Occupational and leisure time physical activity in contrasting relation to ambulatory blood pressure

Background: While moderate and vigorous leisure time physical activities are well documented to decrease the risk for cardiovascular disease, several studies have demonstrated an increased risk for cardiovascular disease in workers with high occupational activity. Research on the underlying causes to the contrasting effects of occupational and leisure time physical activity on cardiovascular health is lacking. The aim of this study was to examine the relation of objective and self-report measures of occupational and leisure time physical activity with 24-h ambulatory systolic blood pressure (BP). Methods: Results for self-reported physical activity are based on observations in 182 workers (60% male, mean age 51 years), while valid objective physical activity data were available in 151 participants. The usual level of physical activity was assessed by 5 items from the Job Content Questionnaire (high physical effort, lifting heavy loads, rapid physical activity, awkward body positions and awkward positions of head or arms at work) and one item asking about the general level of physical activity during non-working time. On a regular working day, participants wore an ambulatory BP monitor and an accelerometer physical activity monitor during 24 h. Associations were examined by means of Analysis of Covariance. Results: Workers with an overall high level of self-reported occupational physical activity as well as those who reported to often lift heavy loads at work had a higher mean systolic BP at work, at home and during sleep. However, no associations were observed between objectively measured occupational physical activity and BP. In contrast, those with objectively measured high proportion of moderate and vigorous leisure time physical activity had a significantly lower mean systolic BP during daytime, while no differences were observed according to self-reported level of leisure time physical activity. Conclusions: These findings suggest that workers reporting static occupational physical activities, unlike general physically demanding tasks characterized by dynamic movements of large muscle groups, are related to a higher daily systolic BP, while high objective levels of moderate and vigorous leisure time physical activity are related to lower daytime systolic BP. Ambulatory systolic BP may be a physiological explanatory factor for the contrasting effects of occupational and leisure time physical activity

Representações sociais sobre hipertensão arterial e o cuidado: o discurso do sujeito coletivo

OBJETIVO: Analisar as representações sociais da equipe de saúde sobre a hipertensão arterial e a maneira como desenvolvem os cuidados específicos aos hipertensos. MÉTODOS: Utilizou-se a entrevista semiestruturada com 21 profissionais de saúde que atuavam em Unidades Básicas de Saúde, a técnica do discurso do sujeito coletivo para organização dos dados e interpretação pela teoria das representações sociais. RESULTADOS: As representações dos profissionais revelaram um distanciamento entre as ações preconizadas pelo programa de controle e as que se realizam nas unidades de saúde. CONCLUSÕES: Os profissionais reconhecem a hipertensão como uma doença grave, com grandes consequências, porém as dificuldades estruturais por parte dos serviços, aliadas à desmotivação do usuário para participação em ações de promoção em saúde, não favorecem um cuidado em saúde voltado para as necessidades dos portadores de hipertensão. Tais resultados indicam a necessidade de ações interdisciplinares na prática assistencial que impactem positivamente na oferta e qualidade dos cuidados.OBJETIVO: Analizar las representaciones sociales del equipo de salud sobre la hipertensión arterial y la manera cómo desarrollan los cuidados específicos a los hipertensos. MÉTODOS: Se utilizó la entrevista semiestructurada con 21 profesionales de salud que actuaban en Unidades Básicas de Salud, la técnica del discurso del sujeto colectivo para la organización de los datos e interpretación por la teoría de las representaciones sociales. RESULTADOS: Las representaciones de los profesionales revelaron un distanciamiento entre las acciones preconizadas por el programa de control y las que se realizan en las unidades de salud. CONCLUSIONES: Los profesionales reconocen a la hipertensión como una enfermedad grave, con grandes consecuencias, sin embargo las dificultades estructurales por parte de los servicos, aliadas a la desmotivación del usuario para participar en acciones de promoción en salud, no favorecen a un cuidado en salud volcado a las necesidades de los portadores de hipertensión. Tales resultados indican la necesidad de acciones interdisciplinaris en la práctica asistencial que impacten positivamente en el ofrecimiento y calidad de los cuidados.OBJECTIVE: To analyze the social representations of the health team about arterial hypertension and the manner that develops specific care with hypertensive patients. METHODS: We used semi-structured interviews with 21 health professionals who worked in the Basic Health Units. The technique of collective subject discourse was used for organization and interpretation of the data, using the theory of social representation. RESULTS: The representations of health professionals showed a gap between the actions recommended by the control program and those taking place in health facilities. CONCLUSIONS: Professionals recognized hypertension as a serious disease, with great consequences, but the structural difficulties for part of the services, together with the user's motivation to participate in activities to promote health, did not favor health care focused on the needs of those suffering with hypertension. These results indicate the need for interdisciplinary actions in care practice that impact positively on the delivery and quality of care

Expression profile of genes associated with mastitis in dairy cattle

In order to characterize the expression of genes associated with immune response mechanisms to mastitis, we quantified the relative expression of the IL-2, IL-4, IL-6, IL-8, IL-10, IFN-γ and TNF- α genes in milk cells of healthy cows and cows with clinical mastitis. Total RNA was extracted from milk cells of six Black and White Holstein (BW) cows and six Gyr cows, including three animals with and three without mastitis per breed. Gene expression was analyzed by real-time PCR. IL-10 gene expression was higher in the group of BW and Gyr cows with mastitis compared to animals free of infection from both breeds (p < 0.05). It was also higher in BW Holstein animals with clinical mastitis (p < 0.001), but it was not significant when Gyr cows with and without mastitis were compared (0.05 < p < 0.10). Among healthy cows, BW Holstein animals tended to present a higher expression of all genes studied, with a significant difference for the IL-2 and IFN- γ genes (p < 0.001). For animals with mastitis no significant difference in gene expression was observed between the two breeds. These findings suggest that animals with mastitis develop a preferentially cell-mediated immune response. Further studies including larger samples are necessary to better characterize the gene expression profile in cows with mastitis

Analysis of Population Structure: A Unifying Framework and Novel Methods Based on Sparse Factor Analysis

We consider the statistical analysis of population structure using genetic data. We show how the two most widely used approaches to modeling population structure, admixture-based models and principal components analysis (PCA), can be viewed within a single unifying framework of matrix factorization. Specifically, they can both be interpreted as approximating an observed genotype matrix by a product of two lower-rank matrices, but with different constraints or prior distributions on these lower-rank matrices. This opens the door to a large range of possible approaches to analyzing population structure, by considering other constraints or priors. In this paper, we introduce one such novel approach, based on sparse factor analysis (SFA). We investigate the effects of the different types of constraint in several real and simulated data sets. We find that SFA produces similar results to admixture-based models when the samples are descended from a few well-differentiated ancestral populations and can recapitulate the results of PCA when the population structure is more “continuous,” as in isolation-by-distance models

Historical analysis of the Brazilian cervical cancer screening program from 2006 to 2013: a time for reflection

BACKGROUND: The Cervical Cancer Database of the Brazilian National Health Service (SISCOLO) contains information regarding all cervical cytological tests and, if properly explored, can be used as a tool for monitoring and managing the cervical cancer screening program. The aim of this study was to perform a historical analysis of the cervical cancer screening program in Brazil from 2006 to 2013. MATERIAL AND METHODS: The data necessary to calculate quality indicators were obtained from the SISCOLO, a Brazilian health system tool. Joinpoint analysis was used to calculate the annual percentage change. RESULTS: We observed important trends showing decreased rates of low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and an increased rate of rejected exams from 2009 to 2013. The index of positivity was maintained at levels below those indicated by international standards; very low frequencies of unsatisfactory cases were observed over the study period, which partially contradicts the low rate of positive cases. The number of positive cytological diagnoses was below that expected, considering that developed countries with low frequencies of cervical cancer detect more lesions annually. CONCLUSIONS: The evolution of indicators from 2006 to 2013 suggests that actions must be taken to improve the effectiveness of cervical cancer control in Brazil

Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule

<p>Abstract</p> <p>Background</p> <p>Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.</p> <p>Methods</p> <p>Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.</p> <p>Results</p> <p>Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.</p> <p>Conclusion</p> <p>The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.</p