Massive enlargement of gastric pouch as a complication of gastrojejunal anastomotic stenosis following one anastomosis laparoscopic gastric bypass: A case report.

INTRODUCTION AND IMPORTANCE: By 2030 it is predicted that 1 in 5 women and 1 in 7 men will be living with obesity. The only long-term effective strategy for achieving significant weight loss over time is surgical treatment. One Anastomosis Gastric Bypass (OAGB) has been proposed as an effective therapeutic option. Stenosis of Gastro-Jejunal Anastomosis (GJA) is one of the most common long-term complications and its cause recognized as multifactorial. CASE PRESENTATION: We present the case of a patient with a history of progressive postoperative oral intolerance after OAGB with 60 kg weight loss (BMI 20.7 kg/m2). Severe stenosis of the GJA and massive dilation of the gastric remnant was documented, treated multiple times with endoscopic balloon dilation. He was referred to our unit due to persistent symptoms. Revision surgery to a Gastric Bypass was programmed, ultimately performed via an open approach with resection of 80 % of the gastric remnant. CLINICAL DISCUSSION: Endoscopic dilatation and surgical revision are the two primary treatment options for GJA stricture. In refractory cases to pneumatic dilation, laparoscopic revision surgery is indicated, however an open approach is frequently required, as surgeries are technically demanding due to distorted anatomy in this population. CONCLUSION: Operations to correct chronic complications are tailored to the patient's anatomy as well as the symptoms or pathologies they are intended to correct. Whilst revision surgeries are associated with an increased risk of conversion, complications and longer hospital stay, they can be performed safely in experienced centers.

Implications of the clone by harvest interaction in the selection of sugarcane genotypes in a regionalized program.

The recommendation of sugarcane clones depends on several factors, as the response or performance of the clones over different cuts or harvests. The clone by harvest interaction might be difficult to identify superior clones in the final stages of the sugarcane breeding program. Thus, the objective of this study was to investigate and describe the implications of the genotype by harvest interaction in the adaptability and stability of genotypes and delineation of mega-environments from a set of multi-environment trials. Fifteen clones and four checks were evaluated in eight environments. The trait TPH (tons of pol per hectare) was evaluated in two harvests (plant cane and ratoon cane) in 2010 and 2011. The joint analysis showed significance for harvest (H), environment (E), and genotype (G) effects. The interactions GxE, ExH, GxH, and ExGxH were also significant. The last three-way interaction indicated the differential response of the genotypes over environments, and that it depends on the harvests. The overall mean of the trials was 12.77 TPH. The coefficient of variation was 8.70% and the selective accuracy was 98.63%, indicating high experimental precision. The genotypes G4, G14, and G16 were statistically superior to the check varieties used; however, these genotypes did not show high stability as described by the additive main effects and multiplicative interaction method. There was a specific adaptation between the E7 and E5 environments and the G4 and G5 genotypes, respectively. In general, the grouping of the environments was inconsistent throughout the harvests, except for the E1 and E4 environments, which exhibited similarities for the different genotypes.

Multivariate statistics applied to the reaction of common bean plants to parasitism by Meloidogyne javanica.

The availability of common bean cultivars tolerant to Meloidogyne javanica is limited in Brazil. Thus, the present study aimed to evaluate the reactions of 33 common bean genotypes (23 landrace, 8 commercial, 1 susceptible standard and 1 resistant standard) to M. javanica, employing multivariate statistics to discriminate the reaction of the genotypes. The experiment was conducted in a greenhouse using a completely randomized design with seven replicates. The seeds were sown in 1-L pots containing autoclaved soil and sand in a 1:1 ratio (v:v). On day 19, after emergence of the seedlings, the plants were treated with inoculum containing 4000 eggs + second-stage juveniles (J2). At 60 days after inoculation, the seedlings were evaluated based on biometric and parasitism-related traits, such as number of galls, final nematode population per root system, reproduction factor, and percent reduction in the reproduction factor of the nematode (%RRF). The data were subjected to analysis of variance using the F-test. The Mahalanobis generalized distance was used to obtain the dissimilarity matrix, and the average linkage between groups was used for clustering. The use of multivariate statistics allowed groups to be separated according to the resistance levels of genotypes, as observed in the %RRF. The landrace genotypes FORT-09, FORT-17, FORT-31, FORT-32, FORT-34 and FORT-36 presented resistance to M. javanica; thus, these genotypes can be considered potential sources of resistance.

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.

Dissimilarity between Mouriri elliptica (Mart.) plants cultivated in vitro and in situ through anatomic parameters.

Mouriri elliptica (Mart.) is a genetic resource of the Cerrado domain, which has potential for food and medicinal use. A few studies have been performed on its in vitro propagation, and no studies have examined dissimilarities between plants of this species when cultivated in situ or in vitro. Therefore, the objective of the present study was to identify in vitro cultivation conditions that permit the formation of plantlets with leaf anatomical features that are less dissimilar to those of plants grown in situ. Thus, an anatomical study of the leaves was conducted to investigate the adaxial epidermis thickness, abaxial epidermis thickness, chlorenchyma thickness, stomatal crypt depth, stomatal crypt density, and leaf surface stomatal crypt aperture area. The distance between phenotypes was determined based on micromorphometric data, and unweighted pair group mean arithmetic clustering was performed. Four different groups were tested, and cultivation with sucrose and 50 and 75 µmol⋅m-2⋅s-1 irradiance was found to promote plantlet development and maximize similarity to plants cultivated in situ. The most important anatomical parameters in this study were the stomatal crypt aperture area and the crypt density. This study is of importance for the anatomical characterization of M. elliptica (Mart.) leaves, as it identifies plasticity as a function of in vitro culture conditions.

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.

TRPV4 mediates flow-induced increases in intracellular Ca in medullary thick ascending limbs.

UNLABELLED: Medullary thick ascending limbs (mTAL) regulate Na balance and therefore blood pressure. We previously showed that cell swelling and luminal flow activates the mechanosensitive channel TRPV4 in mTAL. AIM: We hypothesized that TRPV4 mediates flow-induced increases in intracellular Ca (Cai) in rat mTALs. METHODS: We performed ratiometric measurements of Cai in perfused mTALs. RESULTS: Increasing luminal flow from 0 to 20 nL min(-1) caused Cai to peak 231 ± 29 nmol L(-1) above basal concentrations (n = 18). The general TRPV inhibitor ruthenium red at 15 and 50 µmol L(-1) reduced peak Cai by 41 ± 9 (P < 0.01; n = 5) and 77 ± 10% (P < 0.02; n = 6). The selective TRPV4 inhibitor RN1734 at 10 and 50 µmol L(-1) reduced peak Cai by 46 ± 11 (P < 0.01; n = 7) and 76 ± 5% (P < 0.02; n = 5) respectively. To specifically target TRPV4, mTALs were transduced with adenoviruses expressing TRPV4 small hairpin (sh) RNA. In non-transduced control mTALs, luminal flow generated a peak increase in Cai of 111 ± 21 nmol L(-1) (n = 8). In TRPV4shRNA-transduced mTALs, the Cai peak was reduced to 56 ± 8 nmol L(-1) (P < 0.03, n = 9). Removing extracellular Ca completely abolished flow-induced increases in Cai. Increasing luminal flow in the presence of hexokinase 20 (U mL(-1) ) to scavenge extracellular ATP did not modify significantly the increases in Cai induced by luminal flow. Finally, we studied the effect of the TRPV4 selective agonist GSK1016790A on Cai. In the absence of luminal flow, GSK1016790A (10 nmol L(-1) ) increased Cai from 60 ± 11 nmol L(-1) to 262 ± 71 nmol L(-1) (P < 0.05; n = 7). CONCLUSION: We conclude that flow-induced increases in Cai are mediated primarily by TRPV4 in the rat mTAL.

Molecular characterization of Anthurium genotypes by using DNA fingerprinting and SPAR markers.

We characterized single primer amplification reaction (SPAR) molecular markers from 20 genotypes of Anthurium andraeanum Lind., including 3 from commercial varieties and 17 from 2 communities in the State of Espírito Santo, Brazil. Twenty-four SPAR, consisting of 7 random amplified polymorphic DNA and 17 inter-simple sequence repeat markers were used to estimate the genetic diversity of 20 Anthurium accessions. The set of SPAR markers generated 288 bands and showed an average polymorphism percentage of 93.39%, ranging from 71.43 to 100%. The polymorphism information content (PIC) of the random amplified polymorphic DNA primers averaged 0.364 and ranged from 0.258 to 0.490. Primer OPF 06 showed the lowest PIC, while OPAM 14 was the highest. The average PIC of the inter-simple sequence repeat primers was 0.299, with values ranging from 0.196 to 0.401. Primer UBC 845 had the lowest PIC (0.196), while primer UCB 810 had the highest (0.401). By using the complement of Jaccard's similarity index and unweighted pair group method with arithmetic mean clustering, 5 clusters were formed with a cophenetic correlation coefficient of 0.8093, indicating an acceptable clustering consistency. However, no genotype clustering patterns agreed with the morphological data. The Anthurium genotypes investigated in this study are a germplasm source for conservational research and may be used in improvement programs for this species.

Genetic gains in the UENF-14 popcorn population with recurrent selection.

The popcorn breeding program of Universidade Estadual do Norte Fluminense Darcy Ribeiro aims to provide farmers a cultivar with desirable agronomic traits, particularly with respect to grain yield (GY) and popping expansion (PE). We evaluated full-sib families from the seventh cycle of recurrent selection and estimated the genetic progress with respect to GY and PE. Eight traits were evaluated in 200 full-sib families that were randomized into blocks with two replicates per set in two contrasting environments, Campos dos Goytacazes and Itaocara, located in north and northwest Rio de Janeiro State, respectively. There were significant differences between sets in families with respect to all traits evaluated, which indicates genetic variability that may be explored in future cycles. Using random economic weights in the selection of superior progenies, the Mulamba and Mock index showed gains for PE and GY of 5.11 and 7.78%, respectively. Significant PE and GY increases were found when comparing the evolution of mean values of these two parameters that were assessed at cycles C0-C6 and predicted for C7. Thus, an advanced-cycle popcorn cultivar with genotypic superiority for the main traits of economic interest can be made available to farmers in Rio de Janeiro State.

Efectos de la yerba mate (Ilex paraguariensis) en los niveles plasmáticos de glucosa, lípidos, urea y creatinina de ratas Wistar / Effects of yerba mate (Ilex paraguariensis) in the plasma levels of glucose, lipids, urea and creatinine of Wistar rats

INTRODUCCIÓN: La yerba mate (Ilex paraguariensis) es un vegetal nativo de las regiones subtropicales de Sudamérica utilizada en la preparación de infusiones que se beben en ciertos países de la región. El objetivo del estudio fue determinar los efectos de extractos acuosos de Ilex paraguariensis en los niveles plasmáticos de glucosa, lípidos, urea y creatinina en ratas Wistar. MATERIALES Y MÉTODO: Estudio experimental. Se distribuyeron al azar 20 ratas Wistar en 2 grupos de 10 animales cada uno; el grupo control recibió como bebida agua y el grupo expuesto a yerba recibió como bebida una infusión de Ilex paraguariensis. El periodo de experimentación fue de 60 días, a cuyo término se determinaron las concentraciones plasmáticas de glucosa, colesterol, triglicéridos, urea y creatinina. Las medias de los parámetros fueron comparadas por la prueba U de Mann-Whitney, considerándose significativas las diferencias con p<0,05. RESULTADOS: El consumo de yerba mate disminuyó los niveles de glicemia en el grupo expuesto en comparación con el grupo control, siendo la diferencia altamente significativa (p<0,001). Se observaron niveles significativamente mayores de urea (p=0,04) y creatinina (p=0,02)en el grupo expuesto en comparación con el grupo control. No hubo diferencias significativas entre los niveles de colesterol y triglicéridos entre ambos grupos. DISCUSIÓN: Los resultados sugieren que el consumo de Ilex paraguariensis reduce los niveles plasmáticos de glucosa y podrían poseer un efecto nocivo en la función renal.

INTRODUCTION: yerba mate (Ilex paraguariensis) is a plant species native to subtropical regions of South America and is used to make tea in local countries. The aim of the study was to determine the effects of aqueous extracts of Ilex paraguariensis in plasmatic levels of glucose, lipids, urea and creatinine in Wistar rats. MATERIALS AND METHODS: Experimental study. 20 Wistar rats were randomized in two groups of ten animals each: control group received water while the exposed group received an infusion of Ilex paraguariensis. After 60 days of experiment, plasmatic concentrations of glucose, cholesterol, triglycerides,urea and creatinine were determined. Mann- Whitney U test was used to compare means, differences were considered statistically significant atp <0.05. RESULTS: Blood glucose levels were lower in the exposed group compared with the control group(p <0.001).Plasmatic levels of urea and creatinine were signiticantly higher in the exposed group (p=0.04 and p=0.02 respectively). No significant differences were observed in the levels of cholesterol and triglycerides among the groups. DISCUSSION: The results suggest that consumption of Ilex paraguariensis reduces plasma glucose levels and could have an adverse effect on renal function.

Prevalencia de anemia en la población pediátrica de una comunidad rural del Paraguay y su asociación con el estado nutricional / Prevalence of anemia in the pediatric population of a rural community in Paraguay and its association with nutritional status

INTRODUCCIÓN: La anemia prevalece como un problema de salud pública en la población pediátrica de países en desarrollo. El objetivo fue determinar la prevalencia de anemia en niños de la comunidad de Yvyraty (Paraguarí, Paraguay) y evaluar su asociación con el estado nutricional. MATERIAL Y MÉTODO: Estudio observacional, descriptivo, de corte transverso con componente analítico. Se colectaron datos antropométricos y se extrajo sangre a una muestra de 94 niños entre 2 y 18 años. Para determinar la asociación entre sexo-anemia, y edad-anemia se utilizó la prueba de Chi-cuadrado; para determinar la asociación entre eosinofilia-hemoglobinemia; y estado nutricional-hemoglobinemia se utilizaron las pruebas de t de Student, y de Kruskal-Wallis respectivamente. En todos los casos se consideró significación estadística cuando p<0,05. RESULTADOS: La prevalencia de anemia en la muestra fue del 19,1 por ciento. A partir de la evaluación antropométrica se verificó que el 70,2 por ciento de los niños era normopeso,14,9 por ciento estaba en riesgo de desnutrición, 6,4 por ciento con desnutrición moderada y 8,5 por ciento con sobrepeso. No se encontró diferencia significativa entre el sexo y la edad con la presencia de anemia (p=1 y p=0,4 respectivamente), ni entre los indicadores nutricionales agudos y crónicos con la hemoglobinemia (p=0,3 y p=0,5 respectivamente). Se observó asociación entre la presencia de eosinofilia y la hemoglobinemia (p=0,04) hallándose una diferencia de medias de 0,36 g/dl (IC 95 por ciento: 0,19 - 0,71). DISCUSIÓN: La prevalencia de anemia en la población pediátrica de Yvyraty fue de 19,1 por ciento, no se encuentra asociada al estado nutricional de los niños, pero si a la presencia de eosinofilia.

INTRODUCTION: Anemia remains a prevalent public health problem in pediatric population of developing countries. The objective was to determine the prevalence of anemia in children of the community of Yvyraty (Paraguarí, Paraguay) and evaluate its association with nutritional status. MATERIAL AND METHOD: Cross-sectional study with an analytical component. Anthropometric data were collected and blood was taken from a sample of 94 children between the ages of 2 and 18 years old. The Chi square test was used to determine sex-anemia and anemia-age associations; hemoglobin-eosinophilia and hemoglobin-nutritional status were analized using Student’s t test and Kruskal-Wallis analysis, respectively. In all cases considered a statistical significance when p <0.05. RESULTS: The prevalence of anemia in the sample was 19.1 percent From the anthropometric assessment 70.2 percent have a normal weight, 14.9 percent were at risk of malnutrition,6.4 percent had moderate malnutrition and 8.5 percent were overweight. No significant difference was found between sex or age and the presence of anemia (p = 1 and p = 0.4 respectively) or between acute or chronic nutritional indicators and hemoglobin (p = 0.3and p = 0.5 respectively). Association was observed between the presence of eosinophilia and hemoglobin levels (p = 0.04), with a mean difference of 0.36 g / dl (95 percent CI: 0.19 - 0.71). DISCUSSION: The prevalence of anemia in the pediatric population of Yvyraty was 19.1 percent, and was not associated with nutritional status, but eosinophilia.

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)

Nutritional screening in clinical patients at a University Hospital in Northeastern Brazil / Evaluación nutricional en pacientes clínicos en un hospital universitario en el noreste de Brasil

Objectives: According to the Brazilian Hospital Nutritional Assessment Inquiry, malnutrition in hospitals reaches 48.1% in Brazil, with this figure reaching as high as 63.9% in the northern and northeastern regions of the country. Despite its high prevalence, hospital malnutrition is not well identified by the majority of professionals on healthcare teams. The aim of the present study was to identify nutritional risk in patients hospitalized for clinical conditions. Method: This study was conducted at a university hospital in northeastern Brazil. Data were collected using the NRS 2002 screening tool (score ≥ 3 for nutritional risk) within 48 hours after admission to hospital. Results: Ninety-nine patients (44.4% men and 55.6% women; 58.6% elderly individuals and 41.4%) were studied between April and October 2010. Nutritional risk was identified in 39.4% upon admission to hospital. Reduced food intake and body mass index were associated with nutritional risk. Conclusions: A high percentage of clinical patients were at nutritional risk, which corroborates findings described in the literature. Low food intake was associated with nutritional risk. These results underscore the importance of nutritional care upon admission to hospital, which can contribute to improving or maintaining nutritional status and the avoidance of complications throughout the hospitalization period (AU)

Objetivos: De acuerdo con la Encuesta de Evaluación Nutricional del Hospital de Brasil, la desnutrición en los hospitales alcanza el 48,1% en Brasil, esta cifra alcanza hasta el 63,9% en las regiones del norte y noreste del país. A pesar de su elevada prevalencia, la desnutrición hospitalaria no está bien identificado por la mayoría de los profesionales en los equipos de salud. El objetivo del presente estudio fue identificar el riesgo nutricional en pacientes hospitalizados por cuadros clínicos. Método: El estudio se llevó a cabo en un hospital universitario en el noreste de Brasil. Los datos fueron recolectados a través de la herramienta de detección NRS 2002 (puntuación ≥ 3 para riesgo nutricional) dentro de las 48 horas después del ingreso al hospital. Resultados: Noventa y nueve pacientes (44,4% los hombres y las mujeres 55,6%, 58,6% personas de edad avanzada y 41,4%) fueron estudiados entre abril y octubre de 2010. El riesgo nutricional fue identificado en 39,4% al momento del ingreso al hospital. Reducción de la ingesta de alimentos y el índice de masa corporal se asoció con riesgo nutricional. Conclusiones: Un alto porcentaje de pacientes clínicos estaban en riesgo nutricional, lo que corrobora los hallazgos descritos en la literatura. Baja ingesta de alimentos se asoció con riesgo nutricional. Estos resultados subrayan la importancia de la atención nutricional al ingreso en el hospital, que puede contribuir a mejorar o mantener el estado nutricional y la prevención de complicaciones durante el período de hospitalización (AU)

Nutritional status and adequacy of enteral nutrition in pediatric cancer patients at a reference center in northeastern Brazil.

INTRODUCTION: Individualized nutritional support is important to pediatric cancer patients and should be integrated to the overall treatment of these patients. OBJECTIVE: Analyze the nutritional status of cancer patients submitted to enteral nutrition (EN) and assess the adequacy of this form of nutrition. METHODS: A case series study was carried out at the Pediatric Oncology Unit of the Institute of Integrative Medicine Professor Fernando Figueira (IMIP, Brazil, Recife-PE) between January and December 2009. Clinical and anthropometric data were obtained from medical charts and nutritional follow-up charts. Z scores for height for age, weight for age and body mass index for age indicators (H/A, W/A and BMI/A, respectively) were calculated using the AnthroPlus program. Caloric and protein requirements were calculated based on the recommendations of the Brazilian National Council of Oncologic Nutrition. RESULTS: At the beginning of EN, 32.4% of the sample had short stature and 23.9% were underweight based on the BMI/A indicator. The assessment of EN adequacy demonstrated that 49.3% reached the caloric requirements and 76.1% reached the protein requirements, with maximal intakes of 65.6 Kcal/Kg/day and 1.95 g of protein/kg/day. Malnourished patients had greater mean Z scores for W/A and BMI/A at the end of EN, whereas no significant changes were found among patients with adequate nutritional status and significant reductions in these indicators were found among those with overweight or obesity. CONCLUSION: The patients either maintained or achieved a significant improvement in nutritional status, which demonstrates the importance of nutritional support and follow up during hospitalization.

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)

Portación nasal de Staphylococcus aureus en manipuladores de alimentos del Mercado Nº 4 de Asunción, Paraguay / Nasal carriage of Staphylococcus aureus in food handlers in Market Number 4 in Asuncion, Paraguay

INTRODUCCIÓN: La correcta manipulación de los alimentos es indispensable para proteger nuestra salud; sin embargo, las enfermedades transmitidas por alimentos son bastante frecuentes, siendo el Staphylococcus aureus uno de los agentes causales más comunes. OBJETIVO: Determinar la prevalencia de portación de nasal de Staphylococcus aureus en manipuladores de alimentos del Mercado Nº4 de Asunción - Paraguay, y evaluar su susceptibilidad al antibiótico oxacilina. MATERIAL Y MÉTODO: Estudio observacional, descriptivo y de corte transversal, con componentes analíticos. Se realizaron hisopados nasales en una muestra compuesta por 105 manipuladores de alimentos en el Mercado Nº4 de Asunción - Paraguay con el fin de detectar la portación nasal de Staphylococcus aureus y sus sensibilidad a la oxacilina. También se determinó la asociación entre el sexo y la portación nasal de Staphylococcus aureus mediante la prueba de X2 (Chi cuadrado) con un nivel de significación de 0,05. RESULTADOS: Staphylococcus aureus fue aislado de las muestras nasales provenientes de 33,3 por ciento de los manipuladores de alimentos estudiados. El estudio de susceptibilidad a antibióticos mostró que 88,6 por ciento fueron sensibles a oxacilina, con 5,7 por ciento de sensibilidad intermedia y 5,7 por ciento de resistencia. No se observó asociación entre sexo y portación nasal de Staphylococcus aureus: Prevalencia Relativa =1,23 (Intervalo de Confianza del 95 por ciento: 0,45 – 1,99; valor p=0,9). DISCUSIÓN: Los resultados de nuestro estudio revelaron una portación nasal de Staphylococcus aureus similar a la comunicada por otros trabajos científicos. Estos resultados confirman la necesidad de educación y programas de capacitación sobre seguridad alimentaria dirigida a manipuladores de alimentos.

INTRODUCTION: Proper food handling is essential to protect our health. However food-borne diseases are common, Staphylococcus aureus being one of the most common causative agents. OBJECTIVE: Determine the prevalence of nasal carriage of Staphylococcus aureus in food handlers of Market No. 4 in Asunción - Paraguay, and assess their susceptibility to oxacillin. MATERIAL AND METHOD: Observational, cross-sectional, descriptive study with analytical components. Nasal swabs were performed on a sample of 105 food handlers in the No. 4 market in order to detect nasal carriage of Staphylococcus aureus and their susceptibility to oxacillin. We also determined the association between sex and nasal carriage of Staphylococcus aureus by the X2 test (Chi square) with a significance level of 0.05. RESULTS: Staphylococcus aureus was isolated from nasal swabs from 33.3 percent samples of food handlers studied. The antibiotic susceptibility study showed that 88.6 percent were susceptible to oxacillin, with 5.7 percent sensitivity and 5.7 percent intermediate resistance. There was no association between gender and nasal carriage of Staphylococcus aureus: Relative Prevalence = 1.23 (95 percent of Confidence Interval: 0.45 to 1.99, p value = 0.9). DISCUSSION: The results of our study revealed a Staphylococcus aureus nasal carriage similar to that reported by other scientific studies. These results confirm the need for education and training programs focused on food safety for food handlers.

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.