Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort

The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.

Factors associated with non-treatment of hypertension and gender differences at baseline in the ELSA-Brasil cohort.

The treatment of arterial hypertension (AH) contributes to the reduction of morbidity and mortality. Gender differences are likely to play a role, as non-treatment is associated with clinical and sociodemographic aspects. The aim of this study was to investigate the factors associated with non-treatment of AH and gender differences in hypertensive individuals from the ELSA-Brasil cohort. The study was conducted with 5,743 baseline hypertensive cohort participants. AH was considered if there was a previous diagnosis or if systolic blood pressure (SBP) was ≥140 and/or diastolic BP (DBP) was ≥90 mmHg. Sociodemographic and anthropometric data, lifestyle, comorbidities, and use of antihypertensive medications were evaluated through interviews and in-person measurements. Treatment with renin-angiotensin-aldosterone system inhibitors (RAASi) or other antihypertensive medications and non-treatment were evaluated with multivariate logistic regression. Non-treatment was observed in 32.8% of hypertensive individuals. Of the 67.7% treated individuals, 41.1% received RAASi. Non-treatment was associated with alcohol consumption in women (OR=1.41; 95%CI: 1.15-1.73; P=0.001), lowest schooling level in men (OR=1.70; 95%CI: 1.32-2.19; P<0.001), and younger age groups in men and women (strongest association in males aged 35-44 years: OR=4.58, 95%CI: 3.17-6.6, P<0.001). Among those using RAASi, a higher proportion of white, older individuals, and with more comorbidities was observed. The high percentage of non-treatment, even in this civil servant population, indicated the need to improve the treatment cascade for AH. Public health policies should consider giving special attention to gender roles in groups at higher risk of non-treatment to reduce inequities related to AH in Brazil.

Responses of fish assemblages of sandy beaches to different anthropogenic and hydrodynamic influences.

This study tested whether some attributes of the diversity, communities and populations of surf-zone fish assemblages varied with different hydrodynamic and anthropogenic influences at four Guanabara Bay sandy beaches: Dentro (sheltered with limited human access), Fora (exposed with limited human access), Urca (sheltered with unlimited human access) and Vermelha (exposed with unlimited human access), between autumn 2011 and summer 2012. Twenty-nine species and 1613 individuals were recorded from 76 trawls. The 10 most abundant species accounted for 94·5% of the total number, but only four species (Diplodus argenteus, Harengula clupeola, Sardinella brasiliensis and Sphoeroides greeleyi) were recorded at all four beaches, revealing a high level of species substitution. Fish assemblages differed not only for diversity attributes, but also at community and population levels, with lower values of the Shannon-Wiener index, richness and total fish abundance and biomass at Vermelha beach, and higher densities of Trachinotus carolinus, Atherinella brasiliensis and S. greeleyi related to beaches with high anthropogenic influence. The findings reveal that fish assemblages of Dentro, Fora, Urca and Vermelha beaches differed not only in response to hydrodynamic influences, but also due to the effects of different degrees of human interference (i.e. presence of solid residues, population density and fishing impacts), emphasizing the importance of the sheltered and less anthropogenically affected beaches, as spawning, nursery and growth areas.

Neolignans from plants in northeastern Brazil (Lauraceae) with activity against Trypanosoma cruzi.

Trypanosoma cruzi is the ethiological agent for Chagas disease in Latin America. This study aimed to test the trypanocidal effect of licarin A and burchellin isolated from plants in northeastern Brazil. These neolignans were tested on T. cruzi and on peritoneal macrophages, to evaluate drug toxicity. Epimastigote growth was inhibited in 45% with licarin A and 20% with burchellin with an IC(50)/96 h of 462.7 microM and 756 microM, respectively. Epimastigotes treated with licarin A presented swollen mitochondria and disorganized mitochondrial cristae, kDNA and Golgi complex. When treated with burchellin, they presented enormous autophagosomes and chromatin disorganization. Licarin A and burchellin were able to induce trypomastigote death with IC(50)/24 h of 960 microM and 520 microM, respectively. Although licarin A presented an IC(50) for trypomastigotes higher than for epimastigotes, both substances acted as therapeutic trypanocidal agents, because they were able to kill parasites without affecting macrophages. Due to our results, burchellin and licarin A need to be further analysed to observe if they may be used as alternative blood additive prophylaxis against Chagas disease, since it has been established that blood transfusion is an important mechanism in the transmission process.

Amides from Piper tuberculatum fruits.

The fruits of Piper tuberculatum Jacq yielded piperine S (1) and N-(12,13,14-trimethoxydihydrocinnamoyl)-delta(3)-piperidin-2-one (2). Their complete NMR analysis based on one- and two-dimensional experiments is reported.

Constituents from Piper marginatum fruits.

The hexane extract of the dried fruits of Piper marginatum yielded 1-(1Z-propenyl)-2,4,6-trimethoxybenzene, a new natural product, besides 3-farnesyl-4-hydroxybenzoic acid and caryophyllene oxide.

Two amides from Piper tuberculatum fruits.

The fruits of Piper tuberculatum yielded pellitorine, N-isobutyl-2E,4E-decadienamide (1), and piperidide-2E,4E-decadienamide (2). Their complete NMR analysis, based on one- and two-dimensional experiments, is reported.

Nitric oxide synthase inhibition and the uterotrophic response to oestrogen in immature rats.

The role of nitric oxide in the uterotrophic action of oestradiol after 6 h or 72 h was studied in immature (19-21 days old) female Wistar rats by use of L-arginine, the amino acid from which nitric oxide is synthesized, and N omega-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase. Oestradiol at single s.c. doses of 2.5, 5.0 and 10.0 micrograms per rat induced dose-dependent uterine oedema in 6 h. L-NAME (10 and 20 mg kg-1, i.p.) administered 30 min before oestradiol (10 micrograms per rat) injection suppressed the formation of uterine oedema in a dose-related manner. This action of L-NAME on oestradiol-induced uterine oedema was effectively blocked by pretreatment of rats with L-arginine (600 mg kg-1, s.c.), a precursor of nitric oxide, but not by L-lysine, an amino acid not involved in the generation of nitric oxide. In addition, L-NAME at similar doses significantly prevented oestradiol-induced (3 micrograms per rat, s.c. on three successive days) increases in uterine growth after 72 h; however, this effect was mitigated by L-arginine (600 mg kg-1). These results suggest the involvement of an L-arginine-nitric oxide system in the oestradiol-induced uterotrophic effect in immature rats.

Possible involvement of nitric oxide in estrogen-induced uterine edema in the immature rat.

We examined whether nitric oxide mediates estrogen-induced uterine edema in the immature rat. Immature Wistar rats (19-21 days) received estradiol-17 beta (E2) in a single sc dose of 10 micrograms/animal and 6 h later the animals were sacrificed and the changes in uterine wet and dry weights were determined. E2 treatment caused a 93% increase in uterine wet weight (control, N = 6, 39.88 +/- 3.2 mg; E2 treated, N = 6, 76.8 +/- 4.9 mg), but not in dry weight, suggesting that it induces uterine edema. Pretreatment with L-nitroarginine methyl ester (L-NAME), a competitive antagonist of nitric oxide synthetase, at doses of 10 and 20 mg/kg, ip, caused a dose-related reduction (59 and 86%) in the uterine wet weight increase induced by E2. Furthermore, L-arginine (300-600 mg/kg, sc), the nitric oxide precursor, was able to reverse L-NAME (20 mg/kg)-induced decreases in uterine weight by 47 and 62%, respectively. The results suggest that nitric oxide is the principal mediator involved in estrogen-induced uterine edema in the immature rat.

Possible involvement of nitric oxide in estrogen-induced uterine edema in the immature rat

We examined whether nitric oxide mediates estrogen-induced uterine edema in the immature rat. Immature Wistar rats (19-21 days) received estradiol-17 beta (E2) in a single sc dose of 10 micrograms/animal and 6 h later the animals were sacrificed and the changes in uterine wet and dry weights were determined. E2 treatment caused a 93 per cent increase in uterine wet weight (control, N = 6, 39.88 +/- 3.2 mg; E2 treated, N = 6, 76.8 +/- 4.9 mg), but not in dry weight, suggesting that it induces uterine edema. Pretreatment with L-nitroarginine methyl ester (L-NAME), a competitive antagonist of nitric oxide synthetase, at doses of 10 and 20 mg/kg, ip, caused a dose-related reduction (59 and 86 per cent ) in the uterine wet weight increase induced by E2. Furthermore, L-arginine (300-600 mg/kg, sc), the nitric oxide precursor, was able to reverse L-NAME (20 mg/kg)-induced decreases in uterine weight by 47 and 62 per cent , respectively. The results suggest that nitric oxide is the principal mediator involved in estrogen-induced uterine edema in the immature rat

Contraceptive effectiveness of Silastic implants containing the progestin R-2323.

PIP: The long-term contraceptive effectiveness of subdermal silastic implants containing 30-40 mg of the progestin R-2323 (13-ethyl-17 alpha ethinyl-17 hydroxy-gona-4, 9,11-trien-3-one), was studied in 531 women. 98 women received 2 capsules (Group A), 180 received 3 capsules (Group B), 181 received 4 capsules (Group C) and 68 received 5 capsules (Group D). There were 5 pregnancies reported for Group A over 610 months of use, 3 pregnancies for 2124 months of use in Group B, 4 pregnancies for 2128 months of use in Group C, and Group D had 3 pregnancies over 732 months of use. All of the pregnancies in Group A occurred in the first 4 months while pregnancies in the other 3 groups generally occurred between Months 6-12 of use. Amenorrhea was most frequent during Months 2-6. The frequency of spotting and breakthrough bleeding was minimal.^ieng