Acute and Cumulative Effects With Whole-Body Vibration Exercises Using 2 Biomechanical Conditions on the Flexibility and Rating of Perceived Exertion in Individuals With Metabolic Syndrome: A Randomized Clinical Trial Pilot Study.

This study evaluated the effects of 6 weeks of whole-body vibration (WBV) exercise on flexibility and the rating of perceived exertion (RPE) in metabolic syndrome (MetS) individuals using 2 biomechanical conditions (fixed frequency [FF] and variable frequency [VF]). Nineteen MetS individuals were randomly allocated in FF-WBV (n = 9, 7 women and 2 men) and VF-WBV (n = 10, 8 women and 2 men) groups. Anterior trunk flexion (ATF) and RPE were determined before and after each session. The acute cumulative exposure effects were analyzed. The FF-WBV group was exposed to 5 Hz on a side alternating vibrating platform (SAVP), exposed to 10 and 50 seconds with the SAVP turned off. The VF-WBV group individuals were intermittently exposed (1 minute WBV exercise/1 minute rest) to 5 to 16 Hz, increased by 1 Hz per session and the peak-to-peak displacement (PPD) were 2.5, 5.0, and 7.5 mm. Regarding to ATF, significant improvements (P < .05) were observed in the in the acute (VF group) and cumulative intervention (FF and VF-WBV groups). The RPE significantly (P < .05) improved only in VF-WBV (cumulative intervention). In conclusion, WBV exercise improved the flexibility and decreased the RPE in MetS individuals. These findings suggest that WBV exercise can be incorporated into physical activities for MetS individuals.

Penile microvascular endothelial function in hypertensive patients: effects of acute type 5 phosphodiesterase inhibition.

The primary aim of this study was to evaluate penile endothelial microvascular function in patients with primary arterial hypertension and age-matched normotensive subjects using laser speckle contrast imaging (LSCI). Additionally, we analyzed the acute penile microvascular effects induced by oral phosphodiesterase type 5 inhibitor (sildenafil; SIL) administration. Endothelium-dependent microvascular reactivity was evaluated in the penises and forearms of hypertensive patients (aged 58.8±6.6 years, n=34) and age-matched healthy volunteers (n=33) at rest and 60 min following oral SIL (100 mg) administration. LSCI was coupled with cutaneous acetylcholine (ACh) iontophoresis using increasing anodal currents. Basal penile cutaneous vascular conductance (CVC) values were not significantly different between control subjects and hypertensive individuals. Penile CVC values increased significantly after SIL administration in control (P<0.0001) and hypertensive (P<0.0001) subjects. Peak CVC values were not different between the two groups during penile ACh iontophoresis before SIL administration (P=0.2052). Peak CVC values were higher in control subjects than in hypertensive subjects after SIL administration (P=0.0427). Penile endothelium-dependent microvascular function is, to some extent, preserved in patients presenting with primary arterial hypertension under effective anti-hypertensive treatment. LSCI may be a valuable non-invasive tool for the evaluation of penile vascular responses to phosphodiesterase type 5 inhibitor.

Hypertension in Latin America: Current perspectives on trends and characteristics.

The region of Latin America, which includes Central America, the Caribbean and South America, is one that is rapidly developing. Signified by socio-economic growth, transition and development over the last few decades, living standards in countries like Brazil and Mexico have improved dramatically, including improvements in education and health care. An important marker of socio-economic change has been the epidemiological shift in disease burden. Cardiovascular disease is now the leading cause of death in Latin America, and the drop in prevalence of infectious diseases has been accompanied by a rise in non-communicable diseases. Hypertension is the major risk factor driving the cardiovascular disease continuum. In this article we aim to discuss the epidemiological and management trends and patterns in hypertension that may be specific or more common to Latin-American populations - what we term 'Latin American characteristics' of hypertension - via a review of the recent literature. Recognizing that there may be a specific profile of hypertension for Latin-American patients may help to improve their treatment, with the ultimate goal to reduce their cardiovascular risk. We focus somewhat on the countries of Brazil, Mexico and Venezuela, the experience of which may reflect other Latin American countries that currently have less published data regarding epidemiology and management practices.

Calcitonin in bone-guided regeneration of mandibles in ovariectomized rats: densitometric, histologic and histomorphometric analysis.

The aim of the present study was to investigate bone promotion in surgical defects created in the mandible of normal and ovariectomized female rats using calcitonin associated with a polytetrafluoroethylene barrier. The 100 female rats were divided into four groups: control (C), control treated with calcitonin (CM), ovariectomized control (OV) and ovariectomized treated with calcitonin (OVM). A circumscribed bone defect 4mm in diameter was created in the region of the mandibular angle, and covered with the barrier. Groups CM and OVM received 2 IU/kg of synthetic salmon calcitonin intramuscularly three times a week. The animals were killed 3, 7, 14, 21 and 28 days after surgery. The bone defects were submitted to densitometric, histologic and histomorphometric analysis. Groups C and CM showed higher levels of bone formation after 7 days compared to the OV and OVM groups. A significant difference was observed between groups C and OV at 3-14 days. The OV group presented slower bone regeneration of the surgical bone defect created in the mandibular angle than group C. Synthetic salmon calcitonin accelerated regeneration of the bone defect in the mandibles of OVM animals similarly to group C, and also increased the formation of new bone during the regeneration process in CM.

The heterogeneity of choanomastigote-shaped trypanosomatids as analyzed by their kDNA minicircle size: taxonomic implicaitons.

The kDNA minicircle size was analyzed in 15 species of choanomastigote-shaped trypanosomatids and four main groups of species were identified: (1) "Crithidia" deanei, "C." desouzai and "Herpetomonas" roitmani, which presented the largest molecules (> or = 3,800 bp), (2) "C." oncopelti with minicircles of at least four different sizes within 1,300-2,650 bp, (3) C. fasciculata, C. guilhermei and C. luciliae, having at least two sizes of minicircle (2,650 bp and 3,000 bp) and (4) a heterogeneous group of species presenting minicircles of a single size, including several Crithidia spp. (having 1,600 bp or 1,700 bp minicircles) and two Proteomonas spp. presenting the smallest minicircles (about 1,500 bp). These results were compared with other observations and discussed from a taxonomic point of view.

In situ hybridization in paracoccidioidomycosis.

In situ hybridization (ISH) was performed using oral biopsies from patients with paracoccidioidomycosis and guinea pig testes inoculated with a culture of Paracoccidioides brasiliensis isolated from soil, employing both a 14 base-pair specific oligoprobe (ACT CCC CCG TGG TC) and its complementary sequence. When combining ISH with the Gridley stain which detects fungal cell walls, about 2-3% of the fungal cells present in the tissues were labelled. When the complementary probe was used, labelling was higher, reaching the 3% level.

Early blood pressure level as a mark of familial aggregation of metabolic cardiovascular risk factors--the Rio de Janeiro Study.

OBJECTIVE: To investigate the familial aggregation of metabolic risk factors (RF) according to blood pressure (BP) percentile of children and adolescents. DESIGN AND METHODS: Normal BP was established in 3906 children and adolescents in 1987. From this population two groups of target individuals were separated: group A (n = 327) with systolic and/or diastolic BP percentile > 95 and group B (n = 327) with systolic and diastolic BP percentile < or = 50. Ten years later, familial aggregation of metabolic RF was evaluated using clinical and laboratorial data from 785 individuals, divided into two groups: group 1 with 135 target individuals (BP percentile > 95), 181 parents, 100 siblings and 16 grandparents; and group 2: 106 target individuals (BP percentile < or = 50), 145 parents, 84 siblings and 18 grandparents. RESULTS: (1) The longitudinal study 10 years later (tracking effect) showed that 34.8% of target individuals of group 1 and 90.5% of group 2 remained at the same BP percentile. (2) Comparing the two groups of target individuals, group 1 had higher weight and body mass index (BMI), systolic BP (SBP), diastolic BP (DBP), and heart rate (HR) (P < 0.001) and lower HDL (P < 0.003). (3) Comparing target individuals' and their relatives' measurements together, group 1 had higher BMI, HR, SBP, DBP (P < 0.03) and lower HDL (P < 0.001). (4) SBP and DBP showed significant correlation with all metabolic variables even when BMI was controlled in a multiple regression analysis (P < 0.04). CONCLUSION: BP level in children and adolescents was a good marker for familial aggregation of metabolic RF, suggesting an interaction of genetic and environmental factors. Primary intervention should be carried out in early stages of life.

Hyperglycemia, hyperinsulinemia, overweight, and high blood pressure in young adults: the Rio de Janeiro Study.

Children and adolescents (n=3906, 10-15 years old) have been participating in a screening program for high blood pressure. Sixty-four individuals (17-23 years old) from this population were followed up for 8 years and four consecutive screenings and were stratified into three groups according to blood pressure: group 1 (n=23), > or = 95th percentile for at least three of four evaluations; group 2 (n=28), < 50th percentile for at least three of four screenings; and group 3 (n=13), with unstable blood pressure percentiles. All 64 individuals underwent an oral glucose tolerance test after a 12-hour fast. Blood samples were collected at 0, 30, 60, 90, and 120 minutes for insulin and glucose measurements. Group 1 had a greater body mass index and higher systolic and diastolic blood pressures, basal glucose and insulin levels, and peak values of insulin and glucose levels than the other groups (P<.05). Group 1 also had a higher prevalence of overweight and abnormal values of basal insulin than the other groups (P<.05) and a higher proportion of glucose-intolerant individuals when compared with group 2 (P<.05). Systolic and diastolic blood pressures were positively related to body mass index (P<.05) and insulin variables (P<.05); however, when body mass index was controlled for, only systolic blood pressure demonstrated a significant correlation with insulin variables (P<.05). The association of overweight, hyperinsulinemia, glucose intolerance, and high blood pressure can be detected early, but the significance of these findings would be better explained by longitudinal studies.

Role of anthropometric indexes and blood pressure as determinants of left ventricular mass and geometry in adolescents. The Rio de Janeiro Study.

To evaluate left ventricular structural changes and their relationship to blood pressure and anthropometric indexes, we examined by echocardiography 108 adolescents aged 13 to 19 years. Subjects were divided into three groups according to blood pressure tracking during three moments of observation: group 1 (n = 27), > or = 95th percentile; group 2 (n = 37), < or = 50th percentile; and group 3 (n = 44), blood pressure not stable in the original percentile. Left ventricular mass index and the prevalence of altered left ventricular geometry were greater in group 1 (P < .05 and P < .02, respectively). Of all the anthropometric indexes, body surface area showed the best correlation with left ventricular mass (P < .00001). Left ventricular mass also correlated with systolic and diastolic pressures (P < .00001 and P < .003, respectively). Ventricular septal and posterior wall thicknesses and left ventricular diastolic diameter showed good correlations with body surface area (P < .00001). These variables also correlated with systolic pressure (P < .001). In a multiple regression model when body surface area was controlled, systolic pressure did not correlate significantly with left ventricular mass. In a similar model systolic pressure maintained a significant correlation with ventricular septal and posterior wall (P < .00001) thicknesses but not with left ventricular diastolic diameter (P > .05). We conclude that left ventricular structural changes can occur early after initial abnormalities of blood pressure. Considering that body surface area and systolic pressure were the best predictors of left ventricular alterations in adolescents, the usual way of correcting left ventricular mass by body surface area should be reviewed.

Familial aggregation of arterial blood pressure and possible genetic influence.

The aggregation of arterial blood pressure, weight, and height were compared between family members of children and adolescents with blood pressure percentiles at or above 95 (group 1) and at or below 50 (group 2). Weight, height, and systolic and diastolic blood pressures were significantly higher in siblings and target individuals of group 1 (p less than 0.001). Weight and systolic and diastolic blood pressures were significantly higher in mothers of group 1 (p less than 0.001). Covariant analysis comparing the average systolic and diastolic blood pressures of both groups controlled by age, age and weight, and age and Quetelet index revealed that the arterial blood pressure of mothers, siblings, and target individuals remained higher in group 1 (p less than 0.05 to p less than 0.001). These observations show a strong familial aggregation of arterial blood pressure not dependent only on physical development and also raise the question of a genetic basis as a possible mechanism of systemic arterial hypertension.

Rotavirus associated diarrhoea during infancy in the city of S. Luís (MA), Brazil: a two-year longitudinal study.

A total of 479 diarrhoeic children and 337 children without diarrhoea (controls) less than 5 years old were investigated in a two-year study in the city of S. Luís (MA), with the purpose to determine the incidence, the age distribution and the seasonality of rotaviruses, as well as to establish the severity of the disease in this region between the North and the Northeast of Brazil. rotavirus incidence was highest in children of the 1st. year of life, showing an average of 25% per year among the diarrhoeic patients attending the two main hospitals and three health units at the periphery of the city. It was shown that rotaviruses are significant enteropathogens in children less than 18 months old. Frequency of rotaviruses dropped in diarrhoeic patients 18 to 23 months old to only 4%, the same percentage observed in children of the control group. A typical seasonal distribution of rotaviruses was not seen during the two years of study. There was a peak in the incidence of rotaviruses in 1986, during the rainy season, and two peaks in 1987, one in the rainy season and one in the dry season. It was also shown that severity of diarrhoea in rotavirus positive cases was higher than in the negative cases. Rotavirus diarrhoeic patients had more loose stools per day, and higher frequencies of vomiting and fever, resulting more often (> 2 times) in moderate or severe dehydration. Finally, it is concluded that the introduction of immunoprophylaxis may reduce significantly the high mortality rates in early childhood observed in S. Luís.

The significance of physical development on the blood pressure curve of children between 6 and 9 years of age and its relationship with familial aggregation.

Arterial blood pressure values of 3109 children between 6 and 9 years of age in the city of Rio de Janeiro were analysed according to low, medium and high socio-economic levels. At medium and high socio-economic levels, arterial pressures, weight and height were higher than those observed in children of a lower socio-economic level. Blood pressure was best correlated to body weight. The aggregation of arterial pressure, weight and height was compared between family members of children with percentiles below 50 and above 90. Systolic blood pressure and weight were significantly lower in family members with a percentile below 50. We conclude that there is a need for a long-term follow-up of these children and their families, in order to improve our knowledge of the mechanisms involved in the origin of arterial hypertension.