Hypertrophied myocardium is more dependent on extracellular calcium than the normal cardiac muscle.

BACKGROUND: The aim of this study was to analyze stable hypertrophied myocardial function and its response to inotropic maneuvers in rats submitted to renovascular hypertension for a 10-week period (RHT group, n=10). MATERIAL/METHODS: Myocardial performance was studied in isolated left ventricle papillary muscles in isometric contraction under the following conditions: at postrest contraction of 30 seconds (PRC), at extracellular calcium (ECa2+) chloride concentration of 1.25 and 5.20 mM, and after beta-adrenergic stimulation with 10-6 M isoproterenol (ISOP). RESULTS: The results were compared with normotensive Wistar controls rats (C group, n=10). In basal condition, resting tension, and contraction time (TPT) were greater, while relaxation time (RT50) tended to be longer in RHT than C group. PRC and ISOP promoted a similar change in muscle function response intensity (delta) in both groups. ECa2+ shift did not change TPT in the C group and decreased TPT in the RHT animals; delta was different between these groups. RT50 increased in C and decreased in RHT, both without statistical significance; however, delta was different. CONCLUSIONS: These results suggest that hypertrophied myocardial dysfunction may be attributed to changes in intracellular calcium cycling.

Growth hormone attenuates myocardial fibrosis in rats with chronic pressure overload-induced left ventricular hypertrophy.

1. The role of growth hormone (GH) in cardiac remodelling and function in chronic and persistent pressure overload-induced left ventricular hypertrophy has not been defined. The aim of the present study was to assess short-term GH treatment on left ventricular function and remodelling in rats with chronic pressure overload-induced hypertrophy. 2. Twenty-six weeks after induction of ascending aortic stenosis (AAS), rats were treated with daily subcutaneous injections of recombinant human GH (1 mg/kg per day; AAS-GH group) or saline (AAS-P group) for 14 days. Sham-operated animals served as controls. Left ventricular function was assessed by echocardiography before and after GH treatment. Myocardial fibrosis was evaluated by histological analysis. 3. Before GH treatment, AAS rats presented similar left ventricular function and structure. Treatment of rats with GH after the AAS procedure did not change bodyweight or heart weight, both of which were higher in the AAS groups than in the controls. After GH treatment, posterior wall shortening velocity (PWSV) was lower in the AAS-P group than in the control group. However, in the AAS-GH group, PWSV was between that in the control and AAS-P groups and did not differ significantly from either group. Fractional collagen (% of total area) was significantly higher in the AAS-P and AAS-GH groups compared with control (10.34 +/- 1.29, 4.44 +/- 1.37 and 1.88 +/- 0.88%, respectively; P < 0.05) and was higher still in the AAS-P group compared with the AAS-GH group. 4. The present study has shown that short-term administration of GH to rats with chronic pressure overload-induced left ventricular hypertrophy induces cardioprotection by attenuating myocardial fibrosis.

Daytime variations in glucose tolerance in people with impaired glucose tolerance.

To determine whether glucose tolerance varies throughout the day in people with impaired glucose tolerance (IGT). We studied 15 healthy IGT, and 18 matched normal glucose tolerant (NGT) individuals. Blood samples were taken every 30-120 min during a 24h period in which all individuals had three mixed meals and nocturnal sleep. We measured glucose, free fatty acids, specific insulin, intact proinsulin, cortisol and growth hormone. Variable responses were considered as concentrations and areas under the curves. Comparison between the groups was by Student's t-test, Mann-Whitney, and analysis of variance. Higher total glucose response, inappropriate normal total insulin response, and unproportionally increased proinsulin total response were observed in the IGT group. Lower glucose tolerance occurred in IGT after dinner, as in the NGT, and after breakfast associated with increased insulin response after breakfast, and similar proinsulin response after all three meals. IGT had higher glucose response than NGT after breakfast and lunch, similar insulin responses, and increased proinsulin-insulin ratio after all three meals. Data from this study demonstrate that IGT individuals present lower glucose tolerance in the evening, as those with NGT, and in the morning, as reported in patients with type 2 diabetes.

[Blockade of renin-angiotensin system attenuates cardiac remodeling in rats undergoing aortic stenosis]. / O bloqueio do sistema renina-angiotensina atenua a remodelação cardíaca de ratos submetidos a estenose aórtica.

OBJECTIVE: To assess the role of the AT1 receptor blocker and the angiotensin-converting enzyme inhibitor in cardiac remodeling induced by aortic stenosis in rats. METHODS: Wistar rats were divided into the following 4 groups: 1) C--control (n=13); 2) AoS--aortic stenosis (n=11); 3) LIS--AoS treated with lisinopril, 20 mg/kg/day (n=11); and 4) LOS--AoS treated with losartan, 40 mg/kg/day (n=9). The treatments were initiated 3 days before surgery. After 6 weeks, the animals underwent echocardiographic study, and quantification of the hydroxyproline (HOP) concentration and the left ventricular (LV) myocyte cross-sectional area (CSA). RESULTS: Aortic stenosis induced an increase in left ventricular wall thickness. The LIS and LOS groups showed no difference as compared with the control group. The AoS and LIS rats had greater left atrial diameters than the control rats did, while no difference was observed in the LOS animals. The AoS animals had greater values of shortening percentage than control animals did. This fact was modified with neither LIS nor LOS. The cross-sectional area of the animals in the AoS group was greater than that in the control group. However, treatment with LOS and LIS attenuated the AoS-induced increase in area. Aortic stenosis caused an increase in HOP concentration, while the LOS group showed no difference as compared with the control group. CONCLUSION: Blockade of the renin-angiotensin system with AT1 blocker and ACEI may attenuate the development of heart hypertrophy, but only the blockade of AT1 receptors attenuates left ventricular interstitial fibrosis.

Thyroid cell proliferation in Graves' disease. Use of MIB-1 monoclonal antibody.

OBJECTIVE: To measure thyroid cell proliferation in patients with Graves' disease (GD) before and during treatment with antithyroid drugs. STUDY DESIGN: Patients were assessed by fine needle aspiration biopsy before (n = 20) and after 4 (n = 19) and 12 months of treatment (n = 15) with propylthiouracil or methimazole. Cell proliferation index (CPI) was estimated by immunocytochemistry using MIB-1. CPI was studied in relation to the cytologic parameters of the smears; clinical parameters, such as Wayne's Clinical Index (WCI) and time without treatment; laboratory parameters, such as 131I uptake and dosage of serum free thyroxin and thyroid-stimulating hormone; and thyroid ultrasound. RESULTS: CPI varied from 0.00% to 25.00% before treatment, 0.00% to 23.00% at 4 months and 0.00% to 14.84% at 12 months. CPI median values were 6.50%, 4.30% and 3.30%, respectively (before and after 4 months and 12 months of treatment). CPI had a positive correlation with WCI and FT4 at 12 months of treatment. CONCLUSION: Thyroid CPI in GD varies from case to case. However, due to its decreasing pattern during follow-up and its positive correlation with thyrotoxicosis severity, CPI may indicate the functional status of the gland and contribute to a better understanding of GD.

Prolactin and zinc in dialysis patients.

The objectives of the present study were to investigate the frequencies of hyperprolactinemia and hypozincemia in patients undergoing hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD), the associations between blood levels of zinc (Zn2+) and hormones, and dietary zinc intake amount and its relation to zincemia. We studied 28 patients (14 HD and 14 CAPD) who had their blood levels of Zn2+, prolactin (PRL), parathyroid hormone (PTH), and gonadotropins (LH, FSH) evaluated. Thirteen patients had dietary nutrient amounts evaluated from a 3-d nutritional record. Hyperprolactinemia occurred in 29% patients (HD = CAPD), hypozincemia in 62% (20% HD and 42% CAPD), and low dietary Zn2+ intake in 90% of patients. No correlation among blood concentration of Zn2+ and PRL, PTH, LH, and FSH were observed in the two modalities of dialysis or between zincemia and Zn2+ ingestion. We concluded that the occurrence of hyperprolactinemia and hypozincemia were not related to dialysis modality and that zincemia did not reflect the observed low dietary intake of Zn2+.

O efeito do exercício em mini-trampolim de solo sobre medidas de resistência muscular localizada (RML), capacidade aeróbia (VO2) e flexibilidade / Effects of rebound exercise training on some variables with located muscular strength, aerobic capability and flexibility

O presente estudo teve como objetivo analisar os efeitos de um programa de dezesseis semanas em mini-trampolim de solo sobre resistência muscular localizada “RML” de membros inferiores e abdominal, flexibilidade e capacidade aeróbia, em mulheres sedentárias entre 20 e 35 anos de idade. Trata-se de ensaio de intervenção em 26 voluntárias, aplicado em três sessões semanais de quarenta e cinco minutos. Foram realizados os seguintes testes: 1) RML: por repetição máxima em 1 minuto, 2) Capacidade aeróbia (VO2): banco de Astrand, 3) flexibilidade: sentar e alcançar (banco de Wells). Para comparação dos dados antes e depois do treinamento, aplicou-se teste t de Student para amostras dependentes, utilizando-se pacote estatístico SPSS. Observou-se que o programa proporcionou aumentos significativos da flexibilidade, resistência muscular abdominal e de membros inferiores, além de melhora significativa na freqüência cardíaca de recuperação pós-exercício e no consumo máximo de oxigênio. Estes resultados indicam que o mini-trampolim de solo é atividade capaz de incrementar capacidades físicas importantes para manutenção da saúde.

The present study aimed to analyze the effects of a program of sixteen weeks on mini-trampoline ground on muscular endurance "RML" lower limb and abdominal, flexibility and aerobic capacity in sedentary women between 20 and 35 years old. It is intervention trial in 26 volunteers applied three times per week for forty-five minutes. 1) RML: The following tests were performed by repetition maximum in 1 minute, 2) Aerobic capacity (VO2): bank Astrand, 3) flexibility: sit and reach (Wells). to comparison of data before and after training, we applied the Student t test for samples dependent, using SPSS statistical package. It was noted that the program provided increases significant flexibility, abdominal muscle endurance and lower limbs, as well as improvement significant in heart rate recovery after exercise and maximal oxygen consumption. These results indicate that the mini trampoline is soil activity to increase capacity Physical important for health maintenance.

Subclinical abnormalities of glucose metabolism in Brazilian women with a history of gestational diabetes mellitus.

BACKGROUND: To evaluate insulin release and insulin sensitivity in women with prior gestational diabetes mellitus (GDM) to gain a better understanding of type 2 diabetes pathogenesis. METHODS: GDM women were individually matched for age, body mass index, and waist/hip ratio with those who were normal glucose tolerant in a previous pregnancy (NGT). All women presented with normal glucose tolerance. Twenty pairs were submitted to the oral glucose tolerance test (OGTT) with plasma glucose, insulin, and C-peptide determinations. Of the 20 pairs, 18 participated in hyperglycemic (10.0 mmol/l) clamp experiments with frequent plasma glucose and insulin determinations, allowing us to calculate first- and second-phase insulin release and the insulin sensitivity index. GDM and NGT women were compared using Student's t-test, the Mann-Whitney U-test, Friedman's non-parametric test, and the two proportion test for independent groups. RESULTS: GDM women showed higher glycosylated hemoglobin values; at OGTT, they showed late insulin peak with increased plasma insulin levels only during the second hour, and a similar plasma C-peptide response despite a higher plasma glucose curve; during hyperglycemic clamp procedures, they showed similar biphasic insulin release and insulin sensitivity index. Considering that a woman with previous GDM had a defect in insulin release and/or insulin sensitivity, if its magnitude was at least 25% lower than that of the matched NGT woman, 43.8% showed impairment of first-phase insulin release and 55.6% insulin resistance. CONCLUSIONS: GDM women showed some degree of glucose intolerance. It is therefore necessary to follow them for a longer time.

Agravos músculo-esqueléticos em bailarinas clássicas, não clássicas e praticantes de educação física / Musculoskeletal injuries in classical and non-classical ballerinas, and people who practice physical education: a comparative study

A literatura especializada descreve grande número de agravos que são típicos das praticantes de dança compredominância das lesões nos membros inferiores. No entanto, em nosso meio, pouco se conhece sobre oimpacto da exposição das bailarinas a esses processos mórbidos. O objetivo da presente investigaçãobuscou observar a ocorrência de Agravos Músculos-Esqueléticos (AME) em praticantes de balé e embailarinas sem formação clássica, comparando-as com escolares participantes apenas de aulas de EducaçãoFísica. Para tanto, realizou-se um estudo na cidade de Bauru - SP com 83 jovens de 12 a 17 anos dispostas emtrês grupos, a saber: i) bailarinas clássicas (27); ii) praticantes de dança sem formação clássica (19) e iii)alunas que participavam apenas de aulas escolares de Educação Física (37). A investigação ocorreu noperíodo de 225 dias, sendo que, por quinzena, cada participante foi entrevistada e as informações registradasem formulário específico. Os números médios de dias com AME nos grupos considerados foram de 42,16+59,09nas escolares, 181,80+118,65 para as bailarinas clássicas e 36,32+ 61,71 para às não-clássicas. Entre asbailarinas clássicas, 24 (89%) relataram agravos, as quais passaram, em média, 81% dos dias do período deacompanhamento com manifestações dolorosas. As bailarinas clássicas e não clássicas apresentarammovimentos de flexão como a causa situacional que mais resulta em AME. Entre as escolares os movimentosde força muscular são responsáveis por grande parte dos AME. Entre os grupos a região corporal que maisse destaca com relação a presença de AME é o joelho, com predominância de intensidade moderada. Oelevado número de dias que as bailarinas clássicas referiram queixas de dor pode estar relacionado commovimentos repetitivos resultantes de microtraumas na ultra estrutura de músculos, tendões e ligamentosque indicam o caráter crônico dos agravos.

The technical literature describes a large number of disorders typical of people who practice dance withpredominance of lower extremities injuries. Nevertheless, there is a little knowledge about the impact of theexposure of ballerinas to these morbid processes. The aim of this investigation was to observe the occurrenceof musculoskeletal injuries in ballet dancers and ballerinas with no classical formation comparing them toschool dancers, which only practice it in their physical education classes. To accomplish that, a study wascarried out in Bauru, São Paulo, Brazil, with 83 youths aging from 12 to 17 years old and divided into threegroups as follow: i) classic ballerinas (27); ii) dancers without classical formation (19) and iii) students thatparticipate in regular P.E classes (37). The evaluation was accomplished in 225 days. Each participant wasinterviewed in an interval of fifteen days and an appropriated formulary was filled to register the information.The average of days with musculoskeletal injuries in the considered groups was 42.16 + 59.09 into studentsgroup, 181.80 + 118.65 to classical ballerinas group, and 36.32 + 61.71 to non-classical ballerinas group. Amongclassical ballerinas 24 (89%) presented injuries and spend approximately 81% of the attendance days with painfulmanifestation. The classical and non-classical ballerinas presented movements with flexion as the situationalcause, which mostly results in MSI. Among the schoolgirls the movement of muscular strength is responsible formost part of MSI. Among these groups the body region where the MSI is easily recognized, with predominanceand in moderate intensity, is the knee. The high number of days in which the classical ballerinas mentioned to befeeling pain can be related to the repetitive movements resulting from micro traumas in the ultra structure of themuscles, tendons, and ligaments that indicate the chronic aspect of the injuries.

O bloqueio do sistema renina-angiotensina atenua a remodelação cardíaca de ratos submetidos a estenose aórtica / Blockade of renin-angiotensin system attenuates cardiac remodeling in rats undergoing aortic stenosis

OBJETIVO: Avaliar o papel do bloqueador dos receptores AT1 e do inibidor da enzima conversora da angiotensina na remodelação cardíaca induzida por estenose aórtica em ratos. MÉTODOS: Ratos Wistar foram divididos em 4 grupos: controle (C, n=13), estenose aórtica (EAo, n=11), EAo com lisinopril, 20 mg/kg/dia (LIS, n=11) e EAo com losartan, 40 mg/kg/dia (LOS, n=9). Os tratamentos foram iniciados 3 dias antes da cirurgia. Após 6 semanas, os animais foram submetidos ao estudo ecocardiográfico, quantificação da concentração de hidroxiprolina e da área seccional (CSA) miocitária do ventrículo esquerdo (VE). RESULTADOS: A EAo induziu aumento da espessura da parede do VE. Os animais LIS e LOS não apresentaram diferença em relação aos animais controles. Os ratos EAo e LIS apresentaram maiores diâmetros do átrio esquerdo que os ratos controles, enquanto nos animais LOS não houve diferença. Os animais com EAo apresentaram maiores valores da porcentagem de encurtamento que os controle. Esse fato não foi modificado com LIS ou LOS. A CSA dos animais do grupo EAo foi maior que a dos controle. Entretanto, o tratamento com LOS e com LIS atenuou o aumento da área induzida pela EAo. A EAo resultou em aumento na concentração de HOP, enquanto o grupo LOS não apresentou diferença em relação ao grupo controle. CONCLUSÃO: O bloqueio do sistema renina-angiotensina, com bloqueador AT1 e com IECA, pode atenuar o desenvolvimento de hipertrofia cardíaca, porém só o bloqueio dos receptores AT1 atenua a fibrose intersticial do VE.

Laser de argônio no tratamento da triquíase e da distiquíase / Argon laser in the treatment of trichiasis and distichiasis

Objetivo: Avaliar a eficácia da fotocoagulaçäo com laser de argônio no tratamento da triquíase e distiquíase. Métodos: Estudo prospectivo de 77 pálpebras de portadores de triquíase e/ou distiquíase, tratados com fotocoagulaçäo dos folículos pilosos com '' Argon green laser '' (Nidek). Avaliou-se a idade, sexo, queixa apresentada, causa do mau posicionamento dos cílios, pálpebra acometida, tratamento efetuado (número de disparos efetuados em cada sessäo) e a evoluçäo após a aplicaçäo (cura ou reaplicaçäo). Os parâmetros utilizados foram: mira de 50 µm, 0.2 segundos de exposiçäo, potência inicial de 600mw e final de 1000mw. Os dados foram submetidos à análise estatística descritiva. Resultados: A pálpebra inferior (PI) foi mais acometida que a superior (PS) (89PI X 40PS) e a triquíase, mais comum que a distiquíase (89T X 44D). Apesar dos cílios distiquíaticos serem destruídos com menor número de aplicaçöes, a efetividade de destruiçäo de folículos pilosos foi maior na triquíase do que na distiquíase. A média dos disparos de laser na primeira aplicaçäo foi de 31 disparos, sendo que 75 por cento dos pacientes tiveram os cílios mal posicionados destruídos com 39 disparos. Com uma única sessäo de tratamemto 37.7 por cento dos pacientes se curaram e a porcentagem de cura com até cinco aplicaçöes foi de 98.7 por cento. Conclusäo: O laser de argônio é efetivo no tratamento da triquíase e da distiquíase.

Trauma ocular em hospital universitário / Eye injuries in a university hospital

O objetivo deste estudo foi avaliar aspectos do trauma ocular em um Hospital Universitário. Fio feiro estudo restrospectivo em portadores de trauma ocular atendidos no Pronto-Socorro da Faculdade de Medicina de Botucatu - UNESP - no período de dezembro de 1995 a maio de 1999, avaliando-se aleatoriamente 2329 prontuários, dos quais 28 por cento eram portadores de trauma ocular, estudando-se: idade, sexo, horário de atendimento, queixa, tipo de trauma e conduta. Rsultados: os traumas aconteceram mais em homens, na faixa etária de 20 a 40 anos, principalmente durante o dia. Os traumas acometeram mais a Zona I, a maioria traumas fechados, com predomínio significativo do corpo estranho extra-ocular e trauma contuso. Assim, o trauma ocular em nossa região tema as mesmas características dos que ocorrem em outros locais; os autores chamam a atenção para a necessidade de usar classificação uniforme e de se adotar medidas preventivas e eficientes, com o inutito de evitar a cegueira por trauma