Opinions and attitudes regarding sexuality: Brazilian national research, 2005

OBJETIVO: Descrever opiniões e atitudes sobre sexualidade da população urbana brasileira. MÉTODOS: Inquérito de base populacional realizado em 2005, em amostra representativa de 5.040 entrevistados. Realizou-se análise das atitudes diante da iniciação e educação sexual de adolescentes, considerando sexo, idade, escolaridade, renda, estado civil, religião, cor, região geográfica e opiniões sobre fidelidade, homossexualidade e masturbação. Os resultados foram contrastados com pesquisa similar realizada em 1998, sempre que possível. RESULTADOS: A maioria dos entrevistados escolheu como significado para o sexo a alternativa: "sexo é uma prova de amor". Como em 1998, a maioria manifestou-se pela iniciação sexual dos jovens depois do casamento (63,9% para iniciação feminina vs. 52,4% para a masculina), com diferenças entre praticantes das diversas religiões. A educação escolar de adolescentes sobre o uso do preservativo foi apoiada por 97% dos entrevistados, de todos os grupos sociais. Foi elevada a proporção de brasileiros que concordaram com o acesso ao preservativo nos serviços de saúde (95%) e na escola (83,6%). A fidelidade permaneceu um valor quase unânime e aumentou, em 2005, a proporção dos favoráveis à iniciação sexual depois do casamento, assim como a aceitação da masturbação e da homossexualidade, em relação à pesquisa de 1998. As gerações mais novas tendem a ser mais tolerantes e igualitárias. CONCLUSÕES: Como observado em outros países, confirma-se a dificuldade de estabelecer uma dimensão única que explique a regulação da vida sexual ("liberal" vs "conservador"). Sugere-se que a normatividade relativa à atividade sexual deva ser compreendidas à luz da cultura e organização social da sexualidade ao nível local, auscultadas pelos programas de DST/Aids. A opinião favorável ao acesso livre ao preservativo na escola contrasta com resultados mais lentos no âmbito do combate ao estigma e à discriminação das minorias homossexuais. A formulação de políticas laicas dedicadas à sexualidade permitirá o diálogo entre diferentes perspectivas.OBJECTIVE: To describe opinions and attitudes concerning sexuality of the Brazilian urban population. METHODS: A population survey was carried out in 2005 on a representative sample of 5,040 interviewees. An analysis of the attitudes regarding sexual initiation and sexual education of teenagers, considering gender, age, schooling, income, marital status, color, geographic region and opinion on fidelity, homosexuality, and masturbation. The results were contrasted with a similar survey carried out in 1998, when possible. RESULTS: Most interviewees selected the "sex is evidence of love" option when describing the meaning of sex. As in 1998, the majority was in favor of sexual initiation after marriage (63.9% for women vs. 52.4% for men initiation); results differed among religions. School teenage education on the use of condoms was supported by 97% of the interviewees across all social groups. The proportion of Brazilians who agreed with having access to condoms in health services (95%) and at school (83.6%) was high. Fidelity remained an almost unanimous value and there was an increase, in 2005, in the proportion of those in favor of sexual initiation after marriage, and in the rate of acceptance of masturbation and homosexuality compared to the 1998 survey. The younger generations tend to be more tolerant and equalitarian. CONCLUSIONS: As observed in other countries, this study confirms the difficulty in establishing a single dimension that guides sexual life ("liberal" vs "conservative"). The study suggests that the normativity concerning sexual activity should be understood in the light of the local culture and social organization of sexuality, considered by the STD/Aids programs. Opinions in favor of free access to preservatives at school clash with the slower results obtained in fighting the stigma and discriminating against homosexual minorities. The design of laical policies on sexuality allow for the dialog across different perspectives.Ministério da Saúd

Age and condom use at first sexual intercourse of Brazilian adolescents

OBJETIVO: Analisar a idade e o uso do preservativo na iniciação sexual de adolescentes brasileiros em dois períodos: 1998 e 2005. MÉTODOS: Amostras representativas da população urbana brasileira foram entrevistadas em inquérito domiciliar por duas pesquisas, realizadas em 1998 e 2005. Dentre os entrevistados, 670 jovens (16 a 19 anos) sexualmente ativos foram selecionados para o estudo, 312 de 1998 e 358 de 2005. Para análise dos dados ponderados foram utilizados o teste qui-quadrado de Pearson e o teste exato de Fisher (±<5%). RESULTADOS: Em 2005, 61,6% dos jovens entrevistados tinham iniciado-se sexualmente, cuja idade média foi 14,9 anos, sem diferenças significativas para os jovens entrevistados em 1998. O uso de preservativo na primeira relação sexual aumentou significativamente em relações estáveis (48,5% em 1998 vs. 67,7% em 2005) e casuais (47,2% em 1998 vs. 62,6% em 2005) em quase todos os segmentos. Persistiram as diferenças relacionadas à iniciação sexual e ao uso de preservativos segundo gênero, cor da pele e escolaridade, tal como observado em 1998. A diminuição no uso de preservativo entre os jovens que se iniciaram sexualmente antes dos 14 anos, em todos os contextos de parceria, foi expressiva na região Sudeste e entre os mais escolarizados. CONCLUSÕES: Como em outros países, observou-se tendência à estabilização da idade da iniciação sexual entre jovens de 15 a 19 anos. O adiamento do início da vida sexual, mais freqüente entre os jovens mais escolarizados, deve ser tema discutido no planejamento da educação dos adolescentes para a sexualidade e prevenção das IST. Quanto à diminuição da vulnerabilidade ao HIV, é relevante e significativo o incremento no uso de preservativo na iniciação sexual.OBJECTIVE: To analyze age and condom use at first sexual intercourse among Brazilian adolescents at two periods: 1998 and 2005. METHODS: Representative samples of the Brazilian urban population were interviewed during a household survey for two studies, carried out in 1998 and 2005. Interviewees included 670 sexually active young people (aged 16 to 19) who were selected for the study, 312 in 1998 and 358 in 2005. Pearson's chi-square test and Fisher's exact test (±<5%) were used to analyze the weighted data. RESULTS: In 2005, 61.6% of young interviewees had practiced sex and the average age for first intercourse was 14.9, with no significant difference to young interviewees in 1998. Condom use during first sexual intercourse increased significantly in both stable relationships (48.5% in 1998 vs. 67.7% in 2005) and casual relationships (47.2% in 1998 vs. 62.6% in 2005) across almost all segments. There were differences by gender, skin color and schooling for both age of first sexual intercourse and condom use, as per findings in 1998. Decreases in condom use for young people who were sexually active before the age of 14, across all types of partnerships, were marked in the Southeast region and for people with more schooling. CONCLUSIONS: As in other countries, there was a trend towards the stabilizing of the age of first sexual intercourse for young people aged 15 to 19. The postponement of the first sexual intercourse is more frequent among youth with more years of schooling, a theme that should be discussed in the planning of sexual education and STI prevention initiatives for adolescents. In terms of reductions in vulnerability to HIV, the increase in condom use at first sexual intercourse is both relevant and significant.Ministério da Saúd

Balance of IL-10 and Interferon-γ plasma levels in human visceral leishmaniasis: Implications in the pathogenesis

BACKGROUND: Leishmaniasis remains a serious public health problem in several parts of the developing world. Effective prophylactic measurements are hampered by imprecise comprehension of different aspects of the disease, including its immunoregulation. A better comprehension of immunoregulation in human VL may be useful both for designing and evaluating immunoprophylaxis. METHODS: To explore immunoregulatory mechanisms, 20 visceral leishmaniasis (VL) patients were evaluated during active disease and at different periods up to one year after treatment determining their plasma cytokine levels, clinical parameters (palpable spleen and liver) and antibody levels. RESULTS: Elevated plasma levels of IFN-γ and of IL-12 p40 were observed during active disease, significantly decreasing after treatment whereas in vitro Leishmania antigen-stimulated IFN-γ production by PBMC exhibited an inverse pattern being low during disease and increasing steadily thereafter. Absence of IFN-γ activity is a hallmark of VL. The main candidate for blunting IFN-γ activity is IL-10, a cytokine highly elevated in plasma with sharp decrease after treatment. Activity of IL-10 is inferred by high levels of anti-Leishmania specific IgG1 and IgG3. TGF-β had elevated total, but not of active, levels lessening the likelihood of being the IFN-γ counterpart. Spleen or liver size presented a steady decrease but return to normal values at only 120 days after treatment. Anti-Leishmania IgG (total and subclasses) levels and DTH or Leishmania-stimulated lymphocyte proliferation conversion to positive also present a slow decrease after treatment. IL-6 plasma levels were elevated in only a few patients. CONCLUSION: Taken together our results suggest that IFN-γ and IL-10 are the molecules most likely involved in determining fate of disease. After treatment, there is a long delay before the immune profile returns to normal what precludes using plasma cytokine levels as criteria of cure as simpler clinical evaluations, as a palpable spleen or liver, can be used

Could a remarkable decrease in leptin and insulin levels from colostrum to mature milk contribute to early growth catch-up of SGA infants?

Background: Breast milk is known to contain many bioactive hormones and peptides, which can influence infant growth and development. In this context, the purpose of this study was to evaluate the influence of different clinical pregnancy conditions on hormone concentrations in colostrum and mature breast milk. Methods: An observational study was performed with mother-newborn pairs divided into five groups according to maternal clinical background: diabetes (12), hypertension (5), smoking (19), intrauterine growth restriction of unknown causes with small-for-gestational-age newborns at delivery (12), and controls (21). Socioeconomic data, anthropometric measurements and breast milk samples were collected between the first 24 and 48 h and 30 days postpartum. Leptin, adiponectin, and insulin levels in breast milk were measured by immunoassays. Results: A significant decrease in leptin (p = 0.050) and insulin (p = 0.012) levels from colostrum to mature breast milk in mothers of small-for-gestational-age infants was observed. Maternal body mass index was correlated with both leptin and insulin, but not with adiponectin. Insulin levels were negatively correlated to infant weight gain from birth to one month (p = 0.050). In addition, catch-up growth was verified for small-for-gestational-age infants throughout the first month of life. Conclusions: This study suggests that a remarkable decrease in leptin and insulin levels in mature milk of mothers of small-for-gestational-age newborns may be involved in the rapid weight gain of these newborns. The physiological and external mechanisms by which these significant decreases and rapid weight gains occur in this group remain to be elucidated

Evolvable Neuronal Paths: A Novel Basis for Information and Search in the Brain

We propose a previously unrecognized kind of informational entity in the brain that is capable of acting as the basis for unlimited hereditary variation in neuronal networks. This unit is a path of activity through a network of neurons, analogous to a path taken through a hidden Markov model. To prove in principle the capabilities of this new kind of informational substrate, we show how a population of paths can be used as the hereditary material for a neuronally implemented genetic algorithm, (the swiss-army knife of black-box optimization techniques) which we have proposed elsewhere could operate at somatic timescales in the brain. We compare this to the same genetic algorithm that uses a standard ‘genetic’ informational substrate, i.e. non-overlapping discrete genotypes, on a range of optimization problems. A path evolution algorithm (PEA) is defined as any algorithm that implements natural selection of paths in a network substrate. A PEA is a previously unrecognized type of natural selection that is well suited for implementation by biological neuronal networks with structural plasticity. The important similarities and differences between a standard genetic algorithm and a PEA are considered. Whilst most experiments are conducted on an abstract network model, at the conclusion of the paper a slightly more realistic neuronal implementation of a PEA is outlined based on Izhikevich spiking neurons. Finally, experimental predictions are made for the identification of such informational paths in the brain

Impact of Daily Thermocycles on Hatching Rhythms, Larval Performance and Sex Differentiation of Zebrafish

In the wild, water temperature cycles daily: it warms up after sunrise, and cools rapidly after sunset. Surprisingly, the impact of such daily thermocycles during the early development of fish remains neglected. We investigated the influence of constant vs daily thermocycles in zebrafish, from embryo development to sexual differentiation, by applying four temperature regimens: two constant (24&deg;C and 28&deg;C) and two daily thermocycles: 28:24&deg;C, TC (thermophase coinciding with daytime, and cryophase coinciding with night-time) and 24:28&deg;C, CT (opposite to TC) in a 12:12 h light:dark cycle (LD). Embryo development was temperature-dependent but enhanced at 28&deg;C and TC. Hatching rhythms were diurnal (around 4 h after lights on), but temperature- and cycle-sensitive, since hatching occurred sooner at 28&deg;C (48 hours post fertilization; hpf) while it was delayed at 24&deg;C (96 hpf). Under TC, hatching occurred at 72 hpf, while under CT hatching displayed two peaks (at 70 hpf and 94 hpf). In constant light (LL) or darkness (DD), hatching rhythms persisted with tau close to 24 h, suggesting a clock-controlled "gating" mechanism. Under 28&deg;C or TC, larvae showed the best performance (high growth and survival, and low malformations). The sex ratio was strongly influenced by temperature, as the proportion of females was higher in CT and TC (79 and 83% respectively), contrasting with 28&deg;C and 24&deg;C, which led to more males (83 and 76%). Ovarian aromatase (cyp19a) expression in females was highest in TC and CT (6.5 and 4.6 fold higher than at 28&deg;C, respectively); while anti-m&uuml;llerian hormone (amh) expression in males increased in testis at 24&deg;C (3.6 fold higher compared to TC) and particularly at 28&deg;C (14.3 fold increase). Taken together, these findings highlight the key role of environmental cycles during early development, which shaped the daily rhythms in fish embryo and larvae, and ultimately influenced sex differentiation

Prior outpatient antibiotic use as predictor for microbial aetiology of community-acquired pneumonia: hospital-based study

Objective: The causative micro-organism in community-acquired pneumonia (CAP) is often difficult to predict. Different studies have examined chronic morbidity and clinical symptoms as predictors for microbial aetiology of pneumonia. The aim of our study was to assess whether prior outpatient antimicrobial treatment is predictive for determining the microbial aetiology of CAP. Methods: This was a hospital-based prospective observational study including all patients admitted with CAP between 1 October 2004 and 1 August 2006. Microbial investigations included sputum, blood culture, sputum PCR, antigen testing and serology. Exposure to antimicrobial drugs prior to hospital admission was ascertained through community pharmacy dispensing records. Multivariate logistic regression analysis was conducted to assess whether prior outpatient antimicrobial treatment is a predictor of microbial aetiology. Patient demographics, co-morbidities and pneumonia severity were considered to be other potential predictors. Results: Overall, 201 patients were included in the study. The microbial aetiology was determined in 64% of the patients. The five most prevalent pathogens were Streptococcus pneumoniae, Heamophilus influenzae, Legionella spp., Mycoplasma pneumoniae and Influenza virus A+B. Forty-seven of the patients (23%) had received initial antimicrobial treatment as outpatients. Multivariate analyses revealed that initial outpatient beta-lactam treatment was associated with a threefold increased chance of finding atypical pathogens and a threefold decreased probability of pneumococcal infection; the corresponding odds ratios were 3.51 (95% CI 1.25-9.99) and 0.30 (95% CI 0.10-0.90), respectively. Patients who received macrolides prior to hospitalisation had an increased probability of viral pneumonia. Conclusion: Prior outpatient antimicrobial therapy has a predictive value in the diagnostic workup aimed at identifying the causative pathogen and planning corresponding antimicrobial treatment in patients hospitalised for pneumonia

Dual-Labeling Strategies for Nuclear and Fluorescence Molecular Imaging: A Review and Analysis

Molecular imaging is used for the detection of biochemical processes through the development of target-specific contrast agents. Separately, modalities such as nuclear and near-infrared fluorescence (NIRF) imaging have been shown to non-invasively monitor disease. More recently, merging of these modalities has shown promise owing to their comparable detection sensitivity and benefited from the development of dual-labeled imaging agents. Dual-labeled agents hold promise for whole-body and intraoperative imaging and could bridge the gap between surgical planning and image-guided resection with a single, molecularly targeted agent. In this review, we summarized the literature for dual-labeled antibodies and peptides that have been developed and have highlighted key considerations for incorporating NIRF dyes into nuclear labeling strategies. We also summarized our findings on several commercially available NIRF dyes and offer perspectives for developing a toolkit to select the optimal NIRF dye and radiometal combination for multimodality imaging