Repositório RCAAP

Purpose: We hypothesize that patients with type 1 diabetes (T1D) may have abnormal retinal vascular responses before diabetic retinopathy (DR) is clinically evident. Optical coherence tomography angiography (OCTA) was used to dynamically assess the retinal microvasculature of diabetic patients with no clinically visible retinopathy. Methods: Controlled nonrandomized interventional study. The studied population included 48 eyes of 24 T1D patients and 24 demographically similar healthy volunteers. A commercial OCTA device (AngioVue) was used, and two tests were applied: (1) the hypoxia challenge test (HCT) and (2) the handgrip test to induce a vasodilatory or vasoconstrictive response, respectively. The HCT is a standardized test that creates a mild hypoxic environment equivalent to a flight cabin. The handgrip test (i.e., isometric exercise) induces a sympathetic autonomic response. Changes in the parafoveal superficial and deep capillary plexuses in both tests were compared in each group. Systemic cardiovascular responses were also comparatively evaluated. Results: In the control cohort, the vessel density of the median parafoveal superficial and deep plexuses increased during hypoxia (F1,23 = 15.69, P < 0.001 and F1,23 = 16.26, P < 0.001, respectively). In the T1D group, this physiological response was not observed in either the superficial or the deep retinal plexuses. Isometric exercise elicited a significant decrease in vessel density in both superficial and deep plexuses in the control group (F1,23 = 27.37, P < 0.0001 and F1,23 = 27.90, P < 0.0001, respectively). In the T1D group, this response was noted only in the deep plexus (F1,23 = 11.04, P < 0.01). Conclusions: Our work suggests there is an early impairment of the physiological retinal vascular response in patients with T1D without clinical diabetic retinopathy.

Introduction: Optical coherence tomography angiography (OCT-A) is a novel diagnostic tool with increasing applications in ophthalmology clinics that provides non-invasive high-resolution imaging of the retinal microvasculature. Our aim is to report in detail an experimental protocol for analyzing both vasodilatory and vasoconstriction retinal vascular responses with the available OCT-A technology. Methods: A commercial OCT-A device was used (AngioVue®, Optovue, CA, United States), and all examinations were performed by an experienced technician using the standard protocol for macular examination. Two standardized tests were applied: (i) the hypoxia challenge test (HCT) and (ii) the handgrip test, in order to induce a vasodilatory and vasoconstriction response, respectively. OCT-A was performed at baseline conditions and during the stress test. Macular parafoveal vessel density of the superficial and deep plexuses was assessed from the en face angiograms. Statistical analysis was performed using STATA v14.1 and p < 0.05 was considered for statistical significance. Results: Twenty-four eyes of 24 healthy subjects (10 male) were studied. Mean age was 31.8 ± 8.2 years (range, 18–57 years). Mean parafoveal vessel density in the superficial plexus increased from 54.7 ± 2.6 in baseline conditions to 56.0 ± 2.0 in hypoxia (p < 0.01). Mean parafoveal vessel density in the deep plexuses also increased, from 60.4 ± 2.2 at baseline to 61.5 ± 2.1 during hypoxia (p < 0.01). The OCT-A during the handgrip test revealed a decrease in vessel density in both superficial (55.5 ± 2.6 to 53.7 ± 2.9, p < 0.001) and deep (60.2 ± 1.8 to 56.7 ± 2.8, p < 0.001) parafoveal plexuses. Discussion: In this work, we detail a simple, non-invasive, safe, and non-costly protocol to assess a central nervous system vascular response (i.e., the retinal circulation) using OCT-A technology. A vasodilatory response and a vasoconstriction response were observed in two physiologic conditions—mild hypoxia and isometric exercise, respectively. This protocol constitutes a new way of studying retinal vascular changes that may be applied in health and disease of multiple medical fields.

The article by Cekirdekci and Bugan published in this issue of the Journal opens up new prospects for improving our knowledge of microvascular angina (MVA). Clinical characterization of MVA and coronary artery disease (CAD) shows them to be examples of endothelial dysfunction at the level of the microcirculation and macrocirculation, respectively. There is now general consensus about both coronary microcirculation and macrocirculation. The authors selected biomarkers of hemorheology and inflammation and applied clinical methodology to diagnose and classify the patients and the control group. The latter were similar to the MVA and CAD patient groups regarding the presence of other associated diseases. The statistical computation performed confirmed the value of the control group used, which in my opinion is more realistic than other control groups selected without comorbidities.

Understanding Disaster Risk: A Multidimensional Approach presents the first principle from the UNISDR Sendai Framework for Disaster Risk Reduction, 2015-2030. The framework includes a discussion of risk and resilience from both a theoretical and governance perspective in light of ideas that are shaping our common future. In addition, it presents innovative tools and best practices in reducing risk and building resilience. Combining the applications of social, financial, technological, design, engineering and nature-based approaches, the volume addresses rising global priorities and focuses on strengthening the global understanding of vulnerability, displaced communities, cultural heritages and cultural identity. Readers will gain a multifaceted understanding of disaster, addressing both historic and contemporary issues. Focusing on the various dimensions of disaster risk, the book details natural and social components of risk and the challenges posed to risk assessment models under the climate change paradigm.

Riverine floods are responsible for significant human and material losses. Climate change scenarios pose additional challenges to flood susceptibility and risk assessment (Kundzewicz et al., 2014; Winsemius et al., 2015). While in recent decades the increases in global flood damage have mainly been driven by population and economic activity growth in flood-prone areas, climate change projections launch a high level of uncertainty about future impacts, showing, however, that flood protection standards can play a relevant part in mitigating such effects (Winsemius et al., 2015) [...]

In contemporary societies the media is oriented to cover disaster considering the intersection between three dimensions of risk: hazard, exposure and vulnerability. In the past, the prevailing theory was the naturalization of disasters that considered disasters as extreme events generated by the nature, where human action did not influence disaster occurrences and consequences. In view of the predominant theory of the nature of disasters, the objective of this work is to analyze the approach of journalism on disasters in the early 20th century. This research explores a catalogue of hydro-geomorphological events selected from the Disaster database for the period 1865–1909, which were reported by the Portuguese newspaper Diário de Notícias (DN). News analysis was guided by the News Protocol. The news set highlighted the naturalization of disasters, the focus on post-disaster consequences and local correspondents as the main source reporting disaster occurrences in the territory.

Plant sterols have been reported to decrease plasma concentrations of cholesterol without any side effects. To evaluate the effects on plasma cholesterol concentrations and the hemorheological parameters, we performed a study with hypercholesterolemic patients (n=19) treated with phytosterol-enriched milk (2 g/day). Hypercholesterolemic patients (n=15) of matched age drinking equal type of milk but without phytosterols were used as control group. Concentrations of total cholesterol, HDL-C, LDL-C and hemorheological parameters were measured in the beginning, after 15 and 30 days of milk intake. After 15 days of beverage intake, hypercholesterolemic subjects treated with phytosterol-enriched milk showed a significant decrease in plasma concentrations of total cholesterol and LDL-C by 9.62% (p<0.05) and 12.20% (p<0.05), respectively. After 30 days, a little increase in the total cholesterol and LDL-C concentrations were observed. In the hypercholesterolemic control group there were nonsignificant changes between plasma concentrations of total cholesterol, HDL-C and LDL-C during the study. The evaluation of plasma viscosity and erythrocyte aggregation shows no changes statistically significant during the study for both groups studied. The results obtained during the study show a positive effect with the phytosterol-enriched milk as plasma cholesterol-lowering as combined treatment for hypercholesterolemia.

The consumption of plant sterols has been shown to decrease plasma concentrations of cholesterol without adverse effects in human subjects. To evaluate if milk would be a good vehicle for phytosterols to lower plasma levels of cholesterol, we performed a randomized blind study with healthy subjects (n = 22) and hypercholesterolemic patients (n = 19), both groups treated with phytosterol-enriched milk (2 g/d). Another hypercholesterolemic group (n = 15) was used as a control group. Lipid profile and biochemical, hematologic, and hemorheological parameters were determined at the beginning and after 15 and 30 days of milk beverage intake. After 15 days of treatment, healthy individuals showed lowered total cholesterol and LDL-C levels, by 8.31% (P = .05) and 11% (P < .05), respectively. After 30 days of the trial, these values did not change significantly. Hypercholesterolemic patients treated with phytosterol-enriched milk demonstrated significantly diminished levels of total cholesterol and LDL-C concentrations, by 9.62% (P < .05) and 12.20 % (P < .05), respectively. After 30 days, an increase in the total cholesterol and LDL-C levels was observed for hypercholesterolemic subjects, 6.69% (P < .05) and 8.68% (P < .05), respectively. In the hypercholesterolemic control subjects, no difference was found between plasma levels of total cholesterol, high-density lipoprotein cholesterol, and LDL-C. Only healthy subjects showed significant changes during the intake of phytosterol-enriched milk. The results obtained indicate that phytosterol-enriched milk is a good vehicle for reducing plasma cholesterol in hypercholesterolemic subjects.

The interactions between membrane, peripheral and cytoskeleton proteins are responsible for the maintenance of erythrocyte deformability (EEI) and some of these interactions are modulated by PKC activity. Protein band 3 of the erythrocyte membrane is phosphorylated by phosphotyrosine kinases (PTK) and dephosphorylated by phosphotyrosine phosphatase (PTP). It was previously described by us a signal transduction mechanism that describes a possible pathway connecting an erythrocyte external membrane protein, acetylcholinesterase (AChE), with protein band 3. So how does PKC activity modulate EEI when protein band 3 is phosphorylated or dephosphorylated in absence or presence of AChE effectors? To answer this we used phorbol 12-myristate 13-acetate (PMA) as an activator and chelerythrine chloride as inhibitor of PKC and also band 3 modulators of band 3 phosphorylation degree, in presence and absence of AChE effectors in order to measure in whole blood samples EEI. Our results showed that erythrocyte deformability was significantly (i) decreased by inhibition of PKC, in absence and presence of AChE inhibitor velnacrine (ii) increased with PMA in absence and presence of ACh and (iii) decreased in presence of calpeptin in absence and presence of either chelerythrine or PMA. These results establish dependence between cytoskeleton proteins, PKC activity, band 3 phosphorylation degrees and EEI. Better understanding of those proteins interactions on transduction mechanisms might trigger possible targets for drug action that would modulate EEI.

Os complexos alcalino-carbonatíticos correspondem a produtos de magmas mantélicos gerados e instalados durante os eventos de reactivação tectono-magmática (rifting intracontinental) de terrenos antigos, predominantemente de idade Arcaica ou Proterozóica. As rochas carbonatíticas são rochas ígneas ricas com mais de 50% em volume de minerais carbonatados magmáticos, contendo menos de 10% de sílica. No território de Angola conhecem-se 45 complexos alcalino-carbonatíticos, os quais correspondem a estruturas (sub)intrusivas com morfologia (sub)circular que se distribuem ao longo de dois alinhamentos tectónicos intra-continentais activos desde o Cretácico Inferior (138-130 Ma). O Complexo Carbonatítico de Bailundo (CCB) situa-se a 11 km a NE da localidade de Bailundo e a cerca de 100 km a NNE da cidade de Huambo, numa região denominada Mungo. Apresenta uma morfologia típica de estrutura anelar com ≈ 7 km de diâmetro e ≈ 38.5 km2 de área. Desenvolve-se na Província Alcalino-Carbonatítica Diagonal Trans-angolana, definida ao longo de um alinhamento SW-NE desde o litoral até à fronteira com a República Democrática do Congo. O CCB compreende um domínio central, correspondendo ao Morro Belém (atingindo 1805 m de altitude), constituído por rochas carbonatíticas (ferro-carbonatitos e cálcio-carbonatitos) e um anel externo de fenitização. O tema desta tese tem como objectivo primordial o estudo dos Elementos de Terras Raras (ETR), nomeadamente: (i) sua abundância relativa; (ii) caracterização e distribuição espacial; (iii) fases minerais que as incorporam e seu modo de ocorrência e (iv) avaliação do potencial económico. Um último objectivo prende-se com a avaliação das características petrogenéticas do CCB, com base na análise dos ETR e elementos traço. Os ETR, também designados por lantanídeos, compreendem os 15 metais do grupo IIIA da Tabela Periódica com número atómico 57 ao 71; a estes associam-se ítrio (Y), escândio (Sc) e tório (Th). As suas aplicações em diversas soluções tecnológicas, levam ao contínuo aumento da procura. Neste contexto, o estudo dos complexos carbonatíticos é muito importante, pois contêm frequentemente, para além de outros elementos, concentrações anómalas em ETR. Em termos gerais, os fenitos e carbonatitos examinados revelam textura e natureza composicional relativamente heterogénea que reflecte a sobreposição de transformações desencadeadas por processos tardi-magmáticos e hidrotermais subsequentemente intensificados pela meteorização química. Estes processos revelam-se cruciais ao desenvolvimento de associações minerais singulares; tal é o caso dos minerais portadores de ETR como flúor-carbonatos (parisite), fosfatos (rabdofanite e apatite) e óxidos (pirocloro e cerianite). Estas fases minerais, em conjunto com outras descritas em trabalhos anteriores (e.g. Santos, 2010), portadoras de metais de interesse, tornam o CCB um complexo polimetálico Fe-Nb-ETR (Ba) com potencial económico significativo. A avaliação do potencial económico em [ETR+Y+Sc] (= REO*) revela conteúdos medianos elementares mais elevados para os ferro-carbonatitos com 0.81 wt% (x= 1.26 wt%), seguido dos cálcio-carbonatitos com 0.64 wt% (x= 1.16 wt%) e fenitos com 0.33 wt% (x= 0.75 wt%); as anomalias em ETR desenvolvem-se nomeadamente sector central e SW dos ferro-carbonatitos e nas faixas de transição para os cálcio-carbonatitos. Os minerais do grupo do pirocloro (pirocloro e Ba-pirocloro) ocorrem em todas as litologias, excepto o Ba-pirocloro que apenas se encontra nas rochas carbonatíticas; apresentam-se sob a forma de cristais euédricos de granularidade grosseira, disseminados pela matriz e apresentando quantidades traço em ETR (≤ 7.78 wt%), mas elevados conteúdos em Nb (67.57 wt% - ferro-carbonatitos; 69.57 wt% - cálcio-carbonatitos; 64.95 wt% - fenitos) e Ba (19.16 - ferro-carbonatitos e 14.1 wt% - cálcio-carbonatitos). A cerianite ocorre nos ferro-carbonatitos sob a forma de grãos de dimensão muito reduzida disseminados pela matriz e com conteúdos em ETR de 64.4 wt% (essencialmente Ce com 56.3 wt%); os minerais do grupo da rabdofanite [brockite, rabdofanite-(Ce), rabdofanite-(Nd)] são encontrados nos exemplares dos ferro-carbonatitos e formam disseminações matriciais tardias, bem como preenchimentos de redes anastomosadas de veios, filonetes e venulações, apresentando conteúdos em ETR2O3 variáveis entre 21.2 e 61.2 wt%; a parisite presente nos cálcio-carbonatitos ocorre em agregados de grão fino e morfologia radial e fibrosa, disseminados na matriz e desenvolvendo intercrescimentos com outros flúor-carbonatos (e.g. bastnäsite, synchysite) cuja identificação fidedigna não foi possível; apresenta conteúdos medianos em ETR2O3 de 44.8 wt%. A apatite, assim como o pirocloro, apresenta conteúdos traço em ETR (≤ 1.13 wt%) e ocorre em exemplares dos cálcio-carbonatitos e fenitos em secções prismáticas e basais, constituindo por vezes agregados monominerálicos. São observadas três tipologias de mineralização: (i) mineralizações primárias tipificadas pela fase pirocloro, (ii) magmático-hidrotermais tipificadas pelo desenvolvimento de Ba-pirocloro, parisite e apatite e (iii) supergénicas (hidrotermais?) tipificadas pelo desenvolvimento de cerianite e rabdofanite. Os padrões de concentração em ETR e multi-elementares normalizados relativamente ao condrito e manto primitivo, respectivamente, afiguram-se compatíveis com a distribuição e abundância das fases minerais portadoras em ETR. Mostram elevados conteúdos em ETR tipificados por forte enriquecimento em ETRL relativamente a ETRP, onde o La e o Ce constituem os ETRL mais abundantes. De salientar os enriquecimentos em BaO e SrO; os empobrecimentos bem marcados em Rb, K, Zr-Hf e Ti e a fraccionação Nb/Ta (em média 14016 e 3521.97 para os ferro-carbonatitos e cálcio-carbonatitos, respectivamente) e Zr/Hf (em média 36.97 e 59.02 para os ferro-carbonatitos e cálcio-carbonatitos, respectivamente), com valores superiores ao manto primitivo (Nb/Ta = 17 e Zr/Hf = 36; Sun & McDonough, 1989), congruentes com o metassomatismo carbonatítico. Sublinha-se a elevada fraccionação Nb/Ta atribuída à fraccionação do pirocloro. O exame comparativo da assinatura petrogenética do CCB com as informações publicadas para os complexos carbonatíticos de Angola e Brasil torna-se importante, na medida em que permite caracterizar a província carbonatítica de Angola e definir (potencialmente) guias para a prospecção e pesquisa mineral. A análise realizada confirma a potencialidade de Bailundo em ETR relativamente a alguns complexos carbonatíticos angolanos (Sulima-Monte Verde, Logonjo, Tchivira-Bonga e Lupongola) e brasileiros (Juquiá e Jacupiranga). Virulundo (complexo carbonatíticos angolano) e Itapirapuã, Angico dos Dias e Araxá (complexos carbonatíticos brasileiros) mostraram conteúdos em ETR próximos e, por vezes, superiores (e.g. Araxá e Virulundo) aos obtidos para Bailundo. A distribuição de concentração em ETR normalizados relativamente ao condrito para os complexos angolanos e brasileiros revela, tal como para Bailundo, forte enriquecimento em ETR, nomeadamente ETRL. Os padrões de concentração em elementos incompatíveis revelam assinaturas geoquímicas semelhantes às obtidas para Bailundo, destancando-se diferenças nos valores de BaO e SrO, mais elevadas para Bailundo que nos restantes complexos (angolanos e brasileiros), com excepção de Araxá que apresenta valores de SrO mais elevados. A elevada fraccionação Nb/Ta apenas se observa para os carbonatitos angolanos, incluindo Bailundo (excepto Tchivira-Bonga), e para o carbonatito brasileiro de Araxá.

We assessed the redox thiol status influence on nitric oxide (NO) metabolism and efflux in erythrocytes stimulated with acetylcholinesterase substrate (acetylcholine, ACh) and inhibitor (velnacrine maleate, VM). Erythrocyte suspensions from healthy donors were incubated with increasing concentrations of dithiothreitol (1-50microM), in the presence and absence of acetylcholine/velnacrine (10microM). Levels of NO, nitrite/nitrate, S-nitrosohemoglobin, peroxynitrite and S-nitrosoglutathione were determined by spectrofluorimetric and spectrophotometric methods. Dithiothreitol significantly mobilized NO toward nitrite/nitrate and S-nitrosoglutathione, and decreased the amount of NO efflux. Both ACh/VM induce changes on the levels of erythrocyte nitrite/nitrate dependent on the DTT concentration. Higher levels of peroxynitrite and S-nitrosoglutathione were seen with velnacrine in presence of DTT 1 and 50microM. We concluded that dithiothreitol-induced activation of erythrocyte thiol status decreases NO efflux and allows greater intracellular NO mobilization onto different derivative molecules, both in the absence and presence of acetylcholinesterase substrate and inhibitor.

We present detailed simulation results of localised hemodynamics for a cluster of rolling leukocytes under shear-thinning blood flow using a lattice Boltzmann model. Leukocytes were modelled as hard spheres moving through a venule of rigid walls. The used hemorheological parameters were obtained from in vivo measurements in blood samples of Wistar rats. Velocities, shear stresses and torques were computed and visualised for each individual cell, for the cluster and for the fluid. We have found that the flow is mainly three-dimensional due to the swirling and the asymmetry of the formed vortices during the recruitment process. The shear stress is maximum on a cap covering the cell and a cone with its base on the endothelial wall at the contact region. The leukocyte is recruited to the wall with the aid of trapping vortices and four stagnant regions surrounding the cell in addition to lateral motion towards the wall. We suggest that these phenomena are highly dependent on the angular velocity of the leukocyte and on the attractive force between the leukocyte and the endothelial wall. For a moving cluster of recruited leukocytes, velocities and shear stresses as well as torques are computed. It was found that the shear stress at the endothelium gets higher as the cluster moves in the main stream enabling early initialisation of the rolling process.

Sport participation has been advocated as a strategy to improve adolescents' mental health. However, how these variables evolve during the adolescent years is uncertain. The objective of the present work was to examine the longitudinal associations of sports participation and depressive symptoms in adolescents. Participants were 525 Spanish adolescents (50.3% boys), aged between 12 and 15 years old (M = 13.45, SD = 0.69). They were enrolled in 18 secondary schools located in Andalusia (Spain) in the first two academic years of Compulsory Secondary Education. Data were collected in three waves, separated by one year, by administering self-report measures of depressive symptoms and sport participation. Repeated measures analyses of variance were conducted to examine the change in depressive symptoms and sport participation, and a latent growth curve model was tested to examine the change in depressive symptoms controlling initial sport participation and gender. At each wave, more frequent sport participation was related to lower depressive symptoms. Two years after the first assessment, adolescents became more depressed but not more active. Less active adolescents had more depressive symptoms in each assessment time. At all moments of assessment, girls were less active and reported more depressive symptoms. Moreover, girls had a higher increase in depressive symptoms than boys. Promotion of physical activity (PA) as a mental health strategy needs to consider gender differences as boys and girls have different patterns of presentation of depressive symptoms throughout adolescence.

O presente estudo subordina-se à análise do contrato de cash pooling. O seu estudo justifica-se pelo facto do contrato de cash pooling constituir um verdadeiro meio alternativo de financiamento, que visa gestão consolidada da tesouraria de um grupo de sociedades e justifica-se pela necessidade de evitar-se custos inerentes ao financiamento externo, bem como minimizar o valor dos juros, que aumentaram, fruto da crise no sector financeiro. Entretanto, a nossa pesquisa procura demonstrar que os principais motivos que norteiam a implementação do contrato de cash pooling, devem ser confrontados com os entraves estabelecidos pela lei das sociedades comerciais, bem como pela lei das instituições financeiras. A primeira abordagem, vai no sentido de apresentar a figura, o seu conceito, as suas modalidades, modo de funcionamento e a natureza jurídica da figura. É também feita uma análise do direito comparado do sistema de cash pooling, a nível dos países africanos francófonos, em países como a África do Sul e Nigéria que demonstram um estudo superficial da figura e de países da Europa, onde o estudo da figura tem-se mostrado mais desenvolvido. Finalmente, no terceiro capítulo será feita uma abordagem aos problemas jurídicos que a implementação da figura de cash pooling pode provocar ao ordenamento jurídico Angola, bem como as possíveis soluções para resolução destes problemas, com vista a alcançar os objectivos das sociedades participantes no grupo.

The Blockchain technology that revolutionized the world was launched in 2008 with the publication of the paper undertitled ‘Bitcoin: A Peer-to-peer Electronic Cash System’, by the enigmatic pseudonym of Satoshi Nakamoto, which described a version of electronic cash that allowed online payments to be directly made from one party to another. Succeeding the ground-breaking transformation that was carried out, cryptocurrencies commenced to shift the monetary system to a predominantly digital one, more adapted to the reality of a fast, technological, audacious and computerized world, interconnected by the largest and worldwide network ever seen. Behind this ingenious structure comes the concept of Blockchain, Virtual Currencies and Distributed Ledger Technology (DLT), innovative and high-tech tools of security and storage that aim to reduce mistakes, frauds and costs. Decentralization, transparency and immutability are the three pillars that allow the safekeeping of private relations in order to generate confidence, reduction of finance transaction costs as well as reinforce any and all public relations involved. On the other hand, these revolutionary novelties follow an unregulated social pattern, fostering an unbridled advance by generating vast uncertainties, diversity and asymmetries. In order to reduce its vulnerabilities, these technologies are in most need of a financial and tax regulatory effort to align them under a uniform concept, as well its main characteristics and aptitudes. Beyond the legislative and conceptual approach, the challenges of a digital era and the financial revolution lead the world to innovative methods to solve issues that have arisen. The Blockchain, DLT and Virtual Currencies provide transformation and key answers that might contribute to efficient, scientific and solid solutions in real-time to governmental activities, specially tax administrations. Considering its foremost democratic and accountable features, they can be used in e-identities, personal records, assets inventories, citizenships, border control, tax transparency, financial and tax compliance, and especially smart contracts on public administration. From this perspective, it is key to scrutinize the efficiency of the new world’s Blockchain paradigm in order to verify its utmost reliability prospective.

An exaggerated accumulation of type I and type III fibrillar collagens occurs throughout the free wall and interventricular septum of patients with primary hypertension and left ventricular hypertrophy (LVH). In the present study the serum concentration of procollagen type III amino terminal peptide (PIIIP) was measured to determine the value of this peptide as a potential marker of ventricular fibrosis in hypertensive patients, particularly those with LVH.

Objective: Physical fitness (PF) and physical activity (PA) are inversely associated with body mass index and waist circumference (WC), whereas sedentary time (ST) seems to boost obesity in youth. The aim was to examine the associations of each selected PF test, PA-related exposures, and specific ST patterns with obesity and determine the most relevant ones, in a large sample of a school-aged adolescent. Methods: The sample consisted of 2696 Portuguese youth aged 10 to 18 years. Height, weight, and WC were measured. PA and ST components were measured using accelerometry. PF was evaluated using a battery of tests. Results: The Progressive Aerobic Cardiovascular Endurance Run (PACER) and push-up tests seemed to be the exposures that presented the strongest and more consistent associations with obesity, independent of PA/ST profiles (P < .05). The second exposure of relevance for adolescent obesity level was the breaks in ST with a negative relationship regardless of PA/PF profiles (P < .05). Finally, ST accumulated in periods of <30 minutes, and moderateto-vigorous PA were favorably associated with obesity, independent of ST/PF. Conclusions: Independent of PA and ST, cardiorespiratory fitness (CRF), measured by PACER, was associated with obesity markers. This may be in part due to the dependence of PACER performance on adiposity. Also, limiting prolonged ST and promoting interruptions in this behavior were associated with obesity. These associations suggest that future research should examine other strategies beyond PA promotion for tackling obesity that consider CRF and breaking ST.

The use of aspirin, while well established in the secondary prevention of cardiovascular events, remains controversial in the primary prevention of these events in the general adult population. In this setting, aspirin showed a significant but modest decrease of cardiovascular event incidence at the cost of a significantly increased risk of bleeding, a pattern that is also seen in higher risk patients, such as diabetics. It becomes exceedingly important to identify other patient clusters that would benefit from cardiovascular risk reduction at the best benefit/risk ratio.

The aim of this work is to study the relationships between blood pressure profile, cardiac manifestations of high blood pressure and P-III-P as an index of fibrosis. We studied hypertensives without other diseases using echocardiography (M and B mode, and Doppler), ABPM using a Spacelabs 9000, and plasma levels of P-III-P. The model ANOVA, one way, was used for the statistical analysis. The level of significance was accepted for p<0.01 (two-tailed probabilities). The 73 hypertensives studied were divided in two subgroups: dippers (49 subjects) and non-dippers (21 subjects). The non-dipper group had an higher degree of left ventricular hypertrophy obtained by the higher measurement of the inter-ventricular septum thickness (p<0.01), posterior wall thickness (p<0.01), and an higher index of left ventricular mass (p<0.01) then the dippers, they also had higher levels of fibrinogen (p<0,01) and higher plasma levels of P-III-P then dippers (p<0.01). It was found a correlation between the fibrinogen, P-III-P levels and index of left ventricular mass (p<0,01). In conclusion, P-III-P might be a marker of tissue lesion, and fibrinogen might be a plasma marker of gravity of hypertension. This gravity can be express by the degree of left ventricular hypertrophy.

Purpose: Acanthosis nigricans (AN) is a hyperpigmented dermatosis associated with obesity and insulin resistance (IR). There is no consensus whether AN extension scoring offers added value to the clinical estimation of IR. In this study we aimed to assess and score AN using both a short and an extended version of the scale proposed by Burke et al. and analyze the relationships of both versions with hyperinsulinemia and IR. Methods: We analyzed data from 139 overweight adolescents (body mass index ≥85th percentile) aged 12–18 with (n=67) or without (n=72) AN who were followed at a pediatric obesity clinic. Results: Adolescents with AN had higher levels of insulin (d=0.56, P=0.003) and HOMA-IR (d=0.55, P=0.003) compared to those without. Neither the short nor the extended versions of AN scores explained either hyperinsulinemia (β=1.10, P=0.316; β=1.15, P=0.251) or IR (β=1.07, P=0.422; β=1.10, P=0.374). The presence of AN alone predicted hyperinsulinemia and the presence of IR in 7.3% (β=2.68, P=0.008) and 7.1% (β=2.59, P=0.009) of adolescents, respectively. Conclusion: Screening for AN at the neck and axilla is a noninvasive and cost-effective way to identify asymptomatic overweight adolescents with or at risk of developing IR.