O laboratório clínico na terceira idade

The aging of Brazilian population is inevitable. Thus, this article reviews the main aspects related to the elderly population, taking into account the particularities and problems encountered in the clinical laboratory when serving this population group. We start with a brief review of the aging process physiology and then discuss the difficulties of pre-analytical (appropriateness of care), analytical (main issues for this age group sorted into body system categories) and post-analytical phases.O aumento da população idosa em nosso meio é fato incontestável. Assim, este artigo faz uma revisão dos principais aspectos referentes a essa população, sempre considerando as particularidades e os problemas observados no atendimento dessa faixa de população no laboratório clínico. Partimos de uma breve revisão sobre a fisiologia do envelhecimento para então percorrermos as dificuldades das fases pré-analítica (adequação do atendimento), analítica (principais problemas dessa faixa etária, divididos por sistemas orgânicos) e pós-analítica.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP-EPMHospital do CoraçãoUNIFESP, EPMSciEL

Positive association of the hepatic lipase gene polymorphism c.514C > T with estrogen replacement therapy response

<p>Abstract</p> <p>Background</p> <p>Hepatic lipase (HL), an enzyme present in the hepatic sinusoids, is responsible for the lipolysis of lipoproteins. Human HL contains four polymorphic sites: G-250A, T-710C, A-763G, and C-514T single-nucleotide polymorphism (SNPs). The last polymorphism is the focus of the current study. The genotypes associated with the C-514T polymorphism are CC (normal homozygous - W), CT (heterozygous - H), and TT (minor-allele homozygous - M). HL activity is significantly impaired in individuals of the TT and CT genotypes. A total of 58 post-menopausal women were studied. The subjects were hysterectomized women receiving hormone replacement therapy consisting of 0.625 mg of conjugated equine estrogen once a day. The inclusion criteria were menopause of up to three years and normal blood tests, radiographs, cervical-vaginal cytology, and densitometry. DNA was extracted from the buccal and blood cells of all 58 patients using a commercially available kit (GFX^®- Amersham-Pharmacia, USA).</p> <p>Results</p> <p>Statistically significant reductions in triglycerides (t = 2.16; n = 58; p = 0.03) but not in total cholesterol (t = 0.14; n = 58; p = 0.89) were found after treatment. This group of good responders were carriers of the T allele; the CT and TT genotypes were present significantly more frequently than in the group of non-responders (p = 0.02 or p = 0.07, respectively). However, no significant difference in HDL-C (t = 0.94; n = 58; p = 0.35) or LDL-C (t = -0.83; n = 58; p = 0.41) was found in these patients.</p> <p>Conclusions</p> <p>The variation in lipid profile associated with the C-514T polymorphism is significant, and the T allele is associated with the best response to ERT.</p