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Introduction: The thrombin generation assay (TGA) assesses the risk of developing thrombotic events. The aim of this study was to investigate the association between the use of oral contraceptives (OCs) and hormone therapy (HT) with the TGA and resistance to activated protein C (APC). Methods: Cross-sectional study with women from the Longitudinal Study of Adult Health (ELSA-Brasil). TGA was performed by the CAT method. Results: There was an association between all parameters of the TGA and the use of OCs and an association of lag time and peak time with the use of HT. Conclusion: The TGA allows us to assess the hypercoagulability status and may be useful in the management of female hormones users. Introducción: La prueba de generación de trombina (TGT) evalúa el riesgo de desarrollar eventos trombóticos. El objetivo de este estudio fue investigar la asociación entre el uso de anticonceptivos orales (AO) y la terapia hormonal (TH) con TGT y la resistencia a la proteína C activada (CaP). Métodos: Estudio transversal con mujeres del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil). La TGT se realizó mediante el método CAT. Resultados: Hubo asociación entre todos los parámetros TGT y el uso de CO y asociación de latencia y tiempo pico con el uso de TH. Conclusión: TGT permite la evaluación del estado de hipercoagulabilidad y puede ser útil en el manejo de mujeres usuarias de hormonas. Introdução: O teste de geração de trombina (TGT) avalia o risco de desenvolvimento de eventos trombóticos. O objetivo deste estudo foi investigar a associação entre o uso de contraceptivos orais (COs) e a terapia hormonal (TH) com a TGT e a resistência à proteína C ativada (PCa). Métodos: Estudo transversal com mulheres do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). A TGT foi realizada pelo método CAT. Resultados: Houve associação entre todos os parâmetros do TGT e o uso de COs e associação do tempo de latência e pico com o uso de TH. Conclusão: A TGT permite avaliar o estado de hipercoagulabilidade e pode ser útil no manejo de usuárias de hormônios femininos.

BackgroundHigh-sensitivity C reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of hsCRP with the risk of all-cause mortality in a multiethnic Brazilian population.MethodsBaseline data (2008–2010) of a cohort of 14 238 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. hsCRP was assayed with immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after a mean follow-up of 8.0±1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease.ResultsThe risk of death increased steadily by quartiles of hsCRP, from 1.45 (95% CI 1.05 to 2.01) in quartile 2 to 1.95 (95% CI 1.42 to 2.69) in quartile 4, compared with quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the HR was unaffected by the exclusion of participants who had self-reported medical history of diabetes, cancer and chronic obstructive pulmonary disease.ConclusionsOur study shows that hsCRP level is associated with mortality in a highly admixed population, independent of a large set of lifestyle and clinical variables.

We evaluated the influence of an Antarctic expedition, consisting of 26-day ship travel followed by 24-day camping in the Antarctic field during the summer season, on hormonal responses, autonomic cardiac control, and mood states in individuals that live in tropical regions. Data collection was carried out in 10 individuals on the 2nd, 16th, and 26th days aboard the ship (characterized by exposure to low-luminosity and temperature-controlled environments) and on the 4th, 11th, and 23rd days of camping in the Antarctic field (prolonged exposure to natural luminosity and cold environments). Morning samples of saliva (to determine testosterone and cortisol concentrations) and blood [to determine thyroid-stimulating hormone (TSH) and thyroxine (T4) concentrations] were obtained. Next, resting heart rate variability (HRV) was recorded, and the volunteers answered a mood questionnaire. Samples of saliva for measurement of melatonin concentration were obtained at night. At the end of ship travel, blood TSH and salivary melatonin increased by 15.6% and 72.3%, respectively, whereas salivary cortisol reduced by 37.1% compared to initial values and T4 reduced by 12.2% compared to 16th day. These hormonal changes occurred alongside increased depression score and biphasic changes in HRV parameters; for example, the RMSSD, a parasympathetic-related parameter, initially decreased by 47.8% and then returned towards baseline values by the end of the ship travel. In contrast, during the camp period, blood TSH and T4 reduced by 26.5% and 34.1%, respectively, and salivary cortisol increased by 72.1%, without concomitant changes in melatonin and HRV. Also, tension score transiently reduced and then increased towards the pre-camp score by the end of the field period. Testosterone remained unaltered throughout the expedition. In conclusion, ship travel and camping in Antarctica induced distinct neuroendocrine changes, cardiac autonomic regulation, and mood states. These specific changes most likely resulted from exposure to different natural luminosity, degrees of confinement, and ambient temperature in these environments.

Background and aims Non–high-density lipoprotein cholesterol (non-HDL-C) goals are defined as 30 mg/dL (0.78 mmol/L) higher than the respective low-density lipoprotein cholesterol (LDL-C) goals. This definition, however, do not consider the population distribution of non-HDL-C, which could represent a more appropriate individual goal when both markers are discordant. The aim of this study is to establish non-HDL-C goals at the same population percentiles of LDL-C. Methods Non-HDL-C values were assigned at the same percentiles correspondent to the LDL-C treatment goals for 14,837 participants from the Longitudinal Study of Adult Health (ELSA-Brasil) with triglycerides levels ≤ 400 mg/dL (4.52 mmol/L). We also assessed the frequency of reclassification, defined as the number of subjects with LDL-C levels in the recommended therapeutic category, but with non-HDL-C levels above or below the category. Results The non-HDL-C values, based on correspondent LDL-C population percentiles, were 92 (2.38), 122 (3.16), 156 (4.04), 191 (4.95), and 223 mg/dL (5.78 mmol/L). Among participants with LDL-C Conclusions Our results demonstrated that non-HDL-C percentiles-based goals were up to 8 mg/dL (0.21 mmol/L) lower than the guidelines recommended goal and had a profound impact on the reclassification of participants, notably when LDL-C was

Antarctic climate is challenging, since the cold, wind and sensory monotony are stressful stimuli to individuals. Moreover, camp activities and heavy clothes may contribute to increase physiological strain. Thus, we aimed to characterise the physiological demand of a 24-day period in the Antarctic field and then to evaluate the effect of this expedition on the aerobic fitness in individuals with heterogeneous initial aerobic fitness (as determined by estimating maximum oxygen consumption – V̊O2MAX). Before and after the 24-day period in Antarctica, 7 researchers and 2 mountaineers were subjected to incremental tests to estimate their V̊O2MAX. Field effort was characterised by measuring heart rate (HR). During the field trips, their HR remained 33.4% of the recording time between 50–60% HRMAX, 22.3% between 60–70% HRMAX, and only 1.4% between 80 and 90% HRMAX. The changes in estimated V̊O2MAX during the expedition depended on the pre-expedition aerobic fitness. The post-expedition V̊O2MAX increased by 5.9% and decreased by 14.3%in individuals with lower (researchers) and higher (mountaineers) initial V̊O2MAX, respectively. We concluded that physical effort in the Antarctic field is characterised as predominantly of low- to moderate-intensity. This effort represented an effective training load for individuals with lower initial V̊O2MAX, but not for those with higher V̊O2MAX.

Platelet volume indices (PVI) are associated with hematological and non-hematological diseases, notably cardiovascular and cerebrovascular diseases. The establishment of PVI reference intervals (RIs) are essential to evaluate whether these indices are useful in clinical practice. Healthy-associated RIs have not yet been established for the Brazilian population. Here, we determined RIs of PVI for a health adult population, participants of the Brazilian Longitudinal Study of Adult Health ELSA-Brasil. A total of 580 individuals out of an initial sample of 3115 subjects constituted the healthy reference sample. To be part of the study, individuals had to fulfill the following criteria: blood count within 2 hours of collection, no use of continuous medication, self-rated health as good or very good, no reported diagnosis of diabetes and/or arterial hypertension, not smoking, lack of metabolic syndrome, body mass index (BMI)

Background:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.