Sarcopenic obesity definitions and their associations with physical frailty in older Brazilian adults: data from the SARCOS study

ABSTRACT Objective: To identify the obesity diagnosis with the highest association with physical frailty associated with sarcopenia EWGSOP II (sarcopenic obesity). Subjects and methods: We performed a cross-sectional analysis of 371 community-dwelling older adults. Appendicular skeletal lean mass and total body fat (TBF) were assessed using dual-energy x-ray absorptiometry, and physical frailty was defined using Fried's criteria. The phenotypes were identified according to the presence of sarcopenia by EWGSOP II and obesity, which was diagnosed using two concepts: BMI obesity (BMI ≥ 30 kg/m2) and TBF obesity (percentage of TBF ≥ 35% for women and ≥ 25% for men). Finally, the association of each group with physical frailty was evaluated. Results: The mean age was 78.15 ± 7.22 years. Sarcopenia EWGSOP II was diagnosed in 19.8% (n = 73), body mass index obesity was identified in 21.8% (n = 81), TBF obesity was identified in 67.7% (n = 251), and physical frailty was identified in 38.5% (n = 142). In a regression analysis for frailty, sarcopenic TBF obesity presented an odds ratio of 6.88 (95% confidence interval 2.60-18.24; p < 0.001). Conclusion: In older Brazilian adults, sarcopenic obesity diagnosed by TBF obesity has a robust association with frailty and is independent of body mass index.

Sarcopenic obesity definitions and their associations with physical frailty in older Brazilian adults: data from the SARCOS study.

Objective: To identify the obesity diagnosis with the highest association with physical frailty associated with sarcopenia EWGSOP II (sarcopenic obesity). Subjects and methods: We performed a cross-sectional analysis of 371 community-dwelling older adults. Appendicular skeletal lean mass and total body fat (TBF) were assessed using dual-energy x-ray absorptiometry, and physical frailty was defined using Fried's criteria. The phenotypes were identified according to the presence of sarcopenia by EWGSOP II and obesity, which was diagnosed using two concepts: BMI obesity (BMI ≥ 30 kg/m2) and TBF obesity (percentage of TBF ≥ 35% for women and ≥ 25% for men). Finally, the association of each group with physical frailty was evaluated. Results: The mean age was 78.15 ± 7.22 years. Sarcopenia EWGSOP II was diagnosed in 19.8% (n = 73), body mass index obesity was identified in 21.8% (n = 81), TBF obesity was identified in 67.7% (n = 251), and physical frailty was identified in 38.5% (n = 142). In a regression analysis for frailty, sarcopenic TBF obesity presented an odds ratio of 6.88 (95% confidence interval 2.60-18.24; p < 0.001). Conclusion: In older Brazilian adults, sarcopenic obesity diagnosed by TBF obesity has a robust association with frailty and is independent of body mass index.

Chronic diseases, chest computed tomography, and laboratory tests as predictors of severe respiratory failure and death in elderly Brazilian patients hospitalized with COVID-19: a prospective cohort study.

BACKGROUND: The primary risk factors for severe respiratory failure and death in the elderly hospitalized with COVID-19 remain unclear. OBJECTIVE: To determine the association of chronic diseases, chest computed tomography (CT), and laboratory tests with severe respiratory failure and mortality in older adults hospitalized with COVID-19. METHOD: This was a prospective cohort with 201 hospitalized older adults with COVID-19. Chronic diseases, chest CT, laboratory tests, and other data were collected within the first 48 h of hospitalization. Outcomes were progression to severe respiratory failure with the need of mechanical ventilation (SRF/MV) and death. RESULTS: The mean age was 72.7 ± 9.2 years, and 63.2% were men. SRF/MV occurred in 16.9% (p < 0.001), and death occurred in 8%. In the adjusted regression analyses, lung involvement over 50% [odds ratio (OR): 3.09 (1.03-9.28; 0.043)], C-reactive protein (CRP) > 80 ng/mL [OR: 2.97 (0.99-8.93; 0.052)], Vitamin D < 40 ng/mL [OR: 6.41 (1.21-33.88; 0.029)], and hemoglobin < 12 g/mL [OR: 3.32 (1.20-9.20; 0.020)] were independent predictors for SFR/MV, while chronic atrial fibrillation [OR: 26.72 (3.87-184.11; 0.001)], cancer history [OR:8.32 (1.28-53.91; 0.026)] and IL-6 > 40 pg/mL [OR:10.01 (1.66-60.13; 0.012)] were independent predictors of death. CONCLUSION: In hospitalized older adults with COVID-19, tomographic pulmonary involvement > 50%, anemia, vitamin D below 40 ng/mL, and CRP above 80 mg/L were independent risk factors for progression to SRF/MV. The presence of chronic atrial fibrillation, previous cancer, IL-6 > 40 pg/mL, and anemia were independent predictors of death.

The association between low lean mass and osteoporosis increases the risk of weakness, poor physical performance and frailty in Brazilian older adults: data from SARCOS study.

PURPOSE: To characterize the phenotypes of older adults with low lean mass and osteoporosis, concomitantly or isolated, in regards to poor physical performance and frailty status. DESIGN: Cross-sectional analysis of the SARCopenia and OSteoporosis in Older Adults with Cardiovascular Diseases Study (SARCOS). SETTING: Outpatient geriatric cardiology clinic. PARTICIPANTS AND METHOD: 385 older adults underwent DXA analysis. Low lean mass was diagnosed according to FNIH and low BMD by a T-score ≤ -2.5 SD. Subjects were grouped into: I-Low lean mass and Osteoporosis (LLMO); II-Low lean mass (LLM); III-Osteoporosis (OP), and IV-Controls. Poor physical performance was diagnosed by weakness or slow walking speed or impaired mobility. Frailty was diagnosed by CHS criteria. RESULTS: The mean age was 78.22 ± 7.16 years. The prevalence of LLMO, LLM, and OP were 14.8%, 39.5%, and 19.2%, respectively. LLMO subjects were older, predominantly women, with a high percentage of body fat (HTBF). LLM was represented by obese men, while individuals with OP were preferably women, older and leaner. In a regression analyses, LLMO presented an OR: 6.42 (2.63‒15.65; p < 0.001) for weakness, OR: 2.55 (1.09‒5.95; p = 0.030) for impaired mobility, and OR: 14.75 (2.72‒79.94; p = 0.002) for frailty. After adjusting for HTBF, the OR for frailty, decreased to 7.25 (1.11-47.21; p = 0.038). LLM and OP were associated only with weakness with an OR: 3.06 (1.36-6.84; p = 0.006) and OR: 3.14 (1.29-7.62; p = 0.011), respectively. CONCLUSION: In Brazilian older community-dwelling outpatient adults, the phenotype characterized by low lean mass and osteoporosis presents a higher association with impaired mobility, weakness and frailty status compared to the others phenotyeps and controls. A high percentage of body fat presents a synergistic effect with low lean mass and osteoporosis phenotype in regards to frailty.

Therapeutical properties of Mimosa caesalpiniifolia in rat liver intoxicated with cadmium.

The aim of this study was to evaluate the therapeutic properties of Mimosa caesalpiniifolia in liver of rats exposed to cadmium under morphological, oxidative, inflammatory, and mutagenic parameters. A total of 40 Wistar rats (90 days, ~ 250 g) were distributed into eight groups (n = 5) as follows: (i) control; (ii) cadmium: cadmium chloride injection at 1.2 mg/kg; (iii) Mimosa extract: treatment with Mimosa extract at 250 mg/kg; (iv) Mimosa fraction: treatment with Mimosa acetate fraction at 62.5 mg/kg; (v) cadmium and Mimosa extract 62.5: submitted to cadmium chloride at 1.2 mg/kg injection and treatment with Mimosa extract at 62.5 mg/kg; (vi) cadmium and Mimosa extract 125: subjected to cadmium chloride at 1.2 mg/kg injection and treatment with Mimosa extract at 125 mg/kg; (vii) cadmium and Mimosa 250 extract: submitted to cadmium chloride 1.2 mg/kg injection and treatment with Mimosa extract at 250 mg/kg; (viii) cadmium treated with fraction of Mimosa acetate: submitted to cadmium chloride 1.2 mg/kg injection and treatment with acetate fraction of Mimosa extract at 62.5 mg/kg. In the animals intoxicated with cadmium and treated with fraction [62.5], increased expression of SOD-Mn reduced frequency of binucleated hepatocytes, karyolysis, and karyorrhexis, besides the antimutagenic and antioxidant action. The extract [62.5] was cytoprotective, antimutagenic, and reduced karyolysis. The extract [125] was cytoprotective, antioxidant, antifibrotic, anti-inflammatory, and reduced frequency of binucleated hepatocytes, while extract [250] was cytotoxic and mutagenic. In summary, the extract of Mimosa exerts some therapeutic properties in hepatic tissue after Cd intoxication, but only when it is administrated at intermediate doses. Probably, a high content of polyphenols in the EHM [250] and Fr-EtOAc groups exert pro-oxidant activities in the liver particularly when associated with Cd.

The protective effect of grape skin or purple carrot extracts against cadmium intoxication in kidney of rats.

The aim of this study was to evaluate the protective effect of grape skin or purple carrot extracts against cadmium-induced intoxication in rats' kidneys. For this purpose, 30 male Wistar rats were distributed into six groups (n = 5), as follows: control group; cadmium group and groups treated with grape skin at 175 or 350 mg / L doses; or purple carrot extract at 400 mg / L or 800 mg / L doses, by drinking water. In the group exposed to cadmium, histopathological analysis revealed severe tissue injury as a result of coagulation necrosis, congested vessels and inflammatory infiltrate. Animals treated with grape skin or purple carrot extracts improved the histopathological changes induced by cadmium. 8-OHdG immunoexpression and catalase gene expression decreased in rats treated with purple carrot or grape skin extracts. Grape skin extract was able to increase SOD-CuZn gene expression as well. Toll-like signaling pathway (TLR2, PIKK and TRAF6) and cytochrome c expressions were not altered after the treatment with grape skin or purple carrot extracts. Taken together, we conclude that grape skin and purple carrot extracts had a protective effect on the rats' kidneys after cadmium intoxication, by means of tissue regenerating tissue regeneration and antioxidant properties, grape skin extract being more effective for this purpose.

Seroepidemiology of sheep brucellosis in the microregion of Feira de Santana, BA, Brazil / Soroepidemiologia de brucelose ovina na microrregião de Feira de Santana, Bahia, Brasil

The aim of the present study was to perform a seroepidemiological survey of Brucella ovis in ovine flocks in the microregion of Feira de Santana, State of Bahia (BA), Brazil. Ten municipalities with the largest sheep flocks were selected for this survey: Antonio Cardoso, Feira de Santana, Ipecaetá, Ipirá, Itatim, Pintadas, Rafael Jambeiro, Santa Teresinha, Santo Estévão and Serra Preta. The sample size was established on the basis of three parameters: significance level (99%), sampling error (5%), and estimated prevalence (50%). The total sample was divided proportionally to the sheep population found in the respective municipalities. The flocks examined in each municipality were randomly selected. The animals were older than six months and were distributed among 49 properties in the municipalities. Samples of blood from 793 male and female sheep were analyzed. During visitations, an epidemiological questionnaire was applied for collection of information and analysis of possible risk factors. All sera samples were analyzed by agar gel immunodiffusion (AGID) and the antigen was a mixture of soluble proteins and lipopolysaccharides from B. ovis (strain Reo 198). Seropositive animals (6.94%, 55/793) to B. ovis were detected. However, significant statistical difference (p>0.05) was not found for age and sex. Risk factors that might be associated with cases of seropositive animals for the variables analyzed were not found. In 61.22% (30/49) of the examined farms at least one seropositive animal was detected. Only two of the ten municipalities above had no seropositive animal.

O objetivo do presente trabalho foi a realização de um inquérito soroepidemiológico de Brucella ovis em rebanhos de ovinos da Microrregião de Feira de Santana, Estado da Bahia, Brasil. Foram selecionados os dez municípios de maior efetivo ovino: Antônio Cardoso, Feira de Santana, Ipecaetá, Ipirá, Itatim, Pintadas, Rafael Jambeiro, Santa Teresinha, Santo Estévão e Serra Preta,. O tamanho da amostra foi calculado com base nos parâmetros: nível de significância, 99%; erro amostral, 5%, prevalência estimada, 50%. A amostra total foi fracionada segundo a população de ovinos do respectivo município. Foram examinados 793 animais, machos e fêmeas, com idade superior a seis meses, distribuídos em 49 propriedades dos municípios visitados. Por ocasião das visitas, foi aplicado um questionário epidemiológico destinado à análise de possíveis fatores de risco. Todos os soros foram submetidos ao teste da imunodifusão em gel de ágar (IDGA) com o antígeno constituído por proteínas e lipopolissacarídeos solúveis de B. ovis amostra Reo198. Foram obtidos 6,94% (55/793) de animais positivos e não houve diferença significativa (p>0,05) para idade e sexo. Para as variáveis analisadas, não foram encontrados fatores de risco que pudessem estar associados aos casos de animais reatores positivos. Dentre as propriedades trabalhadas, 61,22% (30/49) apresentaram pelo menos um animal reagente e dos dez municípios visitados, apenas dois não apresentaram animais positivos.

O secundarista e o processo de escolha da profissao

Analisa o processo de escolha profissional de secundaristas, alunos da rede publica e particular da cidade de Recife, partindo do relatorio da evasao da Universidade do Federal de Pernanbuco (UFPE). Apesar da relevancia das variaveis apresentadas, esta pesquisa atem-se ao processo de escolha profissional, apoiada na hipotese de que este pode ser um dos pontos de origem deste fenomeno. A amostra constituiu-se de 360 alunos, do segundo e terceiro anos, de nove escolas, divididas em tres categorias: tradicional, voltada para o vestibular e publica. Os instrumentos de investigacao foram questionarios e entrevistas semidirigidas, aplicadas a 10 por cento da amostra. Para selecao, observou-se os criterios: escola, genero e ano escolar. Foram realizadas analises estatistica e qualitativa dos dados. Esta ultima foi resultado do conteudo emergente no discurso, cuja referencia teorica foi a Psicanalise. Orientadores e psicologos, tambem, foram entrevistados. Os resultados demonstram que estudantes de todas as categorias de escola fazem a escolha profissional com elementos pouco consistentes, enquanto orientadores e psicologos exercem uma pluralidade de funcoes que os desviam da sistematizacao de um trabalho estruturado sobre a Orientacao Profissional.