Gender differences in glucoregulatory responses to intense exercise

Trabalho final de mestrado integrado em Medicina (Cardiologia), apresentado á Faculdade de medicina da Universidade de CoimbraIntrodução: A angioplastia primária (ICPp) é considerada internacionalmente como o gold-standard no tratamento de doentes diagnosticados com enfarte agudo do miocárdio com supradesnivelamento do segmento ST (EAMST). Estudos prévios mostram resultados até então contraditórios, relativamente ao prognóstico dos doentes que realizaram a ICPp em horário laboral (L) comparativamente aos que a realizaram em horário não laboral (NL). O objectivo deste estudo é comparar, em termos clínicos e prognósticos, os doentes com EAMST submetidos a ICPp de acordo com o horário de realização da sua realização (laboral versus não laboral). Materiais e métodos: Estudou-se 341 doentes com EAMST submetidos a ICPp ao longo de 3 anos, num centro de elevado volume com serviço 24horas/7dias. Dividiuse os doentes em dois grupos, consoante o horário de realização da ICPp: horário laboral (L (n=167): dias da semana das 8h-18h) e não laboral (NL (n=174): dias da semana das 18h-8h e fins de semana). Os doentes foram comparados em termos clínicos, analíticos, angiográficos e prognósticos. O seguimento médio foi de 24,1 ± 9,2 meses. Resultados: O grupo L apresentou, mais frequentemente, antecedentes de doença coronária (15,6% versus 5,2%, p=0,002) e angioplastia prévia (14,6% versus 4,0%, p=0,004). Os doentes do grupo NL tinham mais frequentemente oclusão da artéria culprit (87,4% versus 68,3%, p<0,001) assim como a valores de troponina I máxima mais elevados (137,9 ± 167,0 versus 102,4 ± 163,3, p=0,001). Não se encontraram outras diferenças a nível da evolução clínica, duração do internamento ou mortalidade intra-hospitalar (grupo NL: 8,6% versus grupo L: 4,2%, p=0,123). Durante o seguimento, não foram encontradas diferenças quanto à incidência de eventos cardíacos e cerebrovasculares major entre os dois grupos. 5 Conclusão: O prognóstico a curto e a longo prazo dos doentes com EAMST admitidos num centro de elevado volume é independente do horário da realização da ICPp.Introduction: Primary percutaneous coronary intervention (pPCI) is considered the gold-standard in the treatment of patients diagnosed with ST-segment elevation myocardial infarction (STEMI). Previous studies have shown contradictory results in the outcome of patients who underwent pPCI during regular working hours versus those who underwent pPCI during off-hours. This study’s aim is to compare clinically and in terms of outcome, the patients who were admitted with STEMI that underwent pPCI according to the schedule of the procedure. Methods: We studied 341 patients that underwent pPCI during a 3 years period in a high-volume centre with 24/7 service. The patients were divided in two groups according the schedule of the pPCI’s realization: regular hours (RH: days of the week from 8:00 to 18:00) and off-hours (OH: days of the week from 18:00 to 8:00 and weekends). The groups were compared clinically, analytically, angiographically and in terms of the outcome during a 24,1 ± 9,2 months follow-up. Results: The RH group was more commonly associated with previous history of coronary disease (15,6% versus 5,2%, p=0,002) and previous PCI (14,6% versus 4,0%, p=0,004). The patients in the OH group presented more frequently a culprit artery’s occlusion (87,4% versus 68,3%, p=0,000) and a significant superior value of maximum troponin I (137,9 ± 167,0 versus 102,4 ± 163,3, p=0,001). Differences were not found in either clinical evolution, length of stay nor in-hospital mortality (group NL: 8,6% versus group L: 4,2%, p=0,123). Also, during the follow-up, major adverse cardiac and cerebrovascular events (MACCE) have shown similar outcomes in both groups. 7 Conclusion: This study showed that the short and long term outcomes of the STEMI patients who underwent pPCI in a high-volume centre with 24/7 service is independent of the procedure’s schedule

The role of prolactin in fish reproduction

Prolactin (PRL) has one of the broadest ranges of functions of any vertebrate hormone, and plays a critical role in regulating aspects of reproduction in widely divergent lineages. However, while PRL structure, mode of action and functions have been well-characterised in mammals, studies of other vertebrate lineages remain incomplete. As the most diverse group of vertebrates, fish offer a particularly valuable model system for the study of the evolution of reproductive endocrine function. Here, we review the current state of knowledge on the role of prolactin in fish reproduction, which extends to migration, reproductive development and cycling, brood care behaviour, pregnancy, and nutrient provisioning to young. We also highlight significant gaps in knowledge and advocate a specific bidirectional research methodology including both observational and manipulative experiments. Focusing research efforts towards the thorough characterisation of a restricted number of reproductively diverse fish models will help to provide the foundation necessary for a more explicitly evolutionary analysis of PRL function