Heteropterys tomentosa A. Juss: Toxicological and adaptogenic effects in experimental models.

BACKGROUND: The constant pursuit of improved athletic performance characterizes high-performance sport and the use of medicinal plants as dietary supplements is becoming widespread among athletes to enhance long-term endurance performance. AIM: The present study evaluated the toxicity of Heteropterys tomentosa (HEHt) and its acute adaptogenic effects. METHODS: The in vitro safety profile was evaluated on CHO-k1 cells using the alamar Blue assay, at concentrations ranging from 3.125 to 200 µg/mL. In vivo acute oral toxicity was conducted in male and female mice with oral administration of graded doses of HEHt from 400 to 2000 mg/kg. A subchronic oral toxicity study was completed by oral administration of HEHt (50, 200 or 1000 mg/kg) and vehicle for 30 days in male Wistar rats. Clinical observations and toxicological related parameters were determined. Blood was collected for biochemical and hematological analyses, while histological examinations were performed on selected organs. Thereafter, an adaptogenic test consisting of progressive loads until exhaustion was conducted in rats ( n = 5/group) orally pre-treated with the vehicle and HEHt (25, 100 or 400 mg/kg). RESULTS: HEHt exhibited no cytotoxic effects on the CHO-k1 cells and, apparently, no acute toxicity in mice and no subchronic toxicity in rats. An ergogenic effect was observed only at the dose of 25 mg/kg compared with the vehicle in relation to time to exhaustion and exercise load ( p = .011 and .019, respectively). HEHt is safe at up to 400 mg/kg, contains astilbin and taxifolin as the major phytochemical compounds, and exhibited a potential adaptogenic effect. CONCLUSIONS: These results justify its anecdotal usage as a tonic, show that the hydroethanolic maceration of the root does not cause toxicity, and provide scientific evidence of its potential as a source of new adaptogenic substance(s).

Hiperinsuflação manual: revisão de evidências técnicas e clínicas / Manual hyperinflation: technical and clinical evidence review

INTRODUÇÃO: A técnica de hiperinsuflação manual (HM), também conhecida como "bag squeezing" ou "bagging", foi inicialmente descrita como um recurso para melhorar a oxigenação pré e pós-aspiração traqueal, mobilizar o excesso de secreção brônquica e reexpandir áreas pulmonares colapsadas. OBJETIVO: Apresentar evidências científicas sobre os efeitos da manobra de HM como recurso fisioterapêutico, bem como suas indicações clínicas. MATERIAIS E MÉTODOS: Realizou-se uma busca nas bases de dados eletrônicas SciELO, ScienceDirect, PubMed e PEDro, utilizando-se os descritores "hiperinsuflação manual" (manual hyperinflation) e "fisioterapia" (physiotherapy). Como critério de inclusão considerou-se: conter os descritores no título ou resumo; ensaios clínicos que abordassem "hiperinsuflação manual" e fisioterapia; textos em inglês e português; publicações entre 1994 e 2011. RESULTADOS: Foram selecionados 25 estudos e todos apontaram a importância dessa manobra na mobilização de secreções traqueobrônquicas e para reexpansão de alvéolos colapsados, devido à melhora do volume pulmonar. Adequação das trocas gasosas, melhora da oxigenação e da complacência pulmonar, prevenção e tratamento de atelectasias são outras indicações. Também é consensual a preocupação com a padronização na aplicação da técnica. Melhores resultados são alcançados quando o volume aplicado é cerca de 50% maior que o volume corrente do paciente. Precauções quanto a limites de pressão em torno de 40 cm H2O, para se evitar barotraumas, também são referidas pela maioria dos estudos. CONCLUSÃO: A literatura traz evidências que sustentam a indicação do HM para mobilização e eliminação de secreções traqueobrônquicas e prevenção de infecções/complicações, além da necessidade de padronização da técnica.

INTRODUCTION: The manual hyperinflation technique, also called like "bag squeezing" or "bagging", primarily it has described as a tool to improve oxygenation in pre and post-aspiration, tracheobronchial secretions mobilization and reexpansion of collapsed alveoli. OBJECTIVE: To present scientific evidence on the effects of manual hyperinflation (MH) like a physiotherapy resource, as well as clinical indications. MATERIALS AND METHODS: It was performed a review in the electronic databases SciELO, ScienceDirect, PubMed and PEDro, using the descriptors "manual hyperinflation" (hiperinsuflação manual) and "physiotherapy" (fisioterapia). The criteria for inclusions were: include the descriptors in title or abstract; clinical trial about "manual hyperinflation" and physiotherapy; papers in English and Portuguese; publications between 1994 and 2011. RESULTS: It was selected 25 paper; they were unanimous about the importance of MH for tracheobronchial secretions mobilization and for collapsed alveoli reexpansion, to improvement in lung volume. Other indications of this feature are: prevention and treatment of atelectasis, effects can be enhanced when combined with physiotherapy techniques. In this review was noted a concern about the standardization of the technique that shown better results when a volume 50% higher than the patient's tidal volume are applied during the maneuver. Precautions to limit pressure around 40 cm H2O to avoid barotrauma, are also cited by most studies. CONCLUSION: The literature brings evidence that support the indication of MH for tracheobronchial secretions mobilization and elimination, and prevention of infection/complications, and it is necessary to standardize the technique.