Atividade sexual pós-infarto do miocárdio: tabu ou desinformação?

FUNDAMENTO: O retorno à atividade sexual após síndrome coronária aguda (SCA), apesar da importância clínica e social, é assunto pouco abordado pela equipe de saúde, e que tem recebido pouca ênfase durante a internação. A disfunção erétil tem sido uma queixa freqüente entre pacientes cardiopatas, aliada a dúvidas sobre a segurança no retorno à atividade sexual após evento cardiovascular. OBJETIVO: Descrever o conhecimento dos pacientes quanto ao infarto agudo do miocárdio (IAM) e às orientações recebidas para o retorno à atividade sexual. MÉTODOS: Estudo transversal realizado entre junho e julho de 2005. Foram incluídos pacientes que se encontravam no sexto dia pós-IAM. Foi aplicado um instrumento relacionado ao conhecimento sobre o IAM, à freqüência e às expectativas de retorno à atividade sexual no período pós-alta hospitalar. RESULTADOS: Foram incluídos 96 pacientes, dos quais 70% eram do sexo masculino, com média de idade de 59 ± 12 anos, e 80% eram vítimas de primeiro infarto agudo do miocárdio. Desses pacientes, 96% desconheciam as manifestações clínicas e as possíveis limitações provocadas pelo IAM, 63% relataram ter vida sexual ativa antes do evento, 60% tinham dúvidas quanto ao retorno à atividade sexual após a alta, e apenas 4% dos pacientes receberam orientações pelos profissionais de saúde durante o período de internação. CONCLUSÃO: Nossos achados indicam que as orientações dispensadas pela equipe aos pacientes durante a internação são subótimas, no que tange tanto ao IAM quanto ao retorno à atividade sexual. A atualização da equipe de saúde, principalmente dos enfermeiros que despendem mais tempo com os pacientes, são estratégias que podem melhorar esses resultados.

Evaluation of Sexual Dimorphism in the Efficacy and Safety of Simvastatin/Atorvastatin Therapy in a Southern Brazilian Cohort

Background: Dyslipidemia is the primary risk factor for cardiovascular disease, and statins have been effective in controlling lipid levels. Sex differences in the pharmacokinetics and pharmacodynamics of statins contribute to interindividual variations in drug efficacy and toxicity. Objective: To evaluate the presence of sexual dimorphism in the efficacy and safety of simvastatin/atorvastatin treatment. Methods: Lipid levels of 495 patients (331 women and 164 men) were measured at baseline and after 6 ± 3 months of simvastatin/atorvastatin treatment to assess the efficacy and safety profiles of both drugs. Results: Women had higher baseline levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) compared with men (p < 0.0001). After treatment, women exhibited a greater decrease in plasma TC and LDL-C levels compared with men. After adjustment for covariates, baseline levels of TC and LDL-C influenced more than 30% of the efficacy of lipid-lowering therapy (p < 0.001), regardless of sex. Myalgia [with or without changes in creatine phosphokinase (CPK) levels] occurred more frequently in women (25.9%; p = 0.002), whereas an increase in CPK and/or abnormal liver function was more frequent in in men (17.9%; p = 0.017). Conclusions: Our results show that baseline TC and LDL-C levels are the main predictors of simvastatin/atorvastatin therapy efficacy, regardless of sex. In addition, they suggest the presence of sexual dimorphism in the safety of simvastatin/atorvastatin. The effect of sex differences on receptors, transporter proteins, and gene expression pathways needs to be better evaluated and characterized to confirm these observations.

4-Second Exercise Test: Reference Values for Ages 18–81 Years

Background: Physiological reflexes modulated primarily by the vagus nerve allow the heart to decelerate and accelerate rapidly after a deep inspiration followed by rapid movement of the limbs. This is the physiological and pharmacologically validated basis for the 4-s exercise test (4sET) used to assess the vagal modulation of cardiac chronotropism. Objective: To present reference data for 4sET in healthy adults. Methods: After applying strict clinical inclusion/exclusion criteria, 1,605 healthy adults (61% men) aged between 18 and 81 years subjected to 4sET were evaluated between 1994 and 2014. Using 4sET, the cardiac vagal index (CVI) was obtained by calculating the ratio between the duration of two RR intervals in the electrocardiogram: 1) after a 4-s rapid and deep breath and immediately before pedaling and 2) at the end of a rapid and resistance-free 4-s pedaling exercise. Results: CVI varied inversely with age (r = -0.33, p < 0.01), and the intercepts and slopes of the linear regressions between CVI and age were similar for men and women (p > 0.05). Considering the heteroscedasticity and the asymmetry of the distribution of the CVI values according to age, we chose to express the reference values in percentiles for eight age groups (years): 18–30, 31–40, 41–45, 46–50, 51–55, 56–60, 61–65, and 66+, obtaining progressively lower median CVI values ranging from 1.63 to 1.24. Conclusion: The availability of CVI percentiles for different age groups should promote the clinical use of 4sET, which is a simple and safe procedure for the evaluation of vagal modulation of cardiac chronotropism.

Biologia reprodutiva de Apidoras fuscoguttatus (Siluriformes, Callichthyidae) em riacho de cabeceira da bacia do alto Rio Paraná

The reproductive biology of Aspidoras fuscoguttatus Nijssen & Isbrücker, 1976 from a stream in São José do Rio Preto, northwestern São Paulo State, Brazil, was monthly investigated in the period of August 1999 to July 2000. Measurements of total length, body weight, gonadal weight and macroscopic assessment of gonadal maturation were performed. Environmental parameters were considered in order to verify associations with the reproductive period. Populational structure showed total length amplitude between 14.2 and 50.8 mm. Pronounced sexual dimorphism was verified. The largest mean values of gonadosomatic relation for females coincided with the rainy season (November to March). Mean length at first sexual maturity was different for males (30.5 mm) and females (37.1 mm). Fecundity varied between 51 and 166 oocytes. Gonadal maturation curve, frequency of maturation stages and size frequency distributions of oocytes in mature ovaries revealed a long reproductive period, suggesting fractional spawning.

Sexual dimorphism in Liolaemus occipitalis (Iguania, Tropiduridae)

The sexual dimorphism in size, morphology and color of the lizard Liolaemus occipitalis Boulenger, 1885 was studied. Thirty-two adult males and twenty-eight adult females were sampled from a population in the Jardim do Éden beach, near Tramandaí, Rio Grande do Sul, Brazil. Size related sexual dimorphism occurred in all compared body dimensions. The largest female was 59.6 mm in snout-vent length, and the largest male was 69.3 mm. Males and females also presented differences in ventral and dorsal color pattern, and in the presence of pre-cloacal pores. The results suggest that, in Liolaemus occipitalis, sexual dimorphism in size is determined by sexual selection, competition between males and by the high energetic cost for females a few months after hatching.

The stridulatory setae of Acanthoscurria suina (Araneae, Theraphosidae) and their possible role in sexual communication: an experimental approach

Specialized setae placed on proximal segments of appendages in tarantulas have been related to sound production (stridulation), used in defense or sexual communication. The surface structure of called stridulatory setae of Acanthoscurria suina Pocock, 1903 was studied by SEM. Three morphological types of setae were recognized and at least two of them could be involved in stridulation. Their role in sexual communication was tested by experimental removal. Our results showed no differences in the sexual success between the setaeless and control individuals. Consequently, a defensive function for stridulatory setae seems to be more likely than a sexual function.

Maturidade sexual das fêmeas de Callinectes danae (Crustacea, Decapoda, Portunidae) nos estuários dos rios Botafogo e Carrapicho, Itamaracá, PE, Brasil

Callinectes danae (Smith, 1869), siri-azul, constitui um importante recurso pesqueiro nos estuários dos rios Botafogo e Carrapicho. O objetivo do presente estudo foi estimar a maturidade sexual das fêmeas de C. danae. Os espécimes foram capturados, entre outubro de 2003 a junho de 2004, com auxílio de um barco de pesca equipado com rede de arrasto do tipo "wing-trawl" e arrastados durante 5 minutos. No laboratório, os siris foram contados, numerados, sexados, pesados e mensurados. A largura da carapaça (LC) foi medida na base do espinho lateral e a largura do abdome (LA) mensurada na altura da articulação do quinto esternito abdominal. Um total de 596 fêmeas de C. danae foram analisadas: 417 (69,97%) no rio Botafogo e 179 (30,03%) no Carrapicho; as fêmeas não-ovígeras apresentaram LC de 18,38 a 101 mm (59,14 ± 13,65 mm) e 26,70 a 83,48 mm (59,16 ± 13,77 mm), nos respectivos rios; a LC de fêmeas ovígeras foi de 57,04 a 83,30 mm (67,68 ± 6,56 mm). As médias de larguras das carapaças não apresentaram diferenças estatisticamente significativas O conhecimento da maturidade sexual das fêmeas de Callinectes danae é de grande importância para o seu manejo e conservação. O L50 gonadal foi estimado em 63,58 mm (chi2 = 140,47; g.l. = 1; p < 0,01) e 61,59 mm (chi2 = 90,94; g.l. = 1; p < 0,01) e o L50 morfológico foi de 57,13 mm (chi2 = 484,51; g.l. = 1; p < 0,01) e 56,46 mm (chi2 = 257,82; g.l. = 1; p < 0,01), nos estuários dos rios Botafogo e Carrapicho, respectivamente. Em ambos os estuários, a maturidade morfológica de fêmeas de C. danae ocorreu antes da maturidade gonadal e para garantir que esta espécie seja manejada com êxito, sugere-se que a pesca seja permitida apenas em indivíduos com largura da carapaça superior a 65 mm.

Cranial sexual discrimination in hatchling broad-snouted caiman (Caiman latirostris)

Broad-snouted caiman (Caiman latirostris) hatchlings present a consistent sexual dimorphism in their cranium shape and size. Male hatchlings have smaller crania than females. Using multivariate statistical analyses it is possible to discriminate sex in broad-snouted caiman hatchlings by their cranial shape with a reasonable efficiency. The understanding of sexual dimorphism of crocodilian hatchlings might be possibly improved by experimental approach considering, genetic and phenotypic variables such as incubation temperature and clutch of origin.

Population dynamic of Sesarma rectum (Crustacea, Brachyura, Sesarmidae) from a muddy flat under human impact, Paraty, Rio de Janeiro, Brazil

A population of Sesarma rectum Randall, 1840 under the influence of human impact was studied. Monthly sampling (CPUE, two people during 30 min) took place from August/2001 to July/2002 at an impacted muddy flat in Paraty city, State of Rio de Janeiro (23º13'S, 44º42'W). At the laboratory, specimens were classified by sex and measured with a vernier caliper (0.01 mm). The size at the beginning of the sexual maturity was obtained by means of different techniques: in the case of males it was used the allometric procedure and the macroscopic analysis of gonads wile for females, the size of the smallest ovigerous female was also considered. The population structure was evaluated by means the analysis of the variations in the modes of the size frequency distribution. The fecundity was assessed using sub samples of the egg mass. For males, the macroscopic analyses of gonads revealed larger values of carapace width than those obtained with morphometric analysis. Males larger than 18.5 mm of carapace width can be considered as mature. For females, such size was 17.4 mm CW. Despite of the human impact in the habitat, the population presented to be stable, as indicated by a single mode on the size frequency distribution. The second mode that appeared in some months is probably related to the entrance of juveniles in the population. The sex ratio of this population is closely approximating to 1:1 until crabs reach a carapace width of about 28 mm; after that, males outnumbered females. Comparing the fecundity of the present population with a previous study from Ubatuba, it can be verified a difference in the number of eggs. The fecundity of Paraty's population is significantly lower than the Ubatuba's population. This is probably related to the scarcity of food resource in Paraty, once no vascular plant can be found in that place. The continuity of reproductive processes and the juvenile recruitment suggest this species is able to live in the area with human impact. The ability to obtaining nutrients from different source of food is probably a feature that allows S. rectum to occupy such impacted ecosystem.

Relative growth and morphological sexual maturity of Chasmagnathus granulatus (Crustacea, Varunidae) from a mangrove area in southeastern Brazilian coast

The relative growth and morphological sexual maturity of Chasmagnathus granulatus Dana, 1851 are presented for the first time to a mangrove population. The crabs were obtained during low tide periods, in the mangrove of Jabaquara Beach, Paraty, Rio de Janeiro, Brazil. All crabs in intermolt stage were sexed and had their body parts measured as follows: body height (BH), carapace length (CL) and width (CW), major cheliped propodus height (PH) and length (PL) for each sex, gonopod length (GL) and abdomen width (AW) for males and females, respectively. The relative growth was described using the allometric equation y=ax b and the size at onset sexual maturity was achieved using the software Mature I. The size of specimens ranged from 4.1 mm to 39.5 mm CW. The growth pattern was different between sexes in the cheliped relationships; the relationships BH vs. CW evidenced positive allometry for juveniles; PL vs. CW and PH vs. CW positive allometry for most crabs except juvenile females; AW vs. CW and GL vs. CW evidenced positive allometry for juveniles and isometry for adults. The relationships that best indicated the change from the juvenile to the adult phase were PH vs. CW for males and AW vs. CW for females. The size in which 50% of males from this population are mature is at 19.7 mm of CW (F=144.14; p<0.05) and for females it is at 19.2 mm of CW (F=166.54; p<0.05). The sizes obtained in this mangrove population are larger than those from previous studies, that could be attributed to a species plasticity concerning the habitat structure.

Reproductive biology and sexual dimorphism in Cnemidophorus vacariensis (Sauria, Teiidae) in the grasslands of the Araucaria Plateau, southern Brazil

The reproductive cycle and sexual dimorphism of the lizard Cnemidophorus vacariensis Feltrim & Lema, 2000 were studied on the basis of data gathered between August 2004 and August 2006 in Vacaria, Rio Grande do Sul, Brazil. Snout-vent length (SVL) of sexually mature males varied between 48.8 and 72.9 mm (x = 63.3 ± 6.0 mm; n = 76) and, for females, between 57.4 and 81.8 mm (x = 70.0 ± 5.9 mm; n = 73). Other morphological characteristics were also compared between sexes. Reproduction was seasonal, and observations indicate two clutches in the same reproductive season. Clutch size and other reproductive characteristics were analyzed as well as the relation between reproduction and environmental factors. Cnemidophorus vacariensis is apparently endemic to highland plateaus in southern Brazil and has been classified as vulnerable on some lists of threatened fauna in this country. Some suggestions for conservation measures are presented, due to the observed degradation of this species' environment.

Sexual and asexual reproduction in Didemnum rodriguesi (Ascidiacea, Didemnidae)

Sexual and asexual reproduction and associated population dynamics were investigated in the colonial ascidian Didemnum rodriguesi Rocha & Monniot, 1993 (Didemnidae) in southern Brazil. Investment in sexual (production of new individuals) and asexual (colony growth) reproduction was compared between seasons. Permanently marked quadrats were repeatedly photographed to measure changes in colonies. Eggs and larvae were counted monthly in collected colonies. This species alternates seasonally between sexual (summer) and asexual (winter) reproduction. In summer, colonies were smaller, brooded eggs and larvae and recruitment rates were greater, while in winter, colony size was larger and eggs and larvae were absent. There is a relationship between fecundity and colony area. Fragmentation and fusion of colonies were similar in summer and winter, as well as mortality. In conclusion, D. rodriguesi has a lifecycle usual for high latitude ascidians with a limited time length for sexual reproduction and alternate investment in sexual and asexual reproduction along the year.

Classes de comprimento e proporção sexual em Diplodon expansus (Mollusca, Bivalvia, Hyriidae) no rio Piraquara, Paraná, Brasil

O presente estudo tem como objetivo analisar a distribuição de classes de tamanho e proporção sexual ampliando o conhecimento do comportamento reprodutivo de Diplodon expansus (Küster, 1856) e da biodiversidade dos corpos de água da Área de Proteção Ambiental do Piraquara, Paraná, Brasil. A área de estudo corresponde a um trecho do rio Piraquara de águas lóticas, e mata ciliar relativamente bem preservada. Foram realizadas quatro coletas no período de março de 2006 a dezembro de 2006. No rio Piraquara o D. expansus ocorre em substratos arenoso e lodoso. O comprimento dos exemplares variou entre 17 mm e 65 mm, sendo que a maior frequência de classes de comprimento foi registrada para as classes intermediárias. A análise histológica das gônadas possibilitou a determinação de uma razão sexual 1:1, não tendo sido identificado nenhum exemplar hermafrodita, caracterizando uma população tipicamente dióica. Análises qualitativas e quantitativas demonstram uma gametogênese contínua, com picos de liberação larval no verão.

Maturidade sexual morfológica de Aegla platensis (Crustacea, Decapoda, Anomura) no Lajeado Bonito, norte do estado do Rio Grande do Sul, Brasil

O tamanho da primeira maturação sexual (TPM) em Aegla platensis Schmitt, 1942 foi estimado através das mudanças nas proporções de dimensões corporais dos animais. Para isso, foram realizadas coletas mensais, de julho de 2007 a junho de 2008 no Lajeado Bonito (27º25'27''S, 53º24'39''W), um tributário de primeira ordem do Rio da Várzea, município de Frederico Westphalen, Rio Grande do Sul. Foram utilizados 437 machos com comprimento de cefalotórax (CC) variando de 6,00 mm a 31,75 mm e 368 fêmeas, com tamanhos entre 6,08 mm e 27,92 mm de CC. As seguintes dimensões corporais foram mensuradas em todos os indivíduos coletados: comprimento do cefalotórax (CC), largura do abdome (LA), comprimento do própodo do quelípodo direito (CPD) e comprimento do própodo do quelípodo esquerdo (CPE). Após o registro dessas medidas, os animais foram devolvidos ao mesmo local de captura. As análises de maturidade sexual morfológica foram realizadas com auxílio do software Mature 2, nas quais foram utilizadas as medidas de CC, considerada como variável independente e relacionada com as demais dimensões. As relações que melhor se ajustaram para estas análises, em machos, foram CPD x CC (TPM: CC=18,2 mm) e CPE x CC (TPM: CC=20,1 mm) e LA x CC (TPM: CC=16,5 mm) nas fêmeas.