Do Adult Attachment Style or Personality Mediate the Relationship Between Childhood Maltreatment and Late-Life Depression in Poor Communities?

OBJECTIVE

Childhood maltreatment is associated with late-life depression. Preliminary evidence indicates that personality characteristics, in particular neuroticism and extroversion, and an anxious attachment style mediate this association. The objective is to evaluate 3 models, in which personality and attachment are considered mediators between childhood maltreatment and late-life depression in a socioeconomically disadvantaged Brazilian population.

METHODS

This study included participants (n = 260) from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil, who completed measures of childhood maltreatment (Childhood Trauma Questionnaire - CTQ), personality characteristics (NEO-Five Factor Inventory), attachment styles (Relationship Scales Questionnaire), and geriatric depression (Mini-International Neuropsychiatric Interview-Plus). General multiple and sequential mediation analyses were used to test for possible associations.

RESULTS

Attachment anxiety but not attachment avoidance is a mediator between childhood maltreatment and geriatric depression. Neuroticism is a full mediator. At that, attachment anxiety was found to be a predictor of neuroticism. Finally, sequential mediation analysis shows a path from childhood maltreatment to geriatric depression through attachment anxiety and neuroticism.

CONCLUSIONS

The results suggest a pathway from childhood maltreatment to anxious attachment, which in turn predicts higher neuroticism that itself may favor late-life depression. This hypothesis could have implications for older adults living in low socioeconomic settings in that treating the high-risk group of maltreated children may help prevent late-life depression.

Association of Val16Ala Polymorphism of Manganese Superoxide Dismutase (MnSOD) with Food Intake and Cardiometabolic Risk Factors in the Elderly in Primary Care in Porto Alegre

BACKGROUND

The aging process causes physiological changes on its own. The combination of an unhealthy lifestyle with the presence of genetic polymorphisms, such as the Val16Ala of the antioxidant enzyme manganese-dependent superoxide dismutase (MnSOD) may contribute to a greater occurrence of cardiometabolic risk factors.

OBJECTIVE

This study aimed to verify the association of Val16Ala-MnSOD polymorphism with food intake, caloric expenditure, and cardiometabolic risk factors in the elderly.

METHODS

A cross-sectional study with a sample size of 270 elderly individuals assisted in primary health care in the city of Porto Alegre, RS, Brazil. Val16Ala polymorphism, glucose, lipid profile, insulin, HOMA-IR, blood pressure, waist circumference, PCR-us, IL-6, food consumption, and caloric expenditure were evaluated.

RESULTS

The average age of the elderly was 68.6 ± 7.6 years. There were statistically significant differences regarding the consumption of two or more servings of fruits and vegetables daily between the elderly VV versus AV (P=0.017). There were also statistically significant differences regarding the consumption of two or more daily servings of legumes and eggs between the elderly AA versus VV (P=0.002). The median of insulin was higher in the elderly AA versus AV (P=0.025) and the median of HOMA-IR was higher in the elderly VV versus AV (P=0.029). AA elderly individuals had higher means of high-density lipoprotein (HDL-c) compared to AV (P=0.029).

CONCLUSION

The results suggest that Val16Ala -MnSOD polymorphism is associated with the consumption of fruits, vegetables, legumes, and eggs, as well as with cardiometabolic risk factors in the elderly.

Health-related quality of life of inpatients and outpatients with TB in rural Malawi

INTRODUCTION: Patients being treated for TB may suffer reductions in health-related quality of life (HRQoL). This study aims to assess the extent of such reductions and the trajectory of HRQoL over the course of treatment in rural Malawi.METHODS: We collected patient demographic and socioeconomic status, TB-related characteristics, and HRQoL data (i.e., EQ-5D and a visual analogue scale VAS) from adults (age ≥18 years) being treated for TB in 12 primary health centers and one hospital in rural Thyolo District, Malawi, from 2014 to 2016. Associations between HRQoL and patient characteristics were estimated using multivariable linear regression.RESULTS: Inpatients (n = 197) consistently showed lower median HRQoL scores and suffered more severe health impairments during hospitalization than outpatients (n = 156) (EQ5D and VAS: 0.79, 55 vs. 0.84, 70). Longer treatment duration was associated with higher HRQoL among outpatients (EQ5D: 0.034 increase per 2 months, 95%CI 0.012-0.057). We found no substantial associations between patients´ demographic and socioeconomic characteristics and HRQoL in this setting.CONCLUSION: HRQoL scores among patients receiving treatment for TB in rural Malawi differ by clinical setting and duration of treatment, with greater impairment among inpatients and those early in their treatment course.

Effect of Zirconia Pigmentation on Translucency

PURPOSE

the aim of this study was to investigate the effect of shading on translucency and mean grain size of three Zirconia systems (Lava Frame, Ice Zirkon Translucent and Prettau Zirkon).

MATERIALS AND METHODS

specimens pigmented in A1, A4 and a non-pigmented specimen was evaluated with Scanning Electron Microscopy and spectrophotometery.

RESULTS

the transmittance ranged between 0.18 and 0.52, in Ice Zirkon Translucent A4 and Prettau Zircon non-pigmented, respectively. The pigmentation A1 and A4 significantly reduced the light transmission in all the systems evaluated (p⟨0.05), with the exception of Lava A1. The light transmittance of each ceramic system is different from each other in the three pigmentations, except for the Prettau Zirkon A1, which did not show a significant difference compared with Lava A1 (p⟩0.05). The mean grain size increased with pigmentation. The mean grain size ranged between 0.43 μm, for Prettau Zirkon non-pigmented, and 0.82 μm for Prettau Zirkon A4.

CONCLUSION

Light transmission and mean grain size was affected by pigmentation of dental zirconia ceramics.

Klinefelter syndrome and fertility-Impact of X-chromosomal inheritance on spermatogenesis

With the use of testicular sperm extraction (TESE), spermatozoa can be retrieved in about 30%-50% of men with Klinefelter syndrome (KS). The reason for the absence or presence of spermatozoa in half of the men with KS remains unknown. Therefore, the search for an objective marker for a positive prediction in finding spermatozoa is of significant clinical value to avoid unnecessary testicular biopsies in males with (mostly) low testicular volume and impaired testosterone. The objective of this study was to determine whether paternal or maternal inheritance of the additional X-chromosome can predict the absence or presence of spermatogenesis in men with KS. Men with KS who have had a testicular biopsy for diagnostic fertility workup TESE were eligible for inclusion. Buccal swabs from nine KS patients and parents (trios) were taken to compare X-chromosomal inheritance to determine the parental origin of both X-chromosomes in the males with KS. Spermatozoa were found in TESE biopsies 8 of 35 (23%) patients after performing a unilateral or bilateral TESE. Different levels of spermatogenesis (from the only presence of spermatogonia, up to maturation arrest or hypospermatogenesis) appeared to be present in 19 of 35 (54%) men, meaning that the presence of spermatogenesis not always yields mature spermatozoa. From the nine KS-trios that were genetically analysed for X-chromosomal inheritance origin, no evidence of a correlation between the maternal or paternal origin of the additional X-chromosome and the presence of spermatogenesis was found. In conclusion, the maternal or paternal origin of the additional X-chromosome in men with KS does not predict the presence or absence of spermatogenesis.

Independent estimates of marine population connectivity are more concordant when accounting for uncertainties in larval origins

Marine larval dispersal is a complex biophysical process that depends on the effects of species biology and oceanography, leading to logistical difficulties in estimating connectivity among populations of marine animals with biphasic life cycles. To address this challenge, the application of multiple methodological approaches has been advocated, in order to increase confidence in estimates of population connectivity. However, studies seldom account for sources of uncertainty associated with each method, which undermines a direct comparative approach. In the present study we explicitly account for the statistical uncertainty in observed connectivity matrices derived from elemental chemistry of larval mussel shells, and compare these to predictions from a biophysical model of dispersal. To do this we manipulate the observed connectivity matrix by applying different confidence levels to the assignment of recruits to source populations, while concurrently modelling the intrinsic misclassification rate of larvae to known sources. We demonstrate that the correlation between the observed and modelled matrices increases as the number of observed recruits classified as unknowns approximates the observed larval misclassification rate. Using this approach, we show that unprecedented levels of concordance in connectivity estimates (r = 0.96) can be achieved, and at spatial scales (20-40 km) that are ecologically relevant.

Doenças crônicas não transmissíveis e fatores sociodemográficos associados a sintomas de depressão em idosos

RESUMO Objetivo Investigar a associação das doenças crônicas não transmissíveis e fatores sociodemográficos com sintomas de depressão em idosos. Métodos Foi realizado um estudo transversal com 1.391 idosos cadastrados na Estratégia Saúde da Família. Os dados sociodemográficos e de doenças crônicas não transmissíveis foram coletados pelos agentes comunitários de saúde. A Escala de Depressão Geriátrica abreviada foi utilizada para investigar os sintomas de depressão. Resultados Aproximadamente 81% referiram ao menos uma doença crônica não transmissível. Os sintomas depressivos foram associados com sexo feminino, doença coronariana, insuficiência cardíaca e acidente vascular cerebral; ≥ 8 anos de estudo e ter companheiro foram protetores. Dentre as doenças crônicas não transmissíveis, as cardiovasculares e as cerebrovasculares têm associação independente com sintomas de depressão. Conclusões Esses resultados corroboram a hipótese de que a doença vascular seja um fator de risco para o comprometimento encefálico associado à depressão. Evidencia-se o importante papel dos agentes comunitários de saúde, na Estratégia Saúde da Família, com potencial utilidade nas políticas públicas para a saúde mental do idoso.

Mitral Valve Surgery for Rheumatic Lesions in Young Patients

BACKGROUND

The appropriateness of rheumatic mitral valve repair remains controversial due to the risks of recurrent mitral dysfunction and need for reoperation. The aims of this study were to determine the overall short- and long-term outcomes of pediatric rheumatic mitral valve surgery in our center.

METHODS

Single-center, observational, retrospective study that analyzed the results of rheumatic mitral valve surgery in young patients, consecutively operated by the same team, between 1999 and 2014.

RESULTS

We included 116 patients (mean age = 12.6 ± 3.5 years), of which 66 (57%) were females. A total of 116 primary surgical interventions and 22 reoperations were performed. Primary valve repair was possible in 86 (74%) patients and valve replacement occurred in 30 (26%). Sixty percent of the patients were followed up beyond three months after surgery (median follow-up time = 9.2 months [minimum = 10 days; maximum = 15 years]). Long-term clinical outcomes were favorable, with most patients in New York Heart Association functional class I (89.6%) and in sinus rhythm (85%). Freedom from reoperation for primary valve repair at six months, five years, and ten years was 96.4% ± 0.25%, 72% ± 0.72%, and 44.7% ± 1.34%, respectively. Freedom from reoperation for primary valve replacement at six months, five years, and ten years was 100%, 91.7% ± 0.86%, and 91.7% ± 0.86%, respectively. Mitral stenosis as the primary lesion dictated early reintervention.

CONCLUSIONS

Despite the greater rate of reoperation, especially when the primary lesion was mitral stenosis, rheumatic mitral valve repair provides similar clinical outcomes as compared with replacement, with the advantage of avoiding anticoagulation.

Evaluating the forensic application of 19 target microRNAs as biomarkers in body fluid and tissue identification

RNA-based body fluid and tissue identification has evolved as a promising and reliable new technique to classify type and source of biological evidence in crime cases. In particular, mRNA-based approaches are currently on the rise to replace conventional protein-based methods and are increasingly implemented into forensic casework. However, degradation of these nucleic acid molecules can cause issues on laboratory scale and need to be considered for a credible investigation. For this reason, the analysis of miRNAs using qPCR has been proposed to be a sensitive and specific approach to identify the origin of a biological trace taking advantage of their small size and resistance to degradation. Despite the straightforward workflow of this method, suitable endogenous controls are inevitable when performing real-time PCR to ensure accurate normalization of gene expression data in order to allow a meaningful interpretation. In this regard, we have validated reference genes for a set of forensically relevant body fluids and tissues (blood, saliva, semen, vaginal secretions, menstrual blood and skin) and tested 15 target genes aiming to identify abovementioned sample types. Our data showed that preselected endogenous controls (miR26b, miR92 and miR484) and miR144, initially selected as potential marker for the detection of menstrual blood, were the most stable expressed genes among our set of samples. Normalizing qPCR data with these four validated references revealed that only five miRNA markers are necessary to differentiate between the six different cell types selected in this study. Nevertheless, our observations in the present study indicate that miRNA analysis methods may not provide straightforward data interpretation strategies required for an implementation in forensic casework.

Phytochemical profiling as a solution to palliate disinfectant limitations

The indiscriminate use of biocides for general disinfection has contributed to the increased incidence of antimicrobial tolerant microorganisms. This study aims to assess the potential of seven phytochemicals (tyrosol, caffeic acid, ferulic acid, cinnamaldehyde, coumaric acid, cinnamic acid and eugenol) in the control of planktonic and sessile cells of Staphylococcus aureus and Escherichia coli. Cinnamaldehyde and eugenol showed antimicrobial properties, minimum inhibitory concentrations of 3-5 and 5-12 mM and minimum bactericidal concentrations of 10-12 and 10-14 mM against S. aureus and E. coli, respectively. Cinnamic acid was able to completely control adhered bacteria with effects comparable to peracetic acid and sodium hypochlorite and it was more effective than hydrogen peroxide (all at 10 mM). This phytochemical caused significant changes in bacterial membrane hydrophilicity. The observed effectiveness of phytochemicals makes them interesting alternatives and/or complementary products to commonly used biocidal products. Cinnamic acid is of particular interest for the control of sessile cells.

Muscle architecture and torque production in stroke survivors: an observational study

OBJECTIVE

Spasticity poststroke leads to muscle weakness and soft tissue contracture, however, it is not clear how muscle properties change due this motor neural disorder. The purpose was to compare medial gastrocnemius muscle architecture and mechanical properties of the plantarflexor muscles between stroke survivors with spasticity and healthy subjects.

METHODS

The study included 15 stroke survivors with ankle spasticity and 15 healthy subjects. An isokinetic dynamometer was used for the evaluation of maximal isometric plantarflexor torque and images of the medial gastrocnemius muscle were obtained using ultrasonography. Images were collected at rest and during a maximum voluntary contraction.

RESULTS

The affected limb showed reduced fascicle excursion (0.9 ± 0.7 cm), shorter fascicle length, and reduced muscle thickness (0.095 ± 0.010% of leg length and 1.18 ± 0.20 cm, at rest) compared to contralateral (1.6 ± 0.4 cm, 0.106 ± 0.015% of leg length and 1.29 ± 0.24 cm, respectively) and to healthy participants (1.8 ± 0.7 cm, 0.121 ± 0.019% of leg length and 1.43 ± 0.22 cm, respectively). The contralateral limb showed lower force (between 32 and 40%) and similar architecture parameters compared to healthy participants.

CONCLUSION

The affected limb had a different muscle architecture that appears to result in lower force production. The contralateral limb showed a decrease in force compared to healthy participants due to the other neural impairments than muscle morphology. Spasticity likely leds to adaptations of muscle architecture in the affected limb and in force reductions in both limbs of stroke survivors.

Inflammation, Oxidation, Caloric Expenditure and Cognitive Impairment in Brazilian Elderly Assisted at Primary Care

Cognitive impairment (CI) has a multifactorial etiology. Some studies have suggested that inflammatory, oxidative and antioxidant status and physical activity are associated with CI. However, the evidence on this subject is still controversial. The goal of this study was to verify the association of caloric expenditure by physical activity, oxidative, antioxidant power and inflammatory biomarkers with CI in older adults. We performed a cross-sectional study of 424 elderly (224 with normal cognitive function and 200 with CI) patients from the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil. The variables investigated were sociodemographic, biochemical, inflammatory (hs-CRP, IL-6), oxidative (TBARS, AOPP), antioxidant power (FRAP) biomarkers, energy expenditure, and cognitive function. The instruments used were the Minnesota Leisure Time Physical Activity Questionnaire + Compendium of Physical Activities, classification of energy costs of human physical activities (for physical activity evaluation and measurement of energy expenditure in METs), and a battery of neuropsychiatric instruments (for cognitive ability assessment). We found statistically significant differences only with respect to HDL-c and age (higher averages in the CI group; P<0.05). We observed no differences between the groups with respect to biochemical, inflammatory, oxidative and FRAP biomarkers or caloric expenditure. Logistic regression showed that HDL-c (OR=1.02 [IC=95%; 1.01-1.04]; P=0.011), and age (OR=1.05 [IC=95%; 1.02-1.08]; P=0.004) are independent factors associated with CI. Our results suggest that the biochemical (except HDL-c), inflammatory, oxidative, and FRAP biomarkers investigated and caloric expenditure are not associated with CI in the elderly assisted at primary care.

Vulnerabilidad social en la enfermedad de Alzheimer: en búsqueda de derechos

<p>La presente investigación fue diseñada para verificar cuáles son las razones que conllevan a las personas con enfermedad de Alzheimer a interponer un recurso legal. Para ello, se buscó en la página web del Tribunal de Río Grande do Sul, en el trascurso de un año, las decisiones de los recursos judiciales que contenían la palabra "Alzheimer". Fueron encontradas 65 decisiones relacionadas con la enfermedad de Alzheimer. De ellas, la mayoría correspondió a solicitudes de medicamentos (61,6%), seguido de solicitud de pañales (17,0%). Es importante que se dé el cumplimiento de la legislación, posibilitando disminuir la cantidad de interpuestas judiciales, así como la importancia de que se genere la comprensión de la gravedad de esta enfermedad, para que los procesos se den de manera rápida, haciendo que no aumente la vulnerabilidad del anciano con la enfermedad de Alzheimer.</p>

Psychometric characteristics of the full and short versions of the IQCODE-BR among low income elderly persons with a low educational level

Objective : To study the psychometric characteristics of the Brazilian Portuguese version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-BR) using a sample of low income elderly persons with a low educational level, and compare the full and short versions of the questionnaire. Method : A cross-sectional study of a convenience sample of a population with a low educational level was performed. The IQCODE-BR was applied to the informants of 87 elderly persons (60-90 years old), who were triaged by psychiatrists and neurologists for the diagnosis of depression, mild cognitive impairment (MCI), and dementia. Results : The median age of the sample was 72 and the majority were women (72.4%). A total of 31 (35.6%) were illiterate, 30 (34.5%) had dementia, 21 (24.1%) suffered from depression, 20 (23.0%) had MCI, and 16 (18.4%) were diagnosed with none of these conditions. The median IQCODE-BR was higher in the groups with depression and MCI than the normal group, and was highest of all in the group with dementia. The full and reduced versions of the IQCODE-BR had similar levels of accuracy. Conclusion : In this sample the IQCODE-BR was shown to be an effective tool for tracking MCI and dementia. The use of the short version with cut-off points of 3.22 for MCI excluding a diagnosis of depression, and 3.48 for dementia irrespective of the presence of symptoms of depression, is suggested.

The association between the chronic use of non-steroidal anti- inflammatory drugs and oxidative and inflammatory markers in the elderly

OBJECTIVES

Investigate the association between the chronic or occasional use of nonsteroidal anti-inflammatory drugs (NSAIDs) and plasma levels of oxidative and inflammatory markers in elderly at the Family Health Strategy in Brazil.

METHODS

It was a cross-sectional study of data collected from random elderly volunteers. A questionnaire including sociodemographic, health and medicine use data was administered. The blood levels of FRAP (ferric reducing ability of plasma), AOPP (plasma advanced oxidation protein products), MDA (malondialdehyde) and insulin were measured.

RESULTS

The study sample comprised 758 elderly patients, of which 121 (15.96%) used NSAIDs. The mean age was 68.53 years and 68.41 for individuals who used NSAIDs occasionally and chronically, respectively. Gastric problems may be associated with the chronic or occasional use of NSAIDs (P = 0.042). Which indicates mean plasma levels of Insulin and HOMA-IR (Homeostasis Model Assessment Insulin Resistance) are increased in chronic use of NSAIDs and describes a statistical trend (P = 0.065) for the association of chronic NSAIDs use with the BMI (body mass index) of the subjects studied.

CONCLUSION

This study suggests that there is no association between the chronic or occasional use of NSAIDs and oxidative and inflammatory markers. It is known that NSAIDs have innumerable adverse effects, but they can have some benefits. So, additional studies are needed to clarify whether NSAIDs are associated with these markers and whether they are related with their real consequences.

Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil

OBJECTIVE

To analyze the prevalence of depression in older adults and associated factors.

METHODS

Cross-sectional study using a stratified random sample of 621 individuals aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil, between 2010 and 2012. Community health agents measured depression using the 15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as depression and between 11 and 15 as severe depression. Poisson regression was used to search for independent associations of sociodemographic and self-perceived health with both depression and its severity.

RESULTS

The prevalence of depression was 30.6% and was significantly higher in women (35.9% women versus 20.9% men, p < 0.001). The variables independently associated with depression were: female gender (PR = 1.4, 95%CI 1.1;1.8); low education, especially illiteracy (PR = 1.8, 95%CI 1.2;2 6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the strength of association of these factors increases significantly in severe depression.

CONCLUSIONS

A high prevalence of depression was observed in the evaluations conducted by community health agents, professionals who are not highly specialized. The findings identified using the 15-item Geriatric Depression Scale in this way are similar to those in the literature, with depression more associated with low education, female gender and worse self-rated health. From a primary health care strategic point of view, the findings become still more relevant, indicating that community health agents could play an important role in identifying depression in older adults.

Endothelin-converting enzyme 2 differentially regulates opioid receptor activity

BACKGROUND AND PURPOSE

Opioid receptor function is modulated by post-activation events such as receptor endocytosis, recycling and/or degradation. While it is generally understood that the peptide ligand gets co-endocytosed with the receptor, relatively few studies have investigated the role of the endocytosed peptide and peptide processing enzymes in regulating receptor function. In this study, we focused on endothelin-converting enzyme 2 (ECE2), a member of the neprilysin family of metallopeptidases that exhibits an acidic pH optimum, localizes to an intracellular compartment and selectively processes neuropeptides including opioid peptides in vitro, and examined its role in modulating μ receptor recycling and resensitization.

EXPERIMENTAL APPROACH

The effect of ECE2 inhibition on hydrolysis of the endocytosed peptide was examined using thin-layer chromatography and on μ opioid receptor trafficking using either elisa or microscopy. The effect of ECE2 inhibition on receptor signalling was measured using a cAMP assay and, in vivo, on antinociception induced by intrathecally administered opioids by the tail-flick assay.

KEY RESULTS

The highly selective ECE2 inhibitor, S136492, significantly impaired μ receptor recycling and signalling by only those ligands that are ECE2 substrates and this was seen both in heterologous cells and in cells endogenously co-expressing μ receptors with ECE2. We also found that ECE2 inhibition attenuated antinociception mediated only by opioid peptides that are ECE2 substrates.

CONCLUSIONS AND IMPLICATIONS

These results suggest that ECE2, by selectively processing endogenous opioid peptides in the endocytic compartment, plays a role in modulating opioid receptor activity.

LINKED ARTICLES

This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2.

Soroepidemiologia de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família, Porto Alegre, Rio Grande do Sul, Brasil

O objetivo desse estudo foi avaliar a soroprevalência para Toxoplasma gondii e a relacionar com as condições socioeconômicas, higiênicas, sanitárias e de saúde nos idosos da Estratégia Saúde da Família - ESF, do município de Porto Alegre, Rio Grande do Sul, Brasil. A pesquisa realizada foi um estudo transversal, no qual foi aplicado um questionário de inquérito epidemiológico e realizada coleta de sangue. A avaliação de IgG e IgM anti-T. gondii foi realizada pela técnica de ELISA. Foram avaliados 599 idosos com soroprevalência para IgG anti-T. gondii de 88,0% e de 0,8% para IgM. Na análise multivariada, as variáveis que se associaram de forma independente para IgG positivo foram: faixa etária, renda pessoal e uso de óculos; e para IgM positivo: faixa etária, autopercepção de saúde e uso de óculos. Os resultados obtidos chamam a atenção pela alta prevalência de IgG anti-T. gondii nos idosos da ESF de Porto Alegre, gerando uma preocupação no caso de ocorrência de reativação da toxoplasmose e desenvolvimento dos sintomas mais graves dessa infecção.

Lack of association of body composition and functionality variables with metabolic syndrome in the elderly

BACKGROUND

The aging process causes alterations in body composition (decrease in lean mass and increase in fat mass), diminution of functionality (strength, mobility, and physical performance), and an increased prevalence of chronic diseases such as metabolic syndrome and obesity. The aim of this study was to investigate the association of body composition and functionality with metabolic syndrome in the elderly.

METHODS

A cross-sectional study was conducted in the Outpatient Clinic of the Geriatric Service of Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul (PUCRS) involving 74 patients (14 males and 60 females). The patients were separated into two groups: Group 1=elderly with metabolic syndrome [through the National Cholesterol Education Program Adult Treatment Panel III (NECP ATP III) criteria; n=34], group 2=elderly without metabolic syndrome (n=40). The variables evaluated included age, gender, body composition (circumferences, skinfold thickness, BMI, muscle and fat thickness and muscle mass), functional variables [hand grip strength, Timed Up and Go Test (TUGT), and Sit-to-Stand Test].

RESULTS

The results showed that elderly individuals with metabolic syndrome had a higher mean of the anthropometric measures (except abdominal skinfold thickness) compared to subjects without metabolic syndrome (P<0.005). We observed significant differences for muscle mass index (higher, P=0.029), TUGT (longer time, P=0.008), and hand grip strength (lower, P=0.015) in elderly with metabolic syndrome compared with subjects without metabolic syndrome. However, when these variables were adjusted for gender, age, and body mass index (BMI), none showed a significant association with metabolic syndrome.

CONCLUSION

We did not observe associations among metabolic syndrome, body composition, and functionality variables.

Healthy eating index of elderly: description and association with energy, macronutrients and micronutrients intake

The purpose of this study was to define the Healthy Eating Index (HEI) of the elderly of Southern Brazil and its association with energy, macronutrients and micronutrients intake. A cross-sectional study was conducted with 186 elderly aged 60 and older of the Geriatric Service of São Lucas Hospital, Porto Alegre, Brazil. Dietary data were collected by two 24-hour recalls, and diet quality was assessed by HEI adapted to the Brazilian population. The HEI total score was divided into three categories: inadequate diet (below 51 points), diet needs improvement (between 51 and 80 points), and healthy diet (over 80 points). The results showed that the mean HEI score was 58.8±10.5 points (ranging from 31.4 to 79.8). Most elderly (74.2%) showed a diet that needed modification and no elderly individual had a healthy diet. The quality of the diet was associated with greater intake of carbohydrates, and lower intake of total lipids, saturated fatty acids, cholesterol, and sodium. Consumption of vitamins C and D and calcium was shown to be positively correlated with the quality of the diet. Less than 1.1% of the elderly consumed a varied diet. The findings suggest that the diet of the majority of the elderly needs improvement, reinforcing the importance of care in relation to adequate nutrition in this population, and can help in guiding the activities and programs of nutritional education and public policies that stimulate increasingly healthy eating.

Prevalence of amyotrophic lateral sclerosis in the city of Porto Alegre, in Southern Brazil

Objective : To determine the prevalence of amyotrophic lateral sclerosis (ALS) in the city of Porto Alegre, Brazil. Method : We conducted an extensive investigation in clinics and hospitals that provide specialized assistance to these patients, contacted neurologists and the regional association of people with ALS. Results : On July 31, 2010, 70 patients were alive and diagnosed with amyotrophic lateral sclerosis. Considering the population living in the city in the same period (1,409,351), the estimated prevalence was 5.0 cases per 100,000 people (95% CI, 3.9-6.2), being higher for men (5.2/100,000 95% CI, 3.6-7.2) than for women (4.8/100,000 95% CI, 3.4-6.5). The prevalence increased with age peaking in the age group 70-79 years in both genders. Conclusion : The prevalence of ALS in the city of Porto Alegre is similar to that reported in other parts of the world.

Prevalence and Patterns of Alcohol Misuse in a Community-Dwelling Elderly Sample in Brazil

Objective: The aim of this study was to estimate prevalence and patterns of lifetime alcohol misuse. Method: This was a cross-sectional study of a representative sample of 1,078 individuals aged 60 or more. Structured interview included sociodemographic, lifestyle, health data, and the five alcohol misuse screening questions of the Self-Reporting Questionnaire. Results: Prevalence of misuse was 6.5%. Men, aged 60 to 69, low educational level, separated/divorced, and tobacco smoking were independently associated with lifetime alcohol misuse. Odds ratios show increasing association with levels of alcohol misuse groups in males, low-educated, and tobacco users. Persons aged 60 to 69, 4 to 7 education years, and non-White ethnicity were significantly associated with the major alcohol misuse score. Discussion: Younger elderly were more exposed to alcohol than previous cohorts. Thus, problems with alcohol in old age will possibly increase as they grow older. The results of this study call attention to a field of lacking evidence in alcohol-related problems of older persons.

RNA/DNA co-analysis from human menstrual blood and vaginal secretion stains: results of a fourth and fifth collaborative EDNAP exercise

The European DNA Profiling Group (EDNAP) organized a fourth and fifth collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling. The task was to identify dried menstrual blood and vaginal secretion stains using specific RNA biomarkers, and additionally test 3 housekeeping genes for their suitability as reference genes. Six menstrual blood and six vaginal secretion stains, two dilution series (1/4-1/64 pieces of a menstrual blood/vaginal swab) and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by 24 participating laboratories, using RNA extraction or RNA/DNA co-extraction methods. Two novel menstrual blood mRNA multiplexes were used: MMP triplex (MMP7, MMP10, MMP11) and MB triplex (MSX1, LEFTY2, SFRP4) in conjunction with a housekeeping gene triplex (B2M, UBC, UCE). Two novel mRNA multiplexes and a HBD1 singleplex were used for the identification of vaginal secretion: Vag triplex (MYOZ1, CYP2B7P1 and MUC4) and a Lactobacillus-specific Lacto triplex (Ljen, Lcris, Lgas). The laboratories used different chemistries and instrumentation and all were able to successfully isolate and detect mRNA in dried stains. The simultaneous extraction of RNA and DNA allowed for positive identification of the tissue/fluid source of origin by mRNA profiling as well as a simultaneous identification of the body fluid donor by STR profiling, also from old and compromised casework samples. The results of this and the previous collaborative RNA exercises support RNA profiling as a reliable body fluid identification method that can easily be combined with current STR typing technology.

Prevalência de obesidade associada à ingestão calórica, glicemia e perfil lipídico em uma amostra populacional de idosos do Sul do Brasil

OBJETIVO: Determinar a prevalência de obesidade associada ao consumo de macronutrientes, às alterações do perfil lipídico, à glicemia e à prática de atividade física em idosos. MÉTODOS: Foi realizado estudo transversal com 304 idosos do município de Porto Alegre, RS, Brasil. Medidas antropométricas de peso e altura foram utilizadas para o cálculo do índice de massa corporal (IMC) e foram analisados o perfil lipídico, a glicemia, a ingestão diária de macronutrientes e a prática de atividade física. RESULTADOS: A prevalência de obesidade foi de 30,6%, sofrendo redução com o aumento da idade. As idosas obesas apresentaram maior frequência de hipertrigliceridemia, cujos valores aumentaram conforme o aumento do IMC. Nesse grupo, a prática de atividade física foi menor. Entre os homens, houve maior consumo de proteína na dieta. CONCLUSÃO: Os resultados mostraram que a obesidade é um importante problema de saúde na Região Sul do Brasil, sofrendo influência de fatores socioculturais e econômicos que prejudicam a manutenção de uma alimentação saudável. Políticas públicas devem ser direcionadas a fim de controlar esse problema, já que a obesidade é um fator limitante para a longevidade.

Hematological parameters and prevalence of anemia among free-living elderly in south Brazil

OBJECTIVE

The aims of this study were to analyze the hematological parameters, the prevalence of anemia and the association between anemia and socioeconomic conditions in an elderly community-based population.

METHODS

A population-based study was performed as part of the Multidimensional Study of the Elderly in Porto Alegre, Brazil (EMIPOA). An initial total of 1058 community residents aged 60 years and older were interviewed. Of these, 392 agreed to have a physical evaluation and a blood sample was taken from each. The hematological parameters analyzed in the blood samples included the hemoglobin concentration, mean cell volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW). The association between the variables and the diagnosis of anemia was assessed using the chi-squared test and a multiple logistic regression model.

RESULTS

The overall prevalence of anemia was 12.8%. Anemia was present in 13.7% of women and in 10.4% of men. Normocytic normochromic anemia without anisocytosis was the most common type of anemia (46%). The assessment of erythrocyte morphology showed significant differences between anemic and non-anemic individuals (microcytosis = 12% vs. 1.5%, hypochromia = 40% vs. 8.8%, and anisocytosis = 26% vs. 7%). In the analysis of socioeconomic conditions, significant differences were found in respect to age and race.

CONCLUSION

The prevalence of anemia increases with age and is associated with race, microcytosis, hypochromia and anisocytosis. Anemia is not a condition that should be associated only with the aging process, as it may be due to pathological conditions that occur most frequently in this age group. As a result, a diagnosis of anemia warrants adequate clinical attention.

Seasonal variation in prevalence of carpal tunnel syndrome

INTRODUCTION

The influence of cold temperatures on neuropathies has been reported previously, but its impact on carpal tunnel syndrome (CTS) is not well analyzed.

METHODS

We analyzed the frequency of CTS among neurophysiological evaluations according to seasonal variation in 9574 consecutive patients (4260 with CTS).

RESULTS

A higher frequency of CTS was found in the winter (50.8%), and the lowest number for CTS diagnosis was found in the summer (38.9%). In both autumn and spring the prevalence remained stable at an intermediate level between summer and winter at 42.8% and 43.5%, respectively.

CONCLUSION

CTS frequency was much higher in winter in this center.

Ghost resonance in the chaotic Chua's circuit

We experimentally investigate the ghost resonance phenomenon in the electronic circuit of Chua operating in the chaotic regime. The circuit can be stimulated to jump between two single-scroll attractors by an external periodic signal with an amplitude above an intrinsic threshold. For subthreshold signals, jumps between the chaotic attractors can be promoted by a superposed white noise. We show that the circuit output can exhibit a well-defined ghost resonance signature, i.e., a resonance on a frequency that is absent in a multicomponent input signal, when the amplitudes of the input components are properly related. Further, we show that ghost resonance can be induced by the Chua's circuit's own chaotic dynamics when it is driven by a suprathreshold multicomponent signal without the need of an external noise source.