Abstract Objectives: investigate whether prenatal characteristics were associated with dietary pattern of pregnant women. Methods: we studied 200 high-risk pregnant women in Fortaleza, Ceará. The identification of dietary patterns was performed through principal component analysis with the orthogonal Varimax rotation. Poisson regression was used to estimate prevalence ratios (PR) and respective confidence intervals (CI95%). Results: three major dietary patterns were identified: ‘common Brazilian’, ‘healthy’ and ‘energy-dense’. After adjustments conducted with multivariate analysis, pregnant women who had not received dietary guidance in prenatal consultations (34%) were less likely to adhere to the ‘healthy’ pattern (PR = 0,81; CI95%= 0,67-0,95). Pregnant women who attended an appropriate number of consultations (≥ 6 consultations) (41%) showed greater adherence to the ‘healthy’ pattern (PR = 1,15; CI95%= 1,01-1,32) and lower adherence to the ‘energy-dense’ pattern (PR = 0,85; CI95%= 0,74-0,99). Conclusion: it was observed that the high-risk pregnant women who attended an adequate number of consultations during the prenatal care had a higher chance to adhere to the ‘healthy’ pattern and a lower chance to adhere to the ‘energy-dense’ pattern. Not receiving guidelines on prenatal nutrition was inversely associated with the healthy pattern. Thus, the importance of high-risk pregnant women undergoing an appropriate prenatal care is reinforced.

Resumo Objetivos: investigar o efeito potencial das características de acompanhamento do pré-natal em padrões alimentares identificados em gestantes de alto risco. Métodos: foram estudadas 200 gestantes de alto-risco de Fortaleza, Ceará. Os padrões alimentares foram identificados pela análise de componentes principais seguida de rotação ortogonal Varimax. Utilizou-se Regressão de Poisson para estimar as razões de prevalência (RP) e os intervalos de confança (IC95%). Resultados: três padrões alimentares foram identificados: ‘comum brasileiro’, ‘saudável’ e ‘denso em energia’. Após a realização de ajuste com análise multivariada, as gestantes que não receberam orientação sobre alimentação nas consultas do pré-natal (34%) apresentaram menores chances de adesão ao padrão ‘saudável’ (RP = 0.81, IC95%= 0.67-0.95). Aquelas que realizaram um número de consultas adequado (≥ 6 consultas) (41%) apresentaram maior adesão ao padrão ‘saudável’ (RP = 1.15, IC95%= 1.01-1.32) e menor adesão ao padrão ‘denso em energia’ (RP = 0.85, IC95%= 0.74-0.99). Conclusão: observou-se que as gestantes de alto risco que compareceram a um número adequado de consultas no pré-natal tiveram maior chance de aderir ao padrão ‘saudável’ e menor chance de aderir ao padrão ‘denso em energia’. Não receber orientações sobre nutrição durante o pré-natal foi inversamente associado ao padrão ‘saudável’. Reforçando a importância das gestantes de alto risco realizarem um pré-natal adequado.

Abstract Mineral profiles of eleven fruits from the northeastern Brazilian agrobiodiversity have been determined. Samples of cajui, murici, pequi, jenipapo, mangaba, bacuri, caja, umbu-caja, umbu, pitanga and araça fruits were digested and element content determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The accuracy of method was performed using SRM 2338 and all elements were statistically similar with 95% of confidence. Potassium is present in higher amounts in the edible part of the fruits, ranging from 107 to 402 mg 100 g-1, followed by P in the range 16 - 150 mg 100 g-1. Iron, presents the lowest content, ranges from 0.07 to 1.1 mg 100 g-1. Caja and umbu-caja fruits are noteworthy sources of P. Analysis of variance (ANOVA) and Principal Component Analysis were performed in order to check similarities between the fruit groups according to the trace element content. The data provide a source of information characterizing the Brazilian biodiversity and it may help the nutritional intake of these fruits in the region.

ABSTRACT The aim of this study was to investigate the association between skipping meals and excess weight in adolescents. This study used a secondary database based on cross-sectional research. Weight and height were measured for the classification of nutritional status and the omission of meals was determined from the 24-hour food record. Statistical analyses were performed on a sample stratified by age from 10 to 13 years and 14 to 19 years. There was a high prevalence of excess weight (overweight and obesity) in the sample and a high frequency of meal omission among adolescents. The omission of lunch and dinner among adolescents between 14 and 19 years and those between 10 to 13 years, respectively, was directly associated with excess weight.

RESUMEN El objetivo de este estudio fue investigar la asociación entre omisión de comidas y condición de exceso de peso en adolescentes. Este es un estudio con datos secundarios de una investigación transversal. El peso y la altura se midieron para clasificar el estado nutricional y la omisión de las comidas se determinó a partir del registro de alimentos de 24 horas. Los análisis estadísticos se realizaron en una muestra estratificada por edad de 10 a 13 años y de 14 a 19 años. Hubo una alta prevalencia de exceso de peso en la muestra y una alta frecuencia de omisión de comidas entre los adolescentes. La omisión del almuerzo y la cena, en los rangos de 14 a 19 años y de 10 a 13 años, respectivamente, se asoció directamente con el exceso de peso.

Abstract Objective: the purpose of this study was to investigate the effects of Chrysobalanus icaco on adiposity and its mechanism of action in the gene and protein expression of acetyl-CoA carboxylase (ACC), a key enzyme in lipogenesis. Method: Wistar rats were divided into a regular or control group (CG) and a high-fat diet (HFD) group. HFD was treated with saline or aqueous extract of Chrysobalanus icaco (AECI) for four weeks. Body weight and food intake were assessed. Subcutaneous, retroperitoneal and periepididymal adipose tissue samples were collected and weighed. Adipocytes from periepididymal tissue were isolated and analyzed. The gene and protein expression of ACC in subcutaneous tissue was determined. Results: AECI showed no effect on intake or body weight. However, the weight of the fat pads and the gene and protein expression of ACC were lower, and glucose tolerance was improved. Conclusion: the aqueous extract of Chrysobalanus icaco proved beneficial for the treatment of obesity, preventing fat storage and improving glycemic homeostasis.

Resumen Objetivo: el objetivo de este estudio fue investigar los efectos del extracto acuoso de Chrysobalanus icaco (AECI) en la adiposidad y su mecanismo de acción en la expresión génica y proteica de la acetil-CoA-carboxilasa (ACC), una enzima clave para la lipogénesis. Métodos: se usaron ratones macho Wistar que se asignaron a una dieta estándar de control (CG) o a una rica en grasa (HFD). La HFD se trató con solución salina o con extracto acuoso de Chrysobalanus icaco (AECI) durante cuatro semanas. Se evaluaron el peso corporal y el consumo alimentario. Se aislaron y analizaron muestras de tejido adiposo subcutáneo, retroperitoneal y periepididímico. Se determinó la expresión génica y proteica de ACC en el tejido subcutáneo. Resultados: el AECI no mostró ningún efecto sobre la ingesta de alimento y tampoco sobre el peso corporal. Sin embargo, el tratamiento con AECI redujo el peso de los tejidos adiposos y la expresión génica y proteica de ACC, y mejoró también la tolerancia a la glucosa. Conclusión: Chrysobalanus icaco (AECI) resultó ser beneficioso para el tratamiento de la obesidad, previniendo el almacenamiento de grasa y mejorando la homeostasis glucémica.

RESUMO: Este artigo busca problematizar os resultados de uma pesquisa que teve como objetivos identificar e analisar a produção de teses e dissertações concluídas em Programas de Pós-graduação em Antropologia a partir de 1990 no Brasil, entender como as questões educacionais foram incorporadas e tratadas teórica e metodologicamente nessas pesquisas e, contiguamente, compreender as condições de desenvolvimento do campo interdisciplinar na interface Antropologia e Educação. De natureza qualitativa e quantitativa, foram analisados cerca de 62 trabalhos. Os resultados depreendidos demonstraram que o olhar do antropólogo contribui para uma melhor compreensão das realidades em contextos de aprendizagens, sejam espaços de educação formal ou não, e contribuem densamente para o campo da educação.

ABSTRACT: This paper presents the results of research that aimed to identify and analyze the production of theses and dissertations completed in graduate programs in anthropology in Brazil from 1990. The purpose of the selected programs was to understand in what ways educational issues were incorporated and treated theoretically and methodologically, and contiguously, to understand the conditions of the development of the interdisciplinary field in the interface of anthropology and education. In both a qualitative and quantitative nature, 62 papers were analyzed. The results obtained demonstrate that the anthropologist’s view contributes to a better understanding of the realities of learning contexts, whether formal or non-formal education spaces and contributes substantially to the field of education.

RESÚMEN: Este artículo busca problematizar los resultados de una investigación que tuvo como objetivos identificar y analizar la producción de tesis y disertaciones realizadas en Programas de Posgrado en Antropología desde 1990 en Brasil, para entender cómo se incorporaron y trataron los temas educativos, teórica y metodológicamente, en estas investigaciones y, además, comprender las condiciones de desarrollo del campo interdisciplinario en la interfaz Antropología y Educación. De carácter cualitativo y cuantitativo, analizamos alrededor de 62 trabajos. Los resultados mostraron que la mirada del antropólogo contribuye para una mejor comprensión de las realidades en los contextos de aprendizajes, sean espacios de educación formal o no, y contribuyen densamente para el campo de la educación.

Abstract Three paste formulations were developed for four fruits: caja, murici with mango and pitanga, with differentiated percentages of fruit pulp, organic honey and gellan gum. Pulps, honey and fruit paste formulations were analyzed by antioxidant capacity, vitamin C and in vitro bioaccessibility. All formulations showed a high content of vitamin C, antioxidant action and the bioaccessibility. All the formulations were accepted regarding the overall impression, except MM3 (murici pulp:mango pulp:honey 50:50:00 and 0.25% gellan gum) and PI1 (pitanga pulp: honey 90:10 and 0.6% gellan gum). Therefore, fruit pastes are options to encourage consumption of tropical fruits of agro-biodiversity in the Brazilian Northeast.

Introdução: As pessoas com doenças terminais estão frequentemente polimedicadas. Nos últimos meses de vida, alguns fármacos podem ser considerados inadequados. Este estudo pretende avaliar o impacto da intervenção de uma equipa de cuidados paliativos (CP) na desprescrição de fármacos potencialmente inadequados (FPI). Métodos: Estudo retrospectivo observacional, com adultos com sobrevida estimada inferior a 6 meses, referenciados a uma equipa domiciliária de CP em 2016. Quantificados os FPI e avaliada a desprescrição dos mesmos, nos 12 meses após início do seguimento pela equipa. Resultados: Incluídos 68 doentes, idade média 77 anos. Cinquenta e sete (83,8%) faziam FPI. O estado funcional não influenciou significativamente o número de FPI. Ocorreu desprescrição em 40% dos doentes. O número de consultas médicas presenciais de CP foi a única varíavel com relação estatisticamente significativa com a desprescrição (p = 0,004). Discussão: Verificou-se elevada prevalência de FPI nesta amostra, independente do estado funcional. Os dados deste estudo estão de acordo com a literatura científica actual, que sugere que uma percentagem significativa de doentes se encontra medicada com fármacos sem benefício comprovado nesta fase da vida. Conclusão: É fundamental rever a pertinência de toda a medicação dos doentes em fim de vida, pela elevada prevalência de FPI e suas consequências. A sua identificação e desprescrição são acções fundamentais, cuja implementação requer uma avaliação atempada por CP.

Introduction: People with terminal illnesses are often polymedicated. In the last months of life, some drugs may be considered inadequate. This study intends to evaluate the impact of the intervention of a palliative care (PC) team on the deprescription of potentially inappropriate drugs (PID). Methods: Retrospective observational study with adults with estimated survival of less than 6 months, followed by a PC team at home, in 2016. The PID were quantified and their deprescription was evaluated, during the first year of follow-up by the team. Results: Sixty-eight patients were included, with a mean age of 77 years. Fifty-seven (83.8%) were medicated with PID. Functional status did not influence the number of PID. Deprescription occurred in 40% of patients. The number of medical visits was the only variable with a statistically significant relation with the deprescription (p = 0.004). Discussion: There was a high prevalence of PID in this sample, regardless of functional status. The data from this study are in line with the current scientific literature, which suggests that a significant percentage of patients are medicated with drugs with no proven benefit at this stage. Conclusion: It is essential to review the relevance of all end-of-life patients' medication, due to the high prevalence of PID and its consequences. Their identification and deprescription are fundamental actions, whose implementation requires a timely evaluation by CP.

A paralisia periódica hipocaliémica é uma doença rara, causada por variantes em canais de cálcio ou sódio dependentes de voltagem. Caracteriza-se por episódios frequentes de fraqueza muscular associados a hipocaliémia, frequentemente despoletados por situações de stress físico ou emocional. Relatamos o caso de um adulto do sexo feminino que se apresentou com um quadro de tetraparésia flácida e hipocaliémia grave, cuja caracterização genética permitiu identificar uma nova variante no gene CACNA1S. Após o diagnóstico iniciou terapêutica com acetazolamida, com redução da frequência e intensidade das crises. A paralisia periódica hipocaliémica constitui uma causa rara de fraqueza muscular súbita. Pode evoluir com fraqueza dos músculos respiratórios ou mesmo arritmias cardíacas, pelo que deve ser reconhecida de forma célere pelos clínicos.

Hypokalemic periodic paralysis is a rare condition secondary to a genetic abnormality in calcium or sodium voltage dependent ion channels. It typically presents with muscle weakness and concomitant low serum concentration of potassium after exercise or emotional distress. We report the case of a woman who presented with flaccid tetraparesis and severe hypokalemia in which we have identified a novel probably disease-causing variant in the CACNA1S gene. After the diagnosis, the patient started acetazolamide treatment, resulting in a reduction in the intensity and number of episodes. Hypokalemic periodic paralysis is a rare cause of sudden muscle weakness. It may cause life-threatening respiratory involvement and cardiac arrhythmias, so all the clinicians should be aware of this condition in order to recognize it quickly.

Abstract Objective: The aim of this study was to analyze the influence of liver transplantation in food intake and nutritional status of severe cirrhotic patients. Methods: The sample consisted of 23 patients who underwent liver transplantation. Three 24-hour dietary recall were applied and anthropometric measurements were collected before and three months after transplantation. The consumption of macronutrients and fat soluble vitamins were also evaluated. The anthropometric data evaluated were body mass index, abdominal circumference, percentage of adequacy of arm circumference, triceps skinfold thickness and arm muscle circumference. Related mean comparison tests, comparison of changes in the proportions of categorical variables and correlation of quantitative variables were used in the statistical analysis. Data were considered to be significant when p < 0.05. Results: Most patients were female and aged between 40 and 65 years. The average consumption of calories, proteins, lipids, cholesterol and monounsaturated fatty acids was significantly higher after liver transplantation (p < 0.05). The average of anthropometric parameters did not differ significantly between the evaluated times. There was no significant change in nutrient intake or anthropometric classification after transplantation. Most patients were classified as malnourished or overweight after transplantation, according to some anthropometric parameters. Conclusion: Food consumption changed after transplantation. There was no change in the nutritional status from pre- to post-transplant but, in general, most patients had altered nutritional status in both evaluation moments.

Resumen Objetivo: el objetivo de este estudio fue hacer un análisis de las influencias del trasplante de hígado en el consumo alimentario y estado nutricional de pacientes cirróticos graves. Métodos: la muestra fue de 23 pacientes a los que se hizo trasplante de hígado. Se recopilan los datos antropométricos, además de tres recordatorios alimentarios de 24 horas antes y tres meses tras el trasplante. El consumo de macronutrientes y vitaminas liposolubles también fue evaluado. Los datos antropométricos evaluados fueron: índice de masa corporal, circunferencia abdominal, porcentual de adecuación del contorno de cintura, los pliegues cutáneos tricipital y de la circunferencia muscular del brazo. En el análisis estadístico se utilizaron tests de comparación de medias relacionadas, comparación de los cambios en las proporciones de las variables categóricas y la correlación de las variables cuantitativas. Los datos fueron considerados significativos cuando p < 0,05. Resultados: la mayoría de los pacientes estudiados eran del sexo femenino y con edad entre 40 y 65 años. El consumo medio de calorías, proteínas, lípidos, colesterol y ácido graso monoinsaturado fue significativamente mayor después del trasplante hepático (p < 0,05). La media de los parámetros antropométricos no difirió significativamente entre los momentos evaluados. No hubo cambio significativo en la ingestión de nutrientes y en la clasificación antropométrica después del trasplante. La mayoría de los pacientes fueron clasificados como desnutridos o con exceso de peso tras el trasplante, de acuerdo con algunos parámetros antropométricos. Conclusión: el consumo alimentario fue modificado después del trasplante. No hubo alteración del estado nutricional del preoperatorio comparado con el postoperatorio, pero de una forma general, la mayoría de los pacientes presentaron alteraciones de su estado nutricional en los dos momentos de la evaluación.

The Algarve Region (AR) in southern Portugal, which is an international tourist destination, has been considered an endemic region of zoonotic leishmaniasis caused by Leishmania infantum since the 1980s. In the present study, phlebotomine and canine surveys were conducted to identify sandfly blood meal sources and to update the occurrence of Leishmania infection in vectors and dogs. Four sandfly species were captured: Phlebotomus perniciosus, Phlebotomus ariasi, Phlebotomus sergenti and Sergentomyia minuta. In one P. perniciosus female, L. infantum DNA was detected. Blood meal tests showed that this species had no host preferences and was an opportunistic feeder. An overall canine leishmaniasis (CanL) seroprevalence of 16.06% was found; the seroprevalence was 3.88% in dogs housed in kennels and 40.63% in dogs that attended veterinary clinics. The simultaneous occurrence of dogs and P. perniciosus infected with L. infantum in the AR indicates that the region continues to be an endemic area for CanL. Our results reinforce the need for the systematic spatial distribution of phlebotomine populations and their Leishmania infection rates and the need to simultaneously perform pathogen monitoring in both invertebrate and vertebrate hosts to investigate the transmission, distribution and spreading of Leishmania infection.

Phlebotomine sandflies of the genus Sergentomyia are widely distributed throughout the Old World. It has been suggested that Sergentomyia spp are involved in the transmission of Leishmania in India and Africa, whereas Phlebotomus spp are thought to be the sole vectors of Leishmania in the Old World. In this study, Leishmania major DNA was detected in one Sergentomyia minuta specimen that was collected in the southern region of Portugal. This study challenges the dogma that Leishmania is exclusively transmitted by species of the genus Phlebotomus in the Old World.

O objetivo do presente trabalho foi avaliar a qualidade microbiológica de hortaliças orgânicas produzidas sob diferentes condições. Três espécies de vegetais, alface (Lactuva sativa), rabanete (Raphanus sativus) e espinafre (Tetragonia expansa), foram cultivadas no sistema orgânico, em solo fertilizado com seis tratamentos diferentes: adubo mineral, estercos de galinha, bovino e suíno, cama de frango e esterco bovino associado com biofertilizante líquido de aplicação foliar. O cultivo das hortaliças foi feito de acordo com as práticas agronômicas recomendadas para o sistema orgânico em escala comercial. Das hortaliças cultivadas, foram coletadas amostras para a determinação do Número Mais Provável de coliformes totais e termotolerantes e detecção da presença de Escherichia coli e Salmonella spp. Todas as amostras analisadas foram consideradas apropriadas para o consumo humano, de acordo com a legislação brasileira em vigor, uma vez que, em nenhuma delas foi detectada a presença de Salmonella spp. Entretanto, 63,3%, 50,0% e 23,3%, respectivamente, das amostras de alface, rabanete e espinafre apresentaram contagens de coliformes totais >100/g. Em nenhuma das amostras de rabanete e espinafre o nível de coliformes termotolerantes foi >100/g e em somente 6,6% das amostras de alface foi maior que 100/g. E. coli foi detectada em uma amostra de espinafre produzido em solo fertilizado com esterco bovino.

An attempt was made to evaluate microbiological quality of horticultural crops grown organically. Three species of vegetables were used, lettuce (Lactuva sativa), radish (Raphanus sativus) and spinach (Tetragonia expansa), grown organically, in fertile soil. Six different treatments were applied: mineral fertilizer, chicken, cow, and pig manure, chicken litter and cow manure, in association with a liquid foliar biofertilizer. These crops were handled according to correct agronomic practices for growing crops organically for commercial purposes. Samples were examined for the Most Probable Number (MPN/g/mL) of total and fecal coliforms and to detect the presence of Escherichia coli and Salmonella spp. All analyzed samples were considered acceptable for consumption, as Salmonella spp. was not detected. However, 63.3%, 50.0%, and 23.3% of the samples of lettuce, radish and spinach, respectively, contained >10² total coliforms/g of product. None of the samples of spinach or radish presented >10² fecal coliforms/g, and only 6.6% of lettuce samples contained >10² fecal coliforms/g. The presence of E. coli was confirmed in one sample of spinach, cultivated with cow manure.

This work aimed to study the T helper type 1/2 (Th1/Th2) cytokine profile in a co-infection murine model of Plasmodium chabaudi chabaudi and Leishmania infantum. Expression of interferon-gamma (IFN<FONT FACE=Symbol>-g</FONT>) and interleukin-4 (IL-4) was analyzed, in spleen and liver of C57BL/6 mice, by reverse transcriptase-polymerase chain reaction. High levels of IFN<FONT FACE=Symbol>-g</FONT> expression did not prevent the progression of Leishmania in co-infected mice and Leishmania infection did not interfere with the Th1/Th2 switch necessary for Plasmodium control. The presence of IL-4 at day 28 in co-infected mice, essential for Plasmodium elimination, was probably a key factor on the exacerbation of the Leishmania infection.