Estado nutricional e consumo alimentar de crianças com paralisia cerebral de um centro de reabilitação da cidade do Recife / Nutritional state and food consumption of children with cerebral palsy of a rehabilitation center in the city of Recife

Avaliar consumo alimentar, estado nutricional e relação com o comprometimento motor de crianças com paralisia cerebral.Estudo tipo série de casos, realizado com 23 crianças de 2 a 10 anos, acompanhadas em centro para crianças com deficiência. A avaliação do consumo alimentar foi realizado através do recordatório de 24 horas e o perfil antropométrico pelo escore-z dos índices altura/idade, peso/idade, índice de massa corporal/idade, circunferência do braço, circunferência muscular do braço e prega cutânea tricipital.Observou-se déficit estatural em 34,7% das crianças. Cerca de 30% apresentaram magreza e 13% excesso de peso, pelo peso/idade. Magreza e excesso de peso foram observados em 13% e 30,4%, respectivamente, pelo índice de massa corporal/idade. Desnutrição foi observada em 43,4%, 30,4% e 30,4%, conforme prega cutânea tricipital, circunferência do braço e circunferência muscular do braço, respectivamente. Observou-se excesso de peso em 13% pela circunferência do braço e 39,1% pela prega cutânea tricipital. Não houve associação entre grau de comprometimento motor e índice de massa corporal/idade. Quanto ao consumo alimentar, 43,5% apresentaram ingestão calórica insuficiente e 39,1% consumo de calorias acima de sua necessidade energética estimada. Consumo de carboidratos excessivo em 43,5% e proteínas em 56,5% das crianças, baixo consumo de lipídios para 47,8%, vitamina A (56,5%) e zinco (30,4%). 78,3% possuíam consumo insuficiente de fibras.Foram observados desequilíbrios no consumo alimentar e a presença de desnutrição, como também de excesso de peso entre o grupo avaliado. Não houve um padrão de estado nutricional e consumo alimentar associado ao comprometimento motor

Glucose-6-Phosphate Dehydrogenase Deficiency in an Endemic Area for Malaria in Manaus: A Cross-Sectional Survey in the Brazilian Amazon

BACKGROUND: There is a paucity of information regarding glucose-6-phosphate dehydrogenase (G6PD) deficiency in endemic areas for malaria in Latin America. METHODOLOGY/PRINCIPAL FINDINGS: This study determined the prevalence of the G6PD deficiency in 200 male non-consanguineous individuals residing in the Ismail Aziz Community, on the outskirts of Manaus (Brazilian Amazon). Six individuals (3%) were deficient using the qualitative Brewer's test. Gel electrophoresis showed that five of these patients were G6PD A(-). The deficiency was not associated with the ethnic origin (P = 0.571). In a multivariate logistic regression analysis, G6PD deficiency protected against three or more episodes of malaria (P = 0.049), independently of the age, and was associated with a history of jaundice (P = 0.020) and need of blood transfusion (P = 0.045) during previous treatment for malarial infection, independently of the age and the previous malarial exposure. CONCLUSIONS/SIGNIFICANCE: The frequency of G6PD deficiency was similar to other studies performed in Brazil and the finding of a predominant G6PD A(-) variant will help the clinical management of patients with drug-induced haemolysis. The history of jaundice and blood transfusion during previous malarial infection may trigger the screening of patients for G6PD deficiency. The apparent protection against multiple malarial infections in an area primarily endemic for Plasmodium vivax needs further investigation

FLOCK-REPROD non hormonal insemination protocols for goats

Projekt je razvio inovativna rješenja za proizvodnju hormone free kozjeg mlijeka tijekom cijele godine. FLOCK-REPROD (Hormone free non-seasonal or seasonal goat reproduction for a sustainable European goat-milk market), uz potporu 7. okvirnog programa, iznosi nehormonska rješenja koja omogućuju kontrolu sezonosti uz primjenu umjetnog osjemenjivanja (UO). Na taj način FLOCK-REPROD pomaže uzgajivačima proizvesti više mlijeka i osigurava alternativni put koji je u skladu sa zakonskom regulativom EU koja ograničava uporabu hormona. Razvijeni su novi progestagen free UO protokoli (PG1, PG1, HF) koji uključuju postupke temeljene na učinku mužjaka i svjetlosnim režimima u svrhu indukcije i sinkronizacije ovulacije tijekom cijele godine. PG1 i PG2 temelje se na jednoj ili dvije injekcije prostaglandina (nisu podvrgnute rezidualnim ograničenjima). HF protokol je hormone free te može biti primijenjen i na organskim uzgojima. Novi protokoli UO testirani su u terenskim uvjetima. Najbolji su rezultati dobiveni s HF (58 % gravidnosti, slično klasičnom hormonskom protokolu HT), a zatim s PG2 (54 %) te PG1 (45 %). Osnovni problem za implementaciju protokola PG1 i HF jest visoka varijabilnost plodnosti među farmama. Novi protokoli UO manje su učinkoviti glede utrošenih radnih sati i ulaznih troškova u usporedbi s HT. PG1 je protokol koji zahtijeva najveći utrošak vremena, a nakon njega to su HF i PG2. HF se pokazao najskupljim protokolom, dok je PG2 jeftiniji od PG1. Veći radni angažman i viši troškovi koje stvaraju novi UO protokoli nastaju najviše zbog potrebe za dodatnim brojem jarčeva nužnih za provođenje utjecaja mužjaka (veći troškovi hranidbe, utrošak vremena za baratanje mužjacima).The project has developed innovative solutions for the production of hormone-free goat milk throughout the year. FLOCK-REPROD (“Hormone-free non-seasonal or seasonal goat reproduction for a sustainable European goat-milk market”), supported by the 7th Framework Programme, created non-hormonal solutions that enable seasonal control of reproduction, which include the use of artificial insemination (AI). In this way, FLOCK-REPROD helps farmers to produce more milk and provides an alternative in line with the EU legislation which restricts the use of hormones. New “progestagen free” AI protocols (PG1, PG2, HF) have been developed, which include protocols based on the male effect and light treatment in order to provide induction and synchronization of blokiovulation throughout the year. PG1 and PG2 are based on one or two injections of prostaglandins (not subject to residual restrictions so far). The HF protocol is hormone-free and can be applied even in organic farming systems. New AI protocols have been tested in field conditions. The best results were obtained with HF (58% pregnancy, similar to classical hormonal protocol HT results), and then with PG2 (54%) and PG1 (45%). The main problem for the implementation of protocols PG1 and HF is the high variability of fertility between goat farms. New AI protocols are less effective with regard to working hours and input costs compared with HT protocols. PG1 is a protocol that requires the greatest working hour input, followed by the HF and PG2 protocols. HF has proven to be the most expensive protocol, while the PG 2 is cheaper than the PG1 protocol. The greater work engagement and higher input costs created by new AI protocols arise mainly due to the need for additional bucks to perform the male effect (higher feeding costs, more time spent in handling males)

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Níveis disfuncionais de ansiedade relacionada ao Coronavírus em estudantes de medicina: Dysfunctional levels of Coronavirus-related anxiety in medical students

As preocupações com a saúde mental das pessoas afetadas pela pandemia de coronavírus não foram abordadas adequadamente. Isso é surpreendente, uma vez que tragédias em massa, particularmente aquelas que envolvem doenças infecciosas, muitas vezes desencadeiam ondas de medo e ansiedade elevados que são conhecidos por causar perturbações maciças no comportamento e no bem-estar psicológico de muitos na população. Assim, o objetivo desse trabalho é demonstrar os níveis disfuncionais de ansiedade relacionada ao coronavírus em estudantes de medicina. Para isso, foi realizado uma revisão sistemática sobre a temática

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions