Publications by authors named "Priscila Moreira"

13 Publications

  • Page 1 of 1

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial.

Am Heart J 2019 09 21;215:187-197. Epub 2019 Jun 21.

Hospital Universitário Pedro Ernesto, Rio de Janeiro-RJ, Brazil.

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD.

Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels.

Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P < .01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P = .15). Secondary end points did not differ between groups after follow-up.

Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death.
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http://dx.doi.org/10.1016/j.ahj.2019.06.010DOI Listing
September 2019

Unsaturated Fatty Acids Improve Atherosclerosis Markers in Obese and Overweight Non-diabetic Elderly Patients.

Obes Surg 2017 10;27(10):2663-2671

Department of Gastroenterology, Hospital das Clínicas, São Paulo, 05403-900, Brazil.

Background: Several studies have demonstrated the benefits of replacing trans and saturated fats with unsaturated fatty acids on cardiovascular diseases. We aimed to demonstrate the effect of polyunsaturated and monounsaturated fat supplementation on the biochemical and endothelial markers of atherosclerotic disease in obese or overweight non-diabetic elderly patients.

Method: Seventy-nine patients were randomly divided into three groups: flaxseed oil, olive oil, and sunflower oil; patients in each group received 30 mL of oil for 90 days. Patients were subjected to anthropometric and bioimpedance assessments; biochemical and endothelial evaluations were performed through ultrasonography of the brachial artery and carotid artery for endothelium-dependent dilation and intima-media thickness assessment, respectively, before and after the intervention. The participants' usual diet remained unchanged.

Results: The flaxseed oil group had improved ultra-sensitive C-reactive protein levels (p = 0.074) and reduced carotid intima-media thickness (CIMT) (p = 0.028); the olive oil group exhibited an improved apolipoprotein (Apo)B/ApoA ratio (p = 0.021), reduced CIMT (p = 0.028), and improved flow-mediated vasodilation (FMV) (p = 0.054); and similarly, the sunflower oil group showed an improved ApoB/ApoA ratio (p = 0.024), reduced CIMT (p = 0.048), and improved FMV (p = 0.001).

Conclusion: Unsaturated fatty acid supplementation using the three vegetable oils attenuated pro-inflammatory properties and improved prothrombotic conditions. Therefore, introducing or replacing saturated and trans fat with unsaturated fatty acids is beneficial for cardiovascular risk reduction in obese or overweight non-diabetic elderly people. Further studies are needed to determine which unsaturated fat best prevents cardiovascular disease in elderly patients.
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http://dx.doi.org/10.1007/s11695-017-2704-8DOI Listing
October 2017

Chloroplast sequence of treegourd (, Bignoniaceae) to study phylogeography and domestication.

Appl Plant Sci 2016 Oct 18;4(10). Epub 2016 Oct 18.

UMR DIADE, Institut de Recherche pour le Développement (IRD), 393 Avenue Agropolis, Montpellier, Cedex 5, France.

Premise Of The Study: (Bignoniaceae) fruit rinds are traditionally used for storage vessels and handicrafts. We assembled its chloroplast genome and identified single-nucleotide polymorphisms (SNPs).

Methods And Results: Using a genome skimming approach, the whole chloroplast of was assembled using 3,106,928 sequence reads of 150 bp. The chloroplast is 154,662 bp in length, structurally divided into a large single copy region (84,788 bp), a small single copy region (18,299 bp), and two inverted repeat regions (51,575 bp) with 88 genes annotated. By resequencing the whole chloroplast, we identified 66 SNPs in ( = 30) and 68 SNPs in ( = 6). Nucleotide diversity was estimated at 1.1 × 10 and 3.5 × 10 for and , respectively.

Conclusions: This broadened genetic toolkit will be important to study the origin, domestication, diversity, and phylogeography of treegourds in the Neotropics.
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http://dx.doi.org/10.3732/apps.1600048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077280PMC
October 2016

Anthropometric, functional capacity, and oxidative stress changes in Brazilian community-living elderly subjects. A longitudinal study.

Arch Gerontol Geriatr 2016 Sep-Oct;66:140-6. Epub 2016 Jun 6.

Department of Internal Medicine, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, SP, Brazil. Electronic address:

Objective: To examine the changes and relationships among anthropometric, functional and plasma oxidative stress markers in elderly.

Design: longitudinal study.

Setting: measurements in 2008 and 2010.

Participants: 103 community-dwelling men and women aged 67-92.

Measurements: Anthropometric parameters [waist, hip, arm and calf circumferences; waist-hip ratio, triceps skinfold thickness and others], basic (ADL) and instrumental activities of daily living (IADL)] and plasma oxidative stress markers (α-tocopherol, β-carotene and malondialdehyde) were assessed in 2008 and 2010.

Results: ADL, IADL, body weight, skinfold thickness and circumferences of calf and arm decreased and waist and waist-hip ratio increased from 2008 to 2010. α-Tocopherol decreased and malondialdehyde plasma levels increased during the study period. In multiple logistic regression analyses, increased age (OR=1.12; IC: 1.02-1.23; p=0.02), female gender (OR=8.43; IC: 1.23-57.58; p=0.03), hypertension (OR=0.22; IC: 0.06-0.79; p=0.02), arthritis/arthrosis (OR=0.09; IC: 0.009-0.87; p=0.04) and depression (OR=0.20; IC: 0.04-1.03; p=0.05) were independent risk factors for functional decline.

Conclusion: Fat reduction, muscle loss, central obesity increase, functional decline and worsening of plasma oxidative stress were observed during 2-year follow-up. Some of the risk factors that were identified could be modified to help prevent functional decline in elderly. The factors deserving attention include hypertension, arthritis/arthrosis and depression.
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http://dx.doi.org/10.1016/j.archger.2016.05.013DOI Listing
July 2017

The Brazilian Cardioprotective Nutritional Program to reduce events and risk factors in secondary prevention for cardiovascular disease: study protocol (The BALANCE Program Trial).

Am Heart J 2016 Jan 15;171(1):73-81.e1-2. Epub 2015 Aug 15.

Research Institute, Hospital do Coração (IP-HCor), São Paulo, SP, Brazil.

This article reports the rationale for the Brazilian Cardioprotective Nutritional Program (BALANCE Program) Trial. This pragmatic, multicenter, nationwide, randomized, concealed, controlled trial was designed to investigate the effects of the BALANCE Program in reducing cardiovascular events. The BALANCE Program consists of a prescribed diet guided by nutritional content recommendations from Brazilian national guidelines using a unique nutritional education strategy, which includes suggestions of affordable foods. In addition, the Program focuses on intensive follow-up through one-on-one visits, group sessions, and phone calls. In this trial, participants 45 years or older with any evidence of established cardiovascular disease will be randomized to the BALANCE or control groups. Those in the BALANCE group will receive the afore mentioned program interventions, while controls will be given generic advice on how to follow a low-fat, low-energy, low-sodium, and low-cholesterol diet, with a view to achieving Brazilian nutritional guideline recommendations. The primary outcome is a composite of death (any cause), cardiac arrest, acute myocardial infarction, stroke, myocardial revascularization, amputation for peripheral arterial disease, or hospitalization for unstable angina. A total of 2468 patients will be enrolled in 34 sites and followed up for up to 48 months. If the BALANCE Program is found to decrease cardiovascular events and reduce risk factors, this may represent an advance in the care of patients with cardiovascular disease.
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http://dx.doi.org/10.1016/j.ahj.2015.08.010DOI Listing
January 2016

Allergen Microarray Indicates Pooideae Sensitization in Brazilian Grass Pollen Allergic Patients.

PLoS One 2015 11;10(6):e0128402. Epub 2015 Jun 11.

Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.

Background: Grass pollen, in particular from Lolium multiflorum is a major allergen source in temperate climate zones of Southern Brazil. The IgE sensitization profile of Brazilian grass pollen allergic patients to individual allergen molecules has not been analyzed yet.

Objective: To analyze the IgE sensitization profile of a Brazilian grass pollen allergic population using individual allergen molecules.

Methods: We analyzed sera from 78 grass pollen allergic patients for the presence of IgE antibodies specific for 103 purified micro-arrayed natural and recombinant allergens by chip technology. IgE-ELISA inhibition experiments with Lolium multiflorum, Phleum pratense extracts and a recombinant fusion protein consisting of Phl p 1, Phl p 2, Phl p 5 and Phl p 6 were performed to investigate cross-reactivities.

Results: Within the Brazilian grass pollen allergic patients, the most frequently recognized allergens were Phl p 1 (95%), Phl p 5 (82%), Phl p 2 (76%) followed by Phl p 4 (64%), Phl p 6 (45%), Phl p 11 (18%) and Phl p 12 (18%). Most patients were sensitized only to grass pollen allergens but not to allergens from other sources. A high degree of IgE cross-reactivity between Phleum pratense, Lolium multiflorum and the recombinant timothy grass fusion protein was found.

Conclusions: Component-resolved analysis of sera from Brazilian grass pollen allergic patients reveals an IgE recognition profile compatible with a typical Pooideae sensitization. The high degree of cross-reactivity between Phleum pratense and Lolium multiflorum allergens suggests that diagnosis and immunotherapy can be achieved with timothy grass pollen allergens in the studied population.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0128402PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465745PMC
April 2016

Protective effect of bixin on carbon tetrachloride-induced hepatotoxicity in rats.

Biol Res 2014 Sep 29;47:49. Epub 2014 Sep 29.

Laboratório de Bioquímica Metabólica e Toxicológica (LaBMeT), UNESP - Univ Estadual Paulista, Campus de Dracena, Dracena, SP, 17900-000, Brazil.

Background: The liver is an important organ for its ability to transform xenobiotics, making the liver tissue a prime target for toxic substances. The carotenoid bixin present in annatto is an antioxidant that can protect cells and tissues against the deleterious effects of free radicals. In this study, we evaluated the protective effect of bixin on liver damage induced by carbon tetrachloride (CCl4) in rats.

Results: The animals were divided into four groups with six rats in each group. CCl4 (0.125 mL kg(-1) body wt.) was injected intraperitoneally, and bixin (5.0 mg kg(-1) body wt.) was given by gavage 7 days before the CCl4 injection. Bixin prevented the liver damage caused by CCl4, as noted by the significant decrease in serum aminotransferases release. Bixin protected the liver against the oxidizing effects of CCl4 by preventing a decrease in glutathione reductase activity and the levels of reduced glutathione and NADPH. The peroxidation of membrane lipids and histopathological damage of the liver was significantly prevented by bixin treatment.

Conclusion: Therefore, we can conclude that the protective effect of bixin against hepatotoxicity induced by CCl4 is related to the antioxidant activity of the compound.
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http://dx.doi.org/10.1186/0717-6287-47-49DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192761PMC
September 2014

Association between oxidative stress and nutritional status in the elderly.

Rev Assoc Med Bras (1992) 2014 Jan-Feb;60(1):75-83

Physician and Assistant Professor, Department of Clinical Medicine, Botucatu School of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Ageing is a dynamic and progressive process that is characterized by the occurrence of morphological, biochemical, functional and psychological changes in the organism. The aim of the present article is to provide updated concepts on oxidative stress, covering its importance in aging, as well as nutritional status and supplementation with antioxidants (substances that prevent or attenuate oxidation of oxidizable substrates, such as lipids, proteins, carbohydrates and deoxyribonucleic acid) in the geriatric population. Evidence suggests that there is an inverse relationship between oxidative stress and nutritional status in elderly individuals. Although an increase in oxidative stress in chronic diseases associated with aging has been proven, such as Parkinson's disease and Alzheimer's disease, up to now there has been no consistent clinical evidence proving the efficiency of supplementation with antioxidants against oxidative stress. In this context, supplementation is not recommended. On the other hand, the elderly should be encouraged to eat antioxidant foods, such as fruits and vegetables. Maintaining a normal weight (body mass index between 23 and 28 Kg/m(2)) should also be stimulated.
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http://dx.doi.org/10.1590/1806-9282.60.01.016DOI Listing
April 2015

Assessment of acute toxicity of carbofuran in Macrobrachium olfersii (Wiegmann, 1836) at different temperature levels.

Toxicol Ind Health 2016 Jan 11;32(1):7-14. Epub 2013 Jul 11.

Centro de Investigación en Contaminación Ambiental, Universidad de Costa Rica, San Pedro, Costa Rica.

Carbofuran (2,3-dihydro-2,2-dimethyl-7-benzofuranyl methylcarbamate; C12H15NO3) is one of the most toxic carbamate pesticides. For acute toxicity of carbofuran, juveniles of Macrobrachium olfersii were exposed to different concentrations of carbofuran using the static renewal method at different temperature levels (15, 20 and 25°C) at pH 7.0. The main purpose of the present study was to detect the acute toxicity of carbofuran to M. olfersii and investigate its effects on oxygen consumption and ammonium excretion; these tests have not been carried out in this species before. First, the acute toxicity - median lethal concentration - of carbofuran to M. olfersii for 24, 48, 72 and 96 h was examined, which resulted in the following values: 1.64, 1.22, 0.86 and 0.42 mg L(-1), respectively. Furthermore, we also found that carbofuran caused an inhibition in oxygen consumption of 60.6, 65.3 and 66.2% with respect to the control. In addition, after separate exposures to carbofuran, elevations in ammonium excretion were more than 500% with respect to the control.
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http://dx.doi.org/10.1177/0748233713484655DOI Listing
January 2016

Is intake of vitamin D and calcium important for cardiovascular health in elderly obese patients?

Obes Surg 2012 Mar;22(3):437-44

Dante Pazzanese Institute of Cardiology, Sao Paulo, 04012-909, Brazil.

There is compelling evidence that bariatric weight loss reduces cardiovascular complications; however, these still tend to be the most common cause of late death after surgical intervention. In a prospective cohort study, correlations of dietary nutrients with indexes of vascular health were sought, with emphasis on vitamin D and calcium. Clinically stable obese outpatient subjects (>60 years old, N = 44) were interviewed about dietary macro and micronutrients. Nutritional assessment targeted anthropometric and bioimpedance analysis (BIA), hematologic counts, lipid profile, glucose homeostasis, and inflammatory markers. Carotid intima-media thickness (IMT) and brachial flow-mediated dilation (FMD), along with related vascular measurements, were documented, and results were correlated by uni- and multivariate analysis, corrected for known risk factors. IMT, FMD, and also brachial basal flow were positively influenced by vitamin D (P < 0.001). Calcium appeared beneficial for brachial basal flow only (P = 0.010). No association with IMT occurred, and a negative result for FMD was elicited. Also, vitamins A and B12 were advantageous for FMD, whereas iron was deleterious for IMT. Intake of many micronutrients including calcium and vitamin D did not meet recommendations. Vitamin D displayed a beneficial profile regarding vascular health, and more attention to this nutrient should be given, especially concerning obese patients with cardiometabolic risk. Calcium exhibited less straightforward results but deserves focus as well, along with antioxidant vitamin A as well as the B-complex which were mostly deficient in this experience.
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http://dx.doi.org/10.1007/s11695-012-0593-4DOI Listing
March 2012

Pharmacological dose of {alpha}-tocopherol induces cardiotoxicity in Wistar rats determined by echocardiography and histology.

Hum Exp Toxicol 2011 Oct 11;30(10):1540-8. Epub 2011 Feb 11.

Department of Internal Medicine, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, SP, Brazil.

The effect of pharmacological dose of α-tocopherol on heart health was determined in Wistar rats. Animals were randomly assigned to either C (control, n = 11) or E (α-tocopherol, n = 11) group. Animals received corn oil (C) or α-tocopherol dissolved in corn oil (250 mg α-tocopherol/[kg body wt/day]) (E) by gavage for a 7-week period. Rats underwent echocardiogram and were analyzed for cardiomyocyte histology and cardiac α-tocopherol absorption at the end of the study period. As compared to the C group, α-tocopherol-supplemented group showed significantly (p < 0.05) lower body weight (E, 412.8 g vs C, 480.3 g) and total cardiac weight (E, 0.94 g vs C, 1.08 g); cardiomyocyte histological impairment; smaller left ventricle (LV) (LV end-diastolic diameter (E, 7.22 mm vs C, 7.37 mm), lower LV systolic [left ventricle fractional shortening (E, 47.6% vs C, 53.6%) and ejection fraction ratio (E, 85.4 vs C, 89.9)] and diastolic [early peak velocities of diastolic transmitral flow (E, 64.6 cm/sec vs C, 75.1 cm/sec)] function. The α-tocopherol uptake in target tissue was confirmed by determination of α-tocopherol concentration medians in cardiac tissue (E, 109.91 nmol/kg vs C, 52.09 nmol/kg). The current study indicates that pharmacological dose of α-tocopherol supplementation can induce cardiotoxicity in healthy rats.
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http://dx.doi.org/10.1177/0960327110392401DOI Listing
October 2011

Sensitization to Lolium multiflorum grass pollen in pollinosis patients: evaluation of allergenic fractions recognized by specific IgE antibodies.

Int Arch Allergy Immunol 2006 3;140(2):121-30. Epub 2006 Apr 3.

Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.

Background: Lolium multiflorum (Lm) pollen allergens are the major causative agents for rhinoconjunctivitis in Southern Brazil. There have been no studies about the sensitization and allergenic cross-reactivity between Lm and other grass pollens. We evaluated the sensitization of Brazilian pollinosis patients to Lm pollen allergens through skin prick test (SPT) and immunoassays (ELISA and immunoblot).

Methods: Serum samples from 60 patients with pollinosis and positive SPT to grass pollen extracts (Lm+ group), 30 patients with negative SPT to grass pollen, but positive SPT to mite extracts (Lm- group), and 30 nonatopic subjects (NA group) were tested by SPT, ELISA, and immunoblot using Lm extract. Inhibition immunoassays with Lolium perenne (Lp), mixed grass (Gmix) and Lm extracts were also performed.

Results: A high concordance was found between the Gmix and Lm extracts in SPT. Positivity rates in SPT were also highly concordant with IgE-ELISA results. The assay was able to detect Lm-specific IgE in >95% of Lm+ patients. A significant self- and cross-inhibition was observed in IgE-ELISA, reflecting a high cross-reactivity between the grass pollen allergens. Immunoblot revealed 13 IgE-binding Lm fractions, from which the bands 28-30 kDa and 31-34 kDa were recognized by >90% of Lm+ patients.

Conclusion: Lm-specific IgE antibodies are highly cross-reactive with pollen proteins from other grass species. The results indicate that Lm extracts could be used in both SPT and ELISA for a more specific evaluation of IgE responses to Lm grass pollen in Brazilian pollinosis patients.
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http://dx.doi.org/10.1159/000092531DOI Listing
June 2006
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