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Spatial arrangement of distinct Amazonian environments through time and its effect on specialized biota remain poorly known, fueling long-lasting debates about drivers of biotic diversification. We address the late Quaternary sediment deposition that assembled the world's largest seasonally flooded ecosystems. Genome sequencing was used to reconstruct the demographic history of bird species specialized in either early successional vegetation or mature floodplain forests. Sediment deposition that built seasonally flooded habitats accelerated throughout the Holocene (last 11,700 years) under sea level highstand and intensification of the South American Monsoon, at the same time as global increases in atmospheric methane concentration. Bird populations adapted to seasonally flooded habitats expanded due to enlargement of Amazonian river floodplains and archipelagos. Our findings suggest that the diversification of the biota specialized in seasonally flooded habitats is coupled to sedimentary budget changes of large rivers, which rely on combined effects of sea level and rainfall variations.

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We investigated whether hospitalized malnourished adults would have longer QTc intervals on their electrocardiograms (ECGs) than non-malnourished adults. Seventy-five consecutive adults hospitalized in the Internal Medicine wards of our teaching hospital were prospectively studied. Main diagnoses, anthropometry, including body mass index (kg/m(2)), ECGs, and simultaneous serum levels of sodium, potassium, magnesium, phosphorus, and calcium were recorded. All QT intervals on ECGs were measured in a semiautomatic image analysis system; and QTc intervals were determined with the Bazett formula. Protein-energy malnutrition (PEM) was diagnosed with body mass index below 18.5 kg/m(2). There was no statistical difference between malnourished (n = 30) and non-malnourished (n = 45) with regard to age (40.7 +/- 18.9 y versus 41.4 +/- 16.2 y), male predominance (66.7% versus 80%), or associated diagnoses. Compared with non-malnourished, malnourished patients had higher percentages of positive C-reactive protein (66.7 versus 23.8%), lower serum levels of albumin (2.51 +/- 0.89 g/dL versus 3.41 +/- 0.74 g/dL) and potassium (3.64 +/- 0.65 mEq/L versus 4.12 +/- 0.65 mEq/L), and increased QTc lengths on ECGs (0.423 +/- 0.033 ms versus 0.396 +/- 0.031 ms). Malnourished adults hospitalized in general clinical wards are more likely to have longer QTc intervals on their ECGs, a phenomenon possibly linked to malnutrition and associated electrolyte disturbances.

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The objective of this study was to compare growth retardation frequency, and 24-h food intake data of children with or without positive Montenegro (leishmanin) test, examined in Porteirinha town, Brazil. Daily nutrient intake was determined by 24-h food intake recall and the anthropometric data were compared to the standard values from WHO. Montenegro-positive (n = 9) and Montenegro-negative (n = 17) groups showed similar age (5.5 +/- 1.9 vs 6.7 +/- 2.3y), and energy (1,456.8 +/- 314.8 vs 1,316.2 +/- 223.8kcal) and protein (50.4 +/- 16.7 vs 49.9 +/- 13.9g) daily consumption, respectively. Montenegro-positive children had higher percentage of stunting than their Montenegro-negative counterparts (44.4 vs 5.9), suggesting that previous Leishmania sp infection had negative impact on children's nutritional status.

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AIMS & METHODS: Serum levels of vitamins A, E, C, B2 and carotenoids were determined in protein-energy malnourished (PEM, with body mass index, BMI<18.5 kg/m2) and non-PEM (BMI+/-18.5 kg/m2) hospitalized elderly (age > or = 65 years) patients, in the University Hospital of Faculty of Medicine of Ribeirão Preto, São Paulo University. RESULTS: PEM (n=21) and non-PEM (n=106) patients were paired for age (73.6+/-7.3 vs. 71.6+/-5.6 years) and male percentage (65.1 vs. 52.4%). As expected, PEM elderly showed lower (P<0.05) body weight (median 43.1; range: 29.9-51.4 vs. 58.1; range: 45.7-143.5 kg), triceps skinfold (5.2+/-3.1 vs. 10.1+/-4.9 mm), and mid-arm muscle circumference (20.3+/-2.5 vs. 23.1+/-3.4 cm). Serum albumin (4.0+/-0.9 vs. 4.1+/-0.7 g/dl) and total lymphocytes count (1918.3+/-919 vs. 1842.7+/-862 mm(3)) were similar, respectively, among PEM and non-PEM patients. The percentage of biochemical riboflavin deficiency (58.8 vs. 56.2), low serum levels of vitamin A (28.6 vs. 29.6) and vitamin E (18.7 vs. 25) were similar, respectively, between PEM and non-PEM groups. The prevalence of low serum levels of water soluble vitamins was higher (P<0.01) in malnourished elderly than in the non-PEM group (ascorbic acid, 80.9 vs. 56.7%, and carotenoids, 14.3 vs. 3%, respectively). CONCLUSIONS: These results suggest that hospitalized malnourished elderly show high percentage of low water soluble vitamin serum levels, a phenomenon possibly linked to decreased food intake, especially fruits and vegetables.

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The objective of this study was to compare growth retardation frequency, and 24-h food intake data of children with or without positive Montenegro (leishmanin) test, examined in Porteirinha town, Brazil. Daily nutrient intake was determined by 24-h food intake recall and the anthropometric data were compared to the standard values from WHO. Montenegro-positive (n = 9) and Montenegro-negative (n = 17) groups showed similar age (5.5 +/- 1.9 vs 6.7 +/- 2.3y), and energy (1,456.8 +/- 314.8 vs 1,316.2 +/- 223.8kcal) and protein (50.4 +/- 16.7 vs 49.9 +/- 13.9g) daily consumption, respectively. Montenegro-positive children had higher percentage of stunting than their Montenegro-negative counterparts (44.4 vs 5.9), suggesting that previous Leishmania sp infection had negative impact on children's nutritional status.

O objetivo deste trabalho foi comparar a ingestão alimentar habitual e a freqüência de retardo do crescimento de crianças com reação intradérmica positiva para leishmaniose (Montenegro-positivas), com um grupo Montenegro-negativo. A ingestão alimentar habitual foi avaliada pelo recordatório de 24 horas e o retardo do crescimento definido segundo critérios da OMS. Crianças Montenegro-positivo (n = 9) e Montenegro-negativo (n = 17) ingeriam, respectivamente, quantidades similares de energia (1456,8 ± 314,8 vs 1316,2 ± 223,8kcal/dia) e proteínas (50,4 ± 16,7 vs 49,9 ± 13,9g/dia). Déficit de altura foi mais comum em crianças Montenegro-positivas (44,4 vs 5,9). Estes dados sugerem que a infecção prévia pela Leishmania sp afeta desfavoravelmente o estado nutricional de crianças vivendo em área endêmica.

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PURPOSE: Hyperglycemia and abnormal glucose tolerance tests observed in some patients with chronic Chagas' disease suggest the possibility of morphological changes in pancreatic islets and/or denervation. The purpose of this study was to describe the morphology and morphometry of pancreatic islets in chronic Chagas' disease. METHODS: Morphologic and computerized morphometric studies were performed in fragments of the head, body, and tail regions of the pancreas obtained at necropsies of 8 normal controls and 17 patients with chronic Chagas' disease: 8 with the digestive form (Megas) and 9 with the congestive heart failure form. RESULTS: The Megas group had a larger (p < 0.05) pancreatic islet area in the tail of the pancreas (10649.3 +/- 4408.8 micrometer2) than the normal control (9481.8 +/- 3242.4 micrometer2) and congestive heart failure (9475.1 +/- 2104.9 micrometer2) groups; likewise, the density of the pancreatic islets (PI) was greater (1.2 +/- 0.7 vs. 0.9 +/- 0.6 vs. 1.9 +/- 1.0 PI/mm2, respectively). In the tail region of the pancreas of patients with the Megas form, there was a significant and positive correlation (r = +0.73) between the area and density of pancreatic islets. Discrete fibrosis and leukocytic infiltrates were found in pancreatic ganglia and pancreatic islets of the patients with Chagas' disease. Trypanosoma cruzi nests were not observed in the examined sections. Individuals with the Megas form of Chagas' disease showed increased area and density of pancreatic islets in the tail of the pancreas. CONCLUSION: The observed morphometric and morphologic alterations are consistent with functional changes in the pancreas, including glycemia and insulin disturbances.

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UNLABELLED: Pressure sores are common among bedridden, elderly, or malnourished patients, and may occur in terminal ill patients because of impaired mobility, fecal or urinary incontinence, and decreased healing capacity. The aim of this study was to compare frequency of pressure sores between malnourished and non-malnourished necropsied adults. METHOD: All (n = 201) adults (age >/= 18 years) autopsied between 1986 and 1996 at the Teaching Hospital of Triangulo Mineiro Medical School (Uberaba) were eligible for the study. Gender, race, weight, height and main diagnoses were recorded. Ninety-six cases were excluded because of probable body water retention (congestive heart failure, hepatic insufficiency, nephrotic syndrome) or pressure sores secondary to peripheral vascular ischemia. Body mass index (BMI) was used to define malnourished (BMI < 18.5 kg/m2) and non-malnourished (BMI > 18.5kg/m2) groups. RESULTS: Except for weight (42.5kg; range: 28-57 vs. 60; 36-134.5kg) and BMI (16.9; range: 12.4-18.5 vs. 22.7; range: 18.5-54.6kg/m2), respectively, there were no statistical differences among 43 malnourished and 62 non-malnourished cases in relation to age (54.9 +/- 20.4 vs. 52.9 +/- 17.9 years), percentage of white persons (74.4 vs. 64.5%), male gender (76.7 vs. 69.3%) and main diagnoses. Five malnourished (11. 6%) and 7 (11.5%) non-malnourished cases had pressure sores (p=0.89). CONCLUSION: Pressure sores were equally common findings in necropsied persons with protein-energy malnutrition, as assessed by body mass index.

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Nutritional status and some iron metabolism parameters of acute phase response (APR) positive and APR-negative AIDS patients were studied. Twenty-nine AIDS patients were submitted to 24h food intake recall, anthropometry, and albumin, C-reactive protein (CRP), hemoglobin, ferritin, and total iron binding capacity (TIBC) measurements. Infection plus serum CRP > 7 mg/dl were criteria for APR presence. Protein-energy malnutrition (PEM) was ascertained by body mass index (BMI) lower than 18.5 kg/m2 and height-creatinine index (HCI < 70%). PEM (77.8 vs 40%) and pulmonary tuberculosis (44. 4 vs 9.5%) were more frequent in APR-positive patients, which also had lower serum albumin (3.7 +/- 0.9 vs 4.3 +/- 0.9 g/dl), TIBC (165. 8 +/- 110.7 vs 265.9 +/- 74.6 mg/dl) and blood hemoglobin (10.5 +/- 1. 8 vs 12.6 +/- 2.3g/dl). Iron intake was similar between groups; however, serum ferritin levels (median, range) were higher among APR-positive (568, 45.3-1814 vs 246, 18.4-1577 ng/ml) patients. HIV-positive adults with systemic response to invading pathogens showed worse nutritional status than those APR-negative. In APR-positive AIDS patients, anemia appears to be unrelated to recent iron intake.

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