Caffeine intake and CYP1A2 variants associated with high caffeine intake protect non-smokers from hypertension

The 15q24.1 locus, including CYP1A2, is associated with blood pressure (BP). The CYP1A2 rs762551 C allele is associated with lower CYP1A2 enzyme activity. CYP1A2 metabolizes caffeine and is induced by smoking. The association of caffeine consumption with hypertension remains controversial. We explored the effects of CYP1A2 variants and CYP1A2 enzyme activity on BP, focusing on caffeine as the potential mediator of CYP1A2 effects. Four observational (n = 16 719) and one quasi-experimental studies (n = 106) including European adults were conducted. Outcome measures were BP, caffeine intake, CYP1A2 activity and polymorphisms rs762551, rs1133323 and rs1378942. CYP1A2 variants were associated with hypertension in non-smokers, but not in smokers (CYP1A2-smoking interaction P = 0.01). Odds ratios (95% CIs) for hypertension for rs762551 CC, CA and AA genotypes were 1 (reference), 0.78 (0.59-1.02) and 0.66 (0.50-0.86), respectively, P = 0.004. Results were similar for the other variants. Higher CYP1A2 activity was linearly associated with lower BP after quitting smoking (P = 0.049 and P = 0.02 for systolic and diastolic BP, respectively), but not while smoking. In non-smokers, the CYP1A2 variants were associated with higher reported caffeine intake, which in turn was associated with lower odds of hypertension and lower BP (P = 0.01). In Mendelian randomization analyses using rs1133323 as instrument, each cup of caffeinated beverage was negatively associated with systolic BP [−9.57 (−16.22, −2.91) mmHg]. The associations of CYP1A2 variants with BP were modified by reported caffeine intake. These observational and quasi-experimental results strongly support a causal role of CYP1A2 in BP control via caffeine intak

Habitat-related birdsong divergence: a multi-level study on the influence of territory density and ambient noise in European blackbirds

Song plays an important role in avian communication and acoustic variation is important at both the individual and population level. Habitat-related variation between populations in particular can reflect adaptations to the environment accumulated over generations, but this may not always be the case. In this study, we test whether variation between individuals matches local conditions with respect to noise level and territory density to examine whether short-term flexibility could contribute to song divergence at the population level. We conducted a case study on an urban and forest population of the European blackbird and show divergence at the population level (i.e. across habitats) in blackbird song, anthropogenic noise level and territory density. Unlike in several other species, we found a lack of any correlation at the individual level (i.e. across individuals) between song features and ambient noise. This suggests species-specific causal explanations for noise-dependent song differentiation which are likely associated with variation in song-copying behaviour or feedback constraints related to variable singing styles. On the other hand, we found that at the level of individual territories, temporal features, but not spectral ones, are correlated to territory density and seasonality. This suggests that short-term individual variation can indeed contribute to habitat-dependent divergence at the population level. As this may undermine the potential role for song as a population marker, we conclude that more investigations on individual song flexibility are required for a better understanding of the impact of population-level song divergence on hybridisation and speciation

Carbapenem-Resistant Pseudomonas aeruginosa Spondylodiscitis Treated with Ceftazidime-Avibactam: A Case Report with Literature Review

Guilherme José da Nóbrega Danda,1 Andreia Craveiro Franco,1 Elisangela Ana Paula Gomes,2 Vinícius Vianna Abreu Montanaro,3 Bernardo José Alves Ferreira Martins,4 Vitor Viana Bonan de Aguiar5 1Department of Internal Medicine, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; 2Department of Microbiology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; 3Department of Neurology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; 4Department of Radiology, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, Brazil; 5Department of Neurosurgery, SARAH Network of Rehabilitation Hospitals, Brasília, Federal District, BrazilCorrespondence: Guilherme José da Nóbrega Danda, Hospital Sarah Brasília, SMHS 501 Bloco A, Brasília, DF, 70335-901, Brazil, Tel +55613199-1111, Email [email protected]: Pyogenic spondylodiscitis (PS) is a highly morbid and potentially fatal bacterial infection with an increasing incidence in recent decades. Its diagnosis and treatment are challenging, especially with the expansion of multidrug- or extensively drug-resistant bacteria. We report a rare case of PS caused by carbapenem-resistant Pseudomonas aeruginosa (CRPA) that was treated with ceftazidime-avibactam (C/A). The choice of C/A therapy was based on the patient’s bacterial sensitivity profile and intolerance to the initial therapeutic regimen (polymyxin B and meropenem). The total antimicrobial treatment time was seven weeks. The evolution of the clinical course met the cure criteria, which was characterized by remission of signs and symptoms, normalization of inflammatory markers, and radiological improvement over 18 months of clinical follow-up. This is a rare case of CRPA spondylodiscitis that responded to C/A treatment.Keywords: antibiotic, β-lactam/β-lactamase inhibitor, resistance, vertebral osteomyelitis, bone and joint infectio

A disseminação cultural das garrafadas no Brasil: um paralelo entre medicina popular e legislação sanitária

Garrafadas, em geral, são combinações de plantas medicinais veiculadas em bebidas alcoólicas, utilizadas com diversas finalidades na medicina popular. O presente estudo apresentou um panorama das garrafadas, relacionando-as à regulamentação sanitária no Brasil. Para tal, foi realizada uma pesquisa descritiva exploratória das garrafadas divulgadas na internet, bem como das notificações de queixas técnicas e eventos adversos junto à Agência Nacional de Vigilância Sanitária (Anvisa). A pesquisa mostrou que as garrafadas são amplamente divulgadas na internet. Concluiu-se que as garrafadas são comercializadas em todo País, sem nenhuma barreira, sendo órfãs de regulamentação sanitária específica, mas legitimadas pela cultura popular