Sleep bruxism is associated with a rise in blood pressure

Objectifs : Le bruxisme survenant au cours du sommeil est un trouble du mouvement caractérisé par du grincement de dents et l’activité rythmique des muscles masticateurs (ARMM). Le bruxisme/ARMM est souvent associé à des mouvements du corps et des à éveils corticaux. Une séquence d’activation précède le ARMM/bruxisme. Ces événements incluent une augmentation des variables suivants : l’activité sympathique (-4 minutes), les activités encéphalographique (-4 second), le fréquence cardiaque, l’amplitude de la respiration (-1 second) et l’activité des muscle suprahyoïdiens (-0.8 second). La présente étude a examiné l’association entre le bruxisme et les changements de la pression artérielle. Méthodes: Dix sujets avec le bruxisme (5 hommes, 5 femmes, âge moyen = 26 ± 1,8) ont complétés 3 nuits de polysomnographie qui comprenait l'enregistrement non invasive de la pression artérielle. La première nuit a servi de dépistage et d’habituation au laboratoire. L'analyse a été réalisée sur les deuxièmes et troisièmes nuits enregistrements. Seuls les épisodes de bruxisme isolés survenant au cours du stade 2 du sommeil ont été utilisés pour l’analyse, pour un total de 65 épisodes. Les mesures des pressions systolique et diastolique ont été prises 20 battements avant et 23 battements après l'apparition de chaque épisode bruxisme lors du sommeil. Les épisodes de bruxisme ont été classés comme suit: 1) bruxisme avec éveil cortical; 2) bruxisme avec mouvement du corps (MC), 3) bruxisme avec éveil cortical et MC. Une quatrième catégorie, bruxisme seul, a également été analysée, mais utilisée comme donnée préliminaire puisque la catégorie se composait de seulement 4 épisodes de bruxisme. Résultats: Les deux pressions systolique et diastolique ont augmenté avec les épisodes de bruxisme. Cette augmentation a été statistiquement significative pour la pression systolique et diastolique pour les épisodes de bruxisme avec éveil cortical et/ou MC (p ≤ 0,05). L’augmentation moyenne de la pression (systolique / diastolique ± SE) a été : 28,4 ± 2,4/13,2 ± 1,5 mm Hg pour le bruxisme avec éveil cortical; 30,7 ± 1,6/19.4 ± 2.3 mm Hg pour bruxisme avec MC; 26.4 ± 2,8 / 14,6 ± 2.0mm Hg pour bruxisme avec éveil cortical et MC; 22,9 ± 5,2/12,4 ± 3,3mm Hg pour les épisodes de bruxisme seuls. Conclusion: Le bruxisme du sommeil est associé à des hausses de la pression artérielle pendant le sommeil. Cette hausse est supérieure dans les épisodes de bruxisme associés à un éveil cortical et / ou MC, qui sont souvent associés avec les événements bruxisme. Ces résultats sont en accord avec nos observations antérieures, où le bruxisme est précédé par une augmentation de l'activité sympathique et de la tachycardie sinusale.

Correlacion entre lactato arterial y venoso central en niños con sepsis en estado critico

Este estudio fue conducido para evaluar la correlación entre lactato arterial y venoso central en niños con sepsis y choque séptico de una unidad de cuidado intensivo pediátrico. Se incluyeron 42 pacientes con edades comprendidas entre 1 mes y 17 años 364 días con diagnóstico de sepsis y choque séptico que ingresaron a la Unidad de Cuidado Intensivo en un hospital universitario de referencia. Se registró el valor del lactato obtenido de una muestra de sangre arterial y de sangre venosa central tomadas simultáneamente y dentro de las primeras 24 horas del ingreso a la unidad. Por medio de la prueba de Rho de Spearman se encontró una correlación de 0,872 (p<0,001) y se ajustó al uso de medicamentos, vasoactivos, edad y peso (modelo de regresión no paramétrico quantílico), manteniéndose una correlación fuerte y significativa.

Respuesta aguda de presión arterial, frecuencia cardiaca y percepción del esfuerzo en hipertensos

Objetivo: Medir y comparar el comportamiento agudo de la presión arterial (TA), la frecuencia cardiaca (FC) y la percepción subjetiva del esfuerzo físico (PSE) durante un circuito de pesas de resistencia variable (CRV) versus ejercicio aeróbico submáximo en cicloergómetro (EA) en hipertensos estados I y II.Métodos: Se evaluaron 21 individuos (8 hombres y 13 mujeres) hipertensos controlados de estados I y II (15 activos y 6 sedentarios, 56±5.9 años). Todos recibieron inducción sobre calentamiento, manejo de escala de PSE, técnica respiratoria y uso de máquinas de pesas durante el ejercicio. Con intervalos de una semana se sometieron a una sesión de CRV en seis estaciones al 50% de 1RM, y a una sesión de EA a intensidades de 70%-80% de la FCmax, en intervalos de una semana. Durante ambas sesiones se realizaron mediciones de FC, PA y PSE.Resultados: Se aplicó una Prueba t pareada para comparar las respuestas a ambos tipos de ejercicio. Se encontró un incremento menor de la FC (p<0.001), PA sistólica (p<0.005) y PSE (p<0.005) durante el CRV. La elevación de la PA diastólica fue mayor con las pesas, pero no significativa (P=0.139). Los sedentarios mostraron incrementos mayores. Entre cada estación de pesas el comportamiento de las variables fue similar (P>0.05).Conclusión: El estudio evidenció que la respuesta cardiovascular aguda y la PSE de hipertensos durante un CRV fueron similares a las observadas con EA. Se observó que la respuesta presora al circuito de pesas fue menor en pacientes con entrenamiento aeróbico previo.

Dipeptidyl peptidase IV inhibition attenuates blood pressure rising in young spontaneously hypertensive rats

Objectives The present study aimed to assess the effect of the specific dipeptidyl peptidase IV (DPPIV) inhibitor sitagliptin on blood pressure and renal function in young prehypertensive (5-week-old) and adult spontaneously hypertensive rats (SHRs; 14-week-old). Methods Sitagliptin (40 mg/kg twice daily) was given by oral gavage to young (Y-SHR + IDPPIV) and adult (A-SHR R IDPPIV) SHRs for 8 days. Kidney function was assessed daily and compared with age-matched vehicle-treated SHR (Y-SHR and A-SHR) and with normotensive Wistar-Kyoto rats (Y-WKY and A-WKY). Arterial blood pressure was measured in these animals at the end of the experimental protocol. Additionally, Na(+)/H(+) exchanger isoform 3 (NHE3) function and expression in microvilli membrane vesicles were assessed in young animals. Results Mean arterial blood pressure of Y-SHR + IDPPIV was significantly lower than that of Y-SHR (104 +/- 3 vs. 123 +/- 5 mmHg, P < 0.01) and was similar to Y-WKY (94 +/- 4 mmHg, P > 0.05). Compared to Y-SHR, Y-SHR + IDPPIV exhibited enhanced cumulative urinary flow and sodium excretion and decreased NHE3 activity and expression in proximal tubule microvilli. In the A-SHR, sitagliptin treatment had no significant effect on either renal function or arterial blood pressure. Conclusion Our data suggest that DPPIV inhibition attenuates blood pressure rising in young prehypertensive SHRs, partially by inhibiting NHE3 activity in renal proximal tubule. J Hypertens 29:520-528 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Implementação de um sistema embarcado aplicado ao controle de pressão arterial

Hypertension is a dangerous disease that can cause serious harm to a patient health. In some situations the necessity to control this pressure is even greater, as in surgical procedures and post-surgical patients. To decrease the chances of a complication, it is necessary to reduce blood pressure as soon as possible. Continuous infusion of vasodilators drugs, such as sodium nitroprusside (SNP), rapidly decreased blood pressure in most patients, avoiding major problems. Maintaining the desired blood pressure requires constant monitoring of arterial blood pressure and frequently adjusting the drug infusion rate. Manual control of arterial blood pressure by clinical personnel is very demanding, time consuming and, as a result, sometimes of poor quality. Thus, the aim of this work is the design and implementation of a database of tuned controllers based on patients models, in order to find a suitable PID to be embedded in a Programmable Integrated Circuit (PIC), which has a smaller cost, smaller size and lower power consumption. For best results in controlling the blood pressure and choosing the adequate controller, tuning algorithms, system identification techniques and Smith predictor are used. This work also introduces a monitoring system to assist in detecting anomalies and optimize the process of patient care.

Contribuição ao estudo da vascularização arterial do testículo de búfalos da raça Murrah

Estudamos o comportamento da artéria testicular, o número e a distribuição dos vasos penetrantes em 30 pares de testículos de búfalos da raça Murrah (Bubalus bubalis), com idade entre 8 meses e 5 anos, procedentes da região de Ilha Solteira, no Estado de São Paulo, mediante a análise de moldes obtidos pela injeção de vinil, na artéria testicular e em seguida corrosão do órgão em ácido sulfúrico a 30%. Encontramos mais freqüentemente (68,4%) a artéria testicular cedendo dois ramos, o cranial e o caudal, com participação equivalente de ambos os ramos na vascularização do órgão (35,0%), ou com predominância do ramo cranial (21,7%) ou do ramo caudal (11,7%). em outros arranjos, a artéria testicular cede três ramos: o cranial, o médio e o caudal (20,0%) ou ainda número variável de ramos craniais (4 a 7) e caudais (3 a 5) (11,6%) para a vascularização arterial do testículo.

Effect of intravenous propofol and remifentanil on heart rate, blood pressure and nociceptive response in acepromazine premedicated dogs

ObjectiveTo investigate the cardiorespiratory, nociceptive and endocrine effects of the combination of propofol and remifentanil, in dogs sedated with acepromazine.Study designProspective randomized, blinded, cross-over experimental trial.AnimalsTwelve healthy adult female cross-breed dogs, mean weight 18.4 +/- 2.3 kg.MethodsDogs were sedated with intravenous (IV) acepromazine (0.05 mg kg-1) followed by induction of anesthesia with IV propofol (5 mg kg-1). Anesthesia was maintained with IV propofol (0.2 mg kg-1 minute-1) and remifentanil, infused as follows: R1, 0.125 mu g kg-1 minute-1; R2, 0.25 mu g kg-1 minute-1; and R3, 0.5 mu g kg-1 minute-1. The same dogs were administered each dose of remifentanil at 1-week intervals. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (f(R)), end tidal CO(2) (Pe'CO(2)), arterial hemoglobin O(2) saturation, blood gases, and rectal temperature were measured before induction, and 5, 15, 30, 45, 60, 75, 90, and 120 minutes after beginning the infusion. Nociceptive response was investigated by electrical stimulus (50 V, 5 Hz and 10 ms). Blood samples were collected for plasma cortisol measurements. Statistical analysis was performed by anova (p < 0.05).ResultsIn all treatments, HR decreased during anesthesia with increasing doses of remifentanil, and increased significantly immediately after the end of infusion. MAP remained stable during anesthesia (72-98 mmHg). Antinociception was proportional to the remifentanil infusion dose, and was considered satisfactory only with R2 and R3. Plasma cortisol concentration decreased during anesthesia in all treatments. Recovery was smooth and fast in all dogs.Conclusions and clinical relevanceInfusion of 0.25-0.5 mu g kg-1 minute-1 remifentanil combined with 0.2 mg kg-1 minute-1 propofol produced little effect on arterial blood pressure and led to a good recovery. The analgesia produced was sufficient to control the nociceptive response applied by electrical stimulation, suggesting that it may be appropriate for performing surgery.

Central nitrergic system regulation of neuroendocrine secretion, fluid intake and blood pressure induced by angiotensin-II

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A comparison between overweight cutoff points for detection of high blood pressure in adolescents

Objectives: To evaluate the accuracy of three different cutoff points for the detection of high blood pressure in adolescents, given the strong relationship between overweight and high blood pressure levels.Methods: A total of 1,021 adolescents of both sexes were enrolled in the study, selected at random from public and private schools in Londrina, Brazil. Their body weight was measured using a digital balance, and their height with a portable stadiometer with a maximum extension of 2 meters. Arterial blood pressure was measured using an automatic apparatus. The capacity of body mass index to detect high blood pressure was gauged using ROC curves and their parameters (sensitivity, specificity, and area under the curve).Results: The cutoff points proposed in a Brazilian standard exhibited greater accuracy (males: 0.636 +/- 0.038; females: 0.585 +/- 0.043) than the cutoff points proposed in an international (males: 0.594 +/- 0.040; females: 0.570 +/- 0.044) and a North-American standard (males: 0.612 +/- 0.039; females: 0.578 +/- 0.044).Conclusions: The Brazilian proposal offered greatest accuracy for indicating high blood pressure levels.

Effects of temperature on lung and blood gases in the South American rattlesnake Crotalus durissus terrificus

The effects of temperature on lung and blood gases were measured in the South American rattlesnake (Crotalus durissus terrificus). Arterial blood and lung gas samples were obtained from chronically cannulated animals at 15, 25, and 35 degrees C. As expected for reptiles, arterial pH fell with increased temperature (0.018 U degrees C-1 between 15 and 25 degrees C and 0.011 U degrees C-1 between 25 and 35 degrees C) while lung gas PCO2 rose from 5.8 mmHg at 15 degrees C to 13.2 mmHg at 35 degrees C. Concurrently, lung gas PO2 declined from 132 mmHg at 15 degrees C to 120 mmHg at 35 degrees C, and arterial PO2 increased from 33 to 76 mmHg in that temperature range. Arterial haemoglobin O-2 saturation rose from 0.53 at 15 degrees C to 0.83 at 25 degrees C but became slightly reduced (0.77) with a further elevation of temperature to 35 degrees C. Arterial haemoglobin concentration increased from 1.96 to 2.53 mM between 15 and 35 degrees C, consistent with higher demands on oxygen delivery to tissues at elevated temperatures. Moreover, the substantial increase of haemoglobin O-2 saturation between 15 and 25 degrees C conforms to the idea that reduction of the central vascular right-to-left shunt (pulmonary bypass of systemic venous return) is associated with high metabolic demands. (C) 1998 Elsevier B.V. All rights reserved.

A mathematical model for wave propagation in elastic tubes with inhomogeneities: Application to blood waves propagation

We study the propagation of waves in an elastic tube filled with an inviscid fluid. We consider the case of inhomogeneity whose mechanical and geometrical properties vary in space. We deduce a system of equations of the Boussinesq type as describing the wave propagation in the tube. Numerical simulations of these equations show that inhomogeneities prevent separation of right-going from left-going waves. Then reflected and transmitted coefficients are obtained in the case of localized constriction and localized rigidity. Next we focus on wavetrains incident on various types of anomalous regions. We show that the existence of anomalous regions modifies the wavetrain patterns. (c) 2007 Elsevier B.V. All rights reserved.

Role of nitric oxide of the median preoptic nucleus (MnPO) in the alterations of salivary flow, arterial pressure and heart rate induced by injection of pilocarpine into the MnPO and intraperitoneally

We investigated the effect of L-NAME, a nitric oxide (NO) inhibitor and sodium nitroprusside (SNP), an NO-donating agent, on pilocarpine-induced alterations in salivary flow, mean arterial blood pressure (MAP) and heart rate (HR) in rats. Male Holtzman rats (250-300 g) were implanted with a stainless steel cannula directly into the median preoptic nucleus (MnPO). Pilocarpine (10, 20, 40, 80, 160 µg) injected into the MnPO induced an increase in salivary secretion (P<0.01). Pilocarpine (1, 2, 4, 8, 16 mg/kg) ip also increased salivary secretion (P<0.01). Injection of L-NAME (40 µg) into the MnPO prior to pilocarpine (10, 20, 40, 80, 160 µg) injected into the MnPO or ip (1, 2, 4, 8, 16 mg/kg) increased salivary secretion (P<0.01). SNP (30 µg) injected into the MnPO or ip prior to pilocarpine attenuated salivary secretion (P<0.01). Pilocarpine (40 µg) injection into the MnPO increased MAP and decreased HR (P<0.01). Pilocarpine (4 mg/kg body weight) ip produced a decrease in MAP and an increase in HR (P<0.01). Injection of L-NAME (40 µg) into the MnPO prior to pilocarpine potentiated the increase in MAP and reduced HR (P<0.01). SNP (30 µg) injected into the MnPO prior to pilocarpine attenuated (100%) the effect of pilocarpine on MAP, with no effect on HR. Administration of L-NAME (40 µg) into the MnPO potentiated the effect of pilocarpine injected ip. SNP (30 µg) injected into the MnPO attenuated the effect of ip pilocarpine on MAP and HR. The present study suggests that in the rat MnPO 1) NO is important for the effects of pilocarpine on salivary flow, and 2) pilocarpine interferes with blood pressure and HR (side effects of pilocarpine), that is attenuated by NO.

Disfunção arterial como possível mecanismo de agressão cardíaca em pacientes com diabetes mellitus tipo II. Estudo Doppler-ecocardiográfico

OBJETIVO: Avaliar a estrutura e função do ventrículo esquerdo (VE) e a rigidez arterial em portadores de diabetes mellitus tipo II. MÉTODOS: Foram estudados 13 doentes diabéticos de ambos os sexos (55±8 anos) sem outras doenças. A estrutura e função do VE foram avaliadas por meio de ecodopplercardiografia associada à monitorização não invasiva da pressão arterial (PA). Os resultados foram comparados aos obtidos em grupo de indivíduos normais de mesma idade (n=12). RESULTADOS: Não houve diferenças entre os grupos quanto a PA diastólica, dimensões das câmaras esquerdas e índices de função sistólica e diastólica. Os pacientes diabéticos apresentaram índice de massa do VE (101±10 vs 80±14g/m²; p<0,001) e índice de rigidez arterial sistêmica (0,86±0,26 vs 0,69±0,19mmHg/mL; p<0,05) significantemente maiores que os controles. CONCLUSÃO: O diabetes mellitus está associado a aumento da rigidez arterial sistêmica e esse fator poderia contribuir para seus efeitos adversos sobre o VE.

DEVELOPMENT OF BLOOD-PRESSURE AND CARDIAC REFLEXES IN THE FROG PSEUDIS-PARADOXSUS

Systemic arterial blood pressure and heart rate (f(H)) were measured in unanesthetized, unrestrained larvae and adults of the paradoxical frog, Pseudis paradoxus from São Paulo State in Brazil. Four developmental groups were used, representing the complete transition from aquatic larvae to primarily air-breathing adults. f(H) (49-66 beats/min) was not significantly affected by development, whereas mean arterial blood pressure was strongly affected, being lowest in the stage 37-39 larvae (10 mmHg), intermediate in the stage 44-45 larvae (18 mmHg), and highest in the juveniles and adults (31 and 30 mmHg, respectively). Blood pressure was not significantly correlated with body mass, which was greatest in the youngest larvae and smallest in the juveniles. In the youngest larvae studied (stages 37-39), lung ventilation was infrequent, causing a slight decrease in arterial blood pressure but no change in heart rate. Lung ventilation was more frequent in stages 44-45 larvae and nearly continuous in juveniles and adults floating at the surface. Bradycardia during both forced and voluntary diving was observed in almost every advanced larva, juvenile, and adult but in only one of four young larvae. Developmentally related changes in blood pressure were not complete until metamorphosis, whereas diving bradycardia was present at an earlier stage.

THE ROLE OF ANGIOTENSIN AT1 RECEPTORS IN THE DIURETIC, NATRIURETIC, KALIURETIC AND BLOOD-PRESSURE RESPONSES INDUCED BY ANGIOTENSIN-II ACTIVATION OF THE MEDIAN PREOPTIC NUCLEUS IN CONSCIOUS RATS

We determined the effects of two classical angiotensin II (ANG II) antagonists, [Sar(1), Ala(8)]-ANG II and [Sar(1), Thr(8)]-ANG II, and losartan (a nonpeptide and selective antagonist for the AT 1 angiotensin receptors) on diuresis, natriuresis, kaliuresis and arterial blood pressure induced by ANG II administration into the median preoptic nucleus (MnPO) of male Holtzman rats weighing 250-300 g. Urine was collected in rats submitted to a water load (5% body weight) by gastric gavage, followed by a second water load (5% body weight) 1 h later. The volume of the drug solutions injected was 0.5 mu l over 10-15 s. Pre-treatment with [Sar(1), Ala(8)]-ANG II (12 rats) and [Sar(1), Thr(8)]-ANG II (9 rats), at the dose of 60 ng reduced (13.7 +/- 1.0 vs 11.0 +/- 1.0 and 10.7 +/- 1.2, respectively), whereas losartan (14 rats) at the dose of 160 ng totally blocked (13.7 +/- 1.0 vs 7.6 +/- 1.5) the urine excretion induced by injection of 12 ng of ANG II (14 rats). [Sar(1), Ala(8)]-ANG II impaired Na+ excretion (193 +/- 16 vs 120 +/- 19): whereas [Sar(1), Thr(8)]-ANG II and losartan blocked Na+ excretion (193 +/- 16 vs 77 +/- 15 and 100 +/- 12, respectively) induced by ANG II. Similar effects induced by ANG II on K+ excretion were observed with [Sar(1), Ala(8)]-ANG II, [Sar(1), Thr(8)]-ANG II, and losartan pretreatment (133 +/- 18 vs 108 +/- 11, 80 +/- 12, and 82 +/- 15, respectively). The same doses as above of [Sar(1), Ala(8)]-ANG II (8 rats), [Sar(1), Thr(8)]-ANG II (8 rats). and losartan (9 rats) blocked the increase in the arterial blood pressure induced by 12 ng of ANG II (12 rats) (32 +/- 4 ru 4 +/- 2, 3.5 +/- 1, and 2 +/- 1: respectively. The results indicate that the AT1 receptor subtype participates in the increases of diuresis, natriuresis. kaliuresis and arterial blood pressure induced by the administration of ANG II into the MnPO.