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1.
Cochrane Database Syst Rev ; 12: CD004022, 2020 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-33314019

RESUMO

BACKGROUND: Recent cohort studies show that salt intake below 6 g is associated with increased mortality. These findings have not changed public recommendations to lower salt intake below 6 g, which are based on assumed blood pressure (BP) effects and no side-effects. OBJECTIVES: To assess the effects of sodium reduction on BP, and on potential side-effects (hormones and lipids) SEARCH METHODS: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to April 2018 and a top-up search in March 2020: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions. The top-up search articles are recorded under "awaiting assessment." SELECTION CRITERIA: Studies randomizing persons to low-sodium and high-sodium diets were included if they evaluated at least one of the outcome parameters (BP, renin, aldosterone, noradrenalin, adrenalin, cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride,. DATA COLLECTION AND ANALYSIS: Two review authors independently collected data, which were analysed with Review Manager 5.3. Certainty of evidence was assessed using GRADE. MAIN RESULTS: Since the first review in 2003 the number of included references has increased from 96 to 195 (174 were in white participants). As a previous study found different BP outcomes in black and white study populations, we stratified the BP outcomes by race. The effect of sodium reduction (from 203 to 65 mmol/day) on BP in white participants was as follows: Normal blood pressure: SBP: mean difference (MD) -1.14 mmHg (95% confidence interval (CI): -1.65 to -0.63), 5982 participants, 95 trials; DBP: MD + 0.01 mmHg (95% CI: -0.37 to 0.39), 6276 participants, 96 trials. Hypertension: SBP: MD -5.71 mmHg (95% CI: -6.67 to -4.74), 3998 participants,88 trials; DBP: MD -2.87 mmHg (95% CI: -3.41 to -2.32), 4032 participants, 89 trials (all high-quality evidence). The largest bias contrast across studies was recorded for the detection bias element. A comparison of detection bias low-risk studies versus high/unclear risk studies showed no differences. The effect of sodium reduction (from 195 to 66 mmol/day) on BP in black participants was as follows: Normal blood pressure: SBP: mean difference (MD) -4.02 mmHg (95% CI:-7.37 to -0.68); DBP: MD -2.01 mmHg (95% CI:-4.37, 0.35), 253 participants, 7 trials. Hypertension: SBP: MD -6.64 mmHg (95% CI:-9.00, -4.27); DBP: MD -2.91 mmHg (95% CI:-4.52, -1.30), 398 participants, 8 trials (low-quality evidence). The effect of sodium reduction (from 217 to 103 mmol/day) on BP in Asian participants was as follows: Normal blood pressure: SBP: mean difference (MD) -1.50 mmHg (95% CI: -3.09, 0.10); DBP: MD -1.06 mmHg (95% CI:-2.53 to 0.41), 950 participants, 5 trials. Hypertension: SBP: MD -7.75 mmHg (95% CI:-11.44, -4.07); DBP: MD -2.68 mmHg (95% CI: -4.21 to -1.15), 254 participants, 8 trials (moderate-low-quality evidence).   During sodium reduction renin increased 1.56 ng/mL/hour (95%CI:1.39, 1.73) in 2904 participants (82 trials); aldosterone increased 104 pg/mL (95%CI:88.4,119.7) in 2506 participants (66 trials); noradrenalin increased 62.3 pg/mL: (95%CI: 41.9, 82.8) in 878 participants (35 trials); adrenalin increased 7.55 pg/mL (95%CI: 0.85, 14.26) in 331 participants (15 trials); cholesterol increased 5.19 mg/dL (95%CI:2.1, 8.3) in 917 participants (27 trials); triglyceride increased 7.10 mg/dL (95%CI: 3.1,11.1) in 712 participants (20 trials); LDL tended to increase 2.46 mg/dl (95%CI: -1, 5.9) in 696 participants (18 trials); HDL was unchanged -0.3 mg/dl (95%CI: -1.66,1.05) in 738 participants (20 trials) (All high-quality evidence except the evidence for adrenalin). AUTHORS' CONCLUSIONS: In white participants, sodium reduction in accordance with the public recommendations resulted in mean arterial pressure (MAP) decrease of about 0.4 mmHg in participants with normal blood pressure and a MAP decrease of about 4 mmHg in participants with hypertension. Weak evidence indicated that these effects may be a little greater in black and Asian participants. The effects of sodium reduction on potential side effects (hormones and lipids) were more consistent than the effect on BP, especially in people with normal BP.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Dieta Hipossódica , Hipertensão/dietoterapia , Cloreto de Sódio na Dieta/farmacologia , Grupo com Ancestrais do Continente Africano , Aldosterona/sangue , Grupo com Ancestrais do Continente Asiático , Viés , Catecolaminas/sangue , Colesterol/sangue , Intervalos de Confiança , Epinefrina/sangue , Grupo com Ancestrais do Continente Europeu , Humanos , Hipertensão/etnologia , Norepinefrina/sangue , Ensaios Clínicos Controlados Aleatórios como Assunto , Recomendações Nutricionais , Renina/sangue , Triglicerídeos/sangue
3.
PLoS One ; 15(7): e0236742, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730302

RESUMO

Surgical castration of male piglets without analgesia is a painful procedure. This prospective, randomized and double-blinded study aimed to evaluate the analgesic effects of four different local anesthetics for piglet castration during the first week of life. In total, 54 piglets aged 3 to 7 days were distributed into 6 treatment groups: handling (H); castration without pain relief (sodium chloride, NaCl); and castration with a local anesthetic: 4% procaine (P), 2% lidocaine (L), 0.5% bupivacaine (B) or 20 mg/ml mepivacaine (M). By excluding stress and fear as disruptive factors via a minimum anesthesia model, all piglets received individual minimum alveolar concentration (MAC) isoflurane anesthesia. Twenty minutes before castration, all treatment groups except group H received one injection per testis. Then, 0.5 ml of a local anesthetic or NaCl was injected intratesticularly (i.t.), and 0.5 ml was administered subscrotally. Acute physiological responses to noxious stimuli at injection and castration were evaluated by measuring blood pressure (BP), heart rate (HR), cortisol, epinephrine, norepinephrine and chromogranin A (CgA); limb movements were quantified. The results confirm that castration without analgesia is highly painful. Surgical castration without pain relief revealed significant changes in mean arterial blood pressure (MAP) and HR. Local anesthetic administration significantly reduced changes in BP and HR associated with castration. Piglets receiving a preoperative local anesthetic exhibited the fewest limb movements during castration, while the NaCl group exhibited the most. Injection itself was not associated with significant changes in MAP or HR. However, many piglets exhibited limb movements during injection, indicating that the injection itself causes nociceptive pain. No significant differences were found between groups regarding parameters of plasma cortisol, catecholamines and CgA. In conclusion, all four local anesthetics administered are highly effective at reducing signs of nociception during castration under light isoflurane anesthesia. However, injection of a local anesthetic seems to be painful.


Assuntos
Anestesia Geral/veterinária , Anestésicos Locais/administração & dosagem , Pressão Sanguínea , Castração/veterinária , Extremidades/fisiologia , Movimento , Animais , Animais Recém-Nascidos , Castração/métodos , Catecolaminas/sangue , Frequência Cardíaca , Hidrocortisona/sangue , Masculino , Suínos
4.
Am J Physiol Regul Integr Comp Physiol ; 319(1): R123-R131, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32491938

RESUMO

Fetal heart rate (FHR) variability (FHRV) and ST segment morphology are potential clinical indices of fetal well-being during labor. ß-Adrenergic stimulation by circulating catecholamines has been hypothesized to contribute to both FHRV and ST segment morphology during labor, but this has not been tested during brief repeated fetal hypoxemia that is characteristic of labor. Near-term fetal sheep (0.85 gestation) received propranolol (ß-adrenergic blockade; n = 10) or saline (n = 7) 30 min before being exposed to three 2-min complete umbilical cord occlusions (UCOs) separated by 3-min reperfusions. T/QRS ratio was calculated throughout UCOs and reperfusion periods, and measures of FHRV (RMSSD, SDNN, and STV) were calculated between UCOs. During the baseline period, before the start of UCOs, propranolol was associated with reduced FHR, SDNN, and STV but did not affect RMSSD or T/QRS ratio. UCOs were associated with rapid FHR decelerations and increased T/QRS ratio; propranolol significantly reduced FHR during UCOs and was associated with a slower rise in T/QRS ratio during the first UCOs, without affecting the maximal rise or T/QRS ratio during the second and third UCO. Between UCOs propranolol reduced FHR and T/QRS ratio but did not affect any measure of FHRV. These data demonstrate that circulating catecholamines do not contribute to FHRV during labor-like hypoxemia. Furthermore, circulating catecholamines did not contribute to the major rise in T/QRS ratio during labor-like hypoxemia but may regulate T/QRS ratio between brief hypoxemia.


Assuntos
Catecolaminas/fisiologia , Frequência Cardíaca Fetal/fisiologia , Carneiro Doméstico/fisiologia , Cordão Umbilical/fisiologia , Agonistas Adrenérgicos beta/farmacologia , Antagonistas Adrenérgicos beta/farmacologia , Adulto , Animais , Catecolaminas/sangue , Eletrocardiografia , Feminino , Hipóxia Fetal/fisiopatologia , Humanos , Hipóxia/fisiopatologia , Trabalho de Parto , Gravidez , Propranolol/farmacologia
5.
Ann Surg Oncol ; 27(5): 1329-1337, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32112212

RESUMO

This first part of a two-part review of pheochromocytoma and paragangliomas (PPGLs) addresses clinical presentation, diagnosis, management, treatment, and outcomes. In this first part, the epidemiology, prevalence, genetic etiology, clinical presentation, and biochemical and radiologic workup are discussed. In particular, recent advances in the genetics underlying PPGLs and the recommendation for genetic testing of all patients with PPGL are emphasized. Finally, the newer imaging methods for evaluating of PPGLs are discussed and highlighted.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Paraganglioma Extrassuprarrenal/diagnóstico , Feocromocitoma/diagnóstico , Abdome , Neoplasias das Glândulas Suprarrenais/epidemiologia , Neoplasias das Glândulas Suprarrenais/genética , Neoplasias das Glândulas Suprarrenais/fisiopatologia , Arritmias Cardíacas/fisiopatologia , Catecolaminas/sangue , Catecolaminas/urina , Células Cromafins/metabolismo , Gânglios Parassimpáticos , Gânglios Simpáticos , Testes Genéticos , Cefaleia/fisiopatologia , Humanos , Hipertensão/fisiopatologia , Neoplasia Endócrina Múltipla Tipo 2a/diagnóstico , Neoplasia Endócrina Múltipla Tipo 2a/genética , Neoplasia Endócrina Múltipla Tipo 2b/diagnóstico , Neoplasia Endócrina Múltipla Tipo 2b/genética , Síndromes Neoplásicas Hereditárias/diagnóstico , Síndromes Neoplásicas Hereditárias/genética , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/genética , Paraganglioma/diagnóstico , Paraganglioma/epidemiologia , Paraganglioma/genética , Paraganglioma/fisiopatologia , Paraganglioma Extrassuprarrenal/epidemiologia , Paraganglioma Extrassuprarrenal/genética , Paraganglioma Extrassuprarrenal/metabolismo , Pelve , Feocromocitoma/epidemiologia , Feocromocitoma/genética , Feocromocitoma/fisiopatologia , Sudorese/fisiologia , Doença de von Hippel-Lindau/diagnóstico , Doença de von Hippel-Lindau/genética
6.
Int Heart J ; 61(2): 316-324, 2020 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-32173711

RESUMO

The mechanisms of urgently presenting acute heart failure (AHF) are not clear. We evaluated the serum catecholamine values of AHF patients immediately after admission. A total of 1,475 AHF patients were screened, and 484 who were admitted from their homes and in whom serum catecholamine could be evaluated immediately after admission were analyzed. The patients were divided into three groups according to the time interval from the onset of symptoms to admission (OA): < 3 hours (early-OA group; n = 283), 3-24 hours (middle-OA group; n = 142), and ≥24 hours (late-OA group; n = 59). In the early-OA group, the systolic blood pressure (SBP) was significantly higher, orthopnea was more frequent, the pH value was significantly decreased, and the use of noninvasive positive-pressure ventilation was required significantly more often than in the other groups. The serum noradrenaline level was significantly increased in the early-OA group (1.96 [1.02-3.60] ng/mL) than in the middle-OA (1.49 [0.73-3.41] ng/mL) and late-OA (1.40 [0.91-2.42] ng/mL) groups, and the adrenaline level was significantly increased in the early-OA group (0.36 [0.13-1.17] ng/mL) than in the late-OA (0.22 [0.09-0.52] ng/mL) group. A multivariate logistic regression model indicated the early-OA group was independently associated with the SBP > 140 mmHg (odds ratio [OR]: 2.219, 95% CI: 1.375-3.581), midnight/early morning admission (OR: 3.158, 95% CI: 2.048-4.868), and high serum catecholamine value (adrenaline > 0.96 ng/mL, noradrenaline > 3.39 ng/mL, and dopamine > 0.21 ng/mL) (OR 2.091, 95% CI: 1.161-3.767). In conclusion, urgently presented AHF might be induced by an endogenous catecholamine surge, which causes an excessive rise in blood pressure leading to increased after-overload and volume-shift lung congestion.


Assuntos
Catecolaminas/sangue , Insuficiência Cardíaca/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/mortalidade , Humanos , Japão/epidemiologia , Masculino , Estudos Retrospectivos
7.
Appl Ergon ; 85: 103065, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32174353

RESUMO

The aim of this study was to employ validated biological markers to quantify the physiologic consequences of exposure to whole-body vibration (WBV) and evaluate the relative impact of mining vehicle operator vibration exposure on physiological responses as compared to vertical-axial dominant WBV. In a laboratory-based study with a repeated-measures design, we played actual field-measured floor vibration profiles into a 6-degree-of-freedom motion platform to create different realistic WBV exposures: 1) vertical-dominant vibration collected from long-haul trucks, 2) multi-axial vibration collected from mining heavy equipment vehicles, and 3) no vibration (control condition). Circulating biomarkers of interest were cortisol and catecholamines (epinephrine and norepinephrine) to assess physiological stress, interleukin-6 (IL-6) and tumor necrosis factor-α (TNFα) to test for inflammation, thiobarbituric acid reactive substances (TBARS) to measure oxidative stress, and myoglobin and plasma creatine kinase to assess muscle damage. We collected blood samples at pre-exposure (0 h), during-exposure (2 and 4 h), and 2 h into recovery after the WBV exposure (6 h) in all four exposure conditions. The results showed that a single, 4-h acute exposure to WBV may not be sufficient to induce skeletal muscle damage, inflammation or physiologic stress measurable in the blood. No significant differences were observed between conditions for any of the biomarkers that could be attributed to the exposure contrast between vertical-dominant and multi-axial WBV exposures. These findings further indicate known complications of WBV exposure likely arise secondary to chronic, repeated exposures that give rise to subclinical stresses that were not captured here.


Assuntos
Mineração , Doenças Profissionais/sangue , Exposição Ocupacional/efeitos adversos , Estresse Fisiológico/fisiologia , Vibração/efeitos adversos , Adulto , Biomarcadores/sangue , Catecolaminas/sangue , Creatina Quinase/sangue , Feminino , Voluntários Saudáveis , Humanos , Hidrocortisona/sangue , Interleucina-6/sangue , Masculino , Veículos Automotores , Mioglobina/sangue , Doenças Profissionais/etiologia , Estresse Oxidativo , Fator de Necrose Tumoral alfa/sangue , Trabalho/fisiologia
8.
Mikrochim Acta ; 187(3): 165, 2020 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-32052188

RESUMO

For the first time, boronate affinity chromatography and metal oxide affinity chromatography mechanisms for cis-diol-compounds extraction are simultaneously realized on a single material, termed borated zirconia. This material was prepared by hydrolyzing zirconium butoxide with boric acid under non-aqueous environment. The diameter of formed particles is around 200 nm. By extracting catechol under different pH conditions or with phosphate ion competition, the dual affinity mechanisms of borated zirconia are confirmed. Benefiting from such unique feature, borated zirconia can function well under neutral condition. By using borated zirconia for dispersive solid phase extraction, specific capture of cis-diol-containing catecholamines, including epinephrine (E), norepinephrine (NE) and dopamine (DA), was achieved. A reliable LC-MS/MS method was established and validated for quantification of these target analytes in plasma samples after derivatisation with benzoyl chloride. The linear ranges are 0.010-0.200 ng·mL-1 for E and DA, and 0.050-1.000 ng·mL-1 for NE. The limits of quantification are 0.008, 0.020 and 0.004 ng·mL-1 for E, NE and DA respectively. By analyzing samples from healthy volunteers and schizophrenia patients, the plasma concentrations of E, NE and DA were found to be higher for the latter. Graphical AbstractSchematic representation of boronate combined metal oxide affinity chromatography (BMOAC) extraction of cis-diol catecholamines from human plasma by borated zirconia following with benzoyl chloride derivatization and LC-MS determination.


Assuntos
Catecolaminas/sangue , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Zircônio/química , Humanos
9.
Anesth Analg ; 130(4): 1054-1062, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-30346356

RESUMO

BACKGROUND: Organ ischemia-reperfusion injury often induces local and systemic inflammatory responses, which in turn worsen organ injury. These inflammatory responses can be regulated by the central nervous system, particularly by the vagal nerve and nicotinic acetylcholine receptors, which are the key components of cholinergic anti-inflammatory pathway. Activation of the cholinergic anti-inflammatory pathway can suppress excessive inflammatory responses and be a potential strategy for prevention of ischemia-reperfusion injury of organs including the kidney. METHODS: Vagal nerve activity, plasma acetylcholine, catecholamine and inflammatory mediators, renal tissue injury, and cell death were measured in mice with bilateral renal ischemia/reperfusion with or without treatment with dexmedetomidine (Dex), an α2-adrenergic receptor agonist. RESULTS: Dex significantly increased the discharge frequency of the cervical vagal nerve by up to 142 Hz (mean) (P < .001), and preserved kidney gross morphology and structure and attenuated cell apoptosis after ischemia-reperfusion. Furthermore, Dex also significantly increased acetylcholine release to 135.8 pmol/L (median) when compared to that (84.7 pmol/L) in the sham group (P < .001) and reduced the levels of several inflammatory mediators induced by renal ischemia/reperfusion. All the effects were abolished by vagotomy, splenectomy, or combinative administration of atipamezole, an α2-adrenergic receptor antagonist. CONCLUSIONS: Our findings suggest that Dex provides renoprotection, at least in part, through anti-inflammatory effects of the parasympathetic nervous system activation in addition to its direct actions on α2-adrenergic receptors.


Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/farmacologia , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Anti-Inflamatórios/farmacologia , Dexmedetomidina/farmacologia , Dexmedetomidina/uso terapêutico , Nefropatias/prevenção & controle , Sistema Nervoso Parassimpático/efeitos dos fármacos , Traumatismo por Reperfusão/prevenção & controle , Acetilcolina/sangue , Antagonistas de Receptores Adrenérgicos alfa 2/farmacologia , Animais , Apoptose/efeitos dos fármacos , Catecolaminas/sangue , Imidazóis/farmacologia , Mediadores da Inflamação/metabolismo , Rim/patologia , Nefropatias/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Nervo Vago/fisiopatologia
10.
J Strength Cond Res ; 34(1): 104-113, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30707143

RESUMO

Soria, M, Ansón, M, Lou-Bonafonte, JM, Andrés-Otero, MJ, Puente, JJ, and Escanero, J. Fat oxidation rate as a function of plasma lipid and hormone response in endurance athletes. J Strength Cond Res 34(1): 104-113, 2020-Plasma lipid changes during incremental exercise are not well known. The aim of this study was to investigate the relationship among fat oxidation rate, plasma lipids, and hormone concentrations in well-trained athletes. Twenty-six trained triathletes completed a graded cycle ergometer test to exhaustion increasing by 0.5 W·kg every 10 minutes. Fat oxidation rates were determined using indirect calorimetry. For each individual, maximal fat oxidation (MFO), the intensity at which MFO occurred (Fatmax), and the intensity at which fat oxidation became negligible (Fatmin) were determined. Blood samples for lipids and hormones analysis were collected at the end of each stage of the graded exercise test. All variables studied except insulin showed an increase at the end of incremental protocol with respect to basal levels. Free fatty acid reached significant increase at 60%VO2max and maximal levels at 70%VO2max. Low-density lipoprotein (LDL) and triglycerides (TG) decreased and showed lowest levels at 60%VO2max and reaching significant increases after 80%VO2max. High-density lipoprotein reached significant increase at 60%VO2max. Adrenaline and noradrenaline increased until the end of the incremental exercise, and significant differences were from 50%VO2max. These results suggest that exercise intensities are related to plasma lipids levels. In the zone when lipids oxidation is maximal, plasma LDL and TG variation differs from other lipids. These results may have application for the more adequate exercise intensity prescription to maximize the beneficial effects of exercise.


Assuntos
Tecido Adiposo/metabolismo , Hormônios/sangue , Metabolismo dos Lipídeos , Lipídeos/sangue , Resistência Física , Adulto , Atletas , Calorimetria Indireta , Catecolaminas/sangue , Ergometria , Exercício Físico/fisiologia , Teste de Esforço , Ácidos Graxos não Esterificados/sangue , Humanos , Insulina/sangue , Masculino , Oxirredução , Consumo de Oxigênio
11.
Intern Med ; 59(6): 793-797, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31813909

RESUMO

A 46-year-old woman complained of a 10-year history of headache, nausea, a precordial oppressive feeling and shortness of breath on miction. She had noted a marked elevation in her blood pressure after miction using home blood pressure measurement. Her catecholamine levels were less than twice the value of the normal upper limit. Several imaging modalities detected a urinary bladder tumor, and 123I-metaiodobenzylguanidine scintigraphy showed positive accumulation. The diagnosis of urinary bladder paraganglioma was confirmed by partial cystectomy. We must keep in mind that paroxysms and hypertension associated with miction are important diagnostic clues of pheochromocytoma/paraganglioma. Home blood pressure measurement was very useful for detecting hypertension in this case.


Assuntos
Hipertensão/etiologia , Paraganglioma/complicações , Paraganglioma/patologia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/patologia , Micção/fisiologia , Pressão Sanguínea , Determinação da Pressão Arterial , Catecolaminas/sangue , Cistectomia , Feminino , Humanos , Pessoa de Meia-Idade , Paraganglioma/diagnóstico por imagem , Paraganglioma/cirurgia , Cintilografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia
12.
J Sports Med Phys Fitness ; 60(4): 643-649, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31818057

RESUMO

BACKGROUND: Beta-blockers are still frequently used in cardiovascular diseases but may negatively influence the exercise capacity. The aim of the study was to analyze the effect of beta-blockade on physical performance and plasma level of catecholamine during different forms of exercise. METHODS: Ten prehypertensive athletes (age: 25.1±2.5 years, BMI: 24.4±2.4 kg/m2) performed repeated incremental exercise and steady-state-tests without and with the cardioselective beta-blocker bisoprolol (5mg/day). The cardiopulmonary, metabolic and the catecholamine responses were monitored. RESULTS: Beta-blocker treatment had no effect on maximum power output (Pmax), lactate and the maximal oxygen uptake (VO2max) (Pmax: 269.0±41.5 vs. 269.0±41.5 W; lactate: 8.7±2.6 vs. 8.6±3.2 mmol/L and VO2max: 3110±482 vs. 3077±425 mL/min, respectively; P not significant). Epinephrine and norepinephrine showed a similar exponential increase to maximum load with and without beta-blockade (epinephrinemax 1.92±1.8 vs. 1.93±1.3 nmol/L; P not significant; norepinephrinemax 12.78±7.9 vs. 16.89±12.2 nmol/L; P not significant). Beta-blockade lowered heart rate (HR) and systolic blood pressure (SBP) at rest and under maximum load (ΔHRrest: 10.6±11.1 bpm, P<0.05, ΔHR-Max: 27.8±6.6 bpm, P<0.01; ΔSBPrest: 19.4±9.3 mmHg, P<0.05, ΔSBPmax: 17.7±15.3 mmHg, P<0.01). The maximum oxygen pulse was higher in the tests performed under beta-blockade (IET: ΔVO2/HR: 3.1±2.2 mL/beat, P<0.01; SST: ΔVO2/HR: 3.4±1.4 mL/beat, P<0.001). CONCLUSIONS: Despite beta blockade and resulting differences in cardiopulmonary regulation during the exercise tests, the maximal oxygen capacity and the catecholamine concentration was similar. Higher exercise intensities (>50% Pmax) are associated with a marked increase in plasma catecholamines, which are not influenced by treatment with bisoprolol 5 mg/day.


Assuntos
Antagonistas de Receptores Adrenérgicos beta 1/administração & dosagem , Antagonistas Adrenérgicos beta/administração & dosagem , Desempenho Atlético , Bisoprolol/administração & dosagem , Catecolaminas/sangue , Adulto , Atletas/estatística & dados numéricos , Epinefrina/sangue , Exercício Físico , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Ácido Láctico/sangue , Masculino , Norepinefrina/sangue , Consumo de Oxigênio , Adulto Jovem
13.
Nutr. clín. diet. hosp ; 40(1): 141-148, 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-194645

RESUMO

INTRODUCCIÓN: el sistema nervioso simpático modula muchas respuestas metabólicas y hormonales al ejercicio. No se conoce bien su influencia en los niveles séricos de la hormona hepcidina, un regulador clave del metabolismo del hierro, durante el ejercicio. MATERIAL Y MÉTODOS: este estudio examinó los efectos de la intensidad del ejercicio en la respuesta de la hepcidina y trató de relacionar las respuestas de catecolaminas y hepcidina al ejercicio. Quince ciclistas y triatletas entrenados realizaron una prueba de esfuerzo máximo con un cicloergómetro seguido de dos pruebas de intensidades diferentes (moderadas y altas) en orden aleatorio. Las dos pruebas consistieron en 30 minutos de ejercicio a una intensidad del 10% inferior al correspondiente al umbral ventilatorio (VT) (30-MI) o el punto de compensación respiratoria (RCP) (30-HI) Resultados y discusión: a pesar de la mayor cantidad de niveles de noradrenalina detectados después de la prueba de 30-MI versus la línea de base (p <0.01) y después de la prueba 30-HI versus 30-MI (p <0.01), la respuesta de la hepcidina no fue modificada por la intensidad del ejercicio. CONCLUSIÓN: dado que no pudimos relacionar la respuesta de la hepcidina a un ejercicio que se sabe que provoca un alto nivel de actividad suprarrenal, nuestros hallazgos sugieren que la intensidad del ejercicio, y por extensión la activación simpática, no modulan la respuesta de la hepcidina al ejercicio


INTRODUCTION: The sympathetic nervous system modulates many metabolic and hormonal responses to exercise. It is not well known its influence on serum levels of peptide hormone hepcidin, a key iron metabolism regulator, during exercise. MATERIAL AND METHODS: This study examined the effects of exercise intensity on the hepcidin response and treated to relate catecholamine and hepcidin responses to exercise. Fifteen trained cyclists and triathletes undertook a maximal stress test on a cycle ergometer followed by two different intensity tests (moderate and high) in random order. The two tests consisted of 30 min of exercise at an intensity 10% lower than that corresponding to the ventilatory threshold (VT) (30-MI) or the respiratory compensation point (RCP) (30-HI). RESULTS AND DISCUSSION: Despite higher norepinephrine levels detected after the 30-MI test versus baseline (p <0.01) and after the 30-HI test versus 30-MI (p <0.01), the hepcidin response was unmodified by the intensity of exercise. CONCLUSION: Given we were unable to relate the hepcidin response to an exercise known to elicit high sympatheticadrenal activity, our findings suggest that exercise intensity, and by extension the sympathetic activation, does not modulate the hepcidin response to exercise


Assuntos
Humanos , Masculino , Adulto , Exercício Físico/fisiologia , Hepcidinas/sangue , Atletas , Catecolaminas/sangue , Consumo de Oxigênio , Fatores de Tempo
14.
Monaldi Arch Chest Dis ; 89(3)2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31850695

RESUMO

A 39-year-old woman underwent heart transplantation (HTx) for advanced heart failure. The donor was a 36-year-old young woman without past medical history. The first day after HTx, T-waves changes were noted. Echocardiography revealed akinesia/dyskinesia of all basal segments of the two ventricles. Coronary catheterization plus biopsy were done 7 days later showing no coronary obstruction, no rejection and complete recovery of wall motion abnormalities on echocardiogram, suggesting biventricular inverted takotsubo syndrome (TTS). This is a case of TTS during the first day after HTx, with completely denervated heart but because of the inotropic drug support it still represents a target for catecholamine-induced cardiac dysfunction.


Assuntos
Insuficiência Cardíaca/cirurgia , Transplante de Coração/efeitos adversos , Cardiomiopatia de Takotsubo/etiologia , Medula Suprarrenal/metabolismo , Adulto , Cardiotônicos/uso terapêutico , Catecolaminas/sangue , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/fisiopatologia , Estresse Fisiológico , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Cardiomiopatia de Takotsubo/fisiopatologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-31670057

RESUMO

Catecholamines [dopamine (DA), epinephrine (E), and norepinephrine (NE)] and their metabolites [metanephrine (MN), normetanephrine (NMN), and 3-methoxytyramine (3-MT)] are functionally important in humans. Their overexpression can indicate the presence of neuroendocrine tumors. Accurate and rapid quantitation of catecholamines and their metabolites may function in differential diagnosis of neuroendocrine tumors. Herein, we diluted 200 µL plasma using isotope labelled internal standards (IS), and extracted using solid phase extraction. The performance of isotope diluted liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) was evaluated and applied to quantify the level of catecholamines and metabolites in clinical samples from 73 apparently healthy adults. The total analysis time of the ID-LC-MS/MS method was 4 min. The improved method was highly sensitive, with a limit of quantification (LOQ) for MN, NMN, 3-MT, and E of 1 pg/mL, a LOQ for DA of 5 pg/mL, and for NE of 10 pg/mL. After correction using IS, no significant matrix effects were observed. Good reproducibility was obtained, with total CVs of 3.2-13.1% (DA), 4.8-10.0% (E), 6.2-6.9% (NE), 3.8-7.9% (MN), 4.1-8.8% (NMN), 3.4-8.9% (3-MT). Recoveries were in the range of 91.1-109.7% for the six analytes. Also, the mean concentration of catecholamines were as follows: MN, 22.9 ±â€¯7.2 pg/mL; NMN, 41.4 ±â€¯17.2 pg/mL; 3-MT, 2.34 ±â€¯2.01 pg/mL; DA, 10.2 ±â€¯4.6 pg/mL; E, 29.3 ±â€¯14.2 pg/mL and NE 427.0 ±â€¯190.6 pg/mL. A reliable ID-LC-MS/MS method for the determination of catecholamines and their metabolites using small volumes of plasma was verified. This method is rapid, simple, and may serve as an essential diagnostic tool for neuroendocrine tumors in clinical practice.


Assuntos
Catecolaminas/sangue , Catecolaminas/metabolismo , Dopamina/análogos & derivados , Metanefrina/sangue , Normetanefrina/sangue , Espectrometria de Massas em Tandem/métodos , Adulto , Idoso , Cromatografia Líquida de Alta Pressão/métodos , Dopamina/sangue , Feminino , Humanos , Limite de Detecção , Masculino , Metaboloma , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Extração em Fase Sólida/métodos
16.
Forensic Sci Int ; 305: 110029, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31726327

RESUMO

The question whether an injury was sustained during life or not is one of the most important subjects in forensic medicine. Therefore, vital reactions have been a main research topic in forensic medicine for a long period and many renowned forensic pathologists have devoted important papers to this field. The research area ranges from macroscopically visible organ reactions, over tissue alterations (enzyme histochemistry, later on immunohistochemistry with a wide range of enzymes and other analytes, molecular pathology) to biochemical responses to injury. Especially in the field of immunohistochemistry and molecular pathology much progress has been achieved in the last years (e.g. heat-shock-proteins or positive aquaporine3-staining in mechanical skin trauma). Furthermore, 20 years after its implementation postmortem imaging also contributes to the detection and visualization of vital signs. The aim of the present review is to provide an update on forensically relevant vital signs/vital reactions. Systemic vital reactions especially of the circulatory and respiratory system as well as local vital reactions will be addressed. Vital reactions of different organ systems will be discussed in detail regarding pathogenesis and possible postmortem evolution. Current research on immunohistochemically detectable vital reactions (heat-shock-protein expression, aquaporine3-staining in mechanical trauma of the skin) will be addressed as well as biochemical vital reactions (agonochemical stress reaction, myoglobine in electrocution death, hypoxanthine as marker of hypoxia).


Assuntos
Medicina Legal/métodos , Ferimentos e Lesões/patologia , Catecolaminas/sangue , Tosse , Deglutição , Embolia/patologia , Exsanguinação/patologia , Hemorragia/patologia , Humanos , Imuno-Histoquímica , Insulina/sangue , Absorção Intestinal , Isquemia/patologia , Pneumotórax/patologia , Proteínas/metabolismo , Enfisema Pulmonar/patologia , Ventilação Pulmonar , Púrpura/patologia , Aspiração Respiratória/patologia , Salivação
17.
Curr Hypertens Rep ; 21(11): 90, 2019 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-31599352

RESUMO

PURPOSE OF REVIEW: The present paper will review the results of experimental and clinical studies aimed at defining the functional behavior of the central and peripheral nervous system in adrenal pheochromocytoma. RECENT FINDINGS: The contribution of sympathetic neural influences to the development of high blood pressure values in pheochromocytoma is complex. Studies performed in experimental animal models have shown that hypertension and the concomitant high circulating levels of catecholamines can lead to inhibition of central sympathetic neural outflow by reflex mechanisms and direct stimulation of central adrenergic receptors, respectively. However, these studies have also shown that high circulating levels of catecholamines favor a downregulation of alpha- and beta-adrenergic receptors, lessening their response to endogenous and exogenous adrenergic stimulation. The present paper reviews results of human studies performed by our group and others on the behavior of the central and peripheral nervous system in human pheochromocytoma. We discuss data collected in patients with different levels of peripheral sympathetic drive, i.e., before and after surgical removal of the adrenal pheochromocytoma. In the presence of elevated plasma catecholamine level, such as that characterizing adrenal pheochromocytoma, microneurography shows that central sympathetic neural activity is normal or even inhibited. At the peripheral vascular level, pheochromocytoma is characterized by a reduced vascular reactivity to exogenous sympathetic stimulation but a normal response by the vessels to endogenous adrenergic stimulation.


Assuntos
Neoplasias das Glândulas Suprarrenais/fisiopatologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Hipertensão/fisiopatologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Feocromocitoma/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Neoplasias das Glândulas Suprarrenais/sangue , Neoplasias das Glândulas Suprarrenais/cirurgia , Animais , Doenças do Sistema Nervoso Autônomo/sangue , Catecolaminas/sangue , Catecolaminas/fisiologia , Sistema Nervoso Central/fisiopatologia , Humanos , Hipertensão/sangue , Hipertensão/etiologia , Doenças do Sistema Nervoso Periférico/sangue , Feocromocitoma/sangue , Feocromocitoma/cirurgia
18.
BMC Infect Dis ; 19(1): 866, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638922

RESUMO

BACKGROUND: Hand, foot and mouth disease (HFMD) remains a burdensome health issue in mainland China. Enterovirus71 (EV-A71) is the main pathogen of severe HFMD. Continuous hemofiltration improves fluid overload, restores kidney function and alleviates inflammatory reactions. The aim of the present study was to evaluate the effects of continuous veno-venous hemodiafiltration (CVVHDF) on severe HFMD caused by EV-A71(EV-A71-HFMD) in a pediatric intensive care unit (PICU). METHODS: A retrospective observational study was performed in a tertiary university PICU from January 2012 to December 2016. Children with severe EV-A71-HFMD complicated by cardiopulmonary failure were included. The patients were divided into a CVVHDF group and a conventional therapy (control) group (non-CVVHDF). The demographics, characteristics, and outcomes between the groups were collected and analyzed. RESULTS: Twenty-nine patients with severe EV-A71-HFMD were enrolled. The 28-day mortality was 17.6% (3/17) in the CVVHDF group and 33.3% (4/12) in the non-CVVHDF group, with no statistical significance between the two groups (P = 0.403). The median interval between CVVHDF initiation and PICU admission was 6 (4,8.5) hrs, and the median duration of CVVHDF was 48 (36, 64) hrs. The left ventricular ejection fraction (LVEF) and cardiac index (CI) in the CVVHDF group were improved after treatment. The plasma levels of catecholamines and renin-angiotensin-aldosterone system (RAAS) substances in the CVVHDF group were significantly decreased after treatment. The decreased catecholamines and RAAS substances included adrenalin (169.8 [145.5, 244.6] vs. 148.0 [109.0, 208.1] ng/L, P = 0.033), dopamine (152.7 [97.0, 191.1] vs. 96.0 [68.0, 160.9] ng/L, P = 0.026), angiotensin II (185.9 [125.2, 800.0] vs. 106.0 [90.8, 232.5] ng/L, P = 0.047), aldosterone (165.7 [94.0, 353.3] vs. 103.3 [84.3, 144.3] ng/L, P = 0.033), and renin (1.12 [0.74, 3.45] vs. 0.79 [0.52, 1.25] µg/L/h, P = 0.029), CONCLUSIONS: CVVHDF reduced the levels of catecholamines and RAAS substances and improved cardiovascular function. Continuous hemodiafiltration may represent a potential therapy in patients with severe EV-A71-HFMD complicated with cardiopulmonary failure.


Assuntos
Doenças Cardiovasculares/terapia , Terapia de Substituição Renal Contínua , Enterovirus Humano A , Doença de Mão, Pé e Boca/terapia , Doença de Mão, Pé e Boca/virologia , Unidades de Terapia Intensiva Pediátrica , Doença Pulmonar Obstrutiva Crônica/terapia , Aldosterona/sangue , Angiotensina II/sangue , Doenças Cardiovasculares/complicações , Catecolaminas/sangue , Pré-Escolar , China , Feminino , Seguimentos , Doença de Mão, Pé e Boca/sangue , Doença de Mão, Pé e Boca/complicações , Hemodiafiltração/métodos , Humanos , Lactente , Masculino , Doença Pulmonar Obstrutiva Crônica/complicações , Renina/sangue , Sistema Renina-Angiotensina/fisiologia , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento
20.
Eur J Appl Physiol ; 119(10): 2225-2236, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407088

RESUMO

PURPOSE: Heart transplantation causes denervation of the donor heart, but the consequences for cardiovascular homeostasis remain to be fully understood. The present study investigated cardiovascular autonomic control at supine rest, during orthostatic challenge and during isometric exercise in heart transplant recipients (HTxR). METHODS: A total of 50 HTxRs were investigated 7-12 weeks after transplant surgery and compared with 50 healthy control subjects. Continuous, noninvasive recordings of cardiovascular variables were carried out at supine rest, during 15 min of 60° head-up tilt and during 1 min of 30% of maximal voluntary handgrip. Plasma and urine catecholamines were assayed, and symptoms were charted. RESULTS: At supine rest, heart rate, blood pressures and total peripheral resistance were higher, and stroke volume and end diastolic volume were lower in the HTxR group. During tilt, heart rate, blood pressures and total peripheral resistance increased less, and stroke volume and end diastolic volume decreased less. During handgrip, heart rate and cardiac output increased less, and stroke volume and end diastolic volume decreased less. Orthostatic symptoms were similar across the groups, but the HTxRs complained more of pale and cold hands. CONCLUSION: HTxRs are characterized by elevated blood pressures and total peripheral resistance at supine rest as well as attenuated blood pressures and total peripheral resistance responses during orthostatic challenge, possibly caused by low-pressure cardiopulmonary baroreceptor denervation. In addition, HTxRs show attenuated cardiac output response during isometric exercise due to efferent sympathetic denervation. These physiological limitations might have negative functional consequences.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Exercício Físico , Transplante de Coração/efeitos adversos , Intolerância Ortostática/epidemiologia , Transplantados , Adolescente , Adulto , Idoso , Pressão Sanguínea , Catecolaminas/sangue , Catecolaminas/urina , Feminino , Força da Mão , Coração/fisiopatologia , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Intolerância Ortostática/fisiopatologia
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