O soro de leite é uma importante fonte de proteínas. Porém, no Brasil ainda há um grande número de laticínios que realizam o descarte deste subproduto da fabricação de queijos, gerando assim, desperdícios e um problema socioambiental. A busca por novas aplicações ao soro de leite pode aumentar o uso potencial deste subproduto como ingrediente lácteo em diversos alimentos. Este trabalho teve como objetivo a hidrólise da lactose do concentrado proteico de soro de leite (CPS) para aplicação como ingrediente lácteo em iogurte cremoso para intolerantes à lactose. A metodologia de superfície de resposta foi utilizada para investigar o efeito de dois parâmetros (tempo e concentração de enzima) na hidrólise da lactose do CPS e do leite para produção de iogurte com redução de lactose. A experimentação teve como objetivo definir as faixas ótimas de operação para as variáveis do processo, visando à maximização da hidrólise da lactose. As condições ótimas para a hidrólise da lactose foram: para o CPS, concentração de enzima 0,22% por 1680 minutos e para o leite, 0,13% de enzima por 120 minutos. Depois de hidrolisado, o CPS foi submetido à secagem por atomização e apresentou os valores de lactose, glicose, galactose e proteínas iguais a 2,98; 19,41; 15,89 e 36,7g. 100 g-1 de amostra, respectivamente; 5,00% de umidade e 8,06% de cinzas. Após a hidrólise, as amostras de leite foram fortificadas com diferentes concentrações de CPS e leite em pó desnatado (LPD) para produção de iogurte cremoso. A amostra controle e as amostras fortificadas com 2 e 4% de CPS apresentaram os menores valores de lactose: 0,05; 0,09 e 0,13 g. 100 g-1 de iogurte, respectivamente. Foram realizadas análises microbiológicas e físico-químicas no CPS em pó e nas amostras de iogurtes, e ambos estavam dentro dos padrões da legislação vigente. A partir da pesquisa, verificou-se ser possível o uso potencial do CPS hidrolisado na produção de iogurte com baixo teor de lactose, beneficiando os intolerantes à lactose, à indústria e o meio ambiente.

nÃo hà / IntroduÃÃo. A intolerÃncia à lactose à uma sÃndrome clÃnica composta por um ou mais cortejos sintomatolÃgicos associados à ingestÃo de lÃcteos (fenÃtipo clÃnico intolerante) e tolerÃncia à lactose na ausÃncia desses sintomas (fenÃtipo clÃnico tolerante). Assim, na prÃtica clÃnica, deve-se estar atento aos casos semelhantes a essa sintomatologia disabsortiva, pois as convergÃncias e diferenÃas entre esses distÃrbios sÃo tÃnues e os diagnÃsticos muitas vezes sÃo imprecisos, tornando o tratamento e a conduta insatisfatÃrios. Portanto, sÃo necessÃrios estudos que utilizem diferentes mÃtodos diagnÃsticos, assim como comparar os diferentes mÃtodos utilizados na prÃtica clÃnica e averiguar o mais apropriado para dar o diagnÃstico conclusivo, uma vez que nem sempre à fÃcil, haja vista que os sintomas sugerem outras doenÃas. Objetivo. Avaliar as caracterÃsticas fenotÃpicas, a resposta ao teste quÃmico de tolerÃncia à lactose e genÃtipo de pacientes com hipÃtese diagnÃstica de intolerÃncia à lactose e a correlaÃÃo entre eles. Material e mÃtodos. Foi realizado um estudo transversal no Hospital UniversitÃrio Walter CantÃdio (HUWC), com 173 pacientes que apresentavam fenÃtipo positivo e foram atendidos no serviÃo do ambulatÃrio dos servidores do HUWC, no perÃodo de janeiro a agosto de 2010. A amostra final foi composta por 119 pacientes que realizaram o teste de tolerÃncia à lactose e genotipagem do gene da florizina-lactase hidrolase (LPH). Resultados. Dentre os participantes, a maioria era: do sexo feminino, 54,6% (65 casos); da faixa etÃria de 46-55 anos, 26,5% (32 casos); casada, 65,6% (78 casos); de cor parda, 53,8% (65 casos); de nÃvel superior, 42,9% (51 casos). A prevalÃncia de intolerÃncia à lactose foi de 45,4% e a de intolerÃncia quÃmica foi de 73,9%. Os sintomas investigados que apresentaram maior prevalÃncia no intolerante à lactose foram: flatulÃncia, 81,4% (44 casos); empachamento, 68,5% (37casos); borborigmo, 59,3% (32 casos); e diarreia, 46,3% (25 casos). A presenÃa dospolimorfismos C>T-13910 e polimorfismos G>A-22018 no gene da LPH foi identificada nos indivÃduos autorreferidos como intolerantes à lactose, sendo, portanto, um excelente exame para o diagnÃstico. O diagnÃstico de intolerÃncia à lactose que mais se apresentou adequado foi a diferenÃa basal <15 com a curva de ROC maior que 80,3%, com boa sensibilidade e especificidade. ConclusÃes. Observa-se uma correlaÃÃo genotÃpica e quÃmica entre os indivÃduos intolerantes, sugerindo que o teste molecular poderia ser proposto para o diagnÃstico laboratorial de intolerÃncia à lactose, e, no teste quÃmico, a diferenÃa basal <15 foi a mais adequada. / Introduction. Intolerance to lactose is a clinical syndrome comprising one or more corteges symptomatology associated with the ingestion of milk (clinical phenotype intolerant) and lactose tolerance in the absence of symptoms (clinical phenotype tolerant). Thus, in practice, must be attentive to cases similar to these badly absorptive symptoms because the convergences and differences between these disorders are tenuous and diagnoses are often inaccurate, making treatment and unsatisfactory conduct. Therefore, studies are needed using different diagnostic methods, and compare the different methods used in clinical practice and determine the most appropriate to give a conclusive diagnosis, since it is not always easy, given that the symptoms suggest other diseases. Objective.To evaluate the phenotypic characteristics, the response to chemical test for lactose tolerance and the genotype of patients with diagnostic hypothesis of intolerance to lactose and the correlation between them.Material and methods. We conducted a cross-sectional study at the University Hospital Walter Cantidio (HUWC), with 173 patients who had positive phenotype and were seen at the outpatient service of servers HUWC, from January to August 2010. The final sample consisted of 119 patients who underwent the lactose tolerance test and genotyping of the gene for lactase-phlorizin hydrolase (LPH). Results. Among the participants, most were: female, 54.6% (65 cases), the age group of 46-55 years old, 26.5% (32 cases); married, 65.6% (78 cases); dun-colored, 53.8% (65 cases); higher level, 42.9% (51 cases). The prevalence of intolerance to lactose was 45.4% and chemical intolerance was 73.9%. Symptoms investigated more prevalent in lactose intolerant were flatulence 81.4% (44 cases); bloating, 68.5% (37casos); borborygmus, 59.3% (32 cases) and diarrhea, 46, 3% (25 cases). The presence of the polymorphisms C> T polymorphisms and 13 910-G> A-22018 in LPH gene was identified in individuals selfreferred as lactose intolerant, and is therefore an excellent test for the diagnosis. The diagnosis of lactose intolerance that most had adequate baseline the difference was <15 with ROC curve greater than 80.3%, with good sensitivity and specificity. Conclusions. There is a correlation between genotype and chemical intolerant individuals, suggesting that the molecular test could be proposed for the laboratory diagnosis of lactose intolerance, and the chemical test, the difference basal <15 was more appropriate.

Análises sobre a sustentabilidade intertemporal da dívida pública nos países emergentes ganham cada vez mais importância no debate econômico internacional devido à sua importância na avaliação das políticas macroeconômicas desses países. Depois da reforma monetária de junho de 1994 que deu fim ao processo hiperinflacionário, a economia brasileira obteve como sub-produto a exposição de um grave desequilíbrio fiscal, em que a razão dívida/PIB passou a apresentar uma trajetória monotonicamente crescente, ultrapassando a marca de 50%, nível considerado extremante perigoso para um país emergente que se defronta com a intolerância da dívida. O presente estudo tem como objetivo estimar uma função de reação da política fiscal no Brasil para o período pós-Real, quantificando a relação entre o resultado primário do setor público consolidado, o comportamento da razão dívida/PIB, as instituições e a intolerância da dívida, bem como avaliar a ciclicidade da política fiscal no Brasil. Além disso, realiza-se um teste de raiz unitária com quebra endógena da razão dívida líquida/PIB descontada bem como testes de cointegração a fim de avaliar a hipótese de spend and tax da política fiscal brasileira no período em questão. Dentre as conclusões que foram extraídas deste estudo, destacam-se as evidências de que a política fiscal se comportou de maneira insustentável após a reforma de 1994, sendo marcado pela indisciplina fiscal, em que a receita foi a variável endógena do regime fiscal, caracterizado esse por um sistema spend and tax. / Analyses of the sustainability of public debt across time in emerging countries are increasingly gaining in importance in the international economic debate, due to their importance for the evaluation of the macroeconomic policies of these countries. Following the June 1994 monetary reform that did away with hyperinflation, a major fiscal imbalance came to light in the Brazilian economy as a sub-product, with the debt/GDP ratio following a monotonically rising path and exceeding the 50% level. This is considered extremely dangerous for an emerging nation that is faced with debt intolerance. The aim of this study is to estimate a reaction function regarding Brazils fiscal policy for the post-Real period, quantifying the relation between the consolidated public sectors primary results, the behavior of the debt/GDP ratio, institutions and debt intolerance, as well as evaluating the cyclical aspects of fiscal policies in Brazil. Additionally, a unit root test was carried out, with endogenous breakdown of the discounted net debt/GDP ratio, as well as co-integration tests, in order to evaluate the spend and tax hypothesis of Brazilian fiscal policy during the period in question. One of the prominent conclusions of this study is that the fiscal policy behaved in a unsustainable manner after the 1994 reform, and underscored by fiscal indiscipline, with revenue being the endogenous variable of the fiscal regime, characterized by a spend and tax system.

INTRODUCTION: Celiac disease (CD), an inflammatory condition of the small bowel, is now recognized as the most common of the autoimmune disorders (Kenrick & Day, 2014). Unfortunately, due to poor awareness among primary care providers (PCPs) this disease remains highly underdiagnosed despite its increasing prevalence (Catassi & Fasano, 2008). Aims of this quality improvement project were to examine current knowledge and practices of nurse practitioners in the primary care setting that influence the screening and diagnosis of CD. METHODS: A 32-item survey was sent out to nurse practitioner primary care providers (NP- PCPs) in the Dallas-Fort Worth Metroplex over a four-week period. The survey assessed demographic characteristics, knowledge and clinical practices of nurse practitioners as it relates to CD diagnosis. Data was analyzed using SPSS and descriptive statistics. RESULTS: Eighteen valid responses were received for analysis. The majority of respondents reported having no familiarity with the American College of Gastroenterology (ACG) and National Institute for Health and Care Excellence (NICE) guidelines. Two thirds of the respondents reported their education did not properly prepare them to accurately diagnose celiac disease. The vast majority also reported they do not test patients, pediatric or adult, using any celiac related blood test. The same results were true for patients being sent for intestinal biopsy. Although able to list typical symptoms of CD, many respondents were unaware of atypical symptoms. Most also omitted family history as important when considering celiac related testing. CONCLUSIONS: Overall NP-PCPs are not aware of and therefore do not follow clinical guidelines related celiac disease. It is clear that NP-PCPs need to be made aware of the prevalence of this disease and should be directed to follow evidence-based practice guidelines in their primary care practices. One step for doing this includes providing better education for NP- PCP students. Educators should include lectures or discussions about CD in their curriculum and provide students with resources such as the NICE and ACG guidelines. For practicing NPs, free continuing education can be offered. Lastly, clinicians who are aware of the high rates of underdiagnosis can present CD related information at conferences and meetings.

Over the past forty years, there has been an increase in obesity, diabetes, and heart disease, collectively known as metabolic syndrome (MetS), in which fructose has been implicated. In addition to MetS, hereditary fructose intolerance (HFI) has no known treatment aside from the difficult removal of fructose from the diet. Ketohexokinase (KHK) is the first enzyme in the fructose metabolic pathway and catalyzes an ATP-dependent reaction that phosphorylates fructose to fructose 1-phosphate. For effective inhibitor development, it is key to understand the KHK-catalytic mechanism. To that end, the research described in this thesis focuses on two goals: 1) understanding how KHK functions in its role as a metabolic enzyme, using structure-function analysis to inform the development of KHK inhibitors, and 2) investigating how these findings can be used to make KHK a prime therapeutic target for alleviating diseases such as HFI and MetS. The X-ray crystal structure of the mouse-liver isozyme, KHK-C (mKHK-C), was determined at a resolution of 1.79 Å. The mKHK-C structure is in complex with the substrate fructose and the product of catalysis, ADP, forming a ground-state complex. The mKHK-C structure has nearly identical secondary structure to its human homolog and has similar steady-state kinetic parameters validating the use of mouse models for exploring the pre-clinical efficacy of KHK-C inhibitors. Furthermore, six structures of human KHK-C in complex with inhibitors and ligands are presented. These structures support the kinetic analyses showing these inhibitors are all competitive with ATP and reveal the shape and polarity of the ATP-binding pocket to achieve inhibition constants (Ki) as low as 50 nM. Lastly, comparison of all KHK structures demonstrate that the β-sheet domain of KHK is capable of 30.3° rotation of the β-sheet domain towards the active site of the opposing dimer subunit. Kinetic experiments using site-directed mutants of human KHK-C and various viscogens confirmed that a conformational change is linked to KHK’s catalytic function. This research provides a foundation for further development of more specific KHK inhibitors aimed at HFI and MetS therapies. / 2022-10-30T00:00:00Z

Several models of anxiety in autistic adults have focused on the role of intolerance of uncertainty which has biological and evolutionary bases, as a cognitive explanation for the high prevalence of anxiety in autism. This framework suggests that all people are born with a healthy level of intolerance of uncertainty, and as we develop, this intolerance is lessened as we learn when situations are safe and begin to understand and manage the uncertainty. This process of learning about managing uncertainty does not happen in the same way in those who are high in autistic traits, which could be the reason for the high levels of anxiety symptoms commonly seen in this population. We conducted two path analyses to examine the role of intolerance of uncertainty in anxiety in autistic adults. The first model tested the idea that intolerance of uncertainty, an evolutionary phenomenon common for all people, could explain some of the cognitive aspects of anxiety in autism. The second model suggests that primary neurodevelopmental differences associated with autistic traits underlie the sensory sensitivity and sensory seeking behaviors, which in turn increase intolerance of uncertainty and subsequent anxiety. We found that the “neurodevelopmental” model had better model fit than the “evolutionary stress” model, suggesting that the neurodevelopmental impact of higher levels of autistic traits could moderate a neurotypical trajectory of learning to manage uncertainty as children develop and understand that uncertainty is common and acceptable.

Sensory processing challenges are common and often difficult for children on the autism spectrum and can affect some neurotypical children. Furthermore, sensory processing atypicalities are associated with autistic traits and other co-occurring behaviors associated with autism, such as intolerance of uncertainty. As such, traits common to autism may vary continuously across diagnostic boundaries (i.e., Broad Autism Phenotype). Working to uncover behavioral and neurophysiologic correlates of sensory differences could positively impact clinical support of children with and without a diagnosis of autism. Therefore, this study examined relationships between sensory processing, intolerance of uncertainty (a possible measure of prediction), autistic traits, and associated resting state brain connectivity, in autistic (n=30) and neurotypical (NT; n=26) children ages 6-11. To this end, we calculated the relationships between behavioral scores on measures related to sensory processing, intolerance of uncertainty, and autistic traits. Also, we carried out independent component network functional connectivity analysis to investigate associations between cortical and cerebellar networks and behavioral results. Autistic participants presented with significant correlations of sensory processing with autistic traits and sensory processing with intolerance of uncertainty. Neurotypical participants presented with significant correlations of autistic traits with sensory processing and autistic traits with intolerance of uncertainty. Between groups correlations demonstrated sensory processing and intolerance of uncertainty scores overlapping and spanning the groups. Brain (rs-fMRI)--behavioral relationships regarding the above were also examined revealing strong associations between sensory and cerebellar networks and behavioral scores. Overall, our findings suggest that sensory differences may be related to altered prediction abilities and, in NT children, autistic traits. Neurophysiologic data pointed to abnormal functional connectivity between sensory cortices and the cerebellum in autistic children. These findings provide evidence for the notion of the BAP and suggest a role of prediction in sensory processing and its behavioral correlates.

Children diagnosed with Autism Spectrum Disorder (ASD) are known to experience higher levels of sensory processing differences as well as anxiety, compared to the neurotypical population (NT). Both theory and evidence suggest that there is an interrelationship between sensory processing, anxiety and fear, and prediction abilities in autism. However, much more remains to be discovered about their relationship and especially underlying neural mechanisms. Thus, the purpose of the current study was to examine the behavioral relationship between sensory processing, fear and anxiety, prediction, and related brain activity in autistic children. To this end, 30 autistic children (ages 6-11 years) and 25 age-matched peers participated in a resting-state fMRI as well as various behavioral assessments of sensory processing, anxiety, fear, and intolerance of uncertainty (i.e., as an indirect measure of prediction). Between groups comparisons showed higher levels of sensory processing difference, fear/anxiety, sensory processing differences, and intolerance of uncertainty in autistic children when compared to NT controls. Among autistic children, a mediation analysis also revealed that intolerance of uncertainty was a significant mediator between sensory processing differences and both anxiety and fear, supporting past research and suggesting a role of prediction in this relationship. Network connectivity findings showed that cerebellar, higher order sensory, and limbic regions were significantly correlated with anxiety, sensory processing, and intolerance of uncertainty. These results add information concerning the neurophysiologic underpinnings of anxiety/fear, sensory processing, and prediction to prior research focusing on behavioral relationships between these constructs. These results have the potential to inform future clinical practice, demonstrating the need for a predictable clinical environment as well as thorough explanation of expected tasks for autistic children who experience sensory processing differences and resulting anxiety. Finally, these findings may suggest that addressing sensory and prediction difficulties has the potential to lead to improvements in anxiety in children with ASD. Addressing these issues through both neurological and/or therapeutic means may be possible in the future.

No description available.

Sound intolerance affects a large part of the population and thus contributes to increased ill health in society. However, the extent to which and in what way sound intolerant is affected is unclear. The ​purpose​ was to contribute to a more qualitative understanding of the impact that sound intolerance can have by mapping and analyzing literature on sound intolerance in a perspective of Empowerment. The ​method​ used was a scoping study. In total, n = 24 studies were reviewed and n = 10 were included for an in-depth qualitative analysis. The results​ show that there are studies that describe that sound intolerance has an impact on Empowerment, but that none of the studies examined have such a pronounced focus. Sound intolerance seems in many respects to be a hidden or unconscious phenomenon and there is reason to work for higher knowledge and awareness to strengthen the sound intolerant's Empowerment. / Ljudintolerans drabbar en stor del av befolkning och bidrar således till ökad ohälsa isamhället. I vilken utsträckning och på vilket sätt ljudintoleranta påverkas är dock oklart.Syftet var att bidra till en mer kvalitativ förståelse för den påverkan ljudintolerans kan hagenom att kartlägga- och analysera litteratur om ljudintolerans i ett perspektiv avEmpowerment. Metoden som användes var en kartläggande litteraturöversikt. Totaltgranskades n=24 studier och n=10 inkluderades för en fördjupad kvalitativ analys.Resultatet visar att det finns studier som beskriver att ljudintolerans har en påverkan påljudintolerantas Empowerment men att inga av de granskade studierna har ett sådant uttalatfokus. Ljudintolerans förefaller i många avseende vara ett dolt eller omedvetet fenomenoch det finns anledning att arbeta för högre kunskap och medvetenhet för att stärkaljudintolerantas Empowerment.