ABSTRACT Objective: Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Materials and methods: This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of pre-conception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results: No association between previous paternal BMI and offspring’s body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring’s total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring’s BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring’s ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035). Conclusion: Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Abstract Mental health care in Brazil has been changing throughout history, establishing new practices, forming the Psychosocial Care Network, affirming the protagonism of users in the production of care, their social rights and their citizenship. Among the professionals involved in these changes are occupational therapists. This qualitative research aimed to understand the performance of these professionals in this Psychosocial Care Network in the Paraíba state, Brazil. Thirteen occupational therapists were interviewed using a semi-structured questionnaire, applied remotely. These professionals are mostly women, with professional experience and interest in working in Mental Health, as well as work in Psychosocial Care Centers I. A low number of professionals in state services was evidenced, being only 17 in a Network of 124 services. As for the actions developed, they listed: individualized care, reception/screening, groups, Unique Therapeutic Projects, participation in team meetings, crisis management and workshops. The precariousness of working conditions was perceived, in particular, by the lack of resources to carry out the interventions. Only occasionally they feel supported by the representative entities (class council, union, and state professional association). The service coordinators understand the professional performance, but it is the users who value it the most, followed by family members, teams, and service coordinators. This appreciation and recognition by the main agents involved in the production of community life demonstrates that occupational therapists are an integral and active part in this process of reception, coexistence and inclusion of vulnerable and fragile people facing their condition of mental suffering.

Resumo O cuidado em saúde mental no Brasil vem mudando ao longo da história, instituindo novas práticas, formando a Rede de Atenção Psicossocial, afirmando o protagonismo dos usuários na produção do cuidado, seus direitos sociais e sua cidadania. Dentre os profissionais envolvidos nessas mudanças, estão os terapeutas ocupacionais. Esta pesquisa qualitativa teve como objetivo compreender a atuação desses profissionais na RAPS do estado da Paraíba, Brasil. Foram entrevistadas 13 terapeutas ocupacionais utilizando um questionário semiestruturado, aplicado de forma remota. Essas profissionais são, em sua maioria, mulheres, com experiência profissional e interesse pelo trabalho em saúde mental e atuam em Centros de Atenção Psicossocial I. Foi evidenciado um baixo número de profissionais nos serviços do estado, apenas 17 em uma rede de 124 serviços. Quanto às ações desenvolvidas, elencaram: atendimentos individualizados, acolhimento/triagem, grupos, Projetos Terapêuticos Singulares, participação em reuniões de equipe, manejo de crise e a realização de oficinas. A precarização das condições de trabalho foi percebida, em especial, pela insuficiência dos recursos para a realização das intervenções. Somente eventualmente elas se sentem apoiadas pelas entidades representativas (conselho de classe, sindicato e associação profissional estadual). Os coordenadores dos serviços compreendem a atuação profissional, mas são os usuários quem mais a valorizam, seguidos pelos familiares, equipes e coordenadores do serviço. Essa valorização e reconhecimento pelos principais agentes envolvidos na produção da vida comunitária demonstra que as terapeutas ocupacionais são parte integrante e atuante nesse processo de acolhimento, convivência e inclusão das pessoas vulnerabilizadas e fragilizadas diante de sua condição de sofrimento mental.

RESUMO Este consenso realizado pela Academia Brasileira de Neurologia (ABN) abordará de maneira prática como avaliar pacientes com queixas cognitivas e como realizar o diagnóstico clínico e etiológico das três síndromes clínicas associadas aos estágios de declínio cognitivo: declínio cognitivo subjetivo (DCS), comprometimento cognitivo leve (CCL) e demência. O diagnóstico de DCS é discutido pela primeira vez em consenso da ABN e as atualizações para o diagnóstico de CCL e demência são abordadas, bem como a recomendação para o uso de testes cognitivos apropriados, investigação etiológica pertinente e cuidados aos pacientes com declínio cognitivo nos diferentes níveis de atenção do Sistema Único de Saúde. Foi realizada pesquisa dos principais instrumentos de avaliação utilizados em nosso meio e na América Latina.

ABSTRACT This consensus, performed by the Brazilian Academy of Neurology (BAN) will approach practically how to evaluate patients with cognitive complaints and how to clinically and etiologically diagnose the three clinical syndromes associated with the different stages of cognitive decline: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. This BAN consensus discusses SCD diagnosis for the first time, updates MCI and dementia diagnoses, recommends the adequate cognitive tests and the relevant etiological work-up and care of patients with cognitive decline at different levels of care within the Brazilian Unified Health System. We also review the main assessment instruments used in Brazil and Latin America.

Abstract Recently a surface plasmon resonance (SPR) optical sensor, based on the Otto configuration — the Otto chip — has been developed. One essential step in the quality control of the fabrication process is characterization of the active region of several devices in a batch. Characterization is done by measuring the angular spectrum of the optical re ectance on several points across the active region of the device, and determining parameters by regression analysis of the data. Traditional gradient methods used in the regression process are extremely dependent on an initial guess and are not very efficient for batch analysis of curves, when those include poorly defined SPR spectra, where an initial guess may be hard to infer. An alternative approach for the regression problem is to model the analysis as an optimization problem and using an efficient stochastic algorithm. In this paper one discusses the use of Particle Swarm Optimization (PSO) for characterization of Otto chip devices. From comparative studies carried out in an existing Otto chip, it is observed that PSO can be a very efficient approach for batch analysis and yields better results when compared with the traditional gradient-based regression method.

Resumo Objetivos: determinar a frequência e os fatores associados aos sinais e sintomas de estresse, ansiedade e depressão grave/extremos em pacientes diabéticos durante a pandemia pela COVID-19. Métodos: realizou-se estudo de corte transversal em abril/maio de 2020 que incluiu 162 indivíduos com diabetes mellitus e maiores de 18 anos. Aplicou-se um questionário online divulgado nas mídias sociais, sendo composto por características biológicas, sociodemográ-ficas, clínicas e a Escala de Estresse, Ansiedade e Depressão (DASS-21). Para análise estatística foi aplicado modelo de regressão logística multivariado com nível de significância de 5%. Resultados: encontrou-se frequência de 37,7%, 43,3% e 45,1% para qualquer sinal e sintoma de estresse, ansiedade e depressão, respectivamente. Os fatores associados a sinais e sintomas psíquicos graves/extremos foram: não ter religião (estresse, ansiedade e depressão); estar na graduação (estresse e ansiedade);antecedente de ansiedade e/ou depressão (ansiedade e depressão); não realizar ou ter diminuído exercícios físicos, iniciado, aumentado ou mantido medicações para dormir (estresse); história de contato com caso suspeito da COVID-19; ausência ou diminuição de lazer (ansiedade) e sexo feminino, ausência de companheiro, diminuição da renda familiar e do trabalho ou estudo (depressão). Conclusão: a frequência de transtornos psíquicos foi maior que a descrita na literatura em pacientes diabéticos, sendo associada a fatores biológicos, sociodemográficos, clínicos e aspectos relacionados à COVID-19 durante a pandemia.

Abstract Objectives: to determine the frequency and factors associated with severe / extreme signs and symptoms of stress, anxiety and depression in diabetic patients during the COVID-19 pandemic. Methods: cross-sectional study conducted in April /May 2020, which included 162 individuals with diabetes mellitus and over 18 years old. An online questionnaire was applied on social networks, composed of biological, sociodemographic, clinical characteristics and the Stress, Anxiety and Depression Scale (DASS-21). For statistical analysis, a multivariate logistic regression model was applied with a 5% significance level. Results: frequency of 37.7%, 43.3% and 45.1% were found for some symptom of stress, anxiety and depression, respectively. The factors associated with sign and symptoms of severe / extreme psychic disorders were: not having religion (stress, anxiety and depression); be at graduation (stress and anxiety); history of anxiety and depression (anxiety and depression); not practicing or decreasing physical exercises and starting, increased or continue taking sleeping medications (stress); history of contact with a suspected case of COVID-19, absence or decreased leisure (anxiety); female gender, absence of a partner, decreased family income and work or study (depression). Conclusion: the frequency of psychological disorders was higher than described in the literature on diabetic patients, being associated with biological, sociodemographic, clinical factors and aspects related to COVID-19 during the pandemic

Abstract Background: açaí is the fruit of the palm tree Euterpe oleracea Martius, which is native to the Amazon region. This fruit has been extensively studied due to its potential effects on human health. Studies have also evaluated the potential effect of açaí on the inflammatory response, but there are still few studies that have assessed this property in humans. Objective: in this study we aimed to evaluate the effects of 200 g of açaí pulp consumption per day during four weeks on a rich panel of inflammatory biomarkers. Methods: a prospective nutritional intervention study was conducted on forty apparently healthy women who consumed 200 g of açaí pulp per day for four weeks. A panel of serum inflammatory markers were evaluated before and after the nutritional intervention, namely, cell adhesion molecules (ICAM-1, IVAM-1, P-selectin, MCP-1, and fractalkine), interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17) and adipokines (adiponectin, leptin, visfatin, and adipsin). The data were analyzed using paired Student's t-test to evaluate the effect of the intervention using PASW Statistics, version 18.0, and a p-value of < 0.05 was considered significant. Results: four weeks of açaí pulp consumption decreased p-selectin, leptin, and visfatin concentrations in the serum of the participating women. Conclusion: these results show that consumption of açaí pulp was able to modulate important biomarkers of the inflammatory process in apparently healthy women.

Resumen Introducción: el açaí es el fruto de la palmera Euterpe oleracea Martius, originaria de la región amazónica. Esta fruta ha sido ampliamente estudiada debido a sus posibles efectos sobre la salud humana. Los estudios también han evaluado el efecto potencial del açaí sobre la respuesta inflamatoria, pero todavía hay pocos estudios que hayan evaluado esta propiedad en seres humanos. Objetivo: en este estudio, nuestro objetivo ha sido evaluar los efectos del consumo de 200 g de pulpa de açaí por día durante cuatro semanas sobre un rico panel de biomarcadores inflamatorios. Métodos: se ha realizado un estudio prospectivo de intervención nutricional en el que cuarenta mujeres aparentemente sanas han consumido 200 g de pulpa de açaí al día durante cuatro semanas. Se ha evaluado un panel de marcadores inflamatorios séricos antes y después de la intervención nutricional, a saber, moléculas de adhesión celular (ICAM-1, IVAM-1, P-selectina, MCP-1 y fractalquina), interleucinas (IL-1β, IL-6, IL-8, IL-10 e IL-17) y adipocinas (adiponectina, leptina, visfatina y adipsina). Los datos han sido analizados mediante la prueba de la t de Student pareada para evaluar el efecto de la intervención mediante el PASW Statistics, versión 18.0, y todo valor de p < 0,05 se consideró significativo. Resultados: después de cuatro semanas de consumo de pulpa de açaí disminuyeron las concentraciones de p-selectina, leptina y visfatina en el suero de las mujeres participantes. Conclusión: estos resultados muestran que el consumo de pulpa de açaí ha sido capaz de modular importantes biomarcadores del proceso inflamatorio en mujeres aparentemente sanas.

RESUMO CONTEXTO: A deficiência de vitamina D está sendo reconhecida como uma pandemia devido ao volume de pessoas afetadas pela deficiência e o número de doenças geradas ou estimuladas por tal deficiência. Há falta de consenso na literatura sobre o que é considerado deficiência de vitamina D [25(OH)D]. OBJETIVO: Esta revisão reúne os níveis mais comuns de 25(OH)D encontrados em escolares saudáveis e o que é considerado deficiência. MÉTODOS: Esta revisão sistemática foi baseada na literatura acessada a partir das bases de dados eletrônicas: MEDLINE, EMBASE, LILACS, SCOPUS e WEB OF SCIENCE. Foram utilizados os seguintes descritores em inglês, português e espanhol: “Vitamina D”; “Deficiência de vitamina D”; “Suplementos Nutricionais”, bem como todos os seus sinônimos. A meta-análise foi realizada considerando o modelo aleatório. Critérios de inclusão: crianças saudáveis na faixa etária de 6 a 12 anos, estudos que tinham níveis de vitamina D, deficiência de vitamina D definida. RESULTADOS: Dos 191 artigos potencialmente elegíveis, apenas seis artigos foram incluídos, com 2618 escolares no total. O valor médio de 25(OH)D foi estimado em 18,11 ng/mL com 95% de intervalo de confiança. Dentre os artigos encontrados três consideraram deficiência níveis abaixo de 20 ng/mL, um considerou abaixo de 18 ng/mL, outro abaixo de 15 ng/mL, e o último abaixo de 11 ng/mL. A prevalência da deficiência de vitamina D entre os artigos foi de 48,6%, 7%, 98%, 64,63%, 19,5%, 28,4%, de acordo com cada classificação utilizada por eles. CONCLUSÃO: A definição mais comum na literatura de deficiência de 25(OH)D em escolares foi em níveis inferiores a 20 ng/mL. Nenhum efeito colateral foi relatado em estudos que usaram fortificação e/ou suplementação de vitamina D. A suplementação diária é mais eficaz do que a suplementação sazonal. No entanto, mais estudos são necessários para definir o que pode ser considerado como níveis ótimos de 25(OH)D em crianças.

ABSTRACT BACKGROUND: Vitamin D deficiency is being recognized as a pandemic due to the volume of people affected by the deficiency and the number of illnesses generated or stimulated by the deficiency. There is a lack of consensus in the literature on what is considered vitamin D deficiency [25(OH)D]. OBJECTIVE: This review brings together the most common levels of 25(OH)D found in healthy schoolchildren and what is considered deficient. METHODS: This systematic review was based on the literature accessed from the electronic databases: MEDLINE, EMBASE, LILACS, SCOPUS and WEB OF SCIENCE. The following descriptors were used in English, Portuguese and Spanish: “Vitamin D”; “Vitamin D deficiency”; “Nutritional Supplements” as well as all their synonyms. The meta-analysis was performed considering the random model. Inclusion criteria: healthy children aged 6 to 12 years, studies that had vitamin D levels, defined vitamin D deficiency. RESULTS: Of the 191 potentially eligible articles, only six articles were included, with 2618 students in total. The mean value of 25(OH)D was estimated at 18.11 ng/mL with 95% confidence interval. Among the articles found, three were considered deficiency levels below 20 ng/mL, one considered below 18 ng/mL, another below 15 ng/mL, and the latter below 11 ng/ mL. The prevalence of vitamin D deficiency among the articles was 48.6%, 7%, 98%, 64.63%, 19.5%, 28.4%, according to each classification used by the same. CONCLUSION: The most common definition in the literature of 25(OH)D deficiency in schoolchildren was at levels below 20 ng/mL. No side effects have been reported in studies that used fortification and/or vitamin D supplementation. Daily supplementation is more effective than seasonal supplementation. However, more studies are needed to define what can be considered as optimal levels of 25(OH)D in children.

Resumo Objetivo: Analisar o estado nutricional relativo ao selênio e verificar o efeito da suplementação desse mineral em pacientes pediátricos durante 14 dias de nutrição parenteral (NP). Método: Trata-se de estudo prospectivo de uma série de casos de pacientes acompanhados durante duas semanas de uso de NP. A coleta de dados foi realizada no início (T0), no 7º (T1) e no 14º dia de NP (T2). Após randomização, o grupo suplementado recebeu 2 µg/kg/dia de ácido selenioso. Peso e altura foram aferidos para avaliação do estado nutricional. Exames coletados: selênio plasmático, albumina, pré-albumina, proteína C-reativa (PCR), colesterol total e HDL-colesterol. Resultados: Foram avaliados 14 pacientes com processo inflamatório em curso e com baixo ou muito baixo peso para a idade. Os pacientes (grupo suplementado e não suplementado) tinham baixas concentrações de selênio. A mediana dos valores de selênio plasmático foi de 17,4 µg/L (T0), 23,0 µg/L (T1) e 20,7 µg/L (T2). Aumento e redução de selênio ocorreram tanto nos pacientes com PCR elevada quanto naqueles que apresentaram normalização desse parâmetro. Conclusão: Os níveis de selênio detectados foram muito baixos e a suplementação (2 µg/kg/dia de ácido selenioso) não foi suficiente para normalização dos níveis plasmáticos.

Summary Objective: To analyze the nutritional status of selenium and verify the effect of its supplementation in pediatric patients during 14 days of parenteral nutrition (PN). Method: This is a series of cases with patients followed for two weeks while using PN. Data collection was performed at the beginning (T0), in the 7th (T1) and 14th days of PN (T2). The supplemented group received 2 µg/kg/day of selenous acid. Weight and height were measured for nutritional status assessment. Tests requested: plasma selenium, albumin, pre-albumin, C-reactive protein (CRP), total cholesterol and HDL-cholesterol. Results: Fourteen (14) patients with inflammatory process and with low or very low weight for their ages were evaluated. In both groups (with and without supplementation), all patients had low selenium levels. Median plasma selenium concentrations were 17.4 µg/L (T0), 23.0 µg/L (T1) and 20.7 µg/L (T2). Increase and reduction of selenium occurred both in patients with high CRP and in those presenting normalization of this parameter. Conclusion: Lower plasma selenium levels have been detected since the start of the research and supplementation (2 µg/kg/day of selenous acid) was not to enough to approach the reference values.

Introduction: Breast cancer is the second most common cancer in the world, and the most frequent cancer among women. Moreover, there are factors that influence the risk for breast cancer including the age, genetic and endocrine factors, and lifestyle. Objectives: To evaluate the consumption of fatty acids; compare the fatty acids composition in the breast adipose tissue of women with breast cancer and benign breast disease as well as potential risk factors; and describe the genotypic frequency of the Pro12Ala PPARγ polymorphism. Material and methods: A hospital-based case-control study was conducted including incident cases (n = 38 breast cancer; n = 75 benign breast disease; n = 166 control). Lifestyle features, socioeconomic issues, dietary intake, anthropometry, and blood and tissue data were assessed. Results: No differences were observed for fatty acids intake. Interestingly, lauric acid (p = 0.001), myristic acid (p = 0.036), stearic acid (p = 0.031), and total saturated fatty acids (SFAs) (p = 0.048) had lower concentrations in BC than in BBD women, while palmitoleic acid (p = 0.022), erucic acid (p = 0.002), total monounsaturated fatty acids (MUFAs) (p = 0.039) and oleic acid/stearic acid ratio (p = 0.015) increased. There was no significant association between PPARγ polymorphism and studied groups (p = 0.977). The age at first full pregnancy (p = 0.004) was significantly associated with the development BC, whereas BMI (p = 0.005); percentage of body fat (p = 0.024); physical activity (p = 0.036); and age at menarche (p = 0.008), at first full pregnancy (p < 0.001), and of first mammogram (p = 0.018) were significantly associated with the development of BBD. Conclusion: The results suggest a different fatty acids composition of breast adipose tissue, a biomarker of long-term dietary intake, particularly for SFAs, MUFA and 18: 1 n-9/18: 00 ratio. Our findings also show that are differences in the factors related to the development of BC and BBC.

Introducción: el cáncer de mama (CM) es el segundo cáncer más común en el mundo, y el cáncer más frecuente entre las mujeres. Por otra parte, hay factores que influyen en el riesgo de padecer CM, entre los que se encuentran la edad, factores genéticos y endocrinos, y el estilo de vida. Objetivos: evaluar el consumo de ácidos grasos; comparar la composición de ácidos grasos en el tejido adiposo de mama de las mujeres con CM y enfermedad benigna de mama (EBM), así como los posibles factores de riesgo; y describir la frecuencia genotípica del polimorfismo Pro12Ala PPARγ. Material y métodos: se llevó a cabo un estudio caso-control basado en hospitales, incluyendo casos incidentes (n = 38 cáncer de mama, n = 75 enfermedad benigna de mama, n = 166 control). Se evaluaron las características del estilo de vida, las cuestiones socioeconómicas, la ingesta dietética, la antropometría y los datos de sangre y tejidos. Resultados: no se observaron diferencias para la ingesta de ácidos grasos. Curiosamente, ácido láurico (p = 0,001), ácido mirístico (p = 0,036), ácido esteárico (p = 0,031) y los ácidos grasos totales saturados (AGS) (p = 0,048) tenían concentraciones más bajas en CM que en mujeres EBM, mientras ácido palmitoleico (p = 0,022), ácido erúcico (p = 0,002), los ácidos totales grasos monoinsaturados (MUFA) (p = 0,039) y la relación ácido oleico/ácido esteárico (p = 0,015) aumentó. No hubo asociación significativa entre el polimorfismo PPAR gamma y los grupos de estudio (p = 0,977). La edad al primer embarazo (p = 0,004) se asoció de forma significativa con el desarrollo de CM, mientras que el IMC (p = 0,005), porcentaje de grasa corporal (p = 0,024), la actividad física (p = 0,036) y la edad de la menarquia (p = 0,008), al primer embarazo (p < 0,001), y de la primera mamografía (p = 0,018), fueron significativamente asociados con el desarrollo de EBM. Conclusiones: los resultados sugieren una composición diferente de ácidos grasos del tejido adiposo de la mama, un biomarcador de la ingesta dietética a largo plazo, particularmente para SFA, MUFA y 18: 1 n-9/18: 00. Nuestros hallazgos también muestran que existen diferencias en los factores relacionados con el desarrollo de CM y EBM.

Introduction: The prevention strategy of breast cancer is still the key factor for early diagnosis and the most effective method for tracking the disease. Objective: This study aimed to evaluate the association vitamin D level with breast cancer in women. Methods: This hospital case-control study was conducted with 181 women with breast cancer and 197 healthy controls. Vitamin D status, calcium, phosphorus and PTH serum dosage and data collection related to lifestyle and patient's history, besides anthropometric measurements were performed. Univariate analysis (Chi-square and raw odds ratio) and multivariate analysis were performed through multivariate logistic regression. Results: This study shows a higher value of vitamin D in health controls (26.9 mg/dL) than in breast cancer women (24.8 mg/dL). Higher numbers of women with sufficient vitamin D status (34.85%) were found in control group than cancer group. Using the multiple logistic regression model, the family history of breast cancer (OR 36.37, 95%CI 4.75-278.50) and menopause (OR 5.17, 95% CI 2.72-9.80) had a direct association with breast cancer, while the level of vitamin D (OR 0.95, 95%CI 0.91-0.99) and moderate physical activity (OR 0.31, 95%CI 0.10-0.93) maintained the inverse associations with the disease. Conclusion: Vitamin D status and the practice of moderate physical activity were considered protective factors for breast cancer. However, menopause and family history of breast cancer were considered a risk factor for breast cancer.

Introducción: la estrategia de prevención del cáncer de mama sigue siendo el factor clave para el diagnóstico precoz y el método más eficaz para el seguimiento de la enfermedad. Objetivo: este estudio tuvo como objetivo evaluar el nivel de vitamina D asociado con el cáncer de mama en las mujeres. Métodos: este estudio de casos y controles hospitalarios se llevó a cabo con 181 mujeres con cáncer de mama y 197 controles sanas. Se estudió el nivel de vitamina D, calcio, fósforo y la dosis de suero PTH; se recopilaron de datos relacionados con el estilo de vida y com la historia de las pacientes, además se realizaron mediciones antropométricas. El análisis univariante (Chi-cuadrado probabilidades y primas ratio) y el análisis multivariado se realizó mediante regresión logística multivariante. Resultados: este estudio muestra un valor más alto de vitamina D en los controles de salud (26,9 mg/dl) que en las mujeres con cáncer de mama (24,8 mg/dl). Se encontraron más mujeres con suficiente vitamina D (34,85%) en el grupo control que en el grupo de cáncer. Usando el modelo de regresión logística múltiple, la historia familiar de cáncer de mama (OR 36,37; IC del 95%: 4,75 a 278,50) y la menopausia (OR 5,17; IC del 95%: 2,72 a 9,80) se halló una relación directa con el cáncer de mama, mientras que el nivel de vitamina D (OR 0,95; IC del 95%: 0,91 a 0,99) y la actividad física moderada (OR 0,31; IC del 95%: 0,10 a 0,93) mantienen las asociaciones inversas con la enfermedad. Conclusión: el estado de vitamina D y la práctica de actividad física moderada se consideraron factores de protección para el cáncer de mama. Sin embargo, la menopausia y la historia familiar de cáncer de mama se consideran un factor de riesgo para el cáncer de mama.

RESUMO O Brighton Paediatric Early Warning Score (BPEWS) é um instrumento construído para identificar sinais de alerta para deterioração clínica em crianças hospitalizadas. Objetivo: traduzir e adaptar o BPEWS para o português a fim de verificar sua aplicabilidade no contexto brasileiro estudado. Método: estudo metodológico guiado por recomendações internacional e nacionalmente aceitas para tradução e adaptação de instrumentos de medida em saúde. Descreve-se as etapas de equivalências conceitual, de itens, semântica, operacional e pré-testagem para obtenção da versão em português do BPEWS para uso no Brasil. Resultados: o BPEWS na sua versão traduzida e adaptada para o português brasileiro (BPEWS-Br) identificou no estudo-piloto que 26,6% das crianças estavam apresentando sinais de alerta para deterioração clínica. Conclusão: o BPEWS-Br parece ser aplicável ao contexto estudado, e seu uso poderá ajudar o enfermeiro no reconhecimento e documentação de sinais de alerta para deterioração clínica em crianças brasileiras hospitalizadas.

ABSTRACT The Brighton Paediatric Early Warning Score (BPEWS) is an instrument developed to identify warning signs for clinical deterioration in hospitalized children. Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil. Results: the BPEWS version translated and adapted for Brazilian Portuguese (BPEWS-Br) identified, in the pilot study, that 26.6% of children were presenting warning signs for clinical deterioration. Conclusion: the BPEWS-Br seems to be applicable for the context studied, and its use might help nurses in the recognition and documentation of warning signs for clinical deterioration in hospitalized Brazilian children.

RESUMEN El Brighton Paediatric Early Warning Score (BPEWS) es un instrumento construido para identificar señales de alerta de deterioro clínico en niños hospitalizados. Objetivo: traducir y adaptar el BPEWS al portugués, a fin de verificar su aplicabilidad en el ámbito brasileño estudiado. Método: estudio metodológico orientado por recomendaciones nacional e internacionalmente aceptadas de traducción y adaptación de instrumentos de medición en salud. Se describen las etapas de equivalencias: conceptual, de ítems, semántica, operativa y pre-testeo para obtención de versión en portugués del BPEWS para utilización en Brasil. Resultados: el BPEWS en su versión traducida y adaptada al portugués brasileño (BPEWS-Br) identificó en su estudio piloto que el 26,6% de los niños estaba presentando señales de alerta de deterioro clínico. Conclusión: el BPEWS-Br parece ser aplicable en el contexto estudiado, y su uso ayudará al enfermero en el reconocimiento y documentación de señales de alerta de deterioro clínico en niños brasileños hospitalizados.

ABSTRACT The Brighton Paediatric Early Warning Score (BPEWS) is an instrument developed to identify warning signs for clinical deterioration in hospitalized children. Objective: to translate and adapt the BPEWS for the Portuguese language, with the purpose of verifying its applicability in the Brazilian context studied. Method: methodological study guided by international and nationally accepted recommendations for translation and adaptation of health measurement instruments. Stages of conceptual, item, semantic, operational and pre-test equivalence are described for obtaining the BPEWS Portuguese version to be used in Brazil. Results: the BPEWS version translated and adapted for Brazilian Portuguese (BPEWS-Br) identified, in the pilot study, that 26.6% of children were presenting warning signs for clinical deterioration. Conclusion: the BPEWS-Br seems to be applicable for the context studied, and its use might help nurses in the recognition and documentation of warning signs for clinical deterioration in hospitalized Brazilian children.

RESUMEN El Brighton Paediatric Early Warning Score (BPEWS) es un instrumento construido para identificar señales de alerta de deterioro clínico en niños hospitalizados. Objetivo: traducir y adaptar el BPEWS al portugués, a fin de verificar su aplicabilidad en el ámbito brasileño estudiado. Método: estudio metodológico orientado por recomendaciones nacional e internacionalmente aceptadas de traducción y adaptación de instrumentos de medición en salud. Se describen las etapas de equivalencias: conceptual, de ítems, semántica, operativa y pre-testeo para obtención de versión en portugués del BPEWS para utilización en Brasil. Resultados: el BPEWS en su versión traducida y adaptada al portugués brasileño (BPEWS-Br) identificó en su estudio piloto que el 26,6% de los niños estaba presentando señales de alerta de deterioro clínico. Conclusión: el BPEWS-Br parece ser aplicable en el contexto estudiado, y su uso ayudará al enfermero en el reconocimiento y documentación de señales de alerta de deterioro clínico en niños brasileños hospitalizados.

RESUMO O Brighton Paediatric Early Warning Score (BPEWS) é um instrumento construído para identificar sinais de alerta para deterioração clínica em crianças hospitalizadas. Objetivo: traduzir e adaptar o BPEWS para o português a fim de verificar sua aplicabilidade no contexto brasileiro estudado. Método: estudo metodológico guiado por recomendações internacional e nacionalmente aceitas para tradução e adaptação de instrumentos de medida em saúde. Descreve-se as etapas de equivalências conceitual, de itens, semântica, operacional e pré-testagem para obtenção da versão em português do BPEWS para uso no Brasil. Resultados: o BPEWS na sua versão traduzida e adaptada para o português brasileiro (BPEWS-Br) identificou no estudo-piloto que 26,6% das crianças estavam apresentando sinais de alerta para deterioração clínica. Conclusão: o BPEWS-Br parece ser aplicável ao contexto estudado, e seu uso poderá ajudar o enfermeiro no reconhecimento e documentação de sinais de alerta para deterioração clínica em crianças brasileiras hospitalizadas.

Stainless steel (SS) is successfully used in food industries due to the characteristics of its surface, which is essential for the maintenance of the properties of food. Tanks and stainless steel pipes, which come into direct contact with food and drink, undergo a process of cleaning and disinfecting called CIP (Clean-in-Place). This method consists of automatic recirculation of a detergent solution for a controlled time followed by a rinsing with water, and finally a cleaning and sanitizing solution immersion. This work consists of investigating the corrosion resistance of stainless steels used in the food industry using sanitizing solutions employed in the CIP procedure, and using electrochemical techniques such as potentiodynamic anodic polarization and electrochemical impedance spectroscopy.

Introduction: obesity, characterized by adiposity excess, is associated with endothelial dysfunction and possible inflammatory state with release of cytokines that determine endothelial function and can trigger chronic diseases. The dietary pattern are associated with the synthesis these cytokines. Fruits as the acai, which is rich in flavonoids, have a direct and beneficial effect on the control of this inflammatory process through the exercised antioxidant capacity. Objective: to evaluate the effect of acai pulp consumption on the inflammatory markers, anthropometric measurements, body composition, biochemical and dietary parameters in healthy women. Methods: forty women, were divided in 25 eutrophic and 15 with overweight. They intaked 200 g of acai pulp during 4 weeks. Anthropometric measurements, body composition, inflammatory markers, biochemical data, dietary intake and dietary antioxidants capacity were evaluated before and after the intervention. Results and discussion: after the intervention, there was significant increase of EGF (p = 0.021) and PAI- 1(p = 0.011) in overweight women. Moreover, there was increase in body weight (p = 0.031), body mass index (p = 0.028), percentage of truncal fat (p = 0.003) and triceps skinfold thickness (p = 0.046) in eutrophic women. However, the skinfold thickness (p = 0.018) and total body fat (p = 0.016) decreased in overweight women. There was reduction of total protein (p = 0.049) due to the globulin reduction (p = 0.005), but the nutritional status was maintained in eutrophic group. Conclusion: the intake of 200g acai pulp, modulated the EGF and PAI-1 expression, possibly by modulation of acai on the parameters of body composition, dietary, clinical, biochemical and inflammatory, led to a redistribution and resizing of body fat of the trunk area, and presumably increased visceral fat.

Introducción: la obesidad, que se caracteriza por el exceso de adiposidad, se asocia con disfunción endotelial y posible estado inflamatorio con liberación de citoquinas que determinan la función endotelial y pueden desencadenar enfermedades crónicas. El patrón de dieta está asociado con la síntesis de estas citoquinas. Los frutos de el acai, que es rico en flavonoides, tienen un efecto directo y positivo en el control de este proceso inflamatorio a través de los ejercicios de la capacidad antioxidante. Objetivo: evaluar el efecto del consumo de pulpa de acai en los marcadores inflamatorios, las medidas antropométricas, la composición corporal y los parámetros bioquímicos y dietéticos en mujeres sanas. Métodos: cuarenta mujeres fueron divididas en 25 eutróficas y 15 con sobrepeso. Se las adeministró 200 g de pulpa de acai durante 4 semanas. Antes y después de la intervención se evaluaron: medidas antropométricas, composición corporal, marcadores inflamatorios, datos bioquímicos, ingesta dietética y antioxidantes en la dieta. Resultados y discusión: después de la intervención, hubo un aumento significativo de EGF (p = 0,021) y PAI-1 (p = 0,011) en las mujeres con sobrepeso. Por otra parte, en las mujeres eutróficas hubo aumento del peso corporal (p = 0,031), el índice de masa corporal (p = 0,028), el porcentaje de grasa del tronco (p = 0,003) y el espesor del pliegue cutáneo del tríceps (p = 0,046). Sin embargo, el espesor del pliegue cutáneo (p = 0,018) y la grasa corporal total (p = 0,016) se redujeron en las mujeres con sobrepeso. Hubo una reducción de la proteína total (p = 0,049) debida a la disminución de globulina (p = 0,005), pero el estado nutricional se mantuvo en el grupo eutrófico. Conclusión: la ingesta de 200 g de pulpa de acai modula el EGF y PAI-1 de expresión, posiblemente por la modulación del acai en los parámetros de la composición corporal, la dieta, clínicos, bioquímicos e inflamatorios, lo que dio lugar a una redistribución y modificación del tamaño de la grasa corporal de la zona del tronco, y, presumiblemente, un aumento de la grasa visceral.

Background: assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. Methods: longitudinal study with three evaluations made (during the first 72 hours, on the 7th and the 14th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). Results: among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3rd to 7th days of PN), and 30.9 ± 12.19 kcal/kg (7th to 14th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3rd to 7th days of PN) and 1.49 ± 0.69 g/kcal/kg (7th to 14th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). Conclusions: the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition.

Introducción: evaluar si las recomendaciones de ingesta de proteínas actuales pueden mejorar los parámetros bioquímicos de los pacientes críticos que reciben nutrición parenteral. Métodos: estudio longitudinal con tres evaluaciones realizadas (durante las primeras 72 horas, en el séptimo y los días decimocuarto de nutrición parenteral). Se aplicaron las siguientes pruebas: albúmina, proteína C reac ti va, prealbúmina, colesterol total, HDL, triglicéridos, linfocitos y glutatión peroxidasa. La gravedad se determinó por SOFA. El análisis estadístico incluyó las pruebas de Spearman y Mann-Whitney, así como ANOVA (análisis de varianza). Resultados: de los 53 pacientes evaluados, 20 (37,74%) fallecieron. La caloría media fue de 24,68 ± 9,78 kcal/kg (comienzo de PN), 26,49 ± 8,89 kcal/kg (tercero-séptimo días de PN), y 30,9 ± 12,19 kcal/kg (séptimo-décimo cuarto días de PN). La proteína media fue de 1,19 ± 0,44 g/ kcal/kg (primeras 72 horas de PN), 1,29 ± 0,44 g/kcal/kg (tercero-séptimo días de PN) y 1,49 ± 0,69 g/kcal/kg (séptimo- decimocuarto días de PN). La prealbúmina, la albúmina, el colesterol total y la HDL estaban por debajo de los valores de referencia, mientras que los niveles de PCR eran altos. A lo largo de los tres tiempos de evaluación, no hay una mejora significativa en los niveles de los exámenes de laboratorio. Una correlación fuerte y negativa entre SOFA y prealbúmina (r = -0,64, p = 0,05). Conclusiones: la oferta de proteínas, de acuerdo con las recomendaciones tradicionales, no fue suficiente para mejorar los parámetros bioquímicos de los pacientes críticos sometidos a nutrición parenteral.