Systemic inflammation and carotid diameter in obese patients: pilot comparative study with flaxseed powder and cassava powder.

BACKGROUND: Botanical omega-3 fatty acid (alphalinolenic acid/ALA) has been shown to alleviate the prothrombotic and proinflammatory profile of metabolic syndrome, however clinical protocols are still scarce. Aiming to focus an obese population, a pilot study was designed. METHODS: Morbidly obese candidates for bariatric surgery (n = 29, age 46.3 ± 5.2 years), 82.8% females (24/29), BMI 44.9 ± 5.2 kg/m², with C-reactive protein/CRP > 5 mg/L were recruited. Twenty were randomized and after exclusions, 16 were available for analysis. Flaxseed powder (60 g/day, 10 g ALA) and isocaloric roasted cassava powder (60 g/day, fat-free) were administered in a double-blind routine for 12 weeks. RESULTS: During flaxseed consumption neutrophil count decreased and fibrinogen, complement C4, prothrombin time and carotid diameter remained stable, whereas placebo (cassava powder) was associated with further elevation of those measurements. CONCLUSIONS: Inflammatory and coagulatory markers tended to exhibit a better outlook in the flaxseed group. Also large-artery diameter stabilized whereas further increase was noticed in controls. These findings raise the hypothesis of a less deleterious cardiovascular course in seriously obese subjects receiving a flaxseed supplement.

[Iron deficiency in female athletes]. / Deficiência de ferro em atletas femininas.

Iron deficiency and anemia have been reported frequently in athletes. In São Paulo-Brazil among elite athletes overt anemia is uncommon, but our studies showed that they were in a borderline anemic state. Sports anemia is used to describe both pseudodilutional anemia and the true anemia of athletes. We studied 12 female young athletes, all with normal hemoglobin. Four athletes had laboratory features (serum ferritin, red cell volume, and/or transferrin saturation) suggestive of iron deficiency. There are association of high iron body stores with cardiac arrhythmia, carotid atherosclerosis, myocardial infarction, liver and colorectal cancer but minor iron deficiency may impair the physical fitness.

[Hematologic aspects of the national hockey team athletes]. / Aspectos hematológicos da seleção nacional de hóquei.

Athletes tend to have lower hemoglobin (Hb) concentrations than sedentary counterparts. Sports anemia is used to describe both pseudodilutional anemia and the true anemia of athletes. Pseudodilutional anemia is a beneficial adaptation to endurance training; the two most common causes of true anemia are iron deficiency and intravascular hemolysis. We used questionnaires, physical examination and laboratory investigation to study 19 highly trained hockey athletes and laboratory investigation to study 32 outpatients without hematological diseases. One athlete had anemia (Hb 10.5 g/ dL; 5.44 million red cells/mL; serum iron-13 micrograms/dL; without parasites in the stools); the athletes had Hb = 14.88 +/- 1.33 g/dL and the outpatients had 15.24 +/- 0.74 g/dL; the maximal oxygen uptake of the athletes was 54.0 +/- 6.03 ml/kg/min (112.15 +/- 14.35% of the predicted values). The maximal oxygen uptake of the anemic athlete was 86% of the predicted value. The three athletes with the best maximal uptake had a mean Hb = 15.8 g/dL. In São Paulo-Brazil anemia is uncommon among males but elite athletes are in a borderline anemic state, that may impair the physical fitness.

[Magnesium and myocardial infarction. Brazilian aspects]. / O magnésio e o infarto do miocárdio: aspectos brasileiros.

Most of the brazilian's territory is poor in magnesium (Mg) and an evaluation of urinary Mg indicated very low concentration of this cation in a normal population sample. The study of the behavior of plasmatic Mg in the acute phase of uncomplicated myocardial infarction permitted the following conclusions; a) during the first three days of the clinical course there is significant hypomagnesemia; b) magnesemia rises progressively during the three days of infarction, without however reaching normal levels. The lymphocytic magnesium also show the same behavior. Mg infusion in patients with acute myocardial infarction (four grams of MgSO4 during the first three days) reduced the incidences of arrhythmias, death and the size of infarction, in São Paulo. Another study in Bahia also showed reduction of mortality with infusion of 10 grams of MgSO4 in 24 hours. These studies about the protective role of Mg show potential limitations because the samples were small.

[Pericarditis in a general hospital]. / Pericardites em hospital geral.

The authors studied 57 patients with pericarditis in the Ward of Internal Medicine of the University of São Paulo from January 1993 through May 1995. A comparison was made with the results of a similar study performed in the same hospital in 1989. Increasing frequency of pericarditis was verified. Tuberculosis, formerly the most frequent etiologic agent, decreased while neoplastic diseases became more common.

[Cardiovascular effects of arginine and nitric oxide]. / Efeitos cardiovasculares da arginina e do óxido nítrico.

Amino acids are an unusual chemical category because they are endowed with alimentary properties, but at the same time they may determine typical pharmacologic responses in some circumstances. These facts were responsible for the origin of modern pharmaconutrition, which has been using arginine for some time because of its beneficial impact on immune function, nitrogen anabolism and wound healing. The recent identification of its metabolite NO (nitric oxide), a powerful mediator related to a large number of physiologic and pathophysiologic phenomenons, has augmented the interest for this amino acid.

[Cardiovascular impact of alcoholism]. / Repercurssões cardiovasculares do alcoolismo.

A history of alcohol abuse associated with hypertension and chronic alcohol consumption is the leading cause of secondary cardiomyopathy. Both acute and chronic alcohol consumption precipitate arrhythmias. However moderate alcohol intake exerts a protective effect against coronary heart disease and stroke. Morbidity is lowest among light drinkers, slightly higher among lifelong abstainers and much higher among heavy drinkers. Magnesium deficiency is common among chronic alcoholics and frequent in Brazil. Magnesium therapy may have beneficial effects when there is excessive ethanol consumption.

[Hematologic features of olympic volley-ball athletes]. / Aspectos hematológicos em jogadores olímpicos de volei.

Athletes tend to have lower hemoglobin concentrations than sedentary counterparts. Sports anemia is used to describe both pseudodilutional anemia and the true anemia of athletes. Pseudodilutional anemia is a beneficial adaptation to endurance training; the two most common causes of true anemia are iron deficiency and intravascular hemolysis. We used questionnaires, physical examination and laboratory investigation to study 16 volley-ball highly trained athletes and 23 outpatients with the same ages and gender that have not had any significant disease. All athletes and patients had Hb > 13 g/dl; the athletes hab Hb and hematocrit lower than the control patients; 25% of the athletes had both total and indirect bilirubin increased. Seven patients and only one athlete had intestinal parasitic infestation. These data support the idea that in São Paulo-Brazil among athletes overt anemia is uncommon but the volleyball athletes are in a borderline anemic state.

[Hematologic changes in female athletes]. / Alterações hematológicos em atletas femininas.

Iron deficiency is the most common cause of anemia throughout the world. Physical performance, endurance capacity and resistance to fatigue in human are dependent upon many different factors. One of them is the oxygen carrying capacity of blood, mainly determined by hemoglobin concentration. We used questionnaires, physical examination and laboratory investigation to study the hematologic patterns in 18 volley-ball athletes. Their average intake of iron was 13.99 +/- 6.26 mg/day; the average serum iron concentration was 108.61 +/- 29.13 micrograms/dl; the hemoglobin concentration was 12.94 +/- 1.10 g/dl. Four athletes had less than 12 g of hemoglobin/dl and a serum iron concentration of 99.25 +/- 39.73 micrograms/dl. The maximal aerobic exercise capacity measured by exercise electrocardiography showed no important differences between the athletes with hemoglobin values higher or lower than 12 g/dl. These data support the idea that in São Paulo among young female athletes overt anemia is uncommon.

[Acute lethal intoxication caused by mercury vapor]. / Intoxicação aguda letal por vapor de mercúrio.

Nowadays mercury poisoning usually results from the oral ingestion of methylmercury or from inhalation of mercury vapor. Mercury intoxication in a gold prospector after inhalation of mercury vapor is described. The patient presented a history of fever, tachypnea and headache. Despite the treatment with dimercaprol, penicillamine and intensive supportive care the patient died with symptoms of acute respiratory distress.

[Mononuclear magnesium in elderly hypertensive patients treated with thiazide]. / Magnésio mononuclear em hipertensos idosos tratados com tiazídico.

PURPOSE: To study mononuclear magnesium and serum cations (Na, K and Mg) in elderly hypertensive patients treated with hydrochlorothiazide during 90 days. PATIENTS AND METHODS: 15 elderly hypertensive patients treated with hydrochlorothiazide, 25 mg/day or placebo. A method of freezing produced total lysis of the cells; Mg was measured by atomic spectrophotometry. RESULTS: No differences were noted in mononuclear or serum magnesium in the thiazide or placebo treated patients, and the diuretic produced significant decreases in supine systolic and diastolic blood pressure. CONCLUSION: Magnesium supplementation does not seem essential in most patients in this conditions.

[Lethal pulmonary involvement in neurofibromatosis]. / Comprometimento pulmonar letal na neurofibromatose.

A unusual case of a 61-year-old man who presented dyspnea and cough associated to skin and subcutaneous lesions typical of neurofibromatosis type 1 is reported. Chest roentgenograms and CT-scan showed emphysematous bullae. The patient underwent drainage of the greatest bulla, but death eventually ensured as a consequence of upper digestive bleeding. It can be expected that with the longer survival of neurofibromatosis patients with respiratory troubles, that are generally considered unusual will be recognized more frequently.

[Lymphocytic and serum magnesium in older healthy and hypertensive subjects]. / Magnésio linfocitário e sérico em idosos sadios e hipertensos.

PURPOSE: To study the lymphocyte and serum magnesium in older patients with and without arterial hypertension. PATIENTS AND METHODS: We studied the lymphocyte and serum Mg in 22 older patients, with diastolic blood pressure between 95 and 120 mmHg, not receiving drug treatment. A method of freezing produced total lysis of the cells. RESULTS: The mean lymphocyte Mg concentration in the older patients was 1.15 +/- 0.74 picomoles per 100 cells, significantly higher (p less than 0.05) than in the control group, that was 0.77 +/- 0.32 picomoles per 100 cells (lymphocyte Mg in older hypertensive patients/control = 1.49); there were no significant differences between groups with regard to serum Mg. Twelve older normotensive men studied also had lymphocyte Mg significantly higher than in the respective control group (lymphocyte Mg in older normotensive men/control = 1.70) and the serum Mg was also significantly higher than in the control group (1.63 +/- 0.12 versus 1.44 +/- 0.22 mEq/l. CONCLUSION: Since the high intracellular Mg concentration in the elderly patients may more accurately reflect the total body Mg status. We suggest to use Mg and Mg sparing diuretics in these patients, both hypertensive and normotensive, cautiously.

Pericardites em hospital geral: estudo de 100 casos / Pericarditis in a general hospital: report of 100 cases

Os autores estudaram 100 pacientes portadores de pericardite internados em enfermaria da clínica médica do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. As etiologias mais freqüentes foram: tuberculose (19%), ou outras infecçöes bacterianas (19%), idiopática (15%), neoplasias (11%) e lupus eritematoso sistêmico (11%). Analisando-se a casuística em dois períodos verificou-se que a tuberculose, que era a causa mais comum da pericardite (28,5%) até 1981, a partir de 1982 transformou-se em terceira causa enquanto que a etiologia lúpica tornou-se mais freqüente

[Electrocardiographic changes in pancreatitis]. / Alterações eletrocardiográficas nas pancreatites.

Of 400 patients with acute, chronic or chronic relapsing pancreatitis surveyed in the present study, only 54 had had ECG in their files. Among these, 80% showed ECG alterations, mostly sinus tachycardia and diffuse disturbances of ventricular repolarization. The causes of these alterations are, as yet controversial. Some explanations for these alterations are hypovolemia, sepsis and acute inflammatory state. Other important findings in the patients were bundle branch block, not encountered either before the pancreatic crisis or after its resolution, nor was dielectric effect and lesion current observed in either the acute and chronic forms. The possibility of the presence of previous cardiopathy in patients with high alcoholic intake, Chagas' disease, high blood pressure or diabetes, which are quite likely in these patients, should be recalled as important factors: marked electrolytes disorders were not frequent and did not correlate with ECG findings. The aim of this study is to highlight the importance of ECG during systematic search in the follow-up of patients with pancreatitis, in order to better understand associated cardiac disorders and to improve diagnosis, prevention and treatment.