Vanilla from Brazilian Atlantic Forest: In vitro and in silico toxicity assessment and high-resolution metabolomic analysis of Vanilla spp. ethanolic extracts.

The natural vanilla market, which generates millions annually, is predominantly dependent on Vanilla planifolia, a species characterized by low genetic variability and susceptibility to pathogens. There is an increasing demand for natural vanilla, prized for its complex, authentic, and superior quality compared to artificial counterparts. Therefore, there is a necessity for innovative production alternatives to ensure a consistent and stable supply of vanilla flavors. In this context, vanilla crop wild relatives (WRs) emerge as promising natural sources of the spice. However, these novel species must undergo toxicity assessments to evaluate potential risks and ensure safety for consumption. This study aimed to assess the non-mutagenic and non-carcinogenic properties of ethanolic extracts from V. bahiana, V. chamissonis, V. cribbiana, and V. planifolia through integrated metabolomic profiling, in vitro toxicity assays, and in silico analyses. The integrated approach of metabolomics, in vitro assays, and in silico analyses has highlighted the need for further safety assessments of Vanilla cribbiana ethanolic extract. While the extracts of V. bahiana, V. chamissonis, and V. planifolia generally demonstrated non-mutagenic properties in the Ames assay, V. cribbiana exhibited mutagenicity at high concentrations (5000 µg/plate) in the TA98 strain without metabolic activation. This finding, coupled with the dose-dependent cytotoxicity observed in WST-1 (Water Soluble Tetrazolium) assays, a colorimetric method that assesses the viability of cells exposed to a test substance, underscores the importance of concentration in the safety evaluation of these extracts. Kaempferol and pyrogallol, identified with higher intensity in V. cribbiana, are potential candidates for in vitro mutagenicity. Although the results are not conclusive, they suggest the safety of these extracts at low concentrations. This study emphasizes the value of an integrated approach in providing a nuanced understanding of the safety profiles of natural products, advocating for cautious use and further research into V. cribbiana mutagenicity.

Marketable 1,3-dimethylamylamine and caffeine-based thermogenic supplements: Regulatory genotoxicity assessment through in vitro and in silico approaches.

The consumption of dietary supplements to enhance physical performance has increased significantly in the last century, especially thermogenic pre-workout supplements. Nevertheless, this industry has faced criticism for inadequate safety measures surveillance in regulatory issues regarding their products. The aims of our study were to investigate two pre-workout supplements with respect to (1) mutagenicity utilizing Salmonella/microsome assay; (2) genotoxicity employing cytokinesis-block micronucleus (CBMN) assay protocols; and (3) hepatocytoxicity using WST cell proliferation, activities of lactate dehydrogenase (LDH) and alkaline phosphatase using human liver carcinoma (HepG2) and mouse fibroblast (F C3H) cells. Oxidative stress was determined through glutathione (GSH) measurement and in silico for predictions of pharmacokinetics and toxicity for the most abundant isolated substances present in these supplements. Both supplements induced mutagenicity in all examined bacterial strains, especially in the presence of exogenous metabolism. Further, tested supplements significantly elevated the formation of micronuclei (MN) as well as other cellular phenomena. Concentration- and time-dependent curves were observed for hepatotoxicity in both studied cell lines. In addition, both supplements decreased levels of intracellular and extracellular GSH. In silico predictions showed that the isolated individual compounds failed to induce the observed outcomes. Our findings provide contributions to the molecular mechanisms underlying two pre-workout supplement-induced toxicity and the need for surveillance.

Toxicogenetic assessment of a pre-workout supplement: In vitro mutagenicity, cytotoxicity, genotoxicity and glutathione determination in liver cell lines and in silico ADMET approaches.

The benefits of practicing physical activity, such as weight loss and control, are commonly associated with caloric restriction diets and may be improved by the ingestion of thermogenic and ergogenic supplements. However, there is a lack of safety data on commonly marketed nutritional supplements. Therefore, this investigation aims to evaluate a pre-workout supplement for mutagenicity using the Ames test, hepatocytoxicity in HepG2 and F C3H cells after 24 h, 48 h and 72 h, genotoxicity using the CBMN assay, determination of gluthatione activity and computational prediction of the three major isolated compounds present in the supplement. The mutagenicity test showed a mutagenic response in TA98 His+ revertants of 5 mg/plate in the presence of metabolic activation, cytotoxicity in TA98 of 5 mg/plate in the absence of metabolic conditions, and in TA102 of 0.5 mg/plate both in the presence and absence of metabolic activation. In our in vitro eukaryotic cell viability, WST-1, LDH and alkaline phosphatase assays, the supplement showed hepatocytotoxicity both dose-dependently and time-dependently. In the cytokinesis blocking micronuclei assay, the supplement induced micronuclei, nuclear buds, nucleoplasmatic, bridge formation, and a decreased in nuclear division. In addition, the supplement decreased intra and extracellular GSH. Computational analysis showed that the three isolated compounds most present in the supplement have the potential to cause hepatotoxicity. In the present investigation, the pre-workout supplement induced mutagenic, genotoxic, and cytotoxic responses and GSH decrease. Thus, considering food safety and public health sanitary vigilance, the consumption of this pre-workout supplement may harm the health of its consumers.

Colonic Kaposi's sarcoma as the first clinical manifestation of undiagnosed HIV.

A 52-year-old male, without significant past medical history, is referred for new onset constipation, hematochezia and significant weight loss. Blood tests were unremarkable. A colonoscopy was performed, showing reddish, hematocystic and friable mucosa in a circumferential pattern in the rectum, with similar patches throughout the whole colon, one of them infiltrating the ileocecal valve. Biopsies were obtained and revealed spindle cell proliferation immunoreactive for CD34 and herpesvirus 8 (HHV-8), compatible with Kaposi's sarcoma (KS). HIV serologies were subsequently done, with a positive result, the patient then reporting previous heterosexual unprotected sexual activities. He was started on highly active antiretroviral therapy (HAART) and chemotherapy with liposomal doxorubicin, with a favorable outcome to this date. KS is a low-grade tumor of the vascular endothelium that requires infection with HHV-8. HIV-related KS is more commonly diagnosed in homosexual males with uncontrolled HIV infection and is associated with a variable clinical course. The gastrointestinal tract is involved in up to 51% of patients, but since the majority is clinically silent (70%), visceral involvement is probably underestimated. The treatment goal is symptomatic relief, and may range from HAART alone to a combination with systemic chemotherapy, depending on disease extent. We present this case given its endoscopic exuberance, with biopsies showing an HIV-defining condition, in a patient unaware of his diagnosis.

Hepatocellular Carcinoma with Atrial Extension: A Case Report.

Hepatocellular carcinoma is a common malignancy usually associated with cirrhosis. Despite being a highly aggressive tumor with several cases of vascular invasion, metastatic disease to the heart is a rare condition. A 65-year-old male cirrhotic patient was admitted with dyspnea, ascites, and lower extremity edema. A transthoracic echocardiogram showed a large mass in the right atrium. Further imaging studies revealed the presence of hepatocellular carcinoma extending from the liver to the right atrium through the inferior vena cava. The cardiac mass was surgically removed to treat the symptoms of right heart failure, but unfortunately the patient died on the 30th day after surgery due to septic shock.

O carcinoma hepatocelular é uma neoplasia comum, maioritariamente associada à cirrose hepática. Apesar de se tratar de uma entidade clínica agressiva com predisposição à invasão vascular, a doença metastática com envolvimento cardíaco é rara. Os autores reportam o caso de um homem de 65 anos com cirrose hepática que recorreu ao serviço de urgência por um quadro clínico de dispneia, ascite e edema periférico. Foi realização ecocardiograma transtorácico à admissão, que revelou presença de uma massa a nivel da aurícula direita. A investigação clínica, laboratorial e imagiológica realizada permitiu o diagnóstico de carcinoma hepatocelular com extensão desde o fígado até à aurícula direita através da veia cava inferior. A massa intracardíaca foi removida cirurgicamente para alivio sintomático, no entanto o doente faleceu no 30° dia de pós-operatório devido a choque séptico.

Plinia cauliflora (Mart.) Kausel (Jaboticaba) leaf extract: In vitro anti-Trypanosoma cruzi activity, toxicity assessment and phenolic-targeted UPLC-MSE metabolomic analysis.

ETHNOPHARMACOLOGICAL RELEVANCE: Plinia cauliflora (Mart.) Kausel, known as Brazilian grape or jaboticaba, is widely used in Brazilian traditional medicine to treat infectious and inflammatory disorders. However, several aspects of its biological potential remain unclear, such as toxicity and effects on pathogenic protozoa. AIM OF THE STUDY: Investigate the phenolic composition, the in vitro and in silico toxicity profile, and the anti-Trypanosoma cruzi activity of the phenolics-enriched hydromethanolic extract of P. cauliflora leaf. MATERIAL AND METHODS: Phytochemical analysis was performed ultra-performance liquid chromatography-mass spectrometry (UPLC-MSE). Mutagenicity, genotoxicity and eukaryotic cytotoxicity was evaluated by Ames test, cytokinesis-block micronucleus and colorimetric assays, respectively, alongside with a computational prediction of the major compound's pharmacokinetics and toxicity. Anti-T. cruzi activity was investigated on T. cruzi bloodstream trypomastigotes. RESULTS: A total of 14 phenolic compounds were identified, including 11 flavonoids and 2 phenolic acids. No positive response regarding mutagenic potential was detected in Salmonella strains TA97, TA98, TA100, TA102, TA104, both in absence or presence of metabolic activation. The extract induced significant dose-response reduction on nuclear division indexes of HepG2 cells, suggesting cytostatic effects, with no micronuclei induction on cytokinesis-block micronucleus assay. Likewise, it also presented cytotoxic effects, inducing HepG2 and F C3H dose and time dependently cell death through cell membrane damage and more evidently by mitochondrial dysfunction. A dose-response curve of in vitro trypanocidal activity was observed against T. cruzi bloodstream trypomastigotes after 2 and 24 h of exposure. In silico predictions of most abundant compounds' structural alerts, pharmacokinetics and toxicity profile indicates a moderately feasible druglikeness profile and low toxicity for them, which is compatible with in vitro results. CONCLUSIONS: The present study demonstrated that P. cauliflora leaf extract is a potential source of antiparasitic bioactive compounds, however it presents cytotoxic effects in liver cell lines.

In vitro biochemical characterization and genotoxicity assessment of Sapindus saponaria seed extract.

ETHNOPHARMACOLOGICAL RELEVANCE: Sapindus saponaria, also popularly known as soapberry, has been used in folk medicinal values because of its therapeutic properties and several compounds in its composition, which represent a target in potential for drug discovery. However, few data about its potential toxicity has been reported. AIM OF THE STUDY: Plant proteins can perform essential roles in survival, acting as defense mechanism, as well functioning as important molecular reserves for its natural metabolism. The aim of the current study was to investigate the in vitro toxicity profile of protein extract of S. saponaria and detect protein potentially involved in biological effects such as collagen hydrolysis and inhibition of viral proteases. MATERIALS AND METHODS: Protein extract of soapberry seeds was investigated for its cytotoxic and genotoxic action using the Ames test. The protein extract was also subjected to a partial purification process of a protease and a protease inhibitor by gel chromatography filtration techniques and the partially isolated proteins were characterized biochemically. RESULTS: Seed proteins extract of S. saponaria was evaluated until 100 µg/mL concentration, presenting cytotoxicity and mutagenicity in bacterial model mostly when exposed to exogenous metabolic system and causing cytotoxic and genotoxic effects in HepG2 cells. The purification and partial characterization of a serine protease (43 kDa) and a cysteine protease inhibitor (32.8 kDa) from protein extract of S. Saponaria, corroborate the idea of ​​the biological use of the plant as an insecticide and larvicide. Although it shows cytotoxic, mutagenic and genotoxic effects. CONCLUSION: The overall results of the present study provide supportive data on the potential use of proteins produced in S. saponaria seeds as pharmacological and biotechnological agents that can be further explored for the development of new drugs.

Lower Gastrointestinal Bleeding Associated With Sodium Polystyrene Sulfonate Use.

Sodium polystyrene sulfonate (kayexalate) is a cation-exchange resin widely used in the management of hyperkalemia. Gastrointestinal adverse events are uncommon; symptoms are nonspecific, and mucosal injury can range from mild ulceration to bowel perforation. An 81-year-old man was admitted because of decompensation of cirrhosis with acute kidney injury and hyperkalemia, treated with sodium polystyrene sulfonate. During admission, he presented multiple episodes of hematochezia, accompanied by tachycardia and hemoglobin drop. Colonoscopy revealed colonic ulceration, and histopathological findings were compatible with ulceration due to kayexalate injury. Despite rare, the widespread use of sodium polystyrene sulfonate puts a large population at risk of serious complications related to its use.

Reduced heart-rate variability and increased risk of hypertension-a prospective study of the ELSA-Brasil.

Although autonomic disturbances are known to precede hypertension onset, the risks underlying different ranges of blood pressure and impaired cardiac autonomic modulation are still unknown. This study aimed to identify the risk of hypertension incidence related to low heart-rate variability profile in normotensive blood pressure subcategories: normal (<120/80 mmHg) and prehypertension (120/80-139/89 mmHg) in a 4-year follow-up. 7665 participants free of hypertension at baseline were examined. They were allocated into one of two groups (

Primary hepatic lymphoma in a patient with cirrhosis: a case report.

BACKGROUND: Primary hepatic lymphoma is a very uncommon disease. Due to its nonspecific clinical, laboratory, and imaging findings, it is often misdiagnosed. Liver biopsy is required to make a final diagnosis. Chemotherapy is the current gold standard of treatment. CASE PRESENTATION: An asymptomatic 65-year-old Caucasian man with Child-Pugh class A cirrhosis presented to our hospital with a nodular lesion seen on a routine surveillance abdominal ultrasound. His physical examination revealed hepatomegaly and no other significant findings. Magnetic resonance imaging of the abdomen showed a voluminous nodule on the left lobe with heterogeneous contrast enhancement. His liver biopsy was compatible with diffuse large B-cell lymphoma. Systemic staging showed no evidence of nodal or bone marrow involvement, confirming the diagnosis of primary hepatic lymphoma. He was treated with chemotherapy. However, he developed febrile neutropenia after one of the cycles and died. CONCLUSIONS: In this article, we report a rare presentation of non-Hodgkin lymphoma and review the current literature on clinical features, diagnosis, and management.

Experiência com a Transmissão de um programa sobre automedicação por meio de uma Web Rádio / Experience with the transmission of a program about self-medication through a Web Radio

Objetivo: descrever a experiência com alunos de uma escola estadual, após transmissão de um programa sobre automedicação por meio de uma web rádio com participação ativa da juventude. Metodologia: estudo descritivo do tipo relato de experiência, do projeto de extensão Web Cuidado em Infância e Juventude nas Escolas da Universidade Federal do Piauí, desenvolvido na cidade de Picos com alunos do nono ano de uma escola pública. Obteve aprovação do Comitê de Ética em Pesquisa da Universidade Estadual do Ceará com o parecer 11043817-5. Resultados: com o desenvolvimento da atividade foi verificado um grande aproveitamento com influência de melhorias educacionais sobre automedicação, um tema relevante para a saúde humana, envolvendo a tecnologia da Web Rádio. Teve a participação ativa dos alunos com aprendizado sobre o tema e as dúvidas mais frequentes foram relativas às consequências (50%). Conclusão: o encontro na escola mostrou-se um dia construtivo de aprendizagem, onde os alunos participantes tiveram a oportunidade de tirarem suas dúvidas sobre o tema em discussão e a transmissão de informações por recursos tecnológicos mostrou-se uma necessidade de atividades de promoção sobre a temática.

Objective: to describe the experience with students of a state school, after broadcasting a program on selfmedication through a web radio with active participation of youth. Methodology: it is a descriptive study of the experience report type, from the Web Care in Childhood and Youth extension project at the Schools of the Federal University of Piauí, developed in the city of Picos with students from the ninth year of a public school. It was approved by the Research Ethics Committee of the State University of Ceará with the report 11043817-5. Results: with the development of the activity was verified that there was a great use with the influence of educational improvements on self-medication, a relevant topic for human health, involving the technology of Web Radio. There was the active participation of students with learning on the topic and the most frequent doubts were related to the consequences (50%). Conclusion: the meeting at the school proved to be a constructive learning day, where the participating students had the opportunity to clarify their doubts about the topic under discussion and the transmission of information by technological resources proved to be a need for promotional activities on the subject thematic.

Validação da escala de atitude em tecnologias digitais da informação e comunicação / Validación de la escala de actitud en las tecnologías digitales de la información y la comunicación / Validation of the attitude scale for information and communications technologies

Resumo Objetivo: Validar uma escala que identifica a atitude de acadêmicos, dos cursos de ciências da saúde, quanto ao uso de tecnologias digitais da informação e comunicação. Métodos: Estudo metodológico, realizado com 292 acadêmicos dos cursos de ciências biológicas, enfermagem, nutrição e medicina, e aplicado a Escala de Atitude em Tecnologias Digitais da Informação e Comunicação para a Saúde com 14 itens. A validação ocorreu por intermédio de um comitê de especialistas envoltos na criação da tradução da versão em língua portuguesa, validação interna, adaptação cultural. Seguida ainda para pré-teste, e, pós-teste, por meio de analise fatorial exploratória, consistência e representabilidade dos componentes da escala. Resultados: Foram validados 14 itens, todos apresentando adequabilidade de constructo, conforme medida de adequabilidade de 0,80 e p<0,000. Ainda, as analises fatoriais produziram uma solução de dois fatores, constructos positivos e negativos, o que permite melhor identificar as atitudes dos acadêmicos. Conclusão: A escala apresentou valores de adequabilidade acima da media para este tipo de instrumento, mostrando ser efetiva para a mensuração do objeto proposto, fornecendo assim, um inovador meio de pesquisas neste campo de atuação.

Resumen Objetivo: Validar una escala que identifica la actitud de académicos de los cursos de ciencias de la salud, en cuanto al uso de tecnologías digitales de la información y comunicación. Métodos: Estudio metodológico, realizado con 292 académicos de los cursos de ciencias biológicas, enfermería, nutrición y medicina, y aplicado a la Escala de Actitud en Tecnologías Digitales de la Información y Comunicación para la Salud con 14 ítems. La validación se llevó a cabo a través de un comité de expertos involucrados en la creación de la traducción de la versión en portugués, la validación interna y la adaptación cultural. A continuación, para pre-test y post-test, por medio de análisis factorial exploratorio, consistencia y representación de los componentes de la escala. Resultados: Fueron validados 14 ítems, todos presentando adecuabilidad de constructo, conforme medida de adecuación de 0,80 y p <0,000. Además, los análisis factoriales produjeron una solución de dos factores, constructos positivos y negativos, lo que permite identificar mejor las actitudes de los académicos. Conclusión: La escala presentó valores de adecuación por encima de la media para este tipo de instrumento, mostrando ser efectiva para la medición del objeto propuesto, proporcionando así un innovador medio de investigaciones en este campo de actuación.

Abstract Objective: To validate a scale that identifies the attitude of academics, from Health Sciences courses, as to the use of Information and Communications Technologies. Methods: Methodological study, carried out with 292 undergraduates from Biological Sciences, Nursing, Nutrition and Medical School, and applied to the Information and Communications Technology Attitude Scales for Health with 14 items. Validation was conducted by a committee of experts involved in the translation from the Portuguese version, with internal validation, cultural adaptation. It passed through a pre-test, and a post-test, by means of exploratory factorial analysis, consistency and representability of the scale components. Results: A total of 14 items was validated, all of which with construct adequacy, according to the measure of suitability of 0.80 and p<0.000. Factorial analyses produced a two-factor solution, positive and negative constructs, which allows better identification of academic attitudes. Conclusion: The scale presented values of suitability above the average for this type of instrument. Thus, it is effective to assess the proposed object and it provides an innovative means of research within this field.

Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.

OBJECTIVE: Autonomic dysfunction is an important mechanism that could explain many symptoms observed in fibromyalgia (FM). Exercise is an effective treatment, with benefits potentially mediated through changes in autonomic modulation. Strengthening is one of the less studied exercises in FM, and the acute and chronic effects of strengthening on the autonomic system remain unknown. The objective of this study was to assess the chronic effects of strengthening exercises (STRE) on autonomic modulation, pain perception and the quality of life (QOL) of FM patients. METHODS: Eighty sedentary women with FM (ACR 1990) were randomly selected to participate in STRE or flexibility (FLEX) exercises in a blinded controlled trial. The intensity of STRE was set at 45% of the estimated load of 1 Repetition Maximum (RM) in 12 different exercises. Outcomes were Visual Analog Scale (VAS) for pain, Heart Rate Variability (HRV) analysis, treadmill test, the sit and reach test (Wells and Dillon's Bench), maximal repetitions test and handgrip dynamometry; and quality of life by the Fibromyalgia Impact Questionnaire (FIQ), the Beck and Idate Trait-State Inventory (IDATE), a short-form health survey (SF-36). RESULTS: The STRE group was more effective to strength gain for all muscles and pain control after 4 and 16 weeks (p<0.05). The FLEX group showed higher improvements in anxiety (p<0.05). Both groups showed improvements in the QOL, and there was no significant difference observed between the groups. There was no change in the HRV of the STRE and FLEX groups. CONCLUSIONS: Strengthening exercises show greater and more rapid improvements in pain and strength than flexibility exercises. Despite the benefits in fitness, pain, depression, anxiety and quality of life, no effect was observed on the autonomic modulation in both groups. This observation suggests that changes in autonomic modulation are not a target tobe clinically achieved in fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov NCT02004405.

Comparação da resposta autonômica cardiovascular de praticantes de musculação, corredores de longa distância e não praticantes de exercício / Comparison of cardiovascular autonomic response among body builders, long distance runners and non-trained

Objetivou-se comparar a resposta autonômica cardiovascular (RAC) de praticantes de musculação, corredores de longa distância e não praticantes de exercício. Homens, 21 a 55 anos, foram agrupados em: Praticantes Musculação (PM, n = 31); Praticantes Corrida (PC, n = 28); Controle (C, n = 35). Foram selecionadas quatro técnicas para avaliação da RAC: Frequência cardíaca de repouso (FCR), Teste pressórico do frio (TPF), Variabilidade da FC (VFC) e recuperação da FC pós-teste máximo em esteira. A FCR foi menor no grupo PC (PC = 54 ± 2; PM= 62 ± 2; C = 65 ± 2 bpm; média ± EPM). A recuperação da FC aos 60 s pós-teste de esforço foi maior no grupo PC (PC = 34 ± 3; PM = 23 ± 1; C = 24 ± 2; bpm). Quanto aos parâmetros espectrais de alta (HF) e baixa (LF) frequência da VFC, o grupo PC apresentou maior HF (55,1 ± 4,0 n.u) e menor LF (43,1 ± 4,0 n.u) comparado ao grupo C (HF = 40,7 ± 3,3; LF = 56,7 ± 3,5 n.u). O grupo PM não apresentou qualquer diferença de RAC em comparação ao grupo C. Conclui-se que prática contínua em musculação por longo prazo, diferentemente da prática de corrida de longa distância, não é capaz de alterar significativamente a RAC.

The aim of the study was to compare the cardiovascular autonomic response (CAR) of recreational weight trainers, long distance runners and non-exercised subjects. Men, 21 to 55 years old, were grouped in: recreational weight trainers (W, n = 31), long distance runners (R, n = 28) and non-exercised (C, n = 35). Four strategies of evaluation of the CAR were selected: Resting heart rate (RHR), cold pressor test (CPT), heart rate variability (HRV) and heart rate recovery (HHR) following maximal exercise test. The RHR was lower (R = 54 ± 2; W = 62 ± 2; C= 65 ± 2 bpm; mean ± SE) and the HHR 60s post exercise was larger in the R group (R = 34 ± 3; W = 23 ± 1; C = 24 ± 2 bpm). The R group presented larger high-frequency (HF; 55.1 ± 4.0 n.u) and smaller low-frequency (LF; 43.1 ± 4.0 n.u) components of HRV than C group (HF = 40.7 ± 3.3; LF = 56.7 ± 3.5 n.u.). The W group did not show any differences compared to C group. The study's conclusion was that long-term weight-training program, unlike of long-term running training, it is not able to alter significantly the regulatory pattern of CAR.

Carvedilol recovers normal blood pressure variability in rats with myocardial infarction.

BACKGROUND: The aim of this study was to investigate the effects of chronic treatment with carvedilol in blood pressure (BPV) and heart rate (HRV) variability of rats with myocardial infarction (MI). METHODS: MI was produced in male rats by ligature of anterior interventricular branch of left coronary artery. Control rats were submitted to a sham surgery (SO). MI and SO rats were randomized to receive for 30 days placebo (Plac 0.5% metilcelulose) or carvedilol (Carv, 2mg/Kg body weight/day, drinking water): SO-Plac (N = 10), SO-Carv (N = 10), MI-Plac (N = 12), MI-Carv (N = 13). Blood pressure (BP) was directly recorded in the awake animals and BPV was determined, in time (variance, mmhg(2)) and frequency domains by the autoregressive method. Statistical significance was set in P<0.05. Data are median and interquartile range. RESULTS: No significant changes in HRV was observed in MI rats, while BPV showed significant decreasing of blood pressure variance (SO-Plac = 42.08 (39.21) mmHg(2) vs. MI-Plac = 21.67 (12.58) mmHg(2), P<0.05), reversed by the Carv treatment (MI-Plac = 21.67 (12.58) vs. MI-Carv = 38.64 (29.25), P<0.05). In the frequency domain analyses, MI reduced absolute and normalized LF component (LF (mmHg(2)): SO-Plac = 8.98 (14.84) vs. MI-Plac = 2.08 (4.84), P<0.05; LF(nu): SO-Plac = 79.48 (45.03) nu vs. MI-Plac = 24.25 (40.67) nu, P<0.05) and increased the normalized HF component of the BPV (SO-Plac = 20.51 (39.18) vs. MI-Plac = 60.51 (39.73). Carv treatment significantly attenuated the LF component fall. CONCLUSION: Chronic treatment with carvedilol restored the variance of BPV altered by the MI.

Afericoes e exames clinicos realizados nos participantes do ELSA-Brasil / Medical assessments and measurements in ELSA-Brasil

Este artigo descreve os exames clínicos realizados no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Alguns deles (antropometria, pressão arterial e índice tornozelo-braquial) já têm uso clínico consolidado. Outros, como a velocidade de onda de pulso, variabilidade da frequência cardíaca e medida da espessura médio-intimal de carótidas, carecem de valor de referência na população brasileira não doente e podem constituir preditores importantes de desfechos cardiovasculares. A medida da pressão arterial após manobra postural foi incluída no ELSA-Brasil porque foi pouco testada em estudos epidemiológicos. O ELSA-Brasil inovou na realização do índice tornozelo-braquial, ao usar um aparelho automático em substituição à coluna de mercúrio na medida da pressão arterial, e também na medida do diâmetro ântero-posterior do lobo direito do fígado pela ultrassonografia, proposta para avaliação quantitativa da doença hepática gordurosa não-alcoólica. Os participantes são indivíduos mais jovens (a partir dos 35 anos) do que em outras coortes focadas no estudo da aterosclerose subclínica. A inclusão de indivíduos mais jovens e a diversidade dos exames realizados tornam o ELSA-Brasil um estudo relevante no contexto da epidemiologia brasileira e internacional.

The article describes assessments and measurements performed in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). Some assessments including anthropometric assessment, casual blood pressure measurement, and ankle-brachial index have an established clinical application while others including pulse wave velocity, heart rate variability, and carotid intima-media thickness have no established application and do not have reference values for healthy Brazilian population but may be important predictors of cardiovascular outcomes. Blood pressure measurement following postural change maneuver was included in the ELSA-Brasil because it has not been much tested in epidemiological studies. Innovative approaches were developed for assessing the ankle-brachial index using an automatic device instead of the mercury column to measure blood pressure and for assessing the anterior-posterior diameter of the right lobe of the liver by ultrasound for quantitative assessment of nonalcoholic fatty liver disease. All ELSA-Brasil subjects were younger (35 years or more) than those included in other cohorts studying subclinical atherosclerosis. The inclusion of younger individuals and a variety of assessments make the ELSA-Brasil a relevant epidemiology study nationwide and worldwide.

Distribuição por gênero de ácido úrico sérico e fatores de risco cardiovascular: estudo populacional / Gender distribution of serum uric acid and cardiovascular risk factors: population based study / Distribución por género del ácido úrico sérico y factores de riesgo cardiovascular: estudio poblacional

FUNDAMENTO: Não há dados relativos à epidemiologia da hiperuricemia em estudos brasileiros de base populacional. OBJETIVO: Investigar a distribuição de ácido úrico sérico e sua relação com variáveis demográficas e cardiovasculares. MÉTODOS: Estudamos 1.346 indivíduos. A hiperuricemia foi definida como > 6,8 e > 5,4 mg/dL para homens e mulheres, respectivamente. A síndrome metabólica (SM) foi definida utilizando-se os critérios NCEP ATP III. RESULTADOS: A prevalência de hiperuricemia foi de 13,2 por cento. A associação de ácido úrico sérico (AUS) com fatores de risco cardiovasculares foi específica para o gênero: em mulheres, maiores níveis de AUS estiveram associados com IMC elevado, mesmo após ajustes da pressão arterial sistólica para idade (PAS). Em homens, a relação do AUS com o colesterol HDL esteve mediada pelo IMC, enquanto em mulheres, o AUS mostrou-se semelhante e dependente do IMC, independentemente dos níveis glicose e presença de hipertensão. Nos homens, os triglicerídeos, a circunferência abdominal (CA) e a PAS explicaram 11 por cento, 4 por cento e 1 por cento da variabilidade do AUS, respectivamente. Nas mulheres, a circunferência abdominal e os triglicerídeos explicaram 9 por cento e 1 por cento da variabilidade de AUS, respectivamente. Em comparação com o primeiro quartil, homens e mulheres no quarto quartil apresentavam 3,29 e 4,18 vezes mais de aumento de risco de SM, respectivamente. As mulheres apresentaram uma prevalência quase três vezes maior de diabetes melito. Homens normotensos com MS apresentaram maiores níveis de AUS, independente do IMC. CONCLUSÃO: Nossos resultados parecem justificar a necessidade de uma avaliação baseada no gênero em relação à associação do AUS com fatores de risco cardiovasculares, que se mostraram mais acentuados em mulheres. A SM esteve positivamente associada com AUS elevado, independentemente do gênero. A obesidade abdominal e a hipertrigliceridemia foram os principais fatores associados com a hiperuricemia mesmo em indivíduos normotensos, o que pode adicionar maior risco para a hipertensão.

BACKGROUND: There is no data concerning the epidemiology of hyperuricemia in Brazilian population-based studies. OBJECTIVE: To investigate the distribution of serum uric acid and its relationship with demographics and cardiovascular variables. MEHTODS: We studied 1,346 individuals. Hyperuricemia was defined as > 6.8 and > 5.4 mg/dL for men and women, respectively. Metabolic syndrome (MS) was defined with NCEP ATP III criteria. RESULTS: The prevalence of hyperuricemia was 13.2 percent. The association of serum uric acid (SUA) with cardiovascular risk factors was gender-specific: in women, higher SUA was associated with increasing BMI, even after adjustments for age-systolic blood pressure (SBP). In men, the relationship of SUA with HDLc was mediated by BMI, whereas in women, SUA was similar and dependent on BMI, regardless of glucose levels and presence of hypertension. In men, triglycerides, waist circumference (WC) and SBP explained 11 percent, 4 percent and 1 percent of SUA variability, respectively. In women, WC and triglycerides explained 9 percent and 1 percent of SUA variability, respectively. Compared to the first quartile, men and women in the fourth quartile had a 3.29 fold and 4.18 fold increase of MS risk, respectively. Women had almost three fold higher prevalence of diabetes mellitus. Normotensive men with MS presented higher SUA, regardless of BMI. CONCLUSION: Our results seem to justify the need for gender-based evaluation regarding the association of SUA with cardiovascular risk factors, which was more pronounced in women. MS was positively associated with increasing SUA, regardless of gender. Abdominal obesity and hypertriglyceridemia were the main factors associated with hyperuricemia even in normotensive individuals, which may add a higher risk for hypertension.

RFUNDAMENTO: No existen datos relativos a la epidemiología de la hiperuricemia en los estudios brasileros de base poblacional. OBJETIVO: Investigar la distribución del ácido úrico sérico y su relación con las variables demográficas y cardiovasculares. MÉTODOS: Estudiamos 1.346 individuos. La hiperuricemia se definió como > 6,8 y > 5,4 mg/dL para hombres y mujeres, respectivamente. El síndrome metabólico (SM) fue definido utilizando los criterios NCEP ATP III. RESULTADOS: La prevalencia de hiperuricemia fue de un 13,2 por ciento. La asociación del ácido úrico sérico (AUS), con los factores de riesgo cardiovasculares fue específica para el género: en las mujeres, mayores niveles de AUS estuvieron asociados con un IMC elevado, incluso después de los ajustes para la presión arterial sistólica (PAS) y edad . En los hombres, la relación del AUS con el colesterol HDL fue mediada por el IMC, mientras que en las mujeres, el AUS demostró ser parecido y dependiente del IMC, independientemente de los niveles de glucosa y de la presencia de hipertensión. En los hombres, los triglicéridos, la circunferencia abdominal (CA) y la PAS, explicaron el 11 por ciento, 4 por ciento y el 1 por ciento de la variabilidad del AUS, respectivamente. En las mujeres, la circunferencia abdominal y los triglicéridos explicaron el 9 por ciento y el 1 por ciento de la variabilidad de AUS, respectivamente. En comparación con el primer cuartil, los hombres y las mujeres, en el cuarto cuartil, tenían 3,29 y 4,18 veces más aumento de riesgo de SM, respectivamente. Las mujeres tenían una prevalencia casi tres veces mayor de diabetes mellitus. Los hombres normotensos con MS tenían mayores niveles de AUS, independiente del IMC. CONCLUSIONES: Nuestros resultados parecen justificar la necesidad de una evaluación con base en el género, respecto de la asociación del AUS con los factores de riesgo cardiovasculares, que demostraron ser más acentuados en las mujeres. La SM estuvo positivamente asociada con el AUS elevado, independientemente del género. La obesidad abdominal y la hipertrigliceridemia fueron los principales factores asociados con la hiperuricemia incluso en los individuos normotensos, lo que puede añadirle un riesgo mayor a la hipertensión.