Influência de mudanças de fase no ciclo claro-escuro sobre o controle autonômico cardíaco de ratos

Introduction: The circadian system has neural projections for the Autonomic Nervous System (ANS), directly interfering with sympathetic-vagal modulation of the cardiovascular system. Disturbances in the circadian system, such as phase changes in light-dark cycle (LD), has been related to the risk of development of cardiovascular diseases due to increased sympathetic tone and reduction o Heart Rate Variability (HRV - RR intervals). Purpose: Investigate the interaction between Circadian Timing System and cardiac autonomic control in rats. Materials and methods: We used 18 Wistar rats (♀, age = 139.9 ± 32.1 days, weight = 219.5 ± 16.2 g), divided into three distinct groups: Control (CG), phase delay of 6h (GDe) and phase advance of 6h (GAd). Three animals were excluded during data collection (CG/GDe/GAd - n=5). Telemeters were surgically implanted in each animal for continuous acquisition of electrocardiographic (ECG) signals (duration of 21 days in the CG and 28 days in GDe/ GAd). A LD cycle was established 12h: 12h, beginning of light at18:00h and dark at 06:00h. The animals remained in the same CG LD cycle throughout the experimental period, while, on the 14th day of registration, the GDe and GAd underwent a delay and an advance in 6h, respectively. Throughout the experimental period, the locomotor activity (LA), the mean heart rate (mHR) and variables related to iRR [mean RR (mRR), SDNN, RMSSD, LF, HF and LF/ HF ratio ] were recorded. All data were analyzed in blocks of 3 and 7 days, for the presence of circadian rhythm, values of Cosinor - mesor, amplitude and acrophase (paired t test), phase relationship, differences between light and dark (t test independent), averages every 30 minutes along each time series (two-way ANOVA with post hoc Bonferroni). The data block B1,M1 and M2 in CG served as benchmarks for comparisons between series of analysis of the GAT/GAV. Results: We observed circadian rhythmicity in the variables LA, mRR and mFC(p<0.01). mRR and mFC showed phase relationship with the LA in all three groups, being less stable in GAd. In the CG, no significant differences between blocks were found in any of the analyzes(p>0.05). Among the 7 day blocks, there was a significant reduction in mRR(p=0.04) and mFC(p=0.03) in GDe and significant reduction in HF mean(p=0.02) in GAd; and between 3 day blocks, a significant increase of LF/HF(p= 0.04) in the GDe; besides mRR(p=0.03), SDNN(p=0.04), RMSSD (p=0.04), LF (p=0.01) and HF(p=0.02) significant increase in the GAd. It was found that the differences between the means of the mRR, LA and mFC in light and dark phases were not significant after phase changes in some of the blocks/moments (GDe and GAd). No significant results were found when comparing rhythmic variables means every 30 minutes over the blocks, except for a significant decrease in mRR at the middle of the dark phase (B2) and the start of light phase (B3) - (p<0.01). Conclusion: phase advances and delays (6h) altered cardiac autonomic control in the experimental groups by temporarily HRV decrease. Phase advances apparently had greater negative interference in this process, in relation to the phase delays.

Eficácia do treinamento de força sobre parâmetros cardiovasculares e antropométricos em adultos sedentários

This study aimed to determine the influence of strength training (ST), in three weekly sessions over ten weeks, on cardiovascular parameters and anthropometric measurements. It is a before and after intervention trial, with a sample composed of 30 individuals. Participants were adults aged between 18 and 40 years, from both sexes and sedentary for at least three months previously. Tests were computed ergospirometry, CRP, PWV and body composition (dependent variables) before and after the experiment. Independent variables, age and sex, were considered in order to determine their influence on the dependent variablesevaluatedend. By comparing the initial cardiovascular parameters with those obtained after intervention in patients undergoing the ST proposed (a Student s t-test was conducted within each group for samples matched to parameters with normal distribution, while the Wilcoxin was applied for those without), there was no significant difference in PWV(p =0469) or PCR(p =0.247), but there was an increase in anaerobic threshold(AT) (p=0.004) and Maximal Oxygen Uptake(VO2max) (p =0.052). In regard to anthropometric measures, individuals significantly reduced their body fat percentage (p<0.001) and fat mass (p<0,001), as well as increasing lean mass (p<0.001). However, no changes were recorded in the waist-to-hip ratio (WHR) (p= 0.777), body mass (p=0.226) or body mass index (BMI) (p =0.212). Findings of this study lead us to believe that the proposed ST, and did not increase the VOP or PCR improves cardiorespiratory capacity and body composition. Devotees of this training can therefore safely enjoy all its benefits without risk to the cardiovascular system

Avaliação dos parâmetros hematológicos e imunofenotípicos de pacientes com doenças linfoproliferativas crônicas no Rio Grande do Norte

Chronic lymphoproliferative disorders (DLPC) are lymphoid system diseases characterized by the abnormal proliferation of mature lymphocytes that affect B cells, T lymphocytes and NK cells. The aim of the study was to demonstrate the relevance of immunophenotyping by flow cytometry in patients with prolonged lymphocytosis and / or cytomorphological changes compatible with lymphoproliferative diseases. In this study 460 patients (244 men and 216 women) with DLPC were evaluated. Were analyzed by flow cytometry with a panel of monoclonal antibodies consisting of CD3, CD4, CD5, CD8, CD10, CD19, CD22, CD23, CD25, CD38, CD45, CD16/CD56, and HLADR heavy and light chains of immunoglobulins. It also examines information regarding age, gender of patients and laboratory data as leucocytes, cytomorphological analysis, platelet count and hemoglobin determination. The results showed 398 cases of chronic lymphoproliferative disorders and 62 of DLPC B cell lymphoproliferative diseases T. B showed the following distribution : 253 cases of chronic lymphocytic leukemia (CLL), 42 cases of multiple myeloma ( MM ), 37 cases of lymphoma non - Hodgkin lymphoma in leukemic phase (NHL) , 17 cases of pro- B lymphocytic leukemia ( B -PLL), 15 cases of mantle cell lymphoma (MCL ), 12 cases of plasma cell leukemia ( PCL), 9 cases of lymphoma Burkitt (Linf B), 8 cases of leukemia villous cells ( LCV), 3 cases of splenic lymphoma with villous cells (LECV), a case of follicular lymphoma (LF) and a Waldenströn macroglobulinemia ( MW). The diseases source NK / T were 23 cases of peripheral T cell lymphoma (LCTP), 14 cases of T prolymphocytic leukemia (T -PLL), 10 cases of leukemia T of large granular lymphocytes (LGL -T) 9 cases of leukemia cells of adult T (LCTA), 5 cases of Sezary syndrome (SS) and a case of large granular NK leukemia (LGL -NK) lymphocytes. In conclusion, the combined use of the monoclonal antibody panel careful cytomorphological analysis was shown to be essential in immune diagnosis and classification of chronic lymphoproliferative disorders. This study was approved by the IRB - HUOL under number 356 / 09

Sistematização da assistência de enfermagem (SAE) em um hospital pediátrico de ensino: uma pesquisa-ação

The incessant search if nurse for qualify nursing care makes the Nursing Assistance Systematization, a current topic of discussion throughout the country, not only in order to comply the legal requirements of their practice, but especially by the expected benefits of its application. In this meaning, this research had a qualitative approach, developed for a way of research-action. The general purpose was to analyze the change in the nursing practices in a pediatric teaching hospital, based on construction and implementation of Nursing Assistance Systematization by the nursing team. The results had the thematic analysis of Paulo Freire and were shown in the form of reports. To achieve these purposes, it began by steps pre-trial, to review the charts of the institution and an approach with the managers. In the situational diagnosis of nursing practices without the systematization followed by applying a questionnaire with a nursing team and a focal group with nurses. These ways supported the implementation stage of the Nursing Assistance Systematization which developed actions associate such as focal group with the nurses about the nursing history, capacity with the nursing team about the Nursing Assistance Systematization, development, application and reworking of printed, and discussions in the small groups. The evaluations of the changes after the actions of the research occurred through individual interview with the nurses, to check the results. The charts review confirmed the deficit in the records performed by the nurse on the chart, which reinforced the need for implementation of Nursing Assistance Systematization, an argument used on the meeting with the managers, who promptly agree with the search. The questionnaire and the focal group with the nurses reveal a process of nursing work without systematization, showing gaps in practices, but also obtained relate of expectations of improvements in quality of care as of Nursing Assistance Systematization, furnishing data to the development of ways following-up. The prints were gradually used and modified as the team understood the Nursing Assistance Systematization and its purposes through capacity course. The final evaluation pointed to the partial implementation of the stages of Nursing Assistance Systematization had been institutionalized at the history and the development of nursing, beyond difficulties with diagnosis and prescription of nursing, in later representing a paradigm shift. This search collaborated to change the view about the Nursing Assistance Systematization by nursing team at the institution had been revealed through introduction of new practices in the process of nursing work, as examination of physical exam of the patient, the interview in the admission of customers on service and the daily monitoring by nursing through development of nursing. Before addition, it was noted which the purposes of this search were achieved, since were analyzed the changes in the nursing practices with the systematization. The research-action achieved proposes of the involvement of nursing team in changing their practices. This search contributed to the implementation of the Nursing Assistance Systematization in a pediatric teaching hospital and showed which is possible to seek resolution of problems when the objective is of the group and gave access for further searches within this theme

Avaliação da capacidade de caminhar do portador de obesidade mórbida utilizando teste de caminhada de 6 minutos

Introduction: The ability to walk is impaired in obese by anthropometric factors (BMI and height), musculoskeletal pain and level of inactivity. Little is known about the influence of body adiposity and the acute response of the cardiovascular system during whole the 6-minute walk test (6mWT). Objective: To evaluate the effect of anthropometric measures (BMI and WHR waist-to-hip ratio), the effort heart and inactivity in ability to walk the morbidly obese. Materials and Methods: a total 36 morbidly obese (36.23 + 11.82 years old, BMI 49.16 kg/m2) were recruited from outpatient department of treatment of obesity and bariatric surgery in University Hospital Onofre Lopes and anthropometric measurements of obesity (BMI and WHR), pulmonary function, pattern habitual physical activity (Baecke Questionnaire) and walking capacity (6mWT). The patient was checking to measure: heart rate (HR), breathing frequency (BF), peripheral oxygen saturation, level of perceived exertion, systemic arterial pressure and duplo-produto (DP), moreover the average speed development and total distance walking. The data were analysed between gender and pattern of body adiposity, measuring the behavior minute by minute of walking. The Pearson and Spearmam correlation coefficients were calculated, and stepwise multiple Regression examined the predictors of walking capacity. All analyses were performed en software Statistic 6.0. Results: 20 obese patients had abdominal adiposity (WHR = 1.01), waist circumference was 135.8 cm in women (25) and 139.8 cm in men (10). Walked to the end of 6mWT 412.43 m, with no differences between gender and adiposity. The total distance walked by obesity alone was explained by BMI (45%), HR in the sixth minute (43%), the Baecke (24%) and fatigue (-23%). 88.6% of obese (31) performed the test above 60% of maximal HR, while the peak HR achieved at 5-minute of 6mWT. Systemic arterial pressure and DP rised after walking, but with no differences between gender and adiposity. Conclusion: The walk of obese didn´t suffers influence of gender or the pattern of body adiposity. The final distance walked is attributed to excess body weight, stress heart, the feeling of effort required by physical activity and level of sedentary to obese. With a minute of walking, the obeses achieved a range of intensity cardiovascular trainning

Prevalência de doença arterial obstrutiva periférica (DAOP) e alterações sensoriais em pacientes diabéticos tipo 2: impacto da DAOP sobre a qualidade de vida, nível de atividade física e composição corporal

Diabetes Mellitus (DM) affected approximately 171 million people in the world in the year 2000 as described by the World Health Organization (WHO). Because DM is a multisystem disease it can cause several complications especially those related to the cardiovascular system. The Peripheral Arterial Disease (PAD) of the lower limbs and the Diabetic Distal Symmetric Polyneuropathy (DDSP) can affect the DM patient causing consequences as the diabetic foot and eventually amputations. The main objective of this study was to determine the prevalence of PAD and sensorial impairment in 73 type 2 DM (DM2) patients and also assess the impact of PAD on quality of life, level of physical activity and body composition. For clinical assessment it was used: the ankle-brachial index (ABI); quantitative sensorial test for tactile sensibility (ST), pain (SD), vibration (SV); Achilles tendon reflex (RA); quality of life questionnaire (SF-36); modified Baecke physical activity questionnaire and bioelectric impedance. Prevalence of PAD in the studied population was 13.7%. ABI was inversely correlated to age (p=0,03; rhô= -0,26), diabetes duration (p=0,02; rhô= -0,28) and blood pressure (p= 0,0007; rhô= -0,33). There were lower scores for physical health summary on the SF-36 in DM2 patients; however, the presence of PAD predominantly mild did not significantly impact quality of life, body composition or physical activity level assessed by questionnaire. Fourteen patients (19.2%) present bilateral and symmetrical alterations in two or more sensorial tests compatible to DPN diagnosis. Abnormalities in ST, SD and SV were present in 27.3%, 24.6% and 8.2%; respectively. There was association of results from ST abnormalities with RA and mainly with SD, suggesting the importance of 10g monofilament use in DM2 routine assessment. In conclusion, the prevalence of PAD in subclinical DM2 was slightly higher compared to the general population and in agreement to previously published data in DM patients. The PAD severity was predominantly mild and still without repercussion on quality of life and body composition. Our study demonstrated a significant prevalence of both PAD and DPN in DM2 without previous diagnosis of these complications and indicates the necessity of early preventive and therapeutic interventions for this population

Comparação das respostas fisiológicas entre diferentes testes funcionais em obesos

obesity affects rightly functional capacity diminishing the cardiovascular system efficiency and oxygen uptake (VO2). Field tests, such as, Incremental Shuttle Walking Test (ISWT) and Six Minute Walk Test (6MWT) has been employed as alternative of Cardiopulmonary Exercise Test (CPX), to functional assessing for conditions which transport of oxygen to peripheral is diminished. Nevertheless, the knowing about metabolic variables response in real time and it comparing among different maximal and submaximal tests in obese is absent. Aim: to compare cardiopulmonary, metabolic response during CPX, ISWT and 6MWT and to analyse it influence of adiposity markers in obese. Material e Method: crosssectional, prospective study. Obese included if: (BMI>30Kg/m2; FVC>80%), were assessed as clinical, anthropometric (BMI, body adiposity index-BAI, waist-WC, hip- HC and neck-NC circumferences) and spirometry (forced vital capacity-FVC, Forced expiratory volume-1°second-FEV1, maximal voluntary ventilation-MVV) variables. Obese performed the sequence of tests: CPX, ISWT and 6MWT. Throughout tests was assessed breath-by-breath by telemetry system (Cortex-Biophysik-Metamax3B) variables; oxygen uptake on peak of activity (VO2peak); carbon dioxide production (VCO2); Volume Expiratory (VE); ventilatory equivalents for VO2 (VE/VO2) and CO2 (VE/VCO2); respiratory exchange rate (RER) and perceived effort-Borg6-20). Results: 15 obese (10women) 39.4+10.1years, normal spirometry (%CVF=93.7+9.7) finished all test. They have BMI (43.5+6.6kg/m2) and different as %adiposity (BAI=50.0+10.5% and 48.8+16.9% respectively women and men). Difference of VO2ml/kg/min and %VO2 were finding between CPX (18.6+4.0) and 6MWT (13.2+2.5) but not between ISWT (15.4+2.9). Agreement was found for ISWT and CPX on VO2Peak (3.2ml/kg/min; 95%; IC-3.0 9.4) and %VO2 (16.4%). VCO2(l/min) confirms similarity in production for CPX (2.3+1.0) and ISWT (1.7+0.7) and difference for 6MWT (1.4+0.6). WC explains more the response of CPX and ISWT than other adiposity markers. Adiposity diminishes 3.2% duration of CPX. Conclusion: ISWT promotes similar metabolic and cardiovascular response than CPX in obese. It suggesting that ISWT could be useful and reliable to assess oxygen uptake and functional capacity in obese