Calcium supplementation to prevent pre-eclampsia: study with 788 Brazilian pregnant women

Introdução: Estima-se que a cada ano, 59 000 mil mulheres em todo o mundo morram em decorrencia de sindromes hipertensivas da gestacao. Cerca de 20% (286) das 1.432 mortes maternas de 2010 no Brasil foram decorrentes de pre-eclampsia (PE) ou eclampsia (E) Apesar da existencia de evidencias de boa qualidade (revisoes sistematicas) indicando que a suplementacao de calcio (Ca) reduz significativamente a incidencia de PE e a mortalidade materna, poucos estudos avaliaram a implementacao dessa intervencao na pratica obstetrica. Objetivo: Avaliar a proporcao de gestantes brasileiras que receberam prescricao medica de suplementos de Ca durante a gravidez. Metodos: Estudo transversal e descritivo realizado em 9 unidades basicas (UBS) do sistema unico de Saúde (SUS) em 4 regioes diferentes do Brasil entre 2010- 2012. Gestantes aguardando sua consulta pre-natal foram convidadas a responder a um questionario oral que avaliou se haviam recebido prescricao de suplementos de Ca na gestacao e sua inGestão atual de laticinios. Resultados: Um total de 788 questionarios validos foram analisados; 250 participantes foram categorizadas como sendo de alto risco (AR) para PE devido a um ou mais dos seguintes fatores; nuliparidade, idade 35 anos, ser portadora de diabetes ou historia de hipertensao em gestacao anterior e 538 foram consideradas de baixo risco (BR) para PE por nao apresentarem nenhum desses fatores. Apenas 40 gestantes (5,1%) relataram ter recebido prescricao medica de suplemento de Ca, nao havendo diferenca significativa entre os grupos de AR e BR (5,2% versus 5,0%, respectivamente). Menos da metade dessas gestantes (16/40) relatou ter sido informada sobre o motivo para essa suplementacao e apenas 3 informaram que o Ca estava sendo tomado para evitar problemas de pressao arterial. A inGestão media de Ca proveniente de laticinios foi de 209.6 mg (+ 264.9) mg, o que corresponde a menos de um terco da inGestão diaria recomendada para gestantes. Discussao: A imensa maioria das gestantes entrevistadas nao recebeu prescricao para suplementos de Ca. Este achado e preocupante, especialmente diante da constatacao de que a dieta tipica dessas gestantes e bastante pobre em Ca. Conclusao: Apesar da existencia de evidencias de boa qualidade indicando os beneficios dessa conduta, apenas 1 em cada 20 das gestantes brasileiras entrevistadas recebeu prescricao de suplementacao de Ca. O maior uso desta intervencao poderia reduzir de forma substancial a incidencia de PE/E assim como suas repercussoes, incluindo mortalidade materna. Sao necessarias estrategias para aumentar a implementacao desta intervencaoBackground: It is estimated that each year 59 000 women die worldwide due to hypertensive disorders of pregnancy. In Brazil, in 2010, aproximately 20% (286) of all 1.432 maternal deaths were due to preeclampsia (PE) or eclampsia (E). Despite the existence of good quality evidence (systematic reviews) indicating that calcium (Ca) supplementation significantly reduces the incidence of PE and maternal mortality, few studies have evaluated the implementation of this intervention in obstetric practice. Aim: Evaluate the guidance received by Brazilian pregnant women regarding Ca supplementation during pregnancy. Methods: Cross-sectional,descriptive study carried out in 9 primary health care clinics (UBS) of the Brazilian public health system (SUS) in 4 different geographic regions of Brazil. Pregnant women waiting for their prenatal visit were invited to answer an oral questionnaire that assessed the recommendations related to Ca supplementation during pregnancy and their current intake of dairy products. Results: A total of 788 valid questionnaires were analyzed, 256 participants were categorized as being at high risk (HR) for PE due to the presence of one or more of the following factors: nulliparity, age 35 years, diabetes or history of hypertension in a previous pregnancy, and 538 were classified as being at low risk (LR) for PE for not having any of these factors. Only 40 women (5.1%) reported that they had received aprescription for Ca supplements, without significant differences in the HR and LR groups (5.2% versus 5.0%, respectively). Less than half of these women (16/40) reported having been informed about the reason for the supplementation, and only 3 reported that the Ca was being taken to avoid blood pressure problems. The average daily Ca intake from milk products of the participants was 209.97 mg (+ 264.87) mg, corresponding to less than half the recommended daily intake. Discussion: The vast majority of women in this study did not receive prescriptions for Ca supplements. This finding is alarming, especially given the fact that the typical diet of these women is poor in Ca. Conclusion: Despite good quality evidence indicating the benefits of this practice, only one in every twenty Brazilian pregnant women interviewed reported that she had received a prescription for Ca supplements. The upscale of this intervention could substantially reduce the incidence of PE / E and associated adverse outcomes, including maternal mortality. Strategies to increase the implementation of this intervention are needed.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)BV UNIFESP: Teses e dissertaçõe

CONSUMO ALIMENTAR DE CRIANÇAS DO ENSINO FUNDAMENTAL EM UMA INSTITUIÇÃO PÚBLICA

Objetivo: verificar consumo alimentar e classe econômica de escolares de ensino fundamental em uma instituição pública. Método: estudo transversal com 43 escolares entre 6 a 11 anos, de ambos os sexos, da rede municipal de Manaus, Amazonas, Brasil. Os dados foram obtidos mediante questionário semiestruturado com informações de consumo alimentar e socioeconômicas, e pela observação participante. Resultados: Foi verificado alto consumo de produtos industrializados, fontes de proteína de origem animal, gorduras e açúcares refinados, e baixo consumo de fibras e pescados, bem como pouca aderência aos alimentos oferecidos pela escola, independente de classe econômica. Conclusão: O reduzido consumo de vegetais e frutas em todas as classes socioeconômicas e o frequente consumo de biscoitos, doces e produtos de processamento industrial, refletem a baixa qualidade da dieta das crianças. Por isso, a importância do incremento de ações de educação nutricional para promoção de alimentação saudável entre os escolares. Descritores: Consumo Alimentar, Alimentos industrializados, Fatores Socioeconômicos, Ensino fundamental

Acute Exposure to Two Biocides Causes Morphological and Molecular Changes in the Gill Ciliary Epithelium of the Invasive Golden Mussel Limnoperna fortunei (Dunker, 1857)

Limnoperna fortunei, the golden mussel, is a bivalve mollusk considered an invader in South America. This species is responsible for ecological and economic damages due to its voluminous fouling capability. Chemical biocides such as MXD-100™ and sodium dichloroisocyanurate (NaDCC) are often used to control L. fortunei infestations in hydraulic systems. Thus, we proposed to investigate the effects of different periods (24, 48 and 72 h) of exposure to MXD-100™ (0.56 mg L−1) and NaDCC (1.5 mg L−1) on the gills of L. fortunei through morphological and molecular analyses. NaDCC promoted progressive morphological changes during the analyzed periods and only an upregulation of SOD and HSP70 expression during the first 24 h of exposure. MXD-100™ led to severe morphological changes from the first period of exposure, in addition to an upregulation of SOD, CAT, HSP70 and CYP expression during the first 24 h. In contrast, MXD-100™ led to a downregulation of CAT transcription between 24 and 48 h. In static conditions, NaDCC causes lethal damage after 72 h of exposure, and that exposure needs to be continuous to achieve the control of the species. Meanwhile, the MXD-100™ treatment presented several effects during the first 24 h, showing acute toxicity in a shorter period of time

Rainforest-to-pasture conversion stimulates soil methanogenesis across the Brazilian Amazon

The Amazon rainforest is a biodiversity hotspot and large terrestrial carbon sink threatened by agricultural conversion. Rainforest-to-pasture conversion stimulates the release of methane, a potent greenhouse gas. The biotic methane cycle is driven by microorganisms; therefore, this study focused on active methane-cycling microorganisms and their functions across land-use types. We collected intact soil cores from three land use types (primary rainforest, pasture, and secondary rainforest) of two geographically distinct areas of the Brazilian Amazon (Santarém, Pará and Ariquemes, Rondônia) and performed DNA stable-isotope probing coupled with metagenomics to identify the active methanotrophs and methanogens. At both locations, we observed a significant change in the composition of the isotope-labeled methane-cycling microbial community across land use types, specifically an increase in the abundance and diversity of active methanogens in pastures. We conclude that a significant increase in the abundance and activity of methanogens in pasture soils could drive increased soil methane emissions. Furthermore, we found that secondary rainforests had decreased methanogenic activity similar to primary rainforests, and thus a potential to recover as methane sinks, making it conceivable for forest restoration to offset greenhouse gas emissions in the tropics. These findings are critical for informing land management practices and global tropical rainforest conservation

Local hydrological conditions influence tree diversity and composition across the Amazon basin

Tree diversity and composition in Amazonia are known to be strongly determined by the water supplied by precipitation. Nevertheless, within the same climatic regime, water availability is modulated by local topography and soil characteristics (hereafter referred to as local hydrological conditions), varying from saturated and poorly drained to well-drained and potentially dry areas. While these conditions may be expected to influence species distribution, the impacts of local hydrological conditions on tree diversity and composition remain poorly understood at the whole Amazon basin scale. Using a dataset of 443 1-ha non-flooded forest plots distributed across the basin, we investigate how local hydrological conditions influence 1) tree alpha diversity, 2) the community-weighted wood density mean (CWM-wd) – a proxy for hydraulic resistance and 3) tree species composition. We find that the effect of local hydrological conditions on tree diversity depends on climate, being more evident in wetter forests, where diversity increases towards locations with well-drained soils. CWM-wd increased towards better drained soils in Southern and Western Amazonia. Tree species composition changed along local soil hydrological gradients in Central-Eastern, Western and Southern Amazonia, and those changes were correlated with changes in the mean wood density of plots. Our results suggest that local hydrological gradients filter species, influencing the diversity and composition of Amazonian forests. Overall, this study shows that the effect of local hydrological conditions is pervasive, extending over wide Amazonian regions, and reinforces the importance of accounting for local topography and hydrology to better understand the likely response and resilience of forests to increased frequency of extreme climate events and rising temperatures

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Mapping density, diversity and species-richness of the Amazon tree flora

Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution