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Aims: Non-alcoholic hepatic steatosis (HS) is associated with hypertension and increased cardiovascular risk. While Blood pressure hyper-reactive response (HRR) during peak exercise indicates an increased risk of incident hypertension and increased cardiovascular risk, no data on the association of non-alcoholic HS and HRR exists. In this study, we have evaluated the association of HS with HRR. Methods: We included 13 410 consecutive individuals with a mean age: 42.4 ± 8.9 years, 3561 (26.6%) female with normal resting blood pressure and without a previous diagnosis of hypertension, who underwent symptom limited exercise treadmill test, abdominal ultrasonography and clinical and laboratory evaluation. HS was detected by abdominal ultrasonography. HRR was defined by a peak exercise systolic blood pressure >220 mmHg and/or elevation of 15 mmHg or more in diastolic blood pressure from rest to peak exercise. Results: The prevalence of HS was 29.5% ( n = 3956). Overall, 4.6% ( n = 619) of the study population presented a HRR. Subjects with HS had a higher prevalence of HRR (8.1 vs. 3.1%, odds ratio 2.8, 95% CI 2.4—3.3, P

Objectives To evaluate the PSA in a large population of Brazilian men undergone to check up, and correlate the PSA cutoffs with prostate size and urinary symptoms. Materials and Methods This is a cross sectional study performed with men between 40 and 70 years undergone to check-up. All men were undergone to urological evaluation, digital rectal examination, prostate-specific antigen, and ultrasonography The exclusion criteria were men who used testosterone in the last six months, or who were using 5 alpha-reductase inhibitors. Results A total of 5015 men with an average age of 49.0 years completed the study. Most men were white and asymptomatic. The PSA in the three different aging groups were 0.9 ± 0.7ng/dL for men between 40 and 50; 1.2 ± 0.5ng/dL for men between 50 and 60; and 1.7 ± 1.5ng/dL for men greater than 60 years (p=0.001). A total of 192 men had PSA between 2.5 and 4ng/ml. From these men 130 were undergone to prostate biopsy. The predictive positive value of biopsy was 25% (32/130). In the same way, 100 patients had PSA >4ng/mL. From these men, 80 were undergone to prostate biopsy. In this group, the predictive positive value of biopsy was 40% (32/100). The Gleason score was 6 in 19 men (60%), 7 in 10 men (31%) and 8 in 3 men (9%). Conclusions The PSA level of Brazilian men undergone to check up was low. There was a positive correlation with aging, IPSS and prostate size.

Introduction: the occurrence of a monoclonal gammopathy (MG) is identified in approximately 3% of the population older than 50 years in US and Europe, and is usually an occasional finding. There is very few data about the prevalence of MG in the general population in Brazil and in Latin America, especially in individuals undergoing routine health checkups (HC). Objectives: to evaluate the prevalence of MG in a general population undergoing routine HC in Brazil. Also, to compare demographic and laboratory data between individuals with and without MG. Methods: between January and December 2014, patients with 45 years of age or older who presented for a routine HC at a general hospital in Sao Paulo, Brazil, had a blood sample tested for serum protein electrophoresis (SPEP). Independently of the previous general medical history of these individuals, the reason for going to the hospital was only the HC and not any specific medical diagnostic or treatment procedure. Samples with a positive SPEP for MG were further submitted to serum immunofixation (IF) and serum free light chain assays (FLC- Freelite ®-The Binding Site, UK). The study was approved by the IRB and all participants signed an informed consent. Results: during the 12 months period, 3,095 individuals were studied, 2,393 men (77.3%) and 702 women (22.7%). MG was detected in 37 (1.2%), 31 men (1.3%) and 6 women (0.9%), p=0.35. The table shows the age distribution: there is an increase in the prevalence of MG for the older age groups, and this was statistically significant for individuals with 65 years or older when compared to those less than 55 years old. Age Range (years) MG negative MG positive p 45-54 2,081 (99.0%) 20 (1.0%) 55-64 841 (98.5%) 13 (1.5%) 0.19 ≥ 65 136 (97.1%) 4 (2.9%) 0.04 All 37 cases also presented a positive IF. The immunoglobulin involved was IgG in 28 cases (75.7%), IgM in 5 (13.5%), IgA in 2 (5.4%) and a double MG in 2 (5.4%). The FLC ratio of the patients with a MG ranged from 0.28 to 38.50 and one case showed a very high abnormal FLC ratio of >55.0 (normal FLC ratio range = 0.26 to 1.65). The analysis showed an abnormal FLC ratio in 9 samples (24.3%). The total gammaglobulin levels were significantly higher in the population with MG then in the population without MG (median results were respectively 1.16 g/dL and 1.06 g/dL, p< 0,001). There was no difference in the hemoglobin levels in the two groups (median levels respectively 14.4 g/dL and 14.7 g/dL, p=0.65). Conclusion: it was observed that 1.2% of this general Brazilian population showed a MG. This prevalence is lower than reported in the medical literature in other countries for this age group, but may be explained by the also lower number of individuals older than 65 years studied. The presence of a MG increased significantly with age, as reported in other observations. These results are useful as a reference for epidemiological analysis of MG studies performed in the region. Larger regional studies should be performed, including analysis of environmental and behavioral factors. Disclosures No relevant conflicts of interest to declare.

Objective: To evaluate the impact of traditional check-up appointment on the progression of the cardiovascular risk throughout time. Methods: This retrospective cohort study included 11,126 medical records of asymptomatic executives who were evaluated between January, 2005 and October, 2008. Variables included participants’ demographics characteristics, smoking habit, history of cardiovascular diseases, diabetes, dyslipidemia, total cholesterol, HDL, triglycerides, glucose, c-reactive protein, waist circumference, hepatic steatosis, Framingham score, metabolic syndrome, level of physical activity, stress, alcohol consumption, and body mass index. Results: A total of 3,150 patients was included in the final analysis. A worsening was observed in all risk factors, excepting in smoking habit, incidence of myocardial infarction or stroke and in the number of individuals classified as medium or high risk for cardiovascular events. In addition, a decrease in stress level and alcohol consumption was also seen. Conclusion: The adoption of consistent health policies by companies is imperative in order to reduce the risk factors and the future costs associated with illness and absenteeism. RESUMO Objetivo: Avaliar o impacto do modelo tradicional de check-up na progressão do risco cardiovascular ao longo do tempo. Métodos: Estudo coorte-retrospectivo com análise de 11.126 prontuários de executivos assintomáticos, atendidos entre janeiro de 2005 e outubro de 2008. Foram observados dados demográficos, tabagismo, doenças cardiovasculares, diabetes, dislipidemia prévios, valores de colesterol total e frações, triglicérides, glicemia, proteína C-reativa, circunferência de cintura, esteatose hepática, escore de Framingham, síndrome metabólica, nível de atividade física, estresse, consumo de álcool e índice de massa corporal. Resultados: Foram incluídos 3.150 pacientes. Houve piora de todos fatores de risco, com exceção do tabagismo, do aumento na incidência de doenças cardiovasculares e da população com risco médio ou alto para eventos cardiovasculares. Houve ainda redução na prevalência de pouco ativos, estresse e consumo de álcool. Conclusão: É prioritária a adoção de políticas de saúde por parte das empresas, para a melhora da condição de saúde e a redução dos custos advindos das doenças, além do absenteísmo a eles associados.