The association between the Body Mass Index of schoolchildren aged between 7 and 14 years and that of their parents in the city of Florianópolis, in the State of Santa Catarina, Brazil

OBJETIVOS: verificar a associação entre o Índice de Massa Corporal (IMC) de escolares de 7 a 14 anos e dos respectivos pais. MÉTODOS: estudo transversal com 886 escolares de quatro escolas de Florianópolis, SC. Diagnóstico antropométrico dos escolares e dos pais definido, respectivamente, a partir do IMC para idade de acordo com Centers for Disease Control and Prevention e dos pontos de corte da Organização Mundial da Saúde. A associação entre o IMC dos pais e dos escolares foi estimada por meio da razão de prevalência (RP) com intervalo de confiança (IC) de 95% e teste qui-quadrado com valor de significância de p< 0,05. RESULTADOS: identificou-se prevalência de sobrepeso/obesidade mais elevada em meninos (29,9%) quando comparada a de meninas (17,7%) (p<0,001). Observou-se relação estatisticamente significante entre o IMC de escolares do sexo feminino com o IMC das mães (RP=1,63; IC95%=1,1-3,0; p=0,02) e dos pais (RP=1,78; IC95%= 1,1-3,5; p=0,01). Nos escolares do sexo masculino a associação observada não foi estatisticamente significante. CONCLUSÕES: identificou-se que a prevalência do sobrepeso ou obesidade é 1,63 vezes maior, entre as meninas, quando a mãe também apresenta esse distúrbio e 1,78 vezes maior quando o pai o apresenta, em comparação a mães e pais eutróficos ou de baixo peso.OBJECTIVES: to assess the association between parents 'Body Mass Index and schoolchildren from the age of 7 to 14 years old. METHODS: cross sectional epidemiological study with 886 schoolchildren from two public and two private schools in Florianópolis Island, Santa Catarina state. Schoolchildren and theirs parents anthropometric diagnostic was defined from the respectively BMIfor age according to the Centers for Disease Control and Prevention and WHO cutoff points. The association between parents BMI and schoolchildren was estimated through the prevalence ratio (PR) with confidence interval (CI) 95% and Pearson 's chi-square test with the significant value of p<0.05. RESULTS: higher overweight and obesity prevalence was verified in male students, 29.9%, compare to 17.7% to female students (p<0.001). Significant statistical relation between female students BMI and theirs mothers BMI was found, according to PR=1.63; CI95%=1.1-3.0;p=0.02 and theirs fathers BMI, PR=1.78; CI95%= 1.1-3.5; p=0.01. The association between male students IMC and theirs mothers and fathers did not show significant statistical relation. CONCLUSIONS: the female students prevalence of show overweight or obesity is 1.63 times higher when theirs mothers also showed the same nutritional status and 1.78 times higher when the father shows overweight/obesity in comparison to mothers and fathers with normal weight or underweight

Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Estudos estruturais de complexos entre fosfolipases A2 homólogas isoladas do veneno de Bothrops moojeni e inibidores da atividade miotóxica

Serpentes do gênero Bothrops representam cerca de 90% dos acidentes ofídicos que ocorrem no Brasil. Um componentes presente em venenos de serpentes são as fosfolipases A2 (PLA2s), que podem apresentar diversas atividades biológicas. Diversos estudos com PLA2s e PLA2s-homólogas de venenos de serpentes buscam melhor compreender o mecanismo da ação miotóxica, sugerindo diferentes sítios de ação. Neste trabalho, são apresentados estudos com PLA2s-homólogas do veneno de Bothrops moojeni, conhecida popularmente como caiçaca. A miotoxina II (MjTX-II) foi estudada na forma nativa, complexada com ácidos graxos e os inibidores ácido rosmarínico e suramina, enquanto a miotoxina I (MjTX-I) foi estudada em complexo com o ligante suramina. Para a obtenção dos dados, foram utilizadas diferentes técnicas biofísicas como espalhamento dinâmico de luz, calorimetria por titulação isotérmica e cristalografia de raios X. Estes estudos foram complementados com estudos funcionais por técnicas miográficas e estudos computacionais por dinâmica molecular realizados por outros membros do Laboratório de Biologia Molecular Estrutural. As estruturas cristalográficas da MjTX-II nativa e complexada com ácidos graxos revelaram particularidades para esta toxina, como a independência da ligação de ácidos graxos na estrutura para a sua ativação - alinhamento dos resíduos importantes para a atividade miotóxica. A estrutura da MjTX-II com o ácido rosmarínico revelou que o ligante interage com uma das regiões relacionada com a atividade miotóxica da toxina, o que possivelmente explica a inibição da atividade miotóxica da toxina por técnicas miográficas e está de acordo com mecanismo previamente proposto. Dados cristalográficos do complexo MjTX-II/suramina mostram que há duas moléculas inibidoras interagindo com os sítios relacionados a atividade miotóxica da proteína, o que auxilia na formação de um oligômero induzido pela molécula inibidora corroborando com outros experimentos biofísicos e funcionais. A estrutura cristalográfica do complexo MjTX-I/suramina foi obtida a alta resolução, mostrando mudança oligomérica da forma tetramérica (nativa) para a forma dimérica, com a presença do ligante entre os monômeros, corroborando com dados de calorimetria obtidos.Bothrops genus represents approximately 90% of the ophidian accidents that occur in Brazil. One of the compounds of the venom is the phospholipases A2 (PLA2s), which are proteins with a wide range of biological activities. Several studies with PLA2s and PLA2-homologues from snake venom were performed to better understanding the myotoxic mechanism, suggesting different activity sites. This work presents studies with PLA2s-homologues isolated from Bothrops moojeni, known in Brazil as caiçaca. The myotoxin II (MjTX-II) was studied in native, complexes to fatty acids, rosmarinic acid and suramin inhibitors. Myotoxin I (MjTX-I) was studied complexed to suramin. X-ray crystallography, dynamic light scattering and isothermal titration calorimetry were used to characterize the protein and complexes. Furthermore, functional studies by myographic techniques and computational studies using molecular dynamics were performed by other members of the Laboratory. Crystallographic structures of MjTX-II in native form and complexes to fatty acids reveals particularities for these toxin, such as the independence of the fatty acids binding for myotoxic residues alignment. The structure of MjTX-II complexed to rosmarinic acid showed that this ligand interact to a of regions related to myotoxic activity of toxin, which probably explaining its inbitory action demonstrated by myographic techniques and is according to previous proposed mechanism. Crystallographic data of the MjTX-II/suramin complex shows two inhibitor molecules interacting to toxin surface, inducing its oligomerization and corroborating with other biophysical experiments. In contrast, MjTX-I/suramin complex crystal structure displayed an oligomeric change from the tetrameric (native) to dimeric structure.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Crystal structure of a phospholipase A2 from Bothrops asper venom: Insights into a new putative “myotoxic cluster”

Snake venoms from the Viperidae and Elapidae families often have several phospholipases A2 (PLA2s), which may display different functions despite having a similar structural scaffold. These proteins are considered an important target for the development of drugs against local myotoxic damage because they are not efficiently neutralized by conventional serum therapy. PLA2s from these venoms are generally divided into two classes: (i) catalytic PLA2s (or Asp49-PLA2s) and (ii) non-catalytic PLA2-like toxins (or Lys49-PLA2s). In many Viperidae venoms, a subset of the basic Asp49-PLA2s displays some functional and structural characteristics of PLA2-like proteins and group within the same phylogenetic clade, but their myotoxic mechanism is still largely unknown. In the present study, we have crystallized and solved the structure of myotoxin I (MT-I), a basic myotoxic Asp49-PLA2 isolated from Bothrops asper venom. The structure presents a dimeric conformation that is compatible with that of previous dimers found for basic myotoxic Asp49-PLA2s and Lys49-PLA2s and has been confirmed by other biophysical and bioinformatics techniques. This arrangement suggests a possible cooperative action between both monomers to exert myotoxicity via two different sites forming a putative membrane-docking site (MDoS) and a putative membrane disruption site (MDiS). This mechanism would resemble that proposed for Lys49-PLA2s, but the sites involved appear to be situated in a different region. Thus, as both sites are close to one another, they form a “myotoxic cluster”, which is also found in two other basic myotoxic Asp49-PLA2s from Viperidae venoms. Such arrangement may represent a novel structural strategy for the mechanism of muscle damage exerted by the group of basic, Asp49-PLA2s found in viperid snake venoms.Fundação de Amparo à Pesquisa do Estado de São Paulo/[2015/17286-0]/FAPESP/BrasilFundação de Amparo à Pesquisa do Estado de São Paulo/[2015/24167-7]/FAPESP/BrasilConselho Nacional de Desenvolvimento Científico e Tecnológico/[300596/2013-8]/CNPq/BrasilCoordenação de Aperfeiçoamento de Pessoal de Nivel Superior/[23038.006271/2011-16]/CAPES/BrasilUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Crystallization and preliminary X-ray diffraction analysis of myotoxin I, a Lys49-phospholipase A2 from Bothrops moojeni

A new myotoxic Lys49-phospholipase from B. moojeni has been crystallized and X-ray diffraction data were collected to 2.18 Å resolution. Preliminary analysis indicates the presence of four molecules in the asymmetric unit, leading to a possible new oligomeric structure for Lys49-PLA2s

Can Photobiomodulation Therapy (PBMT) Minimize Exercise-Induced Oxidative Stress? A Systematic Review and Meta-Analysis

Oxidative stress induced by exercise has been a research field in constant growth, due to its relationship with the processes of fatigue, decreased production of muscle strength, and its ability to cause damage to the cell. In this context, photobiomodulation therapy (PBMT) has emerged as a resource capable of improving performance, while reducing muscle fatigue and muscle damage. To analyze the effects of PBMT about exercise-induced oxidative stress and compare with placebo therapy. Data Sources: Databases such as PubMed, EMBASE, CINAHL, CENTRAL, PeDro, and Virtual Health Library, which include Lilacs, Medline, and SciELO, were searched to find published studies. Study Selection: There was no year or language restriction; randomized clinical trials with healthy subjects that compared the application (before or after exercise) of PBMT to placebo therapy were included. Study Design: Systematic review with meta-analysis. Level of Evidence: 1. Data Extraction: Data on the characteristics of the volunteers, study design, intervention parameters, exercise protocol and oxidative stress biomarkers were extracted. The risk of bias and the certainty of the evidence were assessed using the PEDro scale and the GRADE system, respectively. Results: Eight studies (n = 140 participants) were eligible for this review, with moderate to excellent methodological quality. In particular, PBMT was able to reduce damage to lipids post exercise (SMD = &minus;0.72, CI 95% &minus;1.42 to &minus;0.02, I2 = 77%, p = 0.04) and proteins (SMD = &minus;0.41, CI 95% &minus;0.65 to &minus;0.16, I2 = 0%, p = 0.001) until 72 h and 96 h, respectively. In addition, it increased the activity of SOD enzymes (SMD = 0.54, CI 95% 0.07 to 1.02, I2 = 42%, p = 0.02) post exercise, 48 and 96 h after irradiation. However, PBMT did not increase CAT activity (MD = 0.18 CI 95% &minus;0.56 to 0.91, I2 = 79%, p = 0.64) post exercise. We did not find any difference in TAC or GPx biomarkers. Conclusion: Low to moderate certainty evidence shows that PBMT is a resource that can reduce oxidative damage and increase enzymatic antioxidant activity post exercise. We found evidence to support that one session of PBMT can modulate the redox metabolism