Epigenetic Control of Hypertension by DNA Methylation: A Real Possibility.

Hypertension is a common chronic disease that particularly affects the elderly and can trigger several cardiovascular conditions. Although the treatment of hypertension has evolved in recent decades, many hypertensive patients still do not have properly controlled blood pressure. Accumulating evidence supports the hypothesis that DNA methylation plays an important role in regulating gene expression, altering the phenotype and function of the cardiovascular system. The present review highlights recent advances in research on DNA methylation in the development of hypertension. Several preclinical and clinical evidence show that methylation of different targets appears to be involved in hypertension. Studies of the involvement of DNA methylation have greatly improved our understanding of hypertension, but its use as a valid therapeutic target is still unknown. Further studies could help to bring to light the truth about gene therapy in hypertension.

Evaluation of the effectiveness of systematized training of advanced trauma life support protocol in the interpretation of cervical spine and chest radiographs in three different emergency services.

INTRODUCTION: Most Brazilian hospitals have no medical radiologists for emergencies. The radiologic evaluation is provided by doctors with heterogeneous generalist training. The objective is to demonstrate the need for systematization in the care of trauma in the interpretation of cervical spine and chest radiographs. Is it possible that, through a continuing education program, generalist doctors could be trained in the evaluation of these radiographs? MATERIALS AND METHODS: Twenty-five doctors of various specialties were evaluated in the mid region of Santa Catarina Stage, in three stages. Initially, the doctors evaluated seven cervical spine radiographs and seven chest radiographs (stage I). After this evaluation (without knowing the results of the examinations), the doctors received advanced trauma life support protocol training for the interpretation of cervical spine and chest radiographs, through an exhibition class (stage II). Three weeks later, the same doctors were evaluated again, interpreting the same radiographs. RESULTS: The mean percentage of correct answers was 60.73% in the first interpretation of cervical radiographs and 65.25% for the chest radiographs. None of the participant had reached 100%. In stage III, the average success rates in cervical spine and chest radiographs were 86.95% and 87.53%, respectively, an improvement of 21.72% and 26.18% (p < 0.001). During evaluation in the stage III, seven doctors obtained 100% success in the evaluation of cervical spine radiographs and two doctors achieved 100% success in the evaluation of chest radiographs. CONCLUSION: The systematized training, through the advanced trauma life support protocol, significantly increased the success rate of the evaluation of cervical spine and chest radiographs.