BackgroundThe association between high-sensitivity C-reactive protein and recurrent major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction who undergo primary percutaneous coronary intervention remains controversial.ObjectiveTo investigate the potential association between high-sensitivity C-reactive protein and an increased risk of MACE such as death, heart failure, reinfarction, and new revascularization in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.MethodsThis prospective cohort study included 300 individuals aged >18 years who were diagnosed with ST-elevation myocardial infarction and underwent primary percutaneous coronary intervention at a tertiary health center. An instrument evaluating clinical variables and the Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk scores was used. High-sensitivity C-reactive protein was determined by nephelometry. The patients were followed-up during hospitalization and up to 30 days after infarction for the occurrence of MACE. Student's t, Mann-Whitney, chi-square, and logistic regression tests were used for statistical analyses. P values of ≤0.05 were considered statistically significant.ResultsThe mean age was 59.76 years, and 69.3% of patients were male. No statistically significant association was observed between high-sensitivity C-reactive protein and recurrent MACE (p = 0.11). However, high-sensitivity C-reactive protein was independently associated with 30-day mortality when adjusted for TIMI [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.07-1.51; p = 0.005] and GRACE (OR, 1.26; 95% CI, 1.06-1.49; p = 0.007) risk scores.ConclusionAlthough high-sensitivity C-reactive protein was not predictive of combined major cardiovascular events within 30 days after ST-elevation myocardial infarction in patients who underwent primary angioplasty and stent implantation, it was an independent predictor of 30-day mortality.

Objective To evaluate spermatogenesis in rats chronically exposed to finasteride, as the recent use of finasteride in young men to prevent hair loss has raised concerns about chronic use and fertility. Materials and methods Male Wistar rats (4 months old)were selected and divided into two groups. Group 1 (17 rats) received a finasteride suspension of 2 mg/kg/ day in saline solution, 5 days/week for 10 months; group 2 (eight rats of the same age) were treated with placebo for the same period. At the end of the exposure the testes were weighed and processed for histological analysis. Spermatogenesis was evaluated as the mean number of seminiferous tubules with and without spermatozoids in their lumen, in five random fields on the same slide. Student's t-test was used to assess differences in the groups.

RESUMO -Racional -Em torno de 30% dos pacientes com cirrose hepática apresentam infecção bacteriana na admissão hospitalar ou a desenvolvem durante a mesma. As infecções bacterianas são responsáveis por até 25% das mortes nesta população de pacientes. Objetivo -Avaliar a prevalência de infecção bacteriana em uma população de pacientes cirróticos internados em hospital geral, bem como correlacionar sua presença com a etiologia alcoólica da hepatopatia, com o grau de comprometimento da função hepática e com a presença de hemorragia digestiva alta. Pacientes e métodos -Foram avaliadas retrospectivamente 541 internações hospitalares consecutivas em 426 pacientes com cirrose hepática, internados no período de 1992 a 2000. A média de idade destes pacientes foi de 50,5 anos (15-95), sendo 71,2% do sexo masculino. Etiologia alcoólica da hepatopatia esteve presente em 35,4% dos pacientes. Alta ou óbito do paciente no período da internação hospitalar foi considerado como principal desfecho. O nível de significância considerado na análise estatística foi de 5%. Resultados -As infecções bacterianas ocorreram em 25% dos cirróticos (135 episódios). Destas, as mais freqüentes foram: a infecção do trato urinário em 31,1%, a peritonite bacteriana espontânea em 25,9% e a broncopneumonia em 25,2%. Ocorreu associação de infecção urinária e broncopneumonia em 3,7% e infecção de pele e tecido celular subcutâneo em 11,11%. Bacteremia sem foco definido ocorreu nos quatro casos restantes (2,9%). Houve associação da presença de infecção com a etiologia alcoólica da hepatopatia, com a classificação de Child-Pugh e com a ocorrência de hemorragia digestiva alta. A mortalidade hospitalar foi maior nos pacientes infectados (8,9%), estando a mesma associada ao grau de disfunção hepatocelular. Conclusões -A ocorrência de infecção bacteriana no paciente cirrótico hospitalizado é freqüente e correlaciona-se com a etiologia alcoólica da hepatopatia, com a reserva funcional hepática e com a presença de sangramento digestivo. Além disso, a presença de infecção bacteriana correlacionase com mau prognóstico.DESCRITORES -Infecções bacterianas. Cirrose hepática. Hemorragia gastrointestinal.

BackgroundExcessive weight is a cardiovascular risk factor since it generates a chronic inflammatory process that aggravates the endothelial function.ObjectiveTo evaluate the endothelial function in individuals with excess weight and mild dyslipidemia using brachial artery flow-mediated dilation (BAFMD), and the association of endothelial function with anthropometric and biochemical variables.MethodsCross-sectional study that included 74 individuals and evaluated anthropometric variables (body mass index [BMI], waist-hip ratio [WHR], waist circumference [AC], and percentage of body fat [PBF]), biochemical (blood glucose, insulinemia, ultrasensitive C-reactive protein, fibrinogen, total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol) and endothelial function (BAFMD, evaluated by ultrasound). The statistical analysis was performed with SPSS, version 16.0. To study the association between the variables, we used chi-square, Student's t and Mann-Whitney tests, and Pearson's correlation. Logistic regression analyzed the independent influence of the factors. Values of p < 0.05 were considered significant.ResultsThe participants had a mean age of 50.8 years, and 57% were female. BMI, WC, WHR, and PBF showed no significant association with BAFMD. The male gender (p = 0.02) and higher serum levels of fibrinogen (p = 0.02) were significantly and independently associated with a BAFMD below 8%.ConclusionsIn individuals with excess weight and mild untreated dyslipidemia, male gender and higher levels of fibrinogen were independently associated with worse BAFMD.

Oral ingestion of DHEA on a chronic basis in the rat increases serum DHEAS and total testosterone without any evident change in prostate weight or histology.