Este trabalho avaliou a reparação e indicadores de desnutrição de ratos submetidos à fratura unilateral de côndilo mandibular e com desnutrição protéica (8% de proteína com suplemento de vitaminas e minerais). Foram utilizados 45 Rattus norvegicus Wistar, adultos machos, distribuídos em 3 grupos de 15 animais: grupo fraturado, submetido à fratura de côndilo, sem alteração de dieta (23% de proteínas); grupo fraturado desnutrido, submetido à dieta hipoprotéica por 30 dias e posterior fratura condilar; grupo desnutrido, com dieta hipoprotéica prévia por 30 dias e mantida até o final do experimento, sem fratura de côndilo. Foi documentada a quantidade de ingestão de ração e água, feita a avaliação do peso e obtido o coeficiente de eficácia alimentar (CEA). Os animais foram sacrificados nos períodos de 24 horas e 7, 15, 30 e 90 dias pós-operatório. Foram realizados os seguintes testes bioquímicos do sangue: proteínas totais, albumina sérica, cálcio sérico, fosfatase alcalina, ferro sérico e creatinina sérica; e o leucograma. A seguir, foram feitas mensurações cefalométicas por radiografias da maxila e da mandíbula. O estudo histológico compreendeu a avaliação do local da fratura e da articulação temporomandibular. Os valores numéricos foram submetidos a análises estatísticas. O consumo de ração e água foi maior no grupo fraturado desnutrido, na maioria dos períodos. Os valores do CEA foram baixos principalmente nos períodos iniciais, sendo mais significativos para o grupo fraturado desnutrido. Houve pouco ganho de peso nos períodos iniciais, exceto no grupo fraturado desnutrido que apresentou perdas significativas, havendo recuperação de peso nos demais períodos, significativamente menor neste grupo. Os testes de bioquímica do sangue mostraram queda, principalmente nos períodos iniciais, para os valores de proteínas totais e albumina, bem como para cálcio sérico em todos os períodos, significante para o grupo fraturado desnutrido. O leucograma mostrou aumento, principalmente nos períodos iniciais, de leucócitos, linfócitos e neutrófilos, mais significativo no grupo fraturado desnutrido. Houve desvio da linha média mandibular em relação à linha média maxilar, significante para o grupo fraturado desnutrido, bem como assimetria de maxila e mandíbula, em especial no período final do experimento. A análise histológica mostrou que a desnutrição protéica levou à atrofia da fibrocartilagem do côndilo. A fratura sob desnutrição comprometeu a formação do calo ósseo, bem como houve anquilose fibrosa. Foi concluído que a fratura de côndilo mandibular em ratos com desnutrição protéica promoveu alterações negativas nos valores de proteínas totais, albumina e cálcio sérico, leucocitose, bem como comprometeu a formação do calo ósseo e induziu atrofia da fibrocartilagem e anquilose fibrosa. / This study evaluated the healing and undernutrition indicatives of rats submitted to mandibular condyle fracture and with protein undernutrition (8% of protein with vitamin and minerals supplement). Forty-five adult male Wistar Rattus norvegicus were used and distributed in 3 groups of 15 animals: fracture group, submitted to condylar fracture with no changes in diet (23% of proteins); undernutrition fracture group, submitted to hypoproteic diet by 30 days and later to condylar fracture; undernutrition group, with previous hypoproteic diet by 30 days, kept until the end of experiment, without condylar fracture. The amounts of feed and water intake were registered, as well as body weight and food efficiency ratio (FER) were obtained. Animals were sacrificed at 24 hours and 7, 15, 30 and 90 days postoperatively. The following blood biochemical tests were made: total serum proteins, serum albumin, serum calcium, alkaline phosphatase, serum iron, and serum creatinine; and also white blood count. Subsequently, cephalometric mensurations by radiograms of the maxilla and mandible were made. Histological study comprised fracture site and temporomandibular joint evaluations. Numerical values were submitted to statistical analyses. Feed and water intake were higher in undernutrition fracture group, in most of periods. Values of FER were low, in special in the initial periods, being more significative to undernutrition fracture group. There was low gain of weight in the initial periods, but undernutrition fracture group which presented significative loss of weight, with recovering of weight in the remaining periods, significatively lower in this group. Blood biochemical tests showed decrease, mainly in the initial periods, of the values of total serum proteins and serum albumin, as well as serum calcium in all the periods, significative to undernutrition fracture group. White blood count showed increase, in special in the initial periods, of leukocytes, lymphocytes and neutrophils, more significative in undernutrition fracture group. There was deviation of the median line of the mandible relative to the median line of the maxilla, significative to undernutrition fracture group, as well as asymmetry of the maxilla and mandible, in special in the final period of experiment. Histological analysis showed that proteic undernutrition lead to atrophy of condylar fibrocartilage. Fracture in undernutrition impaired callus formation, as well as there was fibrous ankylosis. It was concluded that mandibular condyle fracture in rats with proteic undernutrition promoted negative alterations in values of total proteins, albumin and serum calcium, leukocytosis, as well as impaired callus formation, and induced atrophy of condylar fibrocartilage and fibrous ankylosis.

Objetivo: verificar associação independente entre subnutrição e óbito em idosos brasileiros domiciliados. Métodos: pesquisa epidemiológica, observacional, longitudinal, retrospectiva e analítica, baseada no Estudo SABE: Saúde, Bem-estar e Envelhecimento, realizado nos anos 2000 e 2006, no município de São Paulo. Foram estudados 1170 idosos ( 60 anos), de ambos os sexos, residentes habituais em domicílios particulares da área urbana do município de São Paulo. As variáveis analisadas foram: óbito, subnutrição, sexo, renda, força muscular reduzida, fratura de quadril, hábito de fumar, câncer, depressão, diabete melito, doença coronariana, doença pulmonar crônica, doença vascular cerebral e hipertensão, sendo a maioria relatada pelos idosos ou por seus proxis, com exceção do óbito (averiguado pelo Sistema de Informações sobre Mortalidade de São Paulo), da subnutrição (Miniavaliação Nutricional®), da depressão (Escala de depressão geriátrica) e da força muscular reduzida (força de preensão manual). Realizou-se, segundo grupos etários (60-74 anos e 75 anos), análise multivariada hierarquizada por regressão logística, baseada em modelo teórico proposto, selecionando as variáveis cujo p foi < 0,05. Resultados: constataram-se 332 óbitos, com maior proporção no grupo 75 anos (41,8%) que 60-74 anos (18,3%) (p < 0,001). A subnutrição foi identificada em 2,4% dos idosos e, assim como para óbito, verificou-se maior proporção no grupo 75 anos (2,5% e 2,4%, respectivamente). Em idosos de 60-74 anos, 6,7% daqueles que morreram eram subnutridos e, no grupo etário 75 anos, 3,9%. Tanto em idosos de 60-64 anos (OR = 6,17; IC = 5,89-6,47), como 75 anos (OR = 2,82; IC = 2,57- 3,10), a subnutrição foi fator de risco independente para óbito (p < 0,05). Exceto fratura de quadril e doença vascular cerebral, em ambos grupos etários, e hipertensão, em idosos de 60-74 anos, todas as outras variáveis também explicaram o óbito, porém, com menor efeito. Conclusão: a subnutrição representou fator de risco 6 independente e mais fortemente associado ao óbito em idosos brasileiros domiciliados dentre as variáveis consideradas, com efeito mais pronunciado no grupo de 60-74 anos. / Objective: to verify the independent association between undernutrition and death in older Brazilian adults community-dwelling setting. Methods: epidemiological, observational, longitudinal, retrospective and analytical study based in Health, Wellbeing and Aging survey realized in the years 2000 and 2006. This study included 1170 older adults ( 60 years) both gender that living in private households in São Paulo urban area. The variables analyzed were: death, undernutrition, sex, income, low muscle strength, hip fracture, smoker, cancer, depression, diabetes, coronary heart disease, chronic lung disease, cerebral vascular disease and hypertension being the majority self reported by older adults, except death (investigated in the Mortality Information System of the São Paulo city), undernutrition (Mini-nutritional Assessment®), depression (Geriatric Depression Scale) and muscle strength (handgrip). Hierarchical multivariate analysis by logistic regression was performed according to age groups (60-74 years and 75 years) based on a proposed theoretical model. The p-values < 0.05 were considered significant. Results: were identified 332 death being the highest proportion in the age group 75 years (41.8%) that 60-74 years (18.3%) (p < 0.001). Undernutrition was identified in 2.4% of older adults and as well as for death, there was a higher proportion in the group 75 years (2.6 and 2.4, respectively). In the older adults from 60-74 years, 6.7% died and were undernutrition and the older adults 75 years, 3.9%. Undernutrition was independent risk factor for death (p<0.05) both in the age group 60-74 years (OR = 6.17; CI = 5.89-6.47) and in the age group 75 years (OR = 2.82; CI = 2.57-3.10). Except hip fracture and cerebral vascular disease in both age groups and hypertension in age group from 60-74 years, the other variables also explained the death in older adults, however, the effect of these variables was lower. Conclusion: undernutrition represented the independent and the most strongly risk factor to death in older 8 Brazilian adults in the community-dwelling setting among the variables considered in this study with effect more pronounced in older adults from 60-74 years.

The prepartum surge in fetal plasma cortisol, essential for the maturation of organs in mammals and the normal timing of parturition in some species, including sheep, may result from an increase in the molar ratio of adrenocorticotropin (ACTH) to pro-opiomelanocortin (POMC) in the fetal circulation. Related to this, the cleavage of POMC to ACTH by the enzyme, prohormone convertase 1 (PC1), may be influenced by corticotrophin releasing hormone (CRH) stimulation. Accumulating evidence suggests that the capacity of individual corticotrophs to process POMC to ACTH may vary and individual corticotrophs are differentially responsive to CRH. It is not known, however, if there are separate corticotroph subpopulations in the fetal sheep pituitary which can be identified by differential colocalisation of POMC, ACTH and the CRH receptor 1, CRHR₁, nor if changes in the relative proportions of such subpopulations play a role in the molecular mechanisms underlying the overall changes in pituitary function described previously during gestation and in response to suboptimal uterine environments. To investigate these hypotheses, it was first necessary to develop novel methods for the simultaneous immunohistochemical labelling of POMC, ACTH and CRHR₁ in individual cells on sections of fetal sheep pituitary. In addition, I developed and validated an automated method to categorise and count individual cells to increase the quantitative power of this study. Pituitary tissue was collected from control fetuses at 53-55 (n=6), 63-85 (n=6), 110 (n=4), 139-141 (n=4) and 144-145 (n=6) days gestation. Two animal models, known to alter pituitary function in the fetal sheep, were used to investigate corticotrophic adaptations to suboptimal uterine environments. For the maternal periconceptional undernutrition (PCUN) model, maternal feed was reduced to 70% of maintenance requirements from at least 45 days before to 7 days after mating and fetal tissues were collected at 53-55 days gestation (n=7). For the placental restriction (PR) model, the majority of the placental attachment sites were removed in five ewes before mating and fetal tissues were collected at 140 (n=4) and 144 (n=4) days gestation. Pituitary sections were simultaneously labelled with antisera raised against full length POMC, ACTH and CRHR₁ and the proportions of pituitary cells with combinations of antisera were quantified. Four subpopulations of corticotrophs were identified, which expressed either: POMC+ACTH+CRHR₁, ACTH+CRHR₁, POMC+ CRHR₁ or POMConly. There was a significant decrease in the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ between 53-55 and 65-85 days gestation, before an increase at 110 days gestation and a further marked decrease between 139-141 and 144-145 days gestation. In fetuses from the PCUN group, the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ in early gestation was reduced. PR resulted in a significantly higher proportion of corticotrophs expressing POMC+ACTH+CRHR₁ during the prepartum period. This work represents the discovery of the differential expression of POMC, ACTH and CRHR₁ in individual corticotrophs of the fetal sheep pituitary and the first insights into the pituitary adaptations to periconceptional nutrient restriction and placental restriction at the level of individual corticotrophs. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1337370 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2008

<p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p><p>Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring.</p><p>Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara <em>golden standard</em> samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF).</p><p>Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81).</p><p>Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder.</p> / <p>Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.</p>

Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. Syfte: Undersöka den kriterierelaterade validiteten, mellanbedömarreliabiliteten och användarvänligheten för MEONF, ett screeninginstrument för bedömning av risk för undernäring. Metoder: Hundra patienter inkluderades och nutritionsstatus bedömdes med Mini Nutritional Assessment (MNA) som här anses vara golden standard samt screenades med Malnutrition Universal Screening Tool (MUST) och Minimal Eating Observation and Nutrition Form (MEONF). Resultat: Sjuksköterskorna ansåg MEONFs instruktioner och frågor lätta att förstå, svara på (100 %) samt att frågorna var angelägna (98 %). Instrumentet hade acceptabel sensitivitet (0.83) och specificitet (0.78) jämfört med MNA. Sensitiviteten var högre än den som fanns mellan MUST och MNA (0.57). När BMI ersattes med vadomkrets erhölls likvärdiga resultat (sensibilitet 0.83 specificitet 0.79) för MEONF i förhållande till MNA. Mellanbedömarreliabiliteten var hög (kappa 0.81). Sammanfattning: MEONF har bra validitet jämfört med MNA, med hög mellanbedömarreliabilitet. När BMI ersattes med vadomkrets bibehölls precisionen vilket är viktigt när vikt och längd är svåra att erhålla. Hög sensitivitet är angeläget vid screening för undernäring och i det avseendet fungerar MEONF bättre än MUST. En fundamental vinst med MEONF är att instrumentets kriterier upplevs som meningsfulla, för att vissa svårigheter kan avhjälpas med omvårdnadsåtgärder. / Rationale: Analyse the criterion related validity, interrater reliability and the usefulness of MEONF, an instrument for undernutrition risk screening. Methods: 100 patients were included and assessed with Mini Nutritional Assessment (MNA) regarded as golden standard and screened with Malnutrition Universal Screening Tool (MUST) as well as Minimal Eating Observation and Nutrition Form (MEONF). Results: Nurses regarded MEONF instructions and questions easy to understand, easy to answer (100%) and questions as being important (98%). It had acceptable sensitivity (0.83) and specificity (0.78) in relation to MNA. Sensitivity was higher than found between MUST and MNA (0.57). Replacing BMI with Calf Circumference (CC) gave equivalent results (sensibility 0.83, specificity 0.79) in relation to MNA. Interrater reliability was high (kappa 0.81). Conclusions: MEONF has good validity in relation to MNA and high interrater reliability. If replacing BMI with CC the precision is maintained, which is important in cases were weight or height is difficult to obtain. Having high sensitivity is a major concern for nutritional screening instruments and in that respect MEONF works better than MUST. One fundamental gain with MEONF is that the instruments criteria are experienced as clinically meaningful, in that some observed difficulties can be managed by nursing interventions.

No description available.

The prepartum surge in fetal plasma cortisol, essential for the maturation of organs in mammals and the normal timing of parturition in some species, including sheep, may result from an increase in the molar ratio of adrenocorticotropin (ACTH) to pro-opiomelanocortin (POMC) in the fetal circulation. Related to this, the cleavage of POMC to ACTH by the enzyme, prohormone convertase 1 (PC1), may be influenced by corticotrophin releasing hormone (CRH) stimulation. Accumulating evidence suggests that the capacity of individual corticotrophs to process POMC to ACTH may vary and individual corticotrophs are differentially responsive to CRH. It is not known, however, if there are separate corticotroph subpopulations in the fetal sheep pituitary which can be identified by differential colocalisation of POMC, ACTH and the CRH receptor 1, CRHR₁, nor if changes in the relative proportions of such subpopulations play a role in the molecular mechanisms underlying the overall changes in pituitary function described previously during gestation and in response to suboptimal uterine environments. To investigate these hypotheses, it was first necessary to develop novel methods for the simultaneous immunohistochemical labelling of POMC, ACTH and CRHR₁ in individual cells on sections of fetal sheep pituitary. In addition, I developed and validated an automated method to categorise and count individual cells to increase the quantitative power of this study. Pituitary tissue was collected from control fetuses at 53-55 (n=6), 63-85 (n=6), 110 (n=4), 139-141 (n=4) and 144-145 (n=6) days gestation. Two animal models, known to alter pituitary function in the fetal sheep, were used to investigate corticotrophic adaptations to suboptimal uterine environments. For the maternal periconceptional undernutrition (PCUN) model, maternal feed was reduced to 70% of maintenance requirements from at least 45 days before to 7 days after mating and fetal tissues were collected at 53-55 days gestation (n=7). For the placental restriction (PR) model, the majority of the placental attachment sites were removed in five ewes before mating and fetal tissues were collected at 140 (n=4) and 144 (n=4) days gestation. Pituitary sections were simultaneously labelled with antisera raised against full length POMC, ACTH and CRHR₁ and the proportions of pituitary cells with combinations of antisera were quantified. Four subpopulations of corticotrophs were identified, which expressed either: POMC+ACTH+CRHR₁, ACTH+CRHR₁, POMC+ CRHR₁ or POMConly. There was a significant decrease in the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ between 53-55 and 65-85 days gestation, before an increase at 110 days gestation and a further marked decrease between 139-141 and 144-145 days gestation. In fetuses from the PCUN group, the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ in early gestation was reduced. PR resulted in a significantly higher proportion of corticotrophs expressing POMC+ACTH+CRHR₁ during the prepartum period. This work represents the discovery of the differential expression of POMC, ACTH and CRHR₁ in individual corticotrophs of the fetal sheep pituitary and the first insights into the pituitary adaptations to periconceptional nutrient restriction and placental restriction at the level of individual corticotrophs. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1337370 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2008

The prepartum surge in fetal plasma cortisol, essential for the maturation of organs in mammals and the normal timing of parturition in some species, including sheep, may result from an increase in the molar ratio of adrenocorticotropin (ACTH) to pro-opiomelanocortin (POMC) in the fetal circulation. Related to this, the cleavage of POMC to ACTH by the enzyme, prohormone convertase 1 (PC1), may be influenced by corticotrophin releasing hormone (CRH) stimulation. Accumulating evidence suggests that the capacity of individual corticotrophs to process POMC to ACTH may vary and individual corticotrophs are differentially responsive to CRH. It is not known, however, if there are separate corticotroph subpopulations in the fetal sheep pituitary which can be identified by differential colocalisation of POMC, ACTH and the CRH receptor 1, CRHR₁, nor if changes in the relative proportions of such subpopulations play a role in the molecular mechanisms underlying the overall changes in pituitary function described previously during gestation and in response to suboptimal uterine environments. To investigate these hypotheses, it was first necessary to develop novel methods for the simultaneous immunohistochemical labelling of POMC, ACTH and CRHR₁ in individual cells on sections of fetal sheep pituitary. In addition, I developed and validated an automated method to categorise and count individual cells to increase the quantitative power of this study. Pituitary tissue was collected from control fetuses at 53-55 (n=6), 63-85 (n=6), 110 (n=4), 139-141 (n=4) and 144-145 (n=6) days gestation. Two animal models, known to alter pituitary function in the fetal sheep, were used to investigate corticotrophic adaptations to suboptimal uterine environments. For the maternal periconceptional undernutrition (PCUN) model, maternal feed was reduced to 70% of maintenance requirements from at least 45 days before to 7 days after mating and fetal tissues were collected at 53-55 days gestation (n=7). For the placental restriction (PR) model, the majority of the placental attachment sites were removed in five ewes before mating and fetal tissues were collected at 140 (n=4) and 144 (n=4) days gestation. Pituitary sections were simultaneously labelled with antisera raised against full length POMC, ACTH and CRHR₁ and the proportions of pituitary cells with combinations of antisera were quantified. Four subpopulations of corticotrophs were identified, which expressed either: POMC+ACTH+CRHR₁, ACTH+CRHR₁, POMC+ CRHR₁ or POMConly. There was a significant decrease in the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ between 53-55 and 65-85 days gestation, before an increase at 110 days gestation and a further marked decrease between 139-141 and 144-145 days gestation. In fetuses from the PCUN group, the proportion of pituitary cells expressing POMC+ACTH+CRHR₁ in early gestation was reduced. PR resulted in a significantly higher proportion of corticotrophs expressing POMC+ACTH+CRHR₁ during the prepartum period. This work represents the discovery of the differential expression of POMC, ACTH and CRHR₁ in individual corticotrophs of the fetal sheep pituitary and the first insights into the pituitary adaptations to periconceptional nutrient restriction and placental restriction at the level of individual corticotrophs. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1337370 / Thesis (Ph.D.) -- University of Adelaide, School of Molecular and Biomedical Science, 2008

Objetivo: verificar associação independente entre subnutrição e óbito em idosos brasileiros domiciliados. Métodos: pesquisa epidemiológica, observacional, longitudinal, retrospectiva e analítica, baseada no Estudo SABE: Saúde, Bem-estar e Envelhecimento, realizado nos anos 2000 e 2006, no município de São Paulo. Foram estudados 1170 idosos ( 60 anos), de ambos os sexos, residentes habituais em domicílios particulares da área urbana do município de São Paulo. As variáveis analisadas foram: óbito, subnutrição, sexo, renda, força muscular reduzida, fratura de quadril, hábito de fumar, câncer, depressão, diabete melito, doença coronariana, doença pulmonar crônica, doença vascular cerebral e hipertensão, sendo a maioria relatada pelos idosos ou por seus proxis, com exceção do óbito (averiguado pelo Sistema de Informações sobre Mortalidade de São Paulo), da subnutrição (Miniavaliação Nutricional®), da depressão (Escala de depressão geriátrica) e da força muscular reduzida (força de preensão manual). Realizou-se, segundo grupos etários (60-74 anos e 75 anos), análise multivariada hierarquizada por regressão logística, baseada em modelo teórico proposto, selecionando as variáveis cujo p foi < 0,05. Resultados: constataram-se 332 óbitos, com maior proporção no grupo 75 anos (41,8%) que 60-74 anos (18,3%) (p < 0,001). A subnutrição foi identificada em 2,4% dos idosos e, assim como para óbito, verificou-se maior proporção no grupo 75 anos (2,5% e 2,4%, respectivamente). Em idosos de 60-74 anos, 6,7% daqueles que morreram eram subnutridos e, no grupo etário 75 anos, 3,9%. Tanto em idosos de 60-64 anos (OR = 6,17; IC = 5,89-6,47), como 75 anos (OR = 2,82; IC = 2,57- 3,10), a subnutrição foi fator de risco independente para óbito (p < 0,05). Exceto fratura de quadril e doença vascular cerebral, em ambos grupos etários, e hipertensão, em idosos de 60-74 anos, todas as outras variáveis também explicaram o óbito, porém, com menor efeito. Conclusão: a subnutrição representou fator de risco 6 independente e mais fortemente associado ao óbito em idosos brasileiros domiciliados dentre as variáveis consideradas, com efeito mais pronunciado no grupo de 60-74 anos. / Objective: to verify the independent association between undernutrition and death in older Brazilian adults community-dwelling setting. Methods: epidemiological, observational, longitudinal, retrospective and analytical study based in Health, Wellbeing and Aging survey realized in the years 2000 and 2006. This study included 1170 older adults ( 60 years) both gender that living in private households in São Paulo urban area. The variables analyzed were: death, undernutrition, sex, income, low muscle strength, hip fracture, smoker, cancer, depression, diabetes, coronary heart disease, chronic lung disease, cerebral vascular disease and hypertension being the majority self reported by older adults, except death (investigated in the Mortality Information System of the São Paulo city), undernutrition (Mini-nutritional Assessment®), depression (Geriatric Depression Scale) and muscle strength (handgrip). Hierarchical multivariate analysis by logistic regression was performed according to age groups (60-74 years and 75 years) based on a proposed theoretical model. The p-values < 0.05 were considered significant. Results: were identified 332 death being the highest proportion in the age group 75 years (41.8%) that 60-74 years (18.3%) (p < 0.001). Undernutrition was identified in 2.4% of older adults and as well as for death, there was a higher proportion in the group 75 years (2.6 and 2.4, respectively). In the older adults from 60-74 years, 6.7% died and were undernutrition and the older adults 75 years, 3.9%. Undernutrition was independent risk factor for death (p<0.05) both in the age group 60-74 years (OR = 6.17; CI = 5.89-6.47) and in the age group 75 years (OR = 2.82; CI = 2.57-3.10). Except hip fracture and cerebral vascular disease in both age groups and hypertension in age group from 60-74 years, the other variables also explained the death in older adults, however, the effect of these variables was lower. Conclusion: undernutrition represented the independent and the most strongly risk factor to death in older 8 Brazilian adults in the community-dwelling setting among the variables considered in this study with effect more pronounced in older adults from 60-74 years.

Resumo: A desnutrição diminui a eficácia da resposta imune aumentando a susceptibilidade aos agentes infecciosos. 0 principal tipo de deficiência nutricional e a desnutrição proteico-calórica (DPC). A restrição alimentar experimental e utilizada como modelo de estudo para a DPC. Neste contexto, os objetivos principais deste trabalho foram caracterizar urn modelo murino de DPC e avaliar seu efeito na susceptibilidade e na imunidade protetora ao Staphylococcus aureus. Foram testados três percentuais de restrição alimentar (10, 20 e 30%) em camundongos BALB/c e a restrição de 20% determinou as seguintes alterações as quais são condizentes com um estado de subnutrição: queda significativa de peso corporal e número de linfócitos, alteração na produção de citocinas e atrofia no timo e epitélio intestinal. A comparação do grau de susceptibilidade e da capacidade de montar uma resposta imune protetora ao S. aureus foi realizada atraves de duas metodologias: determinação do numero de unidades formadoras de colônias (UFC) em alguns órgãos e análise histopatológica do tecido pulmonar. Os resultados foram distintos dependendo da metodologia empregada. Quanto a susceptibilidade ao patógeno, a técnica de UFC indicou susceptibilidade similar nos grupos normal e subnutrido, enquanto que a análise histopatológica indicou maior quantidade de bactérias no pulmão dos animais normais. 0 processo de imunização controlou eficazmente a multiplicação bacteriana no pulmão dos animais normais, mas nao dos animais subnutridos. A análise histopatológica também mostrou perfis inflamatórios distintos nestes 2 grupos: camundongos normais apresentaram inflamação pulmonar só após infecção com S. aureus, como esperado, e a imunização prévia com antígenos de S. aureus preveniu esta inflamação. Por outro lado, camundongos subnutridos ja apresentavam inflamação pulmonar antes... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Undernutriton is one of the most relevant causes of secundary immunodeficiency. The main type of nutritional deficiency is called protein energy malnutrition (PEM). Animals submitted to different degrees of food restriction can be used as models of PEM. In this context, this work was done to establish a murine experimental model for PEM and to evaluate the effect of malnutrition on both, susceptibility and ability to mount a protective immunity against Staphylococcus aureus. BALB/c mice were therefore submitted to three distinct percentages of dietary re§triction (10, 20 and 30%). The 20% restricted diet determined the following alterations that characterize a state of malnutrition: a significant decrease in both, body weight and lymphocyte number, alteration in cytokine production and atrophy in thymus and intestinal epithelium. Two methodologies were used to compare susceptibility and ability to mount a protective immunity: determination of the number of colony forming units (CFU) in some organs and histopathological analysis of the lungs. Results varied according to the methodology. CFU indicated a similar susceptibility whereas the histopathological analysis showed a higher amount of bacterias in the lungs of normal mice. Immunization controlled bacterial growth in the lungs of normal mice but not in the ones from undernourished animals. Histopathological analysis also revealed distinct inflammatory scenarios: inflammation appeared in lungs from normal mice only after infection with S. aureus and immunization prevented lung inflammation in the animals. On the other hand, undernourished mice presented lung inflammation even before infection. In addition, the degree of this inflammatory process did not change with infection or previous immunization. Together, this data demonstrates that BALB/c mIce submitted to 20% food restriction developed... (Complete abstract click electronic access below) / Orientador: Alexandrina Sartori / Coorientador: Maria de Lourdes Ribeiro de Souza Cunha / Banca: Rubens Rodrigues dos Santos Júnior / Banca: Maria Terezinha Serrão Peraçoli / Mestre