Carlos Mendes Tavares

Involvement of the atrial natriuretic peptide in cardiovascular pathophysiology and its relationship with exercise

In this minireview we describe the involvement of the atrial natriuretic peptide (ANP) in cardiovascular pathophysiology and exercise. The ANP has a broad homeostatic role and exerts complex effects on the cardio-circulatory hemodynamics, it is produced by the left atrium and has a key role in regulating sodium and water balance in mammals and humans. The dominant stimulus for its release is atrial wall tension, commonly caused by exercise. The ANP is involved in the process of lipolysis through a cGMP signaling pathway and, as a consequence, reducing blood pressure by decreasing the sensitivity of vascular smooth muscle to the action of vasoconstrictors and regulate fluid balance. The increase of this hormone is associated with better survival in patients with chronic heart failure (CHF). This minireview provides new evidence based on recent studies related to the beneficial effects of exercise in patients with cardiovascular disease, focusing on the ANP.

Condom use at last sexual relationship among adolescents of Santiago Island, Cape Verde, - West Africa

ObjectiveTo estimate factors associated with condom use at last sexual intercourse among adolescents.MethodsCross-sectional study of a representative sample of 368 sexually active adolescents aged 13–17 years from eight public high schools on Santiago Island, Cape Verde, 2007. The level of significance was 5.0% obtained from logistic regression, considering the association between condom use and socio-demographic, sexual and reproductive variables.ResultsThe prevalence of condom use at last sexual intercourse was 94.9%. Factors associated with condom use at last sexual relationship were: non-Catholic religion (OR=0.68, 95%CI: 0.52; 0.88) and affective-sexual partnership before the interview (OR=5.15, 95%CI: 1.79; 14.80).ConclusionsThere was a high prevalence of condom use at last sexual intercourse of adolescents.

Efeito da denervação cardíaca ventral na incidência de fibrilação atrial após revascularização cirúrgica do miocárdio

OBJECTIVE To evaluate the effect of ventral cardiac denervation in the incidence of atrial fibrillation after coronary artery bypass surgery. METHODS Between September and November, 50 patients without history or previous diagnosis of atrial arrhythmia from the same institution presenting coronary heart disease with indication for coronary artery graft bypass surgery were enrolled in a prospective and randomized study. The exclusion criteria were: patients older than 75 years of age, previous history of atrial arrhythmia and associated heart surgeries. Denervation was performed before cardiopulmonary bypass and it was achieved by removing the adipose tissues around the superior vena cava, aorta and pulmonary artery. The groups were compared regarding demographic, clinical and operative variables. RESULTS There were no hospital mortalities. The additional time for the denervation was 7.64+/-2.33 minutes, and there were no associated complications. Postoperative atrial fibrillation was present in two (8%) patients of the Control Group and in three (12%) patients who underwent ventral cardiac denervation. The risk of postoperative atrial fibrillation in patients undergoing ventral cardiac denervation was 22% higher than in the Control Group (0.56-2.66,confidence interval); however, this outcome was not statistically significant (p=0.64). CONCLUSION Ventral cardiac denervation, despite being a fast and low-risk procedure, does not significantly reduce the incidence of atrial fibrillation after coronary artery bypass graft surgery.

Prevalence of Family Violence and Associated Factors Among In-School Adolescents in São Paulo, SP, Brazil:

Family violence is a social and public health issue across the world for many populations and affects many different types of people, for example, children, women, and vulnerable adults. Adolescents are one of the main victims of this important phenomenon. This article estimates the prevalence of family violence in adolescents and associated factors. The study was carried out in 2012 with a probability and representative sample of 656 adolescents aged between 11 and 17 years who were enrolled at public schools located in the extreme South of the city of São Paulo. The association was tested by the proportion test, Pearson’s chi-square or Fischer’s exact test, and Poisson regression adjusted by robust variance estimation, considering a level of significance of 5%. Among adolescents, 38.9% reported having been victims of family violence. Women were victimized with higher frequency (44.1%). The factors associated with prevalence of family violence were being of the female sex (prevalence ratio [PR] = 1.47; 95% confidence interval [CI] = [1.20, 1.80]) and living only with the father (PR = 1.52; 95% CI = [1.11, 2.08]). The prevalence of adolescents who were victims of family violence is high; however, special attention must be paid to women and adolescents who live only with their father—they were established, in this study, as a risk group. Epidemiological studies of this nature are important to reveal the reality of family violence and to aid the construction of intersectoral public policies to promote health, prevent violence, and foster a peaceful culture.

Motor development of infants exposed to maternal human immunodeficiency virus (HIV) but not infected.

Background To assess the motor development of infants exposed to maternal human immunodeficiency virus (HIV). Methods Thirty infants were assessed in the period from November 2009 to March 2010 at the AIDS Reference and Training Centre, in São Paulo, Brazil. The assessment instrument used in the research was the Alberta Infant Motor Scale (AIMS). All 30 infants used the antiretroviral drug properly for 42 consecutive days, in accordance with the protocol of the World Health Organization. Results Out of the total number of infants, 27 (90%) had proper motor performance and 3 (10%) presented motor delay, according to the AIMS. Discussion This study demonstrated that only 10% of the assessed group had developmental delay and no relation with environmental variables was detected, such as maternal level of education, social and economic issues, maternal practices, attendance at the day care center, and drug use during pregnancy. It is important to emphasize the necessity of studies with a larger number of participants.