Dietary intake of anthocyanins improves arterial stiffness, but not endothelial function, in volunteers with excess weight: A randomized clinical trial.

Excess body weight has been associated with endothelial dysfunction and increased arterial stiffness. Foods rich in polyphenols and anthocyanins such as açaí-juçara (Euterpe edulis Martius) fruit may have protective vascular effects. Thus, we examined the effect of dietary intake of anthocyanins (açaí-juçara fruit) on endothelial function (flow-mediated dilation [FMD]) and arterial stiffness (pulse wave velocity [PWV]) in individuals with excess body weight. Fifty-five individuals with BMI ≥25 kg/m2 were randomized into non-anthocyanin (N-ATH, n = 25) or anthocyanin (ATH, n = 30) intake groups. A 12-week individualized diet plan (20% reduction in total energy intake) was prescribed and included daily intake of açaí-juçara 200 g (anthocyanins 293.6 mg) in the ATH diet plan. We evaluated anthropometric and biochemical parameters, FMD, PWV, and peripheral vascular resistance (PVR). A GEE (Bonferroni post-hoc) was used (p ≤ 0.05). No change in FMD was observed. However, PWV showed a reduction from baseline in the ATH (p = 0.002) and vs. N-ATH (p = 0.036). Both groups showed reduced peripheral vascular resistance (N-ATH, p = 0.005; ATH, p = 0.040) with no significant differences between them. In conclusion, dietary intake of anthocyanins proved effective in protecting against arterial stiffness (by PWV) in individuals with excess weight. PVR was reduced in both diet groups regardless of dietary intake of anthocyanins.

A photoelectrochemical enzyme biosensor based on functionalized hematite microcubes for rutin determination by square-wave voltammetry.

A photoelectrochemical biosensing strategy for the highly sensitive detection of the flavonoid rutin was developed by synergizing the photoelectrocatalytic properties of hematite (α-Fe2O3) decorated with palladium nanoparticles (PdNPs) and the biocatalysis towards laccase-based reactions. The integration of α-Fe2O3.PdNPs with a polyphenol oxidase as a biorecognition element yields a novel biosensing platform. Under visible light irradiation, the photoactive biocomposite can generate a stable photocurrent, which was found to be directly dependent upon the concentration of rutin. Under the optimal experimental conditions, the cathodic photocurrent, measured at 0.33 V vs. Ag/AgCl, from the square-wave voltammograms presented a linear dependence on the rutin concentration within the range of 0.008-30.0 × 10-8 mol L-1 (sensitivity: 1.7 µA·(× 10-8 M-1)·cm-2), with an experimental detection limit (S/N = 3) of 8.4 × 10-11 mol L-1. The proposed biosensor device presented good selectivity towards rutin in the presence of various organic compounds and inorganic ions, demonstrating the potential application of this biosensing platform in complex matrices. This bioanalytical device also exhibited excellent operational and analytical properties, such as intra-day (standard deviation, SD = 0.21%) and inter-day (SD = 1.30%) repeatability, and long storage stability (SD = 2.80% over 30 days).Graphical abstract.

A new medium-throughput screening design approach for the development of hydroxymethylnitrofurazone (NFOH) nanostructured lipid carrier for treating leishmaniasis.

Hydroxymethilnitrofurazone (NFOH) is a nitrofurazone derivative and has potential use in treating leishmaniasis. However, due to low water solubility and bioavailability, NFOH has failed in in vivo tests. Nanostructured lipid carrier (NLC) is an alternative to overcome these limitations by improving pharmacokinetics and modifying drug delivery. This work is focused on developing a novel NFOH-loaded NLC (NLC-NFOH) using a D-optimal mixture statistical design and high-pressure homogenization, for oral administration to treat leishmaniasis. The optimized NLC-NFOH consisted of Mygliol® 840, Gelucire® 50/13, and Precirol® ATO 5 as lipids. These lipids were selected using a rapid methodology Technobis Crystal 16 T M, microscopy, and DSC. Different tools for selecting lipids provided relevant scientific knowledge for the development of the NLC. NLC-NFOH presented a z-average of 198.6 ±â€¯5.4 nm, PDI of 0.11 ±â€¯0.01, and zeta potential of -13.7 ±â€¯0.7 mV. A preliminary in vivo assay was performed by oral administration of NLC-NFOH (2.8 mg/kg) in one healthy male Wistar rat (341 g) by gavage. Blood from the carotid vein was collected, and the sample was analyzed by HPLC. The plasma concentration of NFOH after 5 h of oral administration was 0.22 µg/mL. This same concentration was previously found using free NFOH in the DMSO solution (200 mg/kg), which is an almost 100-fold higher dose. This study allowed a design space development approach of the first NLC-NFOH with the potential to treat leishmaniasis orally.

Chemometric-assisted construction of a biosensing device to measure chlorogenic acid content in brewed coffee beverages to discriminate quality.

In this work we propose the use of statistical mixture design in the construction of a biosensor device based on graphite oxide, platinum nanoparticles and biomaterials obtained from Botryosphaeria rhodina MAMB-05. The biosensor was characterized by electrochemical impedance spectroscopy. Under optimized experimental parameters by factorial design, the biosensor was applied to the voltammetric determination of chlorogenic acid (CGA) measured as 5-O-caffeoylquinic acid (5-CQA). The biosensor response was linear (R2 = 0.998) for 5-CQA in the concentration range 0.56-7.3 µmol L-1, with limit of detection and quantification of 0.18 and 0.59 µmol L-1, respectively. The new biosensing device was applied to quality control analysis based upon the determination of CGA content in specialty and traditional coffee beverages. The results indicated that specialty coffee had a significantly higher content of CGA. Principal component analysis of the voltammetric fingerprint of brewed coffees revealed that the laccase-based biosensor can be used for their discrimination.

Perspectiva clínica sobre el tratamiento antihipertensivo en adultos con hipertensión grado 1 y riesgo cardiovascular bajo a moderado: consulta internacional de expertos

[RESUMEN]. La hipertensión arterial es el principal factor de riesgo de la carga global de las enfermedades. Una pregunta en debate es si la hipertensión arterial grado 1 (140–159/90–99 mm Hg) con riesgo cardiovascular (RCV) total bajo (mortalidad cardiovascular < 1% a los 10 años) a moderado (mortalidad cardiovascular > 1% y < 5% a los 10 años) debe ser tratada con agentes antihipertensivos. Un proceso de consulta virtual internacional fue realizado para resumir las opiniones de los expertos seleccionados. Después del análisis holístico de todos los elementos epidemiológicos, clínicos, psicosociales y de salud pública, este proceso de consulta llegó al siguiente consenso para adultos hipertensos < 80 años de edad: 1) La interrogante, de si el tratamiento medicamentoso en la hipertensión grado 1 debe ser precedido por un periodo de algunas semanas o meses, durante el cual solo se recomienden medidas sobre el estilo de vida no está basada en evidencia, pero el consenso de opinión es reservar un periodo para solo cambios en el estilo de vida únicamente en los pacientes con hipertensión grado 1 “aislada” (hipertensión grado 1 no complicada con RCV total absoluto bajo, y sin otros factores de RCV mayores ni modificadores del riesgo). 2) El inicio del tratamiento antihipertensivo medicamentoso en pacientes con hipertensión grado 1 y RCV absoluto moderado no debe demorarse. 3) Los hombres ≥ 55 años y las mujeres ≥ 60 años con hipertensión grado 1 no complicada deben ser automáticamente clasificados dentro de la categoría de RCV total absoluto moderado, incluso en ausencia de otros factores de riesgo mayores y modificadores del riesgo. 4) Las estatinas deben tenerse en cuenta junto con la terapia antihipertensiva, independientemente de los valores de colesterol, en pacientes con hipertensión grado 1 y RCV moderado.

[ABSTRACT]. Hypertension is a leading risk factor for disease burden globally. An unresolved question is whether grade 1 hypertension (140-159/90-99 mmHg) with low (cardiovascular mortality < 1% at 10 years) to moderate (cardiovascular mortality > 1% and < 5% at 10 years) absolute total cardiovascular risk (CVR) should be treated with antihypertensive agents. A virtual international consultation process was undertaken to summarize the opinions of select experts. After holistic analysis of all epidemiological, clinical, psychosocial, and public health elements, this consultation process reached the following consensus in hypertensive adults aged < 80 years: (1) The question of whether drug treatment in grade 1 should be preceded by a period of some weeks or months during which only life style measures are recommended cannot be evidence based, but the consensus opinion is to have a period of lifestyle alone reserved only to patients with grade 1 “isolated” hypertension (grade 1 uncomplicated hypertension with low absolute total CVR, and without other major CVR factors and risk modifiers). (2)The initiation of antihypertensive drug therapy in grade 1 hypertension with moderate absolute total CVR should not be delayed. (3) Men ≥ 55 years and women ≥ 60 years with uncomplicated grade1 hypertension should automatically be classified within the moderate absolute total CVR category, even in the absence of other major CVR factors and risk modifiers. (4) Statins should be considered along with blood-pressure lowering therapy, irrespective of cholesterol levels, in patients with grade 1 hypertensive with moderate CVR.

Clinical Perspective on Antihypertensive Drug Treatment in Adults With Grade 1 Hypertension and Low-to-Moderate Cardiovascular Risk: An International Expert Consultation.

Hypertension is a leading risk factor for disease burden globally. An unresolved question is whether grade 1 hypertension (140-159/90-99mmHg) with low (cardiovascular mortality <1% at 10 years) to moderate (cardiovascular mortality ≥1% and <5% at 10 years) absolute total cardiovascular risk (CVR) should be treated with antihypertensive agents. A virtual international consultation process was undertaken to summarize the opinions of select experts. After holistic analysis of all epidemiological, clinical, psychosocial, and public health elements, this consultation process reached the following consensus in hypertensive adults aged <80 years: (1) The question of whether drug treatment in grade 1 should be preceded by a period of some weeks or months during which only lifestyle measures are recommended cannot be evidence based, but the consensus opinion is to have a period of lifestyle alone reserved only to patients with grade 1 "isolated" hypertension (grade 1 uncomplicated hypertension with low absolute total CVR, and without other major CVR factors and risk modifiers). (2) The initiation of antihypertensive drug therapy in grade 1 hypertension with moderate absolute total CVR should not be delayed. (3) Men ≥55 years and women ≥60 years with uncomplicated grade 1 hypertension should automatically be classified within the moderate absolute total CVR category, even in the absence of other major CVR factors and risk modifiers. (4) Statins should be considered along with blood-pressure lowering therapy, irrespective of cholesterol levels, in patients with grade 1 hypertensive with moderate CVR.

Automassagem sob a perspectiva da educação em saúde: análise e intervenção / Self-massage from the health education perspective: analysis and intervention

Introdução: A automassagem é uma prática milenar da Medicina Tradicional Chinesa (MTC), que foi incorporada ao Sistema Único de Saúde do Distrito Federal em 1988. Desde então, sua filosofia contribui para o fortalecimento da atenção básica. Objetivo: Avaliar a prática integrativa de automassagem sob a perspectiva da educação em saúde, segundo a percepção dos participantes, durante o processo de instrumentalização do grupo com tecnologias socioeducativas. Metodologia: Pesquisa-ação crítica qualitativa em três etapas: observação participante, intervenção e grupo focal com usuários da atividade. Os dados foram gravados, transcritos literalmente e analisados por categorização de Bardin.18 Resultados/Discussão: Foram descritos em três categorias: O papel da automassagem na assistência à saúde e qualidade de vida do usu- ário: relato subjetivo de melhora de pressão alta, depressão, dores, estreitamento de vínculos e empoderamento; Mudança na visão do processo saúde-doença: os usuários compartilham do conceito amplo de saúde; Organização e planejamento do grupo: música, pequenos grupos e concentração são algumas sugestões. Conclusão: Embora a automassagem não apresente como característica principal a expressão de saberes pela comunicação verbal, esta consiste em prática educativa evidenciada pela integração e estímulo ao desenvolvimento da autonomia, contribuindo, portanto, para reafirmação e consolidação dos pressupostos da educação popular.

Introduction: Self-massage is an ancient practice of Traditional Chinese Medicine (TCM), which was incorporated into the Unified Health System of the Distrito Federal in 1988. Since then, its philosophy is helping to strengthen primary care. Objective: To evaluate the integrative practice of self-massage from the perspective of health education, as perceived by the participants during the process of instrumentalizing the group with social and educational technologies. Methodology: Qualitative critical action-research in three steps: participative observation, intervention, and focus groups with users of the activity. The data were recorded, literally transcribed, and analyzed with Bardin's categorization. Results/Discussion: These were described in three categories - The role of selfmassage in the health care and quality of life of the user: subjective report of improvement in high blood pressure, depression, pain, closer ties, and empowerment; Changed view of the health-disease process: users share the broad concept of health; Group organization and planning: music, small groups, and focus are some suggestions. Conclusion: Although self-massage does not present the expression of knowledge through verbal communication as a main characteristic, it consists of educational practice demonstrated by the integration and the fostering of autonomy, thus contributing to reaffirm and consolidate the assumptions of popular education.

Effect of hyperbaric pressure during scuba diving on autonomic modulation of the cardiac response: application of the continuous wavelet transform to the analysis of heart rate variability.

This study sought to determine the effects of hyperbaric pressure on heart rate modulation, by analyzing potential changes in heart rate variability (HRV). Ten divers were exposed to pressures of 1, 2, 3, and 4 atmospheres absolute (ATA). The test was performed in a hyperbaric chamber. Heart rate (HR) was recorded in supine subjects for 10 minutes per atmosphere. HRV was analyzed in the frequency mode (fast-Fourier transform and continuous wavelet transform). Results confirmed bradycardia as pressure increased. The drop in HR attained statistical significance after 2, 3, and 4 ATA. Signal energy (normalized TP values) rose progressively, becoming significant at 2 ATA. High frequency and low frequency displayed similar behavior in both cases. Although frequency band peaks did not yield clear results, continuous wave transform analysis showed that the frequency spectrum tended to shift into the high-frequency range as pressure increased. In summary, increased pressure prompted increased bradycardia, and HRV shifted into high-frequency range.

O eletrocardiograma de alta resolução na avaliação da remodelagem elétrica atrial e na predição de recorrência da fibrilação atrial / High resolution electrocardiography in the evaluation of atrial electrical remodeling and to predict of atrial fibrillation

Fundamentos: A fibrilação atrial (FA) apresenta alta taxa de recorrência que pode ser explicada por dois mecanismos: o primeiro diz respeito à capacidade dessa arritmia se perpetuar através da autoindução de alterações eletrofisiológicas, denominadas de remodelagem elétrica. O segundo mecanismo está relacionado a condições cardiovasculares subjacentes que podem estar presentes com alterações estruturais do coração, mesmo que de forma subclínica, por um longo período de tempo até o primeiro episódio de FA. Objetivo: Investigar a importância do eletrocardiograma de alta resolução da onda P (ECGAR-P) na avaliação da remodelagem elétrica atrial e na predição de recorrência da fibrilação atrial. Métodos: Foram realizados dois estudos, o ECGAR-P foi aplicado em ambos. No primeiro avaliaram-se os padrões evolutivos da ativação elétrica atrial durante um mês em 31 pacientes com FA idiopática de longa duração e submetidos à cardioversão. No segundo, investigou-se o ECGAR-P e outros preditores clínicos de não resposta à amiodarona em baixa dose, após a cardioversão do primeiro episódio persistente e altamente sintomático de FA não valvar. O segundo estudo incluiu 87 pacientes e teve seguimento mínimo de 24 meses. Ao final do seguimento, a resposta à terapia antiarrítmica (TA) foi considerada como não responsiva quando ocorreram duas ou mais recorrências de FA ou insucesso em nova cardioversão. Obteve-se de todos os participantes, de ambos os estudos, o Consentimento Livre e Esclarecido, tendo sido o estudo aprovado pelo Comitê de Ética da instituição. Resultados: O primeiro estudo mostrou que entre 31 indivíduos, 9 tiveram recorrência precoce da arritmia, todos nos primeiros sete dias após a cardioversão, e 22 permaneceram em ritmo sinusal por pelo menos um mês. Nesses pacientes a duração da onda P diminuiu progressivamente do primeiro para o terceiro ECGAR. Na análise no domínio da frequência, a turbulência espectral se mostrou inaparente no ECGAR imediato...

Background: Atrial fibrillation is frequently disabling and drug resistant. The high rate of recurrence of AF is represented by two separate mechanisms: the first can be summarized as atrial fibrillation (AF) itself promotes electrophysiological changes, termed "electrical remodeling", facilitationg its recurrence and maintenance. There are evidences that the remodeling process is reversible after restoration of sinus rhythm. However, the timing for recovery of electrophysiological properties is characterized by marked vulnerability to early recurrence of the arrhythmia and still undefined. The second mechanism relates to underlying cardiovascular conditions and cardiac structural changes, which may be hidden for a long time until AF emerges. Objective: In the first article we evaluated the atrial electrical activation by using P-wave signal-averaged electrocardiogram (P-SAECG) post-cardioversion of long-standing lone AF, focusing on the reversal remodeling process to identify the timing of stabilization of the process. The objective of the second article was evaluated the follow-up of patients after cardioversion of the first persistent AF episode, with poorly symptoms and without structural cardiopathy. Methods: In the first study with 31 patients, P-SAECG was performed immediately after cardioversion and repeated on days seven and thirty. The second article included 87 patients with highly symptomatic first-detected persistent AF. After successful electrical cardioversion, echocardiogram and P-SAECG were obtained. During the segment, for all patients were prescribed low-dose of amiodarone and each one were followed-up at least for 24 months. At the end of the follow-up, antiarrythmic therapy (AT) outcome was defined as nonresponse if there were >- 2 recurrences of symptomatic AF or unsuccessful in sequential cardioversion. Results: the results of the first study shows that among 31 subjets, nine underwent early recurrence of AF, all of then...