Abstract In this study, we determined the nutritional and functional characteristics of cookies supplemented with chichá almond, gurguéia nut, and soursop residue using two developed cookie formulations and one standard formulation. Acceptance and purchase intention were evaluated. As the chichá almond 6 and gurguéia nut 2 formulations were sensorially viable, descriptive quantitative analysis, centesimal composition and caloric value, mineral levels, microbiological quality, bioactive compound levels, and antioxidant capacity were evaluated. In the hedonic scale test of the standard cookie, the chichá almond-6 and gurguéia nut-2 cookies obtained scores above 7 (“I liked it”) from 86.18%, 96.35%, and 93% of the evaluators, and 70.79%, 94.36%, and 83.2% of them said they would purchase the product, showing a statistically significant difference between formulations. The chichá almond 6 cookie presented higher ash, protein, lipid, copper, phosphorus, magnesium, potassium, selenium, and zinc levels, and lower carbohydrate levels and total energy values, as well as a higher total phenolic compound, total flavonoid, and condensed tannin levels. The gurguéia nut 2 cookie showed higher vitamin C and antioxidant activity. The use of residue and Cerrado fruit flour proved to be viable in cookie production, conveying sensorially desirable, nutritional, and functional characteristics.

Resumo Introdução A hemorragia uterina anormal é mais frequente na adolescência. Apesar de maioritariamente de etiologia não estrutural, pode dever-se a qualquer causa descrita. Caso clínico Adolescente de 12 anos, sem antecedentes pessoais relevantes, com menarca há 1 mês, observada no serviço de urgência por hemorragia menstrual grave com agravamento progressivo e repercussão hemodinâmica com necessidade de suporte transfusional. Foi colocada a hipótese de disfunção ovulatória fisiológica associada a eventual coagulopatia desconhecida previamente e foi instituído tratamento médico. Por ausência de resposta a tratamento médico, foi submetida a observação sob sedação e aspiração uterina que evidenciou tratar-se de um Linfoma de Burkitt. Discussão Apesar de as causas estruturais, e particularmente as neoplasias, do foro ginecológico ou não, serem uma causa rara de hemorragia uterina anormal nesta faixa etária, elas devem ser levadas em consideração potenciando assim um tratamento mais célere e adequado.

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severemenstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.

Abstract Overview and aims: Surgery for Pelvic Organ Prolapse (POP) is increasing with the aging of population. When maintenance of vaginal length and coital function is not a surgical goal, obliterative surgery is effective for POP treatment, especially in women with comorbidities. Our primary study goal was to evaluate the objective and subjective cure rates of different obliterative surgeries. We also aimed to characterize this population of women and the complications of this type of surgery. Study design: We conducted an observational retrospective cohort study Population: 82 patients who underwent obliterative surgery as a treatment for primary or recurrent POP. Methods: Retrospective review of clinical charts, with descriptive and bivariate analysis. Results: All women were sexually inactive and their mean age was 77.3 years-old. Overall, they had excessive weight and 97.6% of them had a POP-Q stage of III or more. The majority of these women had two or more comorbidities at time of surgery, and cardiovascular disease was the most severe in 40% of them. Twenty eight percent of them had already underwent a surgery for POP. There were only two cases of minor complications after surgery, specifically lower urinary tract infection. Overall, objective cure rate was 89.7% and subjective cure rate was 98.5%, for a mean time of follow-up of 18.5 months. We found no differences between different obliterative procedures. De novo urge urinary incontinence developed in 22% of patients. Conclusions: Obliterative surgery is a good treatment option for severe POP, especially in women with anesthetic risk and no desire for future vaginal coitus. In our cohort we found excellent objective and subjective POP cure rates after obliterative surgeries, combined with low risks..

RESUMO O presente trabalho objetivou avaliar os teores de compostos fenólicos totais, flavonoides totais e atividade antioxidante, bem como identificar e quantificar os ácidos fenólicos antes e após a digestão gastrointestinal simulada in vitro, em grãos crus e cozidos de feijão-caupi, das cultivares biofortificadas BRS Aracê e BRS Tumucumaque. Os grãos crus foram analisados na forma de farinha e os grãos cozidos foram analisados após maceração, antes e após a cocção e nas fases do processo digestivo. Analisou-se os conteúdos de compostos fenólicos totais pelo método espectrofotométrico, utilizando o reagente Folin-Ciocalteu, e flavonoides totais utilizando método espectrofotométrico com a quercetina como padrão. Avaliou-se a atividade antioxidante pelo método de captura dos radicais livres ABTS (ácido 2,2'-azino-bis (3-etilbenzotiazolino-6-sulfônico) e FRAP (Ferric Reducing Antioxidant Power). Pesquisaram-se oito ácidos fenólicos, e a identificação e quantificação foi realizada por cromatografia líquida de alta eficiência (CLAE). O conteúdo de compostos fenólicos totais e a atividade antioxidante foram reduzidos durante a cocção, mas aumentaram com a digestão simulada in vitro, devido à liberação de formas ligadas. Após a ação das enzimas digestivas, houve diferença no comportamento das cultivares cruas e cozidas. Os ácidos fenólicos sofreram degradação sob condições gastrointestinais, mas as cultivares analisadas mantiveram compostos com relevante bioatividade (grão cru - ácidos gálico, cafeico e p-cumárico; grão cozido - ácidos gálico e cafeico) e atividade antioxidante, que podem auxiliar na proteção contra doenças crônicas não transmissíveis, demonstrando que feijão-caupi é um alimento fonte de antioxidantes naturais bioacessíveis.

ABSTRACT The present work aimed to evaluate the contents of total phenolic compounds, total flavonoids and antioxidant activity, as well as to identify and quantify phenolic acids before and after simulated gastrointestinal digestion in vitro, in raw and cooked cowpea grains, of biofortified cultivars BRS Aracê and BRS Tumucumaque. The raw grains were analyzed as flour and the cooked grains were analyzed after maceration, before and after cooking and in the stages of the digestive process. The contents of total phenolic compounds were analyzed by the spectrophotometric method, using the reagent Folin-Ciocalteu, and total flavonoids using a spectrophotometric method with quercetin as standard. The antioxidant activity was evaluated using the free radical capture method ABTS (2,2'-azino-bis (3-ethylbenzothiazolino-6-sulfonic acid) and FRAP (Ferric Reducing Antioxidant Power). Eight phenolic acids were investigated, and the identification and quantification was performed by high performance liquid chromatography (HPLC), the content of total phenolic compounds and the antioxidant activity were reduced during cooking, but increased with simulated digestion in vitro, due to the release of bound forms. action of digestive enzymes, there was a difference in the behavior of the raw and cooked cultivars.The phenolic acids suffered degradation under gastrointestinal conditions, but the cultivars analyzed maintained compounds with relevant bioactivity (raw grain - gallic, caffeic and p-cumáric acids; cooked grain - acids and caffeine) and antioxidant activity, which can help protect against chronic non-communicable diseases, demonstrating that cowpea is a common food bioaccessible natural antioxidants.

Overview and Aims: Gestational diabetes (GD) is associated with increased risk for pregnancy and delivery complications. Ethnicity is a recognized risk factor for GD. Considering ethnic diversity in Portugal, it is important that health providers are familiar with differences in expected outcomes. This study was designed to compare Asian, Black and Caucasian women with GD. Study Design: Observational, retrospective study. Population: Women with singleton pregnancies and GD followed in our hospital, from 2012 to 2015. Materials and Methods: 323 women were divided according to country of birth and skin color - Caucasian (G1, n=230), Black (G2, n=79) and Asian (G3, n=14). Demographic characteristics, risk factors for GD and previous hypertension were compared. Maternal/fetal outcomes were analyzed - maternal weight gain, metabolic control, need of pharmacologic therapy, hypertensive complications, ultrasound biometric measures, intrauterine demise, mode of delivery, newborn weight and comorbidities. X2 and Fisher tests were performed. Significance was set at p-value<0.05. Results: G1 included women mainly from Portugal, G2 from Guinea Bissau, Angola and Portugal and G3 from India. Groups differed in level of education (p=0.023) and Body Mass Index categories (p=0.034) - G2 had the lowest level of education and the highest rates of overweight/obesity. Statistical difference was found in metabolic control, resulting in glycated haemoglobin below 6% (p=0.022) and mode of delivery (p<0,001); G2 and G3 had worse metabolic control than G1, with higher C-section rates. Neonatal comorbidity differed between groups (p=0.021), with G2 having higher rates, mainly hyperbilirrubinemia requiring phototherapy. Need or type of pharmacologic therapy (insulin/metformin) showed no difference between groups. Conclusions: Metabolic control in Asian and Black women with GD was more difficult to achieve than in Caucasians, with afterwards worse maternal/fetal outcomes. Health providers should acknowledge differences between ethnicities and a multidisciplinary and individualized approach should be provided.