A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome.

Calcium channel blockers (CCBs) are prescribed to patients with Marfan syndrome for prophylaxis against aortic aneurysm progression, despite limited evidence for their efficacy and safety in the disorder. Unexpectedly, Marfan mice treated with CCBs show accelerated aneurysm expansion, rupture, and premature lethality. This effect is both extracellular signal-regulated kinase (ERK1/2) dependent and angiotensin-II type 1 receptor (AT1R) dependent. We have identified protein kinase C beta (PKCβ) as a critical mediator of this pathway and demonstrate that the PKCβ inhibitor enzastaurin, and the clinically available anti-hypertensive agent hydralazine, both normalize aortic growth in Marfan mice, in association with reduced PKCβ and ERK1/2 activation. Furthermore, patients with Marfan syndrome and other forms of inherited thoracic aortic aneurysm taking CCBs display increased risk of aortic dissection and need for aortic surgery, compared to patients on other antihypertensive agents.

Non-selective beta-blockers may reduce risk of hepatocellular carcinoma: a meta-analysis of randomized trials

BACKGROUND & AIMS Non-selective beta-blockers (NSBB) are used in patients with cirrhosis and oesophageal varices. Experimental data suggest that NSBB inhibit angiogenesis and reduce bacterial translocation, which may prevent hepatocellular carcinoma (HCC). We therefore assessed the effect of NSBB on HCC by performing a systematic review with meta-analyses of randomized trials. METHODS Electronic and manual searches were combined. Authors were contacted for unpublished data. Included trials assessed NSBB for patients with cirrhosis; the control group could receive any other intervention than NSBB. Fixed and random effects meta-analyses were performed with I(2) as a measure of heterogeneity. Subgroup, sensitivity, regression and sequential analyses were performed to evaluate heterogeneity, bias and the robustness of the results after adjusting for multiple testing. RESULTS Twenty-three randomized trials on 2618 patients with cirrhosis were included, of which 12 reported HCC incidence and 23 reported HCC mortality. The mean duration of follow-up was 26 months (range 8-82). In total, 47 of 694 patients randomized to NSBB developed HCC vs 65 of 697 controls (risk difference -0.026; 95% CI-0.052 to -0.001; number needed to treat 38 patients). There was no heterogeneity (I(2) = 7%) or evidence of small study effects (Eggers P = 0.402). The result was not confirmed in sequential analysis, which suggested that 3719 patients were needed to achieve the required information size. NSBB did not reduce HCC-related mortality (RD -0.011; 95% CI -0.040 to 0.017). CONCLUSIONS Non-selective beta-blockers may prevent HCC in patients with cirrhosis.

Use of Calcium Channel Blockers is Associated with Mortality in Patients with Chronic Kidney Disease.

BACKGROUND/AIMS The use of antihypertensive medicines has been shown to reduce proteinuria, morbidity, and mortality in patients with chronic kidney disease (CKD). A specific recommendation for a class of antihypertensive drugs is not available in this population, despite the pharmacodynamic differences. We have therefore analysed the association between antihypertensive medicines and survival of patients with chronic kidney disease. METHODS Out of 2687 consecutive patients undergoing kidney biopsy a cohort of 606 subjects with retrievable medical therapy was included into the analysis. Kidney function was assessed by glomerular filtration rate (GFR) estimation at the time point of kidney biopsy. Main outcome variable was death. RESULTS Overall 114 (18.7%) patients died. In univariate regression analysis the use of alpha-blockers and calcium channel antagonists, progression of disease, diabetes mellitus (DM) type 1 and 2, arterial hypertension, coronary heart disease, peripheral vascular disease, male sex and age were associated with mortality (all p<0.05). In a multivariate Cox regression model the use of calcium channel blockers (HR 1.89), age (HR 1.04), DM type 1 (HR 8.43) and DM type 2 (HR 2.17) and chronic obstructive pulmonary disease (HR 1.66) were associated with mortality (all p < 0.05). CONCLUSION The use of calcium channel blockers but not of other antihypertensive medicines is associated with mortality in primarily GN patients with CKD.

Incidencia de la aplicación de un programa de fútbol en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular en niños de 6-8 años

El presente trabajo es un macro ciclo de cinco meses que se realizó en la ACADEMIA DE FUTBOL ARNOLDO IGUARAN con niños en edades de los 6 a los 8 años pertenecientes al Municipio de La Villa de San Diego de Ubaté, Colombia; el objetivo principal fue determinar Incidencia de la aplicación de un programa de futbol, en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular, haciendo énfasis en las acciones intermitentes y fundamental mente donde el niño este obligado a desarrollar fuerza y a entrenar con sobre cargas significativas

Incidencia de la aplicación de un programa de fútbol en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular en niños de 6-8 años

El presente trabajo es un macro ciclo de cinco meses que se realizó en la ACADEMIA DE FUTBOL ARNOLDO IGUARAN con niños en edades de los 6 a los 8 años pertenecientes al Municipio de La Villa de San Diego de Ubaté, Colombia; el objetivo principal fue determinar Incidencia de la aplicación de un programa de futbol, en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular, haciendo énfasis en las acciones intermitentes y fundamental mente donde el niño este obligado a desarrollar fuerza y a entrenar con sobre cargas significativas

Incidencia de la aplicación de un programa de fútbol en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular en niños de 6-8 años

El presente trabajo es un macro ciclo de cinco meses que se realizó en la ACADEMIA DE FUTBOL ARNOLDO IGUARAN con niños en edades de los 6 a los 8 años pertenecientes al Municipio de La Villa de San Diego de Ubaté, Colombia; el objetivo principal fue determinar Incidencia de la aplicación de un programa de futbol, en actividades que se basan en el incremento de las unidades motoras activas, utilizando como herramienta un adecuado entrenamiento de la fuerza de tipo neuromuscular, haciendo énfasis en las acciones intermitentes y fundamental mente donde el niño este obligado a desarrollar fuerza y a entrenar con sobre cargas significativas

Análisis de la influencia de la estimulación con vibraciones en la respuesta neuromuscular en competidores de esgrima

La esgrima es un deporte de combate en el que todas las acciones están dirigidas a conseguir el objetivo de la competición, que es el de tocar al contrario sin ser tocado, y para ello los tiradores/as se sirven de todas las herramientas, técnicas, tácticas y de condición física posibles a su alcance. La calidad de las acciones de los esgrimistas en competición dependerá fundamentalmente de dos de los sistemas involucrados en el proceso. Por un lado, la activación del sistema nervioso, y por otro lado la respuesta del sistema muscular. Una de las herramientas utilizadas en los últimos años para estimular el sistema neuromuscular, y que ha reportado en muchas investigaciones resultados positivos, ha sido la plataforma de vibraciones vertical. Por esto, decidimos llevar a cabo un estudio con deportistas de esgrima de competición con un protocolo de exposición aguda a las vibraciones, y medir el efecto producido por esta herramienta sobre el sistema neuromuscular a través del estudio de los cambios experimentados en los tiempos de reacción simple, tiempos de respuesta electiva y tiempos de movimiento, así como los efectos en la eficacia del tocado de esgrima analizados antes y después de recibir el estímulo vibratorio. El estudio se desarrolló con tiradores/as de competición de nivel nacional y pertenecientes al Centro de Tecnificación de la Federación de Esgrima de Castilla y León (n=38; Edad: 22 ±9,08). La muestra estaba compuesta por 12 mujeres y 26 hombres, de categorías, cadetes (13), júnior (12), y absolutos (13). El protocolo elegido fue realizado por cada participante en tres ocasiones, una inicial, otra tras pasar por una carga de estimulación en la plataforma de vibraciones, y una fase final, pasado un tiempo de recuperación de 10 minutos para comprobar el grado de disipación del efecto vibratorio. El estímulo elegido para la estimulación sobre la plataforma de vibraciones fue de una frecuencia de 50 Hz, durante un periodo de 60 segundos y con una amplitud de 4 mm. Los resultados se analizaron en función de las variables dependientes tiempo de reacción, tiempo de respuesta electiva, tiempo de movimiento, y precisión y eficacia. Estos datos se cruzaron con las variables independientes sexo, categoría, nivel deportivo y años de experiencia. El propósito del presente estudio fue el de analizar los efectos producidos por una intervención de estimulación neuromuscular mecánica en fase aguda en un grupo de tiradores/as de esgrima de competición. Los resultados mostraron que la carga de estimulación neuromuscular mecánica (ENM) aplicada en nuestro estudio provocó un discreto efecto en la respuesta neuromuscular de los tiradores participantes en la investigación. Se encontraron efectos significativos provocados por el estímulo vibratorio en las siguientes variables: en el tiempo de reacción simple se registró una mejora del 8,1%, en el tiempo de respuesta electiva a pie parado un 10%, en la precisión a pie parado un 7%, y en la eficacia a pie parado un 18,5%. Igualmente se observaron ligeras diferencias por sexos, encontrando un efecto de mayor tamaño en el grupo femenino. Es necesario resaltar que las características particulares de la muestra parecen haber influido en los resultados encontrados de forma importante. Por último, debemos destacar que el efecto residual producido por la estimulación aplicada en nuestra investigación en algún caso superó los diez minutos, ya que se hallaron efectos positivos de la estimulación neuromuscular mecánica en varios de los registros finales como hemos visto. ABSTRACT Fencing is a combat sport in which all actions are aimed at achieving the objective of the competition, which is that of touching the opponent without being touched and for this the fencers make use of all the tools, techniques, tactics and physical condition possible at their disposal. The quality of the fencers´ actions in competition will depend primarily on two of the systems involved in the process: on the one hand, the activation of the nervous system and, on the other, the response of the muscular system. One of the tools recently used to stimulate the neuromuscular system, and which has produced positive results in many research studies, has been the vertical vibration platform. Therefore, we decided to conduct a study with competition fencers with a protocol of acute exposure to vibration and to measure the effect produced by this tool on the neuromuscular system by means of the study of changes experienced in simple reaction times, the elective response times and movement times, as well as the effects on the efficacy of the fencing touch analyzed before and after receiving the vibratory stimulus. The study was conducted with fencers in national competitions and belonging to the Technification Center of the Fencing Federation of Castilla y León (n = 38), with a mean age of 22 years (SD 9.08). The sample was composed of 12 women and 26 men, by categories cadets (13), juniors (12), and seniors (13). The protocol chosen was performed by each participant on three occasions: an initial one, another after going through a stimulation load on the vibration platform, and a final phase, after a 10 minute recovery time to assess the degree of dissipation of the vibratory effect. The stimulus chosen on the vibration platform was a frequency of 50 Hz, for a period of 60 seconds and an amplitude of 4 mm. The results were analyzed according to the following dependent variables: the reaction time, the response time, the accuracy and the efficiency. This data was crossed with the independent variables: gender, category, sporting level and the years of experience. The purpose of this study was analyze the effects of neuromuscular stimulation intervention in a group of fencing competition shooters. The results showed that the mechanical neuromuscular stimulation (MNS) load applied in our study led to a modest effect on the neuromuscular response of the fencers involved in the research. Significant effects were found caused by the vibratory stimulus on the simple reaction time 8,1%, elective response time 10%, as well as the accuracy 7%, and efficiency 18,5%. We should also point out that slight differences by gender were observed, finding a greater effect in females. It should be emphasized that the specific characteristics of the sample appear to have significantly influenced the results. Finally, we should note that the residual effect produced by the stimulation applied in our research in some cases exceeded ten minutes, given that positive effects of the mechanical neuromuscular stimulation were found in several of the final scores.

Efecto de una exposición aguda a una estimulación neuromuscular mecánica en el tiempo de respuesta electiva a pie parado en tiradores de esgrima

En este trabajo se aplicó un protocolo de exposición aguda a las vibraciones en competidores de esgrima de nivel nacional, para analizar el efecto producido sobre el sistema neuromuscular en el tiempo de respuesta electiva.

Two functionally distinct subsites for the binding of internal blockers to the pore of voltage-activated K+ channels

Many blockers of Na+ and K+ channels act by blocking the pore from the intracellular side. For Shaker K+ channels, such intracellular blockers vary in their functional effect on slow (C-type) inactivation: Some blockers interfere with C-type inactivation, whereas others do not. These functional differences can be explained by supposing that there are two overlapping “subsites” for blocker binding, only one of which inhibits C-type inactivation through an allosteric effect. We find that the ability to bind to these subsites depends on specific structural characteristics of the blockers, and correlates with the effect of mutations in two distinct regions of the channel protein. These interactions are important because they affect the ability of blockers to produce use-dependent inhibition.

Unmasking the functions of the chromaffin cell α7 nicotinic receptor by using short pulses of acetylcholine and selective blockers

Methyllycaconitine (MLA), α-conotoxin ImI, and α-bungarotoxin inhibited the release of catecholamines triggered by brief pulses of acetylcholine (ACh) (100 μM, 5 s) applied to fast-superfused bovine adrenal chromaffin cells, with IC50s of 100 nM for MLA and 300 nM for α-conotoxin ImI and α-bungarotoxin. MLA (100 nM), α-conotoxin ImI (1 μM), and α-bungarotoxin (1 μM) halved the entry of 45Ca2+ stimulated by 5-s pulses of 300 μM ACh applied to incubated cells. These supramaximal concentrations of α7 nicotinic receptor blockers depressed by 30% (MLA), 25% (α-bungarotoxin), and 50% (α-conotoxin ImI) the inward current generated by 1-s pulses of 100 μM ACh, applied to voltage-clamped chromaffin cells. In Xenopus oocytes expressing rat brain α7 neuronal nicotinic receptor for acetylcholine nAChR, the current generated by 1-s pulses of ACh was blocked by MLA, α-conotoxin ImI, and α-bungarotoxin with IC50s of 0.1 nM, 100 nM, and 1.6 nM, respectively; the current through α3β4 nAChR was unaffected by α-conotoxin ImI and α-bungarotoxin, and weakly blocked by MLA (IC50 = 1 μM). The functions of controlling the electrical activity, the entry of Ca2+, and the ensuing exocytotic response of chromaffin cells were until now exclusively attributed to α3β4 nAChR; the present results constitute the first evidence to support a prominent role of α7 nAChR in controlling such functions, specially under the more physiological conditions used here to stimulate chromaffin cells with brief pulses of ACh.

Reduced facilitation and vesicular uptake in crustacean and mammalian neuromuscular junction by T-588, a neuroprotective compound

Bath application of compound T-588, a neuroprotective agent, reduced paired-pulse and repetitive-pulse facilitation at mammalian and crustacean neuromuscular junctions. In addition, it reduced voltage-gated sodium and potassium currents in a use-dependent fashion, but had only a small effect on the presynaptic Ca2+ conductance. By contrast, it blocked FM 1–43 vesicular uptake but not its release, in both species. Postsynaptically, T-588 reduced acetylcholine currents at the mammalian junction in a voltage-independent manner, but had no effect on the crayfish glutamate junction. All of these effects were rapidly reversible and were observed at concentrations close to the compound’s acute protective level. We propose that this set of mechanisms, which reduces high-frequency synaptic transmission, is an important contributory factor in the neuroprotective action of T-588.

Use of calcium channel blockers and risk of suicide: ecological findings confirmed in population based cohort study

Objective: To investigate possible associations between use of cardiovascular drugs and suicide.