Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae) / Alocação de sexo dependente de tamanho em Solanum lycocarpum St. Hil. (Solanaceae)

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura = 1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae)

Abstract Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flowers traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

Resumo A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura = 1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae) / Alocação de sexo dependente de tamanho em Solanum lycocarpum St. Hil. (Solanaceae)

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

A alocação de recursos para reprodução pode mudar dependendo do tamanho, conforme previsto pela alocação sexual dependente do tamanho. Essa teoria é baseada no fato de que indivíduos pequenos investirão na alocação sexual com menor custo de produção, geralmente do sexo masculino. Nas plantas, existem algumas espécies andromonoicas, presença de hermafrodita e flores masculinas no mesmo indivíduo. A andromonoicia fornece uma estratégia para alocar recursos de maneira ideal às funções masculina e feminina, desenvolvendo uma estratégia reprodutiva de economia de energia. Assim, nosso objetivo foi investigar a alocação sexual dependente do tamanho em Solanum lycocarpum St. Hil. Testamos a hipótese de que plantas de maior tamanho investirão na produção de flores hermafroditas, pois indivíduos mais altos economizam mais disponibilidade de recursos para investir em estruturas mais complexas que envolvem maior gasto de energia. A espécie estudada foi S. lycocarpum, uma espécie andromonoica. De junho de 2016 a março de 2017, os dados foram coletados em 38 indivíduos, divididos em dois grupos: o maior grupo de plantas (n = 18; altura = 3-5 m) e o menor grupo de plantas (n = 20; altura =1-2 m). Nossos dados mostram que houve efeito do tamanho da planta na produção de flores e na alocação sexual. As plantas maiores apresentaram mais flores e maior produção de flores hermafroditas. Além disso, observamos uma relação alométrica entre as características da flor, com investimentos proporcionais em biomassa, tamanho da antera e tamanho do gineceu. Nossos resultados estão de acordo com a teoria de alocação de sexo dependente de tamanho e a hipótese de andromonoicia relacionada a mecanismos para a alocação ótima de recursos para a função masculina e feminina.

Use of the socio-ecological model to explore factors that influence the implementation of a diabetes structured education programme (EXTEND project) inLilongwe, Malawi and Maputo, Mozambique: a qualitative study.

BACKGROUND: Diabetes Self-Management Education and Support (DSMES) programmes are vital for type 2 diabetes mellitus (T2DM) management. However, they are limited in Sub-Saharan Africa (SSA). To address this gap, a DSMES, namedEXTEND was developed in Lilongwe (Malawi) and Maputo (Mozambique). This qualitative study aimed to explore factors that influence the implementation of DSMES in these settings. METHODS: The Socio-ecological model was applied to explore factors influencing the implementation of DSMES in SSA. Data was analysed using the Framework method and constant comparative techniques. Sixty-six people participated in the study: people with T2DM who participated in the EXTEND programme; healthcare professionals (HCPs), EXTEND educators, EXTEND trainers, and stakeholders. RESULTS: Our findings indicate that there is a need to develop an integrated and dedicated diabetes services in SSA healthcare systems, incorporating culturally adapted DSMES and tailored diabetes training to all professions involved in diabetes management. Traditional media and the involvement of community leaders were proposed as important elements to help engage and promote DSMES programmes in local communities. During the design and implementation of DSMES, it is important to consider individual and societal barriers to self-care. CONCLUSION: Findings from this study suggest that multi-faceted factors play a significant role to the implementation of DSMES programmes in LICs. In the future, EXTEND could be incorporated in the development of diabetes training and dedicated diabetes services in SSA healthcare systems, acting as an educational tool for both people with T2DM and HCPs. This project was supported by the Medical Research Council GCRF NCDs Foundation Awards 2016 Development Pathway Funding.

Size-dependent sex allocation in Solanum lycocarpum St. Hil. (Solanaceae).

Resource allocation to reproduction can change depending on size, as predicted by the size-dependent sex allocation. This theory is based on the fact that small individuals will invest in the allocation of sex with lower cost of production, usually male gender. In plants, there are some andromonoecy species, presence of hermaphrodite and male flowers in the same individual. Andromonoecy provides a strategy to optimally allocate resources to male and female function, evolving a reproductive energy-saving strategy. Thus, our objective was to investigate the size-dependent sex allocation in Solanum lycocarpum St. Hil. We tested the hypothesis that plants with larger size will invest in the production of hermaphrodite flowers, because higher individuals have greater availability of resources to invest in more complex structures involving greater energy expenditure. The studied species was S. lycocarpum, an andromonoecious species. From June 2016 to March 2017 the data were collected in 38 individuals, divided in two groups: the larger plant group (n=18; height=3-5 m) and the smaller plant group (n=20; height=1-2 m).Our data show that there was effect of plant size on the flower production and the sexual gender allocation. The larger plants showed more flowers and higher production of hermaphrodite flowers. Furthermore, in the flower scale, we observed allometric relationship among the flower's traits with proportional investments in biomass, anther size and gynoecium size. Our results are in agreement with size-dependent sex allocation theory and andromonoecy hypothesis related to mechanisms for optimal resource allocation to male and female function.

Status of cardiac arrhythmia services in Africa in 2018: a PASCAR Sudden Cardiac Death Task Force report.

BACKGROUND: There is limited information on the availability of health services to treat cardiac arrhythmias in Africa. METHODS: The Pan-African Society of Cardiology (PASCAR) Sudden Cardiac Death Task Force conducted a survey of the burden of cardiac arrhythmias and related services over two months (15 October to 15 December) in 2017. An electronic questionnaire was completed by general cardiologists and electrophysiologists working in African countries. The questionnaire focused on availability of human resources, diagnostic tools and treatment modalities in each country. RESULTS: We received responses from physicians in 33 out of 55 (60%) African countries. Limited use of basic cardiovascular drugs such as anti-arrhythmics and anticoagulants prevails. Non-vitamin K-dependent oral anticoagulants (NOACs) are not widely used on the continent, even in North Africa. Six (18%) of the sub-Saharan African (SSA) countries do not have a registered cardiologist and about one-third do not have pacemaker services. The median pacemaker implantation rate was 2.66 per million population per country, which is 200-fold lower than in Europe. The density of pacemaker facilities and operators in Africa is quite low, with a median of 0.14 (0.03-6.36) centres and 0.10 (0.05-9.49) operators per million population. Less than half of the African countries have a functional catheter laboratory with only South Africa providing the full complement of services for cardiac arrhythmia in SSA. Overall, countries in North Africa have better coverage, leaving more than 110 million people in SSA without access to effective basic treatment for cardiac conduction disturbances. CONCLUSION: The lack of diagnostic and treatment services for cardiac arrhythmias is a common scenario in the majority of SSA countries, resulting in sub-optimal care and a subsequent high burden of premature cardiac death. There is a need to improve the standard of care by providing essential services such as cardiac pacemaker implantation.

Participation in research improves overall patient management: insights from the Global Rheumatic Heart Disease registry (REMEDY).

BACKGROUND: Rheumatic heart disease (RHD) is a major public health problem in low- and middle-income countries (LIMCs), with a paucity of high-quality trial data to improve patient outcomes. Investigators felt that involvement in a recent large, observational RHD study impacted positively on their practice, but this was poorly defined. AIM: The purpose of this study was to document the experience of investigators and research team members from LMICs who participated in a prospective, multi-centre study, the global Rheumatic Heart Disease Registry (REMEDY), conducted in 25 centres in 14 countries from 2010 to 2012. METHOD: We conducted an online survey of site personnel to identify and quantify their experiences. Telephone interviews were conducted with a subset of respondents to gather additional qualitative data. We asked about their experiences, positive and negative, and about any changes in RHD management practices resulting from their participation in REMEDY as a registry site. RESULTS: The majority of respondents in both the survey and telephone interviews indicated that participation as a registry site improved their management of RHD patients. Administrative changes included increased attention to follow-up appointments and details in patient records. Clinical changes included increased use of penicillin prophylaxis, and more frequent INR monitoring and contraceptive counselling. CONCLUSION: Our study demonstrates that participation in clinical research on RHD can have a positive impact on patient management. Furthermore, REMEDY has led to increased patient awareness and improved healthcare workers' knowledge and efficiency in caring for RHD patients.

Expression of cell cycle inhibitors in canine prostate with proliferative inflammatory atrophy and carcinoma / Expressão de inibidores do ciclo celular na próstata canina com atrofia inflamatória proliferativa e carcinoma

Gene expression of CDKN1A, CDKN1B, and TP53, and immunostaining of p21, p27 and p53 were evaluated to verify the role of these cell cycle inhibitors in canine prostates with proliferative inflammatory atrophy-PIA and prostatic carcinoma-PC. Seventy samples, 15 normal, 30PIA and 25PC. Regarding number of p27 and p53 labeled cells, difference between normal and PIA and PC was observed, as well as between PIA and PC for p53. Immunostaining intensities of p21, p27 and p53 were different when comparing normal tissues to PIA and PC. Sixteen cDNA of canine prostatic FFPE tissue were subjected to RT-PCR and RT-qPCR, four normal, three PIA, and nine PC. CDKN1A mRNA was detected in four PC by RT-PCR, and it was overexpressed when compared to normal by RT-qPCR, in one PIA and six PC. CDKN1B mRNA was detected in three PC by RT-PCR and it was overexpressed in three PC and decreased in one PC. TP53 mRNA was overexpressed in one PIA and three PC. In conclusion, when overexpressed in canine prostate with premalignant and malignant, p21 and p27 play a role controlling cell proliferation, working as a protective factor in the evolution of PIA to PC, and in the PC development, even in the presence of altered p53.(AU)

A expressão gênica de CDKN1A, CDKN1B e TP53, assim como imunomarcação de p21, p27 e p53 foram realizadas a fim de verificar o papel desses inibidores do ciclo celular na próstata canina com atrofia inflamatória proliferativa (PIA) e carcinoma prostático (PC). Foram obtidas70 amostras de próstata canina, sendo 15 de tecido normal, 30 de PIA e 25 de PC. Quanto ao número de células imunomarcadas foi observada diferença entre amostras normais, com PIA e PC para p27 e p53, assim como entre PIA e PC para p53. Para a intensidade de imunomarcação houve diferença entre os tecidos normais e com PIA e PC para p21, p27 e p53. Foram obtidas dezesseis amostras de cDNA a partir de amostras de próstatas caninas embebidas em parafina para a realização da RT-PCR e RT-qPCR, sendo quatro normais, três com PIA, e nove com o PC. O gene CDKN1A foi detectado em quatro das amostras com PC por RT-PCR, e pela RT-qPCR este estava superexpresso em uma PIA e em seis PC quando da comparação com o tecido prostático normal. O CDKN1B foi detectado em três PC por RT-PCR e pela RT-qPCR estava superexpresso em três PC e reduzido em um PC. O TP53 foi detectado em todas as próstatas caninas com PIA e PC por RT-PCR, sendo também superexpresso em uma glândula com PIA e em três com PC. Concluiu-se que p21 e p27 quando superexpressas na próstata canina com lesões pré-malignas (PIA) e malignas (PC) desempenham ação no controle da proliferação celular, possivelmente atuando como fator de proteção na evolução da PIA para PC, e no desenvolvimento do PC, mesmo na presença de p53 alterada. Assim, o próximo passo é avaliar essas proteínas do ciclo celular em casos de PC canino com metástase.(AU)

Sistema de grupos sanguíneos AB em felídeos neotropicais e compatibilidade com gatos domésticos / AB blood group system in neotropical felids and compatibility with domestic cats

O principal sistema de grupos sanguíneos reconhecido para gatos é o AB. Os felinos apresentam anticorpos naturais contra o antígeno do tipo sanguíneo a que não pertencem, o que torna os testes de compatibilidade e as tipagens sanguíneas importantes na prevenção de reações transfusionais. O objetivo deste estudo foi realizar a tipagem sanguínea de oito gatos-mouriscos (Puma yagouaroundi), oito jaguatiricas (Leopardus pardalis), sete gatos-palheiros (Leopardus colocolo), sete gatos domésticos (Felis catus) da raça Persa e oito gatos domésticos sem raça definida (SRD), bem como realizar testes de compatibilidade entre os tipos sanguíneos iguais das diferentes espécies, para avaliar a possibilidade de transfusões interespecíficas. A técnica empregada para a tipagem foi a hemaglutinação em tubos de ensaio. A ocorrência do tipo sanguíneo tipo A foi de 100% entre as jaguatiricas, os gatos-palheiros e os gatos Persas e de 85,72% entre os gatos SRD. A ocorrência do tipo B foi de 100% nos gatos-mouriscos e de 14,28% nos gatos SRD. Considerando os testes de compatibilidade sanguínea, 87,5% (n=4) das jaguatiricas foram incompatíveis com os gatos domésticos, 100% (n= 6) dos gatos-palheiros foram compatíveis com os gatos domésticos e 100% (n= 4) dos gatos-mouriscos foram incompatíveis com os gatos domésticos do tipo B.(AU)

The blood group system recognized for cats is AB. Antibodies against other blood types occur naturally in cats, which makes the compatibility tests and blood typing important for preventing transfusion reactions. Wild felids need blood transfusions in cases of diseases and when run over on highways. The aim of this study was to perform blood typing of eight jaguarundies (Puma yagouaroundi), eight ocelots (Leopardus pardalis), seven pampas cats (Leopardus colocolo), seven domestic cats (Felis catus) of Persian breed and eight non-pedigree domestic cats (Felis catus), and test compatibility among the different species with the same blood types, to evaluate the possibility of performing interspecific blood transfusions. We conducted the study from August to December. We used haemagglutination in test tubes for typing. The occurrence of blood type A was 100% among ocelots, pampas cats and domestic cats of Persian breed, while non-pedigree domestic cats showed 85.72%. The occurrence of type B was 100% for jaguarundis and 14.28% for non-pedigree domestic cats. Regarding blood compatibility tests, 87.5% (n= 4) of the ocelots were incompatible with domestic cats; 100% (n=6) of the pampas cats were compatible with domestic cats, while 100% (n=4) of the jaguarundis were incompatible with type B domestic cats.(AU)

Active schistosomiasis, severe hypereosinophilia and rapid progression of chronic endomyocardial fibrosis.

Endomyocardial fibrosis (EMF) is a neglected restrictive cardiomyopathy of unknown aetiology and unclear natural history, which causes premature deaths in endemic areas. We present the case of a 13-year-old boy from a highly endemic area, presenting with concurrent signs of chronic EMF and severe hypereosinophilia associated with active schistosomal cystitis. We discuss the possible role of this parasitic infection in determining the progression of EMF in endemic areas for both conditions.

Electromyographic analysis of the gait cycle phases of boxer dogs / Análise eletromiográfica do ciclo de marcha em cães da raça boxer

Systematic studies involving technologies such as surface electromyography (sEMG) may provide important data that enable veterinarians to recognize musculoskeletal, ligamentous, and neurological alterations. The aim of this study was to describe the gait cycle phases and the timing of muscle activation in healthy Boxer dogs during gait by means of sEMG. The gait cycle of seven Boxer dogs was evaluated and sEMG was recorded from the biceps brachii, triceps brachii, brachiocephalic, rectus femoris, semitendinosus, semimembranosus, and superficial gluteal muscles of the right hemibody. Circular monopolar Ag/AgCl electrodes were attached to the mean point between the motor point and the muscle insertion. The electromyographic signals were collected by an active interface with 20-fold gain in a bipolar differential configuration using a 16-channel signal conditioner (EMG Systems Brasil), while the dogs walked on a treadmill at a speed of 2m/s. Pearson's correlation was used for the statistical analysis. A positive correlation was found between the rectus femoris and biceps brachii (r= 0.81); superficial gluteal and triceps brachii (r= 0.69); semitendinosus-semimembranosus and biceps brachii (r= 0.76); and rectus femoris and semitendinosus and semimembranosus muscle groups (r=0.99). The biceps brachii and brachiocephalic muscles work in tandem to position the thoracic limb during the gait cycle, while the semitendinosus-semimembranosus group flexes the knee and, simultaneously with the quadriceps that flexes the hip, prevents the contact of the pelvic limb with the ground during the swing phase. The body is propelled forward by the triceps brachii muscle, which extends the elbow and flexes the shoulder at the final contact, while the superficial gluteal muscle extends the hip.(AU)

Estudos sistemáticos que envolvem uso de tecnologias, como a eletromiografia de superfície (EMGs), podem fornecer dados importantes que capacitam os clínicos a diferenciar as alterações musculoesqueléticas, ligamentares ou neurológicas. Objetiva-se com este trabalho descrever as fases da marcha canina e o momento de ativação dos músculos de cães saudáveis da raça Boxer durante a marcha, por meio da eletromiografia de superfície. Avaliou-se a marcha de sete cães da raça Boxer, e o sinal elétrico da eletromiografia de superfície foi coletado do bíceps braquial, do tríceps braquial, do braquiocefálico, do reto femoral, do semitendinoso/semimembranoso e do glúteo superficial do hemicorpo direito. Os eletrodos monopolares circulares de prata com cloreto de prata (Ag/AgCl) foram posicionados no ponto médio entre a placa motora e a inserção desses músculos. Os sinais eletromiográficos foram capturados e adquiridos por uma interface ativa com ganho de 20x em configuração diferencial bipolar e por um condicionador de sinais (EMG Systems Brasil) de 16 canais, enquanto os cães caminharam em esteira com velocidade de 2m/s. Para análise estatística, foi aplicado teste de correlação de Pearson. Verificou-se correlação positiva entre os músculos retofemoral e bíceps braquial (r= 0,81); glúteo superficial e tríceps braquial (r= 0,69); semitendinoso/semimembranoso e bíceps braquial (r= 0,76); e entre o músculo reto femoral e o grupo muscular semitendinoso e semimembranoso (r=0,99). Os músculos bíceps braquial e braquiocefálico do mesmo membro trabalham em sinergia para posicionar o membro torácico durante o ciclo de marcha, enquanto o grupo muscular semitendinoso/semimembranoso flexiona o joelho e, simultaneamente com o quadríceps, que flexiona o quadril, impede que o membro pélvico entre em contato com o solo no balanço. Para impulsionar o corpo à frente, o músculo tríceps braquial estende o cotovelo e flexiona o ombro no contato final e o glúteo superficial estende o quadril.(AU)

Body mass index, cardiorespiratory fitness and cardiometabolic risk factors in youth from Portugal and Mozambique.

OBJECTIVES: The objectives of this study are to examine differences in cardiometabolic risk indicators, as well as their prevalences, in Portuguese and Mozambican youth, and to investigate the associations between weight status and cardiorespiratory fitness levels with cardiometabolic risk. METHODS: The sample comprises 721 adolescents (323 Mozambican and 398 Portuguese), aged 10-15 years. Anthropometry (height, sitting height, weight and waist circumference), blood pressure, serum-fasting triglycerides, high-density lipoprotein cholesterol and glucose, and cardiorespiratory fitness were measured. Maturity offset was estimated and a cardiometabolic risk score adjusted for sex, age and biological maturity was computed. Adolescents were classified as normal weight and overweight/obese as well as fit or unfit (cardiorespiratory fitness). RESULTS: Portuguese youth have better cardiometabolic and cardiorespiratory fitness profiles. About 32% and 30% of Portuguese boys and girls, respectively, are overweight/obese; in Mozambicans, these prevalences are 7.5% for boys and 21% for girls; in addition, 81.6% of Portuguese boys and 77.7% of Portuguese girls were classified as cardiorespiratory fit, against 54% and 44.4% of Mozambican boys and girls, respectively. No statistically significant differences (P>0.05) were found between Mozambicans and Portuguese for the cluster of three or more cardiometabolic risk indicators. A positive relationship (P<0.001) was found between weight status and cardiometabolic risk in adolescents from both countries; however, a negative association (P<0.001) between cardiorespiratory fitness and cardiometabolic risk was only found among Portuguese youth. CONCLUSIONS: Portuguese and Mozambican youth differ in their cardiometabolic risk profiles, body weight and cardiorespiratory fitness, favoring Portuguese. Overweight/obesity and low cardiorespiratory fitness levels are related to a worse cardiometabolic risk profile, being relevant to design public health intervention strategies to reduce excess weight and increase cardiorespiratory fitness.

Development of the roadmap and guidelines for the prevention and management of high blood pressure in Africa: Proceedings of the PASCAR Hypertension Task Force meeting: Nairobi, Kenya, 27 October 2014.

Africa has one of the fastest growing economies in the world. The economic changes are associated with a health transition characterised by a rise in cardiovascular risk factors and complications, which tend to affect the African population at their age of maximum productivity. Recent data from Africa have highlighted the increasing importance of high blood pressure in this region of the world. This condition is largely underdiagnosed and poorly treated, and therefore leads to stroke, renal and heart failure, and death. Henceforth, African countries are taking steps to develop relevant policies and programmes to address the issue of blood pressure and other cardiovascular risk factors in response to a call by the World Health Organisation (WHO) to reduce premature deaths from non-communicable diseases (NCDs) by 25% by the year 2025 (25 × 25). The World Heart Federation (WHF) has developed a roadmap for global implementation of the prevention and management of raised blood pressure using a health system approach to help realise the 25 × 25 goal set by the WHO. As the leading continental organisation of cardiovascular professionals, the Pan-African Society of Cardiology (PASCAR) aims to contextualise the roadmap framework of the WHF to the African continent through the PASCAR Taskforce on Hypertension. The Taskforce held a workshop in Kenya on 27 October 2014 to discuss a process by which effective prevention and control of hypertension in Africa may be achieved. It was agreed that a set of clinical guidelines for the management of hypertension are needed in Africa. The ultimate goal of this work is to develop a roadmap for implementation of the prevention and management of hypertension in Africa under the auspices of the WHF.

Effects of maternal diabetes on male offspring: high cell proliferation and increased activity of MMP-2 in the ventral prostate.

This study presents a comprehensive view of the histological and functional status of the prostate of adult rat offspring of mothers subjected to gestational diabetes induced by alloxan. The ventral prostate of male adult offspring of diabetic (DP) or normal (CP) mothers was evaluated for collagen fibres, cell death, fibroblasts, smooth muscle cells, cell proliferation, matrix metalloproteinases (MMPs), androgen receptors (AR), transforming growth factor ß1 (TGFß-1), catalase and total antioxidant activity. The prostates of DP animals were lower in weight than those of the CP group. The DP group also exhibited hyperglycaemia and hypotestosteronemia, higher cell proliferation and AR expression, a reduction in α-actin (possibly interfering with the reproductive function of the prostate), and enhanced activity of MMP-2, although the absolute content of MMP-2 was lower in this group. These findings were associated with increased TGFß-1 and decreased collagen distribution. The prostates of DP rats additionally exhibited reductions in catalase and total antioxidant activity. Thus, rats developing in a diabetic intrauterine environment have glycaemic and hormonal changes that impact on the structure and physiology of the prostate in adulthood. The increased AR expression possibly leads to elevated cell proliferation. Stromal remodelling was characterized by enhanced activity of MMP-2 and collagen degradation, even with increased TGFß-1 activation. These changes associated with increased oxidative stress might interfere with tissue architecture and glandular homeostasis.

Monthly variation of multiple sclerosis activity in the southern hemisphere: analysis from 996 relapses in Brazil.

BACKGROUND AND PURPOSE: Seasonal variations of multiple sclerosis (MS) activity have been reported, however, most data come from studies in the northern hemisphere. METHODS: We reviewed medical records of MS patients living in Campinas region, Brazil. The first symptoms' date was defined as the relapse month. Climatic information included UV radiation index, median temperature, rainfall, and humidity. RESULTS: Two hundred and nine patients were included. The incidence of relapses was highest in January (11.2%) and December (10.4%) and lowest in November (5.7%) and October (7.0%) (P < 0.015). The months with highest incidence of relapses (December-January) had higher UV radiation index and humidity rates (P = 0.032 and 0.040, respectively). CONCLUSION: Most exacerbations were in the spring/summer transition, which also showed higher UV radiation index and humidity rate. Along with other environmental factors, seasonal fluctuation contributes to MS activity.

Diabetes in Mozambique: prevalence, management and healthcare challenges.

AIM: The growing trend towards and deficient management of diabetes in Africa are important public-health challenges requiring surveillance. For this reason, this study aimed to assess the prevalence and awareness of diabetes in urban and rural Mozambique, and to describe its management. METHODS: In 2005, a representative sample of the national Mozambican adult population (n=2343) was evaluated, according to the STEPwise approach to chronic disease risk factor surveillance (STEPS). Twelve-hour fasting blood glucose (FBG) was measured, using fingertip capillary whole blood, to estimate the prevalence of impaired fasting glucose (IFG; FBG ≥5.6 mmol/L and less than 6.1 mmol/L) and diabetes (FBG ≥6.1 mmol/L, or treatment with insulin and/or oral blood glucose-lowering drugs). Patients' awareness and management of diabetes were assessed by questionnaire. RESULTS: The prevalence of diabetes and IFG was 2.9% [95% confidence interval (95%CI): 1.8-4.0] and 2.5% (95%CI: 1.3-3.7), respectively. Diabetes was more frequent among urban dwellers (OR=2.92, 95%CI: 1.45-5.86), mostly due to urban-rural differences in age, education, body mass index (BMI) and waist circumference (adjusted OR=2.27, 95%CI: 0.83-6.26). In all, 13% of those with diabetes were aware of their condition, 10.9% had undergone glycaemia determination during the previous year, and 9% were being treated with oral blood glucose-lowering drugs and 3% with insulin. CONCLUSION: Diabetes prevalence is low in Mozambique, but most diabetic patients were neither aware of their condition nor being treated pharmacologically, thus posing serious challenges to the provision of adequate care in an already disadvantageous context.

Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: an analysis of 15,780 patients from the INTERHEART study.

AIMS/HYPOTHESIS: Although diabetes is an established risk factor for myocardial infarction (MI), disease control may vary. HbA(1c) is a reliable index of ambient glucose levels and may provide more information on MI risk than diabetes status. METHODS: The relationship between HbA(1c) levels in MI patients and controls who participated in the 52 country INTERHEART study was analysed. RESULTS: In 15,780 participants with a HbA(1c) value (1,993 of whom had diabetes), the mean (SD) levels for HbA(1c) were 6.15% (1.10) in the 6,761 MI patients and 5.85% (0.80) in the control participants. After adjustment for age, sex and nine major MI risk factors (including diabetes), higher HbA(1c) fifths above the lowest fifth (HbA(1c) <5.4%) were associated with progressively higher OR of MI, with OR for the highest HbA(1c) fifth (≥ 6.12%) being 1.55 (95% CI 1.37-1.75). When analysed as a continuous variable after adjustment for the same factors, every 1% higher HbA(1c) value was associated with 19% (95% CI 14-23) higher odds of MI, while every 0.5% higher HbA(1c) was associated with 9% higher odds of MI (95% CI 7-11). Concordant relationships were noted across subgroups, with a higher OR noted in younger people, patients without diabetes or hypertension, and those from some regions and ethnicities. CONCLUSIONS/INTERPRETATION: The HbA(1c) value provides more information on MI odds than self-reported diabetes status or many other established risk factors. Every 1% increment independently predicts a 19% higher odds of MI after accounting for other MI risk factors including diabetes.

Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke.

UNLABELLED: Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90% of population-attributable risk. However, traditional risk factors (e.g. hypertension, cholesterol) appear to exert contrasting risks for stroke compared with coronary heart disease, and the etiology of stroke is far more heterogeneous. In addition, our knowledge of risk factors for stroke in low-income countries is inadequate, where a very large burden of stroke occurs. Accordingly, a similar epidemiological study is required for stroke, to inform effective population-based strategies to reduce the risk of stroke. METHODS: INTERSTROKE is an international, multicenter case-control study. Cases are patients with a first stroke within 72 h of hospital presentation in whom CT or MRI is performed. Proxy respondents are used for cases unable to communicate. Etiological and topographical stroke subtype is documented for all cases. Controls are hospital- and community-based, matched for gender, ethnicity and age (+/-5 years). A questionnaire (cases and controls) is used to acquire information on known and proposed risk factors for stroke. Cardiovascular (e.g. blood pressure) and anthropometric (e.g. waist-to-hip ratio) measurements are obtained at the time of interview. Nonfasting blood samples and random urine samples are obtained from cases and controls. Study Significance: An effective global strategy to reduce the risk of stroke mandates systematic measurement of the contribution of the major vascular risk factors within defined ethnic groups and geographical locations.

Body mass index and waist circumference in Mozambique: urban/rural gap during epidemiological transition.

In 2005 we evaluated a nationally representative sample of the Mozambican adult population (n=2913; 25-64 years old) following the STEPwise approach to chronic disease risk factor surveillance to estimate urban-rural differences in overweight and obesity and waist circumferences. The prevalences of obesity and overweight were, respectively, 6.8% (95% CI: 5.1-8.6) and 11.8% (95% CI: 8.4-15.4) among women, and 2.3% (95% CI: 1.1-3.6) and 9.4% (95% CI: 5.7-13.1) among men. Overweight/obesity was more frequent in urban settings (age-, income- and education-adjusted prevalence ratios; women, 2.76, 95% CI: 1.82-4.18; men, 1.76, 95% CI: 0.80-3.85). The average waist circumference in Mozambique was 75.2cm (95% CI: 74.3-76.0) in women, significantly higher in urban than rural areas (age-, income- and education-adjusted ß=3.6cm, 95% CI: 1.6-5.5) and 76.1cm (95% CI: 75.0-77.3) in men, with no urban-rural differences (adjusted ß=1.3cm, 95% CI: -0.9 to 3.5). Our results show urban-rural differences, as expected in a country under epidemiological transition, with urban areas presenting a higher prevalence of overweight/obesity, but age- and education-specific estimates suggesting a trend towards smaller divergences. The development and implementation of strategies to manage the foreseeable obesity-related healthcare demands are needed.