Interferential Current Electrotherapy is More Effective Thanthan TENS VIF in Cancer Pain Management / Corrente Interferencial é Mais Efetiva para Alívio da Dor Oncológica que a TENS VIF

Cancer diagnosis is increasing rapidly worldwide and pain is a common feature reported by cancer patients. Therapeutical approach on cancer pain is complex where less invasive methods with little side effects have been sought. The aim of this study was to compare transcutaneous electrical nerve stimulation (TENS) and interferential current (IC) therapies effects on cancer pain. Double blind study with 81 cancer pain patients. Subjects were set up into two groups: one treated with TENS VIF (n=42) and other with IC (n=39). Age, gender, duration of pain, tumor site and histology, medications, treatments, Karnofsky score and clinical state were evaluated. Pain was measured by EMADOR and McGill scores. Electroanalgesia was performed for 30 minutes, the equipments used were Neurodyn III Ibramed® and Neurovector generation 2000 Ibramed®. Electrodes were placed where there was higher intensity of pain according to what was shown by the patient through EMADOR, and each one got only one electrotherapy session. Pain intensity was significantly reduced in both groups (p<0.001) soon after and until 6th hour post electrotherapy. IC group had better results at 4th, 5th (p<0.001) and 6th hour (p=0.022). McGill score in TENS VIF group was significant until 4th hour and in the IC group was highly significant in all evaluated times (p<0.001). Analgesic effect of TENS VIF and IC electrotherapy was clinically effective, however, IC did cause better results regarding analgesia duration.(AU)

O diagnóstico de câncer está aumentando rapidamente em todo o mundo e a dor é uma característica comum relatada por pacientes com câncer. A abordagem terapêutica da dor oncológica é complexa onde métodos menos invasivos e com poucos efeitos colaterais têm sido buscados. O objetivo deste estudo foi comparar os efeitos das terapias de estimulação elétrica nervosa transcutânea (TENS) e corrente interferencial (IC) na dor oncológica. Estudo duplo-cego com 81 pacientes com dor oncológica. Os indivíduos foram divididos em dois grupos: um tratado com TENS VIF (n=42) e outro com IC (n=39). Idade, sexo, duração da dor, local do tumor e histologia, medicamentos, tratamentos, pontuação de Karnofsky e estado clínico foram avaliados. A dor foi mensurada pelos escores EMADOR e McGill. A eletroanalgesia foi realizada por 30 minutos, os equipamentos utilizados foram Neurodyn III Ibramed® e Neurovector geração 2000 Ibramed®. Os eletrodos foram colocados onde havia maior intensidade de dor de acordo com o apresentado pelo paciente através da EMADOR. A intensidade da dor foi significativamente reduzida em ambos os grupos (p<0,001) logo após e até a 6ª hora pós-eletroterapia. O grupo CI teve melhores resultados na 4ª, 5ª (p<0,001) e 6ª hora (p=0,022). O escore de McGill no grupo TENS VIF foi significativo até a 4ª hora e no grupo IC foi altamente significativo em todos os tempos avaliados (p<0,001). O efeito analgésico da TENS VIF e da eletroterapia com IC foi clinicamente eficaz, porém a IC trouxe melhores resultados quanto à duração da analgesia.(AU)

Consumption of latex from Euphorbia tirucalli L. promotes a reduction of tumor growth and cachexia, and immunomodulation in Walker 256 tumor-bearing rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Euphorbia tirucalli L. is an African plant that grows well in Brazil. Individuals diagnosed with cancer frequently consume latex from E. tirucalli, dissolved in drinking water. In vitro studies confirm the antitumor potential of E. tirucalli latex, but in vivo evaluations are scarce. AIM OF THE STUDY: To evaluate the effect of intake of an aqueous solution of E. tirucalli latex on tumor growth, cachexia, and immune response in Walker 256 tumor-bearing rats. MATERIALS AND METHODS: Latex from E. tirucalli was collected and analyzed by LC-MS. Sixty male Wistar rats (age, 90 days) were randomly divided into four groups: C, control group (without tumor); W, Walker 256 tumor-bearing group; SW1, W animals but treated with 25 µL latex/mL water; and SW2, W animals but treated with 50 µL latex/mL water. Animals received 1 mL of latex solution once a day by gavage. After 15 d, animals were euthanized, tumor mass was determined, and glucose and triacylglycerol serum levels were measured by using commercial kits. Change in the body weight during tumor development was calculated, and proliferation capacity of tumor cells was assessed by the Alamar Blue assay. Phagocytosis and superoxide anion production by peritoneal macrophages and circulating neutrophils were analyzed by enzymatic and colorimetric assays. Data are analyzed by one-way ANOVA followed by Tukey's post-hoc test, with the significance level set at 5%. RESULTS: The analysis of the latex revealed the presence of triterpenes. The ingestion of the latex aqueous solution promoted 40% and 60% reduction of the tumor mass in SW1 and SW2 groups, respectively (p < 0.05). The proliferative capacity of tumor cells from SW2 group was 76% lower than that of cells from W group (p < 0.0001). Animals treated with latex gained, on average, 20 g (SW1) and 8 g (SW2) weight. Glucose and triacylglycerol serum levels in SW1 and SW2 animals were similar to those in C group rats. Peritoneal macrophages and blood neutrophils from SW1 and SW2 animals produced 30-40% less superoxide anions than those from W group animals (p < 0.05), but neutrophils from SW2 group showed an increased phagocytic capacity (20%, vs. W group). CONCLUSIONS: E. tirucalli latex, administered orally for 15 d, efficiently reduced tumor growth and cachexia in Walker 256 tumor-bearing rats. Decreased tumor cell proliferative capacity was one of the mechanisms involved in this effect. Further, the data suggest immunomodulatory properties of E. tirucalli latex. The results agree with folk data on the antitumor effect of latex ingestion, indicating that it may be useful as an adjunct in the treatment of cancer patients. For this, further in vivo studies in animal and human models need to be conducted.

Brazilian Version of Cancer Fatigue Scale: Validation of the Brazilian Version of Cancer Fatigue Scale in Patients With Breast Cancer.

CONTEXT: Scales to assess the fatigue in patients with cancer may help the clinical decision-making process. OBJECTIVES: The objective of this study was to cross-culturally adapt and determine the validity of the Brazilian version of Cancer Fatigue Scale. METHODS: Translation and cross-cultural adaptation followed the recommendations of international guidelines. One hundred fifty-one women with breast cancer participated in the validity phase and they filled out the Brazilian version of another instruments (Piper Fatigue Scale Revised, Beck Depression Inventory, Verbal Numerical Rating Scale, and Karnofsky Performance Scale). The measurement properties of reliability, internal consistency, and validity were measured. RESULTS: The few discrepancies identified in the back-translation were solved by consensus, and the Cancer Fatigue Scale was successfully translated and cross-culturally adapted. The Brazilian version of Cancer Fatigue Scale showed good stability (test-retest reliability intraclass correlation coefficient = 0.95, 95% CI = 0.94-0.97 and interexaminer reliability intraclass correlation coefficient = 0.98, 95% CI = 0.97-0.99) and good internal consistency (Cronbach's alpha >0.70 for the three subscales/domains). The high correlation was found with Piper Fatigue Scale (r = 0.643) and Beck Depression Inventory (r = 0.509) in terms of validity. However, a reasonable correlation was found with Verbal Numerical Rating Scale (r = 0.302) and Karnofsky Performance Scale (r = -0.324). CONCLUSION: Here, we validated the Cancer Fatigue Scale in breast cancer Brazilian women meaning its use for the identification and evaluation of cancer-related fatigue in patients with breast cancer.

New insights on the regulation of cancer cachexia by N-3 polyunsaturated fatty acids.

Cancer cachexia is a multifactorial syndrome that develops during malignant tumor growth. Changes in plasma levels of several hormones and inflammatory factors result in an intense catabolic state, decreased activity of anabolic pathways, anorexia, and marked weight loss, leading to cachexia development and/or accentuation. Inflammatory mediators appear to be related to the control of a highly regulated process of muscle protein degradation that accelerates the process of cachexia. Several mediators have been postulated to participate in this process, including TNF-α, myostatin, and activated protein degradation pathways. Some interventional therapies have been proposed, including nutritional (dietary, omega-3 fatty acid supplementation), hormonal (insulin), pharmacological (clenbuterol), and nonpharmacological (physical exercise) therapies. Omega-3 (n-3) polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid, are recognized for their anti-inflammatory properties and have been used in therapeutic approaches to treat or attenuate cancer cachexia. In this review, we discuss recent findings on cellular and molecular mechanisms involved in inflammation in the cancer cachexia syndrome and the effectiveness of n-3 PUFAs to attenuate or prevent cancer cachexia.

Immunomodulatory and Antitumoral Properties of Ganoderma lucidum and Agaricus brasiliensis (Agaricomycetes) Medicinal Mushrooms.

Medicinal mushrooms are used in popular medicine largely as health promoters, mainly because of their antitumor and immunomodulatory activities. Ganoderma lucidum (lingzhi or reishi) and Agaricus brasiliensis are mushrooms that have long been used for medicinal purposes. This study evaluated their immunomodulatory and antitumor effects on mice fed a diet supplemented with G. lucidum and A. brasiliensis mycelia obtained from solid-state fermentation. For 14 weeks the mice were fed chow containing 50% A. brasiliensis and G. lucidum mycelia, using ground wheat as an excipient. The consumption of the supplemented diet inhibited Sarcoma 180 tumor growth and caused important changes in the immune system. The pattern of immune response shifted, increasing CD4+ and CD8+ and decreasing CD19+ cell populations. The restoration of a proper balance between cellular and humoral immunity is an essential process for restraining tumor growth. These results suggest that polysaccharides, such as ß-glucans and other mushroom metabolites, possibly promote the T-cell dominance that is imperative to restrain tumor growth.

Spatiotemporal mapping of soybean plantations in Rondônia, Western Brazilian Amazon

Os plantios de soja têm aumentado ao Norte e Sul dos municípios de Rondônia na última década, entretanto a área plantada de soja tem sido estimada utilizando dados secundários, o que limita o entendimento da distribuição espaço temporal da soja. Este estudo buscou analisar e mapear os padrões espaciais de expansão da soja em Rondônia. O mapeamento de plantios de soja nos anos 2000, 2005, 2010 e 2014 foi feito a partir de uma técnica de classificação baseada na análise de mistura espectral de imagens Landsat e em uma árvore de decisão. A acurácia global, erros de omissão e comissão para o mapeamento da soja foram 93%, 23% e 0%, respectivamente. Os resultados mostraram que os maiores incrementos da área de soja ocorreram no estado de Rondônia entre os períodos de 2000-2005 e 2005-2010 (33,239 ha e 59,628 ha, respectivamente). A expansão das áreas de soja para o norte de Rondônia (25,627 ha) ocorreu em sua maioria no período de 2010 a 2014. Observou-se que 95,4% de todos os plantios de soja detectados em 2014 ocorreram em áreas com pelo menos nove anos de desmatamento. Além disso, encontramos evidências de que os plantios de soja estão contribuindo para o deslocamento de usos da terra prévios de antigas zonas de colonização, predominantemente pastos que foram empurrados para outras áreas de fronteiras da Amazônia, e lá exacerbando novos desmatamentos. (AU)

Obesidade grau II leva a importantes alterações na capacidade cardiorrespiratória / Changes of cardiorespiratory capacity in obesity grade II

Introdução: Obesidade é considerada epidemia mundial e um dos maiores problemas de saúde na atualidade, bem como as comorbidades a ela associadas que acarretam alterações nas funções cardiorrespiratórias desses indivíduos. Objetivo: Avaliar parâmetros cardiorrespiratórios em indivíduos sedentários obesos grau II. Os 44 voluntários foram divididos igualmente em dois grupos, obesos (GOS) e eutróficos (GE). Material e métodos: Foram mensuradas variáveis de expansibilidade torácica, força muscular respiratória, pico de fluxo expiratório (PFE), capacidade vital, além das variáveis do teste de caminhada de seis minutos (TC6). Resultados: Comparando os grupos, o GOS apresentou expansibilidade torácica com diferença significativa na inspiração (P = 0,038) e na expiração (P = 0,031) máximas do processo xifoide e na inspiração máxima (P = 0,039) da cicatriz umbilical, e PFE (P < 0,001). No TC6 o GOS apresentou frequência cardíaca (FC) em repouso mais elevada (P = 0,022) no pré-teste e saturação de oxigênio (SpO2) (P = 0,030) e distância percorrida (P < 0,001) menores, e Borg (P < 0,001) maior no pós-teste em relação ao GE. Comparando os parâmetros no pré e pós-TC6 houve alterações significativas da FC, frequência respiratória (FR), SpO2 e escala de Borg (toda com P < 0,001). Conclusão: A obesidade resulta em várias alterações cardiorrespiratórias importantes, incluindo aumento do trabalho respiratório, diminuição da expansibilidade torácica, obstrução ao fluxo aéreo e diminuição da saturação periférica de oxigênio. (AU)

Introduction: Obesity is a worldwide epidemic and one of the largest health problems leading to changes in the cardiorespiratory system. Objective: The aim of this study was to evaluate cardiorespiratory features on sedentary obese grade II subjects. Methods: Forty four individuals were divided into two groups referred as eutrophic (EG) and obese (OG). We measured chest expansion, respiratory muscle strength, expiratory peak flow (EPF), vital capacity and physiological variables in the six minute walk test (6MWT). Results: OG group showed a chest expansion with a significant difference in the expiration (P = 0.038) and expiration (P = 0.031) maximum in the xiphoid process and maximal inspiration (P = 0.039) of the umbilicus, and EPF (P < 0.001) when compared to EG group. In the 6MWT, OG showed at the pretest a rest heart rate (HR) higher (P = 0.022) and oxygen saturation (O2) (P = 0.030) and distance traveled (P < 0.001) lower, and Borg scale (P < 0.001) higher in the post-test when compared to GE. Comparison between pre- and post-6MWT was no significant changes in the HR, respiratory rate (RR), SpO2 and Borg scale (all P < 0.001). Conclusion: Sedentary obese individuals grade II have cardiorespiratory alterations, particularly in the chest expansion, EPF, HR, RR and SpO2. (AU)

INTERVAL TRAINING IS INSUFFICIENT TO ATTENUATE METABOLIC DISTURBANCES IN DIABETIC RATS / TREINAMENTO INTERVALADO É INSUFICIENTE PARA ATENUAR DISTÚRBIOS METABÓLICOS EM RATOS DIABÉTICOS / ENTRENAMIENTO A INTERVALOS ES INSUFICIENTE PARA ATENUAR TRASTORNOS METABÓLICOS EN RATAS DIABÉTICAS

ABSTRACT Introduction: Type 1 diabetes is a metabolic disease associated to blood disturbances and disorder of the innate immune system functionality. Objective: This study investigated the effect of two weeks interval training on blood biochemistry and immunological parameters in rats with type 1 diabetes. Methods: Male Wistar rats were divided into three groups: sedentary (SE, n = 10), diabetic sedentary (DI, n = 10), diabetic interval training (DIT, n = 10). IV injection of streptozotocin (45 mg/kg) induced diabetes. Interval training consisted of swimming exercise for 30 seconds with 30 seconds of rest for 30 minutes three times a week during two weeks, with an overload of 15% of the total body mass. The evaluations performed were fasting blood glucose, triglycerides, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol concentrations, phagocytic capacity, cationic vesicles content, superoxide anion, and production of hydrogen peroxide of blood neutrophils and peritoneal macrophages. Results: The results showed that two weeks interval training did not attenuate the hyperglycemic state at rest and did not decrease blood lipids in the DIT group. Diabetes increased the functionality of blood neutrophils and peritoneal macrophages in the DI group. Interval training increased the content of cationic vesicles and the phagocytic capacity of blood neutrophils and peritoneal macrophages in the DIT group. Conclusion: It was found that two weeks of interval training increased the functionality parameters of innate immune cells, although this has been insufficient to attenuate the biochemical disorders caused by diabetes.

RESUMO Introdução: O diabetes tipo 1 é uma doença metabólica associada a alterações sanguíneas e distúrbios da funcionalidade do sistema imunológico inato. Objetivo: Este estudo investigou os efeitos de duas semanas de treinamento intervalado sobre a bioquímica sanguínea e os parâmetros imunológicos em ratos com diabetes tipo 1. Métodos: Ratos Wistar machos foram divididos em três grupos: sedentário (SE, n = 10), sedentário diabético (SD, n = 10), treinado diabético (TD, n = 10). O diabetes foi induzido por uma injeção IV de estreptozotocina (45 mg/kg). O treinamento intervalado de natação consistiu em 30 segundos de exercício, com 30 segundos de recuperação, por 30 min., três vezes por semana, durante duas semanas, com sobrecarga de 15% da massa corporal total. Foram avaliados: glicemia de jejum, triglicerídeos, frações de lipoproteínas de muito baixa densidade, baixa densidade e alta densidade do colesterol, concentrações do colesterol total, capacidade fagocítica, conteúdo de vesículas catiônicas, produção de ânion superóxido e produção de peróxido de hidrogênio pelos neutrófilos sanguíneos e macrófagos peritoneais. Resultados: Os resultados mostraram que duas semanas de treinamento intervalado não atenuaram o estado hiperglicêmico em repouso e não diminuíram os lipídeos sanguíneos do grupo TD. O diabetes aumentou a funcionalidade dos neutrófilos sanguíneos e dos macrófagos peritoneais no grupo SD. O treinamento intervalado aumentou o conteúdo das vesículas catiônicas e a capacidade fagocítica dos neutrófilos sanguíneos e macrófagos peritoneais no grupo TD. Conclusão: Em duas semanas de treinamento intervalado verificou-se aumento dos parâmetros de funcionalidade das células do sistema imunológico inato, que foi, porém, insuficiente para atenuar os distúrbios bioquímicos causados pelo diabetes.

RESUMEN Introducción: La diabetes Tipo 1 es un trastorno metabólico asociado con alteraciones de la sangre y trastornos de la funcionalidad del sistema inmunológico innato. Objetivo: Este estudio investigó los efectos de dos semanas de entrenamiento a intervalos sobre la bioquímica de la sangre y los parámetros inmunológicos en ratas con diabetes tipo 1. Métodos: Ratas Wistar machos fueron divididos en tres grupos: sedentario (SE, n=10), sedentario diabético (SD, n = 10), entrenado diabético (ED, n = 10). La diabetes se indujo por medio de inyección IV de estreptozotocina (45 mg/kg). El entrenamiento a intervalos consistió en ejercicios de natación de 30 seg. con 30 seg. de recuperación por 30 minutos, tres veces por semana durante dos semanas, con una sobrecarga del 15% de la masa corporal total. Se evaluaron: glucemia en ayunas, triglicéridos, las fracciones de lipoproteínas de muy baja densidad, de lipoproteínas de baja densidad, de lipoproteínas de alta densidad del colesterol, las concentraciones de colesterol total, la capacidad fagocítica, contenido catiónico vesicular, producción de anión superóxido, producción de peróxido de hidrógeno por neutrófilos sanguíneos, y macrófagos peritoneales. Resultados: Los resultados mostraron que dos semanas de entrenamiento a intervalos no atenuó el estado hiperglucémico en reposo ni disminuyó los lípidos sanguíneos en el grupo ED. La diabetes aumentó la funcionalidad de los neutrófilos sanguíneos y de los macrófagos peritoneales en el grupo SD. El entrenamiento a intervalos aumentó el contenido de las vesículas catiónicas y la capacidad fagocítica de los neutrófilos de la sangre y los macrófagos peritoneales en el grupo ED. Conclusión: En dos semanas de entrenamiento a intervalos se verificó el aumento de los parámetros de funcionalidad de las células del sistema inmunológico innato, que sin embargo fue insuficiente para atenuar los trastornos bioquímicos causados por la diabetes.

Ultrassom terapêutico para cicatrização de feridas: revisão sistemática / Therapeutic ultrasound for wound healing: sistematic review

Introdução: o uso do ultrassom terapêutico (UST) para cicatrização de feridas ainda é discutido pela comunidade científica. Objetivo: determinar se o UST produz desfechos benéficos na cicatrização de feridas e quais tem sido os parâmetros utilizados para proporcionar melhor dose-resposta. Métodos: Foram pesquisadas as bases de dados PubMEd, SciELO e PEDro. Foram selecionados 19 ensaios clínicos, avaliados pelas escalas PEDro e JADAD. Resultados: dos 19 estudos, 8 relacionaram-se à aplicação do NCLFU (Noncontact Low Frequency Ultrasound) com evidência moderada para sua aplicação, 6 à aplicação do HFU (High Frequency Ultrasound) e 1 à aplicação de LIPUS (Low Intensity Pulsed Ultrasound), ambos com evidência limitada. Quanto a relação dose-resposta, não há concordância entre os estudos desta revisão. Conclusões: existe evidência moderada da NCLFU e limitada da HFU como recurso adjuvante para o tratamento de feridas, não sendo possível responder com clareza a melhor relação dose-resposta.

Introduction: the use therapeutic ultrasound (TUS) in wound healing is still discussed by the scientific community. Objetive: to determine whether the UST produces beneficial outcomes in wound healing and the parameters wich have been used to provide better dose-response. Methods: The databases PubMed, SciELO and PEDro were searched. We selected 19 clinical trials, assessed by the PEDro scale and JADAD. Results: of 19 studies, 8 were related to the application of NCLFU (Noncontact Low Frequency Ultrasound) with moderate evidence for its application; 6 were related to the application of HFU (High Frequency Ultrasound) and 1 was related to the application of LIPUS (Low Intensity Pulsed Ultrasound), both of with low evidence. Dose-response relationship there was no agreement between the studies in this review. Conclusion: there is moderate evidence of NCLFU and limited the HFU as an adjunct to wound care resource, not being able to respond clearly the best dose-response relationship.

Fish Oil Supplementation Enhances Pulmonary Strength and Endurance in Women Undergoing Chemotherapy.

We investigated the effect of fish oil (FO) supplementation, at 4 g/day, on the respiratory performance and blood lipid profile of 32 patients with breast cancer at the beginning of chemotherapy. They were randomized into two groups: control (C) and FO supplemented (S). Both groups underwent three respiratory evaluations and blood harvest (before chemotherapy-Day 0, and 30 and 60 days after supplementation). The S group showed a significant increase in the maximal inspiratory and expiratory pressure (P ≤ 0.05 vs. Day 0) and in the maximum voluntary ventilation (P ≤ 0.05). In the treadmill 6-min-walk test, the S group had a significant increase in the walked distance (P ≤ 0.05). Blood lactate concentration was significantly lower in the S group after 60 days, at rest, when compared to C (P ≤ 0.05). Plasma high-density lipoprotein (HDL) cholesterol concentration remained the same after 60 days of supplementation, while in the C group, it decreased significantly (P ≤ 0.05 Day 0 vs. Day 60). Triacylglycerol (TAG) plasma concentration in the S group was lower when compared to the C group (P ≤ 0.05 Day 60S vs. Day 60). Supplementation with FO caused improvement in the respiratory muscle strength and endurance, ameliorated functional performance, and kept TAG, HDL cholesterol, and lactate plasma concentration at normal levels.

A INFLUÊNCIA DO TREINAMENTO RESISTIDOE DA SUPLEMENTAÇÃO DO ÓLEO DE PEIXE EM PARÂMETROS SANGUÍNEOS EM MULHERES IDOSAS / THE INFLUENCE OF STRENGHT TRAINING AND FISH OIL SUPPLEMENTATION ON BLOOD PARAMETERS OF ELDERLY WOMEN

RESUMO Este estudo objetivou investigar o efeito crônico da óleo de peixe (FO) e o treinamento resistido (ST) nos parâmetros sanguíneos (glicemia, triglicérides e HDL, LDL colesterol VLDL) de mulheres idosas. Quarenta e cinco mulheres (64 ± 1,4 anos) foram distribuídas em três grupos: um grupo que realizou 90 dias de treinamento resistido (ST; n = 15), um grupo que realizou 90 dias de treinamento resistido associado à 2g / dia de óleo de peixe (ST90; n = 15) e o ultimo grupo que consumiu óleo de peixe por 60 dias antes de iniciar os 90 dias de treinamento resistido associado ao FO (ST150; n = 15). O treinamento foi realizado 3 vezes / semana, durante 12 semanas. Os parâmetros sanguíneos foram avaliados nos 3 grupos nas condições, pré-suplementação e pré-treinamento (PRÉ) e pós-suplementação (PÓS60) e pós-treinamento (PÓS). Os efeitos positivos foram comprovados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas (ST90 e ST150). A glicemia de ST e ST150 não apresentou mudanças entre PRÉ-PÓS e PRÉ-PÓS60, respectivamente. No entanto, quando foi combinado o exercício com o FO reduções na glicemia foram encontrados no ST90 (21%) e ST150 (19%) a partir de PRÉ e PÓS (p <0,05). A FO causou ganhos significativos no HDL (ST150 PRE- PÓS60). Contudo, o exercício foi eficaz quando acompanhado da suplementação FO (ST90, ST150, PRÉ-PÓS, p<.0.05). Os triglicérides do sangue diminuiu quando FO e o exercício resistido (p<0,05) foram aplicados separadamente (ST, ST90 e ST150 PRÉ, PÓS 60 e PÓS). Houve uma redução nas concentrações de VLDL em todos os grupos (26% de ST, 35% em ST90, ST150 de PÓS60 em 35% e 36% em PÓS). A LDL não foi alterada. Conclui-se que os parâmetros sanguíneos (triglicérides e VLDL) diminuiu quando FO e exercícios foram aplicados separadamente. Os efeitos positivos foram evidenciados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas.

ABSTRACT It was aimed to investigate the chronic effect of FO and ST on blood parameters (glycaemia, triglycerides, and HDL, LDL VLDL cholesterol) of elderly women. METHODS: Forty-five women (64 ± 1.4 years) were assigned to one group of strength training (ST; n=15), one group of strength and 2g/day of FO supplemented by 90 (ST90; n=15) and 150 days (ST150; n=15). The ST150 started FO 60 days before commencing the strength training. Training was performed 3 times/wk, for 12 weeks. The blood parameters were assessed at before supplementation (POST60), pre-training (PRE) and post-training (POST). Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined (ST90 e ST150). The glycaemia of ST and ST150 showed no changes between PRE-POST and POST60-PRE, respectively. However, when training was combined with FO supplementation reductions in the glycaemia were found in the ST90 (21%) and ST150 (19%) from PRE to POST (p<0.05). The FO caused significant gains in HDL (ST150 POST 60-PRE). The HDL was not influenced by exercise alone (ST PRE-POS; p>0.05). However, exercise was effective when accompanied by FO supplementation (ST90, ST150, PRE-POST, p<.0.05). The triglycerides decreased when FO and exercises (p<0.05) were applied separately (ST, ST90 and ST150 POST60-POST). No additional reductions were found by combining FO and exercise. There was a reduction in the concentrations of VLDL in all groups (26% for ST, 35% in ST90, ST150 base in 35% and 36% in post ST150). The LDL was not altered. In concluision The blood parameters (triglycerides and VLDL) decreased when FO and exercises were applied separately. No additional reductionswere found by combining FO and exercise. Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined.

Fish oil administration mediates apoptosis of Walker 256 tumor cells by modulation of p53, Bcl-2, caspase-7 and caspase-3 protein expression.

BACKGROUND: Several studies have been shown pro-apoptotic effects of fish oil (FO), rich in n-3 polyunsaturated fatty acids (n-3 PUFA) on cancer cells. Nevertheless, few in vivo experiments have provided data of its ability on apoptosis protein expression in tumor tissue. Thus, in this study we investigate the effect of FO supplementation on apoptosis protein expression in Walker 256 tumor bearing rats. Male Wistar rats were randomly assigned to three groups: fed with regular chow (W); fed regular chow supplemented with FO (WFO) or coconut fat (WCO) (1 g/kg body weight/daily). After thirty days, all animals were inoculated subcutaneously with Walker 256 tumor cells. FINDINGS: Protein expression was done by western blotting in Walker 256 tumor tissue samples. FO decreased the Bcl-2/Bax ratio (p < 0.05) and increased the p53 (p < 0.05), cleaved caspase-7 (p < 0.05) and cleaved caspase-3 (p < 0.05) in Walker 256 tumor tissue. CONCLUSIONS: Our data suggest that the pro-apoptotic effect of FO in Walker 256 tumor is related with specifics cleaved caspases.

Influence of fish oil supplementation and strength training on some functional aspects of immune cells in healthy elderly women.

Immune function changes with ageing and is influenced by physical activity (strength training, ST) and diet (fish oil, FO). The present study investigated the effect of FO and ST on the immune system of elderly women. Forty-five women (64 (sd 1.4) years) were assigned to ST for 90 d (ST; n 15), ST plus 2 g/d FO for 90 d (ST90; n 15) or 2 g/d FO for 60 d followed by ST plus FO for 90 d (ST150; n 15). Training was performed three times per week, for 12 weeks. A number of innate (zymosan phagocytosis, lysosomal volume, superoxide anion, peroxide of hydrogen) and adaptive (cluster of differentiation 4 (CD4), CD8, TNF-α, interferon-γ (IFN-γ), IL-2, IL-6 and IL-10 produced by lymphocytes) immune parameters were assessed before supplementation (base), before (pre-) and after (post-) training. ST induced no immune changes. FO supplementation caused increased phagocytosis (48 %), lysosomal volume (100 %) and the production of superoxide anion (32 %) and H2O2(70 %) in the ST90. Additional FO supplementation (ST150) caused no additive influence on the immune system, as ST150 and ST90 did not differ, but caused greater changes when compared to the ST (P< 0·05). FO increased CD4+ and CD8+ lymphocytes in the ST150, which remained unchanged when training was introduced. The combination of ST and FO reduced TNF-α in the ST150 from base to post-test. FO supplementation (ST150, base-pre) when combined with exercise (ST150, pre-post) increased IFN-γ, IL-2, IL-6 and IL-10 production. The immune parameters improved in response to FO supplementation; however, ST alone did not enhance the immune system.

Assessing Strategies for Heart Failure with Preserved Ejection Fraction at the Outpatient Clinic / Avaliação de Estratégias para Insuficiência Cardíaca com Fração de Ejeção Normal no Ambulatório

Background: Heart failure with preserved ejection fraction (HFPEF) is the most common form of heart failure (HF), its diagnosis being a challenge to the outpatient clinic practice. Objective: To describe and compare two strategies derived from algorithms of the European Society of Cardiology Diastology Guidelines for the diagnosis of HFPEF. Methods: Cross-sectional study with 166 consecutive ambulatory patients (67.9±11.7 years; 72% of women). The strategies to confirm HFPEF were established according to the European Society of Cardiology Diastology Guidelines criteria. In strategy 1 (S1), tissue Doppler echocardiography (TDE) and electrocardiography (ECG) were used; in strategy 2 (S2), B-type natriuretic peptide (BNP) measurement was included. Results: In S1, patients were divided into groups based on the E/E'ratio as follows: GI, E/E'> 15 (n = 16; 9%); GII, E/E'8 to 15 (n = 79; 48%); and GIII, E/E'< 8 (n = 71; 43%). HFPEF was confirmed in GI and excluded in GIII. In GII, TDE [left atrial volume index (LAVI) ≥ 40 mL/m2; left ventricular mass index LVMI) > 122 for women and > 149 g/m2 for men] and ECG (atrial fibrillation) parameters were assessed, confirming HFPEF in 33 more patients, adding up to 49 (29%). In S2, patients were divided into three groups based on BNP levels. GI (BNP > 200 pg/mL) consisted of 12 patients, HFPEF being confirmed in all of them. GII (BNP ranging from 100 to 200 pg/mL) consisted of 20 patients with LAVI > 29 mL/m2, or LVMI ≥ 96 g/m2 for women or ≥ 116 g/m2 for men, or E/E'≥ 8 or atrial fibrillation on ECG, and the diagnosis of HFPEF was confirmed in 15. GIII (BNP < 100 pg/mL) consisted of 134 patients, 26 of whom had the diagnosis of HFPEF confirmed when GII parameters were used. Measuring BNP levels in S2 identified 4 more patients (8%) with HFPEF as compared with those identified in S1. Conclusion: The association of BNP measurement and TDE data ...

Fundamento: A insuficiência cardíaca com fração de ejeção normal é a forma mais comum de insuficiência cardíaca e seu diagnóstico é um desafio na prática ambulatorial. Objetivo: Descrever e comparar duas estratégias, derivadas dos algoritmos do Consenso Europeu de Diastologia para diagnóstico de insuficiência cardíaca com fração de ejeção normal. Métodos: Estudo transversal com 166 pacientes (67,9 ± 11,7 anos, 72% mulheres) ambulatoriais consecutivos. As estratégias para confirmar insuficiência cardíaca com fração de ejeção normal foram estabelecidas de acordo com os critérios do Consenso Europeu de Diastologia. Na estratégia 1, utilizamos dados do eco Doppler tecidual e eletrocardiograma; na estratégia 2, incluímos o peptídeo natriurético tipo B. Resultados: Na primeira estratégia, os pacientes foram classificados em grupos, de acordo com a relação E/E': GI se E/E' > 15 (n = 16; 9%); GII se E/E' 8 a 15 (n = 79; 48%); e GIII se E/E' < 8 (n = 71; 43%). Insuficiência cardíaca com fração de ejeção normal foi confirmada no GI e excluída no GIII. No GII, parâmetros do eco Doppler tecidual (volume do átrio esquerdo indexado ≥ 40 mL/m2; massa do ventrículo esquerdo indexado > 122 para mulheres e > 149 g/m2 para homens) e do eletrocardiograma (fibrilação atrial) foram analisados, confirmando insuficiência cardíaca com fração de ejeção normal em mais 33 pacientes, totalizando 49 (29%). Na estratégia 2, utilizando o peptídeo natriurético tipo B, os pacientes foram divididos em três grupos. O GI (peptídeo natriurético tipo B > 200 pg/mL) foi formado por 12 pacientes e a insuficiência cardíaca com fração ...

Exercício de força associado a óleo de peixe reduzem massa tumoral e caquexia em ratos / Resistance exercise and fish oil reduce tumor mass and cachexia in rats / Ejercicio de fuerza asociado a aceite de pescado reduce la masa tumoral y la caquexia en ratas

OBJETIVO: Investigar o efeito do treinamento de salto associado à suplementação com óleo de peixe (1g/kg peso corporal/dia) em ratos portadores do tumor de Walker 256, sobre parâmetros bioquímicos de caquexia e crescimento tumoral. MÉTODOS: Oitenta Ratos foram divididos em sedentário sem ou com tumor (S ou SW), exercitado (EX ou EXW), suplementado com óleo de peixe (SO ou SWO) e suplementado e exercitado (EXO ou EXWO). Sessões de treinamento de salto consistiram de 10 séries com duração de 30 segundos e intervalo de 1 minuto entre cada série. Após seis semanas de treinamento, células do tumor de Walker 256 foram inoculadas e após 15 dias os animais foram mortos. RESULTADOS: O peso médio do tumor no grupo SW foi de 25,32 g, p<0,05 vs. ao dos SWO, EXW e EXWO (~11 g). O grupo SW apresentou hipoglicemia, hiperlactatemia, hipertriacilglicerolemia e perda de peso (-7,52±3,19g), caracterizando estado caquético. Suplementação com óleo de peixe (SWO), exercício (EXW) e associação de ambos (EXWO) impediram a instalação da caquexia (p<0,05 vs. SW). No grupo SWO, EXW e suas associações (EXWO) promoveram ganho de peso (p<0,05 vs. SW), mas inferior ao da suplementação isolada (p<0,05 vs. SWO). A proliferação celular in vitro das células tumorais foi menor no grupo SWO (p<0,05 vs. SW) e o exercício reduziu ainda mais (p<0,05 vs. SW e SWO), não havendo incremento quando se associaram ambas as terapias. Lipoperoxidação (p<0,05) foi maior nos SWO, EXW, EXWO vs. S. A expressão de Bcl-2 foi menor também nestes grupos vs. SW. CONCLUSÕES: O treinamento de força e a suplementação com óleo de peixe foram eficazes em evitar a caquexia e induzir a redução do crescimento tumoral, da prolife...

OBJECTIVE: To investigate the effect of jump training associated with fish oil (FO) supplementation (1g/Kg bodyweight/day) on biochemical parameters of cachexia and tumor growth in Walker 256 tumor-bearing rats. METHODS: Eighty rats were divided into sedentary non- and tumor-bearing (S and SW), exercised (EX and EXW), FO supplemented (SO and SWO), and both supplemented and exercised (EXW and EXWO). Jump training sessions consisted of 10 series of 30 seconds each, followed by 1 minute of rest. After six weeks of jump training, ascitic cells from Walker 256 tumor bearing-rat were inoculated, and after 15 days, all the animals were sacrificed. RESULTS: The tumor mass in the SW group was 25.32 g, p<0.05 vs the SWO, EXW and EXWO groups (~11 g). The SW group presented hypoglycemia, hyperlactacidemia and hypertriacylglycerolemia and a reduction in body weight (-7.52 ± 3.19g), characterizing a state of cachexia. Supplementation with fish oil (SWO), exercise (EXW) and both (EXWO) prevented the onset of cachexia and promoted weight gain (p<0.05 vs SW), but less than that of the supplementation alone (p<0.05 vs SWO). In vitro cell proliferation of the tumor cells was lower in the SWO group (p<0.05 vs SW) and exercise reduced still further (p<0.05 vs. SW and SWO), with no increase when both therapies were applied together. Lipoperoxidation (p<0.05) was higher in the SWO, EXW, EXWO groups vs. S. Bcl-2 expression was also lower in these groups vs. SW. CONCLUSIONS: Jump training and fish oil supplementation alone were able to effectively prevent cachexia and reduce tumor growth, tumor cell proliferation, and Bcl-2 expression, but the combination of both did not promote any additive effect. .

OBJETIVO: Investigar el efecto del entrenamiento de salto asociado a suplementación con aceite de pescado (1 g/kg peso corporal/día ) en ratas portadoras del tumor de Walker 256 de acuerdo con los parámetros bioquímicos de la caquexia y el crecimiento tumoral. MÉTODOS: Ochenta ratas fueron divididas en sedentarias sin y con tumor (S o SW), ejercitadas (EX o EXW), suplementadas con aceite de pescado (SO o SWO) y ejercitadas y suplementadas de forma simultánea (EXO o EXWO). Las sesiones de entrenamiento de salto consistieron en 10 series de 30 segundos cada una seguidas por 1 minuto de descanso entre cada serie. Después de seis semanas de entrenamiento, las células del tumor de Walker 256 se inocularon en las ratas y 15 días después todos los animales fueron sacrificados. RESULTADOS: El peso medio del tumor en el grupo SW fue de 25,32 g (p < 0,05) con respecto a los grupos SWO, EXW y EXWO (~11 g). El grupo SW presento hipoglucemia, hiperlactatemia y hipertriacilglicerolemia y reducción de peso corporal (-7,52 ± 3,19 g), lo que caracteriza el estado caquéctico. La suplementación con aceite de pescado (SWO), el ejercicio (EXW) y la asociación de ambos (EXWO) impidieron la instalación de la caquexia (p < 0,05 vs. SW). En el grupo SWO, EXW e sus asociaciones (EXWO) promovieron aumento de peso (p < 0,05 vs. SW), pero inferior al de la suplementación aislada (p < 0,05 vs. SWO). La proliferación in vitro de las células tumorales fue menor en el grupo SWO (p < 0,05 vs. SW) y el ejercicio la redujo todavía más (p < 0,05 vs. SW e SWO), no habiendo incremento cuando se asociaran ambas las terapias. La lipoperoxidación fue mayor en los grupos SWO, EXW, EXWO con respecto al grupo S (p < 0,05). La expresión de Bcl-2 en estos grupos también fue menor que en SW. CONCLUSIONES: El entrenamiento de fuerza ...

Gerador de alta frequência como recurso para tratamento de úlceras por pressão: estudo piloto / High frequency generator as treatment in scar pressure ulcers: pilot study

INTRODUÇÃO: Após a descoberta da existência de campos elétricos em lesões de tecidos, começou-se a empregar a aplicação externa de correntes elétricas na cicatrização de feridas. Baseados nesses conceitos, estudos mostram que a estimulação elétrica por alta frequência (HF - high frequency) é concebida como uma opção útil no processo cicatricial. Apesar dessa afirmativa, não há consenso entre os pesquisadores para sua utilização no tratamento de afecções da pele, sendo utilizada empiricamente no tratamento de feridas crônicas. OBJETIVO: Investigar o uso do gerador de alta frequência sobre a dor, cicatrização e área de superfície de úlceras de pressão (UP). MATERIAIS E MÉTODOS: Estudo piloto de ensaio clínico controlado realizado na Unidade de Tratamento Intensivo do Hospital de Clínicas do Paraná em oito indivíduos (49,6 ± 15,9 anos de idade), com diagnóstico clínico de UP grau II e III, classificados pela National Pressure Ulcer Advisory Panel (NPUAP). Indivíduos foram divididos em dois grupos: controle (n = 2) e alta frequência (n = 6), com aplicação diária durante dez dias. Avaliou-se dor (por meio da Escala Visual Analógica - EVA), processo de cicatrização da úlcera (por meio do Pressure Ulcer Scale for Healing - PUSH Tool e do Pressure Score Status Tool - PSST) e a área de superfície da úlcera (planimetria e ImageJ). RESULTADOS: Houve efeito significativo intragrupo (pré e pós-intervenção) na utilização do gerador de alta frequência no processo de cicatrização (PUSH Tool de 8,6 ± 5,8 para 5,1 ± 5,5, p = 0,04 e PSST de 31,3 ± 5,6 para 18 ± 6,5, p = 0,02) e área de superfície da úlcera (planimetria de 690,3 ± 622,6 para 470 ± 642,4, p = 0,02 e ImageJ de 786,5 ± 690,9 para 537,0 ± 719,3, p = 0,02). Também houve diferença significativa entre os grupos controle e grupo alta frequência em todas as variáveis do estudo (p = 0,04). CONCLUSÕES: A utilização do gerador de alta frequência causou melhora na cicatrização de pacientes com UP. Contudo, são necessários mais estudos com maior número de indivíduos para corroborar tais resultados. Nesse contexto, esta pesquisa agrega valor à procura de alternativas de tratamento para UP.

INTRODUCTION: Following the discovery of the presence of electric fields in tissue injury, started to employ the external application of electric currents in wound healing. Based on these concepts, studies show that high-frequency (HF) electrical stimulation is designed as a useful option in the healing process. Despite this statement, there is no consensus among researchers for its use in the treatment of skin disorders and is used empirically in the treatment of chronic wounds. OBJECTIVE: To explore the application of high frequency generator in the treatment of pain, scarring and surface areas of pressure ulcers (PU). MATERIALS AND METHODS: Controlled clinical trial pilot study carried out in the Intensive Care Unit of Hospital de Clínicas of Paraná. Sample of 8 subjects (age of 49.6 ± 15.9) diagnosed with II and III level degree of UP, following the National Pressure Ulcer Advisory Panel (NPUAP) classification. Subjects were split between groups: control (n = 2) and high frequency daily treatment (n = 10) in a period of 10 days. We assessed pain (by visual analog scale - VAS), the ulcer healing process (Pressure Ulcer Scale for Healing - PUSH Toll and the Pressure Score Status Tool - PSST) and ulcer surface area (planimetry and ImageJ). RESULTS: A significant effect within group (before and after intervention) of high frequency generator treatment on the process of healing (PUSH Tool before: 8.6 ± 5.8; after: 5.1 ± 5.5; p = 0.04 and PSST before: 31.3 ± 5.6; after: 18 ± 6.5; p = 0.02), and on ulcer surface area (planimetry before: 690.3±622.6; after: 470 ± 642.4; p= 0.02 and ImageJ before: 786.5 ± 690; after: 537.0 ± 719.3; p = 0.02). Also, we found a significant difference between group (control and high frequency), p = 0.04. CONCLUSIONS: The treatment of high frequency generator caused improvement in healing UP patients. Although, we need more studies with larger number of subjects in order to confirm the findings. Regarding the UP treatment domain, this study adds in the searching for alternative interventions.

Interval training attenuates the metabolic disturbances in type 1 diabetes rat model / Treinamento intervalado atenua os distúrbios metabólicos em modelo de ratos diabéticos do tipo 1

OBJECTIVE: This study investigated the effect of interval training on blood biochemistry and immune parameters in type 1 diabetic rats. MATERIALS AND METHODS: Male Wistar rats were divided into four groups: sedentary (SE, n = 15), interval training (IT, n = 17), diabetic sedentary (DSE, n = 17), diabetic interval training (DIT, n = 17). Diabetes was induced by i.v. injection of streptozotocin (60 mg/kg). Swimming Interval Training consisted of 30-s exercise with 30-s rest, for 30 minutes, during 6 weeks, four times a week, with an overload of 15% of body mass. Plasma glucose, lactate, triacylglycerol and total cholesterol concentrations, phagocytic capacity, cationic vesicle content, and superoxide anion and hydrogen peroxide production by blood neutrophils and peritoneal macrophages were evaluated. Proliferation of mesenteric lymphocytes was also estimated. RESULTS: Interval training resulted in attenuation of the resting hyperglycemic state and decreased blood lipids in the DIT group. Diabetes increased the functionality of blood neutrophils and peritoneal macrophages in the DSE group. Interval training increased all functionality parameters of peritoneal macrophages in the IT group. Interval training also led to a twofold increase in the proliferation of mesenteric lymphocytes after 6 weeks of exercise in the DIT group. CONCLUSION: Low-volume high-intensity physical exercise attenuates hyperglycemia and dislipidemia induced by type 1 diabetes, and induces changes in the functionality of innate and acquired immunity.

OBJETIVO: Este estudo investigou os efeitos do treinamento intervalado sobre parâmetros bioquímicos e imunológicos em ratos diabéticos do tipo 1. MATERIAIS E MÉTODOS: Ratos Wistar machos foram divididos em quatro grupos: sedentário (SE, n = 15), treinamento intervalado (TI, n = 17), sedentário diabético (SED, n = 17) e treinamento intervalado diabético (TID, n = 17). O diabetes foi induzido por uma injeção intravenosa de estreptozotocina (60 mg/kg). O treinamento intervalado de natação consistiu de 30s de exercício com 30s de recuperação, 30 minutos, durante 6 semanas, 4 vezes por semana, com sobrecarga de 15% da massa corporal. Foram avaliados glicemia, lactato sanguíneo, concentração de triacilglicerol e colesterol total, capacidade fagocítica, conteúdo de vesículas catiô­nicas, produção de ânion superóxido e peróxido de hidrogênio por neutrófilos sanguíneos e macrófagos peritoneais. A proliferação de linfócitos mesentéricos também foi avaliada. RESULTADOS: O treinamento intervalado resultou em atenuação do estado hiperglicêmico e diminuiu os lipídeos sanguíneos no grupo TID. O diabetes aumentou a funcionalidade dos neutrófilos sanguíneos e macrófagos peritoneais do grupo SED. O treinamento intervalado aumentou todos os parâmetros funcionais dos macrófagos peritoneais do grupo TI. O treinamento intervalado também aumentou duas vezes a proliferação dos linfócitos mesentéricos após seis semanas de exercício do grupo TID. CONCLUSÃO: O treinamento intervalado atenua a hiperglicemia e a dislipidemia induzida pelo diabetes do tipo 1 e induz mudanças na funcionalidade da imunidade inata e adquirida.

Antitumor and anti-cachectic effects of shark liver oil and fish oil: comparison between independent or associative chronic supplementation in Walker 256 tumor-bearing rats.

BACKGROUND: Shark liver oil (SLOil) and fish oil (FOil), which are respectively rich in alkylglycerols (AKGs) and n-3 polyunsaturated fatty acids (PUFAs), are able to reduce the growth of some tumors and the burden of cachexia. It is known that FOil is able to reduce proliferation rate and increase apoptotic cells and lipid peroxidation of tumor cells efficiently. However, there are few reports revealing the influence of SLOil on these parameters. In the current study, effects of FOil chronic supplementation on tumor growth and cachexia were taken as reference to compare the results obtained with SLOil supplementation. Also, we evaluated if the association of SLOil and FOil was able to promote additive effects. METHODS: Weanling male Wistar rats were divided into 4 groups: fed regular chow (C), supplemented (1 g/kg body weight) with SLOil (CSLO), FOil (CFO) and both (CSLO + FO). After 8 weeks half of each group was inoculated with Walker 256 cells originating new groups (W, WSLO, WFO and WSLO + FO). Biochemical parameters of cachexia, tumor weight, hydroperoxide content, proliferation rate and percentage of apoptotic tumor cells were analysed. Fatty acids and AKG composition of tumor and oils were obtained by high performance liquid chromatography and gas chromatography - mass spectrometry, respectively. Statistical analysis was performed by unpaired t-test and one-way ANOVA followed by a post hoc Tukey test. RESULTS: Fourteen days after inoculation, SLOil was able to restore cachexia parameters to control levels, similarly to FOil. WSLO rats presented significantly lower tumor weight (40%), greater tumor cell apoptosis (~3-fold), decreased tumor cell proliferation (35%), and higher tumor content of lipid hydroperoxides (40%) than observed in W rats, but FOil showed more potent effects. Supplementation with SLOil + FOil did not promote additive effects. Additionally, chromatographic results suggested a potential incorporation competition between the n-3 fatty acids and the AKGs in the tumor cells' membranes. CONCLUSIONS: SLOil is another marine source of lipids with similar FOil anti-cachectic capacity. Furthermore, despite being less potent than FOil, SLOil presented significant in vivo antitumor effects. These results suggest that the chronic supplementation with SLOil may be adjuvant of the anti-cancer therapy.

Relationship between acute phase proteins and serum fatty acid composition in morbidly obese patients.

BACKGROUND: Obesity is considered a low-grade inflammatory state and has been associated with increased acute phase proteins as well as changes in serum fatty acids. Few studies have assessed associations between acute phase proteins and serum fatty acids in morbidly obese patients. OBJECTIVE: To investigate the relationship between acute phase proteins (C-Reactive Protein, Orosomucoid, and Albumin) and serum fatty acids in morbidly obese patients. METHODS: Twenty-two morbidly obese patients were enrolled in this study. Biochemical and clinical data were obtained before bariatric surgery, and fatty acids measured in preoperative serum. RESULTS: Orosomucoid was negatively correlated with lauric acid (P = 0.027) and eicosapentaenoic acid (EPA) (P = 0.037) and positively with arachidonic acid (AA) (P = 0.035), AA/EPA ratio (P = 0.005), and n-6/n-3 polyunsaturated fatty acids ratio (P = 0.035). C-Reactive Protein (CRP) was negatively correlated with lauric acid (P = 0.048), and both CRP and CRP/Albumin ratio were negatively correlated with margaric acid (P = 0.010, P = 0.008, resp.). Albumin was positively correlated with EPA (P = 0.027) and margaric acid (P = 0.008). Other correlations were not statistically significant. CONCLUSION: Our findings suggest that serum fatty acids are linked to acute phase proteins in morbidly obese patients.

Deficiência de vitamina D em pacientes com suspeita de insuficiência cardíaca e fração de ejeção normal / Vitamin D deficiency among pacients with suspected heart failure with normal ejection fraction

Fundamentos: Estudos têm demonstrado forte associação entre déficit de vitamina D (VitD) e risco de doença cardiovascular. Níveis reduzidos de VitD apresentam elevada prevalência, e são considerados fator de mau prognóstico na insuficiência cardíaca (IC). Objetivo: Avaliar a deficiência de VitD em pacientes com suspeita de IC e fração de ejeção normal e sua correlação com marcadores de função diastólica e sistólica. Métodos: Estudo transversal com 85 pacientes ambulatoriais (idade 70,8±11,5 anos, sexo feminino 72 % - Rio de Janeiro, latitude -22° Sul) com suspeita de IC e que apresentavam fração FEVE normal. Os pacientes foram submetidos à dosagem de vitamina D 25-hidroxi (25(OH)D) e BNP e realização de ecocardiograma, Doppler tecidual e eletrocardiograma para investigação de ICFEN, de acordo com os critérios da Sociedade Europeia de Cardiologia. Resultados: ICFEN foi confirmada em 32 pacientes (38 %) que tinham valores maiores de BNP (135,1 mediana 109 pg/mL vs. 23,4 mediana 16,4 pg/mL; p<0,0001) e dos índices de disfunção diastólica (volume AE-I 44,2±8,9 mL/m2 vs. 29,3±7,4 mL/m2; relação E/E’ 14,5±6,6 vs. 7,5±2,1; p<0,0001). Valores de VitD foram menores no grupo com ICFEN, com significado estatístico (34,9±14,9 mcg/L vs. 45,0±17,6 mcg/L; p=0,008). Regressão binária logística mostrou idade (p=0,001) e VitD (p=0,036) como fatores independentes significativos para ICFEN. Observou-se correlação negativa entre a relação E/E’ e valores de VitD (r=-0,300 p=0,005). Conclusão: Pacientes com ICFEN apresentavam menores níveis séricos de VitD e quase a metade apresentava deficiência de VitD. Observou-se correlação negativa entre VitD e relação E/E’ marcador da pressão de enchimento do VE.

Background: Studies have shown a strong association between vitamin D (VitD) deficiency and the risk of cardiovascular disease. Widely prevalent, VitD deficiency is considered as a poor prognosis factor for heart failure (HF).Objective: To assess VitD deficiency among patients with heart failure with normal ejection fraction (HFNEF) and correlations with systolic and diastolic function markers. Methods: A cross-section study with 85 outpatients (age 70.8±11.5 years, female 72 %, Rio de Janeiro, latitude -22°S) with suspected HF and normal EF, dosed with 25-hydroxy vitamin D (25(OH)D) and BNP measurements, with echocardiograms, tissue Doppler and electrocardiograms for investigating HFNEF, in compliance with the criteria established by the European Society of Cardiology. Results: HFNEF was confirmed in 32 patients (38 %) with higher BNP values (135.1 median 109 pg/mL vs. 23.4 median 16.4 pg/mL; p<0.0001) and diastolic dysfunction rates (volume AE-I 44.2±8.9 mL/m2 vs. 29.3±7.4 mL/m2, E/E’ 14.5±6.6 vs. 7.5±2.1; p<0.0001). The VitD values were lower in the HFNEF group, with statistical significance (34.9±14.9 mcg/L vs. 45.0±17.6 mcg/L; p=0.008). A binary logistic regression revealed age (p=0.001) and vitamin D (p=0.036) as independent factors significant for HFNEF. A negative correlation was noted between the E/E` ratio and the VitD values (r=-0.300 p=0.005). Conclusion: HFNEF patients had lower serum VitD levels and almost half were VitD deficient. A negative correlation was noted between VitD and the E/E’ ratio, an LV filling pressure marker.