Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event.

Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization) and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman's or Pearson's coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048), hsCRP (r = 0.256, P = 0.020), ApoB/ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.

Highly sensitive C-reactive protein and male gender are independently related to the severity of coronary disease in patients with metabolic syndrome and an acute coronary event

Patients with metabolic syndrome are at high-risk for development of atherosclerosis and cardiovascular events. The objective of this study was to examine the major determinants of coronary disease severity, including those coronary risk factors associated with metabolic syndrome, during the early period after an acute coronary episode. We tested the hypothesis that inflammatory markers, especially highly sensitive C-reactive protein (hsCRP), are related to coronary atherosclerosis, in addition to traditional coronary risk factors. Subjects of both genders aged 30 to 75 years (N = 116) were prospectively included if they had suffered a recent acute coronary syndrome (acute myocardial infarction or unstable angina pectoris requiring hospitalization) and if they had metabolic syndrome diagnosed according to the National Cholesterol Education Program/Adult Treatment Panel III. Patients were submitted to a coronary angiography and the burden of atherosclerosis was estimated by the Gensini score. The severity of coronary disease was correlated (Spearman’s or Pearson’s coefficient) with gender (r = 0.291, P = 0.008), age (r = 0.218, P = 0.048), hsCRP (r = 0.256, P = 0.020), ApoB/ApoA ratio (r = 0.233, P = 0.041), and carotid intima-media thickness (r = 0.236, P = 0.041). After multiple linear regression, only male gender (P = 0.046) and hsCRP (P = 0.012) remained independently associated with the Gensini score. In this high-risk population, male gender and high levels of hsCRP, two variables that can be easily obtained, were associated with more extensive coronary disease, identifying patients with the highest potential of developing new coronary events.

Functional specializations within the tectum defense systems of the rat.

Here we review the differential contribution of the periaqueductal gray matter (PAG) and superior colliculus (SC) to the generation of rat defensive behaviors. The results of studies involving sine-wave and rectangular pulse electrical stimulation and chemical (NMDA) stimulation are summarized. Stimulation of SC and PAG produced freezing and flight behaviors along with exophthalmus (fully opened bulged eyes), micturition and defecation. The columnar organization of the PAG was evident in the results obtained. Defecation was elicited primarily by lateral PAG stimulation, while the remaining defensive behaviors were similarly elicited by lateral and dorsolateral PAG stimulation, although with the lowest thresholds in the dorsolateral column. Conversely, the ventrolateral PAG did not appear to participate in unconditioned defensive behaviors, which were only elicited by high intensity stimulation likely to encroach on adjacent regions. In the SC, the most important differences relative to the PAG were the lack of stimulation-evoked jumping in both intermediate and deep layers, and of NMDA-evoked galloping in intermediate layers. Therefore, we conclude that the SC may be only involved in the increased attentiveness (exophthalmus, immobility) and restlessness (trotting) of prey species exposed to the cues of a nearby predator. These responses may be distinct from the full-blown flight reaction that is mediated by the dorsolateral and lateral PAG. However, other evidences suggest the possible influences of stimulation schedule, environment dimensions and rat strain in determining outcomes. Overall our results suggest a dynamically organized representation of defensive behaviors in the midbrain tectum.

Recurrence of atrial septal defect in three generations.

Beginning with a patient presenting with an atrial septal defect (ASD) of the secundum type, the genealogy was identified in four affected individuals who belonged to three successive generations of the same family. The defects were visually confirmed in all individuals and were found to be anatomically similar. No other congenital malformations were present in these individuals. The genealogy was identified in 1972, when ASD recurred in two generations, and it was concluded that the mechanism of transmission was autosomal recessive. The fifth individual, identified 21 years later, and having an anomaly identical to that of the others, was the child of a couple who had no consaguinity and whose mother was a member of the previously studied genealogy. Considering the absence of phenotype in the parents and the rarity of the ASD gene in the general population, the occurrence of the uniparental disomy for this family nucleus, and the same autosomal recessive mechanism of transmission by this affected individual is possible. This study reports the familial occurrence of ASD by genetic mechanisms of transmission, emphasizing the necessity for genetic-clinical studies in members of the familial nucleus in order to detect new carriers, who usually are asymptomatic, thereby allowing for early and adequate treatment of individuals who may be affected.

Taquicardia atrial e funçäo renal / Atrial tachycardia and renal function

A taquicardia atrial induzida artificialmente em cäo produziu nas nossas condiçöes, alteraçäo importante da funçäo renal. Essa alteraçäo se manifestou por significativo aumento do volume urinário por minuto (1,3 ñ 0,12 no controle para 3,2 ñ 0,6ml/min no experimental) e da fraçäo de excreçäo de sódio (FENa) (de 2,3 ñ 0,3 no controle para 3,6 ñ 0,5), na presença de queda significante do fluxo sanguíneo renal (317 ñ 30,9 para 232 ñ 26,7 ml/min), sem alterar o ritmo de filtraçäo glomerular (66,1 ñ 6,7 no controle para 70,6 ñ 6,5 ml/min no experimental). Quanto à hemodinâmica sistêmica, observamos queda signficante do débito cardíaco e aumentos significantes da resistência vascular sistêmica e da pressäo de capilar pulmonar. Esses resultados demonstram que possivelmente fatores näo relacionados à hemodinâmica sistêmica, mas relacionados a alteraçöes hormonais, sejam responsáveis por estas alteraçöes