Body mass index is superior to other body adiposity indexes in predicting incident hypertension in a highly admixed sample after 10‐year follow‐up: The Baependi Heart Study

Hypertension is the leading cause of overall mortality in low‐ and middle‐income countries. In Brazil, there is paucity of data on the determinants of incident hypertension and related risk factors. We aimed to determine the incidence of hypertension in a sample from the Brazilian population and investigate possible relationships with body adiposity indexes. We assessed risk factors associated with cardiovascular disease, including adiposity body indexes and biochemical analysis, in a sample from the Baependi Heart Study before and after a 10‐year follow‐up. Hypertension was defined by the presence of systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or the use of antihypertensive drugs. From an initial sample of 1693 participants, 498 (56% women; mean age 38 ± 13 years) were eligible to be included. The overall hypertension incidence was 24.3% (22.3% in men and 25.6% in women). Persons who developed hypertension had higher prevalence of obesity, higher levels for blood pressure, higher frequency of dyslipidemia, and higher body adiposity indexes at baseline. The best prediction model for incident hypertension includes age, sex, HDL‐c, SBP, and Body Mass Index (BMI) [AUC = 0.823, OR = 1.58 (95% CI 1.23‐2.04)]. BMI was superior in its predictive capacity when compared to Body Adiposity Index (BAI), Body Roundness Index (BRI), and Visceral Adiposity Index (VAI). Incident hypertension in a sample from the Brazilian population was 24.3% after 10‐year follow‐up and BMI, albeit the simpler index to be calculated, is the best anthropometric index to predict incident hypertension.     

Terapia Hormonal e Hipertensão em Mulheres na Pós-Menopausa: Resultados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

BackgroundHypertension is a major risk factor for cardiovascular morbidity and mortality in post-menopausal women. Although menopausal hormone therapy (MHT) is a very effective treatment for vasomotor symptoms during this period, the influence of this therapy on blood pressure is not yet clear.ObjectiveTo evaluate the relationship between the use of MHT and hypertension in participants of the ELSA-Brasil.MethodsA cross-sectional study using the baseline ELSA-Brasil data in a cohort of 2,138 women who had experienced natural menopause. This study analyzed hypertension, defined as arterial pressure ≥140/90 mmHg or previous antihypertensive use, and use of MHT, with participants being classified into never, past, and current users. Associations were assessed using an adjusted logistic regression model, with statistical significance set at p<0.05.ResultsOverall, 1,492 women (69.8%) had never used MHT, 457 (21.4%) had used it in the past, and 189 (8.8%) were current users. The use of MHT was more common in women who had a body mass index (BMI) <25 kg/m²and triglyceride levels <150 mg/dl, and who were physically less inactive, non-smokers, and non-diabetics. Current MHT users were less likely to have hypertension (OR=0.59; 95% CI: 0.41-0.85) compared to those who had never used MHT. In most cases, MHT was started at or before 59 years of age, within 10 years of becoming menopausal, and its use lasted for up to five years.ConclusionCurrent MHT use was not related to hypertension, particularly in healthy women and in those under 60 years of age.     

Analysis of camphorquinone in composite resins as a function of shade.

OBJECTIVE: To identify and quantify the camphorquinone (CQ) used in different brands of composite resins as a function of the shade analyzed. MATERIALS AND METHODS: Filtek Z250 A3 (FZA3), Filtek Z-250 Incisal (FZI), Pyramid Enamel A1 (PEA1), Pyramid Enamel Translucent (PET), Filtek Supreme A3E (FSA3) and Filtek Supreme GT (FSGT) were used. Five hundred milligrams of each resin were weighed and then dissolved in 1.0 ml of methanol. The samples were centrifuged to accelerate the sedimentation of the inorganic particles. 0.8 ml of the supernatant solution was collected with a pipette and assessed under gas chromatography coupled to the mass spectrometer (GC-MS). The results were compared to pure CQ solutions, used as a standard. Student's t-test, (p=0.05) significant at the level of 5%, compared the results of each brand shade. RESULTS: A smaller amount of camphorquinone was found in Filtek Z-250 (FZI) resin incisal shade when compared to (FZA3) A3 shade. On the other hand, Filtek Supreme resin featured a statistically larger camphorquinone amount in the incisal shade. In Pyramid Enamel resin camphorquinone was found only in shade A1, while the photoinitiator used in the Translucent shade was not identified. SIGNIFICANCE: Based on the data obtained, it is possible to conclude that a single composite resin brand may feature differences in amount and type of photoinitiator used.     

Clonal relationship between lymphocytic predominance Hodgkin's disease and concurrent or subsequent large-cell lymphoma of B lineage

The occurrence of a large-cell lymphoma (LCL) concurrent with or subsequent to lymphocytic predominance Hodgkin's disease (LPHD) is well documented. Given the well-characterized B-cell nature of the Reed- Sternberg cell variants in LPHD, there may be a clonal relationship between the LPHD and the associated B-cell LCL. In this study, we adapted a highly sensitive, clonospecific assay to test whether the clone comprising the LCL exists in the corresponding LPHD tumor. Nine cases meeting the histologic criteria of nodular LPHD and B-cell LCL were identified, reviewed, and studied. Initially, clonality of both lesions was assessed using consensus primers to conserved regions in the IgH variable (frame-work III) and joining region genes in a polymerase chain reaction (PCR) assay. The PCR assay detected a clonal B-cell population in five of the LCLs, whereas analysis of eight cases of LPHD did not detect a dominant clone. Clonal products from the LCL were then sequenced, and clonospecific oligonucleotides were designed from the unique nucleotide sequence encoding the complementarity- determining region-III. These were then used as primers and/or probes in sensitive PCR-based assays on the corresponding LPHD tumors. In two cases, the clonospecific assay showed that the LPHD and LCL shared a common clone that was further confirmed by sequence analysis. This finding provides genotypic evidence that, at least in some cases, the LCL represents a clonal progression of LPHD.     

Bilateral subacromial bursitis with macroscopic rice bodies: Ultrasound,CT and MR appearance

The radiological findings of ultrasound, CT and MR of a case of bilateral subacromial bursitis with macroscopic rice bodies is described. The previous literature is also reviewed.     

Visceral leishmaniasis in the State of Maranhão, Brazil: evolution of an epidemic

The authors provide a brief report on the historical evolution of visceral leishmaniasis in the State of Maranh?o, Brazil, evaluating possible factors for growth of the disease in the State and control measures by the Brazilian Ministry of Health to integrate health services into the maintenance of control programs.