Alan Carlos Nery dos Santos

Comparison of Postprandial Lipemia between Women who are on Oral Contraceptive Methods and Those who are not

Background: Postprandial Lipemia (PPL) is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC) on PPL is not known, it is a known fact that their use increases fasting lipid values. Objective: To compare the PPL between women who are on OC and those who are not. Methods: A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤150 mg/dL. They were divided into two groups: oral contraceptive group (COG) and non-oral contraceptive group (NCOG). Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting) and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (∆1) and between fasting and 240 minutes (∆2). Results: Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of ∆1 and ∆2 presented significant differences in both comparisons (p ≤0.05). Conclusion: The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions.

Postprandial lipemia and subclinical inflammation on active women taking oral contraceptive

Fundamentos: Mulheres em uso de contraceptivo oral combinado (COC) apresentam perfil lipidico de jejum, lipemia pos-prandial (LPP) e proteina C-reativa (PCR) maiores do que mulheres que nao utilizam COC. O exercicio fisico apresenta bons resultados no controle lipidico e inflamatorio. Objetivo: Comparar os valores do perfil lipidico de jejum, da LPP e da PCR entre mulheres ativas e irregularmente ativas em uso de COC. Metodos: Avaliadas 44 mulheres em uso de COC, da cidade de Salvador, BA, estratificadas em dois grupos: grupo ativo (GA; n=22) formado por mulheres fisicamente ativas e grupo irregularmente ativo (GIA; n=22) formado por mulheres irregularmente ativas. Nos dois grupos, apos jejum de 12 horas, realizada a dosagem do perfil lipidico de jejum e da PCR. A seguir, as voluntarias ingeriram um composto contendo 25 g de gordura e foram dosados os triglicerideos para verificar a LPP. Utilizado o teste de Mann-Whitney para comparacao da LPP e PCR. Resultados: Os valores dos deltas dos triglicerideos que representam a LPP respectivamente para o GA e GIA foram: 93±38,4 mg/dL vs. 163±49,6 mg/dL e 89±50,9 mg/dL vs. 156±47,6 mg/dL (p˂0,01). Os valores da PCR respectivamente para GA e GIA foram: 1,1 mg/L (0,4-2,1 mg/L) e 2,1 mg/L (0,8-3,4 mg/L) (p=0,04). Conclusao: Neste estudo, mulheres ativas em uso de COC apresentaram triglicerideos e LDL de jejum, LPP e PCR significativamente menores que mulheres irregularmente ativas em uso de COC.

Elevation of Oxidized Lipoprotein of Low Density in Users of Combined Oral Contraceptives

Background The use of combined oral contraceptive (COC) has been related to changes in glycemic, lipid metabolism, increased oxidative stress, and systemic blood pressure, which could suggest a higher oxidation of low-density lipoprotein cholesterol (LDL-cholesterol) in women on use of COC. Objective To test the hypothesis that there is a difference in the plasma values of oxidized LDL among women who use and do not use COC, as well as to evaluate the correlation between it and the lipid profile and high-sensitivity C-reactive protein (hs-CRP). Methods Forty-two women with ages between 18 and 35 years old, who were eutrophic, irregularly active, with triglycerides < 150 mg/dL, blood glucose < 100 mg/dL, and who used or did not use COC were selected. These women were allocated in the COC group, formed by 21 women on COC use for at least 1 year; and a control group (CG), consisting of 21 women who had not used any type of hormonal contraceptive for at least 1 year. A significance level of 5% was adopted for statistical analyses. Results It was observed that GCOC showed higher values of oxidized LDL than the CG, respectively 384 mU/mL versus 283 mU/mL (p < 0.01). A positive correlation between oxidized LDL and LDL-cholesterol (r = 0.3, p < 0.05), with total cholesterol (r = 0.47, p < 0.01) and with triglycerides (r = 0.32, p < 0.03) was observed, and there was no correlation with the hs-CRP. In the categorized analysis of oxidized LDL, 71.4% of GCOC women, and 28.6% of the CG remained above the established cutoff point. Conclusion Women who use COC have higher plasma levels of oxidized LDL, and there is a positive correlation between oxidized LDL and other lipid variables.

Barriers to cardiovascular rehabilitation care in a northeast city of Brazil

67 ABSTRACT Identifying barriers by regions of Brazil can be a valuable strategy to improve the insertion and adherence of patients with cardiopathy to cardiovascular rehabilitation programs. Objective: To identify and describe the reasons that lead to the non-inclusion of individuals with cardiopathy in cardiovascular rehabilitation programs. Methods: Descriptive cross-sectional study with 79 individuals of both sexes, aged over 50 years, with cardiopathy from five private cardiology clinics. To identify the factors that interfered with the inclusion of patients in cardiovascular rehabilitation programs, the scale of barriers for cardiac rehabilitation was applied. This instrument is composed of 22 items, 21 of which are closed and objective questions. Individuals were instructed to tick “YES” or “NO” for each target item on the scale if they identified the item as a barrier to inclusion / adherence. Results: 64 (81%) of the sample did not know about the existence of cardiovascular rehabilitation and its benefits. For 50 (63%) the distance from the residence to the rehabilitation center was a barrier. In addition, the cost of urban mobility 37 (47%) and the lack of indication of the physician as unnecessary 32 (40%) were also pointed as barriers. Conclusion: The results of this study indicate that the main reasons for non-insertion in cardiovascular rehabilitation programs were the lack of knowledge about the benefits of this type of program, the distance of the patients’ residence to the nearest center and the displacement cost.

C-reactive protein in oral contraceptive users: related factors and cardiovascular risk

Mailing Address: Alan Carlos Nery dos Santos Escola Bahiana de Medicina e Saúde Pública. Av. Dom João VI, 275. Postal Code: 44657-086. Brotas – Salvador, BA – Brazil E-mail: alansantos.pos@bahiana.edu.br C-Reactive Protein in Oral Contraceptive Users: Related Factors and Cardiovascular Risk Alan Carlos Nery dos Santos1, Jefferson Petto1, Francisco Tiago Oliveira de Oliveira2, Diego Passos Diogo1, Ana Marice Teixeira Ladeia1 Programa de Mestrado e Doutorado em Medicina e Saúde Humana da Escola Bahiana de Medicina e Saúde Pública – EBMSP1, Salvador, BA; Escola Bahiana de Medicina e Saúde Pública – EBMSP2, Salvador, BA – Brazil

Importance of academic quality in the treatment of chronic venous insufficiency

Chronic venous insufficiency (CVI) is the inability of the venous complex to drain blood from the tissues to the heart, lasting more than three months, mainly due to valvular insufficiency of the lower limbs. Inability of the venous complex results in increased venous vascular pressure and consequent formation of reticular and varicose veins1.In the later stages, CVI evolves with cutaneous and subcutaneous alterations, ulcerations and, in 1-3% of the individuals, amputation2,3.

C-Reactive Protein in the Initial Phase of Postprandial Lipemia in Subjects with Central Obesity

Postprandial lipemia (PPL), which reflects the body’s ability to metabolize lipids after a meal, is one of the main factors of atherosclerosis1. PPL can be divided into three phases: phase of high triglycerides, plateau phase and phase of lipid values returning to baseline. The average duration of the three phases is six to eight hours and its peak in healthy individuals is achieved between the third and fourth hour2. The first phase of PPL to the peak point is measured primarily by the elevation of triglycerides, since no variations are observed in plasma concentrations of lipoproteins2,3.

Adiponectin: characterization, metabolic and cardiovascular action

In the last two decades, the understanding of adipose tissue biology underwent revolutionary changes, from a major energy storage site to an important endocrine organ responsible for the production and secretion of proteins, peptides and non-bioactive peptides. Among the proteins secreted by adipocytes, adiponectin (APN) is the most abundant, with important physiological actions in the cardiovascular and endocrine system, involving the sensitization of insulin action and regulation of body energy metabolism, including the heart. This review aims to describe the action of APN on the cardiovascular system. It includes original manuscripts with humans or animals. The databases PubMed and Medline, from years 1994 to 2013, were searched. Case reports, pilot studies or review studies have not been included. The health science descriptors and MeSH specific for Medline were used as keywords. The following cross searches were carried out: Adiponectin AND Obesity, Adiponectin AND Metabolism and Adiponectin AND Cardiovascular Disease. We found 303 manuscripts, excluded 204 and selected 31 manuscripts that were included this study. In the general context of this review, APN presents anti-inflammatory and ateroprotector effects in the vascular tissue and an insulin sensitizing action in tissues involved in glucose and lipid metabolism. It is thus considered an important biomarker for the development of cardiovascular diseases.