Malnutrition during lactation is associated with hypoprolactinemia and failure in milk production. Adult rats whose mothers were malnourished presented higher body weight and serum triiodothyronine (T 3 ). Maternal hypoprolactinemia at the end of lactation caused higher body weight in adult life, suggesting an association between maternal prolactin (PRL) level and programming of the offspring's adult body weight. Here, we studied the consequences of the maternal PRL inhibition at the end of lactation by bromocriptine (BRO) injection, a dopaminergic agonist, upon serum TSH and thyroid hormones, thyroid iodide uptake, liver mitochondrial a-glycerophosphate dehydrogenase (mGPD), liver and pituitary de-iodinase activities (D1 and/or D2), and in vitro post-TRH TSH release in the adult offspring. Wistar lactating rats were divided into BRO -injected with 1 mg/twice a day, daily for the last 3 days of lactation, and C -control, saline-injected with the same frequency. At 180 days of age, the offspring were injected with 125 I i.p. and after 2 h, they were killed. Adult animals whose mothers were treated with BRO at the end of lactation presented lower serum TSH (K51%), T 3 (K23%), and thyroxine (K21%), lower thyroid 125 I uptake (K41%), liver mGPD (K55%), and pituitary D2 (K51%) activities, without changes in the in vitro post-TRH TSH release. We show that maternal PRL suppression at the end of lactation programs a hypometabolic state in adulthood, in part due to a thyroid hypofunction, caused by a central hypothyroidism, probably due to decreased TRH secretion. We suggest that PRL during lactation can regulate the hypothalamus-pituitary-thyroid axis and programs its function.
The scope of this study was to monitor the access of persons with disabilities and permanent mobility restrictions to the Unified Health System in João Pessoa, State of Pernambuco. This is a descriptive field study, consisting of a random sample of 523 people with disabilities or permanent mobility restrictions. Data collection occurred between August 2007 and December 2008 and consisted of home interviews. The neuromusculoskeletal functions and those related to movement (52%) were among the most affected body functions, with a higher incidence among body structures related to movement (44.2%) and those of the nervous system (39.2%), with special emphasis on the high number of cases (14%) due to the sequelae from strokes. Among the respondents, 63.9% stated that there had not been sufficient and appropriate means to lessen the physical obstacles between their homes and the places where they received healthcare, and 41.7% claimed that there were no special facilities for the handicapped in the healthcare offices. Brazilian law ensures rights for people with disabilities, which were not broadly respected. Action is necessary to prevent the development of disabilities, especially those resulting from the sequelae from strokes.
Protein malnutrition during neonatal programs for a lower body weight and hyperthyroidism in the adult offspring were analyzed. Liver deiodinase is increased in such animals, contributing to the high serum triiodothyronine (T3) levels. The level of deiodinase activities in other tissues is unknown. We analyzed the effect of maternal protein restriction during lactation on thyroid, skeletal muscle, and pituitary deiodinase activities in the adult offspring. For pituitary evaluation, we studied the in vitro, thyrotropin-releasing hormone (TRH)-stimulated thyroid-stimulating hormone (TSH) secretion. Lactating Wistar rats and their pups were divided into a control (C) group, fed a normal diet (23% protein), and a protein-restricted (PR) group, fed a diet containing 8% protein. At weaning, pups in both groups were fed a normal diet until 180 days old. The pituitary gland was incubated before and after TRH stimulation, and released TSH was measured by radioimmunoassay. Deiodinase activities (D1 and D2) were determined by release of (125)I from [(125)I]reverse triiodothyronine (rT3). Maternal protein malnutrition during lactation programs the adult offspring for lower muscle D2 (-43%, P<0.05) and higher muscle D1 (+83%, P<0.05) activities without changes in thyroidal deiodinase activities, higher pituitary D2 activity (1.5 times, P<0.05), and lower TSH response to in vitro TRH (-56%, P<0.05). The evaluations showed that the lower in vivo TSH detected in adult PR hyperthyroid offspring, programmed by neonatal undernutrition, may be caused by an increment of pituitary deiodination. As described for liver, higher skeletal muscle D1 activity suggests a hyperthyroid status. Our data broaden the knowledge about the adaptive changes to malnutrition during lactation and reinforce the concept of neonatal programming of the thyroid function.
Este estudo propõe analisar quais variáveis se associam com a dificuldade no acesso de idosos com deficiência aos serviços de saúde. Trata-se de um estudo observacional analítico de caráter transversal, com uma amostra de 244 idosos com deficiência. Foram agrupados dados pertinentes ao perfil socioeconômico, à caracterização da deficiência e às condições de acessibilidade aos serviços de saúde. Para análise estatística descritiva e analítica dos dados, foi utilizado o software Statistical Package for the Social Science, versão 11.0. As variáveis de proteção para a dificuldade em ser atendido nos serviços de saúde foram: ausência de esgotos, bueiros, dejetos, sacos de lixos, ou pisos quebrados; ausência de degraus nas calçadas e existência de calçamento; presença de transporte; facilidade na marcação de consultas; e o baixo tempo de espera para ser atendido. O somatório dos fatores expostos mostra que as barreiras arquitetônicas e situação atual de atenção à saúde precisam ser adequadas, visando o ingresso e utilização plena dos idosos com deficiência aos serviços de saúde.
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