RESUMEN
INTRODUCTION: The impacts of antidepressant pharmacotherapies on cardiovascular risk are unclear. We completed a systematic review with meta-analysis to assess the effect of paroxetine on heart rate variability (HRV) in patients with major depressive disorder (MDD). METHODS: The searches were accomplished via EMBASE, MEDLINE/PubMed (using the National Library of Medicine), Cochrane Library, CINAHL, Scopus, and Web of Science databases. We included non-blind, single, or double-blind randomized control trials in patients older than 18 diagnosed with MDD. Paroxetine needs to be enforced as a chronic therapeutic medication. We included individual studies that investigated resting HRV. RESULTS: We documented 402 studies, only following screening and eligibility phases; only six were included (five studies in the meta-analysis). No significant change was noticed for the SDNN index: subtotal = 8.23 [CI: -2.17, 18.63], p = 0.12, I2 = 54 % (very low quality of evidence). A significant change was distinguished for the LF index: subtotal = 0.74 [CI: 0.33, 1.15], p = 0.0004, I2 = 0 % (low quality of evidence). A significant alteration was perceived for the HF index: subtotal = 0.33 [CI: 0.06, 0.6], p = 0.02, I2 = 0 % (low quality of evidence). CONCLUSION: Meta-analysis demonstrated that paroxetine could advance HRV in MDD patients. Nevertheless, our supposition is founded only on statistical analysis and the very low quality of evidence breakdown reinforces the necessity for further studies to confirm or reject this theory.
Asunto(s)
Trastorno Depresivo Mayor , Frecuencia Cardíaca , Paroxetina , Paroxetina/uso terapéutico , Paroxetina/farmacología , Humanos , Trastorno Depresivo Mayor/tratamiento farmacológico , Trastorno Depresivo Mayor/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Inhibidores Selectivos de la Recaptación de Serotonina/farmacología , Antidepresivos de Segunda Generación/uso terapéutico , Antidepresivos de Segunda Generación/efectos adversos , Antidepresivos de Segunda Generación/farmacologíaRESUMEN
OBJECTIVES: A systematic review with meta-analysis was completed to study the effects of dietary inorganic nitrate (NO3-) oral ingestion from vegetables and salts on blood pressure responses during and following exercise. BACKGROUND: NO3- is a hypotensive agent with the potential to reduce blood pressure peaks during exercise and amplify exercise-induced hypotensive effects. Several randomized and controlled trials have investigated the effects of NO3- on hemodynamic responses to physical exercise, however this still has yet to be studied systematically. METHODS: The searches were conducted on EMBASE, Medline, and SPORTSDiscus databases. The study included masked randomized controlled trials (RCTs) with participants ≥18 years old. The NO3-intervention group received at least 50 mg NO3-/day with similar sources amid NO3- and placebo conditions. Included studies reported systolic blood pressure (SBP) or diastolic blood pressure (DBP) values during or following exercise performance. RESULTS: 1903 studies were identified, and twenty-six achieved the inclusion criteria. NO3- daily dosages ranged from 90 to 800 mg/day. Throughout exercise, SBP had smaller increases in the NO3- group (-2.81 mmHg (95%CI: -5.20 to -0.41), p=0.02. DBP demonstrated lower values in the NO3- group (-2.41 mmHg (95%CI: -4.02 to -0.79), p=0.003. In the post-exercise group, the NO3- group presented lower SBP values (-3.53 mmHg (95%CI: -5.65 to 1.41), p=0.001, while no changes were identified in DBP values between NO3- and placebo groups (p=0.31). Subgroup meta-analysis revealed that SBP baseline values, exercise type, duration of NO3- ingestion, and its dosages mediated blood pressure responses during and following exercise. CONCLUSIONS: NO3- ingestion prior to exercise attenuated the increases in SBP and DBP during exercise, and increased the decline in SBP after exercise. These results are dependent on factors that moderate the blood pressure responses (e.g., health status, type of exercise, resting blood pressure values).
Asunto(s)
Presión Sanguínea , Nitratos , Recuperación Después del Ejercicio , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Presión Sanguínea/efectos de los fármacos , Suplementos Dietéticos , Nitratos/administración & dosificación , Recuperación Después del Ejercicio/fisiologíaRESUMEN
Negacionism refers to the choice to deny a scientifically proven reality, which can reduce life expectancy and quality of life. Within this context, the uncontrolled trajectory of the COVID-19 Pandemic in Brazil has generated great concern due to the lack of consensus on how to manage the pandemic in a scenario of denial of the seriousness of the disease by the government, since on August 2nd, 2021, there are 556,437 Brazilians killed due to the disease. The denial of COVID-19 and the immunizing agent is another pandemic and turns the current scenario into a syndemic.
O negacionismo refere-se à escolha de negar uma realidade cientificamente comprovada, o que pode reduzir a expectativa e a qualidade de vida. Dentro desse contexto, a trajetória descontrolada da Pandemia de COVID-19 no Brasil tem gerado grande preocupação pela falta de consenso sobre como administrar a pandemia em um cenário de negação da gravidade da doença por parte do governo, visto que na data de 02 de agosto de 2021 há 556.437 brasileiros mortos por conta da doença. O negacionismo da COVID-19 e do imunizante é outra pandemia e torna o cenário atual numa sindemia.
Asunto(s)
Humanos , Masculino , Femenino , Vacunas , Negación en Psicología , COVID-19RESUMEN
Social distancing was planned as a preventive measure to control the extensive spread of COVID-19. COVID-19-related deaths in Brazil were analyzed during the period of social distancing measures. Mortality data for COVID-19 was obtained from the Worldometer website (www.worldometer.info). Deaths were estimated up to the 31st day after the occurrence of the 5th COVID-19-related death in Brazil. Social distance was measured using Google's community mobility reports (https://www.google.com/covid19/mobility/). The Brazilian epidemic curves were interconnected, and mathematical models were evaluated to fit the mortality estimation curves. The optimistic model was defined in the opening period of social distancing and, therefore, in the lower mobility (40-60%). The realistic model was calculated according to relaxed social distance measures (<40%) and the pessimistic model was calculated based on the transmission rate between 2-3. Thus, the equations of the mathematical models provided the outcomes for the date of June 9, 2020, as follows: realistic model with 40,623 deaths, pessimistic model with 64,310 deaths and the optimistic model with a projection of 31,384 deaths. As a result of these analyzes, on May 24, 2020, there were a total of 22,965 deaths related to COVID-19, and those deaths included within the proposed mathematical models were 17,452 for the optimistic model, 22,623 for the realistic model and 32,825 for the pessimistic model. Thus, it is concluded that social distancing measures promoted by the Brazilian public managers contributes to the reduction in approximately ten thousand deaths related to COVID-19 in the current pandemic scenario.
INTRODUÇÃO: O distanciamento social foi planejado como uma medida preventiva para controlar a disseminação extensiva da COVID-19. Nós analisamos as mortes relacionadas à COVID-19 no Brasil durante o período de medidas de distanciamento social. Os dados de mortalidade do COVID-19 foram obtidos no site da Worldometer (www.worldometer.info). As mortes foram estimadas até o 31º dia após a 5ª morte. O distanciamento social foi medido por meio dos relatórios de mobilidade comunitária COVID-19; Google (https://www.google.com/covid19/mobility/). As curvas epidêmicas brasileiras foram interligadas e os modelos matemáticos foram avaliados para se ajustarem às curvas de estimativa de mortalidade. O modelo otimista foi fundado no período de abertura da distância social e, portanto, na menor mobilidade (40-60%). O modelo realista foi calculado de acordo com medidas de distanciamento social relaxado (<40%) e o modelo pessimista foi calculado com base em R0 entre 2-3. Sob essa situação, o modelo matemático realista estimou 40.623 mortes em 9 de junho de 2020, enquanto o modelo pessimista antecipou 64.310 mortes e o modelo otimista projetou 31.384. Até hoje (24 de maio de 2020), um total de 22.965 foram relatadas, enquanto nosso modelo projetou 17.452 para o modelo otimista, 22.623 para o modelo realista e 32.825 para o modelo pessimista. Observamos movimento reduzido ao longo deste período. Em resumo, o modelo matemático sugere que a mobilidade reduzida da comunidade diminuiu o total estimado de mortes relacionadas à COVID-19 no Brasil. Enfatizamos que mais procedimentos metodológicos serão necessários para confirmar esta teoria
Asunto(s)
Humanos , Masculino , Femenino , Aislamiento Social , Infecciones por Coronavirus , Centers for Disease Control and Prevention, U.S. , Muerte , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , BetacoronavirusRESUMEN
BACKGROUNG: Chronic kidney disease is directly related to cardiovascular disorders. Guided physical exercises significantly improve the adverse effects of dialytic treatmentOBJECTIVE: To analyze changes in biochemical parameters of subjects with chronic kidney disease undergoing moderate exercise during hemodialysisMETHODS: This is an experimental study composed of 54 subjects submitted to hemodialysis, split into a control group and a group with intervention. The experimental group underwent three weekly sessions of aerobic exercise, performed during hemodialysis sessions, with a duration of 30 minutes, for 12 weeks. The blood parameters of both groups were comparedRESULTS: Statistically significant differences were observed between pre (p=0.001) and post-exercise protocol for urea (p=0.006), calcium (p=0.001), alanine aminotransferase (p=0.020) and sodium (p=<0.001). In the control group, we observed significant differences for the calcium variable (p<0.001), alanine aminotransferase (p=0.024), hematocrit (p=0.015), calcium vs phosphorus (p=0.018), and sodium (p=0.023), before and after the periodCONCLUSION: Aerobic training during hemodialysis was able to maintain blood level stability in patients with chronic kidney disease, both during and at the end of the protocol, even considering increased blood flow. This trial is registered in the Brazilian registry of clinical Trials - number RBR-7354r6. : July 5, 2018 at 12:59 PM. : July 24, 2018 at 10:24 AM. Identification of the test - UTN Number: U1111-1216-8272
INTRODUÇÃO: A doença renal crônica está diretamente relacionada a distúrbios cardiovasculares. Exercícios físicos guiados melhoram significativamente os efeitos adversos do tratamento dialíticoOBJETIVO: Analisar as alterações nos parâmetros bioquímicos de indivíduos com doença renal crônica submetidos a exercícios moderados durante a hemodiáliseMÉTODO: Este é um estudo experimental composto por 54 indivíduos submetidos à hemodiálise, divididos em um grupo controle e um grupo com intervenção. O grupo experimental passou por três sessões semanais de exercício aeróbico, realizadas durante as sessões de hemodiálise, com duração de 30 minutos, por 12 semanas. Os parâmetros sanguíneos de ambos os grupos foram comparadosRESULTADOS: Diferenças estatisticamente significativas foram observadas entre o protocolo pré (p=0,001) e pós-exercício para urea (p=0,006), cálcio (p=0,001), alanina aminotransferase (p=0,020) e sódio (p=&0.001). No grupo controle, observamos diferenças significativas para a variável cálcio (p<0.001), alanina aminotransferase (p=0,024), hematócrito (p=0,015), cálcio vs fósforo (p=0,018) e sódio (p=0,023), antes e depois do períodoCONCLUSÃO: O treinamento aeróbico durante a hemodiálise foi capaz de manter a estabilidade do nível sanguíneo em pacientes com doença renal crônica, tanto durante quanto no final do protocolo, considerando mesmo o aumento do fluxo sanguíneo. Este ensaio está registrado no registro brasileiro de Ensaios Clínicos - número RBR-7354r6. Data de inscrição: 5 de julho de 2018 às 12h59. : 24 de julho de 2018 às 10h24. Identificação do teste - UTN Número: U1111-1216-8272
Asunto(s)
Humanos , Masculino , Femenino , Circulación Renal , Ejercicio Físico , Estudios Longitudinales , Diálisis Renal , Insuficiencia Renal CrónicaRESUMEN
Exercising prior to experimental infarction may have beneficial effects on the heart. The objective of this study was to analyze studies on animals that had exercised prior to myocardial infarction and to examine any benefits through a systematic review and meta-analysis. The databases MEDLINE, Google Scholar, and Cochrane were consulted. We analyzed articles published between January 1978 and November 2018. From a total of 858 articles, 13 manuscripts were selected in this review. When animals exercised before experimental infarction, there was a reduction in mortality, a reduction in infarct size, improvements in cardiac function, and a better molecular balance between genes and proteins that exhibit cardiac protective effects. Analyzing heart weight/body weight, we observed the following results - Mean difference 95% CI - -0.02 [-0.61,0.57]. Meta-analysis of the infarct size (% of the left ventricle) revealed a statistically significant decrease in the size of the infarction in animals that exercised before myocardial infarction, in comparison with the sedentary animals -5.05 [-7.68, -2.40]. Analysis of the ejection fraction, measured by echo (%), revealed that animals that exercised before myocardial infarction exhibited higher and statistically significant measures, compared with sedentary animals 8.77 [3.87,13.66]. We conclude that exercise performed prior to experimental myocardial infarction confers cardiac benefits to animals.
Asunto(s)
Animales , Masculino , Femenino , Ratones , Ratas , Condicionamiento Físico Animal , Función Ventricular/fisiología , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/terapia , Ratas Wistar , Ratas Sprague-Dawley , Modelos Animales de Enfermedad , Corazón , Ventrículos Cardíacos/fisiopatología , Modelos CardiovascularesRESUMEN
SUMMARY Breast Cancer is common in women, but its etiology is not yet fully understood. Several factors may contribute to its genesis, such as genetics, lifestyle, and the environment. Melatonin may be involved in the process of breast cancer. Therefore, the aim of this study is to evaluate the influence of the levels of melatonin on breast cancer through a systematic review and meta-analysis. We performed a systematic review according to PRISMA recommendations. The primary databases MEDLINE, Embase, and Cochrane were consulted. There was no restriction on the year of publication and language. Data of systematic reviews from April 2017 to September to 2017 were analyzed. The meta-analysis was conducted using RevMan 5.3 software provided by the Cochrane Collaboration. From a total of 570 articles, 9 manuscripts were included in this review. They analy onzed women with breast cancer and control patients, of which 10% and 90% were in the reproductive period and after menopause, respectively. The lowest level of melatonin was found in approximately 55% of studies with breast cancer in post-menopause. The metanalyses of the studies demonstrated low levels of melatonin in breast cancer patients (n=963) compared with control patients (n= 1332), with a mean difference between the studies of 8722;3.54 (CI8722;6.01,8722;1.06). Another difference found was in the comparison between smoking patients, with an average difference between 1.80 [0.97-2.63]. Our data suggest that low levels of melatonin might be a risk factor for breast cancer.
RESUMO O câncer de mama é comum em mulheres, mas sua etiologia ainda não é totalmente compreendida. Vários fatores podem contribuir para sua gênese, genética, estilo de vida e meio ambiente. A melatonina pode estar envolvida no processo de câncer de mama. Portanto, o objetivo deste estudo é avaliar a influência dos níveis de melatonina no câncer de mama por meio de uma revisão sistemática e meta-análise. Realizamos uma revisão sistemática de acordo com as recomendações do Prisma. Os principais bancos de dados, Medline, Embase e Cochrane, foram consultados. Não houve restrição quanto ao ano de publicação e idioma. Os dados de revisão sistemática obtidos de abril de 2017 a setembro a 2017 foram analisados. A meta-análise foi conduzida pelo programa RevMan 5.3 fornecido pela Cochrane Collaboration. De um total de 570 artigos, nove foram incluídos nesta revisão. As análises foram conduzidas em mulheres com câncer de mama e pacientes controle, dos quais 10% e 90% estavam no período reprodutivo e após a menopausa, respectivamente. O nível mais baixo de melatonina foi encontrado em aproximadamente 55% dos estudos com câncer de mama na pós-menopausa. As meta-análises de estudos demonstraram os baixos níveis de melatonina em doentes com câncer da mama (n=963), em comparação com os pacientes de controle (n=1.332), sendo a diferença de médias entre os estudos da 8722;3,54 (CI 8722;6,01, 8722;1,06). Outra diferença é demonstrada nas comparações entre pacientes fumantes, sendo a diferença da média entre 1,80 [0,97-2,63]. Nossos dados sugerem que baixos níveis de melatonina podem ser um fator de risco para câncer de mama.
Asunto(s)
Humanos , Femenino , Neoplasias de la Mama/orina , Neoplasias de la Mama/sangre , Melatonina/orina , Melatonina/sangre , Valores de Referencia , Neoplasias de la Mama/etiología , Biomarcadores de Tumor/orina , Biomarcadores de Tumor/sangre , Factores de RiesgoRESUMEN
INTRODUCTION: Asthma is a chronic disease of the airways, which is increasing its prevalence among teenagers recently. The trigger-related factors are numerous, including environmental factors, genetic, food among others. OBJECTIVE: Investigate the prevalence of asthma symptoms and possible risk factors in adolescents. METHODS: This is a cross-sectional, descriptive and quantitative study conducted in 104 adolescents aged between 13 to 14 years old of both sexes from four educational institutions: three private and one public. Participants answered two questionnaires: one on risk factors for allergic diseases (EISL) and the other on asthma symptoms (ISAAC asthma module). RESULTS: 104 adolescents answered the questionnaire: 54.8% girls and 45.2% boys. Male subjects had the most active asthma (64%) than female (20%) (p = 0.01) and also had more physician-diagnosed asthma (34.4%) than girls (6.1%) (p = 0.04), more wheezing after exercise (34.4%; 12.1%) (p = 0.03). Regarding the association between the symptoms and the risk factors we observed a statistically significant relationship between the presence of wheezing and hospitalization for public schools girls (p = 0.05). CONCLUSION: There is a higher prevalence of asthma symptoms in males than in females unlike other studies was observed.
INTRODUÇÃO: A asma é a doença crônica das vias aéreas que vem apresentando um aumento na sua prevalência entre os adolescentes nas últimas décadas. Os fatores relacionados com o seu desencadeamento são inúmeros, passando por fatores ambientais, genéticos, alimentares dentre outros. OBJETIVO: Analisar a prevalência dos sintomas da asma e possíveis fatores de risco associados em adolescentes. MÉTODO: Trata-se de um estudo transversal, descritivo e quantitativo realizado em 104 adolescentes de 13 e 14 anos, de ambos os sexos, de quatro instituições de ensino: três privadas e uma pública. Os participantes responderam a dois questionários: um sobre os fatores de risco para doenças alérgicas e o outro sobre os sintomas da asma (ISAAC módulo asma). RESULTADOS: Responderam ao questionário 104 adolescentes: 54,8% meninas e 45,2% meninos. Os voluntários do sexo masculino apresentaram mais asma ativa (64,%) que as voluntárias (20%) (p = 0,01) e também tiveram mais asma diagnosticada (34,4%) do que as voluntárias (6,1%) (p = 0,04), além de mais chiado no peito após exercício (34,4%; 12,1%) (p = 0,03). Com relação à associação entre os sintomas e os fatores de riscos observou-se uma relação estatisticamente significante entre presença de sibilos e hospitalizações para as meninas de escolas públicas (p=0,05). CONCLUSÃO: Houve maior frequência de adolescentes do sexo masculino com asma ativa, asma diagnostica e sibilos após exercício físico. Por outro lado, as meninas da escola pública apresentaram um maior risco de hospitalização na presença de sibilos. Os demais fatores de riscos não apresentaram associações estatisticamente significantes com os sintomas da asma.
RESUMEN
OBJECTIVES: We aimed to evaluate the effects of cataract surgery on cardiac autonomic modulation. METHODS: A cross-sectional and analytical study was conducted at the Hospital Maria Braido in the city of São Caetano do Sul, São Paulo, between 2015 and 2016. We investigated 19 patients of both sexes who were all over 50 years old; all patients had a diagnosis of senile or bilateral cataracts and were recommended to undergo implantation of the intraocular lens. Heart rate variability (HRV) was evaluated before, during and after cataract surgery. RESULTS: There were no significant changes in the time and geometric domains of HRV before, during or after surgery. The high-frequency (HF) band in normalized units (nu) on the spectral analysis significantly increased (p=0.02, Cohen's d=0.9, large effect size). However, the low-frequency (LF) band in nu significantly decreased during surgery (p=0.02, Cohen's d=0.9, large effect size). CONCLUSION: Throughout the intraocular lens implantation cataract surgery, there was an increase in parasympathetic modulation and a decrease in the sympathetic component of the heart rate (HR). We propose that this result is attributable to the supine position of the patients during surgery and the trigeminal reflex.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Sistema Nervioso Autónomo/fisiopatología , Extracción de Catarata/efectos adversos , Implantación de Lentes Intraoculares/efectos adversos , Frecuencia Cardíaca/fisiología , Valores de Referencia , Factores de Tiempo , Nervio Trigémino/fisiopatología , Índice de Masa Corporal , Estudios Transversales , Estudios Prospectivos , Estadísticas no ParamétricasRESUMEN
OBJECTIVE: Rest arterial pressure has been shown to be associated with cardiovascular mortality. Autonomic heart rate control during recovery from exercise is estimated to detect changes in cardiovascular system, which may lead to cardiovascular diseases. We assessed the involvement of rest diastolic arterial pressure (DAP) on heart rate dynamics after exercise in normotensive physically active men. METHOD: We evaluated healthy physically active men aged 18 to 22 years old divided into two unequal groups: G1- rest DAP between 80 and 90 mmHg (N=11) and G2- rest DAP < 80mmHg (N=24). Volunteers performed physical exercise on a treadmill with intensity equivalent to 60% of Vmax. Heart rate recovery in the first (HRR1) and third (HRR3) minute after exercise were measured and heart rate variability (HRV) was examined in the time and frequency domain. Additionally, we performed the quantitative analysis of the Poincaré plot. HRV was recorded in the following phases: the 10-minute period before exercise, during exercise and the 60 minute period after exercise. RESULTS: We found no significant difference between G1 and G2 concerning HRV changes during exercise. The G2 group exhibited a delayed recovery of SDNN, RMSSD, RRTri, LF, HF, LF/HF, SD1 and SD2 indices during recovery from exercise. HRR1 and HRR3 was greater in the G2 group. CONCLUSION: Normotensive physically active men with DAP between 80 and 90 mmHg presented faster heart rate recovery and an accelerated recovery of heart rate autonomic control after aerobic exercise.
INTRODUÇÃO: A pressão arterial de repouso demonstrou estar associada à mortalidade cardiovascular. O controle autonômico da frequência cardíaca durante a recuperação pós-exercício é estimado para detetar mudanças no sistema cardiovascular, porque tais mudanças podem levar a doenças cardiovasculares. Avaliamos o envolvimento da pressão arterial diastólica de repouso (PAD) na dinâmica da frequência cardíaca após o exercício em homens normalmente ativos fisicamente normotensos. MÉTODO: Avaliamos homens saudáveis e fisicamente ativos com idades compreendidas entre os 18 e os 22 anos divididos em dois grupos desiguais: PAD de relaxamento G1 entre 80 e 90 mmHg (n=11) e PAD <80mmHg (n=24). Os voluntários realizaram exercícios físicos em uma esteira com intensidade equivalente a 60% da Vmax. A recuperação da frequência cardíaca no primeiro (HRR1) e terceiro (HRR3) minuto após o exercício foi medida e a variação da frequência cardíaca (VFC) foi examinada no domínio do tempo e da frequência. Além disso, realizamos a análise quantitativa da trama de Poincaré. A VFC foi registrada nas seguintes fases: os períodos de 10 minutos antes do exercício, durante o exercício e os períodos de 60 minutos após o exercício. RESULTADOS: Não encontramos diferença significativa entre G1 e G2 em relação às alterações da VFC durante o exercício. O G2 apresentou uma recuperação tardia dos índices SDNN, RMSSD, RRTri, LF, HF, LF/HF, SD1 e SD2 durante a recuperação do exercício. HRR1 e HRR3 foi maior no G2. CONCLUSÃO: Homens normais e fisicamente ativos com PAD entre 80 e 90 mmHg apresentaram RHE mais rápida e recuperação mais acelerada do controle autonômico da freqüência cardíaca após o exercício aeróbio.
Asunto(s)
Sistema Nervioso Autónomo , Sistema Cardiovascular , Fenómenos Fisiológicos Cardiovasculares , Prueba de Esfuerzo , Presión Arterial , Ejercicio Físico , Frecuencia CardíacaRESUMEN
OBJECTIVE: Nonlinear techniques to assess heart rate variability (HRV) have received much recent attention. We aimed to evaluate nonlinear HRV responses during recovery from exercise through the novel algorithm Higuchi Fractal Dimension. METHOD: We examined 35 healthy male volunteers aged between 18 and 35 years old. For the training of exercise intensity we used 60% of Vmax determined through a progressive test using the Conconi threshold. HRV was analyzed 10 minutes before and 10 minutes after exercise. We analyzed the geometric indices of HRV (SD1, a measure of short-term HRV and SD2, a measure of long-term HRV) and applied the Higuchi Fractal Dimension to RR intervals. RESULTS: During recovery from exercise the Poincaré plot indices SD1 and SD1/SD2 decreased while SD2 and SD2/SD1 increased (p<0.0001) compared to control at rest. All parameters of Higuchi Fractal Dimension analysis were lowered after exercise compared to control at rest (p<0.0001). CONCLUSION: Physical exercise acutely decreased the chaotic behavior of HRV as measured through the Higuchi Fractal Dimension analysis. Physiologically, this indicates that we detected complex changes in HRV immediately after exercise.
OBJETIVO: Métodos não-lineares para avaliar a variabilidade da freqüência cardíaca (VFC) têm recebido muita atenção recente. Nosso objetivo é analisar as respostas não-lineares da VFC durante a recuperação do exercício através do novo algoritmo da análise fractal da dimensão de Higuchi. MÉTODO: Foram examinados 35 voluntários saudáveis, com idade entre 18 e 35 anos. Para o treinamento de intensidade de exercício utilizamos 60% de Vmax determinado através de um teste progressivo utilizando o limiar de Conconi. A VFC foi analisada 10 minutos antes e 10 minutos após o exercício. Analisamos os índices geométricos de VFC (SD1, uma medida de VFC em curto prazo e SD2, uma medida de VFC em longo prazo) e aplicamos a Dimensão Fractal de Higuchi aos intervalos RR. RESULTADOS: Durante a recuperação do exercício, os índices de plot de Poincaré SD1 e SD1/SD2 diminuíram, enquanto que SD2 e SD2/SD1 aumentaram (p <0,0001) em relação ao repouso. Todos os parâmetros da análise da Dimensão Fractal de Higuchi foram reduzidos após o exercício em comparação com o controle em repouso (p <0,0001). CONCLUSÃO: O exercício físico diminuiu agudamente o comportamento complexo da VFC, conforme medido pela análise da Dimensão Fractal de Higuchi. Fisiologicamente, isso indica que detectamos alterações na complexidade da VFC imediatamente após o exercício.
Asunto(s)
Humanos , Masculino , Sistema Nervioso Autónomo , Algoritmos , Sistema Cardiovascular , Ejercicio Físico/fisiología , Dinámicas no Lineales , Frecuencia CardíacaRESUMEN
INTRODUCTION: Exercises with a flexible pole have been applied in clinical practice for upper limb rehabilitation. Nevertheless, its acute effects on cardiac autonomic regulation are unclear. OBJECTIVE: To evaluate the acute effects of exercise with flexible pole on complex behavior of heart rate variability (HRV). METHOD: We investigated 32 healthy female volunteers aged between 18 and 25 years who performed a session of exercise with a flexible pole. HRV was analyzed 10 minutes before and 10 minutes immediately after the exercise. RESULTS: Exercises with a flexible pole did not significantly change time and frequency domain indices of HRV. Non-linear analysis of HRV through the Higuchi Fractal Dimension was not significantly changed during recovery from exercise compared to the control reading at rest. CONCLUSION: Exercises with the flexible pole were unable to acutely change chaotic behavior of heart rate dynamics. This is advantageous for assessments of levels of rehabilitative treatment required in such patients; and their susceptibility to dynamical diseases.
INTRODUÇÃO: Exercícios com uma barra flexível têm sido usados na prática clínica para a reabilitação do membro superior. No entanto, os seus efeitos agudos sobre a regulação autonômica cardíaca não estão bem esclarecidas. OBJETIVO: Avaliar os efeitos agudos do exercício com barra flexível sobre o comportamento complexo da variabilidade da frequência cardíaca (VFC). MÉTODO: Foram investigadas 32 voluntárias saudáveis com idades entre 18 e 25 anos que realizaram uma sessão de exercício com barra flexível. A VFC foi analisada 10 minutos antes e 10 minutos imediatamente depois do exercício. RESULTADOS: Os exercícios com a barra flexível não alteraram significativamente os domínios de tempo e frequência de VFC. Análise não-linear da VFC através da Dimensão Fractal Higuchi mostra que a mesma não foi significativamente alterada durante a recuperação do exercício em relação ao controle pré-exercício. CONCLUSÃO: O exercício com a barra flexível não alterou profundamente o comportamento caótico da dinâmica da frequência cardíaca. Isto é vantajoso para a avaliação de níveis de tratamento de reabilitação necessário em tais pacientes; e sua suscetibilidade a doenças dinâmicas.
Asunto(s)
Humanos , Adulto , Medicina Física y Rehabilitación/métodos , Sistema Nervioso Autónomo , Esfuerzo Físico , Frecuencia CardíacaRESUMEN
OBJECTIVE: A previous study suggested that the p-value of normality test applied to RR intervals is an index able to quantify Heart Rate Variability (HRV) through correlation of traditional time and frequency domain indices. We investigate the association between the p-value of normality test applied in RR intervals and symbolic analysis of HRV. METHOD: We evaluated 32 healthy women between 18 and 30 years old. RR intervals were used for HRV analysis and we performed symbolic analysis, where RR intervals are joined by symbols. Sets of three consecutive symbols (RR intervals) were grouped into four types of clusters, as follows: 1. Three equal symbols (zero variation); 2: two equal, one divergent symbol (one variation); 3. Three different symbols monotonically ascending or descending (two like variations); 4. Three different symbols, forming a peak or a trough (two unlike variations). Frequency of occurrence of each type of cluster was calculated. Normality tests were applied to all RR intervals and the p-value was calculated. We computed the correlations between the p-value of normality test and symbolic analysis of HRV. RESULTS: Correlation coefficients between the p-value of normality test from Kolmorogov-Smirnov test and the four types of clusters showed no correlation for any of them. Likewise, the correlation coefficient index between the p-value of normality test calculated from the Shapiro-Wilk test and symbolic analysis produced no significant results for any of the four types of clusters. CONCLUSION: There was no significant correlation between the p-value of normality test and HRV symbolic analysis. The physiological significance of this result is that the PNT is not related to chaotic behavior of HRV.
OBJETIVO: Um estudo anterior sugeriu que o valor "p" do teste de normalidade (PNT) aplicado a intervalos RR é um índice capaz de quantificar variabilidade da frequência cardíaca através da correlação tradicional dos índices de tempo e frequência. Investigamos a associação entre o teste PNT aplicado a intervalos RR e a análise simbólica da variabilidade da frequência cardíaca. MÉTODO: Foram avaliadas 32 mulheres saudáveis entre 18 e 30 anos de idade. Os intervalos RR foram utilizados para análise da variabilidade da frequência cardíaca; foi realizada uma análise simbólica, onde intervalos RR são unidos por símbolos. Grupos de três símbolos consecutivos foram agrupados em quatro tipos de aglomerados, a saber: 1: três símbolos iguais (variação zero); 2: dois símbolos iguais, um divergente (uma variação); 3: três símbolos diferentes, monotonicamente crescentes ou decrescentes (duas variações iguais); 4: três símbolos diferentes, formando um pico ou uma calha (duas variações desiguais). Foi calculada a frequência de ocorrência de cada tipo de cluster. Testes de normalidade foram aplicados a todos os intervalos RR e o valor de "p" foi calculado. Calculamos as correlações entre o PNT e análise simbólica de HRV. RESULTADOS: Os coeficientes de correlação entre PNT de teste Kolmorogov-Smirnov e os quatro tipos de clusters não mostraram correlação com qualquer um deles. Da mesma forma, o coeficiente de correlação entre o índice PNT calculado a partir do teste de Shapiro-Wilk e a análise simbólica não produziu resultados significativos para qualquer dos quatro tipos de aglomerados. CONCLUSÃO: Não houve correlação significativa entre o PNT e análise simbólica da variabilidade da frequência cardíaca. O significado fisiológico deste resultado é que o PNT não está relacionado ao comportamento caótico da VFC.
Asunto(s)
Humanos , Femenino , Adulto , Sistema Nervioso Autónomo/fisiología , Sistema Cardiovascular , Fenómenos Fisiológicos Cardiovasculares , Distribución Normal , Frecuencia Cardíaca/fisiologíaRESUMEN
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is categorized by a lowered attention span, recklessness, and hyperactivity. Autonomic nervous system inequality has previously been studied using the same data by chaotic global techniques. We aim to compare the autonomic function of children with ADHD and controls by analyzing heart rate variability (HRV) METHODS: 28 children with ADHD (22 boys, mean age 10.0 years ± 1.9 years) and 28 controls (15 boys, mean age 9.9 years ± 1.8 years) rested in supine position with spontaneous breathing for 20 minutes. Heart rate was recorded beat by beat. HRV analysis was performed by Higuchi Fractal Dimension technique. RESULTS: ADHD promoted an increase in the Higuchi Fractal Dimension. The optimum value of Kmax was 10. CONCLUSION: ADHD significantly altered cardiac autonomic modulation as measured by the Higuchi fractal dimension of HRV. It can therefore be stated that ADHD has increased the complexity of the HRV signal through cardiac autonomic modulation.
INTRODUÇÃO: O transtorno de deficit de atenção e hiperatividade (TDAH) é caracterizado por um período reduzido de atenção, impulsividade e hiperatividade. O desequilíbrio na função do sistema nervoso autônomo (SNA) tem sido previamente estudado utilizando-se técnicas globais da teoria do caos. OBJETIVO: comparar a função autonômica de crianças com TDAH e controles por meio da análise da variabilidade da frequência cardíaca (VFC) MÉTODO: 28 crianças com TDAH (22 meninos, com média de idade de 10,0 anos ± 1,9 anos) e 28 controles (15 meninos, com média de idade de 9,9 anos ± 1,8 anos) permaneceram em decúbito dorsal, com respiração espontânea por 20 minutos. A frequência cardíaca foi registrada batimento a batimento e a análise da VFC foi realizada pela técnica de Dimensão Fractal Higuchi. RESULTADOS: TDAH promoveu um aumento na Dimensão Fractal Higuchi. O valor ideal de Kmax foi 10. CONCLUSÃO: O TDAH alterou significantemente a modulação autonômica cardíaca, como demonstrado pela Dimensão Fractal Higuchi da VFC. Assim, pode-se afirmar que crianças com TDAH apresentaram aumento das respostas caóticas neste tipo de análise da modulação autonômica cardíaca.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Trastorno por Déficit de Atención con Hiperactividad , Sistema Nervioso Autónomo , Cognición , Frecuencia Cardíaca , Arritmias Cardíacas , Psiquiatría Infantil , TerapéuticaRESUMEN
OBJECTIVE: Isometric exercise is characterized by promoting an overload on the cardiovascular system due to pulsatile contraction followed by a significant increase in muscle blood flow. The hemodynamic responses during exercise and during recovery from endurance exercise are well documented. However, there are few studies with hard data regarding the influence of isometric exercise on autonomic control, which can be obtained by analysis of heart rate variability. Thus, the object of this study was to analyze reports on cardiac autonomic regulation in isometric exercise. METHODS: The articles used in this study were selected fromPubmed, PEDro,Medline, Lilacs and SciELO. The search wasmade by crossing the following keywords: isometric exercise, autonomic nervous system, cardiovascular system, and heart rate variability, which were defined based on descriptors of Health Headings (MeSH). RESULTS: The search provided 17 articles in isometric exercise autonomic modulation characterized by decreased vagalmodulation followedby increased sympatheticmodulation and its reversal shortly after the endof the activity. CONCLUSION: During isometric exercise, increased sympathetic modulation and reduced vagal modulation of the sinus node have been reported.
RESUMO OBJETIVO: O exercício isométrico é caracterizado por promover uma sobrecarga no sistema cardiovascular devido à contração pulsátil seguida por aumento significativo no fluxo sanguíneo muscular. As respostas hemodinâmicas durante o exercício e durante a recuperação do exercício de resistência estão bem documentados. No entanto, existem poucos estudos com dados concretos sobre a influência do exercício isométrico no controle autônomo, a qual pode ser obtida pela análise da variabilidade da frequência cardíaca. O objetivo deste estudo foi analisar publicações sobre a regulação autonômica cardíaca durante o exercício isométrico. MÉTODOS: Os artigos utilizados neste estudo foram selecionados do Pubmed, PEDro, Medline, Lilacs e SciELO. A pesquisa foi feita através do cruzamento das seguintes palavras-chave: exercício isométrico, sistema nervoso autônomo, sistema cardiovascular, e variabilidade da frequência cardíaca, que foram definidas com base nos descritores das rubricas de Saúde (MeSH). RESULTADOS: A pesquisa forneceu 17 artigos sobre modulação autonômica em exercício isométrico: esta modulação caracterizou-se pela diminuição da ação vagal, seguida de aumento da modulação simpática e sua reversão logo após o cessar da contração. CONCLUSÃO: Durante o exercício isométrico, ocorre aumento da modulação simpática e redução da modulação vagal sobre o nódulo sinusal.
Asunto(s)
Humanos , Sistema Nervioso Autónomo , Sistema Cardiovascular , Ejercicio Físico , Frecuencia CardíacaRESUMEN
OBJECTIVES: Flexible poles can provide rapid eccentric and concentric muscle contractions. Muscle vibration is associated with a "tonic vibration reflex” that is stimulated by a sequence of rapid muscle stretching, activation of the muscle spindles and stimulation of a response that is similar to the myotatic reflex. Literature studies analyzing the acute cardiovascular responses to different exercises performed with this instrument are lacking. We investigated the acute effects of exercise with flexible poles on the heart period in healthy men. METHOD: The study was performed on ten young adult males between 18 and 25 years old. We evaluated the heart rate variability in the time and frequency domains. The subjects remained at rest for 10 min. After the rest period, the volunteers performed the exercises with the flexible poles. Immediately after the exercise protocol, the volunteers remained seated at rest for 30 min and their heart rate variability was analyzed. RESULTS: The pNN50 was reduced at 5-10 and 15-20 min after exercise compared to 25-30 min after exercise (p = 0.0019), the SDNN was increased at 25-30 min after exercise compared to at rest and 0-10 min after exercise (p = 0.0073) and the RMSSD was increased at 25-30 min after exercise compared to 5-15 min after exercise (p = 0.0043). The LF in absolute units was increased at 25-30 min after exercise compared to 5-20 min after exercise (p = 0.0184). CONCLUSION: A single bout of exercise with a flexible pole reduced the heart rate variability and parasympathetic recovery was observed approximately 30 min after exercise. .
Asunto(s)
Adulto , Humanos , Masculino , Adulto Joven , Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Sistema Nervioso Parasimpático/fisiología , Análisis de Varianza , Índice de Masa Corporal , Presión Sanguínea/fisiología , Prueba de Esfuerzo , Corazón/fisiología , Valores de Referencia , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
OBJECTIVES: There are no data in the literature with regard to the acute effects of different styles of music on the geometric indices of heart rate variability. In this study, we evaluated the acute effects of relaxant baroque and excitatory heavy metal music on the geometric indices of heart rate variability in women. METHODS: We conducted this study in 21 healthy women ranging in age from 18 to 35 years. We excluded persons with previous experience with musical instruments and persons who had an affinity for the song styles. We evaluated two groups: Group 1 (n = 21), who were exposed to relaxant classical baroque musical and excitatory heavy metal auditory stimulation; and Group 2 (n = 19), who were exposed to both styles of music and white noise auditory stimulation. Using earphones, the volunteers were exposed to baroque or heavy metal music for five minutes. After the first music exposure to baroque or heavy metal music, they remained at rest for five minutes; subsequently, they were re-exposed to the opposite music (70-80 dB). A different group of women were exposed to the same music styles plus white noise auditory stimulation (90 dB). The sequence of the songs was randomized for each individual. We analyzed the following indices: triangular index, triangular interpolation of RR intervals and Poincaré plot (standard deviation of instantaneous beat-by-beat variability, standard deviation of the long-term RR interval, standard deviation of instantaneous beat-by-beat variability and standard deviation of the long-term RR interval ratio), low frequency, high frequency, low frequency/high frequency ratio, standard deviation of all the normal RR intervals, root-mean square of differences between the adjacent normal RR intervals and the percentage of adjacent RR intervals with a difference of duration greater than 50 ms. Heart rate variability was recorded at rest for 10 minutes. ...
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Adulto Joven , Estimulación Acústica/métodos , Sistema Nervioso Autónomo/fisiología , Frecuencia Cardíaca/fisiología , Música , Análisis de Varianza , Índice de Masa Corporal , Musicoterapia , Valores de Referencia , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
OBJECTIVE: Previous studies have demonstrated a relationship between brain oxidative stress and cardiovascular regulation. We evaluated the effects of central catalase inhibition on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke. METHODS: Male Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SH) (16 weeks old) were implanted with a stainless steel guide cannula leading into the fourth cerebral ventricle (4th V). The femoral artery and vein were cannulated for arterial pressure and heart rate measurement and drug infusion, respectively. The rats were exposed to sidestream cigarette smoke for 180 minutes/day, 5 days/week for 3 weeks (CO: 100-300 ppm). The baroreflex was tested using a pressor dose of phenylephrine (8 μg/kg, bolus) and a depressor dose of sodium nitroprusside (50 μg/kg, bolus). Cardiovascular responses were evaluated before and 5, 15, 30 and 60 minutes after injection of a catalase inhibitor (3-amino-1,2,4-triazole, 0.001 g/100 μL) into the 4th V. RESULTS: Vehicle administration into the 4th V did not affect the cardiovascular response, whereas administration of the central catalase inhibitor increased the basal HR and attenuated the bradycardic peak (p<0.05) to a greater extent in WKY rats exposed to sidestream cigarette smoke than in WKY rats exposed to fresh air. However, in spontaneously hypertensive rats, the effect of the catalase inhibitor treatment was stronger in the fresh air condition (p<0.05). CONCLUSION: Administration of a catalase inhibitor into the 4th V combined with exposure to sidestream cigarette smoke has a stronger effect in WKY rats than in SH rats. .