Rio de Janeiro State University

About: Rio de Janeiro State University is a education organization based out in Rio de Janeiro, Brazil. It is known for research contribution in the topics: Population & Large Hadron Collider. The organization has 16631 authors who have published 30919 publications receiving 465753 citations. The organization is also known as: UERJ & Rio de Janeiro State University.

Treat-to-target (T2T) recommendations for gout

Abstract: Objectives The treat-to-target (T2T) concept has been applied successfully in several inflammatory rheumatic diseases. Gout is a chronic disease with a high burden of pain and inflammation. Because the pathogenesis of gout is strongly related to serum urate levels, gout may be an ideal disease in which to apply a T2T approach. Our aim was to develop international T2T recommendations for patients with gout. Methods A committee of experts with experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. Eleven rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient met in October 2015 to develop T2T recommendations based on the available scientific evidence. Levels of evidence, strength of recommendations and levels of agreement were derived. Results Although no randomised trial was identified in which a comparison with standard treatment or an evaluation of a T2T approach had been performed in patients with gout, indirect evidence was provided to focus on targets such as normalisation of serum urate levels. The expert group developed four overarching principles and nine T2T recommendations. They considered dissolution of crystals and prevention of flares to be fundamental; patient education, ensuring adherence to medications and monitoring of serum urate levels were also considered to be of major importance. Conclusions This is the first application of the T2T approach developed for gout. Since no publication reports a trial comparing treatment strategies for gout, highly credible overarching principles and level D expert recommendations were created and agreed upon.

Reprodutibilidade e validade relativa do Questionário de Frequência Alimentar do ELSA-Brasil

Abstract: This study evaluated the reproducibility and relative validity of the Food Frequency Questionnaire (FFQ) used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (n = 281) completed the FFQ and three food records on two occasions during a 12-month period. Energy and nutrient values from food records were disattenuated and log-transformed. Reproducibility and validity were assessed by the intra-class correlation coefficient (ICC). Agreement between the two methods was evaluated by classification in tertiles. In the evaluation of reproducibility, ICC estimated ranged from 0.55 to 0.83 for protein and vitamin E, respectively. On relative validity, ICC ranged from 0.20 to 0.72 for selenium and calcium, respectively. Exact and adjacent agreement between methods varied from 82.9% for vitamin E to 89% for lipids and calcium (mean 86%). Average disagreement was 13.6%. In conclusion, this FFQ showed satisfactory reliability for all nutrients and reasonable validity, especially for energy, macronutrients, calcium, potassium, and vitamins E and C.

A utilização da fitoterapia e de plantas medicinais em unidades básicas de saúde nos municípios de Cascavel e Foz do Iguaçu - Paraná: a visão dos profissionais de saúde

Abstract: Phytotherapy and the use of medicinal plants are part of the practice of folk medicine, which complements treatment traditionally employed for the lower income population. This work analyzed the knowledge of health managers and professionals who work in primary health care (PHC) about phytotherapy in the cities of Cascavel and Foz do Iguacu in the State of Parana. An exploratory, descriptive, and qualitative study using a structured questionnaire was conducted between February and July 2009. A health manager manifested interest in introducing the program. The other professionals interviewed did not receive training during undergraduate studies or within the Basic Health Units (BHU) where they work. Six professionals (60%) reported having access to information on phytoterapy through folk wisdom, one (10%) via training in a BHU, two (20%) from journals, four (40%) from the media and four mentioned more than one source. In Foz do Iguacu, in the BHU where the therapy is deployed, the professionals were not consulted before its implementation. To include phytotherapy in the BHUs of these two cities, it is necessary to train the professionals on the topic, including cultivation and prescription, thereby enhancing the rational use of these medicines.

Neonatal programming of body weight regulation and energetic metabolism.

Abstract: Programming is an epigenetic phenomena by which nutritional, hormonal, physical psychological and other stressful events acting in a critical period of life, such as gestation and lactation, modifies in a prolonged way certain physiological functions. This process was preserved by natural selection as an important adaptive tool for survival of organisms living in nutritional impaired areas. So, malnutrition during gestation and lactation turns on different genes that provide the organism with a thrifty phenotype. In the case of an abundant supply of nutrients after this period, those organisms that were adapted to a low metabolic waste and higher energy utilization will be in a higher risk of developing metabolic diseases, such as obesity, hyperlipidemia, diabetes mellitus and hypertension. The kind of malnutrition, duration and intensity are important for the type of programming obtained. We discuss some of the hormonal and metabolic changes that occur in gestation or lactation, when malnutrition is applied to the mothers and their offspring. Some of these changes, such as an increase of maternal triiodothyronine (T3), leptin and glucocorticoids (GC) and decrease in prolactin are by itself potential programming factors. Most of these hormones can be transfer through the milk that has other important macronutrients composition changes in malnourished dams. We discuss the programming effects of some of these hormones upon body weight and composition, leptin, thyroid and adrenal functions, and their effects on liver, muscle and adipose tissue metabolism and the consequences on thermogenesis.