NADPH Oxidase Plays a Role on Ethanol-Induced Hypertension and Reactive Oxygen Species Generation in the Vasculature.

AIMS: Investigate the role of NADPH oxidase on ethanol-induced hypertension and vascular oxidative stress. METHODS: Male Wistar rats were treated with ethanol (20% v/v). RESULTS: Apocynin (10 mg/kg/day, i.p.) prevented ethanol-induced hypertension. The increased contractility of endothelium-intact and endothelium-denuded aortic rings from ethanol-treated rats to phenylephrine was prevented by apocynin. Ethanol consumption increased superoxide anion (O2 (-)) generation and lipid peroxidation and apocynin prevented these responses. The decrease on plasma and vascular nitrate/nitrite (NOx) levels induced by ethanol was not prevented by apocynin. Treatment with ethanol did not affect aortic levels of hydrogen peroxide (H2O2) or reduced glutathione (GSH). Ethanol did not alter the activities of xanthine oxidase (XO), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Ethanol increased the expression of Nox1, PKCδ, nNOS, SAPK/JNK and SOD2 in the rat aorta and apocynin prevented these responses. No difference on aortic expression of Nox2, Nox4, p47phox, Nox organizer 1 (Noxo1), eNOS and iNOS was detected after treatment with ethanol. Ethanol treatment did not alter the phosphorylation of SAPK/JNK, p38MAPK, c-Src, Rac1 or PKCδ. CONCLUSIONS: The major new finding of our study is that the increased vascular generation of reactive oxygen species (ROS) induced by ethanol is related to increased vascular Nox1/NADPH oxidase expression. This mechanism is involved in vascular dysfunction and hypertension induced by ethanol. Additionally, we conclude that ethanol consumption induces the expression of different proteins that regulate vascular contraction and growth and that NADPH oxidase-derived ROS play a role in such response. SHORT SUMMARY: The key findings of our study are that ethanol-induced hypertension is mediated by NADPH oxidase. Moreover, increased vascular Nox1 expression is related to the generation of reactive oxygen species (ROS) by ethanol. Finally, ROS induced by ethanol increase the expression of the regulatory vascular proteins.

Auto-inhibitory regulation of angiotensin II functionality in hamster aorta during the early phases of dyslipidemia.

Emerging data point the crosstalk between dyslipidemia and renin-angiotensin system (RAS). Advanced dyslipidemia is described to induce RAS activation in the vasculature. However, the interplay between early dyslipidemia and the RAS remains unexplored. Knowing that hamsters and humans have a similar lipid profile, we investigated the effects of early and advanced dyslipidemia on angiotensin II-induced contraction. Cumulative concentration-response curves for angiotensin II (1.0pmol/l to 1.0µmol/l) were obtained in the hamster thoracic aorta. We also investigated the modulatory action of NAD(P)H oxidase on angiotensin II-induced contraction using ML171 (Nox-1 inhibitor, 0.5µmol/l) and VAS2870 (Nox-4 inhibitor, 5µmol/l). Early dyslipidemia was detected in hamsters treated with a cholesterol-rich diet for 15 days. Early dyslipidemia decreased the contraction induced by angiotensin II and the concentration of Nox-4-derived hydrogen peroxide. Advanced dyslipidemia, observed in hamsters treated with cholesterol-rich diet for 30 days, restored the contractile response induced by angiotensin II by compensatory mechanism that involves Nox-4-mediated oxidative stress. The hyporresponsiveness to angiotensin II may be an auto-inhibitory regulation of the angiotensinergic function during early dyslipidemia in an attempt to reduce the effects of the upregulation of the vascular RAS during the advanced stages of atherogenesis. The recovery of vascular angiotensin II functionality during the advanced phases of dyslipidemia is the result of the upregulation of redox-pro-inflammatory pathway that might be most likely involved in atherogenesis progression rather than in the recovery of vascular function. Taken together, our findings show the early phase of dyslipidemia may be the most favorable moment for effective atheroprotective therapeutic interventions.

Hypertension and chronic ethanol consumption: What do we know after a century of study?

The influences of life habits on the cardiovascular system may have important implications for public health, as cardiovascular diseases are among the leading causes of shorter life expectancy worldwide. A link between excessive ethyl alcohol (ethanol) consumption and arterial hypertension was first suggested early last century. Since then, this proposition has received considerable attention. Support for the concept of ethanol as a cause of hypertension derives from several epidemiologic studies demonstrating that in the general population, increased blood pressure is significantly correlated with ethanol consumption. Although the link between ethanol consumption and hypertension is well established, the mechanism through which ethanol increases blood pressure remains elusive. Possible mechanisms underlying ethanol-induced hypertension were proposed based on clinical and experimental observations. These mechanisms include an increase in sympathetic nervous system activity, stimulation of the renin-angiotensin-aldosterone system, an increase of intracellular Ca(2+) in vascular smooth muscle, increased oxidative stress and endothelial dysfunction. The present report reviews the relationship between ethanol intake and hypertension and highlights some mechanisms underlying this response. These issues are of interest for the public health, as ethanol consumption contributes to blood pressure elevation in the population.

[Antidepressants: use, adherence and awareness among medical students]. / Antidepressivos: uso, adesão e conhecimento entre estudantes de medicina.

This study assessed the degree of adherence and drug-related awareness and opinions regarding the importance of guidance with respect to treatment among medical students who use antidepressants. It is a cross-sectional descriptive study, carried out in a public Medical School in the state of Sao Paulo, Brazil. Of the 289 students interviewed, 33 (11.4%) use or had already used antidepressants, with fluoxetine being the most prescribed. The nurse was not cited as being responsible for guidance on the antidepressant. Although most students had received guidance on antidepressants, they did not heed guidance and still had doubts regarding their use. There was a statistically significant association regarding the consumption of other drugs in addition to antidepressants and the existence of side effects, as well as regarding an increase of the dosage without medical consultation and the existence of such side effects. Actions are necessary to acknowledge the importance of the teaching of psychopharmacology in the training of the medical professional and for greater harmony between theory and practice.

Antidepressivos: uso, adesão e conhecimento entre estudantes de medicina / Antidepressants: use, adherence and awareness among medical students

Este estudo avaliou em estudantes de medicina que usam antidepressivos, o grau de adesão e conhecimento relacionados ao medicamento e a opinião sobre a importância da orientação no tratamento. Trata-se de estudo transversal e descritivo, realizado em uma Faculdade de Medicina pública paulista. Dos 289 alunos entrevistados, 33 (11,4%) utilizam ou já utilizaram antidepressivos, sendo a fluoxetina o mais prescrito. O enfermeiro não foi citado como responsável pela orientação sobre o antidepressivo. Embora a maioria dos estudantes tenha recebido orientações sobre antidepressivo, a maioria não aderia ao mesmo havendo, ainda, dúvidas quanto ao seu uso. Houve associação estatisticamente significativa quanto ao consumo de outros medicamentos além do antidepressivo e presença de efeitos colaterais e quanto ao aumento da dose sem consulta médica e presença dos referidos efeitos. São necessárias ações para valorização do ensino da psicofarmacologia na formação do profissional de medicina e para maior articulação entre teoria e prática profissional.

This study assessed the degree of adherence and drug-related awareness and opinions regarding the importance of guidance with respect to treatment among medical students who use antidepressants. It is a cross-sectional descriptive study, carried out in a public Medical School in the state of Sao Paulo, Brazil. Of the 289 students interviewed, 33 (11.4%) use or had already used antidepressants, with fluoxetine being the most prescribed. The nurse was not cited as being responsible for guidance on the antidepressant. Although most students had received guidance on antidepressants, they did not heed guidance and still had doubts regarding their use. There was a statistically significant association regarding the consumption of other drugs in addition to antidepressants and the existence of side effects, as well as regarding an increase of the dosage without medical consultation and the existence of such side effects. Actions are necessary to acknowledge the importance of the teaching of psychopharmacology in the training of the medical professional and for greater harmony between theory and practice.

Ansiedade e consumo de ansiolíticos entre estudantes de enfermagem de uma universidade pública / Anxiety and the consumption of anxiolytics among nursing students of a public university / Ansiedad y consumo de ansiolíticos entre estudiantes de enfermería de una universidad pública

Trata-se de estudo transversal, descritivo, de abordagem quantitativa realizado em uma escola pública de enfermagem do estado de São Paulo, que avaliou a incidência de ansiedade entre os estudantes, seu conhecimento sobre os ansiolíticos e o padrão de consumo destes medicamentos. Dos 308 estudantes, 16% estavam utilizando ansiolíticos no período em que a pesquisa foi realizada ou já usaram em algum momento de suas vidas; destes, 35% apresentaram ansiedade severa, de acordo com a aplicação do Inventário de Ansiedade de Beck. Mesmo tendo recebido orientação, a maioria dos usuários referiram possuir dúvidas, especialmente no que diz respeito à interação com outros fármacos, efeitos colaterais e seu potencial para causar dependência. Destaca-se a importância do reconhecimento e tratamento da ansiedade entre os estudantes, uma vez que sua presença, quando em níveis mais altos, pode afetar de forma significativa a formação da identidade do estudante e sua qualidade de vida...

This cross-sectional, descriptive study was performed at a public nursing school in the state of São Paulo, using a quantitative approach. An evaluation was made of the incidence of anxiety among the students, their knowledge regarding anxiolytics and the consumption pattern of those drugs. Of the 308 students, 16% was using anxiolytics when the study was performed or had already used anxiolytics at some time in their lives; 35% of the later suffered from severe anxiety according to the application of the Beck's Anxiety Inventory. Despite the guidance they received, most users referred having doubts mainly regarding the interaction of anxiolytics with other drugs, their side effects and their potential of being addictive. It is highlighted that recognizing among students and offering treatment is important, as its presence, when at high level can have a significant effect on the development of the student's identity and his/her quality of life...

Estudio transversal, descriptivo, de abordaje cuantitativo, realizado en una escuela pública de enfermería del estado de São Paulo, que evaluó la incidencia de ansiedad entre los estudiantes, su conocimiento sobre ansiolíticos y el patrón de consumo de tales medicamentos. De los 308 estudiantes, 16% estaba utilizando ansiolíticos durante el período de la realización del estudio, o ya los usaron en algún momento de sus vidas. Entre ellos, 35% presentaban ansiedad severa, de acuerdo a la aplicación del Inventario de Ansiedad de Beck. Inclusive habiendo recibido orientaciones, la mayoría de los usuarios refirió dudas, especialmente respecto a la interacción con otros fármacos, efectos colaterales y su potencial para causar dependencia. Se destaca la importancia de reconocimiento y tratamiento de la ansiedad entre los estudiantes, toda vez que su presencia en niveles elevados puede afectar significativamente la formación de la identidad del estudiante y su calidad de vida...

[Adherence to medication among patients with Parkinson's disease treated at a specialized outpatient unit]. / Adesão à medicação em pacientes com doença de Parkinson atendidos em ambulatório especializado.

Parkinson's disease is universal and the second most prevalent neurodegenerative disease among the elderly affecting between 0.5 and 1% of the population between 65 and 69 years of age. Adherence to medication is considered the main determinant for the effectiveness of treatment, but only recently has it been studied in patients with Parkinson's disease. This cross-sectional and descriptive study assessed adherence to medication in 112 patients with Parkinson's disease who regularly attended the movement disorder outpatient unit at the Hospital das Clinicas of the School of Medicine of Ribeirao Preto, University of São Paulo, using the Morisky and Green test and an instrument that assesses attitudes of medicine intake (IAAFTR). Of the patients interviewed, 53% failed to adhere to treatment and 52% did not take the medication at the correct time. Patients should receive guidance about the importance of taking their medication at the correct time, understanding the benefits that adherence to medication can provide. They should also be aware that doses not taken, taken in excess or not taken at the prescribed times can reduce their response to treatment, having a negative effect on the clinical outcome and quality of life, thereby generating higher costs to public health in the country.

Adesão à medicação em pacientes com doença de Parkinson atendidos em ambulatório especializado / Adherence to medication among patients with Parkinson's disease treated at a specialized outpatient unit

A doença de Parkinson é universal, sendo a segunda doença neurodegenerativa mais comum em idosos e tem alta prevalência, afetando entre 0,5 e 1% da população com idade entre 65 e 69 anos. A adesão à terapia medicamentosa é considerada o principal determinante para a efetividade do tratamento, porém apenas recentemente vem sendo estudado em pacientes com doença de Parkinson. Trata-se de estudo transversal e descritivo que avaliou a adesão à terapia com levodopa em 112 pacientes com doença de Parkinson que frequentavam regularmente o ambulatório de distúrbios do movimento do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo utilizando o teste Morisky e Green e o instrumento que avalia atitudes frente à tomada dos remédios (IAAFTR). Dos pacientes entrevistados, 53% não apresentaram adesão ao tratamento e 52% não tomam a medicação no horário correto. Os pacientes devem ser orientados sobre a importância de ingerir sua medicação no horário correto, entendendo os benefícios que a adesão pode proporcionar estando cientes de que doses não tomadas, tomadas em excesso, ou em horários diferentes dos prescritos podem diminuir sua resposta ao tratamento, afetando negativamente sua evolução clínica e qualidade de vida, gerando maiores custos à saúde pública do país.

Parkinson's disease is universal and the second most prevalent neurodegenerative disease among the elderly affecting between 0.5 and 1% of the population between 65 and 69 years of age. Adherence to medication is considered the main determinant for the effectiveness of treatment, but only recently has it been studied in patients with Parkinson's disease. This cross-sectional and descriptive study assessed adherence to medication in 112 patients with Parkinson's disease who regularly attended the movement disorder outpatient unit at the Hospital das Clinicas of the School of Medicine of Ribeirao Preto, University of São Paulo, using the Morisky and Green test and an instrument that assesses attitudes of medicine intake (IAAFTR). Of the patients interviewed, 53% failed to adhere to treatment and 52% did not take the medication at the correct time. Patients should receive guidance about the importance of taking their medication at the correct time, understanding the benefits that adherence to medication can provide. They should also be aware that doses not taken, taken in excess or not taken at the prescribed times can reduce their response to treatment, having a negative effect on the clinical outcome and quality of life, thereby generating higher costs to public health in the country.