ERICA: prevalence of dyslipidemia in Brazilian adolescents

ABSTRACT OBJECTIVE: To determine the distribution of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in Brazilian adolescents, as well as the prevalence of altered levels of such parameters. METHODS: Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were used. This is a country-wide, school-based cross-sectional study that evaluated 12 to 17-year old adolescents living in cities with over 100,000 inhabitants. The average and distribution of plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were evaluated. Dyslipidemia was determined by levels of total cholesterol ≥ 170 mg/dl, LDL cholesterol ≥ 130 mg/dl, HDL cholesterol < 45 mg/dL, or triglycerides ≥ 130 mg/dl. The data were analyzed by gender, age, and regions in Brazil. RESULTS: We evaluated 38,069 adolescents -59.9% of females, and 54.2% between 15 and 17 years. The average values found were: total cholesterol = 148.1 mg/dl (95%CI 147.1-149.1), HDL cholesterol = 47.3 mg/dl (95%CI 46.7-47.9), LDL cholesterol = 85.3 mg/dl (95%CI 84.5-86.1), and triglycerides = 77.8 mg/dl (95%CI 76.5-79.2). The female adolescents had higher average levels of total cholesterol, LDL cholesterol, and HDL cholesterol, without differences in the levels of triglycerides. We did not observe any significant differences between the average values among 12 to 14 and 15-to 17-year old adolescents. The most prevalent lipid alterations were low HDL cholesterol (46.8% .9]), hypercholesterolemia .3]), and hypertriglyceridemia ). High LDL cholesterol was found in 3.5% (95%CI 3.2-4.0) of the adolescents. Prevalence of low HDL cholesterol was higher in Brazil's North and Northeast regions. CONCLUSIONS: A significant proportion of Brazilian adolescents has alterations in their plasma lipids. The high prevalence of low HDL cholesterol and hypertriglyceridemia, especially in Brazil's North and Northeast regions, must be analyzed in future studies, to support the creation of strategies for efficient interventions

Echocardiographic assessment of myocardial infarction evolution in young and adult rats

BACKGROUND: The regeneration of cardiomyocytes after a myocardial infarction (MI) is more evident in young animals; however, it is not known whether it is associated with functional improvement. OBJECTIVE: To perform the functional analysis by echocardiography (echo) of young adult rats submitted to MI. METHODS: Seventy-two animals were included in the study: 35 young rats (group Y) that were 28 days old and 37 adult rats (group A) that were 153 days old. The rats were subdivided in two subgroups: infarcted (YI and AI) and control (YC and AC). The animals were assessed by echocardiogram on the 7thand 30th postoperative days for the analysis of the ejection fraction (EF) and the final systolic (FSV) and diastolic volume (FDV) of the left ventricle. Only animals with EF < 40% were included in the study. RESULTS: The comparison of the FDV and FSV between infarcted and control animals showed that there was a significant increase in infarcted adult animals at the two analyzed phases. Among young animals only the FSV was significantly higher on the 7th day. The intragroup evolution analysis showed an increase in FDV and FSV in the two young subgroups, which was proportional to growth and only increase in FDV in the infarcted adult group. There was an improvement in EF in young rats, whereas EF remained decreased in adult rats when compared to controls. CONCLUSION: The infarcted young rats presented improvement in the systolic function and ventricular volumes 30 days after the infarction, whereas the adult rats presented increased FDV with no improvement in systolic function.FUNDAMENTO: A regeneração dos cardiomiócitos após o infarto do miocárdio (IM) é mais evidente em animais jovens; entretanto, não se sabe se é acompanhada de melhora funcional. OBJETIVO: Realizar a análise funcional pela ecocardiografia (eco) de ratos jovens e adultos submetidos a IM. MÉTODOS: Setenta e dois animais foram incluídos no estudo: 35 ratos jovens (grupo J) com 28 dias, e 37 ratos adultos (grupo A) com 153 dias. Os ratos foram subdivididos em dois subgrupos: infartado (JI e AI) e controle (JC e AC). Os animais foram avaliados por meio de ecocardiograma no 7º e 30º dias de pós-operatório para análise da fração de ejeção (FE) e dos volumes sistólico (VSF) e diastólico (VDF) finais do ventrículo esquerdo. Foram incluídos no grupo de estudo somente animais com FE menor que 40%. RESULTADOS: Na comparação dos VDF e VSF entre infartados e controles, observou-se aumento significativo nos animais adultos infartados nas duas fases analisadas. Nos animais jovens, apenas o VSF, no 7º dia, foi significativamente maior. Na evolução intragrupo, observou-se aumento do VDF e do VSF nos dois subgrupos jovens, proporcional ao crescimento, e somente aumento do VDF no grupo adulto infartado. Houve melhora da FE nos ratos jovens, enquanto nos ratos adultos a FE permaneceu diminuída em relação aos controles. CONCLUSÃO: Os ratos jovens infartados apresentaram melhora da função sistólica e dos volumes ventriculares após 30 dias do infarto, enquanto nos ratos adultos houve aumento do VDF sem melhora da função sistólica.Pontifícia Universidade Católica do ParanáUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

ERICA: prevalência de dislipidemia em adolescentes brasileiros

OBJETIVO Determinar a distribuição de colesterol total, LDL-colesterol, HDL-colesterol e triglicerídeos em adolescentes brasileiros, bem como a prevalência de níveis alterados de tais parâmetros. MÉTODOS Foram utilizados dados do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), estudo transversal, de âmbito nacional e base escolar que avaliou adolescentes de 12 a 17 anos, residentes em municípios com mais de 100 mil habitantes. Foi avaliada a média e distribuição dos níveis plasmáticos de colesterol total, LDL-colesterol, HDL-colesterol e triglicerídeos. Dislipidemia foi determinada por níveis de colesterol total ≥ 170 mg/dl, LDL-colesterol ≥ 130 mg/dl, HDL-colesterol < 45 mg/dL ou triglicerídeos ≥ 130 mg/dl. Os dados foram analisados por sexo, idade e regiões do Brasil. RESULTADOS Foram avaliados 38.069 adolescentes, 59,9% do sexo feminino; 54,2% com idade entre 15 a 17 anos. Os valores médios encontrados foram: colesterol total 148,1 mg/dl (IC95% 147,1-149,1), HDL-colesterol 47,3 mg/dl (IC95% 46,7-47,9), LDL-colesterol 85,3 mg/dl (IC95% 84,5-86,1), e triglicerídeos 77,8 mg/dl (IC95% 76,5-79,2). Adolescentes do sexo feminino apresentaram níveis médios de colesterol total, LDL-colesterol e HDL-colesterol mais elevados, mas sem diferença nos níveis de triglicerídeos. Não houve diferença significativa de valores médios entre adolescentes de 12 a 14 e de 15 a 17 anos. As alterações com maior prevalência foram HDL-colesterol baixo (46,8% [IC95% 44,8-48,9]), hipercolesterolemia (20,1% [IC95% 19,0-21,3]) e hipertrigliceridemia (7,8% [IC95% 7,1-8,6]). O LDL-colesterol elevado foi observado em 3,5% (IC95% 3,2-4,0) dos adolescentes. As prevalências de HDL-colesterol baixo foram mais elevadas nas regiões Norte e Nordeste do País. CONCLUSÕES Uma parcela significativa dos adolescentes brasileiros apresenta alterações dos lípides plasmáticos. A alta prevalência de HDL-colesterol baixo e a hipertrigliceridemia, sobretudo nas regiões Norte e Nordeste do Brasil, devem ser analisadas em futuros estudos para subsidiar formulações de estratégias de intervenções eficazes.OBJECTIVE To determine the distribution of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides in Brazilian adolescents, as well as the prevalence of altered levels of such parameters. METHODS Data from the Study of Cardiovascular Risks in Adolescents (ERICA) were used. This is a country-wide, school-based cross-sectional study that evaluated 12 to 17-year old adolescents living in cities with over 100,000 inhabitants. The average and distribution of plasma levels of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides were evaluated. Dyslipidemia was determined by levels of total cholesterol ≥ 170 mg/dl, LDL cholesterol ≥ 130 mg/dl, HDL cholesterol < 45 mg/dL, or triglycerides ≥ 130 mg/dl. The data were analyzed by gender, age, and regions in Brazil. RESULTS We evaluated 38,069 adolescents – 59.9% of females, and 54.2% between 15 and 17 years. The average values found were: total cholesterol = 148.1 mg/dl (95%CI 147.1-149.1), HDL cholesterol = 47.3 mg/dl (95%CI 46.7-47.9), LDL cholesterol = 85.3 mg/dl (95%CI 84.5-86.1), and triglycerides = 77.8 mg/dl (95%CI 76.5-79.2). The female adolescents had higher average levels of total cholesterol, LDL cholesterol, and HDL cholesterol, without differences in the levels of triglycerides. We did not observe any significant differences between the average values among 12 to 14 and 15- to 17-year old adolescents. The most prevalent lipid alterations were low HDL cholesterol (46.8% [95%CI 44.8-48.9]), hypercholesterolemia (20.1% [95%CI 19.0-21.3]), and hypertriglyceridemia (7.8% [95%CI 7.1-8.6]). High LDL cholesterol was found in 3.5% (95%CI 3.2-4.0) of the adolescents. Prevalence of low HDL cholesterol was higher in Brazil’s North and Northeast regions. CONCLUSIONS A significant proportion of Brazilian adolescents has alterations in their plasma lipids. The high prevalence of low HDL cholesterol and hypertriglyceridemia, especially in Brazil’s North and Northeast regions, must be analyzed in future studies, to support the creation of strategies for efficient interventions

A hybrid modular multilevel converter with reduced full-bridge submodules

A hybrid modular multilevel converter (MMC) with reduced full-bridge (FB) submodules (SMs) is proposed, where a high voltage rating half-bridge (HB) based MMC is connected in series with a low voltage rating FB-MMC in parallel with a fault breaking circuit on its DC side. Unlike conventional hybrid MMCs with mixed HB and FB SMs, the proposed topology uses the DC capacitor in the fault breaking circuit to block DC faults, while the FB-MMC only commutates the fault current from the FB-MMC to the fault breaking circuit. Thus, the proposed converter only requires around 10%-20% FB SMs, leading to reduced capital cost and losses compared to typical hybrid MMC. The optimal ratio of the FB-MMC and HB-MMC is assessed and comparative studies show superiority of the proposed topology over other alternatives. A case study with 10% FB SMs demonstrates the validity of the proposed hybrid MMC for DC fault blocking and post-fault system restart

Estudo higroscópico da polpa em pó do fruto da pitaya (Hylocereus costaricencis) em diferentes concentrações de maltodextrina

Pitaya is a nutritious fruit with low caloric value and high antioxidant power due to the presence of betalains, nitrogenous and water-soluble pigments similar to anthocyanins and flavonoids, with different chemical structures. This article presents a systematic Pitaya pulp powder dye study regarding its hygroscopic behavior. The experiments were conducted by adding maltodextrin in the proportions of 10, 20, 30, 40, 50 and 100%. The different percentages allowed a progressive incremental number of solids in Pitaya dye and a more thorough pure powder dye analysis. The bleaching process was carried out in all samples and, subsequently, the samples were lyophilized for 48 hours to increase stability through the reduction of water activity. This is done to minimize enzymatic chemical reactions, which occur during material storage, and to augment product lifespan. Therefore, by the construction of adsorption and moisture desorption isotherms at 25 °C in different concentrations of maltodextrin, the hygroscopicity of Pitaya dye was analyzed as well as the applicability of mathematical models in the prediction of product isotherms. The obtained isotherms were sigmoidal, classified as type II and the GAB model was proved more suitable to be used in the prediction of dye sorption isotherms.Neste trabalho estudou-se o corante da polpa de pitaya em pó e seu comportamento higroscópico. A pitaya é um fruto nutritivo com baixo valor calórico e alto poder antioxidante devido à presença de betalaínas, pigmentos nitrogenados e hidrossolúveis semelhantes ao grupo das antocianinas e flavonóides, com estruturas químicas diferentes. Os experimentos foram realizados adicionando maltodextrina no corante de pitaya nas proporções de 10, 20, 30, 40, 50 e 100%, visando aumentar a quantidade de sólidos no corante e analisando-se também o corante em pó puro. Em todas as amostras foi realizado o processo de branqueamento e, em seguida, a liofilização por 48 horas, aumentando, assim, a estabilidade por meio da redução da atividade de água, de modo a minimizar reações químicas enzimáticas que ocorrem durante a armazenagem do material, contribuindo para o acréscimo da vida útil do produto. Portanto, por meio da construção de isotermas de adsorção e dessorção de umidade a 25 °C em diferentes concentrações de maltodextrina analisou-se a higroscopicidade do corante de pitaya, assim como, a aplicabilidade de modelos matemáticos na predição das isotermas do produto. As isotermas obtidas foram sigmoidais, classificadas como do tipo II e o modelo de GAB mostrou-se mais adequado para ser utilizado na predição das isotermas de sorção do corante

A Pitaya (hylocereus costaricencis) pulp powder hygroscopic study in different maltodextrin concentrations

Neste trabalho estudou-se o corante da polpa de pitaya em pó e seu comportamento higroscópico. A pitaya é um fruto nutritivo com baixo valor calórico e alto poder antioxidante devido à presença de betalaínas, pigmentos nitrogenados e hidrossolúveis semelhantes ao grupo das antocianinas e flavonóides, com estruturas químicas diferentes. Os experimentos foram realizados adicionando maltodextrina no corante de pitaya nas proporções de 10, 20, 30, 40, 50 e 100%, visando aumentar a quantidade de sólidos no corante e analisando-se também o corante em pó puro. Em todas as amostras foi realizado o processo de branqueamento e, em seguida, a liofilização por 48 horas, aumentando, assim, a estabilidade por meio da redução da atividade de água, de modo a minimizar reações químicas enzimáticas que ocorrem durante a armazenagem do material, contribuindo para o acréscimo da vida útil do produto. Portanto, por meio da construção de isotermas de adsorção e dessorção de umidade a 25 °C em diferentes concentrações de maltodextrina analisou-se a higroscopicidade do corante de pitaya, assim como, a aplicabilidade de modelos matemáticos na predição das isotermas do produto. As isotermas obtidas foram sigmoidais, classificadas como do tipo II e o modelo de GAB mostrou-se mais adequado para ser utilizado na predição das isotermas de sorção do corante.Pitaya is a nutritious fruit with low caloric value and high antioxidant power due to the presence of betalains, nitrogenous and water-soluble pigments similar to anthocyanins and flavonoids, with different chemical structures. This article presents a systematic Pitaya pulp powder dye study regarding its hygroscopic behavior. The experiments were conducted by adding maltodextrin in the proportions of 10, 20, 30, 40, 50 and 100%. The different percentages allowed a progressive incremental number of solids in Pitaya dye and a more thorough pure powder dye analysis. The bleaching process was carried out in all samples and, subsequently, the samples were lyophilized for 48 hours to increase stability through the reduction of water activity. This is done to minimize enzymatic chemical reactions, which occur during material storage, and to augment product lifespan. Therefore, by the construction of adsorption and moisture desorption isotherms at 25 °C in different concentrations of maltodextrin, the hygroscopicity of Pitaya dye was analyzed as well as the applicability of mathematical models in the prediction of product isotherms. The obtained isotherms were sigmoidal, classified as type II and the GAB model was proved more suitable to be used in the prediction of dye sorption isotherms.Facultad de Ciencias Agrarias y Forestale

Correction: Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings.

[This corrects the article DOI: 10.5334/gh.823.]

Avaliação da aterosclerose subclínica e de níveis plasmáticos de LDL minimamente modificada em pacientes com espondilite anquilosante e sua correlação com a atividade da doença

AbstractIntroductionAccelerated atherosclerosis has been shown in some autoimmune diseases, mainly in Systemic Lupus Erythematosus and Rheumatoid Arthritis. Although high preva- lence of corticosteroids use may be a confounding factor due to their detrimental effects on several risk factors, systemic inflammation per se is supposed to play an important role in atherogenesis in these patients.MethodsWe have evaluated sub-clinical atherosclerosis and plasma levels of circulating electronegative LDL, which represents the fraction of LDL that is minimally modified, in patients with ankylosing spondylitis (AS). Fourteen patients who fulfilled the modified New York criteria for AS were compared with 13 paired controls. Carotid intimal-media thick- ness (IMT) was assessed by ultrasonography bilaterally in common carotid artery, internal carotid artery and in the bifurcation. Groups were homogeneous regarding cardiovascular risk factors. Only a single patient in AS group was in use of corticosteroid.ResultsThe presence of active inflammation was demonstrated by elevated BASDAI and higher CRP levels and in patients versus controls (12.36 vs. 3.45mg/dl, P = 0.002). No dif- ference was found in carotid IMT between both groups, in any site of artery. Averaged IMT (6 measurements, at 3 pre-specified sites bilaterally) was 0.72 ± 0.28 in AS group and 0.70 ± 0.45mm in controls (P = 0.91). Minimally modified LDL did not differ significantly either between patients and controls (14.03 ± 17.40 vs. 13.21 ± 10.21; P = 0.88).ConclusionsPatients with AS did not show increased carotid IMT in comparison to con- trols. In the same way, circulating plasma levels of LDL (-), did not differ significantly in both groups