Pericardial Fat is Associated With Atrial Conduction: The Framingham Heart Study

Background: Obesity is associated with altered atrial electrophysiology and a prominent risk factor for atrial fibrillation. Body mass index, the most widely used adiposity measure, has been related to atrial electrical remodeling. We tested the hypothesis that pericardial fat is independently associated with electrocardiographic measures of atrial conduction. Methods and Results: We performed a cross‐sectional analysis of 1946 Framingham Heart Study participants (45% women) to determine the relation between pericardial fat and atrial conduction as measured by P wave indices (PWI): PR interval, P wave duration (P‐duration), P wave amplitude (P‐amplitude), P wave area (P‐area), and P wave terminal force (P‐terminal). We performed sex‐stratified linear regression analyses adjusted for relevant clinical variables and ectopic fat depots. Each 1‐SD increase in pericardial fat was significantly associated with PR interval (β=1.7 ms, P=0.049), P‐duration (β=2.3 ms, P<0.001), and P‐terminal (β=297 μV·ms, P<0.001) among women; and P‐duration (β=1.2 ms, P=0.002), P‐amplitude (β=−2.5 μV, P<0. 001), and P‐terminal (β=160 μV·ms, P=0.002) among men. Among both sexes, pericardial fat was significantly associated with P‐duration in analyses additionally adjusting for visceral fat or intrathoracic fat; a similar but non‐significant trend existed with P‐terminal. Among women, pericardial fat was significantly associated with P wave area after adjustment for visceral and intrathoracic fat. Conclusions: Pericardial fat is associated with atrial conduction as quantified by PWI, even with adjustment for extracardiac fat depots. Further studies are warranted to identify the mechanisms through which pericardial fat may modify atrial electrophysiology and promote subsequent risk for arrhythmogenesis

Efecto de un programa multiprofesional en la promoción de la salud alimentaria de las personas mayores: un estudio longitudinal.

Objective: To analyze the food quality of elderly participants in a multi-professional project for health promotion and healthy longevity. Methodology: 55 older adults aged ≥ 60 years (66.03 ± 3.68 years) residents in the south of Brazil were recruited. However, 28 elderlies dropped out of the interventions. Thus, 27 elderlies were assessed (before and after 12-week interventions). To evaluate food quality, the data from the food record of three non-consecutive days and the healthy eating index (HEI) were used, which were applied before and after interventions. The intervention was developed for three months, with theoretical-practical classes on multidisciplinary groups as physical education, psychology, and nutrition (with food reeducation - without nutrition plan). The mean, (±) standard deviation, and 95% confidence interval (95% CI) were calculated. The comparison between pre- and post-intervention was performed by paired t-test, assuming a p≤ 0.05. Results: After 12 weeks, it was observed that the elderly showed higher values for the HEI after the interventions (pre: 47.78 ± 14.23 points; 95% CI: 42.41-53.15, versus 56.30 ± 13.05, 95% CI: 51.37-61.22; with p = 0.029; d = 0.59; medium effect). Conclusions: a multidisciplinary approach including a nutritional intervention could promote positive changes in the food quality of the elderly investigated. As a limitation, the absence of a control group and the conduction of a randomized controlled trial are highlighted. However, this study already promotes directions to provide nutritional health in older people.Objetivo: Analizar la calidad alimentaria de los adultos mayores participantes en un proyecto multiprofesional de promoción de la salud y longevidad saludable. Metodología: Se reclutaron 55 adultos mayores de ≥ 60 años (66,03 ± 3,68 años) residentes en el sur de Brasil. Sin embargo, 28 ancianos abandonaron las intervenciones. Así, se evaluaron 27 ancianos (antes y después de las intervenciones de 12 semanas). Para evaluar la calidad de los alimentos se utilizaron los datos del registro alimentario de tres días no consecutivos y el índice de alimentación saludable (IES), que se aplicaron antes y después de las intervenciones. La intervención se desarrolló durante tres meses, con clases teórico-prácticas en grupos multidisciplinares como educación física, psicología y nutrición (con reeducación alimentaria - sin plan de nutrición). Se calcularon la media, la desviación estándar (±) y el intervalo de confianza del 95% (IC del 95%). La comparación entre pre y postintervención se realizó mediante la prueba t pareada, asumiendo una p ≤ 0,05. Resultados: Después de 12 semanas, se observó que los ancianos mostraron valores más altos para la IES después de las intervenciones (pre: 47,78 ± 14,23 puntos; IC 95%: 42,41-53,15, versus 56,30 ± 13,05, IC 95%: 51,37-61,22; con p = 0,029; d = 0,59; efecto medio). Conclusiones: un enfoque multidisciplinario que incluya una intervención nutricional podría promover cambios positivos en la calidad alimentaria de los ancianos investigados. Como limitación se destaca la ausencia de un grupo control y la realización de un ensayo controlado aleatorizado. Sin embargo, este estudio ya promueve direcciones para brindar salud nutricional a las personas mayores

Metodologia simplificada para doseamento de ácido ascórbico em extratos vegetais

Extratos vegetais com ação antioxidante são cada vez mais procurados para o desenvolvimento de cosméticos antienvelhecimento. Alguns dos antioxidantes amplamente encontrados nesses extratos são os compostos fenólicos, entre eles os flavonoides, além de ácidos orgânicos, como os ácidos ascórbico, cítrico e gálico. A vitamina C, ou ácido ascórbico (AA), apresenta grande instabilidade química, portanto, a determinação quantitativa do AA em formulações e extratos vegetais é de grande importância e se tornou um desafio para a área cosmética. Sendo assim, este trabalho teve por objetivo estudar a viabilidade de uso da metodologia farmacopeica de doseamento de AA para aplicação em extratos vegetais, com o intuito de indicar um método que o determinasse de forma simples e seletiva em matrizes vegetais complexas, visto que este é um importante componente antioxidante destes extratos. Para comprovar a seletividade pelo AA, soluções de ácido gálico, cítrico e quercetina a 10% também foram avaliadas pela metodologia.        A partir deste ensaio foi comprovada a eficiência do método para a quantificação da solução de AA, assim como descrito pela Farmacopéia Brasileira. O AA foi determinado e as outras substâncias antioxidantes não interferiram nos resultados, isso porque o iodo reagiu com o amido presente em solução logo no início da titulação, caracterizando o teste como seletivo para AA. O método foi considerado linear, preciso e robusto. Ao final deste estudo foram obtidas evidências de que este método pode ser utilizado para quantificação da vitamina C em extratos vegetais de maneira simples e rápida, auxiliando na pesquisa, desenvolvimento e controle de qualidade de fitocosméticos e fitoterápicos

EFEITOS DE UM PROGRAMA DE TREINAMENTO MULTICOMPONENTE NA COMPOSIÇÃO CORPORAL E NA CAPACIDADE FUNCIONAL DE IDOSOS COM EXCESSO DE PESO: UMA PROPOSTA DE INTERVENÇÃO

Objetivo: analisar os efeitos de um programa de treinamento multicomponente na composição corporal e na capacidade funcional de idosos com excesso de peso. Método: trata-se de um estudo quase-experimental, de medidas repetidas, com duração de 16 semanas.&nbsp; Foram incluídos, nas análises finais, 11 idosos, de ambos os sexos, com idade ≥ 60 anos, que foram avaliados em três momentos: 1ª, 8ª e 16ª semanas de intervenção. As medidas utilizadas foram: antropometria (massa corporal e estatura), avaliação da composição corporal via bioimpedância elétrica (massa magra, massa livre de gordura, proteínas, minerais, massa de gordura, percentual de gordura, massa muscular esquelética e taxa metabólica basal), dinamometria de preensão manual, resistência de força de membros inferiores, por meio do teste de flexão e extensão de cotovelos, teste de sentar e levantar durante 30 segundos, teste de caminhada de 6 minutos (TC6) e teste Timed&nbsp;&nbsp; UP and Go (TUG). Resultados: não foram identificadas mudanças nas variáveis antropométricas e de composição corporal e, tampouco, para a força de preensão manual (p&gt;0,05). Foram encontradas melhorias significativas nos resultados dos testes de flexão e extensão de cotovelo, sentar e levantar, TUG e TC6, ao longo das 16ª semanas de intervenção (p&lt;0,01). Conclusão: conclui-se que as intervenções foram insuficientes para promover mudanças significativas nos parâmetros antropométricos, de composição corporal e de força de preensão manual. No entanto, foram observados efeitos positivos de capacidade funcional, tanto na força de membros superiores, como na força de membros inferiores, além de melhora no equilíbrio e na aptidão aeróbia. Em vista disso, acredita-se que o modelo de intervenção proposto foi satisfatório para a melhoria da aptidão física de idosos

Differences in the carcinogenic evaluation of glyphosate between the International Agency for Research on Cancer (IARC) and the European Food Safety Authority (EFSA)

The International Agency for Research on Cancer (IARC) Monographs Programme identifies chemicals, drugs, mixtures, occupational exposures, lifestyles and personal habits, and physical and biological agents that cause cancer in humans and has evaluated about 1000 agents since 1971. Monographs are written by ad hoc Working Groups (WGs) of international scientific experts over a period of about 12 months ending in an eight-day meeting. The WG evaluates all of the publicly available scientific information on each substance and, through a transparent and rigorous process,1 decides on the degree to which the scientific evidence supports that substance's potential to cause or not cause cancer in humans. For Monograph 112,2 17 expert scientists evaluated the carcinogenic hazard for four insecticides and the herbicide glyphosate.3 The WG concluded that the data for glyphosate meet the criteria for classification as a probable human carcinogen. The European Food Safety Authority (EFSA) is the primary agency of the European Union for risk assessments regarding food safety. In October 2015, EFSA reported4 on their evaluation of the Renewal Assessment Report5 (RAR) for glyphosate that was prepared by the Rapporteur Member State, the German Federal Institute for Risk Assessment (BfR). EFSA concluded that ?glyphosate is unlikely to pose a carcinogenic hazard to humans and the evidence does not support classification with regard to its carcinogenic potential?. Addendum 1 (the BfR Addendum) of the RAR5 discusses the scientific rationale for differing from the IARC WG conclusion. Serious flaws in the scientific evaluation in the RAR incorrectly characterise the potential for a carcinogenic hazard from exposure to glyphosate. Since the RAR is the basis for the European Food Safety Agency (EFSA) conclusion,4 it is critical that these shortcomings are corrected

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns