How soon do metabolic alterations and oxidative distress precede the reduction of muscle mass and strength in Wistar rats in aging process?

Here we investigate metabolic changes, the antioxidant system and the accumulation of oxidative damage in muscles with different fiber types during the aging process in Wistar rats and try to map how sooner the changes occur. To do so, 30 male Wistar rats were submitted to behavioral evaluation to determine voluntary strength in the 11, 15, and 19 month old rats, measuring the energy metabolism, antioxidant system, oxidative damage and structure in the soleus and extensor digitorum longus muscles. We detected structural and metabolic changes in both muscles, especially in the EDL of 15 month old rats and in the soleus of 19 month old rats. In the 15 month old rats, there was a reduction in the cross-sectional area of the fibers, and a reduction in the proportion of type I fibers, accompanied by an increase in fiber density and the amount of type IIA fibers. This change in the fiber profile was followed by an increase in the activity of anaerobic metabolism enzymes, suggesting a reduction in the oxidative capacity of the muscle. In addition, there was an increase in the rate of lipid peroxidation, accompanied by a reduced antioxidant capacity. In the 19 month old rats, these disturbances got stronger. In summary, the present study demonstrated that before functional disturbances, there was an accumulation of oxidative damage and structural changes in the skeletal muscle beginning at 15 months old in the EDL and the soleus only in the biochemical parameters. Therefore, the metabolic alterations occurred at 15 months old and not before.

Interferential Current Electrotherapy is More Effective Thanthan TENS VIF in Cancer Pain Management / Corrente Interferencial é Mais Efetiva para Alívio da Dor Oncológica que a TENS VIF

Cancer diagnosis is increasing rapidly worldwide and pain is a common feature reported by cancer patients. Therapeutical approach on cancer pain is complex where less invasive methods with little side effects have been sought. The aim of this study was to compare transcutaneous electrical nerve stimulation (TENS) and interferential current (IC) therapies effects on cancer pain. Double blind study with 81 cancer pain patients. Subjects were set up into two groups: one treated with TENS VIF (n=42) and other with IC (n=39). Age, gender, duration of pain, tumor site and histology, medications, treatments, Karnofsky score and clinical state were evaluated. Pain was measured by EMADOR and McGill scores. Electroanalgesia was performed for 30 minutes, the equipments used were Neurodyn III Ibramed® and Neurovector generation 2000 Ibramed®. Electrodes were placed where there was higher intensity of pain according to what was shown by the patient through EMADOR, and each one got only one electrotherapy session. Pain intensity was significantly reduced in both groups (p<0.001) soon after and until 6th hour post electrotherapy. IC group had better results at 4th, 5th (p<0.001) and 6th hour (p=0.022). McGill score in TENS VIF group was significant until 4th hour and in the IC group was highly significant in all evaluated times (p<0.001). Analgesic effect of TENS VIF and IC electrotherapy was clinically effective, however, IC did cause better results regarding analgesia duration.(AU)

O diagnóstico de câncer está aumentando rapidamente em todo o mundo e a dor é uma característica comum relatada por pacientes com câncer. A abordagem terapêutica da dor oncológica é complexa onde métodos menos invasivos e com poucos efeitos colaterais têm sido buscados. O objetivo deste estudo foi comparar os efeitos das terapias de estimulação elétrica nervosa transcutânea (TENS) e corrente interferencial (IC) na dor oncológica. Estudo duplo-cego com 81 pacientes com dor oncológica. Os indivíduos foram divididos em dois grupos: um tratado com TENS VIF (n=42) e outro com IC (n=39). Idade, sexo, duração da dor, local do tumor e histologia, medicamentos, tratamentos, pontuação de Karnofsky e estado clínico foram avaliados. A dor foi mensurada pelos escores EMADOR e McGill. A eletroanalgesia foi realizada por 30 minutos, os equipamentos utilizados foram Neurodyn III Ibramed® e Neurovector geração 2000 Ibramed®. Os eletrodos foram colocados onde havia maior intensidade de dor de acordo com o apresentado pelo paciente através da EMADOR. A intensidade da dor foi significativamente reduzida em ambos os grupos (p<0,001) logo após e até a 6ª hora pós-eletroterapia. O grupo CI teve melhores resultados na 4ª, 5ª (p<0,001) e 6ª hora (p=0,022). O escore de McGill no grupo TENS VIF foi significativo até a 4ª hora e no grupo IC foi altamente significativo em todos os tempos avaliados (p<0,001). O efeito analgésico da TENS VIF e da eletroterapia com IC foi clinicamente eficaz, porém a IC trouxe melhores resultados quanto à duração da analgesia.(AU)

An Early and Sustained Inflammatory State Induces Muscle Changes and Establishes Obesogenic Characteristics in Wistar Rats Exposed to the MSG-Induced Obesity Model.

The model of obesity induced by monosodium glutamate cytotoxicity on the hypothalamic nuclei is widely used in the literature. However, MSG promotes persistent muscle changes and there is a significant lack of studies that seek to elucidate the mechanisms by which damage refractory to reversal is established. This study aimed to investigate the early and chronic effects of MSG induction of obesity upon systemic and muscular parameters of Wistar rats. The animals were exposed to MSG subcutaneously (4 mg·g-1 b.w.) or saline (1.25 mg·g-1 b.w.) daily from PND01 to PND05 (n = 24). Afterwards, in PND15, 12 animals were euthanized to determine the plasma and inflammatory profile and to assess muscle damage. In PND142, the remaining animals were euthanized, and samples for histological and biochemical analyses were obtained. Our results suggest that early exposure to MSG reduced growth, increased adiposity, and inducted hyperinsulinemia and a pro-inflammatory scenario. In adulthood, the following were observed: peripheral insulin resistance, increased fibrosis, oxidative distress, and a reduction in muscle mass, oxidative capacity, and neuromuscular junctions, increased fibrosis, and oxidative distress. Thus, we can conclude that the condition found in adult life and the difficulty restoring in the muscle profile is related to the metabolic damage established early on.

Obesity-like metabolic effects of high-carbohydrate or high-fat diets consumption in metabolic and renal functions.

Present study investigated which diet, high-carbohydrate (HCD) or high-fat (HFD), most effectively induces classical characteristics of obesity in mice. Mice were fed commercial chow (control), an HCD, or an HFD for 12 weeks. HFD and HCD increased body weight, fat mass, and glycaemia, whereas the HFD augmented insulinemia. In the kidney, the HFD caused albuminuria, and reductions in fractional Na+ excretion, Thromboxane B2 (TXB2) excretion, and urinary flow, whereas the HCD reduced glomerular filtration, plasma osmolality, and TXB2 and Prostaglandin E2 excretion. The consumption of HFD and HCD modified parameters that indicate histopathological changes, such as proliferation (proliferating-cell-nuclear antigen), inflammation (c-Jun N-terminal-protein), and epithelial-mesenchymal transition (vimentin, and desmin) in renal tissue, but the HCD group presents fewer signals of glomerular hypertrophy or tubule degeneration. In summary, the HCD generated the metabolic and renal changes required for an obesity model, but with a delay in the development of these modifications concerning the HFD.

Biomarkers of oxidative stress and inflammation in people witha physical disability treated with a standardized extract of Nasturtium officinale: A randomized, double-blind, and placebo-controlled trial.

It is well established that plants from the Brassicaceae family, particularly watercress, have been associated to reduce oxidative DNA damage. Nasturtium officinale R. Br (watercress) contains glucosinolates, with anti-inflammatory action and protective effect on human health against oxidative stress. We aimed to evaluate whether the standardized extract of Nasturtium officinale (SENO) is capable of changing biomarkers of oxidative stress and inflammation in people with physical disabilities. 65 people enrolled this study: as a control group composed by; 15 people with no physical disability assessed once, 25 people with physical disabilities using 750 mg/kg/day of SENO, and 25 people with physical disabilities using 750 mg/kg/day of placebo-control for 5 weeks. Biomarkers of oxidative stress and inflammation were analyzed on day 0 and 36. The results indicated that SENO was associated with decreasing levels of lipid peroxidation, protein carbonyl, catalase, superoxide dismutase, and C-reactive protein. Furthermore, the cytokine kit demonstrated below and out of invertible range, which was impossible to detect the inflammatory process. Despite the cytokine kit was not able to detect the inflammation; these data might provide supportive evidence that SENO, have affected positively people with physical disabilities decreasing their biomarkers of oxidative stress and C-reactive protein. Further studies are required.

Consumption of latex from Euphorbia tirucalli L. promotes a reduction of tumor growth and cachexia, and immunomodulation in Walker 256 tumor-bearing rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Euphorbia tirucalli L. is an African plant that grows well in Brazil. Individuals diagnosed with cancer frequently consume latex from E. tirucalli, dissolved in drinking water. In vitro studies confirm the antitumor potential of E. tirucalli latex, but in vivo evaluations are scarce. AIM OF THE STUDY: To evaluate the effect of intake of an aqueous solution of E. tirucalli latex on tumor growth, cachexia, and immune response in Walker 256 tumor-bearing rats. MATERIALS AND METHODS: Latex from E. tirucalli was collected and analyzed by LC-MS. Sixty male Wistar rats (age, 90 days) were randomly divided into four groups: C, control group (without tumor); W, Walker 256 tumor-bearing group; SW1, W animals but treated with 25 µL latex/mL water; and SW2, W animals but treated with 50 µL latex/mL water. Animals received 1 mL of latex solution once a day by gavage. After 15 d, animals were euthanized, tumor mass was determined, and glucose and triacylglycerol serum levels were measured by using commercial kits. Change in the body weight during tumor development was calculated, and proliferation capacity of tumor cells was assessed by the Alamar Blue assay. Phagocytosis and superoxide anion production by peritoneal macrophages and circulating neutrophils were analyzed by enzymatic and colorimetric assays. Data are analyzed by one-way ANOVA followed by Tukey's post-hoc test, with the significance level set at 5%. RESULTS: The analysis of the latex revealed the presence of triterpenes. The ingestion of the latex aqueous solution promoted 40% and 60% reduction of the tumor mass in SW1 and SW2 groups, respectively (p < 0.05). The proliferative capacity of tumor cells from SW2 group was 76% lower than that of cells from W group (p < 0.0001). Animals treated with latex gained, on average, 20 g (SW1) and 8 g (SW2) weight. Glucose and triacylglycerol serum levels in SW1 and SW2 animals were similar to those in C group rats. Peritoneal macrophages and blood neutrophils from SW1 and SW2 animals produced 30-40% less superoxide anions than those from W group animals (p < 0.05), but neutrophils from SW2 group showed an increased phagocytic capacity (20%, vs. W group). CONCLUSIONS: E. tirucalli latex, administered orally for 15 d, efficiently reduced tumor growth and cachexia in Walker 256 tumor-bearing rats. Decreased tumor cell proliferative capacity was one of the mechanisms involved in this effect. Further, the data suggest immunomodulatory properties of E. tirucalli latex. The results agree with folk data on the antitumor effect of latex ingestion, indicating that it may be useful as an adjunct in the treatment of cancer patients. For this, further in vivo studies in animal and human models need to be conducted.

Brazilian Version of Cancer Fatigue Scale: Validation of the Brazilian Version of Cancer Fatigue Scale in Patients With Breast Cancer.

CONTEXT: Scales to assess the fatigue in patients with cancer may help the clinical decision-making process. OBJECTIVES: The objective of this study was to cross-culturally adapt and determine the validity of the Brazilian version of Cancer Fatigue Scale. METHODS: Translation and cross-cultural adaptation followed the recommendations of international guidelines. One hundred fifty-one women with breast cancer participated in the validity phase and they filled out the Brazilian version of another instruments (Piper Fatigue Scale Revised, Beck Depression Inventory, Verbal Numerical Rating Scale, and Karnofsky Performance Scale). The measurement properties of reliability, internal consistency, and validity were measured. RESULTS: The few discrepancies identified in the back-translation were solved by consensus, and the Cancer Fatigue Scale was successfully translated and cross-culturally adapted. The Brazilian version of Cancer Fatigue Scale showed good stability (test-retest reliability intraclass correlation coefficient = 0.95, 95% CI = 0.94-0.97 and interexaminer reliability intraclass correlation coefficient = 0.98, 95% CI = 0.97-0.99) and good internal consistency (Cronbach's alpha >0.70 for the three subscales/domains). The high correlation was found with Piper Fatigue Scale (r = 0.643) and Beck Depression Inventory (r = 0.509) in terms of validity. However, a reasonable correlation was found with Verbal Numerical Rating Scale (r = 0.302) and Karnofsky Performance Scale (r = -0.324). CONCLUSION: Here, we validated the Cancer Fatigue Scale in breast cancer Brazilian women meaning its use for the identification and evaluation of cancer-related fatigue in patients with breast cancer.

New insights on the regulation of cancer cachexia by N-3 polyunsaturated fatty acids.

Cancer cachexia is a multifactorial syndrome that develops during malignant tumor growth. Changes in plasma levels of several hormones and inflammatory factors result in an intense catabolic state, decreased activity of anabolic pathways, anorexia, and marked weight loss, leading to cachexia development and/or accentuation. Inflammatory mediators appear to be related to the control of a highly regulated process of muscle protein degradation that accelerates the process of cachexia. Several mediators have been postulated to participate in this process, including TNF-α, myostatin, and activated protein degradation pathways. Some interventional therapies have been proposed, including nutritional (dietary, omega-3 fatty acid supplementation), hormonal (insulin), pharmacological (clenbuterol), and nonpharmacological (physical exercise) therapies. Omega-3 (n-3) polyunsaturated fatty acids (PUFAs), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid, are recognized for their anti-inflammatory properties and have been used in therapeutic approaches to treat or attenuate cancer cachexia. In this review, we discuss recent findings on cellular and molecular mechanisms involved in inflammation in the cancer cachexia syndrome and the effectiveness of n-3 PUFAs to attenuate or prevent cancer cachexia.

Immunomodulatory and Antitumoral Properties of Ganoderma lucidum and Agaricus brasiliensis (Agaricomycetes) Medicinal Mushrooms.

Medicinal mushrooms are used in popular medicine largely as health promoters, mainly because of their antitumor and immunomodulatory activities. Ganoderma lucidum (lingzhi or reishi) and Agaricus brasiliensis are mushrooms that have long been used for medicinal purposes. This study evaluated their immunomodulatory and antitumor effects on mice fed a diet supplemented with G. lucidum and A. brasiliensis mycelia obtained from solid-state fermentation. For 14 weeks the mice were fed chow containing 50% A. brasiliensis and G. lucidum mycelia, using ground wheat as an excipient. The consumption of the supplemented diet inhibited Sarcoma 180 tumor growth and caused important changes in the immune system. The pattern of immune response shifted, increasing CD4+ and CD8+ and decreasing CD19+ cell populations. The restoration of a proper balance between cellular and humoral immunity is an essential process for restraining tumor growth. These results suggest that polysaccharides, such as ß-glucans and other mushroom metabolites, possibly promote the T-cell dominance that is imperative to restrain tumor growth.

Spatiotemporal mapping of soybean plantations in Rondônia, Western Brazilian Amazon

Os plantios de soja têm aumentado ao Norte e Sul dos municípios de Rondônia na última década, entretanto a área plantada de soja tem sido estimada utilizando dados secundários, o que limita o entendimento da distribuição espaço temporal da soja. Este estudo buscou analisar e mapear os padrões espaciais de expansão da soja em Rondônia. O mapeamento de plantios de soja nos anos 2000, 2005, 2010 e 2014 foi feito a partir de uma técnica de classificação baseada na análise de mistura espectral de imagens Landsat e em uma árvore de decisão. A acurácia global, erros de omissão e comissão para o mapeamento da soja foram 93%, 23% e 0%, respectivamente. Os resultados mostraram que os maiores incrementos da área de soja ocorreram no estado de Rondônia entre os períodos de 2000-2005 e 2005-2010 (33,239 ha e 59,628 ha, respectivamente). A expansão das áreas de soja para o norte de Rondônia (25,627 ha) ocorreu em sua maioria no período de 2010 a 2014. Observou-se que 95,4% de todos os plantios de soja detectados em 2014 ocorreram em áreas com pelo menos nove anos de desmatamento. Além disso, encontramos evidências de que os plantios de soja estão contribuindo para o deslocamento de usos da terra prévios de antigas zonas de colonização, predominantemente pastos que foram empurrados para outras áreas de fronteiras da Amazônia, e lá exacerbando novos desmatamentos. (AU)

Obesidade grau II leva a importantes alterações na capacidade cardiorrespiratória / Changes of cardiorespiratory capacity in obesity grade II

Introdução: Obesidade é considerada epidemia mundial e um dos maiores problemas de saúde na atualidade, bem como as comorbidades a ela associadas que acarretam alterações nas funções cardiorrespiratórias desses indivíduos. Objetivo: Avaliar parâmetros cardiorrespiratórios em indivíduos sedentários obesos grau II. Os 44 voluntários foram divididos igualmente em dois grupos, obesos (GOS) e eutróficos (GE). Material e métodos: Foram mensuradas variáveis de expansibilidade torácica, força muscular respiratória, pico de fluxo expiratório (PFE), capacidade vital, além das variáveis do teste de caminhada de seis minutos (TC6). Resultados: Comparando os grupos, o GOS apresentou expansibilidade torácica com diferença significativa na inspiração (P = 0,038) e na expiração (P = 0,031) máximas do processo xifoide e na inspiração máxima (P = 0,039) da cicatriz umbilical, e PFE (P < 0,001). No TC6 o GOS apresentou frequência cardíaca (FC) em repouso mais elevada (P = 0,022) no pré-teste e saturação de oxigênio (SpO2) (P = 0,030) e distância percorrida (P < 0,001) menores, e Borg (P < 0,001) maior no pós-teste em relação ao GE. Comparando os parâmetros no pré e pós-TC6 houve alterações significativas da FC, frequência respiratória (FR), SpO2 e escala de Borg (toda com P < 0,001). Conclusão: A obesidade resulta em várias alterações cardiorrespiratórias importantes, incluindo aumento do trabalho respiratório, diminuição da expansibilidade torácica, obstrução ao fluxo aéreo e diminuição da saturação periférica de oxigênio. (AU)

Introduction: Obesity is a worldwide epidemic and one of the largest health problems leading to changes in the cardiorespiratory system. Objective: The aim of this study was to evaluate cardiorespiratory features on sedentary obese grade II subjects. Methods: Forty four individuals were divided into two groups referred as eutrophic (EG) and obese (OG). We measured chest expansion, respiratory muscle strength, expiratory peak flow (EPF), vital capacity and physiological variables in the six minute walk test (6MWT). Results: OG group showed a chest expansion with a significant difference in the expiration (P = 0.038) and expiration (P = 0.031) maximum in the xiphoid process and maximal inspiration (P = 0.039) of the umbilicus, and EPF (P < 0.001) when compared to EG group. In the 6MWT, OG showed at the pretest a rest heart rate (HR) higher (P = 0.022) and oxygen saturation (O2) (P = 0.030) and distance traveled (P < 0.001) lower, and Borg scale (P < 0.001) higher in the post-test when compared to GE. Comparison between pre- and post-6MWT was no significant changes in the HR, respiratory rate (RR), SpO2 and Borg scale (all P < 0.001). Conclusion: Sedentary obese individuals grade II have cardiorespiratory alterations, particularly in the chest expansion, EPF, HR, RR and SpO2. (AU)

INTERVAL TRAINING IS INSUFFICIENT TO ATTENUATE METABOLIC DISTURBANCES IN DIABETIC RATS / TREINAMENTO INTERVALADO É INSUFICIENTE PARA ATENUAR DISTÚRBIOS METABÓLICOS EM RATOS DIABÉTICOS / ENTRENAMIENTO A INTERVALOS ES INSUFICIENTE PARA ATENUAR TRASTORNOS METABÓLICOS EN RATAS DIABÉTICAS

ABSTRACT Introduction: Type 1 diabetes is a metabolic disease associated to blood disturbances and disorder of the innate immune system functionality. Objective: This study investigated the effect of two weeks interval training on blood biochemistry and immunological parameters in rats with type 1 diabetes. Methods: Male Wistar rats were divided into three groups: sedentary (SE, n = 10), diabetic sedentary (DI, n = 10), diabetic interval training (DIT, n = 10). IV injection of streptozotocin (45 mg/kg) induced diabetes. Interval training consisted of swimming exercise for 30 seconds with 30 seconds of rest for 30 minutes three times a week during two weeks, with an overload of 15% of the total body mass. The evaluations performed were fasting blood glucose, triglycerides, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol concentrations, phagocytic capacity, cationic vesicles content, superoxide anion, and production of hydrogen peroxide of blood neutrophils and peritoneal macrophages. Results: The results showed that two weeks interval training did not attenuate the hyperglycemic state at rest and did not decrease blood lipids in the DIT group. Diabetes increased the functionality of blood neutrophils and peritoneal macrophages in the DI group. Interval training increased the content of cationic vesicles and the phagocytic capacity of blood neutrophils and peritoneal macrophages in the DIT group. Conclusion: It was found that two weeks of interval training increased the functionality parameters of innate immune cells, although this has been insufficient to attenuate the biochemical disorders caused by diabetes.

RESUMO Introdução: O diabetes tipo 1 é uma doença metabólica associada a alterações sanguíneas e distúrbios da funcionalidade do sistema imunológico inato. Objetivo: Este estudo investigou os efeitos de duas semanas de treinamento intervalado sobre a bioquímica sanguínea e os parâmetros imunológicos em ratos com diabetes tipo 1. Métodos: Ratos Wistar machos foram divididos em três grupos: sedentário (SE, n = 10), sedentário diabético (SD, n = 10), treinado diabético (TD, n = 10). O diabetes foi induzido por uma injeção IV de estreptozotocina (45 mg/kg). O treinamento intervalado de natação consistiu em 30 segundos de exercício, com 30 segundos de recuperação, por 30 min., três vezes por semana, durante duas semanas, com sobrecarga de 15% da massa corporal total. Foram avaliados: glicemia de jejum, triglicerídeos, frações de lipoproteínas de muito baixa densidade, baixa densidade e alta densidade do colesterol, concentrações do colesterol total, capacidade fagocítica, conteúdo de vesículas catiônicas, produção de ânion superóxido e produção de peróxido de hidrogênio pelos neutrófilos sanguíneos e macrófagos peritoneais. Resultados: Os resultados mostraram que duas semanas de treinamento intervalado não atenuaram o estado hiperglicêmico em repouso e não diminuíram os lipídeos sanguíneos do grupo TD. O diabetes aumentou a funcionalidade dos neutrófilos sanguíneos e dos macrófagos peritoneais no grupo SD. O treinamento intervalado aumentou o conteúdo das vesículas catiônicas e a capacidade fagocítica dos neutrófilos sanguíneos e macrófagos peritoneais no grupo TD. Conclusão: Em duas semanas de treinamento intervalado verificou-se aumento dos parâmetros de funcionalidade das células do sistema imunológico inato, que foi, porém, insuficiente para atenuar os distúrbios bioquímicos causados pelo diabetes.

RESUMEN Introducción: La diabetes Tipo 1 es un trastorno metabólico asociado con alteraciones de la sangre y trastornos de la funcionalidad del sistema inmunológico innato. Objetivo: Este estudio investigó los efectos de dos semanas de entrenamiento a intervalos sobre la bioquímica de la sangre y los parámetros inmunológicos en ratas con diabetes tipo 1. Métodos: Ratas Wistar machos fueron divididos en tres grupos: sedentario (SE, n=10), sedentario diabético (SD, n = 10), entrenado diabético (ED, n = 10). La diabetes se indujo por medio de inyección IV de estreptozotocina (45 mg/kg). El entrenamiento a intervalos consistió en ejercicios de natación de 30 seg. con 30 seg. de recuperación por 30 minutos, tres veces por semana durante dos semanas, con una sobrecarga del 15% de la masa corporal total. Se evaluaron: glucemia en ayunas, triglicéridos, las fracciones de lipoproteínas de muy baja densidad, de lipoproteínas de baja densidad, de lipoproteínas de alta densidad del colesterol, las concentraciones de colesterol total, la capacidad fagocítica, contenido catiónico vesicular, producción de anión superóxido, producción de peróxido de hidrógeno por neutrófilos sanguíneos, y macrófagos peritoneales. Resultados: Los resultados mostraron que dos semanas de entrenamiento a intervalos no atenuó el estado hiperglucémico en reposo ni disminuyó los lípidos sanguíneos en el grupo ED. La diabetes aumentó la funcionalidad de los neutrófilos sanguíneos y de los macrófagos peritoneales en el grupo SD. El entrenamiento a intervalos aumentó el contenido de las vesículas catiónicas y la capacidad fagocítica de los neutrófilos de la sangre y los macrófagos peritoneales en el grupo ED. Conclusión: En dos semanas de entrenamiento a intervalos se verificó el aumento de los parámetros de funcionalidad de las células del sistema inmunológico innato, que sin embargo fue insuficiente para atenuar los trastornos bioquímicos causados por la diabetes.

Ultrassom terapêutico para cicatrização de feridas: revisão sistemática / Therapeutic ultrasound for wound healing: sistematic review

Introdução: o uso do ultrassom terapêutico (UST) para cicatrização de feridas ainda é discutido pela comunidade científica. Objetivo: determinar se o UST produz desfechos benéficos na cicatrização de feridas e quais tem sido os parâmetros utilizados para proporcionar melhor dose-resposta. Métodos: Foram pesquisadas as bases de dados PubMEd, SciELO e PEDro. Foram selecionados 19 ensaios clínicos, avaliados pelas escalas PEDro e JADAD. Resultados: dos 19 estudos, 8 relacionaram-se à aplicação do NCLFU (Noncontact Low Frequency Ultrasound) com evidência moderada para sua aplicação, 6 à aplicação do HFU (High Frequency Ultrasound) e 1 à aplicação de LIPUS (Low Intensity Pulsed Ultrasound), ambos com evidência limitada. Quanto a relação dose-resposta, não há concordância entre os estudos desta revisão. Conclusões: existe evidência moderada da NCLFU e limitada da HFU como recurso adjuvante para o tratamento de feridas, não sendo possível responder com clareza a melhor relação dose-resposta.

Introduction: the use therapeutic ultrasound (TUS) in wound healing is still discussed by the scientific community. Objetive: to determine whether the UST produces beneficial outcomes in wound healing and the parameters wich have been used to provide better dose-response. Methods: The databases PubMed, SciELO and PEDro were searched. We selected 19 clinical trials, assessed by the PEDro scale and JADAD. Results: of 19 studies, 8 were related to the application of NCLFU (Noncontact Low Frequency Ultrasound) with moderate evidence for its application; 6 were related to the application of HFU (High Frequency Ultrasound) and 1 was related to the application of LIPUS (Low Intensity Pulsed Ultrasound), both of with low evidence. Dose-response relationship there was no agreement between the studies in this review. Conclusion: there is moderate evidence of NCLFU and limited the HFU as an adjunct to wound care resource, not being able to respond clearly the best dose-response relationship.

Fish Oil Supplementation Enhances Pulmonary Strength and Endurance in Women Undergoing Chemotherapy.

We investigated the effect of fish oil (FO) supplementation, at 4 g/day, on the respiratory performance and blood lipid profile of 32 patients with breast cancer at the beginning of chemotherapy. They were randomized into two groups: control (C) and FO supplemented (S). Both groups underwent three respiratory evaluations and blood harvest (before chemotherapy-Day 0, and 30 and 60 days after supplementation). The S group showed a significant increase in the maximal inspiratory and expiratory pressure (P ≤ 0.05 vs. Day 0) and in the maximum voluntary ventilation (P ≤ 0.05). In the treadmill 6-min-walk test, the S group had a significant increase in the walked distance (P ≤ 0.05). Blood lactate concentration was significantly lower in the S group after 60 days, at rest, when compared to C (P ≤ 0.05). Plasma high-density lipoprotein (HDL) cholesterol concentration remained the same after 60 days of supplementation, while in the C group, it decreased significantly (P ≤ 0.05 Day 0 vs. Day 60). Triacylglycerol (TAG) plasma concentration in the S group was lower when compared to the C group (P ≤ 0.05 Day 60S vs. Day 60). Supplementation with FO caused improvement in the respiratory muscle strength and endurance, ameliorated functional performance, and kept TAG, HDL cholesterol, and lactate plasma concentration at normal levels.

Acute Oxidative Effect and Muscle Damage after a Maximum 4 Min Test in High Performance Athletes.

The purpose of this investigation was to determine lipid peroxidation markers, physiological stress and muscle damage in elite kayakers in response to a maximum 4-min kayak ergometer test (KE test), and possible correlations with individual 1000m kayaking performances. The sample consisted of twenty-three adult male and nine adult female elite kayakers, with more than three years' experience in international events, who voluntarily took part in this study. The subjects performed a 10-min warm-up, followed by a 2-min passive interval, before starting the test itself, which consisted of a maximum 4-min work paddling on an ergometer; right after the end of the test, an 8 ml blood sample was collected for analysis. 72 hours after the test, all athletes took part in an official race, when then it was possible to check their performance in the on site K1 1000m test (P1000m). The results showed that all lipoproteins and hematological parameters tested presented a significant difference (p≤0.05) after exercise for both genders. In addition, parameters related to muscle damage such as lactate dehydrogenase (LDH) and creatine kinase (CK) presented significant differences after stress. Uric acid presented an inverse correlation with the performance (r = -0.76), while CK presented a positive correlation (r = 0.46) with it. Based on these results, it was possible to verify muscle damage and the level of oxidative stress caused by indoor training with specific ergometers for speed kayaking, highlighting the importance of analyzing and getting to know the physiological responses to this type of training, in order to provide information to coaches and optimize athletic performance.

The Prevalence of Stages of Heart Failure in Primary Care: A Population-Based Study.

BACKGROUND: Planning strategies to prevent heart failure (HF) in developing countries require epidemiologic data in primary care. The purpose of this study was to estimate the prevalence of HF stages and their phenotypes, HF with preserved ejection fraction (HFPEF), and HF with reduced EF (HFREF) and to determine B-type natriuretic peptide (BNP) levels to identify HF in the adult population. METHODS AND RESULTS: This is a cross-sectional study including 633 individuals, aged ≥45 years, who were randomly selected and registered in a primary care program of a medium-sized city in Brazil. All participants were underwent clinical evaluations, BNP measurements, electrocardiograms, and tissue Doppler echocardiography in a single day. The participants were classified as stage 0 (healthy, 11.7%), stage A (risk factors, 36.6%), stage B (structural abnormalities, 42.7%), or stage C (symptomatic HF, 9.3%). Among patients with HF, 59% presented with HFPEF and 41% presented with HFREF. The mean BNP levels were 20 pg/mL(-1) in stage 0, 20 pg/mL(-1) in stage A, 24 pg/mL(-1) in stage B, 93 pg/mL(-1) in HFPEF, and 266 pg/mL(-1) in HFREF. The cutoff BNP level with optimal sensitivity (92%) and specificity (91%) to identify HF was 42 pg/mL(-1). CONCLUSION: The present study demonstrated a high prevalence of individuals at risk for HF and the predominance of HFPEF in a primary care setting. The clinical examination, along with BNP and tissue Doppler echocardiography, may facilitate early detection of stages A and B HF and allow implementation of interventions aimed at preventing progression to symptomatic HF.

A INFLUÊNCIA DO TREINAMENTO RESISTIDOE DA SUPLEMENTAÇÃO DO ÓLEO DE PEIXE EM PARÂMETROS SANGUÍNEOS EM MULHERES IDOSAS / THE INFLUENCE OF STRENGHT TRAINING AND FISH OIL SUPPLEMENTATION ON BLOOD PARAMETERS OF ELDERLY WOMEN

RESUMO Este estudo objetivou investigar o efeito crônico da óleo de peixe (FO) e o treinamento resistido (ST) nos parâmetros sanguíneos (glicemia, triglicérides e HDL, LDL colesterol VLDL) de mulheres idosas. Quarenta e cinco mulheres (64 ± 1,4 anos) foram distribuídas em três grupos: um grupo que realizou 90 dias de treinamento resistido (ST; n = 15), um grupo que realizou 90 dias de treinamento resistido associado à 2g / dia de óleo de peixe (ST90; n = 15) e o ultimo grupo que consumiu óleo de peixe por 60 dias antes de iniciar os 90 dias de treinamento resistido associado ao FO (ST150; n = 15). O treinamento foi realizado 3 vezes / semana, durante 12 semanas. Os parâmetros sanguíneos foram avaliados nos 3 grupos nas condições, pré-suplementação e pré-treinamento (PRÉ) e pós-suplementação (PÓS60) e pós-treinamento (PÓS). Os efeitos positivos foram comprovados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas (ST90 e ST150). A glicemia de ST e ST150 não apresentou mudanças entre PRÉ-PÓS e PRÉ-PÓS60, respectivamente. No entanto, quando foi combinado o exercício com o FO reduções na glicemia foram encontrados no ST90 (21%) e ST150 (19%) a partir de PRÉ e PÓS (p <0,05). A FO causou ganhos significativos no HDL (ST150 PRE- PÓS60). Contudo, o exercício foi eficaz quando acompanhado da suplementação FO (ST90, ST150, PRÉ-PÓS, p<.0.05). Os triglicérides do sangue diminuiu quando FO e o exercício resistido (p<0,05) foram aplicados separadamente (ST, ST90 e ST150 PRÉ, PÓS 60 e PÓS). Houve uma redução nas concentrações de VLDL em todos os grupos (26% de ST, 35% em ST90, ST150 de PÓS60 em 35% e 36% em PÓS). A LDL não foi alterada. Conclui-se que os parâmetros sanguíneos (triglicérides e VLDL) diminuiu quando FO e exercícios foram aplicados separadamente. Os efeitos positivos foram evidenciados sobre a glicemia e colesterol HDL quando FO e exercício foram combinadas.

ABSTRACT It was aimed to investigate the chronic effect of FO and ST on blood parameters (glycaemia, triglycerides, and HDL, LDL VLDL cholesterol) of elderly women. METHODS: Forty-five women (64 ± 1.4 years) were assigned to one group of strength training (ST; n=15), one group of strength and 2g/day of FO supplemented by 90 (ST90; n=15) and 150 days (ST150; n=15). The ST150 started FO 60 days before commencing the strength training. Training was performed 3 times/wk, for 12 weeks. The blood parameters were assessed at before supplementation (POST60), pre-training (PRE) and post-training (POST). Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined (ST90 e ST150). The glycaemia of ST and ST150 showed no changes between PRE-POST and POST60-PRE, respectively. However, when training was combined with FO supplementation reductions in the glycaemia were found in the ST90 (21%) and ST150 (19%) from PRE to POST (p<0.05). The FO caused significant gains in HDL (ST150 POST 60-PRE). The HDL was not influenced by exercise alone (ST PRE-POS; p>0.05). However, exercise was effective when accompanied by FO supplementation (ST90, ST150, PRE-POST, p<.0.05). The triglycerides decreased when FO and exercises (p<0.05) were applied separately (ST, ST90 and ST150 POST60-POST). No additional reductions were found by combining FO and exercise. There was a reduction in the concentrations of VLDL in all groups (26% for ST, 35% in ST90, ST150 base in 35% and 36% in post ST150). The LDL was not altered. In concluision The blood parameters (triglycerides and VLDL) decreased when FO and exercises were applied separately. No additional reductionswere found by combining FO and exercise. Positive effects were evidenced on glycaemia and HDL cholesterol when FO and exercise were combined.

Fish oil administration mediates apoptosis of Walker 256 tumor cells by modulation of p53, Bcl-2, caspase-7 and caspase-3 protein expression.

BACKGROUND: Several studies have been shown pro-apoptotic effects of fish oil (FO), rich in n-3 polyunsaturated fatty acids (n-3 PUFA) on cancer cells. Nevertheless, few in vivo experiments have provided data of its ability on apoptosis protein expression in tumor tissue. Thus, in this study we investigate the effect of FO supplementation on apoptosis protein expression in Walker 256 tumor bearing rats. Male Wistar rats were randomly assigned to three groups: fed with regular chow (W); fed regular chow supplemented with FO (WFO) or coconut fat (WCO) (1 g/kg body weight/daily). After thirty days, all animals were inoculated subcutaneously with Walker 256 tumor cells. FINDINGS: Protein expression was done by western blotting in Walker 256 tumor tissue samples. FO decreased the Bcl-2/Bax ratio (p < 0.05) and increased the p53 (p < 0.05), cleaved caspase-7 (p < 0.05) and cleaved caspase-3 (p < 0.05) in Walker 256 tumor tissue. CONCLUSIONS: Our data suggest that the pro-apoptotic effect of FO in Walker 256 tumor is related with specifics cleaved caspases.

Influence of fish oil supplementation and strength training on some functional aspects of immune cells in healthy elderly women.

Immune function changes with ageing and is influenced by physical activity (strength training, ST) and diet (fish oil, FO). The present study investigated the effect of FO and ST on the immune system of elderly women. Forty-five women (64 (sd 1.4) years) were assigned to ST for 90 d (ST; n 15), ST plus 2 g/d FO for 90 d (ST90; n 15) or 2 g/d FO for 60 d followed by ST plus FO for 90 d (ST150; n 15). Training was performed three times per week, for 12 weeks. A number of innate (zymosan phagocytosis, lysosomal volume, superoxide anion, peroxide of hydrogen) and adaptive (cluster of differentiation 4 (CD4), CD8, TNF-α, interferon-γ (IFN-γ), IL-2, IL-6 and IL-10 produced by lymphocytes) immune parameters were assessed before supplementation (base), before (pre-) and after (post-) training. ST induced no immune changes. FO supplementation caused increased phagocytosis (48 %), lysosomal volume (100 %) and the production of superoxide anion (32 %) and H2O2(70 %) in the ST90. Additional FO supplementation (ST150) caused no additive influence on the immune system, as ST150 and ST90 did not differ, but caused greater changes when compared to the ST (P< 0·05). FO increased CD4+ and CD8+ lymphocytes in the ST150, which remained unchanged when training was introduced. The combination of ST and FO reduced TNF-α in the ST150 from base to post-test. FO supplementation (ST150, base-pre) when combined with exercise (ST150, pre-post) increased IFN-γ, IL-2, IL-6 and IL-10 production. The immune parameters improved in response to FO supplementation; however, ST alone did not enhance the immune system.

Assessing Strategies for Heart Failure with Preserved Ejection Fraction at the Outpatient Clinic / Avaliação de Estratégias para Insuficiência Cardíaca com Fração de Ejeção Normal no Ambulatório

Background: Heart failure with preserved ejection fraction (HFPEF) is the most common form of heart failure (HF), its diagnosis being a challenge to the outpatient clinic practice. Objective: To describe and compare two strategies derived from algorithms of the European Society of Cardiology Diastology Guidelines for the diagnosis of HFPEF. Methods: Cross-sectional study with 166 consecutive ambulatory patients (67.9±11.7 years; 72% of women). The strategies to confirm HFPEF were established according to the European Society of Cardiology Diastology Guidelines criteria. In strategy 1 (S1), tissue Doppler echocardiography (TDE) and electrocardiography (ECG) were used; in strategy 2 (S2), B-type natriuretic peptide (BNP) measurement was included. Results: In S1, patients were divided into groups based on the E/E'ratio as follows: GI, E/E'> 15 (n = 16; 9%); GII, E/E'8 to 15 (n = 79; 48%); and GIII, E/E'< 8 (n = 71; 43%). HFPEF was confirmed in GI and excluded in GIII. In GII, TDE [left atrial volume index (LAVI) ≥ 40 mL/m2; left ventricular mass index LVMI) > 122 for women and > 149 g/m2 for men] and ECG (atrial fibrillation) parameters were assessed, confirming HFPEF in 33 more patients, adding up to 49 (29%). In S2, patients were divided into three groups based on BNP levels. GI (BNP > 200 pg/mL) consisted of 12 patients, HFPEF being confirmed in all of them. GII (BNP ranging from 100 to 200 pg/mL) consisted of 20 patients with LAVI > 29 mL/m2, or LVMI ≥ 96 g/m2 for women or ≥ 116 g/m2 for men, or E/E'≥ 8 or atrial fibrillation on ECG, and the diagnosis of HFPEF was confirmed in 15. GIII (BNP < 100 pg/mL) consisted of 134 patients, 26 of whom had the diagnosis of HFPEF confirmed when GII parameters were used. Measuring BNP levels in S2 identified 4 more patients (8%) with HFPEF as compared with those identified in S1. Conclusion: The association of BNP measurement and TDE data ...

Fundamento: A insuficiência cardíaca com fração de ejeção normal é a forma mais comum de insuficiência cardíaca e seu diagnóstico é um desafio na prática ambulatorial. Objetivo: Descrever e comparar duas estratégias, derivadas dos algoritmos do Consenso Europeu de Diastologia para diagnóstico de insuficiência cardíaca com fração de ejeção normal. Métodos: Estudo transversal com 166 pacientes (67,9 ± 11,7 anos, 72% mulheres) ambulatoriais consecutivos. As estratégias para confirmar insuficiência cardíaca com fração de ejeção normal foram estabelecidas de acordo com os critérios do Consenso Europeu de Diastologia. Na estratégia 1, utilizamos dados do eco Doppler tecidual e eletrocardiograma; na estratégia 2, incluímos o peptídeo natriurético tipo B. Resultados: Na primeira estratégia, os pacientes foram classificados em grupos, de acordo com a relação E/E': GI se E/E' > 15 (n = 16; 9%); GII se E/E' 8 a 15 (n = 79; 48%); e GIII se E/E' < 8 (n = 71; 43%). Insuficiência cardíaca com fração de ejeção normal foi confirmada no GI e excluída no GIII. No GII, parâmetros do eco Doppler tecidual (volume do átrio esquerdo indexado ≥ 40 mL/m2; massa do ventrículo esquerdo indexado > 122 para mulheres e > 149 g/m2 para homens) e do eletrocardiograma (fibrilação atrial) foram analisados, confirmando insuficiência cardíaca com fração de ejeção normal em mais 33 pacientes, totalizando 49 (29%). Na estratégia 2, utilizando o peptídeo natriurético tipo B, os pacientes foram divididos em três grupos. O GI (peptídeo natriurético tipo B > 200 pg/mL) foi formado por 12 pacientes e a insuficiência cardíaca com fração ...