Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial.

BACKGROUND: Mothers of preterm infants often have symptoms of anxiety and depression, recognized as risk factors for the development of cardiovascular diseases and associated with low rates of heart rate variability (HRV). This study aimed to evaluate the influence of music therapy intervention on the autonomic control of heart rate, anxiety, and depression in mothers. METHODS: Prospective randomized clinical trial including 21 mothers of preterms admitted to the Neonatal Intensive Care Unit of a tertiary hospital, recruited from August 2015 to September 2017, and divided into control group (CG; n = 11) and music therapy group (MTG; n = 10). Participants underwent anxiety and depression evaluation, as well as measurements of the intervals between consecutive heartbeats or RR intervals for the analysis of HRV at the first and the last weeks of hospitalization of their preterms. Music therapy sessions lasting 30-45 min were individually delivered weekly using receptive techniques. The mean and standard deviation of variables were obtained and the normality of data was analyzed using the Kolmogorov-Smirnov test. The paired sample t-test or Wilcoxon test were employed to calculate the differences between variables before and after music therapy intervention. The correlations anxiety versus heart variables and depression versus heart variables were established using Spearman correlation test. Fisher's exact test was used to verify the differences between categorical variables. A significance level of p < 0.05 was established. Statistical analysis were performed using the Statistical Package for the Social Sciences, version 20. RESULTS: Participants in MTG had an average of seven sessions of music therapy, and showed improvement in anxiety and depression scores and autonomic indexes of the time domain (p < 0.05). Significant correlations were found between depression and parasympathetic modulation using linear (r = - 0.687; p = 0.028) and nonlinear analyses (r = - 0.689; p = 0.027) in MTG. CONCLUSION: Music therapy had a significant and positive impact on anxiety and depression, acting on prevention of cardiovascular diseases, major threats to modern society. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (no. RBR-3x7gz8 ). Retrospectively registered on November 17, 2017.

Effects of High-Intensity Interval Training vs. Sprint Interval Training on Anthropometric Measures and Cardiorespiratory Fitness in Healthy Young Women.

Purpose: To compare the effects of 8 weeks of two types of interval training, Sprint Interval Training (SIT) and High-Intensity Interval Training (HIIT), on anthropometric measures and cardiorespiratory fitness in healthy young women. Methods: A randomized clinical trial in which 49 young active women [age, 30.4 ± 6.1 years; body mass index, 24.8 ± 3.1 kg.m-2; peak oxygen consumption (VO2peak), 34.9±7.5 mL.kg-1.min-1] were randomly allocated into a SIT or HIIT group. The SIT group performed four bouts of 30 s all-out cycling efforts interspersed with 4 min of recovery (passive or light cycling with no load). The HIIT group performed four bouts of 4-min efforts at 90-95% of peak heart rate (HRpeak) interspersed with 3 min of active recovery at 50-60% of HRpeak. At baseline and after 8 weeks of intervention, waist circumference, skinfolds (triceps, subscapular, suprailiac, abdominal, and thigh), body mass and BMI were measured by standard procedures and cardiorespiratory fitness was assessed by cardiorespiratory graded exertion test on an electromagnetically braked cycle ergometer. Results: The HIIT and SIT groups improved, respectively, 14.5 ± 22.9% (P < 0.001) and 16.9 ± 23.4% (P < 0.001) in VO2peak after intervention, with no significant difference between groups. Sum of skinfolds reduced 15.8 ± 7.9 and 22.2 ± 6.4 from baseline (P < 0.001) for HIIT and SIT groups, respectively, with greater reduction for SIT compared to HIIT (P < 0.05). There were statistically significant decreases in waist circumference (P < 0.001) for the HIIT (-3.1 ± 1.1%) and SIT (-3.3 ± 1.8%) groups, with no significant difference between groups. Only SIT showed significant reductions in body weight and BMI (p < 0.05). Conclusions: Eight weeks of HIIT and SIT resulted in improvements in anthropometric measures and cardiorespiratory fitness, even in the absence of changes in dietary intake. In addition, the SIT protocol induced greater reductions than the HIIT protocol in the sum of skinfolds. Both protocols appear to be time-efficient interventions, since the HIIT and SIT protocols took 33 and 23 min (16 and 2 min of effective training) per session, respectively.

A Luciferase-Expressing Leishmania braziliensis Line That Leads to Sustained Skin Lesions in BALB/c Mice and Allows Monitoring of Miltefosine Treatment Outcome.

BACKGROUND: Leishmania braziliensis is the most prevalent species isolated from patients displaying cutaneous and muco-cutaneous leishmaniasis in South America. However, there are difficulties for studying L. braziliensis pathogenesis or response to chemotherapy in vivo due to the natural resistance of most mouse strains to infection with these parasites. The aim of this work was to develop an experimental set up that could be used to assess drug efficacy against L. braziliensis. The model was tested using miltefosine. METHODOLOGY/PRINCIPAL FINDINGS: A L. braziliensis line, originally isolated from a cutaneous leishmaniasis patient, was passaged repeatedly in laboratory rodents and further genetically manipulated to express luciferase. Once collected from a culture of parasites freshly transformed from amastigotes, 106 wild type or luciferase-expressing stationary phase promastigotes were inoculated subcutaneously in young BALB/c mice or golden hamsters. In both groups, sustained cutaneous lesions developed at the site of inoculation, no spontaneous self- healing being observed 4 months post-inoculation, if left untreated. Compared to the wild type line features, no difference was noted for the luciferase-transgenic line. Infected animals were treated with 5 or 15 mg/kg/day miltefosine orally for 15 days. At the end of treatment, lesions had regressed and parasites were not detected. However, relapses were observed in animals treated with both doses of miltefosine. CONCLUSIONS/SIGNIFICANCE: Here we described experimental settings for a late-healing model of cutaneous leishmaniasis upon inoculation of a luciferase-expressing L. braziliensis line that can be applied to drug development projects. These settings allowed the monitoring of the transient efficacy of a short-term miltefosine administration.

Generation of luciferase-expressing Leishmania infantum chagasi and assessment of miltefosine efficacy in infected hamsters through bioimaging.

BACKGROUND: The only oral drug available for the treatment of leishmaniasis is miltefosine, described and approved for visceral leishmaniasis in India. Miltefosine is under evaluation for the treatment of cutaneous leishmaniasis in the Americas although its efficacy for the treatment of human visceral leishmaniasis caused by Leishmania infantum chagasi has not been described. Drug efficacy for visceral leishmaniasis is ideally tested in hamsters, an experimental model that mimics human disease. Luciferase has been validated as a quantitative tool for the determination of parasite burden in experimental leishmaniasis. However, there are no reports of luciferase detection in the model of progressive visceral leishmaniasis in hamsters. Therefore, the aims of this study were to generate recombinant Leishmania infantum chagasi expressing the luciferase gene (Lc-LUC), characterize the biological properties of this transgenic line as compared with the wild-type parasites and evaluate miltefosine effectiveness in Lc-LUC infected hamsters. METHODOLOGY/PRINCIPAL FINDINGS: A transgenic line containing a luciferase encoding gene integrated into the ribosomal DNA locus was obtained and shown to produce bioluminescence which correlated with the number of parasites. Lc-LUC growth curves and susceptibility to pentavalent antimony and miltefosine in vitro were indistinguishable from the wild-type parasites. The effectiveness of pentavalent antimony was evaluated in Lc-LUC infected hamsters through bioimaging and determination of Leishman Donovan Units. Both methods showed concordant results. Miltefosine was effective in the treatment of Lc-LUC-infected hamsters, as demonstrated by the reduction in parasite burden in a dose-dependent manner and by prolongation of animal survival. CONCLUSIONS/SIGNIFICANCE: Luciferase expressing parasites are a reliable alternative for parasite burden quantification in hamsters with advantages such as the possibility of estimating parasite load before drug treatment and therefore allowing distribution of animals in groups with equivalent mean parasite burden. Miltefosine was effective in vivo in an L. infantum chagasi experimental model of infection.