Knowledge, attitudes and practices of cervical cancer screening among female students enrolled in higher education institutions in Cabo Verde.

Cervical cancer (CC) is the fourth most common cancer among women in the world and the second in Africa. CC is the third most frequent cancer and the first cause of cancer-related death among women in Cabo Verde, with an estimated incidence of 17 cases per 100,000 women. The mortality rate is around 10.5% and represents one of the largest percentages of all types of cancer diagnosed in women in the country. The high mortality rate can be explained by the absence of a national screening programme and a lack of human and physical resources. This study aims to determine the level of knowledge, attitudes and practices on CC among undergraduate female students in Cabo Verde in 2020. Methods: A descriptive cross-sectional study, using a self-administered structured questionnaire, was conducted in six higher education institutions (HEI) in Cabo Verde between November and December 2020. A total of 618 female undergraduate students were recruited using a simple random sampling technique. Descriptive statistical data analysis was used to report the results. Results: The response rate was 96.6% (n = 618). Most of the participants, 90.6% (549), were single, with average age of 21.79 years (SD =±4). Although most of the participants had already heard about CC (94.6%), most students showed a low knowledge about this disease (86.2%). Moreover, only 9.1% reported having been screened for CC. Conclusion: Most undergraduate female students enrolled in HEI in Cabo Verde have poor knowledge and unfavourable attitudes toward CC. The level of knowledge is quite unsatisfactory. Within this context, the implementation of health policies focused on human papillomavirus education, prevention strategies, and CC screening is crucial.

Characterization of Portuguese Centenarian Eating Habits, Nutritional Biomarkers, and Cardiovascular Risk: A Case Control Study.

BACKGROUND AND AIMS: Eating habits may contribute to longevity. We characterized the eating habits and cardiovascular risk (CVR) biomarkers in Portuguese centenarians (CENT) compared to controls. METHODS AND RESULTS: Centenarians (n = 253), 100.26 ± 1.98 years, were compared with 268 controls (67.51 ± 3.25), low (LCR) and high (HCR) CVR (QRISK®2-2016). Anthropometric and body composition were evaluated by bioimpedance. Abdominal obesity, BMI, and fat mass (FM) cut-offs were according to the WHO. Sarcopenia was defined by muscle mass index cut-off ≤ 16.7 kg/m2. Daily red meat intake, adjusted for age and gender, was sarcopenia protective (OR = 0.25, 95% CI = 0.096-0.670, P = 0.006); however, it contributes for FM excess (OR = 4.946, 95% CI = 1.471-16.626, P = 0.01), overweight, and obesity (OR = 4.804, 95% CI = 1.666-13.851, P = 0.004). This centenarian eating habit (2%) contrasts to HCR (64.3%). The history of red meat (P < 0.0001) and canned/industrialized food intakes (P < 0.0001) was associated with HCR. Basal metabolism was lower in centenarians versus LCR/HCR (CENT = 1176.78 ± 201.98; LCR = 1356.54 ± 170.65; HCR = 1561.33 ± 267.85; P < 0.0001), BMI (CENT = 21.06 ± 3.68; LCR = 28.49 ± 4.69; HCR = 29.56 ± 5.26; P < 0.0001), waist circumference (CENT = 85.29 ± 10.83; LCR = 96.02 ± 11.71; HCR = 104.50 ± 11.84; P < 0.0001), and waist-hip ratio (CENT = 0.88 ± 0.07; LCR = 0.92 ± 0.08; HCR = 1.01 ± 0.08; P < 0.0001). CENT had lower total cholesterol, LDL cholesterol, non-HDL cholesterol, and cholesterol/HDL ratio than controls. CONCLUSIONS: Frequent consumption of red meat, cholesterol, and heme iron rich may contribute to obesity and increased CVR. The low frequency of this consumption, observed in centenarians, although associated with sarcopenia, may be one of the keys to longevity.

Sarcopenia and osteoporosis in Portuguese centenarians.

BACKGROUND/OBJECTIVES: To evaluate the prevalence of sarcopenia and osteoporosis in centenarians and its association with body composition and past physical activity (PPA). SUBJECTS/METHODS: We conducted an observational cross-sectional study in a representative nationwide population of 253 Portuguese centenarians. A clinically oriented questionnaire and anthropometric and body composition analysis by bioimpedance were executed. Sarcopenia was determined using a muscle mass (MM) index cutoff ⩽16.7 kg/m2. Osteoporosis was defined through estimated bone mass (BM), according to gender and body weight. Inadequate physical performance was considered when the timed-up-and-go test was >12 s. RESULTS: BM and MM were gender dependent, even after adjusting for multiple variables. We found a protective effect of intense PPA on sarcopenia risk (OR=0.41, 95% CI=0.20-0.82, P=0.013). Those with worse physical function status presented a significantly higher risk for osteoporosis (OR=8.9, 95% CI=1.94-40.08, P=0.005). Multivariate models showed that low MM, BM and fat mass (FM) were predictors of underweight in centenarians. Underweight, male gender, worst physical function, hypohydration and sarcopenia were associated with increased osteoporosis risk. The risk for sarcopenia was higher in women (P=0.002), in those underweight (P=0.005) and in osteoporotic individuals (P<0.0001). Conversely, increased MM was protective against osteoporosis (P<0.0001), whereas higher BM decreased the risk for sarcopenia (P=0.005). CONCLUSIONS: Gender was revealed to be a relevant factor influencing BM and MM in centenarians. MM and BM were better predictors of underweight than was dehydration. Healthy BM and MM were positively related with PPA intensity and determined physical performance, having a positive impact on the centenarian's independence. During aging, improving physical function might add to sarcopenia and osteoporosis prevention, besides prevention of femur neck fractures and cardiovascular diseases.

Body Composition Assessment and Nutritional Status Evaluation in Men and Women Portuguese Centenarians.

OBJECTIVES: To assess body composition, nutritional status and its differences between genders in a sample of Portuguese centenarians. DESIGN: Observational cross-sectional study. SETTING: Centenarians recruited in Portugal, able to give informed consent. PARTICIPANTS: A total of 252 subjects, with a median age of 100 years, mostly women (77.8%) who accepted to participate in the study, during the period of 2012 to 2014. MEASUREMENTS: Anthropometric data collected (weight, height, BMI, waist circumference, hip and waist/hip ratio) were evaluated according to WHO criteria. A portable tetrapolar bioimpedance analyzer was used to calculate body composition and to assess resting metabolism. Nutritional status was evaluated according to three different criteria: BMI, waist circumference and body fat percentage using anthropometric equations and bioimpedance. RESULTS: We observed an overall mean weight of 51.02±11.03Kg, height of 1.55±0.07m and a BMI of 21.07±3.69Kg/m2. For most of the evaluated parameters, we found substantial differences between genders. The prevalence of underweight and overweight were 25.3% and 13.3%, respectively. Only 5 subjects were obese. Overweight subjects were mostly men (W=10.6% vs. M=22.6%), whereas women were more underweight (W=28.7% vs. M=13.2%). When considering the waist circumference, 26.5% were above the cut-off value. Most of centenarians (72.9%) had a healthy level of visceral fat. This measurement was highly correlated with waist circumference (r= 0.687, p<0.001). The mean of body fat mass was 10.69±6.50Kg, fat-free mass 40.87±7.60Kg and total body water 27.54±6.25Kg. According to body fat mass criteria assessed by bioimpedance, the prevalence of obesity in study population was 6.0% with no gender differences (p = 0.225). Obesity prevalence using anthropometric equations was higher (Deurenberg: 77.7% and Gallagher: 42.8%) than the obtained value by bioimpedance analysis, although according to Bland-Altman analysis both equations showed a good agreement (Deurenberg: 95.8% and Gallagher: 97%) with bioimpedance method. The prevalence of hypohydration (12.9%) was tendentiously higher in women compared to men (W= 15.4% vs. M= 5.0%, p=0.087). Despite the frequency of osteoporosis was higher in women (W = 71.85% vs. M = 28.15%), 95% of men revealed criteria for osteoporosis. Resting metabolic rate (RMR) was significantly different between genders using bioimpedance analysis (W= 1123.33± 173.91; M= 1350.10± 188.88; p<0.001) or Harris Benedict equation (W= 934.92± 102.60; M= 1018.85± 171.68; p=0.001). Bland- Altman analysis between methods indicate that there was an agreement of 97.6%. The overall mean metabolic age obtained was 83.52±1.11 years, well below the chronologic age (p<0.001). CONCLUSION: In Portuguese centenarians, clinical and nutritional approach should be improved on the gender basis. In relation to nutritional status, centenarians were more frequently underweight than overweight. The thinness could be a natural process, contributing for the longevity being rather overweight a reducing factor in life expectancy. BMI and waist circumference showed a good correlation with body fat percentage. Despite the results of Bland- Altman analysis, Deurenberg and Gallagher equations are not suitable to evaluate obesity prevalence in centenarians. Harris Benedict equation seems to be a good option to measure RMR in centenaries, when BIA is not available. Body composition and nutritional characterization of Portuguese centenarians are relevant contribution in scientific evidence production for the action plan of healthy ageing in Europe (2012-2020) and also for clinical practice.

Evaluation of the oxidant and antioxidant balance in the pathogenesis of chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic diseases and a major cause of morbility and mortality. An imbalance between oxidants and antioxidants (oxidative stress) has been proposed as a critical event in the pathogenesis of COPD. The increased oxidative stress in patients with COPD is the result of exogenous oxidants namely pollutants and cigarette smoke as well as endogenous oxidant production during inflammation. The aim of the present study was to clarify the hypothesis about the presence of an imbalance between oxidants and the antioxidant defences associated to COPD. In this study, we evaluated a biomarker of oxidative stress (malondialdehyde, a lipid peroxidation derived product) and non-enzymatic antioxidants (vitamin C and the sulphydryl groups) in COPD patients and healthy controls. The marker of oxidative stress was found to be significantly (p<0,001) higher in COPD patients when compared with the control group. No age dependent changes in the plasma levels of lipid peroxidation products were found. COPD patients had a significant (p<0,001) decrease in antioxidant status compared with control group. Our results show that oxidative stress is an important pathophysiologic change in COPD.

PP159. In women with previous pregnancy hypertension, cardiovascular risk biomarkers may be modulated by haptoglobin genotype.

INTRODUCTION: Preeclampsia may affect the risk for future cardiovascular disease. Haptoglobin (Hp), an acute phase protein with genetic polymorphism (Hp1.1, 2.1 and 2.2) synthesized in the hepatocyte and in many tissues, may modulate the risk through the antioxidant and anti-inflammatory differential effects of their genotypes. OBJECTIVES: Evaluate some parameters of cardiovascular risk in association with genetic polymorphism of Hp in women with previous preeclampsia (HBP) compared to healthy women during gestation (NBP). METHODS: We studied 352 women aged 35±5.48 current year, taking these, 165 presented previous preeclampsia, 2-14 (±6.6) years ago. Genetic polymorphism of Hp was determined from plasma by electrophoresis. The different circulating biomarkers, myeloperoxidase ng/mL (MPO) and nitrates and nitrites (nmol/ml) by ELISA, transaminases - AST and ALT (U/L) and apolipoprotein A and B (mg/dL), uric acid (mg/dl) hs-CRP (mg/L) were determined by conventional methods as well as blood pressure (BP) and anthropometric parameters BMI and hip and waist circumference (WC).Statistical methods were Chi-square, ANOVA (Bonferroni) and t-Student. RESULTS: There were no differences in the distribution of phenotypes of Hp between NBP and those with previous hypertension in pregnancy. There were differences between NBP and HBP in the following parameters: Systolic BP (118.9±13.4 vs 135.0±16.5, p<0.001); Diastolic BP (72.2±10.1 vs 85.9±12.0 p<0.001); MPO (62.3±30.9 vs 85.7±39.4, p=0.020); Nitrite (10.1±3.8 vs 19.1±7.0, p<0.001); ALT (18.0±8.0 vs 22.5±12.9, p=0.016); BMI (25.4±4.1 vs 27.1±4.8, p=0.031); WC (82.8±9.9 vs 89.5±15.6, p=0.002); Apo B (0.6±0.1 vs 0.6±0.1, p=0.023). Those values vary with the genotypes of Hp and were observed Hp 1.1 and 2.1 in NBP and HBP respectively: [Systolic BP 119.2±13.7 vs 134.7±18.3 (p<0.001); Diastolic BP (72.8±11.9 vs 86.2±19.4 p<0.001); MPO (57.9±32.5 vs 94.2±42.1, p=0.008); Nitrites (9.6±3.2 vs 20.0±8.5, p<0.001); ALT(17.0±7.2 vs 20.4±8.0, p=0.033); WC (82.4±10.0 vs 90.8±17.6, p=0.004); Apo A (0.9±0.2 vs 1.0±0.2, p=0.011)] and Hp 2.2 in NBP and HBP respectively: [Systolic BP 118.2±13.1 vs 135.6±12.8 (p<0.001); Diastolic BP (70.9±7.2 vs 85.5±16.3 p<0.001); Nitrites (11.5±5.1 vs 18.0±4.4, p<0.001)]. CONCLUSION: Women with previous hypertension during pregnancy, presented significant differences in some classic cardiovascular risk biomarkers as well as in some others, associated with the inflammatory process, whose variation may be modulated by haptoglobin functional genetic polymorphism. The history of hypertensive disease in pregnancy may be relevant, in association with these biomarkers to the prevention of cardiovascular disease in particular of postmenopausal women.

Association of serotonin transporter gene polymorphism 5HTTVNTR with osteoporosis.

AIM: To study the association of serotonin transporter gene polymorphisms and osteoporosis. MATERIAL AND METHODS: Blood samples were collected from 186 individuals with normal bone mineral density and 89 with osteoporosis. Serotonin transporter gene polymorphisms 5HTTVNTR and 5HTTLPR were studied by PCR and statistical analyses used to test the association between groups. RESULTS: The frequency of 12/10 and 12/12 genotypes of 5HTTVNTR was significantly higher among the osteoporotic patients (OR=2,620 CI 95% [1,112--6,172], P=0,037). For 5HTTLPR we did not find significant differences between the two studied groups. CONCLUSIONS: As far as we know, this is one of the few studies that report an association between 5HTTVNTR and osteoporosis opening the hypothesis that the determination of this specific serotonin transporter gene polymorphism may contribute to the identification of individuals at high risk for the development of osteoporosis.

Low molecular weight protein tyrosine phosphatase genetic polymorphism and susceptibility to cancer development.

Low molecular weight protein tyrosine phosphatases (LMW-PTPs) are a family of 18-kDa enzymes involved in cell growth regulation. Human acid phosphatase 1 (ACP1) is genetically polymorphic, and three common alleles segregating at the ACP1 locus on the short arm of chromosome 2 give rise to six phenotypes. Each allele appears to encode two electrophoretically different isozymes, fast and slow, which are produced in allele-specific ratios. Fast isozymes are related with cytoskeletal organization, cellular organization, and spreading. Slow isozymes are associated with growth factor receptors and dephosphorylation. In this study, ACP1 genetic polymorphisms were determined by polymerase chain reaction-restriction fragment length polymorphism on 74 subjects with various cancers; the control group was 236 healthy subjects randomly selected. With genotypes cumulated according to fast isoform concentration, [A + AC] < [AB + BC] < [BB], subjects with cancer presented an increase of fast isozyme concentration (BB 38.2%; P = 0.002, chi2), relative to the control sample (19.8%). The increase of fast isozyme concentration increased the invasive capacity of cancer cells, whereas a decrease of slow isozyme concentration in cancer did not cause growth inhibition and so resulted in cancer cell proliferation.

Activity of two enzymes associated with apoptosis and cell aging in arterial hypertension.

OBJECTIVE: To study the activity of two enzymes, transmembrane reductase (TMR) and cytosolic low molecular weight protein tyrosine phosphatase (ACP1), in arterial hypertension (HT) in a sample of adults aged over 50 years. METHODS: A sample of 153 adults, 77 with hypertension and 76 normotensive (NT), aged between 50 and 90 years (mean: 71.87 +/- 11.59), of both sexes, was studied. TMR (mmol/cell/h) and ACP1 (micromol/gHb/h) activity in red blood cells was determined by spectrophotometry. Statistical analysis was carried out using the Student's t test and Pearson's correlation. RESULTS: We observed a significant difference in TMR activity between normotensive and hypertensive subjects, with lower levels in the hypertensives (NT = 4.762 +/- 2.595; HT = 3.878 +/- 1.748), p = 0.01. ACP1 activity, although higher in hypertensive patients, did not differ significantly from normotensive subjects (p = 0.08) (NT = 242.827 +/- 97.618; HT = 309.561 +/- 150.738). No correlation was observed between the activity of the two enzymes in either the hypertensive or the normotensive group. CONCLUSIONS: The lower level of activity of transmembrane reductase in arterial hypertension may be implicated in cardiovascular aging processes, reinforced by greater cytosolic acid phosphatase activity, with repercussions on cell proliferation and energy metabolism, leading to atherosclerosis.

Cytochrome P450 1A1 (CYP1A1) T6325C polymorphism might modulate essential hypertension-associated stroke risk.

Stroke is a serious complication associated with hypertension. Because cytochrome P450 1A1 (CYP1A1) is involved in the production of arachidonic acid-derived vasoactive substances, we hypothesized that CYP1A1 functional polymorphisms (linked to changes in enzyme activity) might be related to pathological conditions associated with essential hypertension. We genotyped 32 patients with hypertension for three CYP1A1 polymorphisms, and individuals with or without history of previous stroke were compared. These results were also compared with a control population sample of 152. The distributions of T6235C (m1) CYP1A1 genotypes in patients with (TT: 44.4%; TC/CC: 55.6%; n = 9) and without stroke (TT: 82.6%; TC/CC: 17.4%; n = 23) indicate that the C allele is associated with stroke (OR = 5.94; 95% C = 1.46 - 24.23). No association was found between the polymorphism studied and essential hypertension. Our results suggest a relationship between CYP1A1 activity and incidence of stroke in patients with essential hypertension, but no conclusion can be drawn regarding an association with essential hypertension.

[Ionized calcium and magnesium as interdependent variables in blood pressure origin in healthy adolescents]. / Cálcio e magnésio ionizados como variáveis interdependentes na génese da pressão arterial, em adolescentes saudáveis.

INTRODUCTION: Growing evidence indicates that diet divalent cations--ionized calcium (Ca) and magnesium (Mg)--and MN blood group polymorphism may be associated with essential arterial hypertension. OBJECTIVES: To assess a possible relationship between serum ionized Ca and Mg and MN blood group polymorphism with blood pressure (BP) and body mass index (BMI). POPULATION AND METHODS: The study group consisted of 173 healthy adolescents, 96 female (55.5%) and 77 male (44.5%), with mean age of 13.0 +/- 1.7 years. Serum ionized Ca and Mg were determined by standardized methods based on detection by specific electrodes. MN blood group polymorphism was determined by immunoaglutination of erythrocytes with monoclonal antibodies. BP was evaluated based on AHA recommendations. BMI was calculated as weight divided by squared height (Kg/m2). The statistical method used was the Pearson correlation. RESULTS: In this population no significant correlation was found from serum ionized Ca (mean: 1.07 +/- 0.06 mmol/L) and Mg (mean: 1.15 +/- 0.97 mmol/L) with systolic BP (mean: 113.1 +/- 10.7 mmHg) and diastolic BP (mean: 66.1 +/- 10.1 mmHg). In contrast there was an inverse correlation between the quotient ionized Mg/ionized Ca (0.45 +/- 0.05) and diastolic BP (p = 0.029; r = -0.381). A positive correlation was found between BMI (20.57 +/- 3.24 Kg/m2) and systolic BP (p = 0.007; r = 0.24) and diastolic BP (p = 0.016; r = 0.22). No correlation was found between ionized Ca, ionized Mg and BP with MN blood group polymorphism. CONCLUSIONS: In this population of healthy adolescents there was a dependence between diastolic BP and serum ionized Mg/ionized Ca. There was no interindividual BP and ionized Ca and Mg variation dependent from genetic variation.

Lipid profile and redox status in high performance rhythmic female teenagers gymnasts.

BACKGROUND: The aim of the present study is to evaluate the lipid profile and some parameters of oxi-redox status in a group of teenage female athletes. All gymnasts of the Portuguese National Team of Rhythmic (n=20) were included in the study. A group of untrained healthy female adolescents, matched for age, was also included (n=28). METHODS: Auxology, nutritional status and body composition were evaluated as well as biological parameters, dietary and training habits. Statistics included descriptive analysis, t-Student and Mann-Whitney for comparative study, and Pearson and Spearman correlations, according to variable distribution. RESULTS: Chronological age was 14.3+/-1.7 and 14.6+/-1,7 years, respectively for gymnasts and untrained adolescents. Gymnasts showed lower body mass index (p<0.001) and fat mass (p<0.001) and also a hypoenergetic diet, with higher supply in protein (p<0.05) and saturated fat (p<0.01). Lipid profile showed higher HDL-cholesterol (p<0.01) and lower apo B values (p<0.001) in gymnasts, compared to untrained. Red blood cell's enzymes studied were higher for transmembrane NADH reductase of ferricyanide (TMR), (p<0.01), methaemoglobin reductase (MetHbRed), (p<0.01), and low-molecular weight protein tyrosine phosphatase (LMW-PTP), (p<0.0001) in untrained adolescents. Susceptibility of LDL to peroxidation (LDL-TBARS) were higher in gymnasts (76.3+/-20.3 microM/l versus 35+/-21.7 microM/l), (p<0.001). Correlations were positive and significant in both gymnasts and untrained, between LDL-TBARS and LDL-cholesterol (r=0.674, p<0.01 and r=0.544, p<0.05 respectively) and apolipoprotein B (r=0.721, p<0.001 and r=0.659, p<0.01, respectively). LDL-TBARS were negative and significatively correlated to TMR (t=-0.608; p<0.01) only in gymnasts. CONCLUSIONS: The authors conclude that the practice of intense physical exercise in rhythmic gymnasts induces a compromise of nutritional status and unbalanced food habits. The intensive exercise also induces not only a protective lipid profile, but also a higher lipid peroxidation. Further prospective studies are important to evaluate the influence of intensive training on atherosclerosis development.

Nocturnal sleep quality and circadian blood pressure variation.

OBJECTIVE: To verify whether non-dipper behavior is associated with poor nocturnal sleep quality and a higher rate of obstructive sleep apnea than dipper behavior. METHODS: A sample of 36 subjects older than 50 years (mean age = 70 +/- 6.49 years), 8 males and 28 females, 27 (75%) hypertensive and 9 (25%) normotensive, was studied. Nocturnal polysomnography was carried out in the patients' homes. 24-hour ambulatory blood pressure was studied with Spacelabs 90,207 device. The statistical tests used were Student's t test, Pearson's correlation and the Chi-square test. RESULTS: In the overall sample, higher rates of apnea, higher rates of arousal and shorter duration of the REM (rapid eye movement) phase were linked to high levels of nocturnal diastolic blood pressure, with statistical significance (p < 0.01, p < 0.01, p < 0.05 respectively). Sleep fragmentation was associated with the lowest percentages of variation in daytime to nighttime systolic blood pressure (p < 0.03). Apnea rates were significantly higher in the hypertensive group compared to the normal blood pressure population (p = 0.04). We also observed that higher rates of nocturnal apnea corresponded to lower variations in daytime to nighttime systolic blood pressure (p = 0.015) and to a lower dipper index (p < 0.05). Higher indexes of arousal and lower REM latency were associated with higher nocturnal blood pressure, both systolic (p = 0.039 and p = 0.008, respectively) and diastolic (p = 0.003 and p = 0.029, respectively). Sleep efficiency was also negatively correlated with mean levels of nocturnal diastolic blood pressure (p = 0.038). CONCLUSIONS: The quality of nocturnal sleep seems to play an important role in blood pressure levels, particularly in the nocturnal blood pressure profile. A poor quality of nocturnal sleep and the rate of obstructive sleep apnea were associated with non-dipper behavior in the hypertensive population. Sleep evaluation is particularly useful in non-dipper subjects with hypertension.

Acid phosphatase, genetic polymorphism and cardiovascular risk factors in a pediatric population.

BACKGROUND: Although the clinical expression of cardiovascular disease usually occurs in adulthood, it is unanimously accepted that atherosclerosis begins in the pediatric age. Because of the early onset of the disease, it is of great importance to screen for major risk factors since pre-school age, especially in risk families. Recent investigations have shown a great interest not only in studying the classic risk factors, but also in the evaluation of oxidative stress and the main antioxidant defense systems. The major cause of this interest is the knowledge of the deleterious effect of reactive oxygen species on lipids, the endothelial membrane of arteries and, finally, on the occurrence of cardiovascular disease. POPULATION AND METHODS: 51 children of both genders, aged 9-12 years, randomly selected from a rural community, were observed. A possible association between low molecular acid phosphatase genetic polymorphism of the erythrocyte and the prooxidant status markers (epinephrine oxidase and low molecular protein phosphotyrosine phosphatase from the erythrocyte), some enzymatic systems of the body antioxidant defense (transmembranar reductase of ferricyanide and metahemoglobin reductase) and finally some intermediate phenotypes of cardiovascular disease (lipid profile and blood pressure) were studied. RESULTS: The study of prooxidant status markers and antioxidant enzymes shows significant differences for acid phosphatase and epinephrine oxidase activities in relation to low molecular acid phosphatase genetic polymorphism, the highest values observed being in those homozygous to the B allele (p < 0.05). The inter-relation study between variables showed, among other things, a significant inverse correlation between acid phosphatase and transmembrane reductase and a direct correlation between apolipoprotein B, acid phosphatase and metahemoglobin reductase. A positive family history for cardiovascular disease also showed a direct and significant correlation to total cholesterol, LDL-cholesterol and apolipoprotein B. CONCLUSIONS: The polymorphic variants of low molecular acid phosphatase and protein phosphotyrosine phosphatase with greater activity are strongly associated, not with the classic parameters of cardiovascular risk factors, but with oxidative stress indicators, such as low molecular protein phosphotyrosine phosphatase and epinephrine oxidase. Family history indicators of cardiovascular risk are clearly associated, since early ages, to some conventional risk factors, such as lipid profile and blood pressure.

Influence of salt intake on the daytime-nighttime blood pressure variation in normotensive and hypertensive black subjects.

OBJECTIVE: To evaluate the influence of different salt-intake regimens on the circadian rhythm of blood pressure (daytime-night-time relationship) in normotensive and hypertensive black subjects with different patterns of salt sensitivity. METHODS: Randomized, cross-over study. Twenty normotensive (NT) and 27 hypertensive (HT) black subjects were kept on a low-sodium diet (30 mmol sodium/d, LS) and on a high-sodium diet (300 mmol sodium/d, HS) for 1 week each. On the last day of each regimen, 24 hour ambulatory blood pressure monitoring was performed. RESULTS: Eight normotensives were classified as salt-sensitive (SS), all with haptoglobin phenotypes (FeHap) 1,1 or 1,2, and 12 as salt resistant (SR), 5 with FeHap 2,2. Seventeen hypertensives were classified as SS, all with FeHap 1,1 or 1,2, and 11 as SR, 2 with FeHap 2,2. Salt sensitivity criterium was: difference > 5 mmHg of 24 h mean blood pressure from low sodium to high sodium. The pattern of daytime-nighttime blood pressure relationship between LS and HS was only modified (respectively from dipper to non-dipper) in HT-SS, but not in NT-SS, NT-SR and HT-SR. The percentual drop in nighttime mean blood pressure was about 10% in HT-SR and in NT-SR either under LS or HS. In NT-SS, the percentual night-time drop in mean blood pressure was lower than that of NT-RS (i.e. about 7-8%), but it was not different on LS and on HS. In contrast, in HT-SS, the percentual nighttime drop in mean blood pressure on HS (6%) was significantly lower than that on LS (10%, p < 0.01). In the 27 HT, but not in the NT, changes in the nocturnal drop in mean blood pressure induced by salt restriction correlated positively with the degree of salt sensitivity (r = 0.45, p < 0.05). CONCLUSIONS: In black subjects, the pattern of nighttime-daytime blood pressure relationship appears to be modified from LS to HS diets (or vice-versa) only in SS hypertensive subjects, but neither in NT-SS nor in NT-SS and HT-SR. Only in HT-SS, but not in the other groups, salt restriction shifts the circadian rhythm of blood pressure from a non-dipper to a dipper pattern. We conclude that in black salt-sensitive hypertensives, salt restriction improves the circadian rhythm of blood pressure. This may have important therapeutic consequences on target organ damage associated with non-dipper patterns.

Insulin and high glucose modulation of phosphatase and reductase enzymes in the human erythrocytes: a comparative analysis in normal and diabetic states.

The ability of insulin to influence activities of various protein kinases and protein phosphatases, that are thought to mediate insulin action, are limited in patients with insulin resistance. Because numerous responses to insulin are affected, we undertook studies to determine whether protein tyrosine phosphatases (PTPs) activities are altered in patients with diabetes syndrome. In order to evaluate abnormal PTP activities, we done a comparative study using erythrocytes from normal and diabetic patients. We determined the activity of the cytosolic acid PTP in basal and insulin-dependent states. Mean basal PTP activities, were found to be significantly higher in diabetics than in normal subjects (type 1 diabetics: 0.36 +/- 0.01 vs 0.28 +/- 0.01 mmol p-nitrophenolate/h per g hemoglobin (Hb), P < 0.001; type 2 diabetics: 0.35 +/- 0.01 vs 0.28 +/- 0.01 mmol p-nitrophenolate/h per g Hb, P < 0.001). Insulin, at concentrations above physiological levels (1 mIU/ml), inhibited the PTP activities in erythrocytes from normal subjects (-15 +/- 4.1%, P < 0.01). Insulin could also modulate glycolysis, probably as a consequence of receptor tyrosine kinase activation, inducing phosphorylation of protein band 3 and hence the release of glycolytic enzymes. We have previously reported that a reductase enzyme in human erythrocytes is dependent on glycolysis being significantly activated (+28 +/- 3.1%, P < 0.001) by high insulin levels (1 mIU/ml). Mean basal reductase activities were found to be significantly lower in diabetics than in normal subjects (type 1 diabetics: 0.77 +/- 0.03 vs 0.97 +/- 0.02 mmol ferrocyanide/20 min per l cells, P < 0.001; type 2 diabetics: 0.77 +/- 0.04 vs 0.97 +/- 0.02 mmol ferrocyanide/20 min per l cells, P < 0.001), indicating altered erythrocyte metabolism in the diabetic patients. High glucose levels were used to mimic hyperglycemia condition, using erythrocytes from normal subjects. At 30 mM glucose, erythrocytic phosphatase activity was stimulated (+32 +/- 4.2%, P < 0.0001), although no effect was observed on the reductase enzyme at the same glucose levels. Results indicated that diabetic disorders appear to be associated with quantitative alterations of erythrocyte acid phosphatase activity and other enzymes that depend on the glycolytic rate (reductase). The overall data suggest that erythrocyte acid phosphatase may have a role in the modulation of glycolytic rates through the control of insulin receptor phosphorylation.

LDL peroxidation in adolescent female gymnasts.

UNLABELLED: Physical exercise may in vivo promote an increase of free radical formation. Low-density lipoproteins (LDL) are highly susceptible to oxidation, probably because of their high polyunsaturated fatty acid content, since lipid oxidation is an important factor in the genesis and development of atherosclerosis. The aim of the present study is to evaluate the effect in a group of adolescent gymnasts, of intense and regular physical exercise on lipid profile and redox status. POPULATION: All members of the Portuguese National Team of Rhythm Gymnastics (1996) (n = 20). METHODS: 1. Clinical evaluation 1.1 Anthropometric evaluation: weight, height, triceps, biceps, subscapular and supra- and supra-iliac skinfolds. NCHS were used as the standard of reference for weight and height, and Frisancho for the sum of skinfolds; 1.2. Evaluation of nutritional status (Quetelet body mass index) and body composition (Durnin and Siri). 2. Evaluation of biological parameters: a blood sample was collected after 12 hours fasting and 24 hours detraining, to evaluate: 2.1 Lipid profile: total cholesterol, high (HDL) and low (LDL) density lipoproteins, triglycerides, apolipoproteins A1 and B, were measured using internationally recommended laboratory methods; 2.2. Plasma trace elements: zinc, copper and selenium, by atomic absorption; 2.3 Red blood cell enzymes; transmembranar reductase (TMR), metahemoglobin reductase (MethaHbRed) and acid phosphatase, by spectrophotometry; 2.4. Redox status: MDA and MDA-LDL were evaluated by spectrophotometry. 3. Evaluation of eating habits: 24 hr recall. RESULTS: Chronological age is 14.3 +/- 1.7 years. Nutritional assessment shows a mean value for height near the 50th percentile (99% +/- 3.8), and low mean values respectively for BMI (89.3% +/- 9) and sum of triceps and subscapular skinfolds (51.9% +/- 14). Study of lipid profile shows low mean values for total cholesterol (162.3 mg/dl +/- 27.7) LDL-cholesterol (87.6 mg/dl +/- 22.6) and Apo B (64.4 mg/dl +/- 11.5), but high values for HDL-cholesterol (61.3 mg/dl +/- 14.5) and Apo A1 (173.1 mg/dl +/- 25.1). We observe higher values for total cholesterol and LDL-cholesterol in those with lower Cu plasmatic levels. We also observe a negative significative correlation between MDA-LDL and Zn (r = -0.469), Cu (r = -0.524) and RTM (r = -0.608). CONCLUSIONS: The AA concluded that in this group of gymnasts intense physical exercise induces, a favorable lipid profile, but a clear susceptibility to LDL peroxidation in those with lower plasma Cu and Zn values. It is possible that the negative correlation observed between MDA-LDL and TMR is caused by higher consumption of TMR induced by the action of exercise on the oxidative system.

[Acute effects of tobacco and vascular risk modulated by genetic factors]. / Acções agudas do tabaco e risco vascular modulado por factores genéticos.

Most studies regarding the acute effects of cigarette smoking refer to the higher sympathetic and adrenomedullary activity as a result of sympathetic ganglia and adrenal medulla nicotinic receptor activation. Although it is reasonable to suppose that the renin-angiotensin system might be activated, this possible effect of nicotine has not been studied. We have studied the effects of cigarette smoking on blood pressure, cardiac output, pulse pressure, renin-angiotensin system, kinins-NO, oxidative stress and insulin. Also, we have investigated if the variability of the biochemical parameters was dependent on genetic polymorphisms of the angiotensin converting enzyme and the acute phase protein haptoglobin. 39 normotensive individuals, 18 males and 21 females, of mean age 35.4 +/- 8.9 years were included in this study. Oxidative stress was dependent on the ACE I/D and Hp1/2 polymorphisms, with the ACE DD genotype and the Hp2-2 phenotype not showing variation in the anti-oxidant defense systems, and the ACE II-ID genotypes and Hp1-1 + 2-2 phenotypes showing a higher anti-oxidant response, hence a lower cardiovascular risk being predictable in the latter individuals.

[Plasma prostaglandin E2 in pregnant women undergoing labor induction with endocervical gel application]. / Prostaglandina E2 plasmática en mujeres embarazadas sometidas a inducción del trabajo de parto con aplicación endocervical de gel.

The authors describe an assay that quantify with precision the plasmatic prostaglandin E2 (PGE2). The aim of this study was to evaluate the effect of the gel formulation PGE2 endocervical in the induction of labour. We have studied 26 pregnant women without disease at the term of the pregnancy. The blood sample was collected before and 30 minutes after the labor induction in tubes with 10 mg EDTA Na2 and 5 microg of aspirin. The PGE2 was isolated by extraction and chromatography with 70-100% recovery. The concentration was evaluated by a completion assay with RIA. The PGE2 in plasma was found before and after the induction of labor with the following results: 347 +/- 51.6 and 719 +/- 128 pg/ml. The data was compared by the Student's t test for paired values (df = 50, t = 13. 22 and p < 0.0001). We can conclude that in pregnant women the concentration of PGE2 in plasma was double after the labor induction with the sensitivity in 1.25 pg/tube and the reproducibility 4.6% intraassay and 7% interassay showing that the method is sensitive, reproducible and efficient for the PGE2.

[Significance of family assessment and biological markers in the prevention of arterial hypertension]. / Importância da avaliação familiar e marcadores biológicos na previsão da hipertensão arterial.

OBJECTIVE: To verify the predictability of the appearance of hypertension through the clinical history and biological markers. POPULATION: Consisted of 300 Portuguese Caucasian individuals, M = 130 and F = 170, between the ages 18 and 85, including 90 pregnant women. METHODS: Blood pressure was measured in every individual, and questions were made concerning personal and familiar hypertensive background. The serum renin activity, the active renin, serum endoxin, and the urinary aldosteron, free dopamine, c--AMP, and noradrenalin were checked. The analysis of the results was carried ou using the Student's T Test and de chi(2) method. RESULTS AND CONCLUSIONS: Hypertensive parents lead to the development of hypertension on their descendants; the averages of diastolic blood pressure in normotensive individuals are higher when parents are hypertensive, compared with normotensive, seeming that a possible genetic factor may be implied in the involvement of the vessels. Normotensive young masculine adultshave higher average systolic blood pressure when their fathers are hypertensive, than those whose fathers have normal blood pressure levels; as far as young women are concerned, we verified that the mother's genetic influence seems to be relevant in the appearance of higher blood pressure levels in their daughters during pregnancy, contributing to think hat man and women may have genetically different factors to determine blood pressure levels. We also verified that young adults with normal levels of blood pressure, whose parents suffer from high blood pressure, present significantly higher levels of serum renin activity than a similar group of young adults whose parents have normal blood pressure. We concluded that the family history and the measuring of the blood pressure even at young adults may contribute for the forecasting of high blood pressure, as is the evaluation of biological parameters, particularly in those who have family history of hypertension. Serum renin activity may be a possible biological marker for the forecast of the future development of high blood pressure.