Risk Factors for Early Lower Limb Re-Amputation in Vascular Diseases.

BACKGROUND: Numerous risk factors for lower limb amputations are known; however, this study aimed to identify risk factors for re-amputation in patients within 6 months from an initial lower limb amputation procedure. METHODS: This single-center retrospective cohort study was performed at the Hospital Regional Hans Dieter Schmidt in Brazil. The study included patients who were aged at least 18 years and had undergone lower limb amputation between 2013 and 2022. Patients who died while hospitalized and patients who were lost to follow-up after hospital discharge were excluded from the study. Patient age, sex, number of amputations, revision time, comorbidities, and potential risk factors were extracted from the physical therapy service database and electronic medical records of the hospital. Chi-squared test and student's t-test were used to identify statistical significance. RESULTS: A total of 652 patients were included, of which 35.2% (230) patients underwent re-amputation within 6 months of the first operation. We found that dialysis (P = 0.004; odds ratio [OR] 8.36, 95% confidence interval [CI] 3.09-20.5), smoking (P = 0.004; OR 1.67, 95% CI 1.18-2.35), and hypertension (P = 0.02; OR 1.55, 95% CI 1.09-2.19) were predictive factors for re-amputation within 6 months of lower limb amputation. CONCLUSIONS: Therefore, it is important to intervene early and provide additional support to patients undergoing lower limb amputation with these risk factors to reduce the potential for re-amputation in the future.

Red wine but not alcohol consumption improves cardiovascular function and oxidative stress of the hypertensive-SHR and diabetic-STZ rats.

AIMS: This raised the issue of whether in vivo long-term red wine treatment can act as a modulator of these targets. MAIN METHODS: We monitored SBP, glucose tolerance, oxidative stress, and cardiovascular function. Aortic and atrial tissues from normotensive-WKY, hypertensive-SHR, and diabetic-STZ animals, chronically exposed to red wine (3.715 ml/kg/v.o/day) or alcohol (12%) for 21-days, were used to measure contractile/relaxation responses by force transducers. Key findings: red wine, but not alcohol, prevented the increase of SBP and hyperglycemic peak. Additionally, was observed prevention of oxidative stress metabolites formation and an improvement in ROS scavenging antioxidant capacity of SHR. We also revealed that red wine intake enhances the endothelium-dependent relaxation, decreases the hypercontractile mediated by angiotensin-II in the aorta, and via ß1-adrenoceptors in the atrium. SIGNIFICANCE: The long-term consumption of red wine can improve oxidative stress and the functionality of angiotensin-II and ß1-adrenoceptors, inspiring new pharmacologic and dietetic therapeutic approaches for the treatment of hypertension and diabetes.Abbreviation Acronyms and/or abbreviations: [Ca2+]cyt = Cytosolic Ca2+ Concentration; ACh = Acetylcholine; ANG II = Angiotensin II; AT1 = ANG II type 1 receptor; AUC = Area Under the Curve; Ca2+ = Calcium; Endo + = Endothelium Intact; Fen = Phenylephrine (1 µM); GTT = Glucose Tolerance Test; ISO = Isoprenaline (isoproterenol); KHN = Krebs-Henseleit Nutrient; LA = Left Atria; LH = Lipid Hydroperoxide; NO = Nitric Oxide; RA = Right Atria; RAS = Renin-Angiotensin System; ROS = Reactive Oxygen Species; SBP = Systolic Blood Pressure; SHR = Spontaneously Hypertensive Rats; STZ = Streptozotocin; WKY = Normotensive Wistar Kyoto Rats.

Function of AT1 and AT2 receptors in atrial contractions from spontaneous hypertensive and diabetic-induced streptozotocin rats.

Diabetes mellitus and hypertension are diseases that are strongly correlated. A major factor in this correlation is the renin-angiotensin system (RAS), with the peptide angiotensin II being a key component. This study analyzed the impact of Angiotensin Type 1 receptor (AT1R) and Angiotension Type 2 receptor (AT2R) in atrial function. MAIN METHODS: To perform the experiments, Wistar Kyoto rats (WKY), diabetic streptozotocin-induced WKY rats and spontaneously hypertensive rats (SHR) were used, and stimulation of cardiovascular function was done by means of the following drugs: angiotensin II, novokinin and the antagonists losartan and PD123177. We also measured the systolic blood pressure (SBP). RESULTS: An increase in AT1R function was observed in diabetic and hypertensive rats (18% in right atria [RA] and 11% in left atria [LA]). We also observed an increase in calcium release from the endoplasmic reticulum in right atria of diabetic rats (31%) and in right atria of hypertensive rats (35%). On the other hand, a decreased response of AT2R in diabetic and hypertensive rats was observed, this decreased response was greater in hypertensive rats (RA, 10%; LA, 12%). These results have demonstrated a dysfunction of the RAS that may contribute to the common dysfunctions of the cardiovascular system in diabetic and hypertensive rats.

Alteration of purinergic neurotransmission in isolated atria of streptozotocin-induced diabetic rats.

Cardiac dysfunctions are described in diabetes. However, the role of purinergic neurotransmission in diabetes-related cardiovascular diseases is unknown. The purpose of this study was to evaluate the purinergic neurotransmission in isolated atria from streptozotocin-induced diabetic rats. The animals were grouped as control and diabetic with 30 days (D30) and 60 days (D60) after streptozotocin-induced diabetes. The isolated left and right atria were used in functional experiments. The effects of adenosine triphosphate, uridine diphosphate, and adenosine were evaluated on atrial inotropism and chronotropism. The antagonists 8-cyclopentyl-1,3-dipropylxanthine and pyridoxal-phosphate-6-azophenyl-2',4'-disulfonate were also used, as blockers of P1 and P2 receptors, respectively. A negative inotropic effect followed by a positive inotropic effect was induced by adenosine triphosphate in isolated atria. This negative inotropic effect was decreased by 25% in left atria of D30. Additionally, the apparent affinity for adenosine was diminished in left atria of D30, suggesting changes in P1 receptor function. No changes were found in the right atria of D30 stimulated by adenosine. The left atria and right atria stimulated by uridine diphosphate showed an increased inotropic effect of 92% and 17%, respectively. No changes were observed in left and right atria of D30 stimulated by uridine diphosphate. Our data showed the involvement of purinergic neurotransmission in diabetes-related cardiovascular changes.

Chronic resveratrol consumption prevents hypertension development altering electrophysiological currents and Ca2+ signaling in chromaffin cells from SHR rats.

Resveratrol (RESV) is one of the most abundant polyphenol-stilbene compounds found in red wine with well-established cardioprotective and antihypertensive effects. Hyperactivity of the sympathoadrenal axis seems to be one of the major contributing factors in the pathogenesis of human essential hypertension. Alterations in outward voltage-dependent potassium currents (IK) and inward voltage-dependent sodium (INa), calcium (ICa) and nicotinic (IACh) currents, CCs excitability, Ca2+ homeostasis, and catecholamine exocytosis were previously related to the hypertensive state. This raised the issue of whether in vivo long-term RESV treatment can directly act as a modulator of Ca2+ influx or a regulator of ion channel permeability in CCs. We monitored outward and inward currents, and cytosolic Ca2+ concentrations ([Ca2+]c) using different pharmacological approaches in CCs from normotensive (WKY) and hypertensive (SHR) animals chronically exposed to trans-RESV (50 mg/L/v.o, 28 days). The long-term RESV treatment prevented the increase of the systolic blood pressure (SBP) in SHR, without reversion of cardiac hypertrophy. We also found an increase of the outward IK, reduction in inward INa,ICa, and IACh, and the mitigation of [Ca2+]c overload in CCs from SHR at the end of RESV treatment. Our data revealed that electrophysiological alterations of the CCs and in its Ca2+ homeostasis are potential new targets related to the antihypertensive effects of long-term RESV treatment.

Household cardiovascular screening in adolescents from high-risk families.

BACKGROUND: Some cardiovascular risk factors identified in adults are already present in many children. OBJECTIVE: To identify adolescents that are at risk for developing cardiovascular disease based on the presence of risk factors in their parents and their own lipid profiles, fasting plasma glucose, and blood pressure. METHODS: 182 families were selected. The adolescents were divided into two groups: group I consisted of adolescents from high-risk families and group II consisted of adolescents from healthy families. RESULTS: For total cholesterol (TC), group I presented higher values when compared to group II (153.2 ± 26.5 mg/dL and 138.3 ± 22.0 mg/dL, respectively; p = 0.001). For low-density lipoprotein cholesterol (LDL-C), group I had higher values when compared to group II (80.2 ± 24.8 mg/dL and 62.6 ± 12.3 mg/dL, respectively; p = 0.001). For high-density lipoprotein cholesterol (HDL-C), group I had lower values when compared to group II (53.8 ± 12.3 mg/dL and 63.9 ± 13.4 mg/dL, respectively; p = 0.001). For the values of triglycerides (TG), group I presented higher values when compared to group II (86.98 ± 42.84 mg/dL and 72.50 ± 33.24 mg/dL, respectively; p = 0.014). And for fasting plasma glucose, group I had higher values when compared to group II (81.8 ± 13.2 mg/dL and 77.0 ± 9.7 mg/dL, respectively; p = 0.039). Systolic blood pressure, diastolic blood pressure, and high-sensitivity C - reactive protein did not differ between groups. CONCLUSIONS: Adolescents from high-risk families had higher basal levels of TC, LDL-C, TG, and fasting plasma glucose and lower basal levels of HDL-C. Whether these findings will influence the development of cardiovascular risk factors or diseases in these subjects should be investigated in future studies.

Hypercholesterolemia and hepatic steatosis in mice fed on low-cost high-fat diet / Hipercolesterolemia e esteatose hepática em camundongos submetidos a uma dieta hiperlipídica de baixo custo

To verify whether high-fat diet prepared from commercial diet plus chocolate, roasted peanuts and corn cookies induces hypercholesterolemia in mice and whether there is any hepatic involvement in this type of animal testing. Swiss mice received a high-fat diet for 15 and 30 days; plasma cholesterol, triglycerides and glucose rates were determined. Hepatic impairment was evaluated by histopathological analysis. Cholesterol levels increased 43% in animals treated with high-fat diet for 30 days. Further, histopathological analysis revealed that treatment of animals for 15 and 30 days produced hepatic steatosis and steatohepatitis, respectively. Experimental model is suitable for assessing the action of anti-hypercholesterolemia and the treatment of steatohepatitis.

Verificar se a dieta hiperlipídica preparada a partir de ração comercial acrescida de chocolate, amendoim torrado e bolacha de maisena é capaz de induzir hipercolesterolemia em camundongos e se há comprometimento hepático neste modelo de experimentação animal. Camundongos Swiss receberam a dieta hiperlipídica por 15 e 30 dias e após isso, foram realizadas dosagens plasmáticas de colesterol, glicose e triglicerídeos. O comprometimento hepático foi avaliado por análises histopatológicas. Os níveis de colesterol aumentaram em 43% nos animais após o tratamento com a dieta por 30 dias. Na análise do fígado, contatou -se esteatose e esteato-hepatite nos animais tratados com a dieta por 15 e 30 dias, respectivamente. Este modelo experimental é adequado para a avaliação da ação de fármacos anti-hipercolesterolêmicos e que auxiliem no tratamento da esteato-hepatite