Recreational training improves cardiovascular adaptations, metabolic profile and mental health of elderly women with type-2 diabetes mellitus.

We investigated the effects of a recreational training (RET) protocol in elderly women with type-2 diabetes mellitus (T2DM). We hypothesized that non-conventional physical activities of RET protocol might improve clinical outcomes regarding cardiovascular function, metabolic profile and mental health as participants keep the adherence to the protocol during the 3-month follow-up. Cardiovascular parameters (heart rate, systolic and diastolic blood pressure), circulating biomarkers (glucose and lipids) and salivary cortisol were attenuated in response to exercise. RET also reduced anxiety and depression indexes. RET protocol constitutes a potential therapeutic approach for managing T2DM in elderly women.

Blockade of AT1 type receptors for angiotensin II prevents cardiac microvascular fibrosis induced by chronic stress in Sprague-Dawley rats.

To test the effects of chronic-stress on the cardiovascular system, the model of chronic mild unpredictable stress (CMS) has been widely used. The CMS protocol consists of the random, intermittent, and unpredictable exposure of laboratory animals to a variety of stressors, during 3 consecutive weeks. In this study, we tested the hypothesis that exposure to the CMS protocol leads to left ventricle microcirculatory remodeling that can be attenuated by angiotensin II receptor blockade. Male Sprague-Dawley rats were randomly assigned into four groups: Control, Stress, Control + losartan, and Stress + losartan (N = 6, each group, losartan: 20 mg/kg/day). The rats were euthanized 15 days after CMS exposure, and blood samples and left ventricle were collected. Rats submitted to CMS presented increased glycemia, corticosterone, noradrenaline and adrenaline concentration, and losartan reduced the concentration of the circulating amines. Cardiac angiotensin II, measured by high-performance liquid chromatography (HPLC), was significantly increased in the CMS group, and losartan treatment reduced it, while angiotensin 1-7 was significantly higher in the CMS losartan-treated group as compared with CMS. Histological analysis, verified by transmission electron microscopy, showed that rats exposed to CMS presented increased perivascular collagen and losartan effectively prevented the development of this process. Hence, CMS induced a state of microvascular disease, with increased perivascular collagen deposition, that may be the trigger for further development of cardiovascular disease. In this case, CMS fibrosis is associated with increased production of catecholamines and with a disruption of renin-angiotensin system balance, which can be prevented by angiotensin II receptor blockade.

A puzzle used to teach the cardiac cycle.

The aim of the present article is to describe a puzzle developed for use in teaching cardiac physiology classes. The puzzle presents figures of phases of the cardiac cycle and a table with five columns: phases of cardiac cycle, atrial state, ventricular state, state of atrioventricular valves, and pulmonary and aortic valves. Chips are provided for use to complete the table. Students are requested to discuss which is the correct sequence of figures indicating the phases of cardiac cycle. Afterward, they should complete the table with the chips. Students of biology, dentistry, medicine, pharmacy, and nursing graduation courses from seven institutions performed the puzzle evaluation. They were invited to indicate whether the puzzle had been useful for learning about the subject by filling one of four alternatives. Of the students, 4.6% answered that it was not necessary but helped them to confirm what they had learned, 64.5% reported that although they had previously understood the cardiac cycle, the puzzle helped them to solve doubts and promoted a better understanding of it, and 30.9% said that they needed the puzzle to understand the cardiac cycle, without differences among courses, institutions, and course semesters. The results of the present study suggest that a simple and inexpensive puzzle may be useful as an active learning methodology applied after the theoretical lecture, as a complementary tool for studying cardiac cycle physiology.

Stress-induced cardiometabolic perturbations, increased oxidative stress and ACE/ACE2 imbalance are improved by endurance training in rats.

AIMS: To investigate the effects of endurance training on stress-induced cardiometabolic perturbations given the elevated release of stress hormones and subsequent glucose homeostasis perturbations. MATERIALS AND METHODS: Rats were randomized into non-trained rats, rats submitted to endurance training, non-trained rats submitted to stress, and trained rats submitted to stress. Endurance training was applied for 8 weeks, while chronic stress was applied at the 4th, 5th, and 6th weeks of the training period. Two weeks after the last stressor stimuli, rats were euthanized, and blood and heart were collected for biochemical tests. KEY FINDINGS: Exacerbated corticosterone levels were observed in both stressed groups, and chronic stress per se impaired glucose tolerance and insulin sensitivity. Training reduced circulating adrenaline, even though noradrenaline levels were elevated in the blood and heart of trained rats. While stress-induced high circulating serotonin levels were further increased by endurance training, cardiac serotonin levels were attenuated in trained rats. Endurance training mitigated the stress-induced higher circulating lipids. Cardiac TBARs and GPx activity increased in trained rats while CAT and GPx were reduced in response to chronic stress. Endurance training not only attenuated the stress-induced higher circulating ACE/ACE2 ratio but also reduced ACE/ACE2 balance in the heart. Glucose intolerance, insulin resistance, and altered stress hormones release were linked to impairment of cardiometabolic responses, elevated oxidative stress, and dysregulation of ACE/ACE2 ratio. SIGNIFICANCE: Endurance training mitigated the stress-related pathophysiological responses, which could be related to improvements in the antioxidant capacity and the balance of ACE/ACE2 activity.

Tactile stimulation of adult rats modulates hormonal responses, depression-like behaviors, and memory impairment induced by chronic mild stress: Role of angiotensin II.

Physical touch can help to decrease the effects of stress. The aim of this study was to evaluate the influence of tactile stimulation on the hormonal and behavioral responses of young adult rats submitted to chronic mild unpredictable stress (CMS), considering the role of angiotensin II (Ang II). In Experiment 1, male rats were divided into 4 groups: control, stress, tactile stimulation (TS), and stress + TS. CMS was applied for three weeks. Tactile stimulation was applied for seven weeks, five days a week. After the CMS protocol, depression-like behaviors were evaluated by forced swimming and sucrose consumption tests. Learning and memory were evaluated using the Y-maze test. Fifteen days after the CMS procedure, the animals were euthanized and the levels of stress hormones were determined. The hypothalamus was isolated for determination of the Ang II concentration. In Experiment 2, control and stressed rats, with or without treatment using losartan (angiotensin II type 1 receptor blocker), were evaluated using the same behavioral tests and the hypothalamus Ang II concentration was also determined. CMS increased plasma corticosterone, norepinephrine, and epinephrine concentrations, induced depression-like behaviors, impaired learning and memory, and increased the Ang II concentration in the hypothalamus. Tactile stimulation attenuated these stress-induced effects. Losartan treatment effectively prevented increase of the hypothalamic Ang II concentration and the development of depression-like behavior, and also reduced the impairment of learning and memory in the stressed animals. The results indicated that tactile stimulation seemed to protect adult rats against hormonal and behavioral chronic stress effects, and that Ang II could be involved in the CMS effects.

Relationship among stress, depression, cardiovascular and metabolic changes and physical exercise / Relação entre estresse, depressão, alterações cardiometabólicas e exercício físico

Abstract Introduction: Stress is considered one of the most significant health problems in modern society. It can be characterized as any changes in the homeostasis of an individual that require an adaptive response. An imbalance in the secretion of the primary stress mediators may be responsible for the onset and development of several diseases. Thus, chronic stress has been recognized as a risk factor for depression as well as cardiovascular and metabolic diseases. Given the pathophysiological mechanisms associated with chronic stress and related cardiovascular and metabolic changes, it is necessary to implement measures to prevent, control and/or avoid their development. Physical exercise is a non-pharmacological resource that is widely used for this purpose. Its beneficial effects include the improvement of the emotional state as well as lipid and glycemic control. Objective: The aim of this review is to discuss the relationship between stress, depression, cardiovascular and metabolic changes, and highlight the importance of physical exercise in the prevention and treatment of resulting disorders. Materials and Methods: We searched MEDLINE and SCIELO from 2000 through 2012, using the terms chronic stress, mood disorders, depression, cardiovascular and metabolic changes, and exercise. Results: Most of the studies found in our literature search have shown that exercise can attenuate and/or reverse the deleterious effects of chronic stress. Conclusion: Regular physical exercise is useful for maintaining health, especially with respect to improving mood and mental stress.

Resumo Introdução: O estresse é um dos mais significativos problemas de saúde na sociedade moderna, podendo ser caracterizado como qualquer mudança na homeostase do indivíduo que requer uma resposta adaptativa. O desequilíbrio na produção dos mediadores primários do estresse pode ser responsável pelo surgimento e desenvolvimento de várias doenças. Dessa forma, o estresse crônico tem sido reconhecido como fator de risco para a depressão e doenças cardiometabólicas. Frente aos mecanismos fisiopatológicos associados ao estresse crônico e às alterações cardiometabólicas correlatas, torna-se necessário encontrar medidas adequadas para preveni-las, controlá-las e/ou evitá-las. Sabe-se que o exercício físico é um recurso não-farmacológico amplamente utilizado para essa finalidade e os efeitos benéficos desencadeados incluem melhora do estado emocional e controle lipídico e glicêmico. Objetivo: O objetivo desta revisão foi discutir a relação entre os mecanismos fisiopatológicos do estresse, depressão, alterações cardiometabólicas e a importância da utilização do exercício físico na prevenção e tratamento destas disfunções desencadeadas. Materiais e Métodos: Para esta revisão foram consultadas as bases de dados MEDLINE e SCIELO e inclusos no campo de pesquisa os termos estresse crônico, alterações de humor, depressão, alterações cardíacas e metabólicas e o exercício físico. Como limite de busca, foi definida a pesquisa de artigos publicados entre os anos de 2000 e 2012. Resultados: A maior parte dos estudos mostrou que o exercício é capaz de atenuar e/ou reverter os efeitos deletérios do estresse crônico. Conclusão: A prática regular do exercício físico tem grande utilidade para a manutenção da saúde, sobretudo com relação à melhora do humor e do estresse mental.

A vertigem postural paroxística benigna tratada pela reabilitação vestibular - estudo de caso / The benign paroxysmal positional vertigo treated by vestibular rehabilitation - case report

Objetivo: Descrever o benefício obtido com a reabilitação vestibular (RV), por meio de manobras específicas de reposicionamento a um caso de Vertigem Postural Paroxística Benigna (VPPB). Método: Este trabalho utilizou a manobra de Epley, os exercícios de Brandt-Daroff, algumas orientações relacionadas com o processo terapêutico, anatomofisiologia e aspectos nutricionais. Resultados: Quatro semanas após a entrevista inicial, o paciente que estava afastado de seu trabalho devido à vertigem que o incapacitou, encontrou-se assintomático e pode retornar suas atividades profissionais. Conclusão: Concluímos que a RV foi efetiva no tratamento da VPPB neste caso, por meio da manobra de Epley, das orientações e dos exercícios de Brandt-Daroff pois os sintomas desapareceram sem o uso de medicamentos e ainda possibilitou a reintegração do paciente a sua vida profissional, favorecendo um incremento em sua qualidade de vida.

Evoluçäo do estado nutricional de pacientes pertencentes ao programa de internaçäo domiciliar após sistematizaçäo do tratamento / Evolution of the Nutritional Status of Patients that Belong to the Program for Home Internment after Treatment Systematization

A internação domiciliar tem se mostrado uma opção útil no tratamento de algumas doenças, principalmente de caráter de saúde pública. Por trabalhar com pacientes extremamente vulneráveis, o cuidado nutricional se faz imprescindível, tanto prevenindo como revertendo quadros de distúrbios nutricionais. O seguinte estudo apresenta o acompanhamento feito com 25 pacientes de um programa de internação domiciliar, todos com diagnóstico inicial de desnutrição ou risco para desnutrição. Esses pacientes foram acompanhados por meio de exames bioquímicos, antropométricos e receberam suporte nutricional durante 11 meses. Ao término do período de acompanhamento observou-se melhoria do estado nutricional em 76 por cento dos pacientes atingindo-se eutrofia, num período que variou de 3 a 8 meses após a intervenção dietoterápica