Cardiac reinnervation affects cardiorespiratory adaptations to exercise training in individuals with heart transplantation.

PURPOSE: The purpose of this study was to investigate the hemodynamic and cardiorespiratory adaptations to exercise in individuals with heart transplantation with evidence of cardiac reinnervation (cardiac reinnervation group) versus without evidence of cardiac reinnervation (no cardiac reinnervation group). METHODS: Sedentary individuals with heart transplantation (age = 45.5 ± 2.2 years; time elapsed since surgery = 6.7 ± 0.7 years) were divided into the cardiac reinnervation (n = 16) and no cardiac reinnervation (n = 17) groups according to their heart rate response to cardiopulmonary exercise testing. The 24-hour ambulatory blood pressure, carotid-femoral pulse wave velocity, and cardiorespiratory fitness were assessed before and after 12 weeks of a thrice-weekly exercise program (five minutes of warm-up, 30 min of endurance exercise, one set of 10-15 reps in five resistance exercises, and five minutes of cool-down). RESULTS: The cardiac reinnervation group had reduced (p < 0.01) 24-hour systolic/diastolic blood pressure (7/9 mm Hg), daytime systolic/diastolic blood pressure (9/10 mm Hg) and nighttime diastolic blood pressure (6 mm Hg) after training. The no cardiac reinnervation group reduced (p < 0.05) only 24-hour (5 mm Hg), daytime (5 mm Hg) and nighttime (6 mm Hg) diastolic blood pressure after training. Hourly analysis showed that the cardiac reinnervation group reduced systolic/diastolic blood pressure for 10/21 h, while the no cardiac reinnervation group reduced systolic/diastolic blood pressure for only 3/11 h. The cardiac reinnervation group also improved both maximal oxygen consumption (10.8%) and exercise tolerance (13.4%) after training, but the no cardiac reinnervation group improved only exercise tolerance (9.9%). Pulse wave velocity did not change in both groups. CONCLUSION: There were greater improvements in ambulatory blood pressure and maximal oxygen consumption in the cardiac reinnervation than the no cardiac reinnervation group. These results suggest that cardiac reinnervation associates with hemodynamic and cardiorespiratory adaptations to exercise training in individuals with heart transplantation.

Inflammatory biomarkers and effect of exercise on functional capacity in patients with heart failure: Insights from a randomized clinical trial.

Background In patients with heart failure, inflammation has been associated with worse functional capacity, but it is uncertain whether it could affect their response to exercise training. We evaluated whether inflammatory biomarkers are related to differential effect of exercise on the peak oxygen uptake (V˙O2) among patients with heart failure. Design Open, parallel group, randomized controlled trial. Methods Patients with heart failure and ejection fraction ≤0.4 were randomized into exercise training or control for 12 weeks. Patients were classified according to: 1) inflammatory biomarkers blood levels, defined as 'low' if both interleukin-6 and tumor necrosis factor-alpha blood levels were below median, and 'high' otherwise; and 2) galectin-3 blood levels, which also reflect pro-fibrotic processes. Results Forty-four participants (50 ± 7 years old, 55% men, 25% ischemic) were allocated to exercise training ( n = 28) or control ( n = 16). Exercise significantly improved peak V˙O2 among participants with 'low' inflammatory biomarkers (3.5 ± 0.9 vs. -0.7 ± 1.1 ml/kg per min, p = 0.006), as compared with control, but not among those with 'high' inflammatory biomarkers (0.4 ± 0.6 vs. -0.2 ± 0.7 ml/kg per min, p = 0.54, p for interaction = 0.009). Similarly, exercise improved peak V˙O2 among participants with below median (2.4 ± 0.8 vs. -0.3 ± 0.9 ml/kg per min, p = 0.032), but not among those with above median galectin-3 blood levels (0.3 ± 0.7 vs. -0.7 ± 1.0 ml/kg per min, p = 0.41, p for interaction = 0.053). Conclusion In patients with heart failure, levels of biomarkers that reflect pro-inflammatory and pro-fibrotic processes were associated with differential effect of exercise on functional capacity. Further studies should evaluate whether exercise training can improve clinical outcomes in patients with heart failure and low levels of these biomarkers.

Cáncer de útero: Estudio estadístico (Revisión de un año) / Uterin Cancer: Stadistic Study (Revision of a year)

Se realizó una revisión completa de todos los cánceres de útero en la provincia de Sancti Spíritus en el año 1986. Se analizaron estadísticamente y se valoraron algunos aspectos como: edad, pariedad, relaciones sexuales primarias, mediante los cuales se comprobó que estos factores predisponentes están en relación con el cáncer cervical. Al concluir, recomendamos como medida más importante, la revisión del programa de detección precoz del cáncer y lograr el aumento de su eficacia en cada nivel provincial.

Análisis de algunos factores epidemiológicos en el cáncer cervicouterino / Analysis of some epidemiologic factors in cervical cancer

Se hace un análisis de todos los casos positivos de cáncer cervicouterino ocurridos en un período de 4 años; se estudian algunos factores relacionados con su aparición como son las relaciones sexuales, la edad, la paridad, así como la confirmación diagnóstica y los resultados anatomopatológicos. Pudo confirmarse que la precocidad en las relaciones sexuales predispone a mayor frecuencia de padecer la enfermedad. La detección de esta neoplasia puede hacerse en cualquier etapa clínica y es más frecuente su aparición en la cuarta década de la vida

Incidencia de blenorragia como causa de inflamación pélvica aguda / Incidence of blenorrhagia as a cause of acute pelvic inflammatory disease

Se hace un estudio de la incidencia de blenorragia como causa de inflamación pélvica en 403 pacientes atendidas en nuestro hospital durante el año 1983; para su análisis se distribuyeron en 2 grupos: 1 sintomático y 1 asintomático. Se insiste en que la detección y el control de la blenorragia estan determinados por la búsqueda de portadores asintomáticos y es la coloración de Gram endocervical el medio de detección precoz y masivo. Existe un predominio de la mujer soltera en los casos positivos de blenorragia