ABSTRACT
The association between subclinical thyroid dysfunctions and autonomic modulation changes has been described by many studies with conflicting results. We aimed to analyze the association between subclinical hyperthyroidism (SCHyper), subclinical hypothyroidism (SCHypo), and heart rate variability (HRV) using the baseline from ELSA-Brasil. SCHyper and SCHypo were classified by use of medication to treat thyroid disorders, thyrotropin levels respectively above and under the reference range, and normal free thyroxine levels. For HRV, the participants underwent 10 min in supine position and the R-R intervals of the final 5 min were selected for analysis. We first used linear regression models to report crude data and then, multivariate adjustment for sociodemographic (age, sex, and race) and cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking, body mass index, use of alcohol, and leisure physical activity) using the euthyroid group as reference. From 9270 subjects (median age, 50; interquartile range: 44-56), 8623 (93.0%) were classified as euthyroid, 136 (1.5%) as SCHyper, and 511 (5.5%) as SCHypo. Compared to euthyroid subjects, SCHyper participants presented significantly higher heart rate (68.8 vs 66.5 for euthyroidism, P=0.007) and shorter R-R intervals (871.4 vs 901.6, P=0.007). Although SCHyper was associated with lower standard deviation of NN interval (SDNN) (β: -0.070; 95% confidence interval (95%CI): -0.014 to -0.009) and low-frequency (LF) (β: -0.242, 95%CI: -0.426 to -0.058) compared to the euthyroid group, these differences lost significance after multivariate adjustment for confounders. No significant differences were found for HRV in SCHypo. No association was found between HRV and SCHyper or SCHypo compared to euthyroid subjects in this sample of apparently healthy subjects.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thyroid Diseases/physiopathology , Heart Rate/physiology , Autonomic Nervous System/physiology , Thyrotropin/blood , Risk Factors , Longitudinal Studies , Hyperthyroidism/complications , Hypothyroidism/complicationsABSTRACT
Background. Tuberculous and cryptococcal meningitis (TBM and CM) are the most common causes of opportunistic meningitis in HIV infected patients from resource-limited settings, and the differential diagnosis is challenging. Objective. To compare clinical and basic cerebrospinal fluid (CSF) characteristics between TBM and CM in HIV-infected patients.Methods. A retrospective analysis was conducted of clinical, radiological and laboratory records of 108 and 98 HIV-infected patients with culture-proven diagnosis of TBM and CM, respectively. The patients were admitted at a tertiary centre in São Paulo, Brazil. A logistic regression model was used to distinguish TBM from CM and derive a diagnostic index based on the adjusted odds ratio (OR) to differentiate these two diseases.Results. In multivariate analysis, TBM was independently associated with: CSF with neutrophil predominance (odds ratio (OR) 35.81, 95% confidence interval (CI) 3.80 - 341.30, p=0.002), CSF pleocytosis (OR 9.43, 95% CI 1.30 - 68.70, p=0.027), CSF protein >1.0 g/L (OR 5.13, 95% CI 1.38 - 19.04, p=0.032) and Glasgow Coma Scale <15 (OR 3.10, 95% CI 1.03 - 9.34, p=0.044). Nausea and vomiting (OR 0.27, 95% CI 0.08 - 0.90, p=0.033) were associated with CM. Algorithm-related area under the receiver operating characteristics curve was 0.815 (95% CI 0.758 - 0.873, p<0.0001), but an accurate cut-off was not derived.Conclusion. Although some clinical and basic CSF characteristics appear useful in the differential diagnosis of TBM and CM in HIV infected patients, an accurate algorithm was not identified. Optimised access to rapid, sensitive and specific laboratory tests is essential
Subject(s)
Cerebrospinal Fluid , HIV Infections , Meningitis, Cryptococcal , South Africa , Tuberculosis, MeningealABSTRACT
Objetivou-se avaliar o efeito da ingestão de gossipol livre sobre a qualidade espermática e a morfologia dos testículos e dos epidídimos de touros da raça Nelore. Doze touros receberam dieta contendo 3,3g de gossipol livre/touro/dia (caroço de algodão) (Grupo 1, n=6) e dieta isenta de gossipol (Grupo 2, n=6), respectivamente. Foram realizadas coletas de sêmen no início e no final do experimento, que teve duração de 73 dias. Ao final do estudo, foram retirados os testículos e os epidídimos dos touros para se estudar o efeito do gossipol livre sobre as características histológicas. O consumo médio de 3,3g de gossipol livre/touro/dia (média 7,1mg de gossipol livre/kg/dia) reduziu a motilidade e a concentração espermática e aumentou a porcentagem de defeitos espermáticos maiores e totais. Além disso, os animais apresentaram testículos com túbulos seminíferos de menor espessura de parede, menor número de camadas de células espermatogênicas, menor espessura do epitélio epididimário e menor número de espermatozoide no interior dos ductos epidídimários, em relação aos animais com dieta isenta de gossipol (Grupo 2). O consumo de 3,3g de gossipol livre/touro/dia acarretou alterações na morfologia e na morfometria dos testículos e dos epidídimos e reduziu a qualidade espermática dos touros.
The objective was to evaluate the effect of intake of free gossypol on sperm quality and morphology of the testicles and epididymis of Nelore bulls. Twelve bulls were fed diets containing 3.3g of free gossypol/bull/day (cottonseed) (Group 1, n = 6) and a diet free of gossypol (Group 2, n = 6), respectively. Semen samples were collected in the beginning and end of the experiment which lasted 73 days. In the end of the study the testes and epididymis of bulls were removed to study the effect of free gossypol on histological characteristics. The average consumption of 3.3g of free gossypol/bull/day (mean 7.1mg of free gossypol/kg/day) reduced motility and sperm concentration and increased the percentage of major and total sperm defects, as well as the animals showing testes with seminiferous tubules of smaller thickness, fewer layers of spermatogenic lineage cells, smaller epididymal epithelium thickness and smaller number of sperm within the epididymal ducts, compared to animals with a diet free of gossypol (Group 2). The consumption of 3.3g of free gossypol/bull/day led to changes in morphology and morphometry of the testes and epididymis and reduced sperm quality of bulls.