In the August 2008 Issue of Clinics

Abstract

In this issue of CLINICS we would like to highlight a study by Karadeniz et al. on accumulation of oxidized low-density-lipoprotein in a model of murine liver fibrosis induced by cholestasis. Following a 21 day bile duct ligation, authors report higher levels of malondialdehyde, lower levels of superoxide-dismutase, and positive oxLDL cholesterol staining were found in liver homogenates of jaundiced rats, as compared to sham operated animals. They suggest that oxLDLs are produced as an intermediate agent during exacerbated oxidative stress or, alternatively, that they contribute to mechanisms underlying the process of liver fibrosis.This issue includes five reports on original research related to the cardiovascular system: da Luz et al. studied 374 high risk patients submitted to coronary angiography and found that a high ratio of triglycerides and HDL-cholesterol is a powerful and independent marker of coronary disease: the increment of one quartile of that ratio is followed by a 30% increase in the frequency of extensive CAD, adjusted for other lipid variables and is the greatest influence among lipid variables.Bocalini et al. analyzed the effect of physical exercise on functional and quality of life in 22 patients with grade II and III heart failure (NYHA). Twenty two patients were randomized into training vs. non-training groups and the former went through a 6-months exercise program. Fitness and quality of life indices were evaluated and showed that guided and monitored physical exercise is safe and able to improve the functional capacity and quality of life in heart failure patients.Carvalho et al. studied 25 patients in optimized beta-blocked heart failure with an average left ventricular ejection fraction of 30%, and fourteen controls to evaluate heart rate dynamics during a treadmill cardiopulmonary exercise test. They found that no patient in the heart failure group reached the maximum heart rate for their age, despite the fact that the percentage increase of heart rate was similar to sedentary normal subjects. They proposed that a heart rate increase in optimized beta-blocked heart failure patients during cardiopulmonary exercise test over 65% of the maximum age-adjusted value should be considered an effort near the maximum.Costa e Silva et al. compared conventional and transdisciplinary care in a tertiary outpatient clinic for patients after their first acute myocardial infarction. A total of 153 patients were allotted to conventional (n=75) or transdisciplianry (n=78) care. Patients were followed for 180 days. The primary outcome was clinical improvement, as evaluated by an index including reduction of body weight, lowering of blood pressure, smoking cessation, increase in physical activity, and compliance with medication. Compliance with diet and visits was higher for transdisciplinary care vs. conventional care; however, the transdisciplinary approach did not provide more clinical benefits than the conventional approach.Casella et al. describe the testing of a practical protocol to measure common ...