Impacto do padrão geométrico ventricular na remodelação cardíaca após o infarto do miocárdio

BACKGROUND: The relevance of left ventricular (LV) geometric pattern after myocardial infarction is not known. OBJECTIVES: To analyze the presence of different LV geometric patterns and teir impact as a predictor of remodeling in patients with myocardial infarction. METHODS: Patients with anterior acute myocardial infarction (n = 80) were divided according to the geometric pattern: normal (normal left ventricular mass index [LVMI] and normal relative wall thickness [RWT]), concentric remodeling (normal LVMI and increased RWT), concentric hypertrophy (increased LVMI and RWT) and eccentric hypertrophy (increased LVMI and normal RWT). After six months, echocardiographic assessment was repeated. RESULTS: Four patients died. Of the survivors, 41 showed remodeling (R +), whereas 39 did not (R-). Considering the geometric pattern, the cases were distributed as follows: 24 patients with normal pattern, 13 with concentric remodeling, 29 with concentric hypertrophy and 14 with eccentric hypertrophy. Patients who showed remodeling had larger infarction sizes analyzed by peak CPK (R + = 4,610 (1,688-7,970), R- = 1,442 (775-4247), p <0.001) and CK-MB (R + = 441 (246 - 666), R- = 183 (101-465), p <0.001), trend towards higher prevalence of concentric remodeling (R+ = 10, R- = 3, p = 0.08) and lower prevalence of eccentric hypertrophy (R + = 2 R- = 12, p = 0.006). In the multivariate regression analysis, infarction size was a predictor (OR = 1.01, p = 0.020) and eccentric hypertrophy was a protective factor (OR = 0.189, p = 0.046) of ventricular remodeling after coronary occlusion. CONCLUSION: The LV geometric pattern of can have an impact on the remodeling process in patients with myocardial infarction.

Efeito do betacaroteno sobre o estresse oxidativo e a expressão de conexina 43 cardíaca

BACKGROUND: Intervention studies have shown an increased mortality in patients who received beta-carotene. However, the mechanisms involved in this phenomenon are still unknown. OBJECTIVE: Evaluate the influence of beta-carotene on oxidative stress and the expression of connexin 43 in rat hearts. METHODS: Wistar rats, weighing approximately 100 g, were allocated in two groups: Control Group (n=30), that received the diet routinely used in our laboratory, and Beta-Carotene Group (n = 28), which received beta-carotene (in crystal form, added and mixed to the diet) at a dose of 500 mg of beta-carotene/kg of diet. The animals received the treatment until they reached 200-250g, when they were sacrificed. Samples of blood, liver and heart were collected to perform Western blotting and immunohistochemistry for connexin 43; morphometric studies, dosages of beta-carotene by high-performance liquid chromatography as well as reduced glutathione, oxidized glutathione and lipids hydroperoxides were performed by biochemical analysis. RESULTS: Beta-carotene was detected only in the liver of Beta-Carotene Group animals (288 ± 94.7 µg/kg). Levels of reduced/oxidized glutathione were higher in the liver and heart of Beta-Carotene Group animals (liver - Control Group: 42.60 ± 1.62; liver - Beta-Carotene Group: 57.40 ± 5.90; p = 0.04; heart: - Control Group: 117.40 ± 1.01; heart - Beta-Carotene Group: 121.81 ± 1.32 nmol/mg protein; p = 0.03). The content of total connexin 43 was larger in Beta-Carotene Group. CONCLUSION: Beta-carotene demonstrated a positive effect, characterized by the increase of intercellular communication and improvement of anti-oxidizing defense system. In this model, mechanism does not explain the increased mortality rate observed with the beta-carotene supplementation in clinical studies. (Arq Bras Cardiol. 2013; [online].ahead print, PP.0-0)

Avaliação dos fatores de risco de quedas em mulheres na pós-menopausa inicial

OBJETIVO: Foi avaliar a frequência e os fatores de risco de quedas em mulheres na pós-menopausa. MÉTODOS: Estudo clínico, transversal, envolvendo 358 mulheres (idade entre 45 e 65 anos e amenorreia >12 meses) com tempo de pós-menopausa <10 anos. Os critérios de exclusão foram: doença neurológica ou músculo esquelético, vestibulopatias, hipertensão arterial não controlada, hipotensão postural, déficit visual sem correção, uso de medicamentos (sedativos e hipnóticos). A queda foi definida como mudança de posição inesperada, não intencional, que faz com que o indivíduo permaneça em nível inferior à posição inicial. Foram analisados o histórico de quedas (últimos 24 meses) e as características clínicas, antropométricas (índice de massa corpórea (IMC) e circunferência da cintura (CC)) e densidade mineral óssea. Na comparação segundo grupo de mulheres com e sem histórico de queda, foi empregado o Teste do Qui-quadrado ou Exato de Fisher e regressão logística com cálculo do odds ratio (OR). RESULTADOS: Entre as mulheres incluídas, 48,0% (172/358) referiram queda, com fratura em 17,4% (30/172). A queda ocorreu dentro de casa em 58,7% (101/172). A média de idade foi 55,7±6,5 anos, tempo de menopausa de 5,8±3,5anos, IMC 28,3±4,6 kg/m² e CC 89,0±11,4 cm. Foi observada maior frequência de tabagismo e diabetes entre as mulheres com histórico de quedas quando comparadas àquelas sem queda, de 25,6 versus 16,1% e 12,8 versus 5,9%, respectivamente (p<0,05). Na análise multivariada em função das variáveis clínicas influentes, o risco de queda aumentou com o tabagismo atual (OR 1,93; IC95% 1,01-3,71). Demais variáveis clínicas e antropométricas não influenciaram no risco de queda. CONCLUSÕES: Em mulheres na pós-menopausa inicial houve expressiva frequência de quedas. O tabagismo foi indicador clínico de risco para queda. Com o reconhecimento de fatores determinantes para queda, medidas preventivas são importantes, como a orientação de abolir o tabagismo.

Nutrient intake, productive performance and body measurements of dairy heifers fed with different sources of protein

This study evaluated the effect of different protein sources (soybean meal, cottonseed meal, peanut meal and sunflower meal) on dry matter and nutrient intake, productive performance and body measurements of dairy heifers, Holstein x Zebu, recreated in confinement. The experiment consisted in a randomized complete block design made up by 6 replications and 4 treatments. The mean values of ingestion of ether extract (EEI, kg day-1) were statistically different (p < 0.05). The neutral detergent fiber intake (NDFI, %BW) also presented differences (p < 0.05), with higher values in the diet containing sunflower meal (1.01% BW) in relation to the diet with soybean meal (0.84% BW). The average daily weight gain using the diet with soybean meal was superior (0.95 kg day-1) to the diet with sunflower meal (0.82 kg day-1), and considering the final body weight, the diet with soybean meal was superior to the other treatments (p < 0.05). The heart girth presented greater association with body weight (0.93). The soybean meal promoted the best productive performance of crossbred Holstein x Zebu heifers fed diets based on sugarcane. However, cottonseed meal, peanut meal and sunflower meal can be possible alternatives to soybean meal.

Evaluation of Renal Protection From High Doses of Melatonin in an Experimental Model of Renal Ischemia and Reperfusion in Hyperglycemic Rats

Background. Melatonin is a free radical scavenger with important actions in the study of renal ischemia and reperfusion (I/R). This study evaluated possible renal protection of high doses of melatonin in an experimental model of I/R in which rats were submitted to acute hyperglycemia under anesthesia with isoflurane.Method. Forty-four male Wistar rats, weighing more than 300 g, were randomly divided into 5 groups: G1, sham (n = 10); G2, melatonin (n = 10; 50 mg.kg(-1)); G3, hyperglycemia (n = 9; glucose 2.5 g.kg(-1)); G4, hyperglycemia/melatonin (n = 10; 2.5 g.kg(-1) glucose + melatonin 50 mg.kg(-1)); and G5, I/R (n = 5). In all groups, anesthesia was induced with 4% isoflurane and maintained with 1.5% to 2.0% isoflurane. Intraperitoneal injection of melatonin (G1, G4), glucose (G3, G4), or saline (G1, G5) was performed 40 minutes before left renal ischemia. Serum plasma values for creatinine and glucose were determined at baseline (M1), immediately following reperfusion (M2), and 24 hours after completion of the experiment (M3). Histological analysis was performed to evaluate tubular necrosis (0-5).Results. Serum glucose was higher at M2 in the groups supplemented with glucose, hyperglycemia (356.00 +/- 107.83), and hyperglycemia/melatonin (445.3 +/- 148.32). Creatinine values were higher at T3 (P = .0001) for I/R (3.6 +/- 0.37), hyperglycemia/melatonin (3.9 +/- 0.46), and hyperglycemia (3.71 +/- 0.69) and lower in the sham (0.79 +/- 0.16) and melatonin (2.01 +/- 1.01) groups, P < .05. Histology showed no necrosis injury in the G1, lesion grade 2 in the G2, and severe acute tubular necrosis in the G3: (grade 4), G4: (grade 5) and G5: (grade 4) groups (P < .0001).Discussion. Melatonin protected the kidneys submitted to I/R in rats without hyperglycemia; however, this did not occur when the I/R lesion was associated with hyperglycemia.Conclusions. Due to its antioxidant and antiapoptotic action, melatonin was able to mitigate, but not prevent acute tubular necrosis in rats with hyperglycemia under anesthesia by isoflurane.

Characterization of antibiosis to the redbanded stink bug Piezodorus guildinii (Hemiptera: Pentatomidae) in soybean entries

Stink bugs are among the major pests of soybean [Glycine max (L.) Merrill] worldwide. Piezodorus guildinii [Westwood] (Hemiptera: Pentatomidae) is one of the predominant pest species, causing more severe damage in many regions than other stink bugs. Its attack reduces yield and quality of the beans. Plant resistance is a valuable strategy in integrated pest management that can reduce insect populations below economic injury level. Here, we report the resistance of 17 soybean entries to P. guildinii. PI 229358, PI 274454, L1-1-01, IAC 19, PI 171451, PI 227687, IAC 100, IAC 78-2318, PI 274453, and IAC 74-2832 caused high nymphal mortality (greater than 90 %), indicating the expression of antibiosis. IAC 100, IAC 74-2832, PI 274453, and IAC 24 also increased the length of the nymphal stage of P. guildinii, showing the same mechanism of resistance. Our findings may be useful for breeding programs that focus on the resistance of soybeans to insects.

Ansiedade e baixo nível motivacional associados ao fracasso na cessação do tabagismo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação do efeito da inclinação e umidade antecedente na qualidade e quantidade das parcelas escoadas, percoladas e armazenadas em telhado verde extensivo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of Clinical and Inflammatory Markers of Nonalcoholic Fatty Liver Disease in Postmenopausal Women with Metabolic Syndrome

Background: The aim of this study was to assess clinical and inflammatory markers in nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with metabolic syndrome.Methods: This cross-sectional study included 180 Brazilian women (age >= 45 years and amenorrhea >= 12 months). Metabolic syndrome was diagnosed by the presence of at least three of the following indicators: Waist circumference (WC) > 88 cm, triglycerides (TGs) >= 150 mg/dL, high-density lipoprotein (HDL) < 50 mg/dL; blood pressure >= 130/85 mmHg; and glucose >= 100 mg/dL. NAFLD was diagnosed by abdominal ultrasound. Participants were divided into three groups: Metabolic syndrome alone (n = 53); metabolic syndrome + NAFLD (n = 67); or absence of metabolic syndrome or NAFLD (control, n = 60). Clinical, anthropometric, and biochemical variables were quantified. The inflammatory profile included adiponectin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha). Data were submitted to statistical analysis using a Tukey test, analysis of variance (ANOVA), chi-squared, Pearson correlation, and logistic regression (odds ratio, OR).Results: Women with metabolic syndrome + NAFLD, abdominal obesity, high glucose, and insulin resistance by HOMA-IR were compared to women with metabolic syndrome alone and controls (P < 0.05). High values of IL-6 and TNF-alpha and low values of adiponectin were observed among women with metabolic syndrome alone or metabolic syndrome + NAFLD when compared to controls (P < 0.05). In multivariate analysis, the variables considered as risk of NAFLD development were: High systolic blood pressure (SBP) [(OR 1.02, 95% confidence interval (CI) 1.0-1.04]; large WC (OR 1.07, 95% CI 1.01-1.13); insulin resistance (OR 3.81, 95% CI 2.01-7.13); and metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). Adiponectin levels reduced NAFLD risk (OR 0.88, 95% CI 0.80-0.96).Conclusion: In postmenopausal women, metabolic syndrome, abdominal obesity, and insulin resistance were risk markers for the development of NAFLD, whereas higher adiponectin values indicated a protection marker.

Non-alcoholic fatty liver disease and its associated risk factors in Brazilian postmenopausal women

Objective To evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women.Methods A cross-sectional study was carried involving 188 women (age >= 45 years and amenorrhea >= 12 months) attending the outpatient unit in south-eastern Brazil. Exclusion criteria were liver disease (hepatitis B and C, cholestatic disease, liver insufficiency), use of drugs that affect liver metabolism; alcoholics; AIDS or cancer history; and morbid obesity. NAFLD was diagnosed by abdominal ultrasound. Clinical, anthropometric (body mass index, waist circumference) and biochemical variables were measured.Results Of the 188 women, 73 (38.8%) had NAFLD. Blood pressure, waist circumference, body mass index, LDL cholesterol, triglycerides and glucose were significantly higher in NAFLD patients when compared with women without NAFLD (control group) (p < 0.05). HOMA-IR values indicated insulin resistance only in the NAFLD group (6.1 +/- 4.6 vs. 2.4 +/- 1.4 in control group, p < 0.05). Metabolic syndrome was detected in 93.1% of the women affected by NAFLD, and 46.1% of the control group (p < 0.05). In multivariate analysis, adjusted for age and weight, the variables considered at risk for the development of NAFLD, were: high waist circumference (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.13), insulin resistance (OR 3.81, 95% CI 2.01-7.13), and presence of metabolic syndrome (OR 8.68, 95% CI 3.3-24.1).Conclusion NAFLD showed a high prevalence among postmenopausal women. The presence of metabolic syndrome, abdominal obesity and IR were indicators of risk for the development of NAFLD.

IL-10 e TNF-α no sangue materno e nas placentas de gestações complicadas por diabete ou hiperglicemia gestacional leve - correlação com controle glicêmico e resultados perinatais

Objective - At evaluating the IL-10 production in maternal blood and placenta and correlate them with perinatal outcomes in pregnancies complicated by hyperglycemia, or with risk to developing it, differentiated by the glycemic mean (GM < or ≥ 100mg/dL). Method- 186 pregnant women were distributed into groups GM < 100 mg/dL and GM ≥ 100 mg/dL. We evaluated the GM, HbA1c levels, maternal and placental IL-10 and TNF-α and the correlation between placental cytokines and perinatal outcomes. Results - In maternal blood, the lower concentrations of IL-10 (1.01 ± 0.87 vs. 3.08 ± 5.57 pg / mL, p = 0.0019) were observed in GM ≥ 100 mg / dL group. Placental IL-10 was directly correlated with hemoglobin levels (r = 0.63, p = 0.02) and insulin (r = 0.78, p = 0.01) from umbilical cord and with Apgar scores 1 (r = 0.53, p = 0.0095) and Apgar 5 (r = 0.69, p = 0.0003). Conclusion - GM ≥ 100mg/dL was associated with decreased of maternal IL-10. Placental IL-10 was similar in both groups and correlated directly with hemoglobin and insulin and with Apgar scores of 1st. and 5th. minutes

Comparação de gastos com serviços de atenção básica à saúde de homens e mulheres em Bauru, São Paulo, 2010

OBJECTIVE: to compare expenditure on primary health care services for men and women in Bauru-SP, Brazil. METHODS: cross-sectional study with a sample composed of randomly selected health service users' aged ≥50 years. Healthcare expenditure over the last 12 months was analyzed and stratified into: medical consultations, exams, medication and overall expenditure. RESULTS: 707 women and 256 men were assessed. Women had higher overall expenditures than men (median: R$128.1 versus R$108.6; p-value=0.027). Comparing females and males, being female was associated with higher medical consultation expenditure (27.6% versus 18.4%, respectively p-value=0.005) and exams (27.1% versus 19.5%, respectively p-value=0.022). After statistical adjustments (smoking, socioeconomic status, physical activity and overweight), being female was still associated with higher exam-related expenditure (Odds Ratio= 1.47; 95% confidence interval: 1.01-2.14). CONCLUSION: women have higher expenditure related to exams than men. Female obesity was associated with medical consultation higher expenditure.

Resistência de genótipos de soja a Dichelops melacanthus (Dallas)(HEMIPTERA: PENTATOMIDAE)

Pós-graduação em Agronomia (Proteção de Plantas) - FCA

Low serum potassium levels increase the infectious-caused mortality in peritoneal dialysis patients: a propensity-matched score study

Background and ObjectivesHypokalemia has been consistently associated with high mortality rate in peritoneal dialysis. However, studies investigating if hypokalemia is acting as a surrogate marker of comorbidities or has a direct effect in the risk for mortality have not been studied. Thus, the aim of this study was to analyze the effect of hypokalemia on overall and cause-specific mortality.Design, Setting, Participants and MeasurementsThis is an analysis of BRAZPD II, a nationwide prospective cohort study. All patients on PD for longer than 90 days with measured serum potassium levels were used to verify the association of hypokalemia with overall and cause-specific mortality using a propensity match score to reduce selection bias. In addition, competing risks were also taken into account for the analysis of cause-specific mortality.ResultsThere was a U-shaped relationship between time-averaged serum potassium and all-cause mortality of PD patients. Cardiovascular disease was the main cause of death in the normokalemic group with 133 events (41.8%) followed by PD-non related infections, n=105 (33.0%). Hypokalemia was associated with a 49% increased risk for CV mortality after adjustments for covariates and the presence of competing risks (SHR 1.49; CI95% 1.01-2.21). In contrast, in the group of patients with K < 3.5mEq/L, PD-non related infections were the main cause of death with 43 events (44.3%) followed by cardiovascular disease (n=36; 37.1%). For PD-non related infections the SHR was 2.19 (CI95% 1.52-3.14) while for peritonitis was SHR 1.09 (CI95% 0.47-2.49).ConclusionsHypokalemia had a significant impact on overall, cardiovascular and infectious mortality even after adjustments for competing risks. The causative nature of this association suggested by our study raises the need for intervention studies looking at the effect of potassium supplementation on clinical outcomes of PD patients.

Systemic lupus erythematous and clinical outcomes in peritoneal dialysis

Background: The prevalence of systemic lupus erythematous (SLE) patients requiring renal replacement therapy (RRT) is increasing but data on clinical outcomes are scarce. Interestingly, data on technique failure and peritoneal-dialysis (PD)-related infections are rarer, despite SLE patients being considered at high risk for infections. The aim of our study is to compare clinical outcomes of SLE patients on PD in a large PD cohort. Methods: We conducted a nationwide prospective observational study from the BRAZPD II cohort. For this study we identified all patients on PD for greater than 90 days. Within that subset, all those with SLE as primary renal disease were matched with PD patients without SLE for comparison of clinical outcomes, namely: patient mortality, technique survival and time to first peritonitis, then were analyzed taking into account the presence of competing risks. Results: Out of a total of 9907 patients, we identified 102 SLE patients incident in PD and with more than 90 days on PD. After matching the groups consisted of 92 patients with SLE and 340 matched controls. Mean age was 46.9 +/- 16.8 years, 77.3% were females and 58.1% were Caucasians. After adjustments SLE sub-hazard distribution ratio for mortality was 1.06 (CI 95% 0.55-2.05), for technique failure was 1.01 (CI 95% 0.54-1.91) and for time to first peritonitis episode was 1.40 (CI 95% 0.92-2.11). The probability for occurrence of competing risks in all three outcomes was similar between groups. Conclusion: PD therapy was shown to be a safe and equally successful therapy for SLE patients compared to matched non-SLE patients.