Carnosine supplementation and retinal oxidative parameters in a high-calorie diet rat model.

BACKGROUND: To assess oxidative effects induced by a high-calorie diet on the retina of Wistar rats and test the antioxidative effects of carnosine supplementation. METHODS: Wistar rats were randomly divided into the following groups: standard diet (SD), high-calorie diet (HcD), standard diet + carnosine (SD + Car), and high-calorie diet + carnosine (HcD + Car). The body weight, adiposity index, plasma glucose, total lipids, high-density lipoprotein (HDL), low-density lipoprotein (LDL), uric acid, creatinine, and triglycerides of the animals were evaluated. The retinas were analyzed for markers of oxidative stress. Hydrogen peroxide production was assessed by 2',7'-dichlorodihydrofluorescein diacetate (DCF) oxidation. The total glutathione (tGSH), total antioxidant capacity (TAC), protein carbonyl, and sulfhydryl groups of the antioxidant system were analyzed. RESULTS: TAC levels increased in the retinas of the SD + Car group compared to the SD group (p < 0.05) and in the HcD + Car group compared to the HcD group (p < 0.05). The levels of GSH and the GSSH:GSSG ratio were increased in the HcD + Car group compared to the SD + Car group (p < 0.05). An increase in the retinal carbonyl content was observed in the HcD group compared to the SD group (p < 0.05) and in the HcD + Car group compared to the SD + Car group (p < 0.05). A high-calorie diet (HcD) was also associated with a decrease in retinal sulfhydryl-type levels compared to the SD group (p < 0.05). CONCLUSION: The results suggest that feeding a high-calorie diet to rats can promote an increase in carbonyl content and a reduction in sulfhydryl groups in their retinas. The administration of carnosine was not effective in attenuating these oxidative markers. TRIAL REGISTRATION: Animal Ethics Committee of Botucatu Medical School - Certificate number 1292/2019.

Tomato-Oleoresin Anti-Inflammatory Effect Recovers Obesity-Induced Cardiac Dysfunction by Modulating Myocardial Calcium Handling.

BACKGROUND/AIMS: Considering the importance of inflammation on obesity-related disorders pathogenesis, including cardiac dysfunction, the interest in natural anti-inflammatory therapeutic strategies has emerged. The lycopene is a carotenoid presents in tomato and red fruits that displays anti-inflammatory properties. In this sense, we will evaluate the anti-inflamma-tory effect of tomato-oleoresin supplementation on obesity- related cardiac dysfunction by modulating myocardial calcium kinetic. METHODS: Male Wistar rats were initially randomized into 2 experimental groups: (Control, n= 20) or high sugar- fat diet (HSF, n=20) for 20 weeks. At week 20th, once detected the cardiac dysfunction (cardiac remodeling, systolic and diastolic dysfunction) by echocardiography in HSF group, animals were randomly divided to begin the treatment with tomato-oleoresin, performing 4 groups: Control (n= 10); Control + tomato tomato-oleoresin supplementation (Control + Ly, n= 10); HSF (n= 10) or HSF + tomato tomato-oleoresin supplementation (HSF + Ly, n= 10). Tomato oleoresin was mixed with maize oil equivalent to 10mg lycopene/kg body weight (BW) per day and given orally, by gavage, every morning for a 10-week period. It was analyzed cardiac inflammatory parameters by the enzyme-linked immunosorbent assay (ELISA) and in vivo (echocardiography) and in vitro (studying isolated papillary muscles from the left ventricle) cardiac function. The groups were compared by Two-Way analysis of variance (ANOVA). RESULTS: The HSF diet induced cardiac dysfunction (FS(%) C: 60.4±1.3; C+Ly: 60.9±1.3; HSF: 51.7±1.3; HSF+Ly: 59.4±1.4) and inflammation (TNF-α: C:1.88±0.41; C+Ly: 1.93±1.01; HSF: 4.58±1.99; HSF+Ly: 2.03±0.55; IL-6: C:0.58±0.16; C+Ly: 0.40±0.16; HSF: 2.00±0.45; HSF+Ly: 0.53±0.26; MCP-1: C:0.31±0.08; C+Ly: 0.43±0.22; HSF: 1.54±0.32; HSF+Ly: 0.50±0.16). Tomato-oleoresin supplementation improved cardiac remodeling and dysfunction, cardiac inflammation and myocardial calcium kinetic. CONCLUSION: the anti-inflammatory effect of tomato-oleoresin supplementation treated the obesity-induced cardiac dysfunction by modulating myocardial calcium handling.

Associations among body composition, inflammatory profile and disease extent in ulcerative colitis patients.

OBJECTIVE: The aim of our study was to assess body composition status and its association with inflammatory profile and extent of intestinal damage in ulcerative colitis patients during clinical remission. METHOD: This is a cross-sectional study in which body composition data (phase angle [PhA], fat mass [FM], triceps skin fold thickness [TSFt], mid-arm circumference [MAC], mid-arm muscle circumference [MAMC], adductor pollicis muscle thickness [APMt]), inflammatory profile (C-reactive protein [CRP], a1-acid glycoprotein, erythrocyte sedimentation rate [ESR]) and disease extent were recorded. RESULTS: The mean age of the 59 patients was 48.1 years; 53.3% were women. Most patients were in clinical remission (94.9%) and 3.4% was malnourished according to body mass index. PhA was inversely correlated with inflammatory markers such as CRP (R=-0.59; p<0.001) and ESR (R=-0.46; p<0.001) and directly correlated with lean mass: MAMC (R=0.31; p=0.01) and APMt (R=0.47; p<0.001). Lean mass was inversely correlated with non-specific inflammation marker (APMt vs. ESR) and directly correlated with hemoglobin values (MAMC vs. hemoglobin). Logistic regression analysis revealed that body cell mass was associated with disease extent (OR 0.92; 95CI 0.87-0.97; p<0.01). CONCLUSION: PhA was inversely correlated with inflammatory markers and directly correlated with lean mass. Acute inflammatory markers were correlated with disease extent. Body cell mass was associated with disease extent.

Doxorubicin as an antioxidant: maintenance of myocardial levels of lycopene under doxorubicin treatment.

The mechanism of doxorubicin-induced cardiotoxicity remains controversial. Wistar rats (n=96) were randomly assigned to a control (C), lycopene (L), doxorubicin (D), or doxorubicin+lycopene (DL) group. The L and DL groups received lycopene (5 mg/kg body wt/day by gavage) for 7 weeks. The D and DL groups received doxorubicin (4 mg/kg body wt intraperitoneally) at 3, 4, 5, and 6 weeks and were killed at 7 weeks for analyses. Myocardial tissue lycopene levels and total antioxidant performance (TAP) were analyzed by HPLC and fluorometry, respectively. Lycopene metabolism was determined by incubating (2)H(10)-lycopene with intestinal mucosa postmitochondrial fraction and lipoxygenase and analyzed with HPLC and APCI mass spectroscopy. Myocardial tissue lycopene levels in DL and L were similar. TAP adjusted for tissue protein were higher in myocardium of D than those of C (P=0.002). Lycopene metabolism study identified a lower oxidative cleavage of lycopene in D as compared to those of C. Our results showed that lycopene was not depleted in myocardium of lycopene-supplemented rats treated with doxorubicin and that higher antioxidant capacity in myocardium and less oxidative cleavage of lycopene in intestinal mucosa of doxorubicin-treated rats suggest an antioxidant role of doxorubicin rather than acting as a prooxidant.

Tomato-oleoresin supplement prevents doxorubicin-induced cardiac myocyte oxidative DNA damage in rats.

Doxorubicin (DOX) is an efficient chemotherapeutic agent used against several types of tumors; however, its use is limited due to severe cardiotoxicity. Since it is accepted that reactive oxygen species are involved in DOX-induced cardiotoxicity, antioxidant agents have been used to attenuate its side effects. To determine tomato-oleoresin protection against cardiac oxidative DNA damage induced by DOX, we distributed Wistar male rats in control (C), lycopene (L), DOX (D) and DOX+lycopene (DL) groups. They received corn oil (C, D) or tomato-oleoresin (5mg/kg body wt. day) (L, DL) by gavage for a 7-week period. They also received saline (C, L) or DOX (4mg/kg body wt.) (D, DL) intraperitoneally at the 3rd, 4th, 5th, and at 6th week. Lycopene absorption was checked by HPLC. Cardiac oxidative DNA damage was evaluated by the alkaline Comet assay using formamidopyrimidine-DNA glycosylase (FPG) and endonuclease III (endo III). Cardiomyocyte levels of SBs, SBs FPG and SBs Endo III were higher in rats from D when compared to other groups. DNA damage levels in cardiomyocytes from DL were not different when compared to C and L groups. The viability of cardiomyocytes from D or DL was lower than C or L groups (p<0.01). Lycopene levels (mean+/-S.D.nmol/kg) in saponified hearts were similar between L (47.43+/-11.78) and DL (49.85+/-16.24) groups. Our results showed: (1) lycopene absorption was confirmed by its cardiac levels; (2) DOX-induced oxidative DNA damage in cardiomyocyte; (3) tomato-oleoresin supplementation protected against cardiomyocyte oxidative DNA damage.

Anthropometric, functional capacity, and oxidative stress changes in Brazilian community-living elderly subjects. A longitudinal study.

OBJECTIVE: To examine the changes and relationships among anthropometric, functional and plasma oxidative stress markers in elderly. DESIGN: longitudinal study. SETTING: measurements in 2008 and 2010. PARTICIPANTS: 103 community-dwelling men and women aged 67-92. MEASUREMENTS: Anthropometric parameters [waist, hip, arm and calf circumferences; waist-hip ratio, triceps skinfold thickness and others], basic (ADL) and instrumental activities of daily living (IADL)] and plasma oxidative stress markers (α-tocopherol, ß-carotene and malondialdehyde) were assessed in 2008 and 2010. RESULTS: ADL, IADL, body weight, skinfold thickness and circumferences of calf and arm decreased and waist and waist-hip ratio increased from 2008 to 2010. α-Tocopherol decreased and malondialdehyde plasma levels increased during the study period. In multiple logistic regression analyses, increased age (OR=1.12; IC: 1.02-1.23; p=0.02), female gender (OR=8.43; IC: 1.23-57.58; p=0.03), hypertension (OR=0.22; IC: 0.06-0.79; p=0.02), arthritis/arthrosis (OR=0.09; IC: 0.009-0.87; p=0.04) and depression (OR=0.20; IC: 0.04-1.03; p=0.05) were independent risk factors for functional decline. CONCLUSION: Fat reduction, muscle loss, central obesity increase, functional decline and worsening of plasma oxidative stress were observed during 2-year follow-up. Some of the risk factors that were identified could be modified to help prevent functional decline in elderly. The factors deserving attention include hypertension, arthritis/arthrosis and depression.

Association between oxidative stress and nutritional status in the elderly.

Ageing is a dynamic and progressive process that is characterized by the occurrence of morphological, biochemical, functional and psychological changes in the organism. The aim of the present article is to provide updated concepts on oxidative stress, covering its importance in aging, as well as nutritional status and supplementation with antioxidants (substances that prevent or attenuate oxidation of oxidizable substrates, such as lipids, proteins, carbohydrates and deoxyribonucleic acid) in the geriatric population. Evidence suggests that there is an inverse relationship between oxidative stress and nutritional status in elderly individuals. Although an increase in oxidative stress in chronic diseases associated with aging has been proven, such as Parkinson's disease and Alzheimer's disease, up to now there has been no consistent clinical evidence proving the efficiency of supplementation with antioxidants against oxidative stress. In this context, supplementation is not recommended. On the other hand, the elderly should be encouraged to eat antioxidant foods, such as fruits and vegetables. Maintaining a normal weight (body mass index between 23 and 28 Kg/m(2)) should also be stimulated.

Interactive effects of mechanical ventilation, inhaled nitric oxide and oxidative stress in acute lung injury.

To compare conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV), with/without inhaled nitric oxide (iNO), for oxygenation, inflammation, antioxidant/oxidative stress status, and DNA damage in a model of acute lung injury (ALI). Lung injury was induced by tracheal infusion of warm saline. Rabbits were ventilated at [Formula: see text] 1.0 and randomly assigned to one of five groups. Overall antioxidant defense/oxidative stress was assessed by total antioxidant performance assay, and DNA damage by comet assay. Ventilatory and hemodynamic parameters were recorded every 30min for 4h. ALI groups showed worse oxygenation than controls after lung injury. After 4h of mechanical ventilation, HFOV groups presented significant improvements in oxygenation. HFOV with and without iNO, and CMV with iNO showed significantly increased antioxidant defense and reduced DNA damage than CMV without iNO. Inhaled nitric oxide did not beneficially affect HFOV in relation to antioxidant defense/oxidative stress and pulmonary DNA damage. Overall, lung injury was reduced using HFOV or CMV with iNO.

Associations among body composition, inflammatory profile and disease extent in ulcerative colitis patients / Associações entre composição corporal, perfil inflamatório e extensão da doença em pacientes com retocolite ulcerativa

Summary Objective: The aim of our study was to assess body composition status and its association with inflammatory profile and extent of intestinal damage in ulcerative colitis patients during clinical remission. Method: This is a cross-sectional study in which body composition data (phase angle [PhA], fat mass [FM], triceps skin fold thickness [TSFt], mid-arm circumference [MAC], mid-arm muscle circumference [MAMC], adductor pollicis muscle thickness [APMt]), inflammatory profile (C-reactive protein [CRP], a1-acid glycoprotein, erythrocyte sedimentation rate [ESR]) and disease extent were recorded. Results: The mean age of the 59 patients was 48.1 years; 53.3% were women. Most patients were in clinical remission (94.9%) and 3.4% was malnourished according to body mass index. PhA was inversely correlated with inflammatory markers such as CRP (R=-0.59; p<0.001) and ESR (R=-0.46; p<0.001) and directly correlated with lean mass: MAMC (R=0.31; p=0.01) and APMt (R=0.47; p<0.001). Lean mass was inversely correlated with non-specific inflammation marker (APMt vs. ESR) and directly correlated with hemoglobin values (MAMC vs. hemoglobin). Logistic regression analysis revealed that body cell mass was associated with disease extent (OR 0.92; 95CI 0.87-0.97; p<0.01). Conclusion: PhA was inversely correlated with inflammatory markers and directly correlated with lean mass. Acute inflammatory markers were correlated with disease extent. Body cell mass was associated with disease extent.

Resumo Objetivo: Avaliar a composição corporal de pacientes portadores de retocolite ulcerativa em remissão clínica e sua associação com o perfil inflamatório e a extensão da lesão intestinal. Método: Foi realizado um estudo transversal. Os dados relacionados à composição corporal foram ângulo de fase (AF), massa adiposa (MA), dobra cutânea triciptal (DCT), circunferência do braço (CB), circunferência muscular do braço (CMB) e espessura do músculo adutor do polegar (EMAP). O perfil inflamatório foi avaliado através da dosagem da proteína-C reativa (PCR), a1-glicoproteína ácida e velocidade de hemossedimentação (VHS) e a extensão da doença foi avaliada de acordo com o exame endoscópico. Resultados: Foram avaliados 59 pacientes. A média de idade foi de 48,1 anos e 53,3% eram mulheres. A maioria dos pacientes (94,9%) estava em remissão clínica da doença e 3,4% foi classificada como desnutrida de acordo com o IMC. Observou-se uma correlação inversa entre AF e marcadores inflamatórios como a PCR (R=-0,59; p<0,001) e VHS (R=-0,46; p<0,001) e uma correlação direta entre AF e os indicadores de massa magra como CMB (R=0,31; p=0,01) e EMAP (R=0,47; p<0,001). A massa magra foi inversamente correlacionada com marcadores inflamatórios não específicos, como a VHS, e diretamente correlacionada com a hemoglobina. De acordo com a análise de regressão logística, a massa celular corporal foi associada com extensão da lesão intestinal (OR 0,92; IC95% 0,87-0,97; p<0,01). Conclusão: AF foi inversamente correlacionado com marcadores inflamatórios e diretamente correlacionado com a massa magra. Marcadores inflamatórios de fase aguda e massa celular corporal foram correlacionados com extensão da lesão intestinal.

Biomarkers for oxidative stress in acute lung injury induced in rabbits submitted to different strategies of mechanical ventilation.

Oxidative damage has been said to play an important role in pulmonary injury, which is associated with the development and progression of acute respiratory distress syndrome (ARDS). We aimed to identify biomarkers to determine the oxidative stress in an animal model of acute lung injury (ALI) using two different strategies of mechanical ventilation. Rabbits were ventilated using either conventional mechanical ventilation (CMV) or high-frequency oscillatory ventilation (HFOV). Lung injury was induced by tracheal saline infusion (30 ml/kg, 38°C). In addition, five healthy rabbits were studied for oxidative stress. Isolated lymphocytes from peripheral blood and lung tissue samples were analyzed by alkaline single cell gel electrophoresis (comet assay) to determine DNA damage. Total antioxidant performance (TAP) assay was applied to measure overall antioxidant performance in plasma and lung tissue. HFOV rabbits had similar results to healthy animals, showing significantly higher antioxidant performance and lower DNA damage compared with CMV in lung tissue and plasma. Total antioxidant performance showed a significant positive correlation (r = 0.58; P = 0.0006) in plasma and lung tissue. In addition, comet assay presented a significant positive correlation (r = 0.66; P = 0.007) between cells recovered from target tissue and peripheral blood. Moreover, antioxidant performance was significantly and negatively correlated with DNA damage (r = -0.50; P = 0.002) in lung tissue. This study indicates that both TAP and comet assay identify increased oxidative stress in CMV rabbits compared with HFOV. Antioxidant performance analyzed by TAP and oxidative DNA damage by comet assay, both in plasma, reflects oxidative stress in the target tissue, which warrants further studies in humans.

Manual hyperinflation combined with expiratory rib cage compression for reduction of length of ICU stay in critically ill patients on mechanical ventilation.

OBJECTIVE: Although manual hyperinflation (MH) is widely used for pulmonary secretion clearance, there is no evidence to support its routine use in clinical practice. Our objective was to evaluate the effect that MH combined with expiratory rib cage compression (ERCC) has on the length of ICU stay and duration of mechanical ventilation (MV). METHODS: This was a prospective randomized controlled clinical trial involving ICU patients on MV at a tertiary care teaching hospital between January of 2004 and January of 2005. Among the 49 patients who met the study criteria, 24 and 25 were randomly assigned to the respiratory physiotherapy (RP) and control groups, respectively. Of those same patients, 6 and 8, respectively, were later withdrawn from the study. During the 5-day observation period, the RP patients received MH combined with ERCC, whereas the control patients received standard nursing care. RESULTS: The two groups were similar in terms of the baseline characteristics. The intervention had a positive effect on the duration of MV, as well as on the ICU discharge rate and Murray score. There were significant differences between the control and RP groups regarding the weaning success rate on days 2 (0.0% vs. 37.5%), 3 (0.0% vs. 37.5%), 4 (5.3% vs. 37.5%), and 5 (15.9% vs. 37.5%), as well as regarding the ICU discharge rate on days 3 (0% vs. 25%), 4 (0% vs. 31%), and 5 (0% vs. 31%). In the RP group, there was a significant improvement in the Murray score on day 5. CONCLUSIONS: Our results show that the use of MH combined with ERCC for 5 days accelerated the weaning process and ICU discharge.

Association between oxidative stress and nutritional status in the elderly / Associação entre estresse oxidativo e estado nutricional de idosos.

Ageing is a dynamic and progressive process that is characterized by the occurrence of morphological, biochemical, functional and psychological changes in the organism. The aim of the present article is to provide updated concepts on oxidative stress, covering its importance in aging, as well as nutritional status and supplementation with antioxidants (substances that prevent or attenuate oxidation of oxidizable substrates, such as lipids, proteins, carbohydrates and deoxyribonucleic acid) in the geriatric population. Evidence suggests that there is an inverse relationship between oxidative stress and nutritional status in elderly individuals. Although an increase in oxidative stress in chronic diseases associated with aging has been proven, such as Parkinson’s disease and Alzheimer’s disease, up to now there has been no consistent clinical evidence proving the efficiency of supplementation with antioxidants against oxidative stress. In this context, supplementation is not recommended. On the other hand, the elderly should be encouraged to eat antioxidant foods, such as fruits and vegetables. Maintaining a normal weight (body mass index between 23 and 28 Kg/m2) should also be stimulated.

O envelhecimento é um processo dinâmico e progressivo que se caracteriza pela ocorrência de modificações morfológicas, bioquímicas, funcionais e psicológicas do organismo. O objetivo do presente artigo é fornecer conceitos atualizados sobre estresse oxidativo, abordando sua importância no envelhecimento, assim como o estado nutricional e suplementação com antioxidantes (substâncias que evitam ou atenuam a oxidação de substratos oxidáveis, como lipídeos, proteínas, carboidratos e o ácido desoxirribonucleico) na população geriátrica. Evidências sugerem que existe uma relação inversa entre estresse oxidativo e estado nutricional em indivíduos idosos. Embora seja comprovado o aumento do estresse oxidativo nas doenças crônicas associadas ao envelhecimento, como doença de Parkinson e doença de Alzheimer, não há, até o momento, evidências clínicas consistentes que comprovem a eficiência da suplementação com antioxidantes contra o estresse oxidativo. Nesse contexto, a suplementação não é recomendada. Por outro lado, idosos devem ser encorajados a ingerir alimentos antioxidantes, como, por exemplo, frutas e vegetais. A manutenção do peso dentro da faixa de normalidade (índice de massa corpórea entre 23 e 28 kg/m2) também deve ser estimulada.

Site-specific concentrations of carotenoids in adipose tissue: relations with dietary and serum carotenoid concentrations in healthy adults.

BACKGROUND: Dietary carotenoids are related to a decreased risk of certain diseases. Serum and adipose tissue carotenoid concentrations are used as biomarkers of intake. OBJECTIVES: The objectives of this study were to evaluate site-specific concentrations of carotenoids in adipose tissue and to examine relations between carotenoid concentrations in the diet, serum, and adipose tissue. DESIGN: Healthy adults (12 women and 13 men) participated in this cross-sectional study. Dietary carotenoids over the past year were assessed with a food-frequency questionnaire. Serum and adipose tissue biopsy samples were collected from the abdomen, buttock, and inner thigh for the measurement of carotenoids by HPLC. RESULTS: Many adipose carotenoids were inversely related to percentage body fat, although lycopene was the only carotenoid inversely correlated with all 3 sites. Most of the carotenoids were significantly higher in the abdominal adipose tissue than in the thigh (P < 0.05). Concentrations of alpha-carotene, beta-carotene, 5-cis-lycopene, and total carotenoids were significantly higher in the buttocks than in the thigh (P < 0.05). Concentrations of alpha-carotene, cis-lycopene, and lutein (with or without zeaxanthin) were significantly higher in the abdomen than in the buttocks (P < 0.05). Dietary intake was significantly correlated with serum concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, and total carotenoids. Carotenoid intake was significantly correlated with adipose tissue concentrations of alpha-carotene, beta-carotene, beta-cryptoxanthin, cis-lycopene, and total carotenoids (P < 0.05) but varied by site. Of all the adipose tissue sites evaluated, the abdomen showed the strongest correlation with long-term dietary carotenoid intakes and with serum (indicator of short-term intake) for most carotenoids. CONCLUSIONS: Body fat may influence the tissue distribution of carotenoids. Abdominal adipose tissue carotenoid concentrations may be a useful indicator of carotenoid status.

Dietary patterns are associated with general and central obesity in elderly living in a Brazilian city / Padrões alimentares associados com obesidade geral e central em idosos residentes em uma cidade brasileira

Objective: dietary pattern evaluation is often used in order to determine wheter a diet is healthy, as well as to predict the onset of diseases. This study aimed to identify dietary patterns, and to examine their associations with general (body mass index) and central (waist circumference and waist-to-hip ratio) obesity in community-living elderly in a Brazilian city. Methods: this cross-sectional study included 126 elderly subjects aged 60 or older (57.1% females and mean age 74.2 ± 6.46 years). Anthropometric variables, weight, height, waist (WC) and hip (HC) circumferences, were measured. Body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Answers to a Food Frequency Questionnaire were interpreted by Principal Component Analysis in order to identify dietary patterns. Results: five dietary patterns were identified and named as prudent (fruit, vegetables and meat), sweets and fats (pastries, sugary foods, fatty foods, whole milk), typical Brazilian (fried eggs, cooked beans, beef, candy, string beans, fried cassava), Mediterranean (fruit, vegetables, olive oil and nuts) and traditional meal (rice and beans). Moderate and high adherences to the Mediterranean pattern were protective factors to general and central obesity (WHR). High adherence to prudent was also protective to central obesity (WC). Conclusion: adherences to the dietary patterns prudent and Mediterranean were protective factors to general and central obesity in elderly. .

Objetivo: a avaliação do padrão alimentar é muitas vezes usada para determinar se uma dieta é saudável, bem como para predizer o aparecimento de doenças. Este estudo teve como objetivo identificar padrões alimentares e analisar as suas associações com obesidade geral (índice de massa corporal) e central (circunferência da cintura e relação cintura-quadril) em idosos residentes em comunidade em uma cidade brasileira. Métodos: este estudo transversal incluiu 126 idosos com 60 anos ou mais de idade (57,1% do sexo feminino e média de idade 74,2 ± 6,46 anos). As variáveis antropométricas [peso, altura, circunferências da cintura (CC) e do quadril (CQ)] foram mensuradas. Foram calculados o índice de massa corporal (IMC) e relação cintura-quadril (RCQ). As respostas a um questionário de frequência alimentar foram interpretadas por Análise de Componentes Principais, a fim de identificar os padrões alimentares. Resultados: cinco padrões alimentares foram identificados e nomeados como prudente (frutas, legumes e car-ne), doces e gorduras (alimentos de pastelaria, doces, alimentos gordurosos, leite integral), padrão tipicamente brasileiro (ovos fritos, feijão cozido, carne, caramelo, vagens, mandioca frita), Mediterrâneo (frutas, legumes, azeite de oliva e nozes) e tradicional (arroz e feijão). Adesões moderada e alta ao padrão Mediterrâneo foram fatores de proteção para obesidade geral e central (RCQ). Alta adesão ao padrão prudente também foi protetor contra a obesidade central (CC). Conclusão: adesões aos padrões alimentares prudente e Mediterrâneo foram fatores de proteção para obesidade geral e central em idosos. .

Hiperinsuflação manual combinada com compressão torácica expiratória para redução do período de internação em UTI em pacientes críticos sob ventilação mecânica / Manual hyperinflation combined with expiratory rib cage compression for reduction of length of ICU stay in critically ill patients on mechanical ventilation

OBJETIVO: Embora a hiperinsuflação manual (HM) seja largamente usada para a remoção de secreções pulmonares, não há evidências para sua recomendação como rotina na prática clínica. O objetivo do estudo foi avaliar o efeito da HM combinada com compressão torácica expiratória (CTE) na duração de internação em UTI e no tempo de ventilação mecânica (VM) em pacientes sob VM. MÉTODOS: Ensaio clínico prospectivo, randomizado e controlado com pacientes de UTI sob VM em um hospital acadêmico terciário entre janeiro de 2004 e janeiro de 2005. Dentre os 49 pacientes que preencheram os critérios do estudo, 24 e 25 foram randomicamente alocados nos grupos fisioterapia respiratória (FR) e controle, respectivamente, sendo que 6 e 8 foram retirados do estudo. Durante o período de observação de 5 dias, os pacientes do grupo FR receberam HM combinada com CTE, enquanto os controles receberam o tratamento padrão de enfermagem. RESULTADOS: Os dois grupos apresentaram características basais semelhantes. A intervenção teve efeito positivo na duração de VM, alta da UTI e escore de Murray. Houve diferenças significativas entre os grupos controle e FR em relação à taxa de sucesso no desmame nos dias 2 (0,0% vs. 37,5%), 3 (0,0% vs. 37,5%), 4 (5,3 vs. 37,5%) e 5 (15,9% vs. 37,5%), assim como à taxa de alta da UTI nos dias 3 (0% vs. 25%), 4 (0% vs. 31%) e 5 (0% vs. 31%). No grupo FR, houve uma melhora significante no escore de Murray no dia 5. CONCLUSÕES: Nossos resultados mostraram que o uso combinado de HM e CTE por 5 dias acelerou o processo de desmame e de alta da UTI.

OBJECTIVE: Although manual hyperinflation (MH) is widely used for pulmonary secretion clearance, there is no evidence to support its routine use in clinical practice. Our objective was to evaluate the effect that MH combined with expiratory rib cage compression (ERCC) has on the length of ICU stay and duration of mechanical ventilation (MV). METHODS: This was a prospective randomized controlled clinical trial involving ICU patients on MV at a tertiary care teaching hospital between January of 2004 and January of 2005. Among the 49 patients who met the study criteria, 24 and 25 were randomly assigned to the respiratory physiotherapy (RP) and control groups, respectively. Of those same patients, 6 and 8, respectively, were later withdrawn from the study. During the 5-day observation period, the RP patients received MH combined with ERCC, whereas the control patients received standard nursing care. RESULTS: The two groups were similar in terms of the baseline characteristics. The intervention had a positive effect on the duration of MV, as well as on the ICU discharge rate and Murray score. There were significant differences between the control and RP groups regarding the weaning success rate on days 2 (0.0% vs. 37.5%), 3 (0.0% vs. 37.5%), 4 (5.3% vs. 37.5%), and 5 (15.9% vs. 37.5%), as well as regarding the ICU discharge rate on days 3 (0% vs. 25%), 4 (0% vs. 31%), and 5 (0% vs. 31%). In the RP group, there was a significant improvement in the Murray score on day 5. CONCLUSIONS: Our results show that the use of MH combined with ERCC for 5 days accelerated the weaning process and ICU discharge.

Síndrome metabólica: atualização de critérios diagnósticos e impacto do estresse oxidativo na patogênese: [revisão] / Metabolic syndrome: updated diagnostic criteria and impact of oxidative stress on metabolic syndrome pathogenesis: [review]

JUSTIFICATIVA E OBJETIVOS: Tem sido estimado que a síndrome metabólica (SM) afeta uma substancial porcentagem da população idosa e de média idade, conferindo um aumento de risco para o desenvolvimento de doenças cardiovasculares e diabetes mellitus do tipo 2 (DM2), riscos esses que irão conduzir a uma situação economicamente insustentável nos próximos anos. O objetivo deste estudo foi apresentar critérios diagnósticos atualizados, detalhar o papel do estresse oxidativo em cada um dos diversos sinais, sumarizar os principais estudos clínicos e experimentais,e abordar o tratamento com antioxidantes. CONTEÚDO: SM corresponde a um conjunto de anormalidades,incluindo entre outros sinais, aumento da pressão arterial,alteração da glicemia, hipertrigliceridemia, baixos níveis de lipoproteína-colesterol de baixa densidade e obesidade abdominal. Estresse oxidativo é um importante mecanismo no desenvolvimentodos sinais da SM. CONCLUSÃO: Embora o estresse oxidativo parecesse ser mecanismo determinante na SM, a prescrição de suplementação com antioxidantes não é recomendada de rotina.

BACKGROUND AND OBJECTIVES: Metabolic syndrome (MS) affects a substantial percentage of the middle-aged and elderly populations and confers increased risk for type 2 diabetes and cardiovascular disease that ultimately will lead to economically-unsustainable costs of health care in the next years. This review shows updated diagnostic criteria, detailing the role of oxidative stress in each sign, summarizing the main clinical andexperimental studies and approaching the antioxidant treatment. CONTENTS: MS correspond to a cluster of abnormalities, includin gamong other signs, raised blood pressure, dysglycemia, and elevated triglyceride levels, low high-density lipoprotein cholesterol levels, and abdominal obesity. Oxidative stress is importan tmechanism involved in the MS sign development. CONCLUSION: Although oxidative stress seems to play an importantrole in its pathophysiological mechanism, routine use of antioxidant supplements is not recommended.

Estresse oxidativo como evento determinante na síndrome do desconforto respiratório agudo / Oxidative stress as determinant event acute respiratory distress syndrome

A lesão pulmonar aguda e sua forma mais grave, a síndrome do desconforto respiratório agudo (SDRA), são complicações frequentes em pacientes internados em unidades de terapia intensiva, sendo responsáveis pela alta mortalidade e morbidade. Embora seja considerada uma doença multifatorial, a presença do estresse oxidativo é denominador comum e determinante no mecanismo de lesão. A maioria dos estudos experimentais confirma a importância do estresse oxidativo na patogênese da SDRA. Novas estragégias terapêuticas vêm sendo tentadas, com base nos estudos clínicos e experimentais sobre patogênese da síndrome. O artigo destaca o papel do estresse oxidativo na patogênese da síndrome, por meio de apresentação dos mais recentes estudos na área. O texto objetiva também a desmistificação do tema estresse oxidativo apresentando definições e conceitos básicos.

Acute lung injury (ALI) and its most severe form, the acute respiratory distress syhdrome (ARDS), are frequent complications in critically ill patients and are responsible for significant morbidity and mortality. Although ALI and ARDS appears to be multilfactorial, a common denominator to most of the proposed mechanisms is the cellular damage mediated by oxidative stress. Evidence of oxidative stress and injury are common to most experimental models of lung injury and are corroborated in studies of patients with ALI/ARDS, underscoring the physiologic importance of these processes. New therapies strategies have been proposed based on clinical and experimental research results. The article approaches the role of oxidative stress on ALI/ARDS and also presents the main concepts of free radicals and antioxidants.