Prevalência de doenças sexualmente transmissíveis em mulheres atletas na cidade de São Paulo, Brasil

Objective: To determine the prevalence of sexually transmitted diseases in female athletes. Method: An observational, cross-sectional study was conducted including 50 female athletes with mean age of 20±3 years. Colposcopy, pap smear, and polymerase chain reaction for Chlamydia trachomatis, human papillomavirus and Neisseria gonorrhoeae were performed. Blood samples were collected to test for the human immunodeficiency virus, syphilis, hepatitis B and C. The athletes presenting clinical diseases or conditions identifiable by laboratory tests were treated and followed up in the unit. Result: Forty-six percent of the participants were unaware of sexually transmitted diseases. The prevalence of sexually transmitted diseases among athletes was 48% (24 cases). Human papillomavirus was the most frequent agent (44%). Considering the human papillomavirus genotypes, subtype 16 was the most prevalent (53%), followed by 11-6 (22%) and 18 (13%). Two athletes tested positive for C. trachomatis. There were no cases diagnosed of infection by N. gonorrhoeae, syphilis, hepatitis B, hepatitis C and human immunodeficiency virus. However, only 26 athletes had been vaccinated for hepatitis B. Conclusion: The prevalence of sexually transmitted diseases in female athletes was high. Primary prevention measures (hepatitis B and human papillomavirus vaccination) and secondary (serology, pap smears) must be offered to this specific group of women. The matter should be further approached in sports.Objetivo: Determinar a prevalência de doenças sexualmente transmissíveis em mulheres atletas. Método: Estudo observacional, de corte transversal, que incluiu 50 mulheres atletas com idade média de 20±3 anos. Realizaram-se colposcopia, coleta de colpocitologia oncótica cérvico-vaginal e pesquisa para Chlamydia trachomatis, papilomavírus humano e Neisseria gonorrhoeae, pelo método do reação de cadeia de polimerase. Amostras de sangue foram obtidas para pesquisa de vírus da imunodeficiência humana, sífilis, hepatite B e C. As atletas que apresentaram doenças clínicas ou laboratorialmente identificáveis receberam tratamento e acompanhamento no serviço. Resultado: Dentre as participantes, 46% relataram desconhecimento acerca das doenças sexualmente transmissíveis. A frequência de doenças sexualmente transmissíveis nas atletas foi de 48% (24 casos). Isoladamente, o papilomavírus humano foi o agente mais frequente (44%). Considerando o tipo de genótipo do papilomavírus humano, o subtipo 16 foi o mais prevalente (53%), seguido do 6-11 (22%) e do 18 (13%). Duas atletas tiveram resultado positivo para C. trachomatis. Não foi diagnosticado nenhum caso de infecção por N. gonorrhoeae, sífilis, hepatite B, hepatite C e vírus da imunodeficiência humana. Contudo, somente 26 atletas haviam sido vacinadas para hepatite B. Conclusão: A prevalência de doenças sexualmente transmissíveis em mulheres atletas foi elevada. Medidas de prevenção primária (vacinação para hepatite B e papilomavírus humano) e secundária (sorologias e colpocitologia) devem ser fornecidas a esse grupo específico de mulheres. O assunto deve ser abordado no meio desportivo.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Avaliação ginecológica pré-participação da mulher atleta: uma nova proposta

Objective To propose the inclusion of a gynecological investigation during the evaluation of athletes before competitions, using a specific instrument called the Pre-participation Gynecological Examination (PPGE). Methods The study assessed 148 athletes, mean age of 15.4±2.0 years, who engaged in eight different sports modalities, and who responded to a questionnaire named Pre-Participation Gynecological Examination (PPGE), to the International Consultation on Incontinence Questionnaire - Short Form (for urinary loss), and to the Eating Attitudes Test (for eating disorders). Results Fifty percent of the participants reported irregular menstrual intervals, 23.0% did not know about sexually transmitted diseases, and 72.4% denied having, at least, an annual gynecological appointment. The study identified 18.2% who had urinary loss, and 15% presented with an increased risk of eating disorders. Moreover, 89.9% were not familiar with the occurrence of urinary incontinence in athletes and did not know that they were susceptible to the female athlete triad. A total of 87.1% of them stated that would not mention these issues to their coaches even if this would improve their health or performance. Conclusion The Pre-Participation Gynecological Examination can be considered an easy-to-apply instrument that allowed the diagnosis of alterations often underestimated by the athletes themselves. After its application, the alterations were identified, and determined the athletes’ referral to appropriate evaluation and treatment.Objetivo Propor a inclusão da investigação ginecológica durante a avaliação pré-participação de mulheres praticantes de exercício físico, por meio de um instrumento específico, denominado Pre-Participation Gynecological Examination (PPGE). Métodos Foram avaliadas 148 atletas com média de idade de 15,4±2,0 anos, participantes de oito diferentes modalidades esportivas, que responderam ao Pre-Participation Gynecological Examination, ao International Consultation on Incontinence Questionnaire - Short Form (para avaliar perda urinária) e ao Eating Attitudes Test (para avaliar alterações alimentares). Resultados Cinquenta por cento das atletas referiram irregularidade menstrual, 23% desconheciam as doenças sexualmente transmissíveis e 72,4% negaram acompanhamento ginecológico, no mínimo, anual. Foram identificados 18,2% de mulheres com perda urinária e 15% de maior risco de alterações alimentares. Além disso, 89,9% desconheciam a existência de incontinência urinária em atletas ou o fato de estarem suscetíveis à tríade da mulher atleta. Entre elas, ainda, 87,1% afirmaram não se referirem a seus técnicos sobre as questões ginecológicas, mesmo que isso pudesse melhorar sua saúde e seu desempenho. Conclusão O questionário Pre-Participation Gynecological Examination mostrou-se um instrumento de fácil aplicabilidade e permitiu o diagnóstico de alterações por vezes não valorizadas pelas próprias atletas. Após a aplicação do questionário, as alterações puderam ser identificadas, determinando o encaminhamento das atletas para avaliação e tratamento adequados.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Fatores antinutricionais na alimentação humana

Fatores antinutricionais são compostos oriundos do metabolismo secundário das plantas, presentes numa extensa variedade de alimentos de origem vegetal. Este trabalho teve como objetivo pesquisar os diversos fatores antinutricionais, em especial o ácido cianídrico, o ácido fítico e o ácido oxálico, presentes nos alimentos do nosso dia a dia, as consequências quando há alta ingestão dos mesmos e os métodos de redução desses antinutrientes no preparo dos alimentos como remolho, germinação, cozimento, fatiagem, maceração, trituração, ralagem, fermentação, maltagem, moagem, secagem e torrefação. A metodologia utilizada foi revisão de literatura. A partir desta revisão, conclui-se que tanto o ácido cianídrico como o ácido fítico pode ser reduzido nos alimentos por meio de processos utilizados tanto na preparação doméstica como na industrial, e que a melhor forma de redução do ácido oxálico insolúvel é evitando ou minimizando o consumo de alimentos que o contém

Development of releasable PEG for transient protein PEGylation

reservedPEGylation is a widely used strategy in the pharmaceutical industry to overcome hurdles in delivery of protein therapeutics. It involves linking PEG chains to bioactive molecules such as proteins, peptides, and oligonucleotides to increase molecular weight, reduce renal excretion, improve solubility, prolong retention time in blood, and decrease immunogenicity. Various strategies exist, including random and site-specific conjugation. Simple random conjugation can reduce receptor interaction due to steric entanglement while site-specific conjugation offers better preservation of receptor binding and homogeneity. The interaction between PEG and proteins is typically covalent, which can hinder protein-receptor interactions or catalytic sites. The use of smaller PEG molecules can minimize this constraint but reduces protection in the bloodstream and prolongation of half-life. Releasable PEGs release native proteins slowly, which prevents the efficacy loss observed in stable covalent PEGylation or random conjugation. This work was committed to develop new releasable PEGs useful for the random PEGylation to ε-amino groups, belonging to the ubiquitous lysine of a protein, of human Growth Hormone (hGH). A 40 kDa linear PEG containing an acetal linker chemically modified to be hydrolyzed in the physiological environment was evaluated and compared to a similar non-releasable PEG used as control. To minimize early hydrolysis reactions of the conjugates, it was important to work only with basic pH buffers throughout the synthesis. Once the optimal reaction condition was identified, the pure monoPEGylated protein was purified from the other reaction products. Ion exchange chromatography allowed for the separation of all species present in the reaction mixture. Due to overlapping of the biconjugate and monoconjugates elution peaks a size exclusion chromatography was used to separate the two components. After this, the purified monoPEGylated hGH underwent several characterizations. Mass spectrometry was used to ensure that the protein of interest remained intact and did not degrade in the reaction environment, as well as after the various purification and lyophilization steps. The conjugation was confirmed by using matrix-assisted laser desorption/ionization (MALDI) spectrometry. Furthermore, the preservation of the protein’s secondary structure was assessed by circular dichroism spectroscopy. To assess the ability of these monoconjugates to release the protein of interest, hGH, an in-vitro release study was conducted. The conjugates were exposed to three different environments to confirm the effect of the pH level on the release. Specifically, the conjugates were exposed to buffer solution with pH 5, pH 7.4 and pH 9. To monitor this study reverse phase chromatography was used and by integrating the intensity variation of the monoconjugate peak overtime it was possible to compare the release rate in the different conditions. The study confirmed that the conjugate was rapidly hydrolyzed in an acidic environment, with 50% of it being released after only 20 hours. At physiological pH and temperature, the release was more controlled, with approximately 50% of the conjugate being hydrolyzed after 72 hours. In contrast, at basic pH, only 15% of the conjugate released the protein after 72 hours. The analysis also included non-releasable PEGylated proteins, serving as a negative control, confirming the stability of these conjugates by not releasing hGH. SDS-PAGE was performed for a qualitative analysis of the release. The released hGH from condition with pH 5 and pH 7.4 was collected during the chromatographic analyzes to be characterized by mass spectrometry. The spectra were compared to that of standard hGH to prove the final aim of the project, namely that the released protein was identical to the native one, thus avoiding possible activity limitations due to covalent PEGylation.PEGylation is a widely used strategy in the pharmaceutical industry to overcome hurdles in delivery of protein therapeutics. It involves linking PEG chains to bioactive molecules such as proteins, peptides, and oligonucleotides to increase molecular weight, reduce renal excretion, improve solubility, prolong retention time in blood, and decrease immunogenicity. Various strategies exist, including random and site-specific conjugation. Simple random conjugation can reduce receptor interaction due to steric entanglement while site-specific conjugation offers better preservation of receptor binding and homogeneity. The interaction between PEG and proteins is typically covalent, which can hinder protein-receptor interactions or catalytic sites. The use of smaller PEG molecules can minimize this constraint but reduces protection in the bloodstream and prolongation of half-life. Releasable PEGs release native proteins slowly, which prevents the efficacy loss observed in stable covalent PEGylation or random conjugation. This work was committed to develop new releasable PEGs useful for the random PEGylation to ε-amino groups, belonging to the ubiquitous lysine of a protein, of human Growth Hormone (hGH). A 40 kDa linear PEG containing an acetal linker chemically modified to be hydrolyzed in the physiological environment was evaluated and compared to a similar non-releasable PEG used as control. To minimize early hydrolysis reactions of the conjugates, it was important to work only with basic pH buffers throughout the synthesis. Once the optimal reaction condition was identified, the pure monoPEGylated protein was purified from the other reaction products. Ion exchange chromatography allowed for the separation of all species present in the reaction mixture. Due to overlapping of the biconjugate and monoconjugates elution peaks a size exclusion chromatography was used to separate the two components. After this, the purified monoPEGylated hGH underwent several characterizations. Mass spectrometry was used to ensure that the protein of interest remained intact and did not degrade in the reaction environment, as well as after the various purification and lyophilization steps. The conjugation was confirmed by using matrix-assisted laser desorption/ionization (MALDI) spectrometry. Furthermore, the preservation of the protein’s secondary structure was assessed by circular dichroism spectroscopy. To assess the ability of these monoconjugates to release the protein of interest, hGH, an in-vitro release study was conducted. The conjugates were exposed to three different environments to confirm the effect of the pH level on the release. Specifically, the conjugates were exposed to buffer solution with pH 5, pH 7.4 and pH 9. To monitor this study reverse phase chromatography was used and by integrating the intensity variation of the monoconjugate peak overtime it was possible to compare the release rate in the different conditions. The study confirmed that the conjugate was rapidly hydrolyzed in an acidic environment, with 50% of it being released after only 20 hours. At physiological pH and temperature, the release was more controlled, with approximately 50% of the conjugate being hydrolyzed after 72 hours. In contrast, at basic pH, only 15% of the conjugate released the protein after 72 hours. The analysis also included non-releasable PEGylated proteins, serving as a negative control, confirming the stability of these conjugates by not releasing hGH. SDS-PAGE was performed for a qualitative analysis of the release. The released hGH from condition with pH 5 and pH 7.4 was collected during the chromatographic analyzes to be characterized by mass spectrometry. The spectra were compared to that of standard hGH to prove the final aim of the project, namely that the released protein was identical to the native one, thus avoiding possible activity limitations due to covalent PEGylation

Avaliação do conhecimento e do cuidado relacionados à saúde ginecológica da atleta brasileira participante dos Jogos Olímpicos do Rio de Janeiro – 2016

Objective: To investigate knowledge and care related to gynecological health of the Brazilian female athletes participating of the 2016 Summer Olympic Games held in Rio de Janeiro, Brazil. Material and Methods: An observational study was elaborated and proposed through an online questionnaire drawn up by Informatics Health Department of the Sao Paulo Federal University. It was based on Google Forms and was sent by email to the participants. This tool is an adapted online version of a validated questionnaire for specific evaluation of female athletes – Pre- participation Gynecological Evaluation of Female Athletes (PPGE). The inclusion criterions were: to be female, older than 16 years old and be a participant of the event. This study was approved by Research Ethics Committee of Sao Paulo Federal University under the registration 0761/2016, CAAE 1.615.280. Results: The athletes practiced 28 different sportive modalities, mean age of 27±5 years old. For 66% of them, it was the first Olympic participation. Most of them had already menstruated (99%). They referred the use of contraceptive methods, mainly oral ones (61%). 77% believed that vaginal bleeding influences sportive performance and 63% preferred to compete after it. Only 26% would not compete in their phase of choice. Anxiety symptoms, bloating, increased appetite, depression and dysmenorrhea were referred by 52% of them. Among these, 49% related that these symptoms worsen the sportive performance. The percentual of athletes who had no knowledge about Female Athlete Triad was 56%. 77% referred weight concern and the majority were on a diet. The use of diuretics, laxative or vomiting for weight loss was related at some point by 11% of them, being more prevalent among those who were on a diet. Among these, 77% referred to use these methods to optimize the loss. In relation to urinary incontinence, 67,5% of them knew about Athletic Urinary Incontinence and 40% referred urinary loss at same point. 31% also referred drop in performance. Mostly the participants had access to multidisciplinary follow up, psychological (83%), nutritional (96%) and gynecological (83%) during the Olympic cycle. Conclusion: Most of Brazilian Olympic athletes use hormonal contraceptives, mainly orally. They present physical and mood symptoms related to vaginal bleeding and try to plan their flow to optimize the sports performance. Besides the multidisciplinary follow up, they, still, do not know the affections to which they are exposed as the Female Athlete Triad, present athletic urinary incontinence and put their health at risk to weight control.Objetivo: Investigar o conhecimento e o cuidado relacionado à saúde ginecológica das atletas brasileiras participantes dos Jogos Olímpicos do Rio de Janeiro – 2016 Material e métodos: Estudo observacional realizado por meio de um questionário on-line elaborado junto ao Departamento de Informática em Saúde (DIS) da Escola Paulista de Medicina. O mesmo tinha como base a plataforma Google Forms e foi enviado por e-mail às participantes. Esse instrumento é uma versão online adaptada de um questionário validado e específico para a avaliação de mulheres praticantes de exercício físico - Pre-participation gynecological evaluation of Female athletes (PPGE). Foram critérios de inclusão: ser mulher, ter idade maior que 16 anos e participar do evento. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo - Escola Paulista de Medicina, sob a inscrição CEP 0761/2016, número do parecer 1.615.280. Resultados: As atletas praticavam 28 modalidades esportivas e tinham em média 27±5anos. A maioria encontrava-se (66%) em sua primeira participação olímpica. Quase a totalidade das atletas já havia menstruado (99%). A maioria fazia uso de métodos contraceptivos, principalmente os orais (61%). 77% das atletas acreditavam que o sangramento vaginal influenciava o desempenho esportivo, sendo que 63% preferiam competir após o mesmo e apenas 26% não competiriam os Jogos Olímpicos em sua fase de escolha. Sintomas de ansiedade, inchaço, aumento de apetite, depressão e dismenorreia foram referidos por 52% delas. Dessas 49% relatam que eles pioram o rendimento esportivo. O percentual das atletas que não tinham conhecimento sobre a Tríade da Mulher Atleta foi de 56%. Referiram preocupação com o peso 77% delas, estando a maioria em dieta. O uso de diuréticos, laxante ou vômito foi relatado por 11%, entretanto entre as que faziam dieta, 77% usavam destes meios para otimizar a perda. Em relação à incontinência urinária atlética, 67,5% conheciam o esporte como fator de risco e 40% já tinham perdido urina em algum momento, 31% referindo queda de rendimento. Muitas das atletas apresentaram acompanhamento multidisciplinar, psicológico (83%), nutricional (96%) e ginecológico (83%), durante o ciclo olímpico. Conclusão: A atleta olímpica brasileira faz uso de contraceptivos hormonais, em sua maioria orais. Apresenta sintomas físicos e de humor associados ao sangramento vaginal e busca planejar seu fluxo para otimizar o rendimento esportivo. Apesar do acompanhamento multidisciplinar, ainda desconhecem afecções a que estão expostas como a Tríade da Mulher Atleta, apresentam incontinência urinária atlética e colocam sua saúde em risco para o controle de peso.Dados abertos - Sucupira - Teses e dissertações (2020

Fatores antinutricionais na alimentação humana

Fatores antinutricionais são compostos oriundos do metabolismo secundário das plantas, presentes numa extensa variedade de alimentos de origem vegetal. Este trabalho teve como objetivo pesquisar os diversos fatores antinutricionais, em especial o ácido cianídrico, o ácido fítico e o ácido oxálico, presentes nos alimentos do nosso dia a dia, as consequências quando há alta ingestão dos mesmos e os métodos de redução desses antinutrientes no preparo dos alimentos como remolho, germinação, cozimento, fatiagem, maceração, trituração, ralagem, fermentação, maltagem, moagem, secagem e torrefação. A metodologia utilizada foi revisão de literatura. A partir desta revisão, conclui-se que tanto o ácido cianídrico como o ácido fítico pode ser reduzido nos alimentos por meio de processos utilizados tanto na preparação doméstica como na industrial, e que a melhor forma de redução do ácido oxálico insolúvel é evitando ou minimizando o consumo de alimentos que o contém.</jats:p