Cocoa effects on blood pressure, endothelial function, and inflammation: a systematic review

Hypertension has affected 1,13 billion people worldwide and is one of the main risk factors for cardiovascular disease, which has a high mortality rate. The aim of the study was to review the effect of cocoa on systolic and diastolic blood pressure in hypertensive patients, and its alterations in endothelial function and inflammation. We searched PubMed, Scopus, Science Direct, Lilacs and MedLine databases in August 2018. Inclusion criteria were limited to hypertensive individuals, cardiovascular diseases, intervention and randomized clinical studies; published since 2000 and in English, Spanish and Portuguese languages. A total of 433 articles were found in the search, which 13 met the inclusion criteria. The trials had a sample of 19 to 122 participants. The cocoa was offeredas chocolate bars and cocoa beverage. Chocolate bars doses ranged from 6 g to 100 g/ day and cocoa powder doses ranged from 5 g to 31 g/ day. Intervention ranged from 2 to 18 weeks. The results observed revealed a significant blood pressure-reducing effect of cocoa, an increase in flow-mediated dilation in the evaluation of endothelial function, and no changes in antioxidant and anti-inflammatory capacity were observed after intervention. The conclusion suggests that cocoa has a blood pressure lowering effect, but new studies are still required with hypertensive individuals so that their mechanisms are better evaluates and their efficacy proven

Antioxidative effect of Arthrospira platensis biomass on the lipid oxidation

Introduction: Cyanobacteria are promising natural sources of antioxidants. Environmental conditions that influence synthesis of substances in cultures of cyanobacteria have been studied. Objective: This investigation aimed to evaluate the antioxidative effect of Arthrospira platensis biomass on the process of lipid oxidation in bulk oil and oil/water emulsion. Method: Arthrospira platensis growth potential for antioxidant production under different cultivation conditions using an experimental design. The antioxidative effect of the methanolic extracts and the biomass on preventing lipid oxidation was measured by peroxide value (PV). Results: The results showed that the growing conditions to obtain the biomass promoted change in the protective ability of different biomass extracts. Extracts obtained from the cultivated biomass grown under 150 μmol photons/m2s-1, 1.875 g.L-1 NaNO3; 13.5 g.L-1 NaHCO3 (assay14) and 50 μmol photons/m2s-1, 2.5 g.L-1 NaNO3; 18.0 g.L-1 NaHCO3 (standard)  showed the most antioxidative effect on preventing lipid oxidation, therefore used in the formulation of mayonnaise. The mayonnaise made with soybean oil and 0.5% biomass was preserved against lipid photodegradation during seven days of storage, but the peroxide value related to control varied from 2.9 to 3.1 mEqO2.Kg-1, with no significant difference in the preservation afforded by tert-butilhydroquinone, in the same period of storage. In mayonnaise made with sunflower oil, biomass, independent of concentration, was unable to protect the product against photooxidation. Conclusions: The results demonstrate the protective ability on preventing lipid oxidation of Arthrospira platensis biomass and its potential for use in food lipid-based of soybean oil.TÍTULO PT: Efeito antioxidante da biomassa de Arthrospira platensis sobre a oxidação lipídicaIntrodução: Cianobactérias são promissoras fontes naturais de antioxidantes. Condições ambientais que influenciam síntese de substâncias em cultivos de cianobactérias tem sido estudadas. Objetivo: O objetivo deste estudo foi avaliar o efeito antioxidante da biomassa de Arthrospira platensis no processo de oxidação lipídica do óleo e da emulsão óleo/água. Método: A produção de antioxidantes por Arthrospira platensis em função das condições de cultivo foi avaliada por meio de planejamento experimental. O efeito antioxidante dos extratos metanólicos e das biomassas foi avaliado através do índice de peróxidos. Resultados: Os resultados mostram que as condições de crescimento para se obter a biomassa promoveram mudança na capacidade protetora dos diferentes extratos da biomassa. Extratos obtidos a partir da biomassa cultivada sob 150 μmol fótons/m2s-1, 1,875 g.L-1 NaNO3; 13,5 g.L-1 NaHCO3 (ensaio 14) e 50 μmol fótons/m2s-1, 2,5 g.L-1 NaNO3; 18,0 g.L-1 NaHCO3 (padrão) mostraram maior efeito antioxidante contra a oxidação lipídica, portanto, utilizados para formulação da maionese. A maionese feita com óleo de soja e 0,5% de biomassa foi preservada da fotodegradação lipídica durante sete dias de armazenamento, mas o índice de peroxido em relação ao controle variou de 2,9 para 3,1 mEqO2.Kg-1, não havendo diferença significativa da preservação proporcionada pela terc-butil hidroquinona, no mesmo período de armazenamento. Na maionese feita com óleo de girassol, a biomassa, independentemente da concentração, não foi capaz de proteger o produto contra a foto-oxidação. Conclusões: Os resultados demonstram a capacidade protetora contra a oxidação lipídica da biomassa de Arthrospira platensis e seu potencial para uso em alimentos ricos em lipídeos à base de óleo de soja

Relação da ingestão de cálcio com o perfil lipídico em pacientes hipertensos resistentes

Introdução: A hipertensão arterial resistente (HAR) é um fator determinante para o aumento dos eventos cardiovasculares. Estudos têm demonstrado efeitos benéficos da ingestão adequada de cálcio sobre a saúde cardiovascular e modulação do perfil lipídico. Objetivo: Verificar a correlação entre a ingestão de cálcio e perfil lipídico de pacientes hipertensos resistentes. Métodos: Estudo observacional, transversal, realizado com pacientes diagnosticados com HAR, atendidos em um hospital público do município de Niterói, realizado entre setembro de 2017 a junho de 2019. Foram aferidas a massa corporal e estatura, e calculado o IMC. A avaliação da ingestão dietética de cálcio foi realizada por meio de recordatório 24h (R24h) e os indivíduos foram divididos em 2 grupos, de acordo com a ingestão de cálcio. Os dados de perfil lipídico foram coletados através dos exames bioquímicos listados no prontuário dos pacientes. Para análise estatística foram considerados significativos valores de p < 0,05 e foi utilizado o software Graph Pad Prism 8.0. Resultados: Foram avaliados 55 pacientes com média de idade de 62,3 ± 10,6 anos, sendo 81,8% (n = 45) do sexo feminino. Destes, 60% (n = 33) dos pacientes apresentaram algum grau de obesidade. Quanto ao perfil lipídico, 70,9% (n = 39) dos pacientes possuíam dislipidemia e 85,4% apresentaram ingestão inadequada de cálcio (n = 47). A ingestão média de cálcio foi de 662,5 ±419,8 mg/dia sendo os produtos lácteos as maiores fontes de cálcio dietético identificadas. Observou-se valores médios acima das referências de LDL-c sendo de 114 ± 41,1 mg/dL nos indivíduos com ingestão inadequada de cálcio e de 104,8 + 42,8 mg/dL naqueles com ingestão adequada, porém não se observou diferença significativa entre os grupos (p = 0,4823). Não foi encontrada correlação entre a ingestão dietética de cálcio e as variáveis do perfil lipídico. Conclusão: Esses achados remetem à importância da orientação nutricional, com atenção especial para o consumo de cálcio, objetivando melhora na qualidade de vida dos indivíduos hipertensos resistentes

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Performance of Cowpea under Different Water Regimes in Amazonian Conditions

Water availability is a crucial factor in the final productivity of cowpea. The objective of this work was to evaluate the production and productivity components of cowpea under different irrigation depths in Amazonian conditions. The experiment was carried out at the School Farm of the Federal Rural University of Amazonia, in the municipality of Castanhal-PA, using the cultivar BR3 Tracuateua, from September to November 2014, 2015, and 2016. The experimental design was conducted on six blocks and four treatments, where the four irrigation depths of 0, 25, 50, and 100% of crop evapotranspiration were tested. The productivity analysis was performed when 90% of the plants were in the phenological stage R9. The evaluated production components were pod length, number of pods per plant, number of grains per pod, mass of one hundred grains, and harvest index. There was a statistical difference among all treatments for the components of production and among productivities. An average reduction of 827 kg ha−1 in cowpea productivity was observed during the three years of study, when the treatment without irrigation was compared with the treatment irrigated with 100% of the crop’s water demand. It was found in this research that the simple fulfillment of the nutritional and phytosanitary demands of the crop, associated with an adequate planning of when to plant in the region, would already help in the improvement of local production when choosing times where the water deficit in the reproductive phase is less than 33 mm