Interethnic marriage of Japanese-Brazilians associated with less healthy food habits and worse cardiometabolic profile

OBJETIVO: Casamento interétnico entre brasileiros nikkeis e não nikkeis pode favorecer a ocidentalização da dieta. Compararam-se consumo alimentar, dados clínico-laboratoriais e frequências de doenças metabólicas em população nipo-brasileira, com casamento intraétnico ou interétnico. MÉTODOS: Empregaram-se teste t, Mann-Whitney, qui-quadrado e coeficiente de Pearson. RESULTADOS: Em 1009 nipo-brasileiros havia 18,9% de casamentos interétnicos, mais frequentes entre homens nikkeis. Estes apresentaram maiores médias de IMC, cintura, pressão arterial, glicemia e triglicérides que mulheres. As frequências de obesidade, hipertrigliceridemia e síndrome metabólica foram 47,7%, 68,1% e 45,2%, sendo maiores nos casamentos interétnicos comparados aos intraétnicos. Comparando-se indivíduos com casamento interétnico, hipertrigliceridemia foi mais frequente nos homens e HDL-c baixo nas mulheres. O consumo de calorias, gorduras e dos grupos de álcool, doces e óleos foram maiores nos casamentos interétnicos. Indivíduos casados intraetnicamente consumiam mais carboidratos, proteínas, fibras, vitaminas, minerais, hortaliças, frutas/sucos, cereais e missoshiru. Comparando-se indivíduos com casamento interétnico, homens nikkeis apresentavam padrão mais ocidental que mulheres nikkeis. CONCLUSÃO: Casamento interétnico associa-se a hábitos alimentares menos saudáveis e pior perfil de risco cardiometabólico.OBJECTIVE: Interethnic marriage between nikkey Brazilians and non-nikkey Brazilians may favor the westernization of diet. Dietary consumption, clinical data and frequencies of metabolic diseases were compared in a Japanese-Brazilian population, with intraethnic or interethnic marriage. METHODS: T test, Mann-Whitney, chi-square and Person coefficient were used. RESULTS: Among 1009 Japanese-Brazilians there were 18.9% of interethnic marriage, being more frequent among nikkey men. These showed higher means of BMI, waist, blood pressure, glycemia and triglyceridemia than women. Overall frequencies of obesity, hypertrigliceridemia and metabolic syndrome were 47.7%, 68.1% and 45.2%, being higher in interethnic than intraethnic marriage. Comparing individuals with interethnic marriages, hypertriglyceridemia was more common among men while low-HDL among women. Energy, fat, groups of alcohol, sweets and oils were higher in interethnic marriage. Individuals with intraethnic marriage consumed more carbohydrate, proteins, fibers, vitamins, minerals, vegetables, fruits/juice, cereals and missoshiru. Comparing individuals with interethnic marriages, nikkey men showed a more westernized dietary pattern than nikkey women. CONCLUSION: Interethnic marriage was associated with less healthy food habits and worse cardiometabolic profile.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Factors associated with fruit and vegetable intake in Japanese-Brazilians

The determination of factors associated with fruit and vegetable intake is an important tool for the development of effective intervention programs aimed at increasing the consumption of these foods. The objective of the present cross-sectional study was to identify the factors associated with the adequate consumption of fruit and vegetables (> 400g/day) among 581 adult Japanese-Brazilians, 1st and 2nd generations of immigrants, living in Bauru, SP, Brazil. Food consumption was estimated using three 24-hour recalls. On adjusted logistic regression models, higher meal frequencies were associated with a better chance of adequate daily intake of fruit and vegetables [OR (95% CI)]: [1.31 (1.05, 1.63)]. Nevertheless, individuals at the highest tertile of saturated fat intake were less likely to have adequate daily intake of these foods [0.35 (0.21, 0.60)]. A trend toward adequate intake of fruit and vegetables was found among older participants. These results suggest that more intensive intervention programs are needed among young individuals with higher saturated fat intake. Moreover, higher meal frequency might promote better adherence to the goals of daily fruit and vegetable intake.A identificação de fatores associados ao consumo de frutas, verduras e legumes constitui-se em ferramenta chave na elaboração de programas de intervenção mais eficazes, visando o aumento no consumo desses alimentos. O objetivo do presente estudo foi identificar, em análise transversal, fatores associados ao consumo adequado de frutas, verduras e legumes (> 400g/dia) em 581 nipo-brasileiros adultos, de 1ª e 2ª gerações, residentes em Bauru, SP, Brasil. O consumo alimentar foi avaliado por meio de três inquéritos recordatórios de 24 horas. Em modelos de regressão logística ajustados, verificou-se que o relato de um maior número de refeições diárias estava associado à maior chance [OR (IC 95%)]: [1,31 (1,05; 1,63)] de consumo adequado de frutas, verduras e legumes. Por outro lado, indivíduos no terceiro tercil de consumo de ácidos graxos saturados apresentaram menor chance de consumo adequado destes alimentos [0,35 (0,21; 0,60)]. Verificou-se maior tendência de consumo adequado de frutas, verduras e legumes entre indivíduos de maior idade. Os resultados sugerem que programas de intervenção mais intensivos são necessários entre indivíduos jovens e com consumo elevados de ácidos graxos saturados. Além disso, o estímulo ao maior fracionamento da dieta poderá favorecer a adesão às metas de consumo de frutas, verduras e legumes.USP Faculdade de MedicinaUSP Faculdade de Medicina de Ribeirão Preto Departamento de Medicina SocialUniversidade Federal de São Paulo (UNIFESP) Departamento de Medicina PreventivaUniversidade Sagrado CoraçãoFaculdade de Saúde Pública Departamento de NutriçãoUNIFESP, Depto. de Medicina PreventivaSciEL

Análise do mercado de serviços de regulação de frequência secundária e terciária no sistema eléctrico português

Dissertação para obtenção do grau de Mestre em Engenharia Electrotécnica Ramo EnergiaOs operadores das redes de transporte (ORT) enfrentam desafios cada vez maiores e mais imprevisíveis. A forte penetração de energias renováveis e a liberalização do mercado de energia eléctrica dão origem a uma maior volatilidade na produção de energia eléctrica e a desencontros entre produção e consumo, passíveis de acontecer no decorrer da operação do sistema eléctrico. Os serviços de sistema são um complemento aos mercados de energia eléctrica e caracterizam-se como sendo uma segurança necessária ao bom funcionamento do sistema pois é através destes que é feito o equilíbrio entre geração e consumo em tempo real e assim feita a regulação de frequência da rede eléctrica. Com o presente trabalho pretende-se fazer uma análise aprofundada do que são os serviços de sistema para regulação de frequência, nomeadamente sobre a regulação secundária e a regulação terciária bem como abordar a regulamentação que as fundamenta. Será também aprofundado o funcionamento do mercado de serviços de sistema para regulação de frequência em Portugal e oencadeamento cronológico deste com o mercado diário e com as diversas sessões intradiárias do Mercado Ibérico de Electricidade (MIBEL). Serão ainda referidos diversos serviços de sistema noutros países europeus em comparação com Portugal. Para apoio a esta análise desenvolveu-se uma ferramenta em Matlab®que permita visualizar sob a forma de gráficos as ofertas dos agentes de mercado participantes através das suas unidades físicas (grupos geradores), o custo marginal dessas mesmas centrais e ainda visualizar o preço de fecho de mercado na respectiva hora. Os resultados obtidos apontam para uma dependência do perfil de licitação relativamente à tecnologia da central. Foram ainda analisadas as correlações entre centrais e a dependência do preço das ofertas e da banda contratada relativamente à existência de meses mais ou menos chuvosos, ou seja com maior ou menos índice de produtibilidade hidroeléctrica (IPH). Denota-se ainda uma elevada participação das centrais hídricas neste mercado de banda secundária.Abstract: The transmission system operators (TSO) face increasing and more unpredictable challenges. The high penetration of renewable energy and the liberalization of the electricity market rises the volatility in electricity generation and bigger differences between production and consumption, in the course of the electrical system operation. Ancillary services are a complement to electricity markets and are characterized as a necessary service that allows a proper and reliable functioning of the system as it is the mechanism that allows the TSO to balance generation and consumption in real time operation and control the frequency of the system. The present work aims to make a thorough analysis of what are the ancillary services for frequency regulation, particularly on secondary regulation and tertiary regulation and to address the laws that allow to develop the frequency regulation in Portugal. It will also be studied the operation of the ancillary services market for frequency regulation in Portugal and the chronological connection with the daily market and the various intraday market sessions of Iberian Electricity Market (MIBEL). Itwill be studied also various ancillary services in other European countries compared to Portugal. To support this data analysis a Matlab® tool was developed allowing the user to view in the graphical form the offers of market players participating with their physical units (power plants), the marginal cost of these same power plants and the market clearing price, all for the same selected period of time. The results show a dependence of the bidding profile relative to the power plant technology. It will be also studied the correlations between different power plants and the price variation of the market due to the variation of the hydroelectric capability factor (HCF) variation. It is also relevant the high share of hydro power plants participating in the ancillary services market for secondary frequency control

Preferential binding to elk-1 by sle-associated il10 risk allele upregulates il10 expression

Immunoregulatory cytokine interleukin-10 (IL-10) is elevated in sera from patients with systemic lupus erythematosus (SLE) correlating with disease activity. The established association of IL10 with SLE and other autoimmune diseases led us to fine map causal variant(s) and to explore underlying mechanisms. We assessed 19 tag SNPs, covering the IL10 gene cluster including IL19, IL20 and IL24, for association with SLE in 15,533 case and control subjects from four ancestries. The previously reported IL10 variant, rs3024505 located at 1 kb downstream of IL10, exhibited the strongest association signal and was confirmed for association with SLE in European American (EA) (P = 2.7×10−8, OR = 1.30), but not in non-EA ancestries. SNP imputation conducted in EA dataset identified three additional SLE-associated SNPs tagged by rs3024505 (rs3122605, rs3024493 and rs3024495 located at 9.2 kb upstream, intron 3 and 4 of IL10, respectively), and SLE-risk alleles of these SNPs were dose-dependently associated with elevated levels of IL10 mRNA in PBMCs and circulating IL-10 protein in SLE patients and controls. Using nuclear extracts of peripheral blood cells from SLE patients for electrophoretic mobility shift assays, we identified specific binding of transcription factor Elk-1 to oligodeoxynucleotides containing the risk (G) allele of rs3122605, suggesting rs3122605 as the most likely causal variant regulating IL10 expression. Elk-1 is known to be activated by phosphorylation and nuclear localization to induce transcription. Of interest, phosphorylated Elk-1 (p-Elk-1) detected only in nuclear extracts of SLE PBMCs appeared to increase with disease activity. Co-expression levels of p-Elk-1 and IL-10 were elevated in SLE T, B cells and monocytes, associated with increased disease activity in SLE B cells, and were best downregulated by ERK inhibitor. Taken together, our data suggest that preferential binding of activated Elk-1 to the IL10 rs3122605-G allele upregulates IL10 expression and confers increased risk for SLE in European Americans

Association of genetic variants in complement factor H and factor H-related genes with systemic lupus erythematosus susceptibility

Systemic lupus erythematosus (SLE), a complex polygenic autoimmune disease, is associated with increased complement activation. Variants of genes encoding complement regulator factor H (CFH) and five CFH-related proteins (CFHR1-CFHR5) within the chromosome 1q32 locus linked to SLE, have been associated with multiple human diseases and may contribute to dysregulated complement activation predisposing to SLE. We assessed 60 SNPs covering the CFH-CFHRs region for association with SLE in 15,864 case-control subjects derived from four ethnic groups. Significant allelic associations with SLE were detected in European Americans (EA) and African Americans (AA), which could be attributed to an intronic CFH SNP (rs6677604, in intron 11, Pmeta = 6.6×10-8, OR = 1.18) and an intergenic SNP between CFHR1 and CFHR4 (rs16840639, Pmeta = 2.9×10-7, OR = 1.17) rather than to previously identified disease-associated CFH exonic SNPs, including I62V, Y402H, A474A, and D936E. In addition, allelic association of rs6677604 with SLE was subsequently confirmed in Asians (AS). Haplotype analysis revealed that the underlying causal variant, tagged by rs6677604 and rs16840639, was localized to a ~146 kb block extending from intron 9 of CFH to downstream of CFHR1. Within this block, the deletion of CFHR3 and CFHR1 (CFHR3-1Δ), a likely causal variant measured using multiplex ligation-dependent probe amplification, was tagged by rs6677604 in EA and AS and rs16840639 in AA, respectively. Deduced from genotypic associations of tag SNPs in EA, AA, and AS, homozygous deletion of CFHR3-1Δ (Pmeta = 3.2×10-7, OR = 1.47) conferred a higher risk of SLE than heterozygous deletion (Pmeta = 3.5×10-4, OR = 1.14). These results suggested that the CFHR3-1Δ deletion within the SLE-associated block, but not the previously described exonic SNPs of CFH, might contribute to the development of SLE in EA, AA, and AS, providing new insights into the role of complement regulators in the pathogenesis of SLE

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia: experiência do Hospital de Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas – UNICAMP

RESUMO Objetivo: estudar a prevalência do câncer de vesícula biliar em pacientes submetidos à colecistectomia no Hospital de Clínicas da Universidade Estadual de Campinas. Métodos: estudo de prevalência retrospectivo a partir da análise de laudos de espécimes histopatológicos de pacientes submetidos à colecistectomia, no período de janeiro de 2010 a maio de 2015. Resultados: foram analisados 893 laudos de pacientes submetidos à colecistectomia, dos quais 144 de urgência e 749 eletivas (16,2% e 83,8%, respectivamente). Segundo o sexo, 72,8% correspondiam ao feminino e 27,2%, ao masculino. Em 12 pacientes (1,3%) foi evidenciado o diagnóstico de adenocarcinoma de vesícula biliar e, em um (0,1%), o diagnóstico de linfoma não Hodgkin. Dos 13 pacientes com neoplasia, sete (53,8%) apresentaram colecistolitíase associada. Em dois doentes (15,3%) foi constatado pólipo de vesícula biliar. Sete (53,8%) doentes foram operados com a hipótese diagnóstica de neoplasia de vesícula biliar. Conclusão: a prevalência do adenocarcinoma de vesícula biliar no presente estudo foi semelhante à dos estudos ocidentais e o principal fator de risco foi a colecistolitíase, seguido pela presença de pólipos de vesícula biliar

Brown bowel syndrome: a rare malnutrition-related complication of bariatric surgery

Case report: we present the case of a 44-year-old male who presented with uncontrollable diarrhea, severe protein-calorie malnutrition and multiple vitamin deficiencies, along with peripheral neuropathy ten years after classic biliopancreatic diversion (BPD). He underwent nutritional support and had the surgery converted to a Roux-en-Y gastric bypass, with an uneventful outcome. The histopathology of the resected bowel revealed lipofuscinosis of the muscular layer compatible with brown bowel syndrome. Discussion: brown bowel syndrome is a rare complication of malnutrition that can be observed after BPD. It is associated with vitamin E deficiency. After recovery with nutritional support, a reoperation that elongates the common channel, and thus minimizes the degree of malabsorption, should be indicated in these cases363743747sem informaçãosem informaçã