Maria Arlene Fausto

Factors associated with oxidative stress in women with breast cancer

OBJECTIVE To assess the association between physiological, physical, lifestyle and nutritional variables and oxidative stress biomarkers in women with breast cancer. METHODS This cross-sectional study was conducted on 55 women newly diagnosed with breast cancer. The extent of oxidative stress was analyzed by the measurement of plasma lipid hydroperoxides (LH), thiobarbituric acid reactive substances (TBARS), protein carbonyl, whole blood reduced glutathione (GSH) and serum antioxidant capacity (AC). Diet data were obtained from food frequency questionnaire. Linear regression was used to determine the association between the variables studied and oxidative stress biomarkers. The protein carbonyl data was not included in the linear regression analyses since the data did not show a normal distribution, even after logarithmic and other transformations. RESULTS After adjusting for energy intake, the intake of chicken and high-fat dairy products was associated with increased levels of LH, while vitamin E intake was associated with decreased LH levels (R² = 23.8%). Intake of oils was associated with increased levels of TBARS (R² = 6.82%). Positive axillary lymph node status was associated with decreased levels of GSH (R² = 9.31%). Increasing age was directly associated with levels of AC, while animal fat, dairy product, and sweet food intakes were associated with low levels of AC (R² = 41.42%). CONCLUSION Intake of chicken, vitamin E, dairy products (particularly high-fat dairy products), oils, animal fat, and sweet foods, along with axillary lymph node status and age, may be important determinants of oxidative stress in women with breast cancer.

Risk Factors for Seroconversion by Leishmania infantum in a Cohort of Dogs from an Endemic Area of Brazil

Visceral leishmaniasis (VL) has recently emerged in various urban and peri-urban areas of Brazil and other countries. Understanding the urbanization of VL requires identification of risk factors associated with human and canine infection. To determine the predictors of risk for canine VL, a survey was conducted of 1,443 dogs, from which a cohort was selected (n = 455) and evaluated for approximately 26 months. Serology was conducted with two enzyme-linked immunosorbent assays (ELISA): one conducted in the Laboratory of Zoonosis of the Belo Horizonte Health Department (LZOON) and the other in the Laboratory of Immunopathology of the Federal University of Ouro Preto (LIMP). A molecular diagnostic method (PCR–restriction fragment length polymorphism) and a structured questionnaire were also used. To identify the factors associated with seroconversion, two time-dependent Cox regression models were performed with different sensitivities (model 1, seroconversion by ELISA/LZOON; model 2, seroconversion by ELISA/LIMP). The overall incidences of seroconversion were 6.5/1000 dogs-months and 11.2/1000 dogs-months for ELISA/LZOON and ELISA/LIMP, respectively. Increased risk of seroconversion was associated with short fur (model 1: hazard ratio [HR] 1.9), the presence of dry leaves (model 1: HR 2.8) or manure (model 1: HR 3.5) in the backyard, dogs sleeping predominantly in the backyard (model 2: HR 2.1), the presence of symptoms (model 2: HR 2.0), and positive molecular results during follow-up (model 2: HR 1.5). Decreased risk was associated with insecticide spraying in the house (model 2: HR 0.5). These results indicate that more-vulnerable domiciles, certain dog behaviors, lack of vector control measures, and positive molecular results were associated with the occurrence of canine VL. Furthermore, it is important to emphasize that PCR-positive dogs should be monitored, owing to the possibility of seroconversion. Identifying risk factors for seroconversion in dogs is crucial for developing adequate strategies for VL prevention and control.

Dietary patterns in Brazilian patients with nonalcoholic fatty liver disease: a cross-sectional study.

OBJECTIVE: Recent evidence suggests that non-alcoholic fatty liver disease is associated with diet. Our aim was to investigate the dietary patterns of a Brazilian population with this condition and compare them with the recommended diet. METHODS: A cross-sectional study was conducted on 96 non-alcoholic fatty liver disease patients before any dietetic counseling. All patients underwent abdominal ultrasound, biochemical tests, dietary evaluations, and anthropometric evaluations. Their food intake was assessed by a semi-quantitative food-frequency questionnaire and 24-hour food recall. RESULTS: The median patient age was 53 years, and 77% of the individuals were women. Most (67.7%) participants were obese, and a large waist circumference was observed in 80.2% subjects. Almost 70% of the participants had metabolic syndrome, and 62.3% presented evidence of either insulin resistance or overt diabetes. Most patients (51.5, 58.5, and 61.7%, respectively) exceeded the recommendations for energy intake, as well as total and saturated fat. All patients consumed less than the amount of recommended monounsaturated fatty acids, and 52.1 and 76.6% of them consumed less polyunsaturated fatty acids and fiber, respectively, than recommended. In most patients, the calcium, sodium, potassium, pyridoxine, and vitamin C intake did not meet the recommendations, and in 10.5-15.5% of individuals, the tolerable upper limit intake for sodium was exceeded. The patients presented a significantly high intake of meats, fats, sugars, legumes (beans), and vegetables and a low consumption of cereals, fruits, and dairy products compared with the recommendations. CONCLUSIONS: Although patients with non-alcoholic fatty liver disease exhibited high energy and lipid consumption, most of them had inadequate intake of some micronutrients. The possible role of nutrient-deficient intake in the development of non-alcoholic fatty liver disease warrants investigation.

O modelo de regressão linear misto para dados longitudinais: uma aplicação na análise de dados antropométricos desbalanceados

Os dados provenientes de estudos longitudinais se caracterizam pela sequencia de duas ou mais observacoes em cada individuo. Nos estudos de coorte, esses dados geralmente apresentam estrutura desbalanceada. Uma casuistica que envolve a avaliacao longitudinal de crescimento de lactentes nascidos de maes infectadas pelo HIV foi acompanhada no ambulatorio de AIDS pediatrica do Hospital das Clinicas da Universidade Federal de Minas Gerais, Minas Gerais, Brasil. O objetivo deste estudo e demonstrar a aplicacao do modelo linear misto na analise de dados longitudinais desbalanceados provenientes dessa coorte. Os resultados mostram que, aos seis meses de idade, os meninos eram, em media, 1,8cm maiores que as meninas e as criancas sororrevertoras eram, em media, 2,9cm maiores que as infectadas. Aos 12 meses, a diferenca na altura entre meninos e meninas passou a ser, em media, de 2,4cm enquanto a diferenca entre infectados e sororrevertores passou a ser, em media, de 3,5cm. Alem de descrever o comportamento longitudinal do crescimento, o modelo tambem permite estimar a velocidade de crescimento das criancas por sexo e grupo.

Longitudinal growth of infants born to HIV-1-infected mothers in Belo Horizonte, Brazil

OBJECTIVE To prospectively evaluate growth parameters assessed by weight and length in infected and uninfected infants born to HIV-1-infected mothers and followed from birth to 18 months. METHODS A cohort consisting of ninety-seven uninfected and forty-two infected infants born to HIV-infected mothers enrolled from 1995 to 2004, and admitted during their first 3 months of life at a referral Pediatric AIDS Clinic in Belo Horizonte, Brazil. Infants were followed until 18 months of age. Data were analysed using mixed-effects linear regression models for weight and length fitted by restricted maximum likelihood. RESULTS Infected infants contributed to 466 weight and 411 recumbent length measurements. Uninfected infants provided 924 weight and 907 length measurements. Mean birth weight and length were similar in both groups, 3.1 (sd 0.4) and 3.0 (sd 0.5) kg, and 48.7 (sd 1.4) and 48.8 (sd 2.9) cm for uninfected and infected infants, respectively. However, HIV-1 infection had an early impact in growth impairment: at 6 months of age, HIV-infected children were 1 kg lighter and 2 cm shorter than the uninfected. CONCLUSIONS Growth faltering in weight, but not length, in HIV-infected children in Brazil is more marked than that reported in a European cohort, probably reflecting background nutritional deficiencies and concomitant infections. In these settings, early and aggressive nutritional management in HIV-1-infected infants should be a priority intervention associated with the antiretroviral therapy.

Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6–71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2–40.8) and 9.8% (95%CI 7.2–12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7–22.6) and 21.8% (95%CI 17.8–26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2–2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4–3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1–2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

Risk Factors Associated with HIV Infection among Male Homosexuals and Bisexuals Followed in an Open Cohort Study: Project Horizonte, Brazil (1994-2010)

Background There has recently been an increase in HIV infection rates among men who have sex with men (MSM). This study aimed at investigating risk factors associated with incident HIV infection in a MSM cohort–Project Horizonte, Belo Horizonte, Minas Gerais, Brazil. Methodology This is a nested case-control study in an ongoing open cohort of homosexual and bisexual men, carried out in 1994–2010, during which 1,085 volunteers were enrolled. Each HIV seroconverted volunteer (case) was compared with three randomly selected HIV negative controls, matched by admission date and age (±3 years). During follow-up, 93 volunteers seroconverted and were compared with 279 controls. Principal Findings The risk factors associated with HIV seroconversion were: contact with partner’s blood during sexual relations (OR 3.7; 95% CI 1.2–11.6), attendance at gay saunas in search for sexual partners (OR 2.6; 95% CI 1.3–5.4), occasional intake of alcohol when flirting and engaging in sexual activity (OR 2.5; 95% CI 1.3–5.1), inconsistent use of condoms in receptive anal sex (OR 2.4; 95% CI 1.1–5.4), little interest to look up information about AIDS (OR 2.6; 95% CI 1.0–6.7) particularly in newspapers (OR 3.4; 95% CI 1.4–8.1). Conclusions This study shows that MSM are still engaging in risk behavior, such as unprotected anal intercourse, despite taking part in a cohort study on various preventive measures. New preventive strategies in touch with the epidemic’s development and the specificities of this particular population are needed.

Pattern of alcoholic beverage consumption and academic performance among college students

CONTEXTO: Bebidas alcoolicas estao amplamente disponiveis no ambiente universitario, principalmente nas festas. Ha poucos estudos abordando a relacao entre o consumo de bebidas alcoolicas e o desempenho academico entre estudantes universitarios. OBJETIVO: Este trabalho avaliou o comportamento de estudantes universitarios quanto ao padrao de consumo de bebidas alcoolicas e sua consequencia academica. METODOS: Os voluntarios (343 estudantes) responderam a um questionario sobre o padrao de consumo de alcool e possivel comportamento relacionado a esse consumo, especialmente sobre o desempenho academico. Os participantes foram classificados como nao bebedores (ND), bebedores nao em binge (nBD), bebedores em binge (BD) e bebedores pesados (HD). RESULTADOS: 88,1% dos estudantes relataram ingerir bebidas alcoolicas, sendo 44% bebedores em binge. A maioria dos bebedores (75,5% - nBD, BD ou HD) ficou embriagada pelo menos uma vez por mes. O padrao predominante de consumo foi em binge (66,2% dos que relataram beber). Estudantes HD apresentaram risco 9,2 vezes maior de nao estarem no periodo ideal do curso. CONCLUSAO: Os universitarios avaliados apresentaram maiores taxas de abuso de alcool. O beber em binge pode ter interferido no seu desempenho academico. Consequencias orgânicas, sociais e comportamentais foram tambem relatadas.

Fatores que influenciam o consumo energético de mulheres no tratamento do câncer de mama

PURPOSE: To investigate changes in the dietary consumption as well as the influence of the general characteristics, of the sociodemographic, clinical and nutritional factors, and of the antineoplastic therapy on the changes in the energy intake of women from southern Brazil, before and after adjuvant therapy for breast cancer. METHODS: A non-randomized clinical study was conducted on 53 patients at a hospital of the public health network. Dietary information was collected with a food frequency questionnaire. A mixed-effects linear regression model was used to evaluate the factors that influenced longitudinal alterations of energy intake. RESULTS: A significant increase was observed in daily energy intake of fats, calcium, iron, copper, polyunsaturated fatty acids, omega 6 and omega 3, and a significant decrease in vitamin B2 intake. The final regression model for the change in energy intake showed an average increase of 19.2 kcal/month. Fruit and legume consumption showed the highest association with energy intake, with each 100 g consumed resulting in an average increase of 68.4 and 370.5 kcal, respectively. Women in the 51 to 60 year age range consumed 403.5 kcal less than those in the 31 to 50 year age range. CONCLUSION: There was an increase in energy intake during treatment and the increase in the ingestion of fruits and legumes was associated with significant increases in energy intake.

Níveis de contaminantes inorgânicos em cachaças da região do Quadrilátero Ferrífero armazenadas em copos in natura de esteatito (pedra-sabão)

The levels of inorganic contaminants (As, Cd, Cu, Ni and Pb) were measured in 18 Brazilian spirit beverages, before and after 4 contact cycles of 24h each with in natura soapstone (steatite) cups. Results were compared to Brazilian regulation levels. Spirits contained As, Cd, Ni and Pb within permitted levels. For Cu, 5.6% of the brands were above the limit. The contact with soapstone cups decreased Cu levels in the spirits, while the other elements remained unchanged. The use of in natura soapstone cups was considered safe because this kind of vessel did not transfer inorganic contaminants to the spirits.