Hipotensión arterial y variabilidad de la frecuencia cardiaca en pacientes embarazadas llevadas a cesarea bajo anestesia raquídea

INTRODUCCION La hipotensión arterial por anestesia raquídea en embarazadas llevadas a cesárea es frecuente y deletérea para la madre y el feto, sin que a la fecha exista una herramienta clínicamente útil para predecirla. La variabilidad de la frecuencia cardiaca es una medida que estima la actividad del sistema nervioso autónomo y algunos estudio iniciales indican una posible utilidad como herramienta predictiva de hipotensión arterial en esta población. METODOLOGIA Se realizó un estudio observacional descriptivo para examinar el comportamiento de la variabilidad de la frecuencia cardiaca, medida como razón de Baja frecuencia/Alta frecuencia, con un punto de corte de 2.5 tomada con un reloj POLAR RS800CX, en una población de pacientes con embarazo a término llevadas a cesárea, en un hospital de tercer nivel en Bogotá- Colombia entre Febrero y Abril del 2015. RESULTADOS El estudio incluyó 82 pacientes. Se determinó que la razón Baja frecuencia/Alta frecuencia mayor a 2,5 era poco frecuente en nuestra población (15.85%), y su asociación no fue significativa. DISCUSION El presente estudio demostró que la asociación entre la presencia de hipotensión y un índice Baja frecuencia/Alta frecuencia con punto de corte de 2.5 no es significativo para nuestra población de mujeres con embarazo a término llevadas a cesárea con anestesia espinal. Según los resultados se sugieres un punto de corte de 1.6 como punto de partida para la realización de nuevos estudios que permitan validar este valor.

Tachykinins regulate the function of platelets

Evidence has been mounting for peripheral functions for tachykinins, a family of neuropeptides including substance P (SP), neurokinin A, and neurokinin B, which are recognized for their roles in the central and peripheral nervous system. The recent discovery of 4 new members of this family, the endokinins (EKA, B, C, and 13), which are distributed peripherally, adds support to the notion that tachykinins have physiologic/endocrine roles in the periphery. In the present study we report a fundamental new function for tachykinins in the regulation of platelet function. We show that SP stimulates platelet aggregation, and underlying this is the intracellular mobilization of calcium and degranulation. We demonstrate the presence of the tachykinin receptors NK1 and NK3 in platelets and present evidence for the involvement of NK1 in SP-mediated platelet aggregation. Platelets were found to contain SP-like immunoreactivity that is secreted upon activation implicating SP-like substances in the autocrine/paracrine regulation of these cells. Indeed, NK1-blocking antibodies inhibited aggregation in response to other agonists. Of particular note is the observation that EKA/B cross-react in the SP immunoassay and are also able to stimulate platelet activation. Together our data implicate tachykinins, specifically SP and EKA/B, in the regulation of platelet function. (C) 2004 by The American Society of Hematology.

Variation in the FFAR1 gene modifies BMI, body composition and plasma lipids but not plasma insulin or Beta-cell function in overweight subjects

Background FFAR1 receptor is a long chain fatty acid G-protein coupled receptor which is expressed widely, but found in high density in the pancreas and central nervous system. It has been suggested that FFAR1 may play a role in insulin sensitivity, lipotoxicity and is associated with type 2 diabetes. Here we investigate the effect of three common SNPs of FFAR1 (rs2301151; rs16970264; rs1573611) on pancreatic function, BMI, body composition and plasma lipids. Methodology/Principal Findings For this enquiry we used the baseline RISCK data, which provides a cohort of overweight subjects at increased cardiometabolic risk with detailed phenotyping. The key findings were SNPs of the FFAR1 gene region were associated with differences in body composition and lipids, and the effects of the 3 SNPs combined were cumulative on BMI, body composition and total cholesterol. The effects on BMI and body fat were predominantly mediated by rs1573611 (1.06 kg/m2 higher (P = 0.009) BMI and 1.53% higher (P = 0.002) body fat per C allele). Differences in plasma lipids were also associated with the BMI-increasing allele of rs2301151 including higher total cholesterol (0.2 mmol/L per G allele, P = 0.01) and with the variant A allele of rs16970264 associated with lower total (0.3 mmol/L, P = 0.02) and LDL (0.2 mmol/L, P<0.05) cholesterol, but also with lower HDL-cholesterol (0.09 mmol/L, P<0.05) although the difference was not apparent when controlling for multiple testing. There were no statistically significant effects of the three SNPs on insulin sensitivity or beta cell function. However accumulated risk allele showed a lower beta cell function on increasing plasma fatty acids with a carbon chain greater than six. Conclusions/Significance Differences in body composition and lipids associated with common SNPs in the FFAR1 gene were apparently not mediated by changes in insulin sensitivity or beta-cell function.

Protease-activated receptor 2: activation, signalling and function

PARs (protease-activated receptors) are a family of four G-protein-coupled receptors for proteases from the circulation, inflammatory cells and epithelial tissues. This report focuses on PAR(2), which plays an important role in inflammation and pain. Pancreatic (trypsin I and II) and extrapancreatic (trypsin IV) trypsins, mast cell tryptase and coagulation factors VIIa and Xa cleave and activate PAR(2). Proteases cleave PAR(2) to expose a tethered ligand that binds to the cleaved receptor. Despite this irreversible activation, PAR(2) signalling is attenuated by beta-arrestin-mediated desensitization and endocytosis, and by lysosomal targeting and degradation, which requires ubiquitination of PAR(2). beta-Arrestins also act as scaffolds for the assembly of multi-protein signalling complexes that determine the location and function of activated mitogen-activated protein kinases. Observations of PAR(2)-deficient mice support a role for PAR(2) in inflammation, and many of the effects of PAR(2) activators promote inflammation. Inflammation is mediated in part by activation of PAR(2) in the peripheral nervous system, which results in neurogenic inflammation and hyperalgesia.

Endocannabinoids in neuroendopsychology: multiphasic control of mitochondrial function

The endocannabinoid system (ECS) is a construct based on the discovery of receptors that are modulated by the plant compound tetrahydrocannabinol and the subsequent identification of a family of nascent ligands, the 'endocannabinoids'. The function of the ECS is thus defined by modulation of these receptors-in particular, by two of the best-described ligands (2-arachidonyl glycerol and anandamide), and by their metabolic pathways. Endocannabinoids are released by cell stress, and promote both cell survival and death according to concentration. The ECS appears to shift the immune system towards a type 2 response, while maintaining a positive energy balance and reducing anxiety. It may therefore be important in resolution of injury and inflammation. Data suggest that the ECS could potentially modulate mitochondrial function by several different pathways; this may help explain its actions in the central nervous system. Dose-related control of mitochondrial function could therefore provide an insight into its role in health and disease, and why it might have its own pathology, and possibly, new therapeutic directions.

HISTAMINE IN THE POSTERODORSAL MEDIAL AMYGDALA MODULATES CARDIOVASCULAR REFLEX RESPONSES IN AWAKE RATS

Centrally injected histamine (HA) affects heart rate (HR), arterial blood pressure (BP), and sympathetic activity in rats. The posterodorsal medial amygdala (MePD) has high levels of histidine decarboxylase, connections with brain areas involved with the modulation of cardiovascular responses, and is relevant for the pathogenesis of hypertension. However, there is no report demonstrating the role of the MePD histaminergic activity on the cardiovascular function in awake rats. The alms of the present work were: 1) to study the effects of two doses (10-100 nM) of HA microinjected in the MePD on basal cardiovascular recordings and on baroreflex- and chemoreflex-mediated responses; 2) to reveal whether cardiovascular reflex responses could be affected by MePD microinjections of (R)-alpha-methylhistamine (AH(3)), an agonist of the inhibitory autoreceptor H(3); and, 3) to carry out a power spectral analysis to evaluate the contribution of the sympathetic and parasympathetic components in the variability of the HR and BP recordings. When compared with the control group (microinjected with saline, 0.3 mu l), HA (10 nM) promoted an increase in the MAP(50), i.e. the mean value of BP at half of the HR range evoked by the baroreflex response. Histamine (100 nM) did not affect the baroreflex activity, but significantly decreased the parasympathetic component of the HR variability, increased the sympathetic/parasympathetic balance at basal conditions (these two latter evaluated by the power spectral analysis), and promoted an impairment in the chemoreflex bradycardic response. Microinjection of AH(3) (10 mu M) led to mixed results, which resembled the effects of both doses of HA employed here. Present data suggest that cardiovascular changes induced by baroreceptors and chemoreceptors involve the histaminergic activity in the MePD. This neural regulation of reflex cardiovascular responses can have important implications for homeostatic and allostatic conditions and possibly for the behavioral displays modulated by the rat MePD. (C) 2008 IBRO. Published by Elsevier Ltd. All rights reserved.

The Immune-Pineal Axis Stress as a Modulator of Pineal Gland Function

The temporal organization of mammals presents a daily adjustment to the environmental light/dark cycle. The environmental light detected by the retina adjusts the central clock in the suprachiasmatic nuclei, which innervate the pineal gland through a polysynaptic pathway. During the night, this gland produces and releases the nocturnal hormone melatonin, which circulates throughout the whole body and adjusts several bodily functions according to the existence and duration of darkness. We have previously shown that during the time frame of an inflammatory response, pro-inflammatory cytokines, such as tumor necrosis factor-a, inhibit while anti-inflammatory mediators, such as glucocorticoids, enhance the synthesis of melatonin, interfering in the daily adjustment of the light/dark cycle. Therefore, injury disconnects the organism from environmental cycling, while recovery restores the light/dark information to the whole organism. Here, we extend these observations by evaluating the effect of a mild restraint stress, which did not induce macroscopic gastric lesions. After 2 h of restraint, there was an increase in circulating corticosterone, indicating activation of the hypothalamus-pituitary-adrenal (HPA) axis. In parallel, an increase in melatonin production was observed. Taking into account the data obtained with models of inflammation and stress, we reinforce the hypothesis that the activity of the pineal gland is modulated by the state of the immune system and the HPA axis, implicating the darkness hormone melatonin as a modulator of defense responses.

Atrophy and Neuron Loss: Effects of a Protein-Deficient Diet on Sympathetic Neurons

Protein deficiency is one of the biggest public health problems in the world, accounting for about 30-40% of hospital admissions in developing countries. Nutritional deficiencies lead to alterations in the peripheral nervous system and in the digestive system. Most studies have focused on the effects of protein-deficient diets on the enteric neurons, but not on sympathetic ganglia, which supply extrinsic sympathetic input to the digestive system. Hence, in this study, we investigated whether a protein-restricted diet would affect the quantitative structure of rat coeliac ganglion neurons. Five male Wistar rats (undernourished group) were given a pre- and postnatal hypoproteinic diet receiving 5% casein, whereas the nourished group (n = 5) was fed with 20% casein (normoproteinic diet). Blood tests were carried out on the animals, e.g., glucose, leptin, and triglyceride plasma concentrations. The main structural findings in this study were that a protein-deficient diet (5% casein) caused coeliac ganglion (78%) and coeliac ganglion neurons (24%) to atrophy and led to neuron loss (63%). Therefore, the fall in the total number of coeliac ganglion neurons in protein-restricted rats contrasts strongly with no neuron losses previously described for the enteric neurons of animals subjected to similar protein-restriction diets. Discrepancies between our figures and the data for enteric neurons (using very similar protein-restriction protocols) may be attributable to the counting method used. In light of this, further systematic investigations comparing 2-D and 3-D quantitative methods are warranted to provide even more advanced data on the effects that a protein-deficient diet may exert on sympathetic neurons. (C) 2009 Wiley-Liss, Inc.

Sympathetic mediation of salivation induced by intracerebroventricular pilocarpine in rats

Central cholinergic activation by pilocarpine induces salivation dependent on the integrity of forebrain areas. The present work investigates the autonomic mediation of this salivation. Pilocarpine (500 nmol/rat) was injected into the lateral ventricle (LV) of tribromoethanol-anesthetized adult male rats. Preweighed cotton balls were inserted into the oral cavity and weighed again 7 min later. ol-adrenoceptor antagonists (3-50 mu mol/kg) prazosin (alpha(1)), yohimbine (alpha(2)) or propranolol (beta) injected intraperitoneally (i.p.) produced, 80%, 20% and 0% inhibition respectively of the LV pilocarpine-induced salivation. Intracerebroventricular injections (160 nmol) of the antagonists did not alter the effects of pilocarpine injected into the LV. Bilateral section of chorda tympani nerve or bilateral sympathetic cervical ganglionectomy produced 0% and 40% inhibition of pilocarpine-induced salivation, respectively. Ganglionectomy did not alter salivation induced by i.p, injection of pilocarpine (4 mu mol/kg). The results indicate that there is a large sympathetic contribution to the salivation induced by central cholinergic activation. (C) 1999 Elsevier B.V. B.V. All rights reserved.

Endogenous hydrogen peroxide in the hypothalamic paraventricular nucleus regulates sympathetic nerve activity responses to L-glutamate

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of thyroid hormone T3 on Myosin-Va expression in the central nervous system

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos agudos do tabagismo sobre a modulação autonômica: análise por meio do plot de poincaré

FUNDAMENTO: O tabagismo altera a função autonômica. OBJETIVO: Investigar os efeitos agudos do tabagismo sobre a modulação autonômica e a recuperação dos índices de variabilidade de frequência cardíaca (VFC) pós-fumo, por meio do plot de Poincaré e índices lineares. MÉTODOS: Foram avaliados 25 fumantes jovens, os quais tiveram a frequência cardíaca analisada, batimento a batimento, na posição sentada, após 8 horas de abstinência, por 30 minutos em repouso, 20 minutos durante o fumo e 30 minutos pós-fumo. Análise de variância para medidas repetidas, seguido do teste de Tukey, ou teste de Friedman seguido do teste de Dunn foram aplicados dependendo da normalidade dos dados, com p < 0,05. RESULTADOS: Durante o fumo, houve redução dos índices SD1 (23,4 ± 9,2 vs 13,8 ± 4,8), razão SD1/SD2 (0,31 ± 0,08 vs 0,2 ± 0,04), RMSSD (32,7 ± 13 vs 19,1 ± 6,8), SDNN (47,6 ± 14,8 vs 35,5 ± 8,4), HFnu (32,5 ± 11,6 vs 19 ± 8,1) e do intervalo RR (816,8 ± 89 vs 696,5 ± 76,3) em relação ao repouso, enquanto que aumentos do índice LFnu (67,5 ± 11,6 vs 81 ± 8,1) e da razão LF/HF (2,6 ± 1,7 vs 5,4 ± 3,1) foram observados. A análise visual do plot mostrou menor dispersão dos intervalos RR durante o fumo. Com exceção da razão SD1/SD2, os demais índices apresentaram recuperação dos valores, 30 minutos após o tabagismo. CONCLUSÃO: O tabagismo produziu agudamente modificações no controle autonômico, caracterizadas por ativação simpática e retirada vagal, com recuperação 30 minutos após o fumo.

Espécies reativas de oxigênio no controle neurovegetativo da pressão arterial

The control of the blood pressure depends on the activity of select groups of neurons present in the central nervous system. Evidence has demonstrated that the redox state (a balance between oxidizing and reducing species) is involved in the control of neuronal activity, which suggests that the redox state can influence the neuronal transmission within the central nervous system acting on the neuronal modulation of biological functions. For instance, the glutamatergic transmission may be widely affected by reactive oxygen species, oxidizing agents that have been extensively investigated due to their involvement in physiological and pathological processes. In the present article, we discuss the main experimental finds that support the hypothesis that reactive oxygen species have important role in physiological (and pathological) modulation of the cardiovascular function through alterations in the sympathetic and parasympathetic system. Therefore, reactive oxygen species can actively participate in the development of cardiovascular diseases like hypertension when the balance in the redox state is disrupted.

Performance of children with learning difficulties in fine motor function and handwriting

This study aimed to compare and characterize the fine, sensory and perceptive function performance and handwriting quality between students with learning difficulties and students with good academic performance. Methods: This study comprised 192 students from 2nd to 4th grades, both genders, whose ages ranged from 7 to 11 years old. The students were distributed into: GI, GII, GIII and GIV, comprising 96 students with learning difficulties, and groups GV, GVI, GVII, GVIII comprising 96 students with good academic performance. The students were submitted to evaluation of fine motor, sensorial and perception functions and handwriting evaluation under dictation. Results: The results showed that the students with learning difficulties, from 1st to 3rd grade, had lower performance on tests of fine motor, sensory and perceptive function, when compared to the students with good academic performance in the same grade; the students from 4th grade, both groups, did not show changes on fine motor, sensory and perceptive function; and only the students of GII showed dysgraphia. Conclusions: the results presented in this study suggest that the qualitative aspects of fine motor, sensory and perceptive skills reflect the integrity and maturity of central nervous system and can probably play an important role in early diagnosis of development disorders and consequently prevent academic disorders such as handwriting performance.