Maria Helena Constantino Spyrides

Determinants of weight gain in pregnant women attending a public prenatal care facility in Rio de Janeiro, Brazil: a prospective study, 2005-2007.

The objective of this study was to evaluate the determinants of weight gain during pregnancy. The study adopted a prospective cohort design with four follow-up waves and included a sample of 255 pregnant women that received prenatal care at a public health care facility in Rio de Janeiro, Brazil. A mixed-effects linear longitudinal regression model was used, having as the dependent variable the weight assessed in four follow-up waves, and as independent variables: demographic, socioeconomic, reproductive, behavioral, and nutritional data. Mean weight gain was 0.413kg per gestational week, consistent with recommendations by the Institute of Medicine. Per capita family income and smoking were associated with total weight gain during gestation. According to the longitudinal multiple linear regression model, age (beta = 0.6315), menarche (beta = -2.3861), triglycerides (beta = 0.0437), blood glucose (beta = 0.1544), and adequacy of energy consumption (beta = -0.0642) were associated with gestational weight gain. Special attention should be given to these sub-groups, due to increased risk of excessive weight gain.

Efeito da duração da amamentação predominante no crescimento infantil: um estudo prospectivo com modelos não lineares de efeitos mistos

OBJECTIVE The aim of this study is to assess the effect of predominant breastfeeding duration on infant growth by means of repeated measurements model. METHODS This prospective study is comprised of four follow-up evaluations at approximately 0.5, 2, 6 and 9 months after birth, including structured interviews that simultaneously gathered information regarding infant growth and breastfeeding practices. The study took place in a healthcare center in Rio de Janeiro, Brazil, from 1999 to 2001. Four hundred seventy-nine postpartum women and their newborns were enrolled in the cohort. Body weight and length measurements taken at five different occasions (birth, 0.5, 2, 6, and 9 months) constituted the dependent variables. We expressed the growth process using nonlinear mixed models. RESULTS Infants with longer predominant breastfeeding duration, although growing faster in the first months of life, reached an inferior equilibrium body weight and length compared to infants who received nonhuman milk earlier in life. The age at which the rate of weight gain of the formula-fed infants becomes greater than that of the breastfed infants is approximately 6.75 months for boys and 7 months for girls. CONCLUSIONS This study confirms the differences observed in infant growth according to different breastfeeding practices starting from the sixth month of life. Use of nonlinear models allowed for a greater precision of parameter estimates. We believe that this approach facilitates the analysis and interpretation of growth data at the individual and population levels.

Determinants of sexual dysfunction among middle-aged women

To assess the determinants of sexual dysfunction among middle‐aged women.

The adaptive value of primate color vision for predator detection

The complex evolution of primate color vision has puzzled biologists for decades. Primates are the only eutherian mammals that evolved an enhanced capacity for discriminating colors in the green–red part of the spectrum (trichromatism). However, while Old World primates present three types of cone pigments and are routinely trichromatic, most New World primates exhibit a color vision polymorphism, characterized by the occurrence of trichromatic and dichromatic females and obligatory dichromatic males. Even though this has stimulated a prolific line of inquiry, the selective forces and relative benefits influencing color vision evolution in primates are still under debate, with current explanations focusing almost exclusively at the advantages in finding food and detecting socio‐sexual signals. Here, we evaluate a previously untested possibility, the adaptive value of primate color vision for predator detection. By combining color vision modeling data on New World and Old World primates, as well as behavioral information from human subjects, we demonstrate that primates exhibiting better color discrimination (trichromats) excel those displaying poorer color visions (dichromats) at detecting carnivoran predators against the green foliage background. The distribution of color vision found in extant anthropoid primates agrees with our results, and may be explained by the advantages of trichromats and dichromats in detecting predators and insects, respectively. Am. J. Primatol. 76:721–729, 2014.

The impact of physical activity on menopausal symptoms in middle-aged women

To evaluate the influence of physical activity on climacteric symptoms among middle‐aged women in Brazil.

Influência dos sintomas climatéricos sobre a função sexual de mulheres de meia-idade

PURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2–3.5); 2.4 (95%CI 1.5–4.1); 2.3 (95%CI 1.4–3.8), and 2.2 (95%CI 1.3–3.6) times higher, respectively, compared to those without any risk. CONCLUSION: Climacteric symptoms seem to influence the sexual function inPURPOSE To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2 - 3.5); 2.4 (95%CI 1.5 - 4.1); 2.3 (95%CI 1.4 - 3.8), and 2.2 (95%CI 1.3 - 3.6) times higher, respectively, compared to those without any risk. CONCLUSION Climacteric symptoms seem to influence the sexual function in middle-aged women.

Influence of cortisol and DHEA-S on pain and other symptoms in post menopausal women with fibromyalgia

OBJECTIVE This study aims to assess cortisol and dehydroepiandrosterone sulfate (DHEA-S) levels in post-menopausal women with FMS and correlate it with pain threshold and tolerance, depression and quality of life. METHODS We conducted a cross sectional observational study of 17 women with FMS (FMS group), and 19 healthy volunteers (CT group). Algometry, the Beck Depression Index (BDI) and Fibromyalgia Impact Questionnaire (FIQ) were used. Blood samples were collected in the morning (8:00-9:30 am) to determine cortisol and DHEA-S plasmatic levels by chemiluminescence. RESULTS Significant differences between groups were recorded for pain threshold and tolerance (p< 0.0001), BDI (p< 0.0001) and all FIQ parameters (p< 0.0001). No significant differences in cortisol levels were found between the two groups (p=0.325). In the FMS group, a tangential effect was observed for DHEA-S (p=0.094) and positive correlations were found between DHEA-S, pain threshold (p=0.017) and pain tolerance (p=0.044). No correlation was observed between cortisol and DHEA-S levels and the variables of depression and quality of life for either group. CONCLUSIONS There seems to be an influence of the decreased levels of DHEA-S and increased pain sensitivity in post-menopausal women with FMS.

Impacto da atividade física na qualidade de vida de mulheres de meia idade: estudo de base populacional

PURPOSE To evaluate the influence of physical activity on the quality of life of middle-aged women. METHODS A population-based cross-sectional study was conducted on 370 women aged 40 to 65 years-old recruited from a population-based sample. Enrollment took place in Basic Health Units in each health district of the city (North, South, East, and West) from June to September 2011. According to the Municipal Health Department of the City, 20,801 women were assisted at the Basic Health Units during a one-year period. The sample size calculation was stratified by district and based on a 95% confidence level with a power of 80%, as well as an error estimate of 5% and it was considered proportional to the number of patients classified as having adequate quality of life (indicator >26) in the general population. Data were collected while women waited for their routine appointment at the Health Unit. WHOQOL-Bref was used to evaluate the quality of life, and menopause rating scale (MRS) was used to determine climacteric symptoms. The level of physical activity was assessed by means of the International Physical Activity Questionnaire (IPAQ). To obtain the classification of PA levels, we used three categories: sedentary, moderately active, and very active. Statistical analysis was performed using the Minitab software, version 16. RESULTS The mean age of the subjects was 49.8 years-old (±8.1) and they were predominantly Caucasian (72.7%), married (61.6%), non-smokers (93.5%), and had High School education (47.8%). Using the WHOQOL, mean scores were found to be significantly different between the groups (low, moderate, and vigorous physical activity), classified according to the domains of quality of life (p<0.01). Concerning physical activity and climacteric symptoms, significant differences were found for all domains: psychological (p<0.01), vegetative-somatic (p<0.01), and urogenital (p<0.01). CONCLUSIONS Physical activity improves quality of life in middle-aged women.Abstract PURPOSE: To evaluate the influence of physical activity on the quality of life of middle-aged women. METHODS: A population-based cross-sectional study was conducted on 370 women aged 40 to 65 years-old recruited from a population-based sample. Enrollment took place in Basic Health Units in each health district of the city (North, South, East, and West) from June to September 2011. According to the Municipal Health Department of the City, 20,801 women were assisted at the Basic Health Units during a one-year period. The sample size calculation was stratified by district and based on a 95% confidence level with a power of 80%, as well as an error estimate of 5% and it was considered proportional to the number of patients classified as having adequate quality of life (indicator ≥26) in the general population. Data were collected while women waited for their routine appointment at the Health Unit. WHOQOL-Bref was used to evaluate the quality of life, and menopause rating scale (MRS) was used to determine climacteric symptoms. The level of physical activity was assessed by means of the International Physical Activity Questionnaire (IPAQ). To obtain the classification of PA levels, we used three categories: sedentary, moderately active, and very active. Statistical analysis was performed using the Minitab software, version 16. RESULTS: The mean age of the subjects was 49.8 years-old (±8.1) and they were predominantly Caucasian (72.7%), married (61.6%), non-smokers (93.5%),

Physical activity, fatigue and quality of life in breast cancer patients

OBJECTIVE to evaluate the relationship between levels of physical activity, fatigue and quality of life (QOL) in women diagnosed with breast cancer. METHODS 215 women between the ages of 40 and 65 years were recruited at a cancer clinic. Physical activity levels were assessed by using the International Physical Activity Questionnaire (IPAQ), fatigue levels by using the revised Piper scale, and QOL by means of EORTC QLQ-C30 and WHOQOL-Bref. Statistical analysis was performed using Minitab statistical software, version 16. RESULTS the mean age of subjects was 52.66 years (SD=8.6); patients were mostly white (58.14%) and overweight (55.81%). Most women were fatigued (72.09%) while physically active women showed lower symptoms of fatigue (p<0.001). Mean scores for QOL were significantly lower among fatigued women (p<0.001). More active women scored higher on all scales of QOL (EORTC), especially for functional capacity (p<0.001), compared with the sedentary patients. A significant association was found between level of physical activity and overall QOL (WHOQOL-Bref) for all domains (p<0.001). Climacteric symptoms ranged from mild to strong and did not show any statistically significant results; however, the most active women had the fewest symptoms. CONCLUSION physical activity appears to positively influence fatigue and QOL in women diagnosed with breast cancer.

Physical activity and sexual function in middle-aged women

OBJECTIVE To investigate the relationship between physical activity level and sexual function in middle-aged women. METHODS A cross-sectional study with a sample of 370 middle-aged women (40-65 years old), treated at public health care facilities in a Brazilian city. A questionnaire was used containing enquiries on sociodemographic, clinical and behavioral characteristics: the International Physical Activity Questionnaire (IPAQ), short form, and the Female Sexual Function Index (FSFI). RESULTS The average age of the women studied was 49.8 years (± 8.1), 67% of whom exhibited sexual dysfunction (FSFI ≤ 26.55). Sedentary women had a higher prevalence (78.9%) of sexual dysfunction when compared to active (57.6%) and moderately active (66.7%) females (p = 0.002). Physically active women obtained higher score in all FSFI domains (desire, arousal, lubrication, orgasm, satisfaction and pain) and total FSFI score (20.9), indicating better sexual function than their moderately active (18.8) and sedentary (15.6) counterparts (p <0.05). CONCLUSION Physical activity appears to influence sexual function positively in middle-aged women.