Associations of plasma lipids, lipoproteins, and cardiovascular outcomes with climatic variations in a large Brazilian population of Campinas, São Paulo state: an eight-year study

In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas - Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

Hiperplasia supra-renal congenita. Efeito do tratamento sobre o crescimento estatural e a secrecao de somatotropina. / Congenital adrenal hyperplasia. The effect of the treatment of stature growth and somatotropina secretion

Os autores apresentam oito casos de pacientes com sindrome adrenogenital por hiperplasia suprarenal congenita devida a deficiencia de 21-hidroxilase tratados com corticosteroides. Analisam o efeito do tratamento sobre o desenvolvimento estatural e sobre os niveis serivos de hormonio do crescimento, discutindo os resultados em face dos possiveis mecanismos fisiopatologicos em causa

Purpura trombocitopenica com diminuicao de megacarioticos na medula ossea relato de um caso. / Trombocytopenic purpura with decreased megakariocytes in the bone marrow: report of a case

A ocorrencia de purpura trombocitopenica com diminuicao de megacariocitos e incomum na literatura medica. Os autores relatam o caso de um homem de 26 anos com um quadro hemorragico. Exames complementares comprovaram trombocitopenia que persistiu durante toda a evolucao clinica.Na medula ossea havia diminuicao do numero de megacariocitos sem anormalidades nas outras linhagens hematopoeticas.Foram feitas transfusoes de sangue fresco, corticoides e imunossupressores, sem sucesso. O paciente faleceu. As hipoteses levantadas para explicar as alteracoes hematologicas, a luz dos conhecimentos atuais, nao sao satisfatorias.Estudos posteriores de maior numero de pacientes, utilizando tecnicas mais complexas, sao necessarios para melhor compreensao da patogenese do quadro