Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38
Filtrar
Mais filtros

Base de dados
Tipo de documento
Intervalo de ano de publicação
1.
J Obstet Gynaecol Can ; 45(8): 560-568, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37263525

RESUMO

OBJECTIVES: The objective was to examine the frequency of physical activity (PA) counselling for pregnant women over the course of their pregnancies and the effect on the women's PA behaviour. METHODS: A quasi-experimental study was conducted in the maternity unit of a hospital. In total, 72 pregnant women were randomized into a control or intervention group. Counselling about PA was dispensed to the women in the intervention group throughout pregnancy by health professionals who had been sensitized to its importance and the recommendations. The women in the control group received the usual consultation content. The PA behaviour of pregnant women in the intervention group who reported receiving PA counselling was evaluated. The counselling and PA levels were evaluated by chi-square tests and repeated measures analysis of variance, respectively. RESULTS: Overall, the women received little counselling in accordance with the recommendations, although the intervention group women received this counselling more frequently (P = 0.049). All women in the intervention group who reported receiving counselling throughout pregnancy limited their decline in PA compared with those in the control group. The decline in total PA among normal-weight and overweight pregnant women was reduced in the intervention group (respectively, P = 0.043 and P = 0.044). CONCLUSION: Our intervention showed the effectiveness of counselling on PA behaviour, although the effect was observed at the end of pregnancy. Training and sensitizing for professionals should be strengthened to ensure that counselling in line with the recommendations to maintain or increase PA levels throughout pregnancy is provided.


Assuntos
Complicações na Gravidez , Cuidado Pré-Natal , Feminino , Gravidez , Humanos , Exercício Físico , Gestantes , Aconselhamento
2.
Eur J Haematol ; 106(6): 800-807, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33629431

RESUMO

Inflammation and oxidative stress play a key role in the pathophysiology of sickle cell disease (SCD). However, the potential influence of different sickle genotypes, or hydroxyurea (HU) treatment, on these factors remains poorly documented. The present study compared several plasma markers of inflammation and oxidative stress, as well as microvascular function, between patients with sickle SC disease (HbSC, n = 19) and patients with sickle cell anemia (HbSS) under hydroxyurea (HU) treatment (n = 16), or not (n = 13). Hemorheological parameters and levels of inflammatory (IL-6, IL-8, IFN-γ, MCP-1, MIP-1ß, TNF-α) and oxidative stress (AOPP, MDA, MPO) markers were determined. Peripheral microcirculatory cutaneous blood flow and immediate microvascular response to local heat were evaluated using laser Doppler flowmetry. Oxidative stress and inflammation were lower in HbSC patients and HbSS patients under HU therapy compared to HbSS patients not treated with HU. Blood viscosity was higher in HbSC than in HbSS patients treated with or not with HU. Vasodilation response of the cutaneous microcirculation to heat stress was higher in HbSS patients receiving HU treatment. Our results clearly established that both sickle cell genotype and HU treatment modulate inflammation and oxidative stress.


Assuntos
Anemia Falciforme , Viscosidade Sanguínea/efeitos dos fármacos , Hidroxiureia/administração & dosagem , Microcirculação/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Adulto , Anemia Falciforme/sangue , Anemia Falciforme/tratamento farmacológico , Anemia Falciforme/fisiopatologia , Biomarcadores/sangue , Feminino , Humanos , Inflamação/sangue , Inflamação/tratamento farmacológico , Inflamação/fisiopatologia , Masculino , Pessoa de Meia-Idade
3.
Int J Hyperthermia ; 36(1): 625-631, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223048

RESUMO

Objective: Hot environments are associated with impaired glucose metabolism at rest in healthy humans. The purpose of this study was to explore the contribution of key glucoregulatory hormones and biomarkers to this altered glucose tolerance. Methods: The effects of ambient temperature on glucose tolerance and its determinants were assessed with a 3-hr oral glucose tolerance test (OGTT) administered to 19 healthy young men and women at 22 °C and 31 °C. Results: The glucose response amplitude was greater in warm environment (AUC 904 ± 151 vs. 721 ± 89 mmol/l·180 min at 31 °C and 22 °C, respectively, p < .001). There was no significant effect of environmental temperature on insulin, growth hormone or pancreatic polypeptide concentrations (all p > .17). The cortisol response to the glucose load was reduced 30, 60, 90 and 120 minutes postload at 31 °C compared with 22 °C (p = .001). The interleukin-6 concentration was also lower in the session at 31 °C (p = .043). Conclusion: We conclude that the effects of environmental temperature on the glucoregulatory hormones and biomarkers reported in this study do not explain the exaggerated increase in blood glucose after a glucose load taken in a warm environmental temperature. Precis statement: This work demonstrates in healthy men and women that the ingestion of glucose elicits an exaggerated increase in blood glucose when the environmental temperature is warm.


Assuntos
Teste de Tolerância a Glucose/métodos , Metabolismo/fisiologia , Administração Oral , Adulto , Feminino , Humanos , Masculino , Temperatura , Adulto Jovem
4.
J Pediatr ; 195: 228-235, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29449005

RESUMO

OBJECTIVES: To investigate the associations between several sickle cell disease genetic modifiers (beta-globin haplotypes, alpha-thalassemia, and glucose-6-phosphate dehydrogenase deficiency) and the level of oxidative stress and to evaluate the association between oxidative stress and the rates of vaso-occlusive events. STUDY DESIGN: Steady-state oxidative and nitrosative stress markers, biological variables, genetic modulators, and vaso-occlusive crisis events requiring emergency admissions were measured during a 2-year period in 62 children with sickle cell anemia (58 SS and 4 Sß0). Twelve ethnic-matched children without sickle cell anemia also participated as healthy controls (AA) for oxidative and nitrosative stress level measurement. RESULTS: Oxidative and nitrosative stress were greater in patients with sickle cell anemia compared with control patients, but the rate of vaso-occlusive crisis events in sickle cell anemia was not associated with the level of oxidative stress. The presence of alpha-thalassemia, but not glucose-6-phosphate dehydrogenase deficiency or beta-globin haplotype, modulated the level of oxidative stress in children with sickle cell anemia. CONCLUSION: Mild hemolysis in children with alpha-thalassemia may limit oxidative stress and could explain the protective role of alpha-thalassemia in hemolysis-related sickle cell complications.


Assuntos
Anemia Falciforme/genética , Anemia Falciforme/fisiopatologia , Predisposição Genética para Doença , Estresse Oxidativo , Índice de Gravidade de Doença , Adolescente , Anemia Falciforme/diagnóstico , Criança , Pré-Escolar , Feminino , Seguimentos , Marcadores Genéticos , Humanos , Modelos Lineares , Masculino , Estudos Retrospectivos , Fatores de Risco
5.
Blood Cells Mol Dis ; 64: 23-29, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28340403

RESUMO

It is unclear whether vascular function is affected similarly in children with sickle cell anaemia (SS) and children with sickle haemoglobin C (SC) disease. Therefore, we compared micro and macrovascular functions in healthy (AA) children, children with SS and SC disease, and assessed their association with physical activity. Participants (24 SS, 22 SC and 16 AA), were compared in terms of 1) thermal hyperaemic response (finger pad warming to 42°C) measured by Laser Doppler techniques, 2) arterial stiffness determined by pulse wave velocity, 3) daily energy expenditure related to moderate and intense physical activities estimated by questionnaire and 4) fitness level, evaluated by the six-minute walk test. Response to heating differed between SS, SC and controls. Peripheral microvascular reactivity was lower and pulse wave velocity higher in SS compared to AA. SC had blunted microvascular reactivity in response to heating compared to AA but pulse wave velocity was not different within the two groups. Physical activity and fitness levels were markedly lower in sickle cell patients compared to healthy controls but no association was observed with vascular function. Microvasodilatory reserve is decreased in both SS and SC patients but only SS patients were also characterised by impaired macrovascular function.


Assuntos
Metabolismo Energético , Exercício Físico , Doença da Hemoglobina SC/fisiopatologia , Microcirculação , Análise de Onda de Pulso , Adolescente , Criança , Feminino , Humanos , Masculino
6.
Blood Cells Mol Dis ; 65: 23-28, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28411485

RESUMO

The present study investigated cerebral and muscle hemoglobin oxygen saturation (tissue oxygen index, TOI) in children with sickle cell anemia (SS), sickle cell hemoglobin C disease (SC) and healthy children (AA). TOI was measured by near-infrared spectroscopy (NIRS) and spectral analysis of the TOI variability was used to assess flowmotion and vasomotion. Arterial oxyhemoglobin saturation (SpO2), hemorheological and hematological parameters were also measured in SS and SC children. Both TOI were lower in SS compared to both AA and SC children, with SC exhibiting lower values than AA children. Cerebral vasomotion expressed in absolute values was enhanced in SS compared to AA and SC children. Muscle vasomotion did not differ between the three groups. Hematocrit, SpO2 and red blood cell deformability were positively associated with cerebral TOI in SS children. We demonstrated that 1) cerebral and muscle TOI were markedly decreased in SS children while the decrease of TOI was milder in SC children, 2) cerebral TOI level was associated with several biological markers in SS children only and 3) cerebral vasomotion was enhanced in SS, possibly to counterbalance the effects of chronic cerebral hypoxia.


Assuntos
Anemia Falciforme/metabolismo , Anemia Falciforme/fisiopatologia , Córtex Cerebral/irrigação sanguínea , Córtex Cerebral/metabolismo , Músculos/irrigação sanguínea , Músculos/metabolismo , Oxigênio/metabolismo , Adolescente , Anemia Falciforme/sangue , Anemia Falciforme/genética , Criança , Deformação Eritrocítica , Feminino , Genótipo , Hematócrito , Hemodinâmica , Hemoglobina Falciforme/genética , Hemorreologia , Humanos , Masculino , Consumo de Oxigênio , Espectroscopia de Luz Próxima ao Infravermelho
7.
Blood Cells Mol Dis ; 56(1): 41-5, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26603723

RESUMO

Vascular resistance and tissue perfusion may be both affected by impaired vascular function and increased blood viscosity. Little is known about the effects of vascular function on the occurrence of painful vaso-occlusive crises (VOC) in children with sickle cell anemia (SCA). The aim of the present study was to determine which side of the balance (blood viscosity or vascular function) is the most deleterious in SCA and increases the risk for frequent hospitalized VOC. Microvascular function, microcirculatory oxygenation and blood viscosity were determined in a group of 22 SCA children/adolescents at steady state and a group of 13 healthy children/adolescents. Univariate analyses demonstrated blunted microvascular reactivity during local thermal heating test and decreased microcirculatory oxygenation in SCA children compared to controls. Multivariate analysis revealed that increased blood viscosity and decreased microcirculatory oxygenation were independent risk factors of frequent VOC in SCA. In contrast, the level of microvascular dysfunction does not predict VOC rate. In conclusion, increased blood viscosity is usually well supported in healthy individuals where vascular function is not impaired. However, in the context of SCA, microvascular function is impaired and any increase of blood viscosity or decrease in microcirculatory oxygenation would increase the risks for frequent VOC.


Assuntos
Anemia Falciforme/sangue , Anemia Falciforme/fisiopatologia , Viscosidade Sanguínea , Microvasos/fisiopatologia , Oxigênio/metabolismo , Adolescente , Anemia Falciforme/complicações , Anemia Falciforme/metabolismo , Criança , Feminino , Humanos , Masculino , Microcirculação , Microvasos/metabolismo , Dor/etiologia
8.
Clin Sci (Lond) ; 130(12): 1017-25, 2016 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-26980346

RESUMO

A high demand on thermoregulatory processes may challenge homoeostasis, particularly regarding glucose regulation. This has been understudied, although it might concern millions of humans. The objective of this project was to examine the isolated and combined effects of experimental short-term mild heat exposure and metabolic level on glucoregulation. Two experimental randomized crossover studies were conducted. Ten healthy young men participated in study A, which comprises four sessions in a fasting state at two metabolic levels [rest and exercise at 60% of maximal oxygen uptake (O2) for 40 min] in two environmental temperatures (warm: 31°C and control: 22°C). Each session ended with an ad libitum meal, resulting in similar energy intake across sessions. In study B, 12 healthy young men underwent two 3 h oral glucose tolerance tests (OGTTs) in warm and control environmental temperatures. Venous blood was sampled at several time points. In study A, repeated measure ANOVAs revealed higher postprandial serum glucose and insulin levels with heat exposure. Glycaemia following the OGTT was higher in the warm temperature compared with control. The kinetics of the serum glucose response to the glucose load was also affected by the environmental temperature (temperature-by-time interaction, P=0.030), with differences between the warm and control conditions observed up to 90 min after the glucose load (all P<0.033). These studies provide evidence that heat exposure alters short-term glucoregulation. The implication of this environmental factor in the physiopathology of Type 2 diabetes has yet to be investigated.


Assuntos
Glicemia/metabolismo , Ingestão de Energia/fisiologia , Intolerância à Glucose/metabolismo , Glucose/metabolismo , Adulto , Estudos Cross-Over , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Exercício Físico/fisiologia , Jejum/metabolismo , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , Descanso/fisiologia , Adulto Jovem
10.
Ethn Dis ; 26(4): 485-492, 2016 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-27773975

RESUMO

OBJECTIVE: Thrifty genotypes may predispose to type 2 diabetes and body fat (%BF) excess through a differentiated relationship between physical activity and body fat. We explored this hypothesis in Asian Indians, a population thought to be thrifty. METHODS: Three hundred and nine Guadeloupian adolescents responded to the modifiable activity questionnaire. Their body fat was assessed by bioimpedancemetry. We first studied the relationship between %BF and leisure time physical activity (LTPA). We then explored the associations of ethnicity with this relationship in a subgroup of 93 Asian Indians matched with 93 controls for age, sex, and LTPA class. The alpha risk retained was .05. RESULTS: The analyses showed that Asian Indians had higher %BF even when matched with controls for age, sex and LTPA quartile, and the relationship between LTPA and %BF observed in controls was not evidenced in Asian Indians. CONCLUSIONS: The higher %BF in Asian Indians remained significant even when they were matched with controls for age, sex and LTPA quartile, and their LTPA was not associated ‒ or was at least less robustly associated ‒ with %BF. These findings are consistent with the hypothesis of thriftiness in Asian Indians, with the weaker relationship of high LTPA and low %BF a possible path to thriftiness.


Assuntos
Tecido Adiposo , Povo Asiático , Diabetes Mellitus Tipo 2/etnologia , Exercício Físico , Adolescente , Estudos de Casos e Controles , Feminino , Guadalupe , Humanos , Atividades de Lazer , Masculino , Atividade Motora , Inquéritos e Questionários
11.
Br J Haematol ; 168(5): 728-36, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25316332

RESUMO

Human red blood cells (RBC) express an active and functional endothelial-like nitric oxide (NO) synthase (RBC-NOS). We report studies on RBC-NOS activity in sickle cell anaemia (SCA), a genetic disease characterized by decreased RBC deformability and vascular dysfunction. Total RBC-NOS content was not significantly different in SCA patients compared to healthy controls; however, using phosphorylated RBC-NOS-Ser(1177) as a marker, RBC-NOS activation was higher in SCA patients as a consequence of the greater activation of Akt (phosphorylated Akt-Ser(473) ). The higher RBC-NOS activation in SCA led to higher levels of S-nitrosylated α- and ß-spectrins, and greater RBC nitrite and nitrotyrosine levels compared to healthy controls. Plasma nitrite content was not different between the two groups. Laser Doppler flowmetric experiments demonstrated blunted microcirculatory NO-dependent response under hyperthermia in SCA patients. RBC deformability, measured by ektacytometry, was reduced in SCA in contrast to healthy individuals, and pre-shearing RBC in vitro did not improve deformability despite an increase of RBC-NOS activation. RBC-NOS activation is high in freshly drawn blood from SCA patients, resulting in high amounts of NO produced by RBC. However, this does not result in improved RBC deformability and vascular function: higher RBC-NO is not sufficient to counterbalance the enhanced oxidative stress in SCA.


Assuntos
Anemia Falciforme/enzimologia , Deformação Eritrocítica , Eritrócitos/enzimologia , Óxido Nítrico Sintase/metabolismo , Estresse Oxidativo , Anemia Falciforme/patologia , Ativação Enzimática , Eritrócitos/patologia , Feminino , Humanos , Masculino , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Espectrina/metabolismo , Tirosina/análogos & derivados , Tirosina/metabolismo
12.
Pediatr Blood Cancer ; 62(11): 1962-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25989908

RESUMO

BACKGROUND: Autonomic nervous system (ANS) activity has been suggested to modulate the clinical severity of sickle cell anemia (SCA) by increasing the risk for vaso-occlusive events. Regular physical activity (PA) is known to improve ANS activity and health status in several cardiovascular and metabolic diseases. Whether regular PA improves the health status of SCA patients remains unknown. PROCEDURE: Twenty-two patients with SCA and 15 healthy (AA) children/adolescents participated to the study. Heart rate variability was measured in supine position and after a tilt-test to quantify the ANS activity. PA energy expenditure (PAEE) was assessed with questionnaire. RESULTS: 1) PAEE was lower in SCA compared to AA (190 ± 152 vs. 432 ± 277 kcal · d(-1), respectively, P < 0.01), 2) overall ANS activity was lower in SCA compared to AA, 3) parasympathetic withdrawal was observed in SCA with aging, 4) ANS reactivity was slightly impaired in SCA compared to AA (reduction in HFnu: -38 ± 27 vs. -58 ± 14%, respectively, P < 0.05), 5) ANS indices, PAEE, and rates of clinical events were not correlated. CONCLUSION: Both the level of PA and ANS activity are reduced in SCA compared to AA children/adolescents, particularly in those older than 15 years. Neither PAEE, nor ANS activity seem to influence the clinical severity of children/adolescents with SCA.


Assuntos
Anemia Falciforme/fisiopatologia , Sistema Nervoso Autônomo/fisiopatologia , Nível de Saúde , Atividade Motora , Qualidade de Vida , Adolescente , Fatores Etários , Anemia Falciforme/complicações , Anemia Falciforme/terapia , Arteriopatias Oclusivas/etiologia , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/terapia , Criança , Feminino , Humanos , Masculino , Projetos Piloto
13.
J Educ Health Promot ; 12: 206, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37545993

RESUMO

BACKGROUND: The lockdown linked to COVID-19 was shown to have negative effects on healthy behaviors in the general population, prompting the implementation of adapted public health measures. However, more vulnerable populations, such as pregnant women, were not specifically taken into account. At the time of writing this study, we know little about how the COVID-19 pandemic impacted the physical activity (PA) behavior of pregnant women in France. Given the many reports in the literature about women's low level of PA throughout pregnancy and the negative effects of the COVID-19 lockdown on behaviors in the general population; however, we might assume that their sedentary behaviors increased. The current study aimed to analyze the French recommendations and PA promotion among pregnant women. MATERIALS AND METHODS: A literature search was done using PubMed for the key terms "physical activity/physical activity promotion," "pregnant women/pregnancy,", and "French population/France." All the relevant studies were included to support the argument for this narrative review. RESULTS: Efforts to promote PA for pregnant women often seem ineffective and even unrealistic, and many women become overweight or obese during pregnancy. Health professionals need evidence-based guidelines and continuous training and skills development in order to convincingly encourage women to be more active during pregnancy and the postpartum period. CONCLUSION: Health policies should strengthen PA promotion among pregnant women with detailed evidence-based guidelines on PA during postpartum.

14.
Eur J Public Health ; 22(6): 887-9, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22683775

RESUMO

The aim was to compare the relationship between body composition and body size in two subgroups with different metabolic risk. Body-mass index z-scores (BMIZ), bicipital, tricipital, subscapular and iliac thicknesses were determined in 178 India-originating Guadeloupian (IOG) adolescents and 481 controls of other origins. Various equations were tested in a regression approach to fit the relationship between BMIZ and iliac thickness, and BMIZ and sum of skinfold thickness. A shift towards higher iliac thickness for a given BMIZ was observed in IOG adolescents. This supports the idea that the relationship between BMI and risk for non-communicable diseases is ethnicity-dependent.


Assuntos
Povo Asiático/estatística & dados numéricos , População Negra/estatística & dados numéricos , Composição Corporal , Índice de Massa Corporal , Tamanho Corporal/etnologia , Adolescente , Estudos Transversais , Humanos , Índia/etnologia , Grupo Associado , Dobras Cutâneas , Relação Cintura-Quadril , Índias Ocidentais/epidemiologia
15.
Front Psychol ; 12: 612420, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34899448

RESUMO

Aims: The antenatal period provides an important opportunity for giving advice on healthy lifestyle choices. However, the prevalence of maternal obesity is increasing, and women report that they do not receive counseling. We investigated the information given to pregnant women on gestational weight gain, physical activity, and nutrition during pregnancy in relation with their initial weight status, current gestational weight gain and diagnoses of either pre-pregnancy overweight/obesity or excessive gestational weight gain. Methods: Cross-sectional survey using a questionnaire. Pregnant participants (n = 141) were recruited from a midwife center. They completed a structured questionnaire on the information they received during their pregnancy and we assessed its relationship with their weight. Results: We found that many pregnant women did not receive advice about physical activity, gestational weight gain and nutrition (37.5, 53.2, and 66.2%, respectively). Women with weight problems (pre-pregnancy overweight/obesity and excessive gestational weight gain) were less targeted for counseling, although more than 80% of the women viewed receiving information on these topics as positive. Also, being informed of a weight problem was associated with a greater chance of receiving information about physical activity, gestational weight gain and nutrition (all p < 0.05). However, verbalization of the weight problems was low (14.0% of women with pre-pregnancy overweight were informed of their status). Conclusion: Health professionals should dispense more information, especially on PA and particularly for women with weight problems. Verbalization of the weight problem seems associated with more frequent transmission of information.

16.
Life (Basel) ; 11(11)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34833025

RESUMO

To determine the relationships between limiting factors and neuromuscular activity during a self-paced 20-km cycling time trial and evaluate the effect of environmental conditions on fatigue indices. METHODS: Ten endurance-trained and heat-acclimated athletes performed in three conditions (ambient temperature, relative humidity): HUMID (30 °C, 90%), DRY (35 °C, 46%) and NEUTRAL (22 °C, 55%). Voluntary muscular contractions and electromagnetic stimulations were recorded before and after the time trials to assess fatigue. The data on performance, temperature, heat storage, electromyogram, heart rate and rating of perceived exertion data were analyzed. RESULTS: Performance was impaired in DRY and HUMID compared with NEUTRAL environment (p < 0.05). The force developed by the vastus lateral muscle during stimulation of the femoral nerve remained unchanged across conditions. The percentage of integrated electromyogram activity, normalized by the value attained during the pre-trial maximal voluntary contraction, decreased significantly throughout the trial only in HUMID condition (p < 0.01). Neuromuscular activity in peripheral skeletal muscle started to fall from the 11th km in HUMID and the 15th km in DRY condition, although core temperature did not reach critical values. CONCLUSIONS: These alterations suggest that afferences from core/skin temperature regulate the central neural motor drive, reducing the active muscle recruited during prolonged exercise in the heat in order to prevent the system from hyperthermia.

17.
J Clin Endocrinol Metab ; 106(10): e3979-e3989, 2021 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-34111245

RESUMO

CONTEXT: Type 2 diabetes and peripheral neuropathy exhibit microvascular dysfunction at rest. However, data regarding their microvascular perfusion during exercise remain scarce. OBJECTIVE: This study investigated changes in microvascular perfusion during postexercise recovery in those with type 2 diabetes, with or without peripheral neuropathy, as well as in healthy controls and those with obesity. METHODS: Skin blood perfusion was assessed in each group using laser Doppler flowmetry (LDF) and laser speckle contrast imaging before and immediately after a 6-minute walking test. LDF recordings underwent wavelet transformation to allow specific control mechanisms of blood perfusion to be studied (eg, endothelial nitric oxide-independent and -dependent, neurogenic, myogenic, respiratory, and cardiac mechanisms). RESULTS: Skin blood perfusion increased after exercise in all groups (22.3 ±â€…28.1% with laser speckle contrast imaging and 22.1 ±â€…52.5% with LDF). Throughout postexercise recovery, the decrease was blunted in those with subclinical peripheral neuropathy and confirmed peripheral neuropathy when compared to the other 3 groups. After exercise, total spectral power increased in all groups. The relative contributions of each endothelial band was lower in those with confirmed peripheral neuropathy than in the healthy controls and those with obesity (nitric oxide-dependent function: 23.6 ±â€…8.9% vs 35.5 ±â€…5.8% and 29.3 ±â€…8.8%, respectively; nitric oxide-independent function: 49.1 ±â€…23.7% vs 53.3 ±â€…10.4% and 64.6 ±â€…11.4%, respectively). The neurogenic contribution decreased less in those with confirmed peripheral neuropathy and in those with type 2 diabetes alone, compared to those with subclinical peripheral neuropathy and those with obesity (-14.5 ±â€…9.9% and -12.2 ±â€…6.1% vs -26.5 ±â€…4.7% and -21.7 ±â€…9.4%, respectively). CONCLUSION: Peripheral neuropathy, whatever the stage, altered the microvascular response to exercise via impaired endothelial and neurogenic mechanisms.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Neuropatias Diabéticas/fisiopatologia , Exercício Físico/fisiologia , Pele/irrigação sanguínea , Adulto , Idoso , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Fluxometria por Laser-Doppler , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Fluxo Sanguíneo Regional/fisiologia , Pele/metabolismo , Pele/fisiopatologia , Fatores de Tempo
18.
Artigo em Inglês | MEDLINE | ID: mdl-33260471

RESUMO

Physical activity during pregnancy has many health benefits. However, the physical activity level is insufficient throughout pregnancy and women report perceived barriers to physical activity. This study assessed the impact of a counseling intervention offered in addition to routine pregnancy care on physical activity patterns, perceived barriers, and perinatal health outcomes. A quasi-experimental trial was conducted in the Maternity Unit of a hospital in Guadeloupe (a French department). Ninety-six pregnant women were allocated to a control or intervention group. Regular physical activity counseling was dispensed to the women in the intervention group by trained healthcare providers. The physical activity level and the perceived barriers were assessed in each trimester. Outcomes for the perinatal health of the mother and child were measured throughout pregnancy and after delivery. The perceived barriers, such as a lack of information about the health benefits and risks over the two trimesters (all p < 0.05) and insecurity related to practice throughout pregnancy (all p < 0.05), were different in favor of the intervention group. There were no significant between-group differences for the major indices of physical activity, whether measured or reported. The intervention women reported significantly more sedentary activity compared with the control group in the third trimester, 64.7 (36.4-78.7) vs. 22.7 (9.4-49.8) MET-hours/week, respectively (p < 0.001). The perinatal health outcomes for the mother and child showed no significant differences. The intervention was unable to limit the decline in physical activity or improve health outcomes. However, it was associated with an improvement in the perception of barriers. Future research should focus on interventions that have a sufficient quantitative impact on perceived barriers in order to limit physical activity decline.


Assuntos
Aconselhamento , Exercício Físico , Cuidado Pré-Natal , Criança , Feminino , Humanos , Parto , Gravidez , Gestantes
19.
Front Immunol ; 11: 551441, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33250889

RESUMO

Chronic hemolysis, enhanced oxidative stress, and decreased nitric oxide (NO) bioavailability promote vasculopathy in sickle cell anemia (SCA). Oxidative stress and NO are known to modulate eryptosis in healthy red blood cells (RBCs); however, their role in SCA eryptosis and their impact on the genesis of RBC-derived microparticles (RBC-MPs) remains poorly described. RBC-MPs could play a role in vascular dysfunction in SCA. The aims of this study were to evaluate the roles of oxidative stress and NO in eryptosis and RBC-MPs release, and to determine whether RBC-MPs could be involved in vascular dysfunction in SCA. Markers of eryptosis and oxidative stress, plasma RBC-MPs concentration and arterial stiffness were compared between SCA and healthy (AA) individuals. In-vitro experiments were performed to test: 1) the effects of oxidative stress (antioxidant: n-acetylcysteine (NAC); pro-oxidant: cumene hydroperoxide) and NO (NO donor: sodium nitroprusside (SNP); NO-synthase inhibitor (L-NIO)) on eryptosis, RBC deformability and RBC-MP genesis; 2) the effects of SCA/AA-RBC-MPs on human aortic endothelial cell (HAEC) inflammatory phenotype and TLR4 pathway. Eryptosis, RBC-MPs, oxidative stress and arterial stiffness were increased in SCA. NAC increased RBC deformability and decreased eryptosis and RBC-MPs release, while cumene did the opposite. SNP increased RBC deformability and limited eryptosis, but had no effect on RBC-MPs. L-NIO did not affect these parameters. Arterial stiffness was correlated with RBC-MPs concentration in SCA. RBC-MPs isolated directly from SCA blood increased adhesion molecules expression and the production of cytokines by HAEC compared to those isolated from AA blood. TLR4 inhibition alleviated these effects. Our data show that oxidative stress could promote eryptosis and the release of RBC-MPs that are potentially involved in macrovascular dysfunction in SCA.


Assuntos
Anemia Falciforme/sangue , Micropartículas Derivadas de Células/metabolismo , Eriptose , Eritrócitos Anormais/metabolismo , Óxido Nítrico/sangue , Estresse Oxidativo , Rigidez Vascular , Adolescente , Adulto , Anemia Falciforme/patologia , Micropartículas Derivadas de Células/patologia , Criança , Pré-Escolar , Eritrócitos Anormais/patologia , Feminino , Humanos , Masculino
20.
Br J Nutr ; 102(12): 1820-7, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19747409

RESUMO

The present study aimed at comparing the anthropometric profile of Asian Indian adolescents from Guadeloupe with that of their island counterparts. A total of 720 voluntary 11- to 17-year-old students participated: 180 Asian Indians and 540 age- and sex-matched students of other origin. Weight and height were measured to calculate the BMI. Waist and hip circumferences and bicipital, tricipital, subscapular and supra-iliac skinfold thicknesses were assessed. The percentage of body fat was estimated by bioelectrical impedance analysis. Obesity was defined from BMI according to the International Obesity Task Force recommendations. Asian Indians were smaller and lighter than their counterparts. They had a higher body fat percentage even after adjustment on BMI but the prevalence of obesity did not differ, with an overall prevalence of 5.69 (95 % CI 5.67, 5.71) %. No principal effects of ethnicity on waist and hip circumferences or the waist:hip ratio were evidenced. The sum of the four skinfold thicknesses was the strongest predictor of body fat percentage, and the adjustment of overall body fat on subcutaneous fat cancelled the effect of ethnicity on this dependent variable. The present study found that Asian Indian adolescents from Guadeloupe had the same tendency toward higher body fat and body fat-for-BMI as previously documented in Asian Indian adults. It raises the hypothesis of a higher cardiovascular risk in this ethnic group from adolescence and questions the validity of using common BMI references for screening obesity in multiethnic communities.


Assuntos
Obesidade/etnologia , Obesidade/epidemiologia , Adolescente , Antropometria , Distribuição da Gordura Corporal , Índice de Massa Corporal , Criança , Impedância Elétrica , Feminino , Guadalupe/epidemiologia , Humanos , Índia/etnologia , Masculino , Dobras Cutâneas , Relação Cintura-Quadril
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA