Abstract Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled used interventions with physical activity longer than six months in school children aged 6-12 years, and evaluated body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Data analysis was performed using a random-effects model and a P value <0.05 was considered statistically significant. Results A total of 28,603 articles were retrieved, and 17 RCTs (11,952 subjects) were included. Physical activity interventions were associated with reduction in SBP [−2.11mmHg (95%CI −3.67, −0.54), I243%], DBP [−2.08mmHg (95%CI −3.68, −0,49), I265%] and TG [-0.08mmol/L (95% CI -0.13, -0.03), I20%], and increase in TC [0.17mmol/L (95%CI 0.04, 0.30), I20%]. However, the interventions were not associated with reductions in BMI [−0.03 kg/m2 (95%CI −0.17, 0.10), I20%]. Conclusion This update confirms and reinforces the beneficial effects of physical activity intervention in reducing systolic and diastolic blood pressure and TG levels.

ABSTRACT The aim of this study was to evaluate the osseointegration of implants placed in rat tibia sites grafted with Deproteinized Bovine Bone (DBB) and Native Bone (NB). Twenty-eight rats were divided into two groups according to the type of substrate in which the implants were to be placed: NB – implants placed in native bone; DBB – implants placed in areas grafted with DBB. In the DBB group, the bone defect was made and filled with the bone substitute 60 days before placing the implant. The animals were euthanized 15 or 45 days after implant placement. Osseointegration was assessed by the removal torque, volume of mineralized tissues around the implants (BV/TV), bone-implant contact (%BIC), and bone between threads (%BBT). The implants placed in NB presented higher removal torque (8.00 ± 1.26 Ncm vs. 2.33 ± 0.41 Ncm at 15 days and 22.00 ± 2.44 Ncm vs. 4.00 ± 1.41 Ncm at 45 days), higher %BV/TV (47.92 ± 1.54% vs. 33.33 ± 4.77% at 15 days and 70.06 ± 0.91% vs. 39.89 ± 5.90% at 45 days), higher %BIC (39.68 ± 5.02% vs. 9.12 ± 5.56% at 15 days and 83.23 ± 4.42% vs. 18.81 ± 7.21% at 45 days), and higher %BBT (34.33 ± 5.42% vs. 13.24 ± 8.72% at 15 days and 82.33 ± 3.13% vs. 22.26 ± 8.27% at 45 days) than the implants placed in DBB grafted areas. The degree of osseointegration was lower in implants placed in the area grafted with DBB than in NB in rat tibias.

RESUMO O objetivo deste estudo foi avaliar a osseointegração de implantes instalados em sítios enxertados com Osso Bovino Desproteinizado (DBB) e Osso Nativo (NB). Vinte e oito ratos foram alocados em dois grupos de acordo com o tipo de substrato onde os implantes foram colocados: NB - Implantes colocados em osso nativo; DBB - Implantes instalados em áreas enxertadas com DBB. No grupo DBB, o defeito ósseo foi confeccionado e preenchido com o substituto ósseo 60 dias antes da instalação do implante. Os animais foram sacrificados após 15 e 45 dias da colocação do implante. A osseointegração foi avaliada pelo torque de remoção, volume de tecidos mineralizados ao redor dos implantes (%BV/TV), contato direto do osso com o implante (%BIC), e área de osso entre roscas dos implantes (%BBT). Os implantes instalados em NB tiveram um maior torque de remoção (8.00 ± 1.26 Ncm vs. 2.33 ± 0.41 Ncm aos 15 dias e 22.00 ± 2.44 Ncm vs. 4.00 ± 1.41 Ncm aos 45 dias), um maior %BV/TV (47.92 ± 1.54% vs. 33.33 ± 4.77% aos 15 dias e 70.06 ± 0.91% vs. 39.89 ± 5.90% aos 45 dias), um maior %BIC (39.68 ± 5.02% vs. 9.12 ± 5.56% aos 15 dias e 83.23 ± 4.42% vs. 18.81 ± 7.21% aos 45 dias), e um maior %BBT (34.33 ± 5.42% vs. 13.24 ± 8.72% aos 15 dias e 82.33 ± 3.13% vs. 22.26 ± 8.27% aos 45 dias) que os implantes colocados nas áreas enxertadas com DBB. Implantes instalados em áreas enxertadas com DBB apresentaram menor osseointegração que os implantes instalados no osso nativo em tíbias de ratos.

Abstract Acromegaly is a rare disease characterized by changes in the bone and soft tissue systems, induced by excess growth hormone and insulin-like growth factor type 1. Among the skin lesions associated with acromegaly is cutis verticis gyrata, an hypertrophic, and coarse folding of the skin of the scalp, an association of uncommon incidence and unknown prevalence. This case report describes the case of a patient diagnosed with acromegaly at age 60 with previously unidentified cutis verticis gyrata. This report aims to review the literature on cutis verticis gyrata and its unusual association with acromegaly.

ABSTRACT Objective: Dyslipidemia is prevalent among patients with hypopituitarism, especially in those with growth hormone (GH) deficiency. This study aimed to evaluate the response to statin therapy among adult patients with dyslipidemia and hypopituitarism. Subjects and methods: A total of 113 patients with hypopituitarism following up at a neuroendocrinology unit were evaluated for serum lipid levels. Dyslipidemia was diagnosed in 72 (63.7%) of these patients. A control group included 57 patients with dyslipidemia and normal pituitary function. The distribution of gender, age, weight, and dyslipidemia type was well balanced across both groups, and all participants were treated with simvastatin at doses adjusted to obtain normal lipid levels. Results: Patients with hypopituitarism and dyslipidemia presented deficiency of TSH (69%), gonadotropins (69%), ACTH (64%), and GH (55%) and had a similar number of deficient pituitary axes compared with patients with hypopituitarism but without dyslipidemia. All patients with dyslipidemia (with and without hypopituitarism) had lipid levels well controlled with doses of simvastatin ranging from 20-40 mg/day. The mean daily dose of simvastatin was not significantly different between patients with and without hypopituitarism (26.7 versus 23.5 mg, p = 0.10). Similarly, no significant variation in simvastatin dose was observed between patients with different causes of hypopituitarism, presence or absence of GH deficiency, number of deficient pituitary axes, prior pituitary radiation therapy or not, and presence or absence of obesity. Conclusions: Patients with GH deficiency without GH replacement showed good response to simvastatin at a mean dose equivalent to that used in individuals with dyslipidemia and normal pituitary function.

Resumo Os adenomas secretores de prolactina (PRL) estão associados à alta incidência de cefaleia. O papel da hiperprolactinemia no contexto da dor de cabeça não está claro, nem o efeito da redução dos níveis da PRL na cefaleia. Métodos: O presente estudo longitudinal avaliou pacientes hiperprolactinêmicos (69), quanto à presença e às características da cefaleia antes e após o tratamento da hiperprolactinemia. Resultados: Cefaleia foi relatada por 45 (65,2%) pacientes, independente da etiologia da hiperprolactinemia. O fenótipo de enxaqueca foi mais prevalente (66,6%). Os medicamentos usados no tratamento da cefaleia não foram alterados durante o estudo. A primeira linha de tratamento da hiperprolactinemia foram os agonistas dopaminérgicos. Na última reavaliação, o nível de PRL sob tratamento estava dentro da faixa de referência em 54,7% dos casos, observando-se resolução completa ou parcial da cefaleia em 75% dos casos. A mediana de PRL neste momento em pacientes com resolução completa da cefaleia foi de 17 ng/mL, nos que relataram recuperação parcial foi de 21 ng/mL, e naqueles em que a cefaleia não se alterou foi de 66 ng/mL, com uma diferença significativa entre o grupo com resolução completa da cefaleia versus o grupo com cefaleia inalterada (p=0,022). Nos casos com resolução completa da cefaleia, a queda mediana nos níveis de PRL foi de 89% e nos casos com resolução parcial de cefaleia de 86%, ambos significativamente diferentes (p<0,001) da queda nos casos com cefaleia inalterada. Conclusão: Os dados permitem concluir que, nesta série, na maioria dos casos, a redução do nível de PRL foi seguida pela cessação ou alívio da dor.

Abstract Prolactin (PRL) secreting adenomas are associated with high incidence of headache. The role of hyperprolactinemia in the headache context is not clear, nor is the effect of its treatment on headache. Methods: The present longitudinal study evaluated hyperprolactinemic patients (69), in terms of presence and characteristics of headache before and after hyperprolactinemia treatment. Results: Headache was reported by 45 (65.2%) patients, independent of the etiology of hyperprolactinemia. The migraine phenotype was the most prevalent (66.6%). Medications used in the treatment of headache not changed during the study. The first line of treatment of hyperprolactinemia was dopaminergic agonists. In the last reevaluation, PRL level under treatment was within the reference range in 54.7% of the cases, and it was observed complete or partial resolution of the headache in 75% of the cases. The median PRL at this time in patients with complete headache resolution was 17 ng/mL, in those who reported partial recovery was 21 ng/mL, and in those in whom the headache did not change was 66 ng/mL, with a significant difference between the group with complete headache resolution vs. the group with unchanged headache (p=0.022). In the cases with complete headache resolution, the median fall on PRL levels was 89% and in those cases with partial headache resolution 86%, both significantly different (p<0.001) from the fall in the cases with an unchanged headache. Conclusion: Data allow us to conclude that, in this series, in the majority of cases the reduction in the level of PRL was followe3d by cessation or relief of the pain.

Introduction: prolactinomas are pituitary adenomas that express and secrete prolactin. These patients are overweight and the mechanisms are being studied. Goals: assess nutritional and metabolic status of overweight patients with and without hyperprolactinemia caused by prolactinoma and compare them. Materials and methods: cross-sectional study, patients with body mass index (BMI) ≥ 25 kg/m² with and without prolactinoma: 1) 20 normoprolactinemic (NPrl) with prolactinoma; 2) 23 hyperprolactinemic (HPrl) with prolactinoma; 3) 28 controls without prolactinoma or alterations in prolactin levels. Evaluated through anthropometric, dietetics, and biochemical assessment. Results: of the 71 patients evaluated, most were obese women with macroprolactinomas. All three groups had diets with low caloric and monounsaturated fatty acid (MUFA) intake, the NPrl group had low carbohydrate (CHO) intake and high lipid (LIP) and saturated fatty acid (SFA) intake, and the NPrl and HPrl groups had appropriate intake of polyunsaturated fatty acids (PUFA). The HPrl group had elevated total cholesterol. HDL cholesterol was below the recommended threshold for most patients. No statistically significant differences were found in anthropometric and biochemical variables among the groups. Conclusions: most patients with prolactinomas and controls are obese and metabolically similar regardless of prolactin levels. All groups presented low caloric and MUFA intake. Protein, LIP, SFA, and cholesterol were significantly different among the groups, the NPrl group ingested less amount of protein and greater of fat. Snacking between meals and changes of food consumption on weekends was reported by most patients. This is the first study comparing patients with prolactinomas and controls, both with overweight, regarding food consumption and feeding behavior.

Introducción: los prolactinomas son adenomas hipofisarios que expresan y secretan prolactina. Estos pacientes tienen sobrepeso y el mecanismo está en estudio. Objetivos: evaluar el estado nutricional y metabolico de los pacientes con sobrepeso con y sin hiperprolactinemia causada por prolactinoma y compararlos. Materiales y métodos: es un estudio transversal con pacientes con índice de masa corporal (IMC) . 25 kg/m² con y sin prolactinoma: 1) 20 normoprolactinemicos (NPrl) con prolactinoma; 2) 23 hiperprolactinemicos (HPrl) con prolactinoma; 3) 28 controles sin prolactinoma o alteraciones en los niveles de prolactina. Evaluados a traves de estudios antropometricos evaluacion dietética y bioquímica. Resultados: de los 71 pacientes evaluados, la mayoria eran mujeres obesas con macroprolactinomas. Los tres grupos tenian dietas con baja ingesta de calorias y acidos grasos monoinsaturados (MUFA), el grupo NPrl tenía ingesta baja en carbohidratos (CHO) y alta en lipidos (LIP) y acidos grasos saturados (SFA), y los grupos NPrl y HPrl tenían ingesta apropiada de ácidos grasos poliinsaturados (PUFA). El grupo HPrl tenía el colesterol sérico por encima del valor recomendado, mientras el colesterol HDL estaba por debajo del valor recomendado en la mayoría de los pacientes. No se encontraron diferencias estadísticamente significativas en las variables antropométricas y bioquimicas entre los grupos. Conclusiones: la mayoría de los pacientes con prolactinomas y los controles son obesos y metabolicamente similares, independientemente de los niveles de prolactina. Todos los grupos presentaron baja ingesta de calorías y de ácidos grasos monoinsaturados. Proteinas, LIP, SFA y colesterol fueron significativamente diferentes entre los grupos, el grupo de NPrl ingiere menos cantidad de proteína y mayor de grasa. La mayoría de los pacientes manifiestan picar entre las comidas y cambios en el consumo de alimentos los fines de semana. Este es el primer estudio que compara a pacientes con prolactinomas y controles, ambos con sobrepeso, en cuanto a consumo de alimentos y comportamiento alimentario.

Toxoplasmose destaca-se como uma doença global que tem felinos como hospedeiros definitivos. No município de Natal, Rio Grande do Norte, Brasil, dois parques são notáveis por sua importância ecológica e social. Este estudo teve como objetivo investigar a presença de Toxoplasma gondii em gatos de rua, morcegos e pequenos mamíferos não-voadores nestas duas reservas ecológicas. No total, as amostras biológicas foram obtidas de 154 mamíferos, 92 animais selvagens de ambas as áreas e 62 gatos domésticos do Parque da Cidade. No total, 22 (53,7%) mamíferos silvestres não-voadores, 11 (21,5%) morcegos e 28 (52,8%) gatos foram positivos para IgG anti-T. gondii utilizando o Teste de Aglutinação Modificado (≥ 25). Foi possível detectar a presença de DNA de T. gondii, por meio de uma amplificação molecular de um fragmento do gene B1 (155bp), em 92 amostras de tecido de animais selvagens, incluindo Didelphis albiventris, Monodelphis domestica, Artibeus lituratus, Carollia perspicillata e Glossophaga soricina. Dos 62 gatos examinadas pelo mesmo método molecular, DNA de T. gondii pode ser detectado em quatro gatos. Neste estudo, observou-se a circulação de T. gondii em espécies selvagens e gatos domésticos, demonstrando o envolvimento de animais domésticos e selvagens no ciclo de T. gondii.

Toxoplasmosis stands out as a global disease that has felines as definitive hosts. In the municipality of Natal, Rio Grande do Norte State, Brazil, two parks are notable for their ecological and social importance. This study aimed to investigate the presence of Toxoplasma gondii in short hair cats, bats and small non-volant mammals in these two ecological reserves. Altogether, biological samples were obtained from 154 mammals, 92 wild animals from both areas and 62 domestic cats of the Parque da Cidade. In total, 22 (53.7%) non-volant wild mammals, 11 (21.5%) bats and 28 (52.8%) cats were positive for IgG anti-T. gondii antibodies using the Modified Agglutination Test (≥ 25). It was possible to detect the presence of T. gondii DNA, by means of a molecular amplification of a B1 gene fragment (155bp), in 92 tissue samples from wild animals, including Didelphis albiventris, Monodelphis domestica, Artibeus lituratus, Carollia perspicillata and Glossophaga soricina. Of the 62 cats examined by the same molecular method, T. gondii DNA could be detected in 4 cats. In this study, it was observed the circulation of T. gondii in wild species and domestic cats, demonstrating the involvement of wild and domestic animals in the cycle of T. gondii.

As áreas degradadas demandam prioridade nas ações de revegetação, e os estudos ainda são escassos ou insuficientes para orientar, de forma efetiva, as práticas de recuperação. Os objetivos foram verificar o crescimento, desenvolvimento e capacidade de sobrevivência de indivíduos das espécies implantadas na área de preservação permanente no entorno do reservatório da Fazenda Mandaguari, em Indianópolis, Minas Gerais, como subsídio para programas de recuperação de ambientes em condições similares. Espécies observadas em fragmentos de vegetação natural nas áreas da fazenda foram a base para a seleção e produção das mudas utilizadas na revegetação. A revegetação foi realizada entre 2005 e 2006 em uma área de 2,34 ha, na qual foram alocadas 26 parcelas, medindo 21 x 21 m (441 m²). A distribuição das parcelas e dos indivíduos das espécies por parcela foi aleatória, com algumas restrições na casualização para alocar espécies indiferentes ou, mesmo, resistentes ao alagamento próximas à margem da represa. As parcelas diferenciaram-se entre si pela composição percentual dos grupos ecológicos (fase sucessional) e pelo espaçamento (3 x 3 m e 3 x 6 m). Guazuma ulmifolia e Aegiphila lhotzkiana, apesar de suas taxas de mortalidade relativamente altas, 50 e 28,6%, respectivamente, agregaram características importantes de desenvolvimento que são a capacidade de cobertura (incrementos anuais em altura de 160 e 155 cm, respectivamente) e estabelecimento (incrementos anuais em diâmetro de 40,6 e 36,3 mm, respectivamente). Portanto, foram qualificadas como edificantes do processo de regeneração. Chorisia speciosa, apesar do pouco destaque no incremento em altura (71 cm), investiu mais no crescimento diamétrico (31,4 mm), característica fundamental para o estabelecimento da espécie.

Degraded areas demand priority regarding actions for revegetation and recovery . However, there is a scarcity of studies to effectively guide us in these recovery practices. The objective of this work was to verify the growth, development and survival capacity of the individuals of the species implanted in the area of permanent preservation around the water reservoir on Mandaguari Farm, in Indianópolis, Minas Gerais. The species observed in fragments of the natural vegetation in the areas of the farm were the basis for the selection and production of seedlings used in the replanting. The replanting was carried out between 2005 and 2006 in 2.34 ha, which was divided in 26 parcels, measuring 21 x 21 m (441 m²). The distribution of the species was randomly performed with some restrictions in the randomization, so as to allocate neutral or even resistant species to flooding close to the margin of the dam. The areas differed from each other as to the percentile composition of the ecological groups (succession) and spacing (3 x 3 and 3 x 6 m). In spite of their relatively high mortality rates, Guazuma ulmifolia and Aegiphila lhotzkiana (50 and 28.6%, respectively) aggregated important development characteristics, which are their covering capacity (increments in height of 160 and 155 cm, respectively) and establishment (increments in diameter of 40.6 and 36.3 mm, respectively). Therefore, they were qualified as edifying agents in the regeneration process. Chorisia speciosa, in spite of the little prominence in height increment (71 cm), invested more in the diametric growth (31.4 mm), which is a fundamental characteristic for the establishment of the species.