Communicating diagnostic uncertainty reduces expectations of receiving antibiotics: Two online experiments with hypothetical patients.

The overprescription of antibiotics due to diagnostic uncertainty and inappropriate patient expectations influence antimicrobial resistance. This research assesses (i) whether communicating diagnostic uncertainty reduces expectations of receiving antibiotics and (ii) which communication strategies minimise unintended consequences of such communication. In two experimental online studies conducted in January and April 2023, participants read a vignette describing a doctor consultation for an ear infection and expressed their expectations of receiving antibiotics, trust in their doctor, rated the doctor's reputation and provided their intention to get a second doctor's opinion. Study 1 (N = 2213) investigated whether communicating diagnostic uncertainty and social externalities of antibiotic use (the negative social impacts of developing antibiotic resistance) decreases expectations for antibiotics and explores potential unintended consequences on the doctor-patient relationship. In Study 2 (N = 527), we aimed to replicate and extend the findings by adding specific treatment recommendations. Disclosing diagnostic uncertainty (vs. certainty) and communicating (vs. not communicating) the social externalities of antibiotic overuse reduced patients' expectations of receiving antibiotics. Yet, communicating uncertainty impaired trust in the doctor and the doctor's reputation. Combining the communication of uncertainty with specific treatment recommendations-particularly delayed antibiotic prescriptions-showed important to prevent these unintended consequences.

Myocardial proteome changes in aortic stenosis rats subjected to long-term aerobic exercise.

The effects of exercise training (ET) on the heart of aortic stenosis (AS) rats are controversial and the mechanisms involved in alterations induced by ET have been poorly clarified. In this study, we analyzed the myocardial proteome to identify proteins modulated by moderate-intensity aerobic ET in rats with chronic supravalvular AS. Wistar rats were divided into four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary aortic stenosis (AS-Sed), and exercised AS (AS-Ex). ET consisted of five treadmill running sessions per week for 16 weeks. Statistical analysis was performed by ANOVA or Kruskal-Wallis and Goodman tests. Results were discussed at a significance level of 5%. At the end of the experiment, AS-Ex rats had higher functional capacity, lower blood lactate concentration, and better cardiac structural and left ventricular (LV) functional parameters than the AS-Sed. Myocardial proteome analysis showed that AS-Sed had higher relative protein abundance related to the glycolytic pathway, oxidative stress, and inflammation, and lower relative protein abundance related to beta-oxidation than C-Sed. AS-Ex had higher abundance of one protein related to mitochondrial biogenesis and lower relative protein abundance associated with oxidative stress and inflammation than AS-Sed. Proteomic data were validated for proteins related to lipid and glycolytic metabolism. Chronic pressure overload changes the abundance of myocardial proteins that are mainly involved in lipid and glycolytic energy metabolism in rats. Moderate-intensity aerobic training attenuates changes in proteins related to oxidative stress and inflammation and increases the COX4I1 protein, related to mitochondrial biogenesis. Protein changes are combined with improved functional capacity, cardiac remodeling, and LV function in AS rats.

Understanding and reducing inappropriate antibiotic use in the context of delayed prescriptions.

OBJECTIVE: Antimicrobial resistance is a global health threat perpetuated by the overprescribing of antibiotics in primary care. One strategy to reduce antibiotic use in this setting is delayed prescribing. However, several psychological factors might undermine its effectiveness. The aim of the study was to test whether different interventions aiming at helping patients to manage diagnostic uncertainty in the period of watchful waiting promote appropriate antibiotic use. METHOD: We conducted a preregistered online experiment (N = 690 adult participants from the United Kingdom) in which we modeled delayed prescription in a decision task with behavior-contingent incentives. Participants had either a fictional viral or bacterial infection and received interventions that aimed at facilitating symptom monitoring (i.e., passive monitoring) and engaging participants in the task (i.e., active monitoring). RESULTS: Both interventions decreased antibiotic use when the disease was viral. Active monitoring was more efficient in decreasing antibiotic use than passive monitoring. CONCLUSIONS: The findings have practical implications for managing uncertainty and fostering appropriate antibiotic use in delayed prescribing situations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of early exercise on cardiac function and lipid metabolism pathway in heart failure.

We employed an early training exercise program, immediately after recovery from surgery, and before severe cardiac hypertrophy, to study the underlying mechanism involved with the amelioration of cardiac dysfunction in aortic stenosis (AS) rats. As ET induces angiogenesis and oxygen support, we aimed to verify the effect of exercise on myocardial lipid metabolism disturbance. Wistar rats were divided into Sham, trained Sham (ShamT), AS and trained AS (AST). The exercise consisted of 5-week sessions of treadmill running for 16 weeks. Statistical analysis was conducted by anova or Kruskal-Wallis test and Goodman test. A global correlation between variables was also performed using a two-tailed Pearson's correlation test. AST rats displayed a higher functional capacity and a lower cardiac remodelling and dysfunction when compared to AS, as well as the myocardial capillary rarefaction was prevented. Regarding metabolic properties, immunoblotting and enzymatic assay raised beneficial effects of exercise on fatty acid transport and oxidation pathways. The correlation assessment indicated a positive correlation between variables of angiogenesis and FA utilisation, as well as between metabolism and echocardiographic parameters. In conclusion, early exercise improves exercise tolerance and attenuates cardiac structural and functional remodelling. In parallel, exercise attenuated myocardial capillary and lipid metabolism derangement in rats with aortic stenosis-induced heart failure.

Aerobic Exercise Training Improves Calcium Handling and Cardiac Function in Rats with Heart Failure Resulting from Aortic Stenosis.

Aerobic exercise training (AET) has been used to manage heart disease. AET may totally or partially restore the activity and/or expression of proteins that regulate calcium (Ca2+) handling, optimize intracellular Ca2+ flow, and attenuate cardiac functional impairment in failing hearts. However, the literature presents conflicting data regarding the effects of AET on Ca2+ transit and cardiac function in rats with heart failure resulting from aortic stenosis (AoS). This study aimed to evaluate the impact of AET on Ca2+ handling and cardiac function in rats with heart failure due to AoS. Wistar rats were distributed into two groups: control (Sham; n = 61) and aortic stenosis (AoS; n = 44). After 18 weeks, the groups were redistributed into: non-exposed to exercise training (Sham, n = 28 and AoS, n = 22) and trained (Sham-ET, n = 33 and AoS-ET, n = 22) for 10 weeks. Treadmill exercise training was performed with a velocity equivalent to the lactate threshold. The cardiac function was analyzed by echocardiogram, isolated papillary muscles, and isolated cardiomyocytes. During assays of isolated papillary muscles and isolated cardiomyocytes, the Ca2+ concentrations were evaluated. The expression of regulatory proteins for diastolic Ca2+ was assessed via Western Blot. AET attenuated the diastolic dysfunction and improved the systolic function. AoS-ET animals presented an enhanced response to post-rest contraction and SERCA2a and L-type Ca2+ channel blockage compared to the AoS. Furthermore, AET was able to improve aspects of the mechanical function and the responsiveness of the myofilaments to the Ca2+ of the AoS-ET animals. AoS animals presented an alteration in the protein expression of SERCA2a and NCX, and AET restored SERCA2a and NCX levels near normal values. Therefore, AET increased SERCA2a activity and myofilament responsiveness to Ca2+ and improved the cellular Ca2+ influx mechanism, attenuating cardiac dysfunction at cellular, tissue, and chamber levels in animals with AoS and heart failure.

Hypoxia-Inducible Factor 1-Alpha and Glucose Metabolism during Cardiac Remodeling Progression from Hypertrophy to Heart Failure.

In pathological cardiac hypertrophy, the heart is more dependent on glucose than fatty acids. This shift in energy metabolism occurs due to several factors, including the oxygen deficit, which activates hypoxia-inducible factor-1α (HIF-1α), a critical molecule related to glucose metabolism. However, there are gaps regarding the behavior of key proteins in the glycolytic pathway and HIF-1α during the transition from hypertrophy to heart failure (HF). This study assesses the hypothesis that there is an early change and enhancement of HIF-1α and the glycolytic pathway, as well as an association between them during cardiac remodeling. Sham and aortic stenosis Wistar rats were analyzed at 2, 6, and 18 weeks and in HF (n = 10-18). Cardiac structure and function were investigated by echocardiogram. Myocardial glycolysis, the aerobic and anaerobic pathways and glycogen were analyzed by enzymatic assay, Western blot, and enzyme-linked immunosorbent assay (ELISA). The following were observed: increased left ventricular hypertrophy; early diastolic function change and severe systolic and diastolic dysfunction in HF; increased HIF-1α in the 2nd week and in HF; precocious alteration and intensification of glycolysis with a shift to anaerobic metabolism from the 6th week onwards; association between HIF-1α, glycolysis, and the anaerobic pathway. Our hypothesis was confirmed as there was an early change and intensification in glucose metabolism, alteration in HIF-1α, and an association between data during the progression from hypertrophy to heart failure.

Promoting prosociality toward future generations in antibiotic intake.

Understanding individuals' preferences for antibiotics can help mitigate the acceleration of antibiotic resistance. Similar to the climate crisis, individuals "today" need to appropriately use antibiotics to reduce the negative consequences of antibiotic resistance for individuals "tomorrow." We use an established-yet novel in this research field-behavioral game approach to investigate individuals' preferences for antibiotics in the face of a between-generations conflict. In an online study, we investigated whether a between-generations (vs within-generations) conflict in antibiotic intake leads to larger overuse and how to promote appropriate use of antibiotics. Results indicate that overuse in the face of a between-generations (vs within-generations) conflict increased. Eliciting empathy toward future generations in the case of a between-generations conflict decreased overuse. Findings suggest that different representations of this social dilemma can influence people's preferences for antibiotics, and that empathy-based interventions might promote appropriate antibiotic use.

Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil.

Background: By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods: This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings: Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation: Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).

Lessons learned about willingness to adopt various protective measures during the early COVID-19 pandemic in three countries.

BACKGROUND: Regarding the COVID-19 pandemic, concerted efforts have been invested in research to investigate and communicate the importance of complying with protective behaviors, such as handwashing and mask wearing. Protective measures vary in how effective they are in protecting the individual against infection, how much experience people have with them, whether they provide individual or societal protection, and how they are perceived on these dimensions. METHODS: This study assessed the willingness to follow recommended measures, depending on these features, among participants from Germany (n = 333), Hong Kong (n = 367), and the U.S. (n = 495). From April 24th to May 1st, 2020, individuals completed an online survey that assessed the antecedents of interest. RESULTS: It was shown that assumed effectiveness, previous experience, and intended self- and other-protection positively predicted willingness to comply across countries. When measures were mainly perceived as protecting others (vs. the self), individuals were less prone to adopt them. When a measure's effectiveness to protect the individual was perceived as lower, willingness to adopt the measure increased with higher levels of prior experience and collectivism. Moreover, protecting others was more strongly related to adoption when individuals had higher levels of collectivism and lower levels of individualism. CONCLUSIONS: Emphasizing the benefit for others could be a means to lower the potential detrimental effects of low assumed effectiveness for individual protection.

The Dysfunctional Scenario of the Major Components Responsible for Myocardial Calcium Balance in Heart Failure Induced by Aortic Stenosis. / Cenário Disfuncional dos Principais Componentes Responsáveis pelo Equilíbrio do Trânsito de Cálcio Miocárdico na Insuficiência Cardíaca Induzida por Estenose Aórtica.

BACKGROUND: Maladaptive cardiac remodelling is characterized by diastolic and systolic dysfunction, culminating in heart failure. In this context, the dysfunctional scenario of cardiac calcium (Ca2+) handling has been poorly studied. An experimental model of aortic stenosis has been extensively used to improve knowledge about the key mechanisms of cardiac pathologic remodelling. OBJECTIVE: To understand the dysfunctional process of the major components responsible for Ca2+ balance and its influence on cardiac function in heart failure induced by aortic stenosis. METHODS: Male 21-day-old Wistar rats were distributed into two groups: control (sham; n= 28) and aortic stenosis (AoS; n= 18). Cardiac function was analysed by echocardiogram, isolated papillary muscle, and isolated cardiomyocytes. In the papillary muscle assay, SERCA2a and L-type Ca2+ channel activity was evaluated. The isolated cardiomyocyte assay evaluated Ca2+ handling. Ca2+ handling protein expression was analysed by western blot. Statistical significance was set at p <0.05. RESULTS: Papillary muscles and cardiomyocytes from AoS hearts displayed mechanical malfunction. AoS rats presented a slower time to the Ca2+ peak, reduced Ca2+ myofilament sensitivity, impaired sarcoplasmic reticulum Ca2+ influx and reuptake ability, and SERCA2a and L-type calcium channel (LTCC) dysfunction. Moreover, AoS animals presented increased expression of SERCA2a, LTCCs, and the Na+/Ca2+ exchanger. CONCLUSION: Systolic and diastolic heart failure due to supravalvular aortic stenosis was paralleled by impairment of cellular Ca2+ influx and inhibition of sarcoplasmic reticulum Ca2+ reuptake due to LTCC and SERCA2a dysfunction, as well as changes in Ca2+ handling and expression of the major proteins responsible for cellular Ca2+ homeostasis.

FUNDAMENTO: O remodelamento cardíaco patológico se caracteriza por disfunção diastólica e sistólica, levando à insuficiência cardíaca. Neste contexto, o cenário disfuncional do trânsito de cálcio miocárdico (Ca2+) tem sido pouco estudado. Um modelo experimental de estenose aórtica tem sido extensamente utilizado para aprimorar os conhecimentos sobre os principais mecanismos do remodelamento patológico cardíaco. OBJETIVO: Entender o processo disfuncional dos principais componentes responsáveis pelo equilíbrio do cálcio miocárdico e sua influência sobre a função cardíaca na insuficiência cardíaca induzida pela estenose aórtica. MÉTODOS: Ratos Wistar de 21 dias de idade foram distribuídos em dois grupos: controle (placebo; n=28) e estenose aórtica (EaO; n=18). A função cardíaca foi analisada com o ecocardiograma, músculo papilar isolado e cardiomiócitos isolados. No ensaio do músculo papilar, SERCA2a e a atividade do canal de Ca2+ do tipo L foram avaliados. O ensaio de cardiomiócitos isolados avaliou o trânsito de cálcio. A expressão proteica da proteínas do trânsito de cálcio foi analisada com o western blot. Os resultados foram estatisticamente significativos quando p <0,05. RESULTADOS: Os músculos papilares e cardiomiócitos dos corações no grupo EaO demonstraram falhas mecânicas. Os ratos com EaO apresentaram menor tempo de pico do Ca2+, menor sensibilidade das miofibrilas do Ca2+, prejuízos nos processos de entrada e recaptura de cálcio pelo retículo sarcoplasmático, bem como disfunção no canal de cálcio do tipo L (CCTL). Além disso, os animais com EaO apresentaram maior expressão de SERCA2a, CCTL e trocador de Na+/Ca2+. CONCLUSÃO: Insuficiência cardíaca sistólica e diastólica devido à estenose aórtica supravalvular acarretou comprometimento da entrada de Ca2+ celular e inibição da recaptura de cálcio pelo retículo sarcoplasmático devido à disfunção no CCTL e SERCA2a, assim como mudanças no trânsito de cálcio e na expressão das principais proteínas responsáveis pela homeostase de Ca2+ celular.

Behavioral determinants of antibiotic resistance: The role of social information.

The increasing development of resistant pathogens is one of the greatest global health challenges. As antibiotic overuse amplifies antibiotic resistance, antibiotic intake poses a social dilemma in which individuals need to decide whether to prosocially reduce their intake in the collective interest versus to (over)use it even in case of mild diseases. We devise a novel behavioral game paradigm to model the social dilemma of antibiotic intake. Using this new method in an incentivized laboratory experiment (N = 272 German participants), we varied whether players had mutual knowledge about their antibiotic intake. The results indicate that there was substantial antibiotic overuse in the absence of social information. Overuse decreased when social information was present. Our postexperimental survey data further suggest that social information impacts people's behavioral motivation, evaluation of the other player, and positive affect. Taken together, providing social information about people's antibiotic intake may help in reducing antibiotic overuse. On a more general level, the novel behavioral game may be adapted to study other aspects of antibiotic intake to promote prudent use of antibiotics.

Metodologias de ensino do karatê-do shotokan para crianças / Shotokan karatê teaching methodologies for children / Metodologías para enseñar karate-do skhotokan a niños

O presente artigo tem como objetivo, caracterizar as diferentes metodologias de ensino do Karatê-Do Shotokan para crianças. Utilizando-se de uma pesquisa realizada de forma indireta, por meio de uma revisão bibliográfica. Onde encontrou-se, que as lutas são manifestações elementares da cultura corporal, sofrendo ao longo do tempo constantes modificações, culminando no surgimento de inúmeras lutas ou artes marciais. Entre elas o Karatê-Do Shotokan, tendo como forma tradicional de ensino os três K, pautado no método analítico. Entretanto, no processo de ensino torna-se importante permitir conhecimentos da ciência e da pedagogia do esporte, através das dimensões do ensino e de métodos de ensino global das lutas. E concluiu-se, que para a evolução das crianças no Karatê-Do Shotokan é necessário se pensar em mecanismos pedagógicos, com objetivos claros e concretos, utilizando dos métodos parcial e global, fundamentados nas dimensões do ensino.

This article aims to characterize the different teaching methodologies of Karate-Do Shotokan for children. Using an indirect research, through a bibliographic review. Where it was found, that fights are elementary manifestations of body culture, undergoing constant changes over time, culminating in the emergence of numerous fights or martial arts. Among them the Karate-Do Shotokan, having the three K as a traditional teaching method, based on the analytical method. However, in the teaching process it is important to allow knowledge of science and sport pedagogy, through the dimensions of teaching and methods of global teaching of struggles. And it was concluded that for the evolution of children in Karate-Do Shotokan it is necessary to think about pedagogical mechanisms, with clear and concrete objectives, using partial and global methods, based on the dimensions of teaching.

Este artículo tiene como objetivo caracterizar las diferentes metodologías de enseñanza del Karate-Do Shotokan para niños. Mediante una investigación indirecta, a través de una revisión bibliográfica. Donde se encontró, que las peleas son manifestaciones elementales de la cultura corporal, que experimentan cambios constantes a lo largo del tiempo, culminando con el surgimiento de numerosas peleas o artes marciales. Entre ellos el Karate-Do Shotokan, que tiene las tres K como método de enseñanza tradicional, basado en el método analítico. Sin embargo, en el proceso de enseñanza es importante permitir el conocimiento de la pedagogía científica y deportiva, a través de las dimensiones de la enseñanza y los métodos de enseñanza global de las luchas. Y se concluyó que para la evolución de los niños en Karate-Do Shotokan es necesario pensar en mecanismos pedagógicos, con objetivos claros y concretos, utilizando métodos parciales y globales, basados en las dimensiones de la enseñanza.

Adjustments in ß-Adrenergic Signaling Contribute to the Amelioration of Cardiac Dysfunction by Exercise Training in Supravalvular Aortic Stenosis.

BACKGROUND/AIMS: Aortic stenosis-induced chronic pressure overload leads to cardiac dysfunction and congestive heart failure. The pathophysiological mechanisms of the myocardial impairment are multifactorial and include maladaptive ß-adrenergic signaling. Exercise training (ET) has been used as a non-pharmacological therapy for heart failure management. The present study tested the hypothesis that exercise training attenuates diastolic dysfunction through ß-adrenergic signaling preservation. METHODS: Wistar rats were submitted to ascending aortic stenosis (AS) surgery, and after 18 weeks, a moderate aerobic exercise training protocol was performed for ten weeks. RESULTS: ET attenuated diastolic dysfunction, evaluated by echocardiogram and isolated papillary muscle (IPM) assay. Also, ET reduced features of heart failure, cross-sectional cardiomyocyte area, and exercise intolerance, assessed by treadmill exercise testing. The ß2 adrenergic receptor protein expression was increased in AS rats independently of exercise. Interestingly, ET restored the protein levels of phosphorylated phospholamban at Serine 16 and preserved the ß-adrenergic receptor responsiveness as visualized by the lower myocardial compliance decline and time to 50% tension development and relaxation during ß-adrenergic stimulation in the IPM than untrained rats. Additionally, AS rats presented higher levels of TNFα and iNOS, which were attenuated by ET. CONCLUSION: Moderate ET improves exercise tolerance, reduces heart failure features, and attenuates diastolic dysfunction. In the myocardium, ET decreases the cross-sectional area of the cardiomyocyte and preserves the ß-adrenergic responsiveness, which reveals that the adjustments in ß-adrenergic signaling contribute to the amelioration of cardiac dysfunction by mild exercise training in aortic stenosis rats.

Cardioprotection Generated by Aerobic Exercise Training is Not Related to the Proliferation of Cardiomyocytes and Angiotensin-(1-7) Levels in the Hearts of Rats with Supravalvar Aortic Stenosis.

BACKGROUND/AIMS: The beneficial effect of aerobic exercise training (ET) on cardiac remodeling caused by supravalvar aortic stenosis (AS) has been demonstrated in experimental studies; however, the mechanisms responsible for improving cardiac function are not entirely understood. We evaluated whether ET-generated cardioprotection in pressure-overloaded rats is dependent on cardiomyocyte proliferation, increased angiotensin-(1-7) (Ang-1-7) levels, and its receptor in the myocardium. METHODS: Eighteen weeks after ascending AS surgery, Wistar rats were randomly assigned to four groups: sedentary control (C-Sed), exercised control (C-Ex), sedentary aortic stenosis (AS-Sed) and exercised aortic stenosis (AS-Ex) groups. The moderate treadmill exercise protocol was performed for ten weeks. The functional capacity was assessed by treadmill exercise testing. Cardiac structure and function were evaluated by echocardiogram. Cardiomyocyte proliferation was evaluated by flow cytometry. Expression of cell cycle regulatory genes as CCND2, AURKB, CDK1, and MEIS1 was verified by RT-qPCR. Cardiac and plasma angiotensin I (Ang I), angiotensin II (Ang II), and Ang-(1-7) levels were analyzed by high-performance liquid chromatography (HPLC). The angiotensin-converting enzyme (ACE) activity was assessed by the fluorometric method and protein expression of AT1 and Mas receptors by Western blot. RESULTS: The AS-Ex group showed reduced left ventricular wall relative thickness and improved ejection fraction; also, it showed decreased gene expression of myocyte cell cycle regulators, ACE, Ang I, Ang II and Ang II/Ang-(1-7) ratio levels compared to AS-Sed group. However, ET did not induce alterations in Ang-(1-7) and cardiac Mas receptor expression and myocyte proliferation. CONCLUSION: Aerobic exercise training improves systolic function regardless of myocyte proliferation and Ang-(1-7)/Mas receptor levels. However, the ET negatively modulates the vasoconstrictor/hypertrophic axis (ACE/Ang II) and decreases the expression of negative regulatory genes of the cell cycle in cardiomyocytes of rats with supravalvular aortic stenosis.

Increased angiotensin II from adipose tissue modulates myocardial collagen I and III in obese rats.

It has been described that the cardiac dysfunction in the obesity model is because of collagen imbalance and that angiotensin II (Ang II) contributes to myocardial fibrosis. However, it remains undefined if changes in collagen I and III metabolism in obesity is due to the renin-angiotensin system (RAS) dysregulation from myocardium or excessive adipose tissue. AIM: This study aimed to verify whether the changes in myocardial collagen metabolism result from RAS deregulation of cardiac or adipose tissue in an obesity model. MAIN METHODS: Wistar rats were fed with control (CD) and high-fat (HFD) diets for 30 weeks. After the dietary intervention, animals were assigned to be treated with losartan at the 30 mg/kg/day dosage or kept untreated for an additional five weeks. KEY FINDINGS: HFD induced obesity, comorbidities, and cardiac collagen overexpression. The HFD group presented an increase in Ang II levels in both adipose tissue and plasma, as well as AT1 receptor expression in cardiac tissue. Of note, the myocardial Ang II was not changed in the HFD group. Losartan administration reduced some obesity-induced comorbidities regardless of weight loss. The AT1 receptor blockade also decreased the release of Ang II from adipose tissue and myocardial AT1 receptor and collagen. SIGNIFICANCE: It was seen that excessive adipose tissue is responsible for the exacerbated circulating Ang II, which induced cardiac fibrosis development.

The Effect of Intermittent Hemodialysis on the Hematological and Serum Biochemistry Profile in Dogs With Chronic Kidney Disease.

Intermittent hemodialysis (IHD) is a type of kidney replacement therapy commonly prescribed in veterinary medicine for cases of drug removal, fluid, acid-base, and electrolyte disorders, acute kidney injury, and cases of chronic kidney disease (CKD) in uremic crisis. This study aimed to evaluate the effects of intermittent hemodialysis in dogs with IRIS stage 4 CKD in contrast to dogs treated only with standard medical management, without dialysis, to improve their quality of life. Twenty-five dogs previously diagnosed with IRIS stage 4 CKD were selected for the study according to the inclusion criteria. Dogs were randomized to 2 distinct groups: the control group (n = 11), which underwent a conventional clinical treatment for CKD; and the hemodialysis group (n = 14), which underwent intermittent hemodialysis in addition to the clinical treatment. Both groups had a period of 15 days of clinical and laboratory evaluation. Laboratory analysis consisted of chemistry and hematological evaluation before and after both treatments at a minimum interval of 48 hours. Clinical parameters and eventual complications were assessed every 30 minutes during the IHD. When compared with conventional treatment, IHD was highly efficient in removing urea, creatinine, and phosphorus, but presented a hematological risk to the patient, requiring constant monitoring of hematological and biochemical profiles in order to correct alterations. Therefore, IHD is a highly recommended treatment if adequately monitored by trained professionals.

Landscape of heart proteome changes in a diet-induced obesity model.

Obesity is a pandemic associated with a high incidence of cardiovascular disease; however, the mechanisms are not fully elucidated. Proteomics may provide a more in-depth understanding of the pathophysiological mechanisms and contribute to the identification of potential therapeutic targets. Thus, our study evaluated myocardial protein expression in healthy and obese rats, employing two proteomic approaches. Male Wistar rats were established in two groups (n = 13/group): control diet and Western diet fed for 41 weeks. Obesity was determined by the adipose index, and cardiac function was evaluated in vivo by echocardiogram and in vitro by isolated papillary muscle analysis. Proteomics was based on two-dimensional gel electrophoresis (2-DE) along with mass spectrometry identification, and shotgun proteomics with label-free quantification. The Western diet was efficient in triggering obesity and impaired contractile function in vitro; however, no cardiac dysfunction was observed in vivo. The combination of two proteomic approaches was able to increase the cardiac proteomic map and to identify 82 differentially expressed proteins involved in different biological processes, mainly metabolism. Furthermore, the data also indicated a cardiac alteration in fatty acids transport, antioxidant defence, cytoskeleton, and proteasome complex, which have not previously been associated with obesity. Thus, we define a robust alteration in the myocardial proteome of diet-induced obese rats, even before functional impairment could be detected in vivo by echocardiogram.

Myocardial Dysfunction after Severe Food Restriction Is Linked to Changes in the Calcium-Handling Properties in Rats.

Severe food restriction (FR) impairs cardiac performance, although the causative mechanisms remain elusive. Since proteins associated with calcium handling may contribute to cardiac dysfunction, this study aimed to evaluate whether severe FR results in alterations in the expression and activity of Ca2+-handling proteins that contribute to impaired myocardial performance. Male 60-day-old Wistar-Kyoto rats were fed a control or restricted diet (50% reduction in the food consumed by the control group) for 90 days. Body weight, body fat pads, adiposity index, as well as the weights of the soleus muscle and lung, were obtained. Cardiac remodeling was assessed by morphological measures. The myocardial contractile performance was analyzed in isolated papillary muscles during the administration of extracellular Ca2+ and in the absence or presence of a sarcoplasmic reticulum Ca2+-ATPase (SERCA2a) specific blocker. The expression of Ca2+-handling regulatory proteins was analyzed via Western Blot. Severe FR resulted in a 50% decrease in body weight and adiposity measures. Cardiac morphometry was substantially altered, as heart weights were nearly twofold lower in FR rats. Papillary muscles isolated from FR hearts displayed mechanical dysfunction, including decreased developed tension and reduced contractility and relaxation. The administration of a SERCA2a blocker led to further decrements in contractile function in FR hearts, suggesting impaired SERCA2a activity. Moreover, the FR rats presented a lower expression of L-type Ca2+ channels. Therefore, myocardial dysfunction induced by severe food restriction is associated with changes in the calcium-handling properties in rats.

Prevalence of overweight and obesity in elementary school students of Vitória, ES / Prevalência de sobrepeso e obesidade em escolares do ensino fundamental de Vitória/ES

Although numerous studies have analyzed overweight and obesity among schoolchildren from various Brazilian regions, the data relative to the state of Espírito Santo (ES) remains scarce. Considering the information presented, the purpose of present study was to investigate the prevalence of overweight and obesity among elementary school students from Vitória, ES. This was a cross-sectional study including 572 school children between 7 to 14 years old enrolled in municipal elementary schools in Vitória, ES, totalling 310 girls and 262 boys, who were randomly selected by stratified cluster sampling. The prevalence of overweight and obesity was calculated based on the children's anthropometric profile according to percentage of body fat by measuring skinfold thickness and body mass index (BMI). Based on BMI, the prevalence of overweight was high in both sexes, with 20.6% among the boys and 20.9% among the girls. The prevalence of obesity did not differ between boys and girls, with 6.5% and 7.7%, respectively. The results of the skin-fold thickness of skin show that 31.3% of children attending municipal schools in Vitória/ES were classified as overweight. In summary, the current study found a high prevalence of overweight and obesity, reaffirming that the overweight reaches a significant proportion of children and adolescents who attend public elementary schools in the city of Vitória, ES

Embora numerosos estudos tenham analisado o sobrepeso e a obesidade entre escolares de várias regiões brasileiras, dados relativos ao estado do Espírito Santo (ES) ainda são escassos. Considerando as informações destacadas acima, o objetivo do presente estudo foi investigar a prevalência de sobrepeso e obesidade em crianças do ensino fundamental de Vitória/ ES. Estudo transversal com 572 escolares de 7 a 14 anos matriculados em escolas municipais do ensino fundamental de Vitória/ES, totalizando 310 meninas e 262 meninos, selecionados aleatoriamente por amostra de estratificada por conglomerados. A prevalência de sobrepeso e obesidade foi calculada com base no perfil antropométrico das crianças de acordo com a porcentagem de gordura corporal, medindo-se a espessura das dobras cutâneas e o índice de massa corporal (IMC). Com base no IMC, a prevalência de excesso de peso foi alta em ambos os sexos, com 20,6% entre os meninos e 20,9% entre as meninas. Os resultados da espessura da prega cutânea demonstram que 31,3% das crianças que frequentavam escolas municipais em Vitória/ES foram classificadas com excesso de peso. Em conclusão, o presente estudo encontrou alta prevalência de sobrepeso e obesidade, reafirmando que o excesso de peso atinge uma proporção significativa das crianças e adolescentes que frequentam escolas municipais em Vitória / ES