Diet and mortality from common cancers in Brazil: an ecological study

A prospective ecological evaluation of mortality from common malignancies with dietary risk factors and alcohol consumption was carried out among 10 state capitals of Brazil. Regression analysis was used to examine the association of dietary intake with mortality rates of the most common cancers among adults age 30 years and older. Age-adjusted cancer mortality rates varied 2.4 to 3.3 fold across the state capitals. A positive relationship was observed between energy intake and colon, lung, and esophageal cancer (p相似文献   

Intraspecific variation of second internal transcribed spacer of nuclear ribosomal DNA among populations of Anopheles (Kerteszia) cruzii (Diptera: Culicidae)

Anopheline species of the subgenus Kerteszia, including Anopheles (Kerteszia) cruzii Dyar & Knab (Diptera: Culicidae), are bromeliad-malaria vectors in the Atlantic rain forest of Brazil. Morphological, genetic, and molecular polymorphisms among different populations of An. cruzii have been reported, and it has been suggested that this taxon includes a complex of cryptic species. Specimens of An. cruzii were collected in the states of SHo Paulo and Santa Catarina, from locations where autochthonous malaria cases have been reported during the last decade. The second internal transcribed spacers (ITS2) of nuclear ribosomal DNA of the captured specimens were sequenced and compared with each other. Intraspecific ITS2 sequence polymorphisms were identified, and nucleotide divergence among specimens varied from 0.3 to 0.9%. The number of nucleotides in the ITS2 sequences of these mosquitoes varied from 327 to 334, and the CG contents varied from 61.7 to 62%. The data provide further indication of An. cruzii being a complex of cryptic species.     

Trophic control of cholinesterase activity in a testosterone-dependent muscle of the rat: Effects of castration and denervation

The effects of testosterone withdrawal and chronic denervation on muscle weight and acetylcholinesterase (AChE) activity were studied in the hormone-sensitive levator ani muscle of the rat. Castration of adult male rats for 7 to 60 days caused a linear decrease of the weight, protein content, and AChE activity of the muscle, which stabilized after 30 days. Muscle weight and protein content decreased 2.3% per day. The total AChE activity decreased 7 days later 3.2% per day, reaching 37% of control at day 30. AChE activity per unit weight was increased in all castrated groups. Muscle weights and AChE activity of the extensor digitorum longus and soleus muscles were not altered after castration. Denervation of all three muscles caused 50% reduction of the muscle weight and protein content after 15 days. Total AChE activity decayed exponentially with a rate of 0.12 per day to 15 to 18% of control values. AChE activity per unit weight in the denervated muscles was always lower than in the control muscles. Combined castration and denervation intensified only the levator ani protein loss. The different onset and time course of the effects induced by castration and denervation indicate distinct mechanisms involved in the trophic control of muscle proteins and AChE activity. Chronic muscle denervation decreased total AChE activity to 15% of normal, whereas castration reduced the enzyme to 40% of the control values. The results indicate that neuronal and hormonal influences on AChE activity of the levator ani are not additive but overlap.     

Predictive Validity of the RIASI: Alcohol and Drug Use and Problems Six Months Following Remedial Program Participation

The ability of screening instruments for convicted drinking drivers to predict subsequent alcohol and drug-related problems rarely has been studied. The predictive validity of the Research Institute on Addictions Self-Inventory (RIASI) was investigated in a sample of 6,003 convicted drinking drivers who were participating in Back on Track (BOT), Ontario's remedial measures program for convicted drinking drivers. All BOT participants complete an assessment (which includes the RIASI), followed by a brief education or treatment program, and concluded 6 months later by a follow-up interview. The follow-up interview collects information on self-reported alcohol and other drug use and problems, and contacts with other health care providers in the 90 days prior to the follow-up contact. The ability of scores on the RIASI to predict these measures was assessed. The results revealed that, for almost all comparisons, individuals who used alcohol and other drugs, reported more substance-related problems at follow-up, and reported more contacts with other health and addictions providers had significantly higher scores on the RIASI total score and the RIASI recidivism scale at the initial assessment. The data indicate that this instrument appears to be able to identify individuals who will experience alcohol and drug related problems in the future.     

A randomized, double-blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder

BACKGROUND: Although antidepressants are the pharmacological agents most often studied in the treatment of binge-eating disorder (BED), preliminary evidence from an open trial suggests that the antiobesity agent sibutramine hydrochloride may be effective. The objective of this study was to evaluate the efficacy and tolerability of sibutramine in obese patients with BED. METHODS: After a 2-week run-in period, 60 obese outpatients (body mass index [calculated as weight in kilograms divided by the square of height in meters] 30-45), who met DSM-IV criteria for BED were randomly assigned to receive sibutramine hydrochloride (n = 30), 15 mg/d, or placebo (n = 30) in a 12-week double-blind study at 2 centers. The primary outcome measure was binge frequency, expressed as the number of days with binge-eating episodes during the past week. Secondary outcome measures included Binge Eating Scale, Beck Depression Inventory scores, weight, and treatment responder status (remission and response). For each efficacy outcome, an intent-to-treat analysis was performed using random regression methods. RESULTS: There was a significant reduction in the number of days with binge episodes in the sibutramine group compared with the placebo group (t203 = 2.14; P =.03); this was associated with an important and significant weight loss (-7.4 kg) compared with a small weight gain in the placebo group (1.4 kg) (t147 = 4.88; P<.001). Sibutramine was also associated with a significantly greater rate of reduction in Binge Eating Scale (t202 = 3.64; P<.001) and Beck Depression Inventory (t201 = 3.72; P<.001) scores. Dry mouth (P =.01) and constipation (P<.001) were more common adverse reactions with sibutramine than placebo. CONCLUSIONS: Sibutramine is effective and well tolerated in the treatment of obese patients with BED. Its effects address 3 main domains of the BED syndrome, ie, binge eating, weight, and related depressive symptoms.     

Paracoccidioidomycosis mortality in Brazil (1980-1995)

This study analyzes 3,181 deaths from paracoccidioidomycosis in Brazil, based on 16 years of sequential data (from 1980 to 1995). During this period paracoccidioidomycosis showed considerable magnitude and low visibility, representing the eighth most common cause of death from predominantly chronic or recurrent types of infectious and parasitic diseases. It also had the highest mortality rate among the systemic mycoses. The mean annual mortality rate was 1.45 per million inhabitants, indicating a downward long-term trend (reduction of 31.28%), while spatial distribution among the different regions and States of Brazil was non-homogenous. The South (with the highest regional rate) and the Southeast showed a downward trend, while the Central West had the second highest rate in the country. At least one-fifth of Brazilian municipalities (or 22.71% of the country's total area) reported deaths from paracoccidioidomycosis. Overall nationwide mortality per area was 3.73/10,000km2. The disease was endemic in non-metropolitan areas. The majority of deaths occurred in males (84.75%), and there was a sex ratio of 562 men/100 women. The 30-59-year and over-60-year age groups were the most affected. The study showed that the mortality rate justifies classifying this disease as a major health problem in Brazil.     

Early postnatal growth in preterm infants and cord blood leptin.

Although circulating leptin and insulin concentration is linked to intrauterine growth, fetal development and birth weight in full-term infants, there has been no enquiry into the influence of cord blood insulin and leptin for catch-up growth in preterm infants. The study evaluated the association of cord blood leptin with growth and weight gain of 96 premature babies during 6 months (corrected age). The temporal changes of anthropometric indexes over this period were calculated by repeated random regression (PROC MIXED) using SAS. Cord blood leptin was negatively associated with the rate of change in BMI (p=0.01) and length (p<0.001), from birth until 64 postnatal weeks. Insulin was positively associated with the change rate in BMI (p=0.03); however, this disappeared when adjusted for birth weight. For the first time, the association between lower leptin levels with greater catch up growth is shown for both BMI and length among preterm children. In conclusion, leptin levels at birth, but not insulin levels, predict growth rates.     

Household food availability in Brazil: distribution and trends (1974-2003)

OBJECTIVE: Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003. METHODS: The study uses data from the "Pesquisa de Or?amento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables. RESULTS: Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. CONCLUSIONS: Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.     

Household smoking and stunting for children under five years

Maternal tobacco use during pregnancy is one of the most important factors for low birth weight and length. However, postnatal exposure to environmental tobacco smoke has not been explored in children's growth studies. It is known that smoking is more prevalent in low socioeconomic groups and that stunting is also associated with socioeconomic variables. The objective of this study was to verify the effect of socioeconomic variables and environmental tobacco smoke on growth. Children under five years (n = 2,037) attending a primary health care clinic had their weight and stature measured, and a questionnaire on exposure to household passive smoking and socio-demographic characteristics was applied to parents. Prevalence of stunting (defined as a z-score lower than -2) was 4.3%. There was a negative association between stature and smoking during pregnancy, and positive associations with socioeconomic levels, family income, and parents' education. Linear hierarchical regression analysis showed that maternal and paternal smoking remains associated with low stature even after adjusting for maternal smoking during pregnancy and for socio-demographic variables.