Rejuvenescimento periorbicular por indução ultrassônica: um estudo de casos / Periorbicular rejuvenation by ultrasonic induction: a report case

A blefaroplastia é atualmente o tratamento cirúrgico mais indicado na reversão dos efeitos do envelhecimento palpebral. Porém, a técnica é cara, extremamente invasiva, com recuperação pós-cirúrgica lenta e só pode ser realizada por cirurgiões em ambiente hospitalar. O ultrassom tem se mostrado um método seguro e eficaz no tratamento antienvelhecimento cutâneo, mas pouco se tem pesquisado sobre o efeito do ultrassom na dermatocalase. Este estudo piloto têm como objeto avaliar um emissor ultrassônico no tratamento de rejuvenescimento da região periorbicular. Trata-se uma pesquisa qualitativa descritiva de estudo de casos, no qual foram avaliadas duas voluntárias submetidas a tratamento com ultrassom. Após as sessões, foi possível observar retomada de viço e redução de flacidez palpebral, com consequente minimização da dermatocalase e rugas adjacentes. O uso do ultrassom se mostrou satisfatório e eficaz, principalmente na remodelação na região acometida por dermatocalase. Além disso, a técnica apresenta melhor custo-benefício e recuperação pós-procedimento mais curta em relação a outras terapias atualmente empregadas para tratamento da região periorbital. (AU)

Prevalence and risk factors associated with HIV/hepatitis B and HIV/hepatitis C co-infections among people who inject drugs in Mozambique.

BACKGROUND: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID. METHODS: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who self-reported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited in two cross-sectional samples in Maputo and Nampula/Nacala, two large urban centers of Mozambique. Rapid screening of HIV, HBV (HBsAg) and HCV was performed on site. Data from participants in both cities were pooled to conduct RDS-weighted bivariate analyses with HIV/HBV and HIV/HCV co-infections as separate outcomes. Unweighted bivariate and multivariate logistic regression analyses were conducted to assess correlates of co-infection. RESULTS: Among 492 eligible PWID, 93.3% were male and median age was 32 years [IQR: 27-36]. HIV, HBV and HCV prevalence were respectively 44.9% (95% CI:37.6-52.3), 32.8% (95% CI:26.3-39.5) and 38.3 (95% CI:30.6-45.9). Co-infections of HIV/HBV, HIV/HCV and HIV/HBV/HCV were identified in 13.1% (95% CI:7.2-18.9), 29.5% (95% CI:22.2-36.8) and 9.2% (95% CI:3.7-14.7) of PWID, respectively. Older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HBV co-infection. Living in Maputo city, have older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HCV co-infection. CONCLUSION: There is a high burden of HBV and HCV among HIV-infected PWID in Mozambique. Our results highlight the need for targeted harm reduction interventions that include needle exchange programs and integrated services for the diagnosis and treatment of HIV, HBV and HCV to address these epidemics among PWID. Efforts should be made to strengthen ART coverage in the population as an important treatment strategy for both viruses.

Prevalence and risk factors associated with hiv/hepatitis b and HIV/hepatitis C co infections among people who inject drugs in mozambique

Background: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID. Methods: The first Bio-Behavioral Surveillance Survey was conducted in 2013­2014 among persons who selfreported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited in two cross-sectional samples in Maputo and Nampula/Nacala, two large urban centers of Mozambique. Rapid screening of HIV, HBV (HBsAg) and HCV was performed on site. Data from participants in both cities were pooled to conduct RDS-weighted bivariate analyses with HIV/HBV and HIV/HCV co-infections as separate outcomes. Unweighted bivariate and multivariate logistic regression analyses were conducted to assess correlates of coinfection. Results: Among 492 eligible PWID, 93.3% were male and median age was 32 years [IQR: 27­36]. HIV, HBV and HCV prevalence were respectively 44.9% (95% CI:37.6­52.3), 32.8% (95% CI:26.3­39.5) and 38.3 (95% CI:30.6­45.9). Coinfections of HIV/HBV, HIV/HCV and HIV/HBV/HCV were identified in 13.1% (95% CI:7.2­18.9), 29.5% (95% CI:22.2­ 36.8) and 9.2% (95% CI:3.7­14.7) of PWID, respectively. Older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HBV co-infection. Living in Maputo city, have older age, history of needle/syringe sharing and history of injection with used needle/syringe was associated with HIV/HCV coinfection...

Developmental origins of health and disease: a new approach for the identification of adults who suffered undernutrition in early life.

BACKGROUND: Undernutrition in early life (UELife) is a condition associated with greater occurrence of chronic diseases in adulthood. Some studies on this relationship have used short stature as indicator of UELife. However, other non-nutritional factors can also determine short stature. Depending on the severity of UELife, the human body reacts primarily compromising weight and length gain, but prioritizing brain growth, resulting in disproportionate individuals. Based on this premise, this study aimed to validate a new anthropometric indicator of UELife. DESIGN: Using stature and head circumference data from a probabilistic sample of 3,109 women, the Head-to-Height Index was calculated: HHI = (head × 2.898)/height. A HHI >1.028 (75th percentile) was the best cutoff for predicting obesity (best balance between sensitivity/ specificity, largest area under the receiver operating characteristic curve, and highest correlation coefficient) and was used to define the condition of body disproportionality. The strength of associations with several outcomes was tested for both disproportionality and short stature (height ≤25th percentile: 153.1 cm). RESULTS: In adjusted analysis for confounding factors (age, smoking, and education level), the strength of the associations between body disproportionality and the analyzed outcomes was greater than that observed when short stature was used. Respectively, the observed prevalence ratios (95% CI) were (P<0.05 for all comparisons): obesity: 2.61 (2.17-3.15) vs 1.09 (0.92-1.28); abdominal obesity: 2.11 (1.86-2.40) vs 1.42 (1.27- 1.59); high blood pressure: 1.24 (1.02-1.50) vs 0.90 (0.75-1.08); hypercholesterolemia: 2.98 (1.47-6.05) vs 1.65 (0.91-2.99); and hypertriglyceridemia: 1.47 (1.07-2.03) vs 0.91 (0.69-1.21). CONCLUSION: Body disproportionality is a more accurate indicator of UELife than short stature. While short stature may be genetically determined, a high HHI is due to metabolic adaptations to undernutrition in early life.

Prevalence, temporal trend and associated factors with excess body weight in mothers of children under five years / Prevalência, tendência temporal e fatores associados ao excesso de peso em mães de crianças menores de cinco anos

ABSTRACT Objective This study aims to evaluate the prevalence, temporal trends and associated factors with excess weight in mothers of children under five years of age. Methods This is a time-series study using data from two household surveys conducted in 2005 and 2015. A total of 1,436 mothers were evaluated in 2005, and 690 were evaluated in 2015. The dependent variables were excess body weight (Body Mass Index [BMI] ≥25.0kg/m2), high percentage of Body Fat (%BF ≥33%) and abdominal obesity (waist circumference >80cm). The independent variables were the socioeconomic and demographic factors. The changes that occurred between the two surveys were expressed in percentages, and the measure of association was the Prevalence Ratio, calculated by Poisson regression, in both the crude and multivariate analyses. Results There were increases of 33.2%, 59.2% and 31.0%, respectively, for the prevalence of excess weight (PR=1.33, 95% Confidence Interval [CI]:1.21-1.46), abdominal obesity (PR=1.59, 95% CI:1.43-1.77) and high %BF (PR=1.31, 95% CI:1.07-1.60). The factors independently associated with excess weight and abdominal obesity were the highest age group (>30 years), menarche ≤12 years and higher parity (>2 children). The same was observed for high %BF, except for the loss of significance in the adjusted analysis for the variable menarche ≤12 years. Conclusion The prevalence of high body adiposity is a problem of relevant importance in the studied population and has presented an upward trend in the last 10 years. Women over 30 years and with more than two children should be given priority in prevention and control.

RESUMO Objetivo Este estudo teve como objetivo avaliar a prevalência, a tendência temporal e os fatores associados ao excesso de peso em mães de crianças menores de cinco anos. Métodos Trata-se de um estudo de série temporal que se utilizou de dados de dois inquéritos domiciliares realizados em 2005 e 2015, respectivamente. Em 2005 foram avaliadas 1.436 mães, e em 2015 avaliaram-se 690. As variáveis dependentes foram o excesso de peso (IMC ≥25,0kg/m2), o percentual de gordura corporal elevado (%GC ≥33%) e a obesidade abdominal (perímetro da cintura >80cm). As variáveis independentes foram os fatores socioeconômicos e demográficos. As modificações ocorridas entre os dois inquéritos foram expressas percentualmente, e a medida de associação foi a razão de prevalência, calculada por regressão de Poisson, tanto na análise bruta quanto na multivariável. Resultados Verificaram-se incrementos de 33,2%, 59,2% e 31,0%, respectivamente, para as prevalências de excesso de peso (RP=1,33; IC95%: 1,21-1,46), obesidade abdominal (RP=1,59; IC95%: 1,43-1,77) e percentual de gordura corporal elevado (RP=1,31; IC95%: 1,07-1,60). Os fatores independentemente associados ao excesso de peso e à obesidade abdominal foram a maior faixa etária (>30 anos), menarca (<12 anos) e maior paridade (>2 filhos). O mesmo se observou para o percentual de gordura corporal elevado, exceto pela perda da significância na análise ajustada para a variável menarca <12 anos. Conclusão A prevalência de excesso de adiposidade corporal se apresenta em alta magnitude na população estudada e vem apresentando tendência ascendente nos últimos dez anos. Mulheres com mais de trinta anos e com mais de dois filhos devem receber prioridade nas ações de prevenção e controle.

Modeling tight junction dynamics and oscillations.

Tight junction (TJ) permeability responds to changes of extracellular Ca(2+) concentration. This can be gauged through changes of the transepithelial electrical conductance (G) determined in the absence of apical Na(+). The early events of TJ dynamics were evaluated by the fast Ca(2+) switch assay (FCSA) (Lacaz-Vieira, 2000), which consists of opening the TJs by removing basal calcium (Ca(2+)(bl)) and closing by returning Ca(2+)(bl) to normal values. Oscillations of TJ permeability were observed when Ca(2+)(bl) is removed in the presence of apical calcium (Ca(2+)(ap)) and were interpreted as resulting from oscillations of a feedback control loop which involves: (a) a sensor (the Ca(2+) binding sites of zonula adhaerens), (b) a control unit (the cell signaling machinery), and (c) an effector (the TJs). A mathematical model to explain the dynamical behavior of the TJs and oscillations was developed. The extracellular route (ER), which comprises the paracellular space in series with the submucosal interstitial fluid, was modeled as a continuous aqueous medium having the TJ as a controlled barrier located at its apical end. The ER was approximated as a linear array of cells. The most apical cell is separated from the apical solution by the TJ and this cell bears the Ca(2+) binding sites of zonula adhaerens that control the TJs. According to the model, the control unit receives information from the Ca(2+) binding sites and delivers a signal that regulates the TJ barrier. Ca(2+) moves along the ER according to one-dimensional diffusion following Fick's second law. Across the TJ, Ca(2+) diffusion follows Fick's first law. Our first approach was to simulate the experimental results in a semiquantitative way. The model tested against experiment results performed in the frog urinary bladder adequately predicts the responses obtained in different experimental conditions, such as: (a) TJ opening and closing in a FCSA, (b) opening by the presence of apical Ca(2+) and attainment of a new steady-state, (c) the escape phase which follows the halt of TJ opening induced by apical Ca(2+), (d) the oscillations of TJ permeability, and (e) the effect of Ca(2+)(ap) concentration on the frequency of oscillations.