutrition for the economy are thus evident: either by limitations in income expectations, increased costs deriving from burdens assumed by the population to protect themselves, or considerable hidden social costs--absenteeism, work accidents, and rotation of employees. Given modernization and a competitive economy, there is an unquestionable need for nutrition to head the agenda of national priorities, thus promoting human resource development and the preservation of this human capital, one of the chief goals of a socially responsible economy.