Effect of glycosaminoglycans on the structure and composition of articular cartilage and bone of broilers.

This study aimed to assess the influence of glycosaminoglycan (chondroitin and glucosamine sulfates) supplementation in the diet of broilers on the expression of matrix metallopeptidase 9 (MMP-9) and metallopeptidase inhibitor 2 (TIMP-2) genes, the synthesis of proteoglycans, collagen type II and chondrocytes, bone and cartilage macroscopy, bone mineral densitometry, bone breaking strength and mineral profile. A completely randomized design was carried out in a 3 × 3 factorial scheme (3 levels of chondroitin sulfate: 0.00, 0.05, and 0.10%; and 3 levels of glucosamine sulfate: 0.00, 0.15, and 0.30%), totaling 9 treatments. At 21 and 42 d of age, broilers were slaughtered, and tibias and femurs were collected for evaluation. There was an interaction (P < 0.05) of sulfates for the expression of MMP-9 and its inhibitor TIMP-2 in femur articular cartilage, as well as for the number of chondrocytes, collagen type II and proteoglycans in tibia articular cartilage, bone and cartilage macroscopy and mineral profile (P < 0.05), with better results obtained with the inclusion of chondroitin and/or glucosamine sulfates in the feed. In conclusion, chondroitin and glucosamine sulfates can be used in broiler diets in order to favor the development of the structure of the locomotor system (bones and joints), thus preventing locomotion problems.

Antiglycation potential and antioxidant activity of genipap (Genipa americana L.) in oxidative stress mediated by hydrogen peroxide on cell culture.

Genipa americana L. is a plant widely used by folk medicine for the prevention and as an aid in the treatment of various diseases. In this work, we evaluated the anti-glycant and antioxidant activities of genipap fruit juice, as well as the influence of different temperatures (-6 °C and -80 °C) on the preservation of phenolic compounds. Purified extract from G. americana showed anti-glycant activity reducing the formation of fructosamine by up to 53% and recovered viability of cells under oxidative stress induced by H2O2. HPLC/UV-Vis analysis identified cinnamic acid as a bioactive substance and possibly responsible for the biological activities described above. Taken together, these results indicate that G. americana is a rich source of cinnamic acid with appreciable antioxidant and anti-glycant potential.

Desafios da articulação intersetorial entre saúde e assistência social: uma revisão integrativa / Challenges of intersectoral articulation between health care and social support: an integrative review / Desafíos de la articulación intersectorial entre salud y asistencia social: una revisión integrativa

A organização do modelo de atenção à saúde vigente no Brasil a partir da implementação do Sistema Único de Saúde (SUS) incorporou a intersetorialidade como premissa essencial, definida como a pactuação de diferentes atores no contexto do planejamento e assistência a políticas e programas. Nesse âmbito, enfatiza-se a relevância da articulação entre os setores de saúde e assistência social, pretendendo maior resolutividade das demandas e integralidade da assistência. A partir disso, este estudo pretende analisar os desafios para a colaboração intersetorial entre saúde e assistência social assim como suas implicações para a gestão do cuidado. Para tanto, foi conduzida uma revisão integrativa da literatura disponível nas bases de dados SCIELO e LILACS entre o período 2010-2020. Entre a amostra selecionada para a revisão, é constatado um panorama amplo, heterogêneo e complexo das experiências entre os dois setores, marcadas por variabilidades e desafios institucionais, operacionais e de recursos, sendo unânime o entendimento de que essas experiências ainda se mostram isoladas e verticalizadas. Diversos são os entraves associados ao exercício da intersetorialidade enquanto eixo norteador da elaboração de políticas públicas robustas para a população, especialmente no que tange ao binômio saúde e assistência social, o que reitera a necessidade de revisitar os processos de trabalho, gestão, formação, organização e disposição da atenção à saúde no Brasil tendo em vista a proposição e alcance de resultados mais efetivos na busca pela redução das iniquidades em saúde e fortalecimento das estratégias de bem-estar social.

Following implementation of the Unified Health System (SUS), the current organization of Brazil's health care model incorporated intersectoriality, defined as the agreement of different actors in the context of planning and assisting programs and policies, as an essential premise. This emphasizes the importance of intersectoral articulation between health care and social support for greater resolution of demands and comprehensive care. Given this context, this integrative review analyzes the challenges of intersectoral collaboration between health and social support, and its implications for care management. Bibliographic research was conducted in the SciELO and LILACS databases for articles published between 2010 and 2020. The final sample was characterized by a broad, heterogeneous, and complex panorama of experiences between the two sectors, marked by institutional, operational, and resource challenges and variability, with the unanimous understanding that such experiences are still isolated and verticalized. Many obstacles are associated with the implementation of intersectoriality as a guiding principle for elaborating robust public policies, especially regarding the binomial health and social support, reiterating the need to revise work, management, training, organization and health care processes in Brazil, given the proposal and achievement of more effective results in the search for reducing health inequalities and strengthening social well-being strategies.

La organización del actual modelo de atención a la salud en Brasil a partir de la implementación del Sistema Único de Salud (SUS) incluyó como premisa esencial la intersectorialidad, definida como la concertación de diferentes actores en el contexto de la planificación y asistencia a programas y políticas. En este contexto, se destaca la importancia de la articulación entre los sectores de salud y asistencial, con miras a una mayor resolución de demandas y una atención integral. Ante lo anterior, este estudio pretende analizar los desafíos para la colaboración intersectorial entre salud y asistencia social, así como sus implicaciones para la gestión del cuidado. Para ello, se realizó una revisión integrativa de la literatura en las bases de datos SciELO y LILACS, en el período de 2010-2020. Entre la muestra seleccionada para la revisión, se verificó un panorama vasto, heterogéneo y complejo de las experiencias entre los dos sectores, marcadas por la variabilidad institucional, operativa y de recursos, y fue unánime el entendimiento de que estas experiencias aún son aisladas y verticalizadas. Son varios los obstáculos asociados al ejercicio de la intersectorialidad en tanto eje de la elaboración de sólidas políticas públicas a la población, especialmente en lo que se refiere al binomio salud-asistencia social, lo que plantea la necesidad de revisar los procesos de trabajo, la gestión, la formación, la organización y la atención a la salud en Brasil con miras a proponer y lograr resultados más efectivos en la búsqueda de la reducción de las inequidades en salud y el fortalecimiento de las estrategias de bienestar social.

Reasons to avoid vitamin D deficiency during COVID-19 pandemic.

The effects of vitamin D on the musculoskeletal system are well established. Its deficiency causes osteomalacia, secondary hyperparathyroidism, and an increased risk for fractures and falls. However, clinical and experimental evidence points to extra-skeletal actions of vitamin D, including on immune and respiratory systems. Thus, during this COVID-19 pandemic, a possible deleterious role of vitamin D deficiency has been questioned. This paper aims to present a brief review of the literature and discuss, based on evidence, the role of vitamin D in the lung function and in the prevention of respiratory infections. Relevant articles were searched in the databases MEDLINE/PubMed and SciELO/LILACS. The mechanisms of vitamin D action in the immune system response will be discussed. Clinical data from systematic reviews and meta-analyses show benefits in the prevention of respiratory infections and improvement of pulmonary function when vitamin D-deficient patients are supplemented. At the time of writing this paper, no published data on vitamin D supplementation for patients with COVID-19 have been found. Vitamin D supplementation is recommended during this period of social isolation to avoid any deficiency, especially in the context of bone outcomes, aiming to achieve normal values of 25(OH)D. The prevention of respiratory infections and improvement of pulmonary function are additional benefits observed when vitamin D deficiency is treated. Thus far, any protective effect of vitamin D specifically against severe COVID-19 remains unclear. We also emphasize avoiding bolus or extremely high doses of vitamin D, which can increase the risk of intoxication without evidence of benefits.

Effects of curcumin supplementation on sport and physical exercise: a systematic review.

Curcumin is the main phenolic compound in turmeric. It has been investigated recently due to its numerous medicinal properties and health benefits. However, few studies assessed the effects of curcumin supplementation on physical activity practice. Therefore, the purpose of this review is to assess the available evidences with human beings about the potential effects of curcumin supplementation on sport and physical exercise. This systematic review was conducted within the period from January to February, 2019, following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. The LILACS, Medline, SciELO and PubMed databases were used for the search, with no publication date limit. The following terms, with the respective Boolean operators, were searched: "curcumin" AND sports; "curcumin" AND exercise; curcumin AND "aerobic exercise"; "curcumin" AND "resistance exercise"; "curcumin" AND "endurance exercise"; "curcumin" AND "strength exercise". Eleven papers were selected for this review. Most of the studies displayed positive effects of the curcumin supplementation for athletes and physical exercise practitioners, and no side effects were reported. Participants supplemented with curcumin displayed reduced inflammation and oxidative stress, decreased pain and muscle damage, superior recovery and muscle performance, better psychological and physiological responses (thermal and cardiovascular) during training and improved gastrointestinal function. Curcumin supplementation appears to be safe and beneficial for sport and physical exercise in human beings. PROSPERO (CRD42019126763).

Identification of caffeic acid and rutin by UHPLC MS/MS and antioxidant activity of Commelina erecta Lineu. in cell culture.

The Commelina erecta L. (C. erecta) also known as erva-de-santa-luzia is reported by local population to have medical properties against some pathological conditions. In this study, two extracts of C. erecta leaves (aqueous and ethanolic) were phytochemically analysed and evaluated for their in-vitro antioxidant activities by DPPH, TBARS, NO assays and cell viability assays. The ultra-high performance liquid chromatography followed by tandem mass spectrometry analysis showed the presence of rutin and caffeic acid in aqueous and ethanolic extract. The total polyphenols in aqueous and ethanolic extracts found were 142.7 ± 3.0 and 123.1 ± 5.8 µg/mL of GAE, respectively. The ethanolic extract (5 mg/mL) inhibits TBARS by 33.8%, and the aqueous extract (5 mg/mL) exhibited scavenger property against nitric oxide derivatives to an extent of 77.8%. In cell culture, both extracts improved cell survivability under H2O2 induced oxidative stress. Thus, C. erecta extract is a good candidate to become a phytotherapic medicine.

Does Croton Argyrophyllus Extract Has an Effect on Muscle Damage and Lipid Peroxidation in Rats Submitted to High Intensity Strength Exercise?

Many species of the genus Croton have been used for anti-inflammatory, antiproliferative, antidiabetic, and antitumor purposes. The objective was to evaluate the effect of a hydroethanolic extract (HEE) from the inner bark of Croton argyrophyllus (Euphorbiaceae) on muscle damage and oxidative stress in rats after high intensity exercise. The animals were divided into four groups: (i) the sedentary group (SV; n = 7), (ii) the exercise vehicle group (EV, n = 7), (iii) the sedentary group HEE (SHG; n = 7) composed of sedentary animals and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.), and (iv) the HEE exercise group (HEE; n = 7) composed of animals submitted to resistance exercise (RE) and treated with the hydroethanolic extract of C. argyrophyllus (200 mg/kg, v.o.). In the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) test, the HEE showed lower values of inhibition potential (IP%) at 39.79% compared to gallic acid, 87.61%, and lipoperoxidation inhibition at 27.4% (100 µg/mL) or 28.6% (200 µg/mL) (p < 0.001). There was inhibition in free radicals in vivo. The HEE of C. argyrophyllus partially reduced the biomarkers of oxidative stress in muscle tissue and muscular damage (creatine kinase (CK) and Lactate Dehydrogenase (LDH)) (p < 0.05) in rats, and in this sense it can be an aid to the recovery process after exhaustive efforts.

d-Limonene Ameliorates Myocardial Infarction Injury by Reducing Reactive Oxygen Species and Cell Apoptosis in a Murine Model.

Myocardial infarction (MI) leads to high mortality, and pharmacological or percutaneous primary interventions do not significantly inhibit ischemia/reperfusion injuries, particularly those caused by oxidative stress. Recently, research groups have evaluated several naturally occurring antioxidant compounds for possible use as therapeutic alternatives to traditional treatments. Studies have demonstrated that d-limonene (DL), a monoterpene of citrus fruits, possesses antioxidant and cardiovascular properties. Thus, this work sought to elucidate the mechanisms of protection of DL in an isoproterenol-induced murine MI model. It was observed that DL (10 µmol) attenuated 40% of the ST elevation, reduced the infarct area, prevented histological alterations, abolished completely oxidative stress damage, restored superoxide dismutase activity, and suppressed pro-apoptotic enzymes. In conclusion, the present study demonstrated that DL produces cardioprotective effects from isoproterenol-induced myocardial infarction in Swiss mice through suppression of apoptosis.

TRActional DIabetic reTInal detachment surgery with co-adjuvant intravitreal dexamethasONe implant: the TRADITION STUDY.

AIM: Main failure of diabetic tractional retinal detachment (TRD) surgery is the development of proliferative vitreoretinopathy (PVR), causing higher re-detachment rates. We investigated whether the use of dexamethasone (DEX) implant at the end of pars plana vitrectomy (PPV) with silicone oil tamponade might have an impact on these outcomes. DESIGN: Comparative, nonrandomized, retrospective study. PARTICIPANTS: A total of 148 eyes from 148 patients that underwent PPV with silicone oil tamponade for diabetic TRD (with DEX implant, n = 52; without DEX implant, n = 96). METHODS: Consecutive patients' records were reviewed for time between TRD diagnosis and surgery; lens status before surgery and after 6, 12, and 24 months; retina attachment rate after primary PPV; change in postoperative PVR severity; rate of re-detachment at 6, 12, and 24 months; use of IOP lowering treatment after 6, 12, and 24 months; surgery details; intra- and postoperative complications. Correlations between outcome measures, postoperative PVR severity, and re-detachment rates were analyzed. MAIN OUTCOME MEASURES: Change in postoperative PVR severity and retinal re-detachment rates with and without the adjuvant use of DEX implant. RESULTS: Retinal re-detachment rates were significantly higher in the group of patients that did not receive DEX implant [11/96 (11.5%) vs. 0/52 (0%), p = 0.049; 11/84 (12.9%) vs. 4/52 (7.7%), p = 0.007; 14/71 (19.7%) vs. 5/52 (10%) p < 0.001 at 6, 12, and 24 months, respectively]. PVR severity correlated with retinal status at 12 and 24 months (p = 0.018 and p = 0.027, respectively). The difference in PVR severity between the two groups was statistically significant at 6, 12, and 24 months (p < 0.001). CONCLUSIONS: DEX implant at the end of PPV in patients with diabetic TRD improves PVR severity and decreases re-detachment rates. This should be considered as an option in the customized treatment of TRD.

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder / Resultados cirúrgicos iniciais de 500 Paratireoidectomias por Hiperparatireoidismo relacionado a distúrbio mineral e ósseo da doença renal crônica

ABSTRACT Introduction: Surgical treatment of hyperparathyroidism related to chronic kidney disease is a challenging procedure even for experienced parathyroid surgeons. Over the years, adjuvant techniques have been developed to assist the medical team to improve surgical outcomes. However, medical staff in poor countries have less access to these techniques and the effectiveness of surgery in this context is unclear. Objective: verify the effectiveness of surgery for treatment of hyperparathyroidism related to chronic kidney disease without adjuvant techniques. Methods: Over a 5-years period, patients with hyperparathyroidism that had clinical therapeutic failure were evaluated for surgical treatment. Total parathyroidectomy with autograft or subtotal resection were the selected procedures. Surgeries were performed in a tertiary hospital in Brazil without the assistance of some of the adjuvant techniques that are usually applied, such as frozen section, nerve monitoring, and gamma probe. Intraoperative PTH and localization pre-operative exams were applied, but with huge restrictions. Results: A total of 518 patients with hyperparathyroidism (128 secondary and 390 tertiary) were surgically treated. Total parathyroidectomy were performed in 81.5%, subtotal in 12.4%, and 61% of patients had a surgical failure. Of all failures, only 1.4% needed a second surgery totaling 98.6% of successful initial surgical treatment. Neck hematoma and unilateral focal fold paralysis occurred in 1.9% and 1.5%, respectively. Conclusion: parathyroidectomy is a safe and reproducible surgical procedure even in the absence of adjuvant techniques.

RESUMO Introdução: O tratamento cirúrgico do hiperparatireoidismo relacionado à doença renal crônica é um procedimento desafiador mesmo para cirurgiões de paratireoide experientes. Ao longo dos anos, técnicas adjuvantes foram desenvolvidas para ajudar a equipe clínica a aprimorar os desfechos cirúrgicos. Contudo, as equipes clínicas de países mais pobres têm menor acesso a tais técnicas, o que faz com que a eficácia da cirurgia nesses contextos não seja tão evidente. Objetivo: Verificar a eficácia da cirurgia para tratamento do hiperparatireoidismo relacionado à doença renal crônica, sem técnicas adjuvantes. Métodos: Ao longo de período de cinco anos, pacientes com hiperparatireoidismo cujo tratamento clínico não resultou em melhora foram avaliados para resolução cirúrgica. Os procedimentos selecionados foram paratireoidectomia total com enxerto autólogo ou ressecção subtotal. As cirurgias foram realizadas em um hospital terciário no Brasil sem o auxílio de algumas das técnicas adjuvantes geralmente aplicadas, como exame de congelação, monitorização neurofisiológica e sonda gama. Exames intraoperatórios de PTH e pré-operatório de localização foram realizados, mas com grandes restrições. Resultados: Um total de 518 pacientes com hiperparatireoidismo (128 secundários e 390 terciários) foram tratados cirurgicamente. Paratireoidectomia total foi realizada em 81,5% e subtotal em 12,4% dos casos; 61% dos pacientes apresentaram falha cirúrgica. De todas as falhas, apenas 1,4% necessitaram de uma segunda cirurgia, totalizando 98,6% de sucesso no tratamento cirúrgico inicial. Hematoma cervical e paralisia unilateral de prega vocal ocorreram em 1,9% e 1,5% dos pacientes, respectivamente. Conclusão: A paratireoidectomia é um procedimento cirúrgico seguro e reprodutível, mesmo na ausência de técnicas adjuvantes.

Initial surgical results of 500 Parathyroidectomies for Hyperparathyroidism related to chronic kidney disease - mineral and bone disorder.

INTRODUCTION: Surgical treatment of hyperparathyroidism related to chronic kidney disease is a challenging procedure even for experienced parathyroid surgeons. Over the years, adjuvant techniques have been developed to assist the medical team to improve surgical outcomes. However, medical staff in poor countries have less access to these techniques and the effectiveness of surgery in this context is unclear. OBJECTIVE: verify the effectiveness of surgery for treatment of hyperparathyroidism related to chronic kidney disease without adjuvant techniques. METHODS: Over a 5-years period, patients with hyperparathyroidism that had clinical therapeutic failure were evaluated for surgical treatment. Total parathyroidectomy with autograft or subtotal resection were the selected procedures. Surgeries were performed in a tertiary hospital in Brazil without the assistance of some of the adjuvant techniques that are usually applied, such as frozen section, nerve monitoring, and gamma probe. Intraoperative PTH and localization pre-operative exams were applied, but with huge restrictions. RESULTS: A total of 518 patients with hyperparathyroidism (128 secondary and 390 tertiary) were surgically treated. Total parathyroidectomy were performed in 81.5%, subtotal in 12.4%, and 61% of patients had a surgical failure. Of all failures, only 1.4% needed a second surgery totaling 98.6% of successful initial surgical treatment. Neck hematoma and unilateral focal fold paralysis occurred in 1.9% and 1.5%, respectively. CONCLUSION: parathyroidectomy is a safe and reproducible surgical procedure even in the absence of adjuvant techniques.

α-Terpineol reduces cancer pain via modulation of oxidative stress and inhibition of iNOS.

α-Terpineol (TP) is present in a wide range of essential oils of the genus Eucalyptus, with recognized potential for a range of biological effects, such as analgesic. Hence, our study aimed to investigate the effect of TP on cancer pain induced by sarcoma 180 in Swiss mice. Our results showed that TP reduced significantly mechanical hyperalgesia and spontaneous and palpation-induced nociception, improved paw use without reducing tumor growth and grip strength. Importantly, no evident biochemical and hematological toxicity was oberved. Furthermore, TP increased the tissue antioxidant capacity due to ferric-reducing antioxidant power (FRAP) and glutathione (GSH). TP also reduced inducible nitric oxide synthase (iNOS) immunocontent in the tumors. Molecular docking estimated that TP binds within the same range of iNOS regions (other iNOS inhibitors), such as N-Nitroarginine methyl ester (L-NAME). These data provide strong evidence that TP may be an interesting candidate for the development of new safe analgesic drugs that are effective for cancer pain control.

Efeitos da melatonina na sinalização insulínica de ratos com doença periodontal e pinealectomizados / Effects of melatonin on insulin signaling in rats with periodontal and pinealectomized disease

A doença periodontal (DP) é uma preocupação de saúde pública, uma vez que leva à perda dos elementos dentais; além disso, possui associações com outras doenças inflamatórias crônicas tais como a síndrome metabólica e diabetes mellitus. Sabe-se que períodos irregulares de sono podem prejudicar o processamento de memória, reparo celular, regulação hormonal, metabolismo dos carboidratos e aumentar marcadores inflamatórios, evidenciando que o trabalho noturno ou em turnos alternados podem afetar a saúde do trabalhador. A melatonina (MEL) é o principal hormônio que controla os ritmos biológicos no nosso organismo, participando na regulação do sono, metabolismo de carboidratos e lipídeos, sendo suprimida quando há exposição a luz. Considerando-se os efeitos regulatórios da MEL sobre processos inflamatórios, se faz relevante avaliar a influência da deficiência ou suplementação de MEL sobre um processo inflamatório localizado como a DP. Objetivo deste estudo foi investigar os efeitos da MEL na resistência à insulina (RI), na via de sinalização da insulina, nas citocinas pró-inflamatórias e no perfil lipídico em ratos pinealectomizados (PNX) sem ou com DP. 144 ratos Wistar (40 dias de idade) foram distribuídos em 8 grupos: 1) controle (CN); 2) DP; 3) PNX; 4) PNX e com DP (PNXDP); 5) CN tratado com MEL (CNMEL); 6) DP tratado com ME (DPMEL); 7) PNX tratado com MEL (PNXMEL); 8) PNX com DP e tratados com MEL (PNXDPMEL). Inicialmente os grupos PNX foram submetidos à cirurgia de pinealectomia aos 40 dias de idade e aos 60 dias de idade os animais foram submetidos à indução de DP nos primeiros molares inferiores. Logo após a indução da DP, foi iniciada a reposição com MEL (5 mg/Kg) por via oral (diluída em água de beber) por 28 dias. Ao término do tratamento foram analisados os seguintes parâmetros: 1) dosagem de glicemia e insulinemia; 2) avaliação do perfil lipídico; 3) avaliação do grau de fosforilação em serina da Akt no tecido adiposo, músculo gastrocnêmio e fígado. Os resultados demonstram 1) DP e PNX com DP causaram RI e aumento nas concentrações plasmáticas de TNF-α; 2) nenhuma diferença na glicemia e nos níveis de IL-6; 3) nenhuma alteração no grau de fosforilação em serina da AKT após a estimulação insulínica entre os grupos nos tecidos analisados; 4) apenas os grupos PNX e PNXDP apresentaram alteração no perfil lipídico; 5) a reposição com MEL melhorou todos os parâmetros alterados analisados. A partir desses resultados podemos inferir que a administração de MEL foi capaz de melhorar a resistência à insulina, diminuir a insulinemia e as concentrações plasmáticas de TNF-α e nos grupos DP, PNX e PNXDP, além disso restaurar o perfil lipídico nos grupos pinealectomizados. Podemos sugerir que a MEL teve um papel protetivo, diminuindo a RI em ratos com DP e PNX com ou sem DP. Somente nestes grupos PNX, a MEL melhorou o quadro do perfil lipídico. Desta maneira, o presente estudo enfatiza a importância de se prevenir a DP afim de prevenir a RI, a qual está intimamente relacionada com o DM2, como também alertar aos trabalhadores noturno que podem apresentar desordens nos ritmos biológicos levando as alterações metabólicas(AU)

Periodontal disease (PD) is a public health concern, since it leads to loss of dental elements. Furthermore, it has associations with other chronic inflammatory diseases such as the metabolic syndrome and Diabetes mellitus. It is known that irregular periods of sleep can impair memory processing, cell repair, hormonal regulation, carbohydrate metabolism, and increased inflammatory markers. Furthermore, night work or alternating shifts can affect the health of workers. Melatonin (MEL) is the main hormone that controls the biological rhythms in our organism, participating in the regulation of sleep, metabolism of carbohydrates and lipids, being suppressed when there is exposure to light. Considering the regulatory effects of MEL on inflammatory processes, it is relevant to evaluate the influence of ME deficiency or supplementation on a localized inflammatory process such as PD. The aim of this study was to investigate the effects of MEL on insulin resistance (IR), insulin signaling, proinflammatory cytokines and lipid profile in pinealectomized rats (PNX) with PD. 144 rats (40 days old) were distributed in 8 groups: 1) control (CN); 2) PD; 3) PNX; 4) PNX and with PD (PNXPD); 5) CN treated with MEL (CNM); 6) PD treated with (PDMEL); 7) PNX treated with MEL (PNXMEL); 8) PNX and PD treated with MEL (PNXPDMEL). Initially the PNX groups were submitted to pinealectomy surgery at 40 days of age and at 60 days of age the animals were submitted to the induction of PD in the lower first molars. Immediately after induction of PD, treatment with MEL (5 mg / kg) was initiated orally (diluted in drinking water) for 28 days. After the treatment the following parameters were analyzed: 1) assessment of glycemia and insulinemia; 2) evaluation of the lipid profile; 3) evaluation of the Akt serine phosphorylation status in adipose tissue, gastrocnemius muscle and liver. The results demonstrate that: 1) PD and PNX with PD caused insulin resistance and increased plasma concentrations of TNF-α; 2) no difference in glycemia and IL-6 levels; 3) no alteration in Akt serine phosphorylation status after the insulin stimulation between the groups in the tissues analyzed; 4) only the PNX and PNXPD groups showed alterations in the lipid profile; 5) the administration of MEL improved all altered parameters analyzed. The results suggest that MEL can be efficient in preventing IR, alteration in lipid profile and increase in plasma levels of insulin and TNF-α promoted by PD and PNX. From these results we can infer that the MEL administration was able to improve insulin resistance, decrease insulinemia and plasma concentrations of TNF-α in the PD, PNX and PNXPD groups, in addition to restoring the lipid profile in the pinealectomized groups. We may suggest that MEL had a protective role, decreasing IR in rats with PD and PNX with or without PD. Only in these PNX groups the MEL improved the lipid profile. Thus, the present study emphasizes the importance of preventing PD in order to prevent IR, which is closely related to DM2, as well as to alert shift workers that they may present disorders in the biological rhythms leading to metabolic alterations(AU)

Cardioprotective Action of Ginkgo biloba Extract against Sustained ß-Adrenergic Stimulation Occurs via Activation of M2/NO Pathway.

Ginkgo biloba is the most popular phytotherapic agent used worldwide for treatment of several human disorders. However, the mechanisms involved in the protective actions of Ginkgo biloba on cardiovascular diseases remain poorly elucidated. Taking into account recent studies showing beneficial actions of cholinergic signaling in the heart and the cholinergic hypothesis of Ginkgo biloba-mediated neuroprotection, we aimed to investigate whether Ginkgo biloba extract (GBE) promotes cardioprotection via activation of cholinergic signaling in a model of isoproterenol-induced cardiac hypertrophy. Here, we show that GBE treatment (100 mg/kg/day for 8 days, v.o.) reestablished the autonomic imbalance and baroreflex dysfunction caused by chronic ß-adrenergic receptor stimulation (ß-AR, 4.5 mg/kg/day for 8 days, i.p.). Moreover, GBE prevented the upregulation of muscarinic receptors (M2) and downregulation of ß1-AR in isoproterenol treated-hearts. Additionally, we demonstrated that GBE prevents the impaired endothelial nitric oxide synthase activity in the heart. GBE also prevented the pathological cardiac remodeling, electrocardiographic changes and impaired left ventricular contractility that are typical of cardiac hypertrophy. To further investigate the mechanisms involved in GBE cardioprotection in vivo, we performed in vitro studies. By using neonatal cardiomyocyte culture we demonstrated that the antihypertrophic action of GBE was fully abolished by muscarinic receptor antagonist or NOS inhibition. Altogether, our data support the notion that antihypertrophic effect of GBE occurs via activation of M2/NO pathway uncovering a new mechanism involved in the cardioprotective action of Ginkgo biloba.

Analysis of acoustic frequency and wave amplitude generated by the Oscillatory Thoracic Thixotropic Device (Diottix(r)) in human chest / Análisis de la frecuencia acústica y amplitud de las ondas sonoras generadas por el Dispositivo Oscilatorio Torácico Tixotrópico (Diottix(r)) en el tórax humano / Análise da frequência acústica e amplitude das ondas sonoras geradas pelo Dispositivo Oscilatório Torácico Tixotrópico (Diottix(r)) no tórax humano

Diottix(r) was calibrated at 25 Hz to achieve the frequency indicated in literature as being effective to mobilize the airways secretions. However, the amplitude and frequency of the waves generated by the equipment in different regions of the chest still need to be investigated. The objective of this study was to analyze the frequency and amplitude of waves generated by Diottix(r) in chests of healthy subjects. Diottix(r) was used in the anterior and posterior regions of the chest. The mechanical waves were captured using stethoscopes connected to electret microphones, which were connected to a digital oscilloscope. Frequency and amplitude data were recorded by the stethoscope, positioned in six points in the anterior region and six in the posterior region of the chest, following the positions commonly used in pulmonary auscultation. Signals were recorded and transferred to a computer with software for their analysis. The frequency of waves did not present a significant change (from 24.9 to 26.4 Hz). The wave amplitude in the anterior versus the posterior region in each area of the lung, the upper, middle and lower, had differences. Diottix(r) produces frequencies in the chest according to the calibrated; thus, it can be a complementary resource to bronchial hygiene maneuvers. The amplitudes of waves seem to be affected by other structures like bone parts and heart.

Diottix(r) fue calibrado en 25 Hz para alcanzar la frecuencia indicada en la literatura como eficaz para movilizar secreciones de las vías aéreas. La amplitud y frecuencia de ondas generadas por el equipamiento en las diferentes regiones del tórax aun necesitan de más investigaciones. El objetivo de eso estudio fue analizar la frecuencia y amplitud de ondas generadas por el Diottix(r) en el tórax de sujetos saludables. La aplicación del Diottix(r) fue realizada en las regiones anterior y posterior del tórax. Las ondas mecánicas fueron captadas utilizándose estetoscopios ligados a micrófonos de electret, los cuales estaban ligados a uno osciloscopio digital. Los datos de frecuencia y amplitud fueron captados por lo estetoscopio posicionado en seis puntos en la región anterior y seis en la posterior del tórax, siguiendo las posiciones comúnmente utilizadas en la ausculta pulmonar. Los sígnales fueron registrados y transferidos para una computadora a través de un programa para su análisis de datos. La frecuencia de ondas no presentó variación significativa (del 24,9 al 26,4 Hz). La amplitud de onda en la región anterior versus posterior en cada segmento del pulmón, tercio superior, medio e inferior, presentó diferencia. Lo Diottix(r) produce frecuencias en el tórax según el calibrado. Por lo tanto, puede ser uno recurso complementar a las manobras de higiene de los bronquios. Las amplitudes de ondas parecen ser afectadas por otras estructuras, las cuales incluyen partes óseas y el corazón.

O Diottix(r) foi calibrado a 25 Hz para atingir a frequência indicada na literatura como eficaz a fim de mobilizar secreções de vias aéreas. A amplitude e a frequência das ondas geradas pelo equipamento nas diferentes regiões do tórax ainda precisam ser investigadas. O objetivo de estudo foi analisar a frequência e a amplitude das ondas geradas pelo Diottix(r) no tórax de indivíduos saudáveis. A aplicação do Diottix(r) foi realizada nas regiões anterior e posterior do tórax. As ondas mecânicas foram captadas utilizando estetoscópios conectados a microfones de eletreto, os quais estavam ligados a um osciloscópio digital. Os dados de frequência e amplitude foram captados pelo estetoscópio, posicionado em seis pontos na região anterior e seis na posterior do tórax, seguindo as posições comumente utilizadas na ausculta pulmonar. Os sinais foram registrados e transferidos para um computador por meio de um software para análise deles. A frequência das ondas não apresentou variação significativa (24,9 a 26,4 Hz). A amplitude de onda na região anterior versus posterior em cada segmento do pulmão, terço superior, médio e inferior, apresentou diferença. O Diottix(r) produz frequências no tórax de acordo com o calibrado; desta forma, pode ser um recurso complementar às manobras de higiene brônquica. As amplitudes de ondas parecem ser afetadas por outras estruturas, que incluem as partes ósseas e o coração.

The benefits of a high-intensity aquatic exercise program (HydrOS) for bone metabolism and bone mass of postmenopausal women.

This study aimed to evaluate the 24-week effects of a high-intensity aquatic exercise program on bone remodeling markers and bone mass of postmenopausal women. In this randomized, controlled trial we studied 108 women (58.8 ± 6.4 years), randomized into Aquatic Exercise Group (AEG), n = 64, performing 24 weeks of aquatic exercises, and Control Group (CG), n = 44, sedentary. They had their fasting morning blood sample collected for the measures of intact parathyroid hormone (iPTH), procollagen type 1 amino-terminal propeptide (P1NP) and carboxy-terminal cross-linking telopeptide of type I collagen (CTx). Bone mass was measured by dual-energy X-ray absorptiometry before and after the intervention. Participants of both groups received a daily supplementation of 500 mg of elementary calcium and 1,000 IU of vitamin D (cholecalciferol). Results showed an augment in bone formation marker (P1NP) only in the AEG (15.8 %; p = 0.001), and although both groups experienced significant enhancements in bone resorption marker (CTx), this increase was less considerable in the AEG (15 % in the AEG and 29 % in the CG). IPTH was increased by 19 % in the CG (p = 0.003) at the end. The femoral trochanter BMD presented a 1.2 % reduction in the CG (p = 0.009), whereas in the AEG no change was observed (p = 0.069). The proposed aquatic exercise program was efficient in attenuating bone resorption raise and enhancing bone formation, which prevented the participants in the AEG from reducing the femoral trochanter BMD, as happened in the CG.

High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women.

OBJECTIVE: This study aims to investigate the effects of an aquatic exercise program (HydrOS) on neuromuscular function and falls among postmenopausal women. METHODS: One hundred eight postmenopausal women (mean [SD] age, 58.8 [6.4] y) were randomly divided into the control group (CG; n = 44) and the aquatic exercise group (AEG; n = 64). Both groups received elementary calcium 500 mg/day and cholecalciferol 1,000 IU/day. For 24 weeks, the AEG participated in the aquatic exercise program, whereas the CG remained sedentary. The following variables were measured before and after the program: number of falls and fallers (7 mo before and after the intervention); flexibility, using Wells' Sit-and-Reach Test (FLEX); static balance, using the Unipedal Stance Test (UST); mobility, using the Timed-Up-and-Go test (TUG); handgrip strength of the dominant hand (HGS); and maximal isometric strength of back extensor muscles (SBE), strength of hip flexor muscles (SHF), and strength of knee extensor muscles (SKE). The muscle strength tests were considered the primary outcome, whereas the other neuromuscular tests, together with falls, were considered secondary outcomes. Results were significant when P ≤ 0.05. RESULTS: Serum 25-hydroxyvitamin D significantly increased by 21% in the CG and by 23% in the AEG (P < 0.001). The number of falls and fallers after the program remained unchanged in the CG; in the AEG, the mean number of falls decreased from 2.00 to 0.29 (P < 0.0001), and the number of fallers decreased by 44% (P < 0.0001). All neuromuscular variables significantly improved in the AEG: FLEX (26.6%; P < 0.0001), UST (14.1%; P < 0.001), TUG (23.7%; P < 0.001), HGS (13.4%; P < 0.001), SBE (26.2%; P < 0.001), SHF (18.5%; P = 0.039), and SKE (7.7%; P < 0.001). In the CG, significant improvements in FLEX (12.2%; P = 0.009), UST (4.5%; P < 0.001), TUG (10%; P < 0.001), and SHF (5.7%; P = 0.039) were observed and could be explained by increasing serum 25-hydroxyvitamin D level attributable to supplementation. CONCLUSIONS: The aquatic exercise program HydrOS is a safe and efficient way to improve physical function and to reduce falls among postmenopausal women.

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy.

OBJECTIVE: The purpose of this study was to evaluate if the measurement of peri-operative parathyroid hormone (PTH) is able to identify patients with increased risk of developing symptoms of hypocalcemia. SUBJECTS AND METHODS: Forty patients who underwent total thyroidectomy were studied prospectively. Ionized serum calcium and PTH were measured after induction of anesthesia, one hour (PTH1) and one day after surgery (PTH24). Patients were evaluated for symptoms of hypocalcemia and treated with calcium and vitamin D supplementation as necessary. RESULTS: Symptomatic hypocalcemia developed in 16 patients. Symptomatic patients had significant lower PTH1 and greater drops in PTH levels. The selection of 12.1 ng/L as PTH1 level cutoff level divided patients with and without symptoms with 93.7% sensitivity and 91.6% specificity. The selection of 73.5% as the cutoff value for PTH decrease resulted in 91.6% sensitivity and 87.5% specificity. CONCLUSION: PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy.

Previous use of quinolones: a surrogate marker for first line anti-tuberculosis drugs resistance in HIV-infected patients?

OBJECTIVES: Drug resistant Mycobacterium tuberculosis causes much higher rates of treatment toxicity, failure or relapse, and mortality. We determined the drug resistant profile of Mycobacterium tuberculosis strains isolated from a population of HIV-infected patients in southern Brazil and studied the potential factors associated with resistance. METHODS: We conducted a retrospective cohort study to determine the resistance profile of Mycobacterium tuberculosis isolated from HIV-infected patients and factors that could be associated with resistance from 2000 to 2005. RESULTS: 236 patients were included in the study. Resistance to at least one drug was observed in 32 (14.6%) isolates, and multi-drug resistance was observed in 4 (1.82%) isolates. On multivariate analysis, previous use of tuberculostatics and quinolones were related to any first-line drug resistance. CONCLUSIONS: In our study, previous quinolone use was significantly associated to first-line anti-TB drugs resistance. Multi-drug-resistant tuberculosis (MDR-TB) is a major problem worldwide, and we believe quinolones should be used with caution in settings where TB is endemic.

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy / Hormônio da paratireoide: um preditor precoce da hipocalcemia sintomática após a tireoidectomia total

OBJECTIVE: The purpose of this study was to evaluate if the measurement of peri-operative parathyroid hormone (PTH) is able to identify patients with increased risk of developing symptoms of hypocalcemia. SUBJECTS AND METHODS: Forty patients who underwent total thyroidectomy were studied prospectively. Ionized serum calcium and PTH were measured after induction of anesthesia, one hour (PTH1) and one day after surgery (PTH24). Patients were evaluated for symptoms of hypocalcemia and treated with calcium and vitamin D supplementation as necessary. RESULTS: Symptomatic hypocalcemia developed in 16 patients. Symptomatic patients had significant lower PTH1 and greater drops in PTH levels. The selection of 12.1 ng/L as PTH1 level cutoff level divided patients with and without symptoms with 93.7% sensitivity and 91.6% specificity. The selection of 73.5% as the cutoff value for PTH decrease resulted in 91.6% sensitivity and 87.5% specificity. CONCLUSION: PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy.

OBJETIVO: O objetivo deste estudo é avaliar se a medida perioperatória do hormônio da paratireoide (PTH) pode identificar os pacientes com maior risco de desenvolver sintomas de hipocalcemia. SUJEITOS E MÉTODOS: Foram estudados quarenta pacientes submetidos à tireodiectomia total. A medida do cálcio sérico e do PTH foi feita após a indução anestésica, uma hora (PTH1) e um dia após a cirurgia. Os pacientes foram avaliados quanto à presença de sintomas de hipocalcemia e tratados com suplementação de cálcio e vitamina D quando necessário. RESULTADOS: Dezesseis pacientes apresentaram sintomas de hipocalcemia. Os pacientes sintomáticos apresentaram PTH1 significantemente menor e queda no PTH significativamente maior. Usando o valor de 12,1 ng/L como corte, conseguimos distinguir pacientes com e sem sintomas de hipocalcemia com sensibilidade de 93,7% e especificidade de 91,6%. Utilizando como corte a queda de 73,5% no valor do PTH, temos sensibilidade de 91,6% e especificidade de 87,5%. CONCLUSÃO: O PTH1 e a queda no PTH são bons preditores de hipocalcemia no pós-operatório de tireoidectomia total.