Median preoptic nucleus mediates the cardiovascular recovery induced by hypertonic saline in hemorrhagic shock.

Changes in plasma osmolarity, through central and peripheral osmoreceptors, activate the median preoptic nucleus (MnPO) that modulates autonomic and neuroendocrine adjustments. The present study sought to determine the participation of MnPO in the cardiovascular recovery induced by hypertonic saline infusion (HSI) in rats submitted to hemorrhagic shock. The recordings of mean arterial pressure (MAP) and renal vascular conductance (RVC) were carried out on male Wistar rats (250-300 g). Hemorrhagic shock was induced by blood withdrawal over 20 min until the MAP values of approximately 60 mmHg were attained. The nanoinjection (100 nL) of GABAA agonist (Muscimol 4 mM; experimental group (EXP)) or isotonic saline (NaCl 150 mM; control (CONT)) into MnPO was performed 2 min prior to intravenous overload of sodium through HSI (3 M NaCl, 1.8 mL/kg, b.wt.). Hemorrhagic shock reduced the MAP in control (62 ± 1.1 mmHg) and EXP (61 ± 0.4 mmHg) equipotently. The inhibition of MnPO impaired MAP (CONT: 104 ± 4.2 versus EXP: 60 ± 6.2 mmHg) and RVC (CONT: 6.4 ± 11.4 versus EXP: -53.5 ± 10.0) recovery 10 min after HSI. The overall results in this study demonstrated, for the first time, that the MnPO plays an essential role in the HSI induced resuscitation during hypovolemic hemorrhagic shock.

Maternal high-fat diet consumption during pregnancy and lactation predisposes offspring to renal and metabolic injury later in life: comparative study of diets with different lipid contents.

Accumulating evidence suggests that maternal overnutrition can result in a higher development risk of obesity and renal disease in the offspring's adulthood. The present study tested different lipid levels in the maternal diet during pregnancy and lactation and its repercussions on the offspring of Wistar rats. Offspring of 1, 7, 30 and 90-d-old were divided into the following groups: Control (CNT) - offspring of dams that consumed a standard chow diet (3.5% of lipids); Experimental 1 (EXP1) - offspring of dams exposed to a high-fat diet (HFD) (28% of lipids); and Experimental 2 (EXP2) - offspring of dams exposed to a HFD (40% of lipids). Regarding maternal data, there was a decrease in the amount of diet ingested by EXP2. Daily caloric intake was higher in EXP1, while protein and carbohydrate intakes were lower in EXP2. While lipid intake was higher in the experimental groups, EXP1 consumed more lipids than EXP2, despite the body weight gain being higher in EXP2. Adult offspring from EXP1 presented higher blood glucose. Regarding morphometric analysis, in both experimental groups, there was an increase in the glomerular tuft and renal corpuscle areas, but an increase in the capsular space area only in EXP1. There was a decrease in the glomerular filtration rate (GFR) in EXP1, in contrast to an increase in GFR of EXP2, along with an increase in urinary protein excretion. In conclusion, the maternal HFDs caused significant kidney damage in offspring, but had different repercussions on the type and magnitude of recorded change.

Dysregulation in erythrocyte dynamics caused by SARS-CoV-2 infection: possible role in shuffling the homeostatic puzzle during COVID-19.

Introduction: The evolving COVID-19 pandemic became a hallmark in human history, not only by changing lifestyles, but also by enriching scientific knowledge on viral infection and its consequences. Objective: Although the management of cardiorespiratory changes is pivotal to a favorable prognosis during severe clinical findings, dysregulation of other systems caused by SARS-CoV-2 infection may imbalance erythrocyte dynamics, such as a bidirectional positive feedback loop pathophysiology. Method and Results: Recent evidence shows that SARS-CoV-2 is capable of affecting the genetics and dynamics of erythrocytes and this coexists with a non-homeostatic function of cardiovascular, respiratory and renal systems during COVID-19. In hypothesis, SARS-CoV-2-induced systematical alterations of erythrocytes dynamics would constitute a setpoint for COVID-19-related multiple organ failure syndrome and death. Conclusion: The present review covers the most frequent erythrocyte-related non-homeostatic findings during COVID-19 capable of providing mechanistic clues of SARS-CoV-2-induced infection and inspiring therapeutic-oriented scientific evidence.

Hypotensive activity of Campomanesia xanthocarpa leaf extract: beyond angiotensin II type 1 receptor blockage.

The ability of Campomanesia xanthocarpa leaf extract (CXLE) to alter blood pressure and heart rate was evaluated in anesthetized rats. The CXLE-induced hypotension was evaluated before and after losartan, methylatropine, L-N(ω)-nitro-L-arginine methyl ester (L-NAME), hexamethonium, indomethacin, glibenclamide, or nifedipine administration. The constituents of CXLE were identified by LC-DAD-MS. CXLE decreased blood pressure in a dose-dependent manner; only the highest dose decreased heart rate. The hypotension induced by CXLE was sensitive only to losartan, nifedipine, and glibenclamide. L-NAME decreased the time to recover 50% of the hypotensive effect of CXLE without altering its magnitude. Flavan-3-ols, proanthocyanidins (dimers and trimers), and glycosylated flavonols were identified from CXLE. The chemical constituents of CXLE seem to induce not only angiotensin II type 1 receptor blockage, but also ATP-sensitive potassium channels activation and L-type voltage-dependent Ca2+ channels inactivation. Nitric oxide is involved in the maintenance of the hypotensive effect of CXLE.

Medullary Noradrenergic Neurons Mediate Hemodynamic Responses to Osmotic and Volume Challenges.

Despite being involved in homeostatic control and hydro-electrolyte balance, the contribution of medullary (A1 and A2) noradrenergic neurons to the hypertonic saline infusion (HSI)-induced cardiovascular response after hypotensive hemorrhage (HH) remains to be clarified. Hence, the present study sought to determine the role of noradrenergic neurons in HSI-induced hemodynamic recovery in male Wistar rats (290-320 g) with HH. Medullary catecholaminergic neurons were lesioned by nanoinjection of antidopamine-ß-hydroxylase-saporin (0.105 ng·nl-1) into A1, A2, or both (LES A1; LES A2; or LES A1+A2, respectively). Sham rats received nanoinjections of free saporin in the same regions (SHAM A1; SHAM A2; or SHAM A1+A2, respectively). After 15 days, rats were anesthetized and instrumented for cardiovascular recordings. Following 10 min of stabilization, HH was performed by withdrawing arterial blood until mean arterial pressure (MAP) reaches 60 mmHg. Subsequently, HSI was performed (NaCl 3 M; 1.8 ml·kg-1, i.v.). The HH procedure caused hypotension and bradycardia and reduced renal, aortic, and hind limb blood flows (RBF, ABF, and HBF). The HSI restored MAP, heart rate (HR), and RBF to baseline values in the SHAM, LES A1, and LES A2 groups. However, concomitant A1 and A2 lesions impaired this recovery, as demonstrated by the abolishment of MAP, RBF, and ABF responses. Although lesioning of only a group of neurons (A1 or A2) was unable to prevent HSI-induced recovery of cardiovascular parameters after hemorrhage, lesions of both A1 and A2 made this response unfeasible. These findings show that together the A1 and A2 neurons are essential to HSI-induced cardiovascular recovery in hypovolemia. By implication, simultaneous A1 and A2 dysfunctions could impair the efficacy of HSI-induced recovery during hemorrhage.

Forced internal desynchrony induces cardiometabolic alterations in adult rats.

Disruptions in circadian rhythms have been associated with several diseases, including cardiovascular and metabolic disorders. Forced internal desynchronization induced by a period of T-cycles of 22 h (T22 protocol) reaches the lower limit of entrainment and dissociates the circadian rhythmicity of the locomotor activity into two components, driven by different outputs from the suprachiasmatic nucleus (SCN). The main goal of this study was to evaluate the cardiovascular and metabolic response in rats submitted to internal desynchronization by T22 protocol. Male Wistar rats were assigned to either a control group subjected to a usual T-cycles of 24 h (12 h-12 h) or an experimental group subjected to the T22 protocol involving a 22-h symmetric light-dark cycle (11 h-11 h). After 8 weeks, rats subjected to the T22 exhibited desynchrony in their locomotor activity. Although plasma glucose and insulin levels were similar in both groups, desynchronized rats demonstrated dyslipidemia, significant hypertrophy of the fasciculate zone of the adrenal gland, low IRB, IRS2, PI3K, AKT, SOD and CAT protein expression and an increased expression of phosphoenolpyruvate carboxykinase in the liver. Furthermore, though they maintained normal baseline heart rates and mean arterial pressure levels, they also presented reduced baroreflex sensitivity. The findings indicate that circadian timing desynchrony following the T22 protocol can induce cardiometabolic disruptions. Early hepatic metabolism dysfunction can trigger other disorders, though additional studies are needed to clarify the causes.

Aging-Induced Biological Changes and Cardiovascular Diseases.

Aging is characterized by functional decline in homeostatic regulation and vital cellular events. This process can be linked with the development of cardiovascular diseases (CVDs). In this review, we discussed aging-induced biological alterations that are associated with CVDs through the following aspects: (i) structural, biochemical, and functional modifications; (ii) autonomic nervous system (ANS) dysregulation; (iii) epigenetic alterations; and (iv) atherosclerosis and stroke development. Aging-mediated structural and biochemical modifications coupled with gradual loss of ANS regulation, vascular stiffening, and deposition of collagen and calcium often disrupt cardiovascular system homeostasis. The structural and biochemical adjustments have been consistently implicated in the progressive increase in mechanical burden and functional breakdown of the heart and vessels. In addition, cardiomyocyte loss in this process often reduces adaptive capacity and cardiovascular function. The accumulation of epigenetic changes also plays important roles in the development of CVDs. In summary, the understanding of the aging-mediated changes remains promising towards effective diagnosis, discovery of new drug targets, and development of new therapies for the treatment of CVDs.

Dysregulation in erythrocyte dynamics caused by SARS-CoV-2 infection: possible role in shuffling the homeostatic puzzle during COVID-19

Abstract Introduction The evolving COVID-19 pandemic became a hallmark in human history, not only by changing lifestyles, but also by enriching scientific knowledge on viral infection and its consequences. Objective Although the management of cardiorespiratory changes is pivotal to a favorable prognosis during severe clinical findings, dysregulation of other systems caused by SARS-CoV-2 infection may imbalance erythrocyte dynamics, such as a bidirectional positive feedback loop pathophysiology. Method and Results Recent evidence shows that SARS-CoV-2 is capable of affecting the genetics and dynamics of erythrocytes and this coexists with a non-homeostatic function of cardiovascular, respiratory and renal systems during COVID-19. In hypothesis, SARS-CoV-2-induced systematical alterations of erythrocytes dynamics would constitute a setpoint for COVID-19-related multiple organ failure syndrome and death. Conclusion The present review covers the most frequent erythrocyte-related non-homeostatic findings during COVID-19 capable of providing mechanistic clues of SARS-CoV-2-induced infection and inspiring therapeutic-oriented scientific evidence.

Ajustes Cardiovasculares Induzidos pela Desidratação Crônica nas Fases Iniciais do Período Pós-Natal em Ratos Acordados / Cardiovascular Adjustments Induced by Chronic Dehydration in the Early Stages of PostNatal in Awake Rats

Alterações da osmolaridade do compartimento extracelular podem alterar o volume, o metabolismo e a função celular. Em virtude disso,varias complicações podem ser observadas, dentre elas a hipertensão arterial. Assim, a regulação precisa do volume e da osmolaridade docompartimento extracelular é fundamental para a manutenção das funções normais do organismo e da sobrevivência. O objetivo desse estudofoi avaliar os parâmetros hemodinâmicos através de desidratação induzida por furosemide em ratos jovens não anestesiados. Foram utilizados,ratos Wistar com cinco dias de idade, divididos em dois grupos experimentais, um controle (n=10) e um submetido ao tratamento comFurosemide (10mg/kg de massa corpórea, n=12), administrado três vezes por semana, durante dois meses. Após o tratamento, os animaisforam anestesiados para cateterização com cânulas inseridas na artéria e veia femorais, através de um corte inguinal de um dos lados. Ascânulas foram transpassadas subcutaneamente através do dorso do animal e foram exteriorizadas. Os experimentos foram realizados apósuma recuperação de 48h do procedimento cirúrgico, utilizando um amplificador e um software. Os resultados obtidos demonstraram que nãohouve diferenças nos testes induzidos de ingestão de água durante os 120 minutos analisados, quando comparados o grupo controle e o grupofurosemide, respectivamente. Na análise da pressão arterial méia e frequência cardíaca, não foi observada modificação dos níveis basais. Essepadrão de resposta também foi obtido quando analisado a PAS e PAD. Com esses resultados, concluímos que a depleção do compartimentoextracelular induzido pela administração de furosemide em ratos jovens não é fator determinante para alteração dos parâmetros hemodinâmicosna fase adulta.

Changes in osmolarity of the extracellular compartment may change the volume, metabolism and cellular function. As a result, manycomplications can be observed, among them hypertension. Thus, precise regulation of the volume and osmolality of the extracellularcompartment is critical to maintaining normal body functions and survival. Previous results demonstrated that despite anesthetized ratssubmitted to chronic diuretic treatment showed no change in sensitivity to sodium and water, an increased arterial pressure was observed. Thepresent study aims to assess hemodynamic parameters through furosemide-induced dehydration in anaesthetized young rats. Five days oldWistar rats divided into two groups, a control (n = 10) and a group subjected to subcutaneous treatment with the diuretic Furosemide (10mg/kg of body weight, n = 12) were used. After treatment, the animals were anesthetized for the implantation of the polyethylene tubes, which wereinserted into the artery (for records cardiovascular variables) and femoral vein through a cut inguinal one side (left / right). The cannulaswere transfixed subcutaneously through the back of the animal and were exteriorized. Data were recorded after a 48h recovery of the surgicalprocedure, using an amplifier and software. No differences in induced intake test of water within 120 minutes were observed. With respect tomean arterial pressure and heart rate, no modification on baseline levels were observed (PAM: 99.4 ± 1.9 mmHg, control vs 102.7 ± 1 mmHg,furosemide; FC: 362.5 ± 5.2 bpm, control vs 364.9 ± 7 bpm, furosemide). This response pattern was also obtained for SBP (124.3 ± 6 mmHg,control vs 130 ± 1.6 mmHg, furosemide) and DBP (82.2 ± 1.9 mmHg, control vs 82.1 ± 1 mmHg, furosemide). We concluded that depletionof the extracellular compartment induced by furosemide administration in young rats is not a determining factor to change the hemodynamicparameters in adulthood.

Rede de atenção à saúde mental de base comunitária: a experiência de Santo André / Community-based mental health care network: the Santo André experience

Os distúrbios psiquiátricos constituem um grave problema de saúde pública. Por muitos anos, a única terapêutica disponível ao portador de transtornos mentais era a internação em hospitais psiquiátricos. Hoje a Organização Mundial da Saúde recomenda os serviços de base comunitária como modelo de tratamento em saúde mental. Assim, o objetivo é descrever as características de uma rede de atenção à saúde mental de base comunitária no município de Santo André, SP. Foi realizado um estudo retrospectivo do tipo descritivo, em dados secundários do período de 1987 a 2006. O estudo incidiu sobre o histórico, a infra-estrutura, os recursos humanos, a produção, as práticas e processos de trabalho dos serviços de saúde mental de Santo André. Foram analisados documentos do Programa Municipal de Saúde Mental, da Secretaria Municipal de Saúde, da Prefeitura de Santo André, da Associação José Martins de Araújo Júnior/Organização Social De Volta Para Casa. A Secretaria Municipal de Saúde proveu meios para uma transformação dos serviços de saúde mental no período estudado, partindo de um atendimento exclusivamente manicomial para uma rede de serviços de saúde mental com modelo centrado na comunidade, focando a doença no aspecto psicossocial e com abordagem por equipe multiprofissional. Estas ações no município de Santo André forarm corroborativas aos esforços da sociedade civil e o pleno desenvolvimento da mudança do modelo hospitalocêntrico.

Rede de atenção à saúde mental de base comunitária: a experiência de Santo André / Community-based mental health care network: the Santo André experience

Os distúrbios psiquiátricos constituem um grave problema de saúde pública. Por muitos anos, a única terapêutica disponível ao portador de transtornos mentais era a internação em hospitais psiquiátricos. Hoje a Organização Mundial da Saúde recomenda os serviços de base comunitária como modelo de tratamento em saúde mental. Assim, o objetivo é descrever as características de uma rede de atenção à saúde mental de base comunitária no município de Santo André, SP. Foi realizado um estudo retrospectivo do tipo descritivo, em dados secundários do período de 1987 a 2006. O estudo incidiu sobre o histórico, a infra-estrutura, os recursos humanos, a produção, as práticas e processos de trabalho dos serviços de saúde mental de Santo André. Foram analisados documentos do Programa Municipal de Saúde Mental, da Secretaria Municipal de Saúde, da Prefeitura de Santo André, da Associação José Martins de Araújo Júnior/Organização Social De Volta Para Casa. A Secretaria Municipal de Saúde proveu meios para uma transformação dos serviços de saúde mental no período estudado, partindo de um atendimento exclusivamente manicomial para uma rede de serviços de saúde mental com modelo centrado na comunidade, focando a doença no aspecto psicossocial e com abordagem por equipe multiprofissional. Estas ações no município de Santo André forarm corroborativas aos esforços da sociedade civil e o pleno desenvolvimento da mudança do modelo hospitalocêntrico.(AU)

Psychiatric impairments are a critical public health problem. For many years, the only therapy available to individuals with mental disorders was hospitalization at psychiatric institutions. Nowadays the World Health Organization recommends community-based services as a model of mental health treatment. Therefore, the aim of this study is to describe the characteristics of a community-based mental health care network in the city of Santo André, state of São Paulo. A descriptive and retrospective study was carried out, based on secondary data from the period between 1987 and 2006. The study investigated the history, infrastructure, human recourses, production, practices and work processes of the mental health services of Santo André. Documents of the Municipal Mental Health Program of the Municipal Health Department of Santo André, and of the José Martins de Araújo Júnior Association/Social Organization De Volta Para Casa were analyzed. The Municipal Health Department promoted the transformation of the mental health services in the studied period: from assistance provided exclusively at asylums to a network of mental health services whose model was based on the community, focusing on the psychosocial aspect of the disease and with multi-professional teams. These actions in Santo André corroborated the civil society's efforts and the development of changes in the hospital-centered model.(AU)

Rede de atenção à saúde mental de base comunitária: a experiência de Santo André / Community-based mental health care network: the Santo André experience

Os distúrbios psiquiátricos constituem um grave problema de saúde pública. Por muitos anos, a única terapêutica disponível ao portador de transtornos mentais era a internação em hospitais psiquiátricos. Hoje a Organização Mundial da Saúde recomenda os serviços de base comunitária como modelo de tratamento em saúde mental. Assim, o objetivo é descrever as características de uma rede de atenção à saúde mental de base comunitária no município de Santo André, SP. Foi realizado um estudo retrospectivo do tipo descritivo, em dados secundários do período de 1987 a 2006. O estudo incidiu sobre o histórico, a infra-estrutura, os recursos humanos, a produção, as práticas e processos de trabalho dos serviços de saúde mental de Santo André. Foram analisados documentos do Programa Municipal de Saúde Mental, da Secretaria Municipal de Saúde, da Prefeitura de Santo André, da Associação José Martins de Araújo Júnior/Organização Social De Volta Para Casa. A Secretaria Municipal de Saúde proveu meios para uma transformação dos serviços de saúde mental no período estudado, partindo de um atendimento exclusivamente manicomial para uma rede de serviços de saúde mental com modelo centrado na comunidade, focando a doença no aspecto psicossocial e com abordagem por equipe multiprofissional. Estas ações no município de Santo André forarm corroborativas aos esforços da sociedade civil e o pleno desenvolvimento da mudança do modelo hospitalocêntrico.(AU)

Freqüência de malformações congênitas das extremidades em recém-nascidos / Frequency of congenital malformations of the extremities in newborns

As malformações congênitas constituem alterações de estrutura, função ou metabolismo presentes ao nascer, que resultam em anomalias físicas ou mentais, podendo ou não ser simples ou múltiplas e de maior ou menor importância clínica. O objetivo é de analisar a frequência de malformações congênitas das extremidades em maternidades da cidade de Maceió. Realizou-se um estudo de coorte transversal prospectivo em 2500 recém-nascidos no período de julho de 2002 a junho de 2003, junto às maternidades Casa Maternal Santa Mônica, Hospital Memorial Arthur Ramos e Santa Casa de Misericórdia de Maceió. Foram excluídos os recém-nascidos em alto risco e casos de aborto. Cerca de 2,88 por cento dos recém-nascidos estudados apresentaram algum tipo de anomalia do aparelho locomotor. A anomalia maior mais frequente foi o pé torto equinovaro congênito e a anomalia menor de maior incidência foi o pé calcâneo valgo.

Congenital malformations are structural, functional or metabolic alterations present in birth that cause physical or cognitive anomalies; they may be simple or multiple and of major or minor clinical importance. We aimed to analyze the frequency of locomotor apparatus congenital anomalies (extremities) in maternities of the city of Maceió. A prospective cross-sectional cohort study was carried out with 2500 newborns between July 2002 and June 2003 in the maternities Casa Maternal Santa Mônica, Hospital Memorial Arthur Ramos and Santa Casa de Misericórdia de Maceió. Approximately 2.88 percent of the studied newborns presented some type of locomotor apparatus anomaly. The most frequent major anomaly was the equinovarus clubfoot and the most frequent minor anomaly was the valgus calcaneus foot. It is important to note that an early diagnosis improves the quality of life of this population.

Freqüência de malformações congênitas das extremidades em recém-nascidos / Frequency of congenital malformations of the extremities in newborns

As malformações congênitas constituem alterações de estrutura, função ou metabolismo presentes ao nascer, que resultam em anomalias físicas ou mentais, podendo ou não ser simples ou múltiplas e de maior ou menor importância clínica. O objetivo é de analisar a freqüência de malformações congênitas das extremidades em maternidades da cidade de Maceió. Realizou-se um estudo de coorte transversal prospectivo em 2500 recém-nascidos no período de julho de 2002 a junho de 2003, junto às maternidades Casa Maternal Santa Mônica, Hospital Memorial Arthur Ramos e Santa Casa de Misericórdia de Maceió. Foram excluídos os recém-nascidos em alto risco e casos de aborto. Cerca de 2,88 por cento dos recém-nascidos estudados apresentaram algum tipo de anomalia do aparelho locomotor. A anomalia maior mais freqüente foi o pé torto eqüinovaro congênito e a anomalia menor de maior incidência foi o pé calcâneo valgo.(AU)

Congenital malformations are structural, functional or metabolic alterations present in birth that cause physical or cognitive anomalies; they may be simple or multiple and of major or minor clinical importance. We aimed to analyze the frequency of locomotor apparatus congenital anomalies (extremities) in maternities of the city of Maceió. A prospective cross-sectional cohort study was carried out with 2500 newborns between July 2002 and June 2003 in the maternities Casa Maternal Santa Mônica, Hospital Memorial Arthur Ramos and Santa Casa de Misericórdia de Maceió. Approximately 2.88 percent of the studied newborns presented some type of locomotor apparatus anomaly. The most frequent major anomaly was the equinovarus clubfoot and the most frequent minor anomaly was the valgus calcaneus foot. It is important to note that an early diagnosis improves the quality of life of this population.(AU)