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Objective:: To investigate polypharmacy among the elderly living in the urban area of Florianopolis, in the state of Santa Catarina, Brazil, estimating the prevalence and associated factors., Methods:: This is a cross-sectional population-based study with a sample of 1,705 individuals aged 60 years old or older, between 2009 and 2010. The dependent variable was polypharmacy (defined as "use of five or more medications"). The following exploratory variables were utilized: sociodemographic data, use of health services and self-rated health status. Prevalence ratios (PR) were estimated by multivariate analysis using the Poisson regression., Results:: The mean for the medications used by the elderly population was 3.8 (ranging from 0 to 28). The prevalence of polypharmacy was 32%, with 95% confidence interval (95% CI) 29.8 - 34.3. The characteristics presenting a positive association with polypharmacy were: female gender (PR = 1.27; 95%CI 1.03 - 1.57), increasing age (PR = 1.38; 95% CI 1.08 - 1.77), negative self-rated health status (PR = 1.99; 95% CI 1.59 - 2.48) and medical appointments in the 3 months prior to the interview (PR = 1.89; 95% CI 1.53 - 2.32). The groups of medication most utilized by the elderly individuals in polypharmacy were those indicated for the cardiovascular system, digestive tract and metabolism, as well as the nervous system., Conclusion:: The pattern of medication use among this elderly population is within the national average. The prevalence of polypharmacy and the characteristics associated with it were similar to those found in other regions of Brazil.

Objective: To describe the sample plan, operational aspects, and strategies used in the 2009/2010 and 2013/2014 EpiFloripa Aging Study., Methods: The EpiFloripa Aging is a population-based longitudinal study with 1,705 older adults (60 years or more) living in the municipality of Florianópolis, State of Santa Catarina, Brazil, in 2009/2010 (baseline). The research was conducted with a face-to-face interviews, organized into blocks of identification, socioeconomic, mental health, health and life habits, global functionality, falls, physical activity, morbidities, use of health services, use of medications, food, oral health, and violence, evaluated in the first (2009/2010) and in the second wave (2013/2014). Additionally, in the second wave, we investigated the issue of discrimination and quality of life., Results: The response rate of the first wave was 89.2% (n = 1,705). The baseline sample, with predominance of women (63.9%), was similar to the 2010 Census regarding age for women and slightly different for younger men. In the second wave, 1,197 participants were interviewed (response rate of 70.3%). Follow-up losses were only observed for the variable age group (p = 0.003), and predominantly for those aged 80 years or more. Mortality data linkage and active search for participants were used as a follow-up strategies., Conclusions: This study used strategies that were able to help locate the participants and maintain adherence, which ensured a good response rate during investigations.

This study investigated the therapeutic potential of Euterpe oleracea extract (açaí) on the growth and survival of endometriotic lesions using an experimental model. Twenty female Sprague-Dawley rats were randomized into two groups after the implantation and establishment of autologous endometrium onto the peritoneum abdominal wall and treated with 200 mg/kg hydroalcoholic solution extract from açaí stone or vehicle via gastric tube for 30 consecutive days. Body weight, lesion surface areas, histological and immunohistochemistry analyses of vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2), metalloproteinase-9 (MMP-9), cyclooxygenase-2 (COX-2) and F4-80 were performed. Levels of VEGF, VEGFR-2, MMP-9 and COX-2 mRNA were measured. Flow cytometry of F4-80 was performed, and ELISA immunoassays measured prostaglandin E2 (PGE2), VEGF and nitric oxide (NO) and concentrations. Macrophage cell line J774.G8 was treated with 10, 20, and 40 μg/mL of açaí for 24, 48 and 72 h, and cell viability was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Açaí treatment significantly decreased the implant size, and histological examination indicated atrophy and regression. A reduction in immunostaining and mRNA expression of VEGF, MMP-9 and COX-2 was observed, and F4-80 was lower in the treated group than the control group. The treated group also exhibited lower concentrations of PGE2, VEGF and NO compared to the control group. Macrophages cells treated with 20 and 40 μg/ml of açaí reduced cell viability in about 50% after 24, 48 and 72 h. Our results suggest that açaí effectively suppressed the establishment and growth of endometriotic lesions, and this agent is a promising novel pharmacological therapeutic treatment for endometriosis., Competing Interests: The authors have declared that no competing interests exist.

Injury or death by strangulation, unless otherwise explained, is almost always homicidal. Accidental strangulation may occur but only very rarely. We present such a case of accidental strangulation and survival in a motorbike pillion rider. A long scarf (dupatta) clad woman, sitting at the back of a two wheeler motorbike, fell after her long scarf got caught in the back wheel. The lady was first taken to a local clinic and then later was referred to a hospital for a suspected spine injury where she made an uneventful recovery. This case report exposes the precarious position of women pillion riders wearing a long scarf and emphasizes the need for extra caution and the need for wheel guards on spoked wheels in particular., (© The Author(s) 2016.)

Objective: To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril., Methods: We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20), paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day) or trandolapril (2 to 4 mg/day)., Results: The groups were similar prior to treatment (p<0.05), and both drugs reduced blood pressure at rest (p<0.001). During treatment, trandolapril caused a greater increase in functional capacity (+31%) than captopril (+17%; p=0.01) did, and provided better blood pressure control during exercise, observed as a reduction in the variation of systolic blood pressure/MET (trandolapril: 10.7 1.9 mmHg/U vs 7.4 1.2 mmHg/U, p=0.02; captopril: 9.1 1.4 mmHg/U vs 11.4 2.5 mmHg/U, p=0.35), a reduction in peak diastolic blood pressure (trandolapril: 116.8 3.1 mmHg vs 108.1 2.5 mmHg, p=0.003; captopril: 118.2 3.1 mmHg vs 115.8 3.3 mmHg, p=0.35), and a reduction in the interruption of the tests due to excessive elevation in blood pressure (trandolapril: 50% vs 15%, p=0.009; captopril: 50% vs 45%, p=0.32)., Conclusion: Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.