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- ItemAcesso aberto (Open Access)Pediatric dyslipidemia is associated with increased urinary ACE activity, blood pressure values, and carotidal-femoral pulse wave velocity(Spring Nature, 2023-03-24) Cruz, Nayara Azinheira Nobrega [UNIFESP]; Oliveira, Lilian Caroline Gonçalves [UNIFESP]; Fernandes, Fernanda Barrinha; Zaniqueli, Divanei dos Anjos; Oliosa, Polyana Romano; Mill, José Geraldo; Casarini, Dulce Elena [UNIFSP]; https://lattes.cnpq.br/8161092089656847This study aimed to evaluate the enzymatic activity of the angiotensin-converting enzyme (ACE) in children and adolescents to investigate their relationship with dyslipidemia and other cardiometabolic alterations. Anthropometric measurements, blood pressure (BP), and fasting lipid concentrations were taken from 360 subjects. Categorization was done according to the levels of each lipoprotein (total cholesterol, triglycerides (TG), LDL-C, HDL-C, and non-HDL-C) into three groups: normolipidemic (NL), borderline (BL), and dyslipidemic (DL). Enzymatic activity in urine was measured using the substrates Z-FHL-OH and hippuryl-HL-OH (h-HL-OH) and the ACE activity ratio (Z-FHL-OH/h-HL-OH) was calculated. Dyslipidemic levels of HDL-C, TG, and LDL-C were observed in 23%, 9%, and 3% of the participants, respectively, and were more frequent in obese children (Chi-square, p < 0.001). ACE activity ratio was augmented in BL(HDL-C) when compared to NL(HDL-C) (5.06 vs. 2.39, p < 0.01), in DL(LDL-C) in comparison to BL(LDL-C) and NL(LDL-C) (8.7 vs. 1.8 vs. 3.0, p < 0.01), and in DL(non-HDL-C) than in BL(non-HDL-C) and in NL(non-HDL-C) (6.3 vs. 2.1 vs. 2.9, p = 0.02). The groups with impaired HDL-C and TG levels presented an increased diastolic BP percentile, and a higher systolic BP percentile was observed in BL(TG) and DL(TG). The carotidal-femoral pulse wave velocity (cfPWV) was higher in the groups with DL levels of TG and LDL-C than in NL groups. Hypertriglyceridemia was associated with higher cfPWV. No direct impact of the ACE activity on BP values was observed in this cohort, however, there was an association between hyperlipidemia and ACE upregulation which can trigger mechanisms driving to early onset of hypertension and cardiovascular disease. Graphical abstract exemplifying the cohort, categorization of subjects into the groups NL normolipidemic, BL borderline, DL dyslipidemic, methods, and main findings. Pediatric dyslipidemia was consistent with dyslipidemia secondary to obesity (DSO), associated with higher urinary angiotensin-converting enzyme (ACE) activity ratio, BP blood pressure values, and carotidal-femoral pulse wave velocity (cfPWV).
- ItemAcesso aberto (Open Access)Retrospective analysis of 20 years of activity of the Brazilian malignant hyperthermia hotline service(SBA, 2024-02-08) Silva, Helga Cristina Almeida da [UNIFESP]; Souza, Cezar Daniel Snak de [UNIFESP]; Andrade, Pamela Vieira de [UNIFESP]; Santos, Joilson Moura dos[UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; http://lattes.cnpq.br/0844918862241102; http://lattes.cnpq.br/0222501308244832; http://lattes.cnpq.br/3536599065009604; http://lattes.cnpq.br/6003112490584362; http://lattes.cnpq.br/6456862416626215In Brazil, since 1991 there has been a telephone service to guide the diagnosis and treatment of anesthetic complications related to MH. The MH Hotline is available 24 hours a day, seven days a week, and has a single and exclusive telephone line (+55-11-55759873) to guide Brazilian health professionals in managing MH and its differential diagnoses.[3] The primary objective of the present study was to analyze the characteristics of calls to the Brazilian MH Hotline between 2001‒2019.
- ItemAcesso aberto (Open Access)Postoperative rhabdomyolysis due to neuroleptic malignant syndrome associated with droperidol and metoclopramide(Mirosław Czuczwar, 2023-11-22) Silva, Helga Cristina Almeida da [UNIFESP]; Orfali, Guilherme di Camillo [UNIFESP]; Machado, Henrique Louzan [UNIFESP]; Andrade, Pamela Vieira [UNIFESP]; Santos, Joilson Moura [UNIFESP]; Silva, Mary dos Santos [UNIFESP]; Amaral, José Luiz Gomes do [UNIFESP]; http://lattes.cnpq.br/0844918862241102Neuroleptic malignant syndrome (NMS) is a complication of neuroleptics that can rarely occur per operatively. A female patient, 28 years old, ASA I, was admitted for bilateral mammoplasty with breast implant. During the procedure, under sedation and thoracic epidural, she received droperidol and metoclopramide. After two hours, she evolved with myalgia, tachycardia, tachypnea, hyperthermia, and increased creatine kinase (CK) levels (9,702 IU/L). After supportive therapy, there was a complete improvement. A further extensive investigation with physical/neurological examination, baseline serum CK level, and electroneuromyography was normal. Molecular study for myopathies did not detect any pathogenic variant and the in vitro muscle contracture test for malignant hyperthermia was negative. Diagnosis of exclusion of NMS was performed. The anaesthesiologist must recognize NMS manifestations, allowing early treatment.
- ItemAcesso aberto (Open Access)Academic success, engagement and self-efficacy of first-year university students: personal variables and first-semester performance(Editum - Servicio de Publicaciones de la Universidad de Murcia, 2024-01-01) Casanova, Joana R.; Sinval, Jorge [UNIFESP]; Almeida, Leandro S.; http://lattes.cnpq.br/9227052078286181Higher education can be hugely transformative for students and has an important role in empowering human capital, innovation, and society’s social, cultural, and environmental development. The expansion of higher education has promoted access for a more heterogeneous mix of students, but ensuring access does not guarantee academic success. This paper aims to analyse predictors of academic achievement in 447 first-year students in their 1st and 2nd semesters, considering variables including sex, age, parents’ educational level and grades on entering higher education, along with levels of students’ academic engagement and self-efficacy after some weeks at university. Results show statistically significant paths for sex, age, and GPA to 1st-semester achievement, for parent’s educational levels to perceived self-efficacy, for students’ academic engagement to 1st-semester achievement, and 1st-semester achievement to 2nd-semester achievement. Students’ academic engagement also had an indirect effect on the 2nd-semester achievement. The correlation between academic engagement and self-efficacy was positive, strong, and statistically significant. The model explained 35.2% of the variance in 2nd-semester achievement and 15.0% of the variance in 1st-semester achievement. Knowledge about predictors of academic achievement and the importance of engagement and self-efficacy will support timely interventions, promoting success and preventing failure and dropout.
- ItemRestritoHow would a completely homogeneous malignant hyperthermia susceptible sample be?(SBA, 2023-10-21) Silva, Helga Cristina Almeida da [UNIFESP]; Andrade, Pamela Vieira de [UNIFESP]; Valim, Lívia Maria [UNIFESP]; Santos, Joilson Moura [UNIFESP]; Castro, Isac de [UNIFESP]; Amaral, Jose Luiz Gomes do [UNIFESP]; http://lattes.cnpq.br/0844918862241102Dear Editor, We read with interest the letter to the editor by Finsterer et al.1 We appreciated the interest in our article2 and the comments, which gave us the opportunity to include additional data from our research and deepen the discussion on how would a completely homogeneous malignant hyperthermia (MH) susceptible sample be.