Is Neck Circumference a Marker for Cardiovascular Risk in Obese Adolescents?

Background: Weight excess has become a public health problem worldwide, reaching about 200 million children, of whom 40 to 50 million are obese. Obesity in childhood is associated with increased blood pressure (BP), high triglycerides, low HDL-cholesterol and abnormal glucose metabolism. Visceral fat is a stronger predictor of metabolic dysfunction and cardiovascular risk than total body adiposity. Assessment of neck circumference (NC) is an easy method, which can serve as screening to identify individuals with weight excess. Our study aim was to examine associations between NC with BP values, lipid profile, blood glucose and fasting insulin in obese adolescents and verify the reproducibility of measurements of NC. Methods: 82 adolescents aged 10 to 17 years were included in the study, being 43 (22 boys and 21 girls) with obesity and 39 with normal weight (20 boys and 19 girls). Results: Significant associations were observed between NC and BMI, BP, HDL cholesterol, insulin and HOMA-IR. Disagreement between both observers for NC was observed in 5.2% of the sample, only concerning obese individuals. Conclusion: Our findings strengthen the knowledge about the potential value of NC as a tool for identifying patients at risk for hypertension, insulin resistance, and obesity. However as with the waist circumference it may be flawed in obese individuals

Abdominal circumference measurement by ultrasound does not enhance estimating the association of visceral fat with cardiovascular risk

Objectives: To evaluate the association between visceral fat and cardiovascular risk factors and to compare the ultrasonographic measurements of abdominal visceral fat with abdominal circumference (AC).Methods: This observational cross-sectional study categorized pubertal and postpubertal adolescents into a control group (n = 49) and an obese group (n = 46). Weight, height, AC, blood pressure, biochemical tests (lipid profile, triacylglycerols, fasting glucose for insulinemia, and serum uric acid), and ultrasound to measure visceral fat were assessed.Results: We found significant differences in the vascular risk variables between the groups, except for total cholesterol and fasting blood glucose level. We also observed that 31 subjects in the control group presented abnormalities in cardiovascular risk factors. the correlations between abdominal visceral fat (measured by ultrasound or the AC) and cardiovascular risk factors were significant. in the entire sample, AC presented better sensitivity and specificity than the ultrasound-measured abdominal visceral fat for identifying the presence of a cluster of at least three cardiovascular risk factors (areas under the receiver operating characteristics curve 0.87 and 0.73, respectively).Conclusion: Ultrasonographic measurements of visceral fat were correlated with cardiovascular risk factors, but this association was also demonstrable with AC measurements. Our results suggest that the measurement of visceral fat by ultrasound is unnecessary for the diagnosis of cardiovascular risk in well-nourished or obese adolescents. (C) 2013 Elsevier Inc. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, São Paulo, BrazilFAPESP: 03/02584-8Web of Scienc

Pesquisa de leucócitos residuais

A presença de leucócitos nos concentrados de eritrócitos (CE) e nos concentrados de plaquetas (CP) está associada a uma maior incidência de reacções febris, com transmissão de citomegalovírus (CMV) e aloimunização a antigénios HLA em indivíduos transfundidos. A exigência de componentes sanguíneos pobres em leucócitos implica a existência de um controlo relativamente à persistência dos leucócitos residuais. As amostras foram adquiridas no citómetro de fluxo e analisadas mediante um programa informático. A citometria de fluxo permite quantificar os leucócitos residuais dos diferentes componentes sanguíneos, avaliando a conformidade ou não conformidade com as normas exigidas pelo conselho da Europa

On the refined counting of graphs on surfaces

Ribbon graphs embedded on a Riemann surface provide a useful way to describe the double line Feynman diagrams of large N computations and a variety of other QFT correlator and scattering amplitude calculations, e.g in MHV rules for scattering amplitudes, as well as in ordinary QED. Their counting is a special case of the counting of bi-partite embedded graphs. We review and extend relevant mathematical literature and present results on the counting of some infinite classes of bi-partite graphs. Permutation groups and representations as well as double cosets and quotients of graphs are useful mathematical tools. The counting results are refined according to data of physical relevance, such as the structure of the vertices, faces and genus of the embedded graph. These counting problems can be expressed in terms of observables in three-dimensional topological field theory with S_d gauge group which gives them a topological membrane interpretation.Comment: 57 pages, 12 figures; v2: Typos corrected; references adde

Modeling the impacts of climate extremes and multiple water uses to support water management in the Icó-Mandantes Bay, Northeast Brazil

The hydropower production, water supply and aquaculture services of the Itaparica Reservoir are of immense importance for the Brazilian Northeast. Uncontrolled water resources consumption (e.g. irrigation, water supply), climate and land use change effects deteriorated the water quantity and quality in the reservoir, leading to socio-economic and environmental problems. In this work, a depth-averaged shallow water model was set up for the Icó-Mandantes Bay, one major branch of the reservoir, using the open TELEMAC-MASCARET system. The aim was to assess the impacts of the newly built water diversion channel, as well as the effects of a flood and tracer transport from an intermittent tributary, both located in the bay. An alternative approach to estimate the water retention times was additionally implemented. The simulations showed that though the diversion channel did not significantly influence the hydrodynamics of the bay, it is necessary to continuously monitor water quality parameters in the withdrawal, especially during rainy periods after droughts, because of the nutrient inputs from the tributary and the overflows of the nearby drainage systems. Management measures adapting to the continuously changing natural conditions and anthropogenic impacts are thus indispensable and the model presented can be a valuable supporting tool for this purpose.BMBF, 01LL0904A, Verbundvorhaben INNOVATE: Nachhaltige Nutzung von Stauseen durch innovative Kopplung von aquatischen und terrestrischen Ökosystemfunktionen - Teilvorhaben 1: Verbundkoordination, Grüne Leber und Ökonomi

Gênero, mídia e recepção: sobre as narrativas televisivas e seus espectador

The main objective of this article is to describe some of the ways certain individuals belonging to an specific social group exibit their knowledge about the themes, composicional structure and functioning of a mass media genre: Brazilian soap operas.44265282The main objective of this article is to describe some of the ways certain individuals belonging to an specific social group exibit their knowledge about the themes, composicional structure and functioning of a mass media genre: Brazilian soap operas

Gênero, mídia e recepção: sobre as narrativas televisivas e seus espectador

The main objective of this article is to describe some of the ways certain individuals belonging to an specific social group exibit their knowledge about the themes, composicional structure and functioning of a mass media genre: Brazilian soap operas

Síndrome de Bartter: evaluación del desarrollo estatural y perfil metabólico

OBJECTIVE: Bartter's syndrome is one of the most important inherited diseases that cause chloride leak. The objective of this study was to report the follow-up of ten patients with the syndrome. METHODS: This observational study was based on the review of medical charts reporting the metabolic features, creatinine clearance, nutritional and anthropometric assessment of ten patients with Bartter's syndrome followed at the Nephrology Service of the Universidade Federal de São Paulo (UNIFESP), in their first and last medical appointments, after a mean follow-up period of 43 months (3-76 months). During the follow-up, the management included the administration of potassium (100%) and magnesium (60%) supplements, non-steroidal anti-inflammatory agents (90%), angiotensin-converting enzyme inhibitors (40%) and spironolactone (50%). Statistical analysis was performed comparing the results of first versus last clinical appointment by non-parametric Wilcoxon test. RESULTS: Improvement of serum electrolytes and statural growth after the treatment was observed but only serum potassium [3.05mEq/L versus 3.25 mEq/L (p=0.01)] and weigh-for-age Z-score [initial median -2.47 versus -1.35 (p=0.02)] improved significantly. Out of the ten patients studied, two presented decrease of creatinine clearance with chronic kidney disease at stage 2 at the end of the follow-up. These patients had already started the follow-up with decreased creatinine clearance. CONCLUSIONS: There is a need of early treatment of patients with Bartter's syndrome in order to improve their electrolytes and nutritional condition without compromising the creatinine clearance.OBJETIVO: El síndrome de Bartter (SB) es una enfermedad rara, pero una de las más frecuentes condiciones congénitas perdedoras de cloro. Este trabajo tiene por objetivo relatar la evolución de diez pacientes con SB. MÉTODOS: Estudio observacional, descriptivo, obtenido mediante análisis de prontuarios médicos. Relata el perfil metabólico, la depuración de creatinina, el estado nutricio-nal y ponderoestatural de los diez pacientes atendidos en el ambulatorio de Tubulopatías de Universidade Federal de São Paulo (UNIFESP) con características clínico-laboratoriales de SB, seguidos por un periodo mediano de 43 meses (3-76 meses). Durante el seguimiento se practicó protocolo de tratamiento que consistió en la administración de suplemento de potasio (100%), magnesio (60%), anti-inflamatorios no hormonales (90%), inhibidores de enzima convertidora de angiotensina (40%) y espironolactona (50%). Se consideraron criterios de exclusión la presencia de alteraciones séricas y urinarias no compatibles con SB. El análisis estadístico constó de la comparación de datos de la primera y la última consulta, utilizándose la prueba de Wilcoxon. RESULTADOS: Se observó mejora numérica de los valores absolutos de los ítems evaluados y del desarrollo ponderoestatural con la terapéutica utilizada, pero solamente la calemia [mediana inicial 3,05mEq/L y final 3,25mEq/L (p=0,01)] y el escore Z de peso/edad [mediana inicial -2,47 y final 1,35 (p=0,02)] presentaron mejora significante. De los 10 pacien-tes estudiados, dos presentaban reducción de la depuración de creatinina con enfermedad renal crónica etapa 2 y en el final del seguimiento (ambos habían iniciado el seguimiento con depuración renal comprometida). CONCLUSIONES: Los datos enfatizan la necesidad de la ins-titución terapéutica precoz para mejorar los niveles séricos de los electrólitos y el estado nutricional, sin comprometer la depuración de creatinina.OBJETIVO: A síndrome de Bartter é uma doença rara, porém uma das mais frequentes condições congênitas perdedoras de cloro. Este trabalho teve como objetivo relatar a evolução de dez pacientes com a síndrome. MÉTODOS: Estudo observacional, descritivo, realizado pela análise de prontuários médicos relatando o perfil metabólico, a depuração de creatinina, o estado nutricional e pôndero-estatural de dez pacientes atendidos no Serviço de Nefrologia da Universidade Federal de São Paulo (UNIFESP) com características clínico-laboratoriais da síndrome de Bartter, seguidos por um período médio de 43 meses (3-76 meses). Durante o acompanhamento, o tratamento consistiu na administração de suplemento de potássio (100%), magnésio (60%), anti-inflamatórios não hormonais (90%), inibidores de enzima conversora de angiotensina (40%) e espironolactona (50%). A análise estatística constou da comparação dos dados da primeira e da última consulta, utilizando-se o teste de Wilcoxon. RESULTADOSs: Observou-se melhora dos valores absolutos dos itens avaliados e do desenvolvimento pôndero-estatural com a terapêutica empregada, porém apenas a calemia [mediana inicial 3,05mEqL e final 3,25mEqL (p=0,01)] e o escore Z de peso idade [mediana inicial -2,47 e final -1,35 (p=0,02)] apresentaram melhora significante. Dos dez pacientes estudados, dois apresentavam diminuição da depuração de creatinina com doença renal crônica estágio 2 no final do acompanhamento (ambos tinham iniciado o acompanhamento com depuração renal comprometida). CONCLUSÕES: Há necessidade da instituição terapêutica precoce para melhorar os níveis séricos dos eletrólitos e o estado nutricional dos pacientes acometidos, sem comprometer a depuração de creatinina.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Cystatin C and renal function in pediatric kidney transplant recipients

In clinical practice, the glomerular filtration rate (GFR) is often determined with serum creatinine. However, studies have shown cystatin C to be a better parameter for the diagnosis of impaired renal function. We compared GFR estimated by plasma cystatin C with GFR estimated by serum creatinine in a sample of 50 pediatric renal transplant recipients and 24 healthy children. The correlation between GFR estimated by serum creatinine and by cystatin C was significant (r = 0.75; P < 0.001, Person’s correlation); however, in pediatric kidney transplant recipients, the GFR was 6.7 mL/min lower when determined using cystatin C rather than serum creatinine. Moreover, using GFR estimated by cystatin C we found that 42% of the pediatric kidney transplant recipients had an estimated GFR <60 mL·min-1·1.73 (m²)-1, whereas when GFR was estimated by the serum creatinine formula only 16% of the children had values below this cutoff point indicative of chronic kidney disease (P < 0.001). We conclude that, in pediatric kidney transplant recipients, estimation of GFR yields lower values when cystatin C is used rather than serum creatinine.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo (UNIFESP) Departamento de Medicina Disciplina de NefrologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de PediatriaUNIFESP, Depto. de Medicina Disciplina de NefrologiaUNIFESP, Depto. de PediatriaFAPESP: 04/10342-7SciEL

Propagation of Cestrum corymbosum by seeds and cuttings

Cestrum corymbosum é um arbusto ornamental nativo do Brasil. A pesquisa visou estudar sua propagação sexuada e vegetativa, avaliando a germinação e o crescimento e testando o efeito do tamanho das estacas e do ácido indolbutírico (AIB) no seu enraizamento e desenvolvimento. Para avaliar a germinação, foram utilizadas seis repetições de 100 sementes. Em seguida, 200 plântulas foram transferidas para embalagens individuais mantidas em canteiro. O experimento de propagação vegetativa, com delineamento inteiramente casualizado em arranjo fatorial 3 x 2, constituiu-se na combinação de três concentrações de AIB (0, 1000 e 2000 mg.L-1) e dois tamanhos de estacas (8 e 15 cm). As estacas foram plantadas em substrato comercial Plantmax HA®. No experimento de propagação sexuada, verificou-se elevada germinação (92%), assim como alta taxa de sobrevivência após repicagem para recipientes individuais (99,5%). Para o experimento de propagação vegetativa, foi detectada influência significativa do tamanho das estacas em relação à sobrevivência, enraizamento (P < 0,01) e número de folhas (P < 0,05). Estacas de 8 cm apresentaram melhor sobrevivência (93,3%) e enraizamento (91,3%). A aplicação de concentrações de AIB não resultou em diferenças significativas (P < 0,01), demonstrando não ser necessária para o enraizamento dessa espécie.Palavras-chave: Germinação; enraizamento; ácido indolbutírico; espécie nativa; Solanaceae.AbstractPropagation of Cestrum corymbosum by seeds and cuttings. Cestrum corymbosum is an ornamental bush native from Brazil. This research aimed to study the sexual and vegetative propagation of this species, evaluating germination and growth of the seedlings, and testing the influence of indolebutyric acid (IBA) and cuttings size on its rooting and development. In order to evaluate germination, six repetitions of 100 seeds were considered. After that, 200 seedlings have been transplanted to individual packages kept in a bed. The vegetative propagation experiment has been arranged in a 3 x 2 factorial completely randomized design that comprised the combination of three IBA concentrations (0, 1000 and 2000 mg.L-1) for two cuttings sizes (8 and 15 cm). The cuttings were planted in commercial substrate Plantmax HA®. A high germination (92%) has been verified. The survival after transplantation was very high (99.5%). It was detected statistically significant influence of the cuttings size on plants survival, rooting (P<0.01) and leaves number (P<0.05). The cuttings of 8 cm  presented better survival (93.3%) and rooting (91.3%) rates. The treatment with IBA in distinct concentrations did not produce results with significant differences (P<0.01).Keywords: Germination; rooting; indolebutyric acid; native species; Solanaceae. AbstractCestrum corymbosum is an ornamental bush native from Brazil. This research aimed to study the sexual and vegetative propagation of this species, evaluating germination and growth of the seedlings, and testing the influence of indolebutyric acid (IBA) and cuttings size on its rooting and development. In order to evaluate germination, six repetitions of 100 seeds were considered. After that, 200 seedlings have been transplanted to individual packages kept in a bed. The vegetative propagation experiment has been arranged in a 3 x 2 factorial completely randomized design that comprised the combination of three IBA concentrations (0, 1000 and 2000 mg.L-1) for two cuttings sizes (8 and 15 cm). The cuttings were planted in commercial substrate Plantmax HA®. A high germination (92%) has been verified. The survival after transplantation was very high (99.5%). It was detected statistically significant influence of the cuttings size on plants survival, rooting (P<0.01) and leaves number (P<0.05). The cuttings of 8 cm  presented better survival (93.3%) and rooting (91.3%) rates. The treatment with IBA in distinct concentrations did not produce results with significant differences (P<0.01).Keywords: Germination; rooting; indolebutyric acid; native species; Solanaceae