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Background A common complication in patients undergoing peritoneal dialysis (PD) is a chronic inflammatory state and anemia that can be treating by recombinant human erythropoietin (rHuEPO). Higher required dose of rHuEPO could be expected in patients with higher cytokine levels. Additionally, it is known that peritoneal inflammation can be correlated with systemic inflammation and this could contribute to the compromised rHuEPO required dose in anemic patients with end stage renal disease (ESRD). Thus, the current study aimed to evaluate the association between levels of systemic and local interferon (IFN)-γ, interleukin (IL)-17 and other cytokines and the dose of rHuEPO used by patients undergoing PD for the correction of anemia. Methods Thirty-one patients under PD using rHuEPO were evaluated in this cross-sectional study. Plasma and dialysate levels of IL-2, IL-4, IL-6, IL-10, IL-17, tumour necrosis factor (TNF)-α and IFN-γ were determined using the Cytometric Bead Array TM kit (CBA; BD Bioscences, San Jose, CA). The relation between the levels of each cytokine levels and the tertiles of rHuEPO were plotted on box-plot graphics and then the medians of interleukins levels were compared by median comparison test. The significance level adopted was 5% and the analysis was performed by the softwares STATA (version 12.0) and GraphPad Prism 3.0. Results The median of IL-17 and IFN-γ plasma levels were significant higher in the group with higher rHuEPO dosage. However, this association was not observed in the dialysate levels, as well as was not observed a relationship between the other plasma and dialysate cytokines evaluated in this study and the dose of rHuEPO. Conclusions Our study found increased IL-17 and IFN-γ plasma, but no dialysate levels, in patients receiving higher doses of rHuEPO, suggesting may exist a relationship between systemic inflammation of ESRD, and the necessary levels of rHuEPO for the correction of anemia in these patients. [ABSTRACT FROM AUTHOR]

Studies have shown that acute coffee ingestion can affect cardiovascular autonomic activity, although the chronic effects on heart rate variability (HRV) remain controversial. Method: A cross-sectional study with baseline data (2008-2010) from ELSA-Brasil cohort of 15,105 (aged 35-74), based in six Brazilian states. Coffee consumption in the previous 12 months was measured using the semi-quantitative food frequency questionnaire, and HRV was obtained through electrocardiographic tracings during 10 min at rest. Independent association between the frequency of coffee consumption "never or almost never", "≤1 cup/day", "2-3 cups/day", "≤3 cups/day", and HRV was estimated using generalized linear regression, adjusting for socio-demographic characteristics, health-related behavior, markers of abnormal metabolism, and the presence of coronary artery disease. Further, we applied Bonferroni correction in the full models. Results: The mean age was 52 years (standard deviation (SD) = 9.1), and 52% was female; 9.5% never/almost never consumed coffee. In univariate analysis, coffee consumers had reduced values of HRV indexes, but after full adjustments and correction for multiple comparisons, these associations disappeared. A trend of reduction in HRV vagal indexes was observed in those that consumed ≤3 cups of coffee/day. Conclusion: Most of the effects attributed to the chronic use of coffee on the HRV indexes is related to the higher prevalence of unhealthy habits in coffee users, such as smoking and alcohol use. Adjustment for confounding factors weaken this association, making it non-significant. The effect of higher daily doses of coffee on the autonomic system should be evaluated in further studies. [ABSTRACT FROM AUTHOR]

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Purpose: To determine whether desirable diabetes control is associated with polypharmacy and to evaluate potential drug interactions (DI) in participants with diabetes mellitus in the Brazilian Longitudinal Study on Adult Health (ELSA-Brasil)., Methods: This cross-sectional study included 1418 participants with medical diagnosis of diabetes at study baseline (2008-2010). Polypharmacy was defined as the use of ≥5 drugs. We described the frequency of the most common pharmacological groups used by patients and the potential DI.The association between desirable diabetes control (normal A1c, blood pressure and lipid levels) and polypharmacy was investigated using logistic regression., Results: Most participants were men (52.5%), mean age 57.6 (SD 8.4) years, educated to the university level (39.4%), and self-reported as white (42.9%). In this study, 7.1% (n = 101) of participants had desirable control of diabetes, while 40.4% (n = 573) used polypharmacy, and this use was not significantly associated with better diabetes control (adjusted odds ratio (OR = 1.35 [95%CI 0.86-2.13] P = .19).The pharmacological groups most frequently used were oral antidiabetics followed by acetylsalicylic acid, angiotensin-converting enzyme inhibitors (ACE inhibitors) and statins.The prevalence of potentially mild, moderate and severe DI were, respectively, 2.5%, 14.7% and 0.9%; however, in the desirable control of DM group, these potential DI were related to comorbidity control., Conclusion: Faced with the importance of achieving optimal control of diabetes and minimizing risks of potential DI, these results, which are in keeping with previous findings described in the literature, might indicate that guidelines for the patient-centered management of control of diabetes must be revised., (© 2021 John Wiley & Sons Ltd.)

Studies have shown that acute coffee ingestion can affect cardiovascular autonomic activity, although the chronic effects on heart rate variability (HRV) remain controversial., Method: A cross-sectional study with baseline data (2008-2010) from ELSA-Brasil cohort of 15,105 (aged 35-74), based in six Brazilian states. Coffee consumption in the previous 12 months was measured using the semi-quantitative food frequency questionnaire, and HRV was obtained through electrocardiographic tracings during 10 min at rest. Independent association between the frequency of coffee consumption "never or almost never", "≤1 cup/day", "2-3 cups/day", "≥3 cups/day", and HRV was estimated using generalized linear regression, adjusting for socio-demographic characteristics, health-related behavior, markers of abnormal metabolism, and the presence of coronary artery disease. Further, we applied Bonferroni correction in the full models., Results: The mean age was 52 years (standard deviation (SD) = 9.1), and 52% was female; 9.5% never/almost never consumed coffee. In univariate analysis, coffee consumers had reduced values of HRV indexes, but after full adjustments and correction for multiple comparisons, these associations disappeared. A trend of reduction in HRV vagal indexes was observed in those that consumed ≥3 cups of coffee/day., Conclusion: Most of the effects attributed to the chronic use of coffee on the HRV indexes is related to the higher prevalence of unhealthy habits in coffee users, such as smoking and alcohol use. Adjustment for confounding factors weaken this association, making it non-significant. The effect of higher daily doses of coffee on the autonomic system should be evaluated in further studies., Competing Interests: The authors declare no conflicts of interest.

The exact function of eosinophils in cancer, particularly in oral squamous cell carcinoma (OSCC), has not yet been elucidated and the possible antitumor effect of these leukocytes is associated with the release of cytotoxic proteins, particularly eosinophil cationic protein (ECP). The aim of this study was to evaluate the effect of ECP on human OSCC lines and to provide novel insights into the role of eosinophils in these tumors. The viability of the SCC-4 and SCC-25 OSCC cell lines was assessed by colorimetric assay using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). The cells were plated into 96-well plates in Dulbecco's modified Eagle's medium/Ham's nutrient mixture F12 supplemented with 10% fetal bovine serum. After 24 h, the indicated concentration of ECP (0-10 µ M) was added to each sample. The plate was read using a microplate reader at a wavelength of 570 nm. The association between variables was estimated by linear regression analysis. There was a significant inverse association between ECP concentrations with SCC-4 (β=0.16, P=0.019) and SCC-25 cell viability (β=0.24, P=0.006). To the best of our knowledge, the present study was the first to investigate the effects of ECP on OSCCs and to demonstrate a significant inverse association between ECP concentrations with SCC-4 and SCC-25 cell viability.

Kidney transplantation is the key for patients with end-stage renal disease, improving quality of life and longer survival. However, kidney transplant triggers an intense inflammatory response and alters the hemostatic system, but the pathophysiological mechanisms of these changes are not completely understood. The aim of this cross-sectional cohort study was to investigate hemostatic biomarkers in Brazilian renal transplanted patients according to renal function and time after transplantation. A total of 159 renal transplanted patients were enrolled and D-Dimer (D-Di), Thrombomodulin (TM), von Willebrand Factor (VWF), and ADAMTS13 plasma levels were assessed by ELISA. An increase of D-Di was observed in patients with higher levels of creatinine. ADAMTS13 levels were associated with creatinine plasma levels and D-Di levels with Glomerular Filtration Rate. These results suggested that D-Di and ADAMTS13 can be promising markers to estimate renal function. ADAMTS13 should be investigated throughout the posttransplant time to clarify the participation of this enzyme in glomerular filtration and acceptance or rejection of the graft in Brazilian transplanted patients.

Objective: To explore to what extent patients with diabetes agree with their physicians on diabetes management and whether the agreement varies according to patients' socio-demographic characteristics., Methods: A cross-sectional study was conducted among patients with diabetes and their Family Health physicians in 108 healthcare centres in Belo Horizonte, Brazil. Patients and physicians were interviewed face-to-face using standard questionnaires. Physicians were unaware of which of their patients would be interviewed. Their responses were compared using descriptive statistics and Cohen's weighted kappa., Results: 282 patient-physician pairs were included. Kappa coefficients were often low, the highest was found for presence of diabetic foot and the lowest for kidney disease. Physicians tended to overestimate patients' risk of diabetes complications and underestimate patients' adherence to all diabetes self-management activities as well as diabetes control. Moreover, the agreement rate regarding adherence to diet, foot care and medicine prescriptions was significantly higher among male, younger and higher educated patients., Conclusion: Results indicate that physicians' recommendations are generally poorly apprehended by their patients, especially by the lower educated, compromising the goal of patient-centred care., Practice Implications: Educational programmes need to incorporate strategies to improve the comprehension and effectiveness of physician-patient communication, especially with the most socially vulnerable groups., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)