Maria José de Carvalho Costa

Effect of vitamin D3 supplementation and influence of BsmI polymorphism of the VDR gene of the inflammatory profile and oxidative stress in elderly women with vitamin D insufficiency: Vitamin D3 megadose reduces inflammatory markers.

OBJECTIVE This study aimed to evaluate the effect of vitamin D3 megadose supplementation and influence of BsmI polymorphism in the VDR gene on the inflammatory profile and oxidative stress in elderly women with vitamin D deficiency. METHODS A double blind, randomized, placebo-controlled trial was conducted with 40 elderly women (aged 68±6 years) diagnosed with vitamin D insufficiency (24.7±3.1 ng/mL). Participants were distributed into a supplementation group that received 200,000 IU of vitamin D3 (SG; n=20) and a placebo group (PG; n=20). Blood samples were collected at baseline and after intervention to analyse the 25(OH)D, parathyroid hormone, serum calcium, ultra-sensitive C-reactive protein (us-CRP), alpha 1-acid glycoprotein (AGP-A), total antioxidant capacity (TAC), and malondialdehyde (MDA) levels, as well as the renal and hepatic function, and genotyping was performed for BsmI polymorphism. RESULTS Four weeks after supplementation, elderly women in the SG group showed a significant increase in the serum concentration of 25(OH)D (25.29±2.8 to 31.48±6.0; p=0.0001), which was followed by increased TAC (65.25±15.66 to 71.83±10.71; p=0.03) and decreased serum PTH (46.32±13.2 to 35.45±11.0; p=0.009), us-CRP (0.38±0.3 to 0.19±0.1; p=0.007) and AGP-A levels (75.3±15.4 to 61.1±5.9; p=0.005). Changes in BP, ANAC and MDA were not observed. The 25(OH)D and PTH, us-CRP and AGP-A levels of participants with the BB/Bb genotype were more responsive to supplementation, but their other markers did not change. CONCLUSIONS Supplementation with a vitamin D3 megadose reduced inflammatory markers and increased the total antioxidant capacity in elderly women with vitamin D insufficiency. The 25(OH)D, PTH, us-CRP and AGP-A levels of elderly patients with the BB/Bb genotype were more responsive to supplementation compared with those with the bb genotype.

Deficiências de micronutrientes no pré-operatório de cirurgia bariátrica

INTRODUCAO: Achados epidemiologicos tem demonstrado o aumento da prevalencia de obesidade em diversos segmentos da populacao mundial. Neste contexto, a cirurgia bariatrica e aceita, atualmente, como a ferramenta mais eficaz no tratamento e controle da obesidade morbida. Varios estudos vem avaliando o estado nutricional apos operacoes bariatricas, principalmente as mistas, detectando reducao no consumo alimentar de proteinas, vitaminas e minerais. No entanto, outros investigam a presenca de deficiencias nutricionais antes da realizacao da operacao, que podem ser agravadas com o procedimento cirurgico, resultando em complicacoes pos-operatorias graves. OBJETIVO: Analisar a literatura para as deficiencias de micronutrientes em pacientes obesos antes da cirurgia bariatrica. METODO: Realizou-se revisao sistematica em bases eletronicos, a saber: PubMed/Medline, Scielo, Lilacs e Bireme. As seguintes palavras-chave foram utilizadas individualmente ou em associacao: bariatric surgery, obesity, preoperative, gastric bypass, vitamin deficiencies, mineral deficiencies and absorption nutrient. Foram incluidos 40 artigos de revisao e originais, publicados entre 2005 a 2012. RESULTADOS: Encontrou-se como consenso o fato de que a combinacao de deficiencias nutricionais no pre-operatorio, as restricoes e ma absorcao induzidas pela cirurgia bariatrica podem levar a importante deficits nutricionais durante o periodo pos-operatorio tardio, principalmente de micronutrientes, resultando em complicacoes graves. CONCLUSAO: A alta ocorrencia de deficiencia de micronutrientes no pre-operatorio detectada em obesos morbidos candidatos a cirurgia bariatrica, somado a um processo disabsortivo, pode envolver pior prognostico durante o periodo pos-operatorio tardio. Avaliacao pre-operatoria dos parâmetros nutricionais e da ingestao de alimentos e recomendado em conjunto com as intervencoes.

Cartografia do retardo estatural em escolares do Estado da Paraíba, Brasil

OBJECTIVE The study is part of a project financed by the United Nations (FAO) and the Ministry of Education of Brazil (Fundação de Assistência ao Escolar) which intends to evaluate the nutritional status of public schools students in order to estimate, giving emphasis to geographical aspects, the magnitude and distribution of statural deficit of this population in the Paraíba State, Northeastern Brazil. METHODS Schoolchildren, aged 6-9 years and enrolled in the first grade inall municipalities of Paraíba state went through a height survey. We consider as statural deficit values below -2 standard deviations according to the anthropometric pattern of National Center of Health Statistics. RESULTS A frequency of 14. 5% of statural deficit was found in the whole state, as well as 18. 7% in the semidesertic region (sertão), 13.8% in Agreste area, 11. 9% in Borborema region and 10.9% in Mata zone. In rural area, the prevalence of statural deficit was higher (17.8%) than for those living in urban area (11.8%). CONCLUSIONS The results reveal a process of inlanding of statural deficit, which contrasts with historical descriptions of the geographical distribution of this problem in the Northeastern region of Brazil

Resistence of Triatoma brasiliensis to fasting

Triatoma brasiliensis suporta prolongados periodos de jejum em condicoes de laboratorio. O numero medio de dias que os animais nao alimentados e mantidos a 30oC e a 70-80% U.R. resistiram, foi: 33,30 + 1,12; 44,23 + 1,31; 40,28 + 1,78; 48,00 + 1,56; 58,46 + 3,06; 42,63 + 2,38 e 52,33 + 1,83 para ninfas de 1.°, 2.°, 3.° 4.°, 5.° estadios e adultos, femeas e machos, respectivamente. A perda de peso corporeo durante o jejum e mais drastica na primeira semana decrescendo nas semanas seguintes. Existe diferenca nas taxas de perda de peso entre as ninfas do 5.° estadio e os outros estadios estudados. A grande variacao na resistencia apresentada pelos animais em cada estadio pode ser explicada em termos do peso corporeo do inseto. A resistencia ao jejum aumenta com o aumento de peso podendo, estas relacoes, serem expressas como funcoes alometricas. Sao feitos comentarios sobre programas de erradicacao.

Modulation of drug resistance in Staphylococcus aureus by extract of mango (Mangifera indica L., Anacardiaceae) peel

In an ongoing project to evaluate natural compounds isolated from by-products or wastes from vegetables and fruits (edible plants) as modulators of antibiotic resistance, ethanol extract from mango peel was investigated using Staphylococcus aureus strains possessing efflux mechanisms of resistance to norfloxacin, erythromycin and tetracycline. The minimum inhibitory concentrations (MIC) of the antibiotics were determined by the micro dilution assay in the absence and in the presence of sub-inhibitory mango peel extract concentration. Although the extract did not display relevant antibacterial activity (MIC>2048 µg/mL), it modulated the activity of antibiotics, i.e. in combination with antibiotics (at 512 µg/mL), a four-fold reduction in the MIC values for tetracycline and erythromycin was observed. The results presented here indicates that mango peel could serve as a source of potential adjuvant of antibiotics which add value to this mango by-product.

Psicologia e nutrição: predizendo a intenção comportamental de aderir a dietas de redução de peso entre obesos de baixa renda

Psychology and nutrition: predicting behavioral intention to follow weight reduction diets among low-income obese patients. The present study was accomplished with 189 low income obese attended by public health nutritionists of Joao Pessoa, Paraiba. We found out positive and negative beliefs plus the most expressive referees on these patients about the behavior of following a medical diet to reduce weight. This permitted to build a behavioral intention measurement instrument to check those who might really follow these diets. It was verified the emphasis on general normative and attitudinal aspects over obese who had up to one minimum-wage income. This may indicate two efficacious points to be explored on targeted communications to this social class during weight loss public health campaigns. This measurement can be turned into preventive health actions; obesity is considered worldwide as epidemics, in need of immediate control, growing in incidence mainly among lower ranks of the population of developing countries.

Pré-natal na atenção primária do município de João Pessoa-PB: caracterização de serviços e usuárias

OBJETIVOS: caracterizar a assistencia pre-natal em Unidades basicas de Saude envolvendo profissionais e usuarias do municipio de Joao Pessoa-PB. METODOS: estudo do tipo transversal e analitico-descritivo. A fim de caracterizar o pre-natal, um instrumento especifico foi elaborado com base nas diretrizes do Programa de Humanizacao do Pre-natal e Nascimento reunindo questoes distribuidas e analisadas segundo a triade avaliativa: estrutura, processo e resultados. RESULTADOS: observou-se boa infra-estrutura em maior parte dos servicos; quanto ao processo, identificou-se baixa adesao aos requisitos minimos do Programa de Humanizacao do Pre-natal e Nascimento (39,9%), alem de baixo percentual de servicos com atividades de educacao em saude (45,5%) e avaliacao interna (47,7%). Para os resultados da assistencia, altos percentuais de gestantes com intercorrencias clinicas (60,9%), inadequada situacao nutricional (56,3% sobrepeso e obesidade) e baixa prevalencia de aleitamento materno exclusivo (58,05 ± 34,19 dias) foram observados. CONCLUSOES: aspectos de processo referentes a adesao ao pre-natal, presenca de servicos com atividades de educacao em saude e indicadores de avaliacao interna alem de questoes de resultados envolvendo intercorrencias clinicas, inadequada situacao nutricional na gestacao e baixa prevalencia de aleitamento materno exclusivo sao barreiras a qualidade das acoes de pre-natal no âmbito da atencao primaria a saude.

Vitamin C restores blood pressure and vasodilator response during mental stress in obese children.

FUNDAMENTO: A resposta vasodilatadora periferica tem um papel importante na fisiopatologia da obesidade e das doencas cardiacas. OBJETIVO: Avaliar o efeito cronico da suplementacao de vitamina C (VitC) sobre a pressao arterial e na resposta vasodilatadora ao estresse mental. METODOS: Neste estudo prospectivo, randomizado e duplo cego foram avaliadas criancas obesas, de ambos os generos e com idade entre 8 a 12 anos divididas em 2 grupos: 1) grupo de criancas suplementadas com 500 mg de vitamina C (n = 11) e, 2) substância placebo (n = 10) durante 45 dias. Oito criancas eutroficas, pareadas por idade tambem foram arroladas no estudo. Foi avaliada a pressao arterial media (PAM), frequencia cardiaca (ECG) e fluxo sanguineo no antebraco pela plestimografia de oclusao venosa. A condutância vascular no antebraco (CVA) foi obtida atraves da relacao entre o fluxo sanguineo no antebraco e a PAM (X100). RESULTADOS: Antes da intervencao, as criancas obesas apresentaram PAM maior e CVA menor quando comparadas as criancas eutroficas. Pos-intervencao, o Grupo VitC apresentou reducao da PAM no repouso (81 ± 2 vs 75 ± 1 mmHg, p = 0,01), enquanto no Grupo Placebo nao houve alteracao da PAM (p = 0,58). Adicionalmente, VitC promoveu um aumento da CVA no repouso (3,40 ± 0,5 vs 5,09 ± 0,6 un, p = 0,04) e durante o estresse mental (3,92 ± 0,5 vs 6,68 ± 0,9 un, p = 0,03). Alem disso, pos suplementacao com VitC, os niveis da CVA foram estatisticamente semelhantes aos das criancas eutroficas no repouso (5,09 ± 0,6 vs 5,82 ± 0,4 un, p > 0,05) e durante o estresse mental (6,68 ± 0,9 vs 7,35 ± 0,5 un, p > 0,05). CONCLUSAO: Suplementacao com VitC reduziu a pressao arterial e restabeleceu a resposta vasodilatadora periferica em criancas obesas.BACKGROUND Peripheral vasodilation response plays an important role in the pathophysiology of obesity and heart disease. OBJECTIVE To evaluate the chronic effect of vitamin C (VitC) supplementation on blood pressure and on vasodilation response to mental stress. METHODS In a double-blind, randomized and prospective study we evaluated obese children with 8 to 12 years in 2 similar groups: 1) supplemented with 500 mg VitC (n = 11) and 2) placebo (n = 10) for 45 days. Eight age-matched lean control children were also studied. We evaluated: mean blood pressure (MBP), heart rate (HR) and forearm blood flow by venous occlusion plethismography. Forearm vascular conductance (FVC) was calculated by: (forearm blood flow/PAM) X100. RESULTS On pre-intervention evaluations obese children showed higher MBP and lower FVC compared to lean control children. After intervention VitC diminished MBP at rest (81 ± 2 vs 75 ± 1 mmHg, p = 0.01), whereas placebo did not promote changes in MBP (p = 0.58). In addition, VitC promoted FVC increase at rest (3.40 ± 0.5 vs 5.09 ± 0.6 un, p = 0.04) and during the mental stress (3.92 ± 0.5 vs 6.68 ± 0.9 un, p = 0.03). Moreover, after VitC supplementation FVC levels were similar to the lean control children at rest (5.09 ± 0.6 vs 5.82 ± 0.4 un, p > 0.05) and during mental stress (6.68 ± 0.9 vs 7.35 ± 0.5 un, p > 0.05). CONCLUSION VitC supplementation reduced the MBP and restored peripheral vasodilatation response during mental stress in obese children.

A Higher Meal Frequency May be Associated with Diminished Weight Loss after Bariatric Surgery

OBJECTIVE This study aimed to investigate the relationship between meal frequency, the occurrence of vomiting and weight loss among patients submitted to Roux-en-Y gastric bypass up to 9 months after surgery. METHODS Female patients (n = 80) were followed at 3-month intervals for 9 months. Weight, BMI, 24-hour dietary recall, drug consumption and vomiting episodes were recorded and compared with nutritional outcome. RESULTS The BMI values at 3, 6 and 9 months were 45.1 ± 9.7, 39.9 ± 7.6 and 35.4 ± 8.2 kg/m2, respectively. The corresponding choleric intakes were 535.6 ± 295.7, 677.1 ± 314.7 and 828.6 ± 398.2 kcal/day, and the numbers of daily meals were 5.0 ± 2.5, 4.7 ± 1.8 and 4.9 ± 1.0, respectively. The peak of vomiting episodes occurred within 6 months; however, patients tolerated this complication despite its high prevalence. A significant negative correlation between weight loss and diet fractioning, but not vomiting, was observed throughout the entire postoperative period (P = 0.001). CONCLUSIONS 1) Frequent small meals were associated with a reduction in weight loss after gastric bypass and a decrease in vomiting episodes at 6 months, and 2) vomiting did not interfere with nutritional outcome. Unless required because of vomiting or other reasons, multiple small meals may not be advantageous after such intervention.

Concentrações de 25-hidroxivitamina D e níveis pressóricos em idosos hipertensos

OBJECTIVE: To evaluate the prevalence of inadequate vitamin D status and its relationship with associated factors in 91 elderly hypertensive patients in Joao Pessoa, PB/BR. MATERIALS AND METHODS: In a cross-sectional study, levels of 25-hydroxyvitamin D of 91 elderly patients were compared with biochemical, anthropometric, and dietary data, type of skin, exposure to sunlight, and blood pressure. RESULTS: The prevalence of inadequate vitamin concentrations (25-hydroxyvitamin D < 29 ng/mL) was 33%. The concentration of serum 25-hydroxyvitamin D was inversely associated with systolic blood pressure and positively associated with weekly fish consumption. The other variables showed no significant association with 25-hydroxyvitamin D. CONCLUSION: The prevalence of inadequate vitamin D concentrations was related with higher blood pressure in elderly patients. Moreover, greater fish weekly consumption influenced greater 25-hydroxyvitamin D concentration.