Comparison between the six-minute walk test and the six-minute step test in post stroke patients

Background: The Stroke remains one of the major chronic diseases worldwide, and is considered a major cause of disability, which results not only in persistent neurological deficits, but also in the high physical deconditioning, nevertheless there are not many forms of assessing functional capacity in this population. We aimed to investigate the feasibility of the Six Minute Walk Teste and the Six-Minute Step Test (6MST) in post-stroke patients and compare the behavior of physiological variables during the 6MST and the Six-Minute Walk Test (6MWT), by correlating the functional performance obtained in both tests. Method. The 6MWT was carried out according to the American Thoracic Society (ATS) and the 6MST was performed in six minutes in order to compare it to the 6MWT in a 20 cm step. Was included post-stroke individuals able to walk without aid. All of them did the 6MWT and the 6MST. Results: 12 patients participated in the study. There was no statistical difference in the parameters analyzed when tests were compared. There was poor correlation between the functional performance in both tests. Conclusion: The 6MWT and the 6MST is feasible for post-stroke patients and physiological responses are equal during the performance of both tests. However, there was no correlation with respect to functional performance, which was assessed by the distance walked in the 6MWT and by the number of steps climbed in the 6MST. © 2013 da Silva et al.; licensee BioMed Central Ltd.

Efeito da tosquia na temperatura corpórea e outros parâmetros clínicos em ovinos

The aim of this study was to determine the variation of the temperature after shearing in sheep under dry and hot environment conditions and to compare the temperature changes with variation in cardiac and respiratory frequencies, ruminal movements and hydration status. Twenty Suffolk unshorn ewes were studied. Physical examination was performed in all animals three times a day at 7:00 AM, 1:00 PM and 7:00 PM, during 42 days (22 days before shearing and 20 days after shearing). The skin temperature was measured by infrared thermometer over several surfaces of the body. Data were submitted to analysis of variance, for comparisons between groups (shorn versus unshorn) at each time, and the significant difference was evaluated at level of P<0.05 by Tukey test. The respiratory frequency was statistically significant at all times. When air humidity was high, the respiratory frequencies were low. The thermal stress was clear in sheep of this study, reflecting marked changes in cardiac and respiratory frequencies and rectal temperature. The respiratory frequency was the parameter more reliable to establish a framework of thermal stress in the unshorn sheep, with values on average three times higher than those reported in the literature. The heart rate monitors the thermal variation of the environment and is also an indicator of heat stress. This variation shows the Suffolk breed is well adapted to hot climates. The correlation between the body surface temperatures with environment temperature and air humidity was negative, as explained by the effect of wool insulation, i.e. even with an increase in environment temperature and humidity, the body temperature tends to maintain a compensating balance. In the shorn animals, the correlation between skin temperature with environment temperature and air humidity showed that the skin temperature increases when the environment temperature increases. The increase in the environment temperature does not affect the body temperature of unshorn animals due the insulating effect of the wool. However, when environment temperature rises, the presence of the wool starts to affect the thermal comfort as the heat absorption is larger than the capacity of heat loss. In this study, the best thermal stress indicators were the respiratory frequency and rectal and skin temperatures. The temperatures of the skin measured at the perineum, axillae and inner thigh were considered the most reliable.

Branchial O2 chemoreceptors in Nile tilapia Oreochromis niloticus: Control of cardiorespiratory function in response to hypoxia

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

Cannabidiol administration into the bed nucleus of the stria terminalis alters cardiovascular responses induced by acute restraint stress through 5-HT1A receptor

Systemic administration of cannabidiol (CBD) is able to attenuate cardiovascular responses to acute restraint stress through activation of 5-HT1A receptors. Previous results from our group suggest that the bed nucleus of the stria terminalis (BNST) is involved in the antiaversive effects of the CBD. Moreover, it has been proposed that synapses within the BNST influence restraint-evoked cardiovascular changes, in particular by an inhibitory influence on the tachycardiac response associated to restraint stress. Thus, the present work investigated the effects of CBD injected into the BNST on cardiovascular changes induced by acute restraint stress and if these effects would involve the local activation of 5-HT1A receptors. The exposition to restraint stress increased both blood pressure and heart rate (HR). The microinjection of CBD (30 and 60nmol) into the BNST enhanced the restraint-evoked HR increase, in a dose-dependent manner, without affecting the pressor response. The selective 5-HT1A receptor antagonist WAY100635 by itself did not change the cardiovascular responses to restraint stress, but blocked the effects of CBD. These results showed that CBD microinjected into the BNST enhanced the HR increase associated with acute restraint stress without affecting the blood pressure response. Although these results are not in agreement with those observed after systemic administration of CBD, they are similar to effects observed after reversible inactivation of the BNST. Moreover, similar to the effects observed after systemic administration, CBD effects in the BNST seem to depend on activation of 5-HT1A receptors. © 2012 Elsevier B.V. and ECNP.

Glucose homoeostasis in rats exposed to acute intermittent hypoxia

Aim: Chronic exposure to intermittent hypoxia commonly induces the activation of sympathetic tonus and the disruption of glucose homoeostasis. However, the effects of exposure to acute intermittent hypoxia (AIH) on glucose homoeostasis are not yet fully elucidated. Herein, we evaluated parameters related to glucose metabolism in rats exposed to AIH. Methods: Male adult rats were submitted to 10 episodes of hypoxia (6% O2, for 45 s) interspersed with 5-min intervals of normoxia (21%), while the control (CTL) group was kept in normoxia. Results: Acute intermittent hypoxia rats presented higher fasting glycaemia, normal insulinaemia, increased lactataemia and similar serum lipid levels, compared to controls (n = 10, P < 0.05). Additionally, AIH rats exhibited increased glucose tolerance (GT) (n = 10, P < 0.05) and augmented insulin sensitivity (IS) (n = 10, P < 0.05). The p-Akt/Akt protein ratio was increased in the muscle, but not in the liver and adipose tissue of AIH rats (n = 6, P < 0.05). The elevated glycaemia in AIH rats was associated with a reduction in the hepatic glycogen content (n = 10, P < 0.05). Moreover, the AIH-induced increase in blood glucose concentration, as well as reduced hepatic glycogen content, was prevented by prior systemic administration of the β-adrenergic antagonist (P < 0.05). The effects of AIH on glycaemia and Akt phosphorylation were transient and not observed after 60 min. Conclusions: We suggest that AIH induces an increase in blood glucose concentration as a result of hepatic glycogenolysis recruitment through sympathetic activation. The augmentation of GT and IS might be attributed, at least in part, to increased β-adrenergic sympathetic stimulation and Akt protein activation in skeletal muscles, leading to a higher glucose availability and utilization. © 2013 Scandinavian Physiological Society.

Influência da seleção dos estágios incrementais sobre a intensidade de lactato mínimo: Estudo piloto

The purposes of this study were to assess the influence of stage selection from the incremental phase and the use of peak lactate after hyperlactatemia induction on the determination of the lactate minimum intensity (iLACmin). Twelve moderately active university students (23±5 years, 78.3±14.1 kg, 175.3±5.1 cm) performed a maximal incremental test to determine the respiratory compensation point (RCP) (initial intensity at 70 W and increments of 17.5 W every 2 minutes) and a lactate minimum test (induction with the Wingate test, the incremental test started at 30 W below RCP with increments of 10 W every 3 minutes) on a cycle ergometer. The iLACmin was determined using second order polynomial adjustment applying five exercise stage selection: 1) using all stages (iLACmin P); 2) using all stages below and two stages above iLACminP(iLACminA); 3) using two stages below and all stages above iLACminP(iLACminB); 4) using the largest and same possible number of stages below and above the iLACminP(iLACminI); 5) using all stages and peak lactate after hyperlactatemia induction (iLACminD). No differences were found between the iLACminP(138.2±30.2 W), iLACminA(139.1±29.1 W), iLACminB(135.3±14.2 W), iLACminI(138.6±20.5 W) and iLACmiD(136.7±28.5 W) protocols, and a high level of agreement between these intensities and iLACminPwas observed. Oxygen uptake, heart rate, rating of perceived exertion and lactate corresponding to these intensities was not different and was strongly correlated. However, the iLACminBpresented the lowest success rate (66.7%). In conclusion, stage selection did not influence the determination of iLACmin but modified the success rate. © Creative Commom.

Perioperative evaluation of tumescent anaesthesia technique in bitches submitted to unilateral mastectomy

Background: Tumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications.Results: The heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation.Conclusions: Compared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing. © 2013 Credie et al.; licensee BioMed Central Ltd.

Commissural nucleus of the solitary tract regulates the antihypertensive effects elicited by moxonidine

The rostral ventrolateral medulla (RVLM) contains the presympathetic neurons involved in cardiovascular regulation that has been implicated as one of the most important central sites for the antihypertensive action of moxonidine (an α2-adrenergic and imidazoline agonist). Here, we sought to evaluate the cardiovascular effects produced by moxonidine injected into another important brainstem site, the commissural nucleus of the solitary tract (commNTS). Mean arterial pressure (MAP), heart rate (HR), splanchnic sympathetic nerve activity (sSNA) and activity of putative sympathoexcitatory vasomotor neurons of the RVLM were recorded in conscious or urethane-anesthetized, and artificial ventilated male Wistar rats. In conscious or anesthetized rats, moxonidine (2.5 and 5. nmol/50. nl) injected into the commNTS reduced MAP, HR and sSNA. The injection of moxonidine into the commNTS also elicited a reduction of 28% in the activity of sympathoexcitatory vasomotor neurons of the RVLM. To further assess the notion that moxonidine could act in another brainstem area to elicit the antihypertensive effects, a group with electrolytic lesions of the commNTS or sham and with stainless steel guide-cannulas implanted into the 4th V were used. In the sham group, moxonidine (20. nmol/1. μl) injected into 4th V decreased MAP and HR. The hypotension but not the bradycardia produced by moxonidine into the 4th V was reduced in acute (1. day) commNTS-lesioned rats. These data suggest that moxonidine can certainly act in other brainstem regions, such as commNTS to produce its beneficial therapeutic effects, such as hypotension and reduction in sympathetic nerve activity. © 2013 IBRO.

Estudo da alterações funcionais cardiorrespiratórias em pacientes submetidos a simpatectomia toráxica videoassistida

Pós-graduação em Bases Gerais da Cirurgia - FMB