Hypertension in a Brazilian Urban Slum Population

Low- and middle-income countries account for the majority of hypertension disease burden. However, little is known about the distribution of this illness within subpopulations of these countries, particularly among those who live in urban informal settlements. A cross-sectional hypertension survey was conducted in 2003 among 5649 adult residents of a slum settlement in the city of Salvador, Brazil. Hypertension was defined as either an elevated arterial systolic (≥140 mmHg) or diastolic (≥90 mmHg) blood pressure. Sex-specific multivariable models of systolic blood pressure were constructed to identify factors associated with elevated blood pressure. The prevalence of hypertension in the population 18 years and older was 21 % (1162/5649). Men had 1.2 times the risk of hypertension compared with women (95 % confidence intervals (CI), 1.05, 1.36). Increasing age and lack of any schooling, particularly for women, were also significantly associated with elevated blood pressure (p < 0.05). There was also a direct association between men who were black and an elevated blood pressure. Among those who were hypertensive, 65.5 % were aware of their condition, and only 36.3 % of those aware were actively using anti-hypertensive medications. Men were less likely to be aware of their diagnosis or to use medications (p < 0.01 for both) than women. The prevalence of hypertension in this slum community was lower than reported frequencies in the non-slum population of Brazil and Salvador, yet both disease awareness and treatment frequency were low. Further research on hypertension and other chronic non-communicable diseases in slum populations is urgently needed to guide prevention and treatment efforts in this growing population.     

Photorefractive keratectomy and butterfly laser epithelial keratomileusis: a prospective, contralateral study

PURPOSE: To evaluate results of two surface excimer laser refractive surgery techniques--photorefractive keratectomy (PRK) and butterfly laser epithelial keratomileusis (butterfly LASEK). METHODS: A prospective, randomized, double-masked study of 51 patients (102 eyes) who underwent laser refractive surgery. One eye of each patient was randomized to be operated with PRK and the fellow eye with butterfly LASEK. Patients were followed for 1 year. RESULTS: No significant difference between groups for distance uncorrected visual acuity (UCVA) (P = .559) was noted. At 1 year, 98% (50 eyes) in the PRK group and 96.1% (49 eyes) in the butterfly LASEK group reached UCVA of 20/20. Predictability, efficacy, safety, and stability were not statistically significant between groups. Safety index was 1.0 for PRK and 0.996 for butterfly LASEK. One eye in the butterfly LASEK group lost one line of best-spectacle corrected visual acuity. At 12 months, 94.1% (48 eyes) and 86.3% (44 eyes) in the PRK and butterfly LASEK groups (P = .188), respectively, had a spherical equivalent refraction of +/- 0.50 diopters. Slight haze was observed in both groups. A statistical difference in haze between the groups was observed only in the first postoperative month, with higher intensity in the butterfly LASEK group (0.18 +/- 0.39) compared to the PRK group (0.08+/- 0.21) (P = .04). CONCLUSIONS: Butterfly LASEK had similar predictability, efficacy, safety, stability, and haze incidence to PRK for the treatment of low to moderate myopia. However, on the second postoperative day, PRK showed better UCVA than butterfly LASEK.     

Serum 25-hydroxyvitamin D concentrations and prevalence estimates of hypovitaminosis D in the U.S. population based on assay-adjusted data

Prevalence of hypovitaminosis D from previous NHANES reports did not account for assay changes and drifts over time. Thus, published NHANES reports on vitamin D status for the U.S. population were likely either over- or underestimated. We investigated changes in vitamin D status in the U.S. using assay-adjusted serum 25-hydroxyvitamin D [25(OH)D] data from NHANES, 1988-1994 (n = 18,641) and three cycles of NHANES, 2001-2006 (n = 23,424). Changes in geometric mean serum 25(OH)D and prevalence estimates for various serum 25(OH)D cut points (<25, <30, <40, <50, and <75 nmol/L) were determined. From 1988-1994 to 2001-2006, geometric mean serum 25(OH)D significantly decreased by 9% in all participants, 12% in men, 14% in blacks, 16% in 12- to 15-y-old adolescents, 16% in 20- to 30-y-old adults, 13% in nonsupplement users, and 12% in persons with BMI >80th percentile (P < 0.001). From 1988-1994 to 2001-2006, prevalence of serum 25(OH)D <30 nmol/L increased from 5 to 10% in all participants, from 3 to 8% in men, from 22 to 38% in blacks, from 3 to 8% in 12- to 15-y-old adolescents, from 5 to 12% in 20- to 30-y-old adults, from 6 to 14% in nonsupplement users, and from 8 to 17% in persons with BMI >80th percentile (P < 0.001). Previous NHANES reports overestimated the increase in prevalence of hypovitaminosis D. The recent decline in vitamin D status in the U.S. is more likely due to increased prevalence of obesity and other lifestyle changes but not to changes in milk consumption.     

Effects of Passiflora edulis (yellow passion) on serum lipids and oxidative stress status of Wistar rats

The aim of this study was to evaluate the effects of Passiflora edulis f. flavicarpa Degener (yellow passion) juice on the lipid profile and oxidative stress status of Wistar rats. Adult male Wistar rats were divided in two groups (n=8 animals per group): the control group, which received water, and the treated group, which was given P. edulis juice (1,000 mg/kg). Both groups received by gavage treatment twice a day for 28 days. The treated group showed an increased high-density lipoprotein-cholesterol level and decreased low-density lipoprotein-cholesterol and free fatty acid levels compared with the control group. Levels of triglycerides and and very low-density lipoprotein-cholesterol, superoxide dismutase activity, and total glutathione concentration were not statistically different between the two groups, but the thiobarbituric acid-reactive substances concentration (indicating lipid peroxidation) decreased in the treated group. These findings suggests that P. edulis juice in the experimental conditions used showed beneficial effects on lipid profile and improved lipid peroxidation in Wistar rats.     

1-(7-Chloroquinolin-4-yl)-2-[(1H-pyrrol-2-yl)methylene]hydrazine: a potent compound against cancer

Heteroaromatic derivatives (3a–f) have been synthesized and evaluated for their activity against four cancer cell lines. Among the studied compounds, 1-(7-Chloroquinolin-4-yl)-2-[(1H-pyrrol-2-yl)methylene]hydrazine (3e) exhibited an excellent cytotoxic activity against the referred lines, and especially on melanoma cells (MDAMB-435). In this case, compound 3e is four times more active than the standard substance Doxorubicin. Together with other results from our group, 7-chloro-4-quinolinylhydrazones derived from chloroquine could be considered a relevant finding toward the rational design of new leads for antitumor compounds.     

Depressive-like behavior induced by tumor necrosis factor-α in mice

Pro-inflammatory cytokines are implicated in the pathogenesis of depression. However, few animal models of cytokine-induced depression well characterized regarding its response to antidepressants are available. Hence, the aim of this study was to propose a model of depressive-like behavior induced by the administration of tumor necrosis factor-α (TNF-α) responsive to antidepressant treatments. TNF-α administered by i.c.v. route produced a depressive-like behavior in the forced swimming test (FST) and tail suspension test (TST) (0.1-1 fg/site and 0.001 fg/site, respectively), without altering the locomotor activity in the open-field test. In addition, anti-TNF-α antibody (0.1-1 pg/site, i.c.v.), but not the inhibitor of TNF-α synthesis thalidomide (3-30 mg/kg, s.c.) produced an antidepressant-like response in the FST. Moreover, either anti-TNF-α antibody (0.01 pg/site, i.c.v) or thalidomide (30 mg/kg, s.c.) reversed the depressive-like behavior induced by TNF- (0.1 fg/site, i.c.v.) in the FST. TNF-α receptor 1 (TNFR1) knockout mice exhibited an antidepressant-like behavior in the FST and in the TST as compared with the wild type mice. Treatment with fluoxetine (32 mg/kg, i.p), imipramine (15 mg/kg, i.p.) and desipramine (16 mg/kg, i.p) prevented the depressant-like effect induced by TNF-α (0.1 fg/site, i.c.v.) in the FST. In addition, TNF-α (0.1 fg/site, i.c.v.) administration produced an anhedonic response in a sucrose intake test, which was prevented by anti-TNF-α antibody (0.01 pg/site, i.c.v) or fluoxetine (32 mg/kg, i.p). Taken together, these results indicate that TNF-α produces a depressive-like state in mice, reinforcing the notion that an inflammatory component may play an important role in the pathophysiology of depression and suggesting that the central administration of TNF-α may be a novel approach to study the inflammatory component of depressive disorder. This article is part of a Special Issue entitled 'Anxiety and Depression'.     

Fortification of orange juice with vitamin D: a novel approach for enhancing vitamin D nutritional health

BACKGROUND: Fortification of milk with vitamin D may not be adequate for satisfying the vitamin D requirement because of variability in vitamin D content after fortification and because many persons have milk allergy or lactose intolerance. Additional foods need to be fortified with vitamin D. OBJECTIVE: We determined whether vitamin D, a fat-soluble vitamin, is bioavailable in orange juice and skim milk, 2 nonfat beverages. DESIGN: On 3 separate occasions, 18 adults ingested 25 000 IU vitamin D(2) in 240 mL whole milk or skim milk or in 0.1 mL corn oil applied to toast. A separate, double-blind, randomized, controlled trial investigated whether the consumption of orange juice fortified with vitamin D(3) would increase serum 25-hydroxyvitamin D [25(OH)D] concentrations: 14 subjects ingested 240 mL orange juice fortified with 1000 IU vitamin D, and 12 subjects ingested a control orange juice daily for 12 wk. RESULTS: Peak serum vitamin D(2) concentrations did not differ significantly after the ingestion of vitamin D(2) in whole milk, skim milk, or corn oil on toast. After subjects consumed orange juice fortified with 1000 IU vitamin D(3) daily for 12 wk, serum 25(OH)D(3) concentrations increased by 150%, and serum parathyroid hormone concentrations decreased by 25% compared with baseline; control subjects had a seasonal increase of 45% in 25(OH)D and no significant change in serum parathyroid hormone. CONCLUSIONS: The fat content of milk does not affect vitamin D bioavailability. Vitamin D fortification at 1000 IU/240 mL orange juice for 12 wk safely increased 25(OH)D(3) concentrations in adults.     

Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009

Overweight and obesity are public health issues that affect an important part of the world population. This study aims at describing the trends in overweight and obesity prevalence rates from 2006 to 2009, by means of telephone surveys in 27 Brazilian cities, with a population aged 18 years or older. The body mass index (BMI) was calculated by the reported height and weight; overweight and obesity were considered as BMI >25 kg/m2 and >30 kg/m2, respectively. Temporal variation in overweight and obesity prevalence is presented for men and women, according to age group, schooling, stable relationship, and skin color. Poisson regression was used for the analysis. Overweight prevalence was 43.0, 42.7, 44.2 and 46.6%,for each year of the period from 2006 to 2009, respectively. For obesity, in the same period, the trend was: 11.4, 12.7, 13.2 and 13.8%. The temporal trend varied in relation to some demographic and socioeconomic variables. The prevalence was higher among women and young adults. The temporal trend was independent of the relationship status of the interviewees, but the prevalence was higher among white women and those with less years of schooling. The results in this study confirmed the urgent need for effective prevention and control measures, as the increasing trend is occurring in a short period of time, especially among youngsters.     

New series of isoniazid hydrazones linked with electron-withdrawing substituents

A series of new isoniazid hydrazones was synthesized by two procedures. In the first isoniazid was activated with diethoxymethyl acetate and condensed with the appropriate anilines. Alternatively, substituted anilines were activated by diethoxymethyl acetate and subsequently condensed with isoniazid. NMR study confirmed that both synthetic approaches gave the same tautomer. All compounds were screened for in vitro antimycobacterial activity. Most of them exhibited the same activity against Mycobacterium tuberculosis (MIC 1 μmol L⁻¹) as isoniazid (INH), better activity against Mycobacterium kansasii 325/80 (MIC 0.125–0.250 μmol L⁻¹), high value of selectivity index (SI) and IC₅₀ between 0.0218 and 0.326 mmol L⁻¹. Compound 2o with the best SI was used as a model compound for the stability test and was found to be stable at neutral pH, but under acidic conditions it slowly hydrolysed.     

The efficacy of Veinobiase in venous disorders presented in women taking estroprogesterone agents (a statistical study of 2,295 patients)

The authors tryed by a statistical study to evaluate the efficacy of aphlebotinic therapy in venous diseases induced or aggravated by estroprogestative contraception. During this study, it emerged that the induced functional venous problems were quite virtually corrected by this treatment.