Efeitos preventivos do exercício físico sobre as proteínas ciclooxigenase-2 (COX-2) e fator de crescimento de vasos derivado do endotélio (VEGF) no músculo cardíaco em ratos tratados com dexametasona

Dexamethasone (DEXA) is a synthetic glucocorticoid widely used in the handling of several drugs, for its proven benefits in fighting inflammation and allergies. Despite their benefits, their chronic use leads to several side effects that include changes in the body in the metabolism of carbohydrates, lipids and proteins. Moreover, being an anti-inflammatory, acts on the arachidonic acid pathway, reducing the expression of the enzyme cyclooxygenase (COX-2) and growth factor derived from the endothelium of blood vessels (VEGF) in various tissues. However, its effects on the myocardium are still uncertain. The physical training (PT), in turn, promotes effects contrary to those caused by chronic use of DEXA, however, little is known about the preventive effects of TF in the side effects of Dexa in the myocardium. Therefore, the aim of this study was to determine if the TF has the ability to prevent and/or mitigate the effects of Dexa in protein expression of COX-2 and VEGF in the myocardium. Forty animals were divided into 4 groups: sedentary control (SC), sedentary treated with Dexa (SD), trained control (TC) and Trained treated with Dexa (TD) and submitted to a protocol of physical training on the treadmill for 70 days (1 h/day-5 days per week, 60% of physical capacity) or kept sedentary. Over the past 10 days, rats were treated with Dexa (Decadron, 0.5 mg/kg per day, ip) or saline. During training the animals were weighed weekly and during treatment daily. At the end of treatment was made to measure fasting glucose levels of animals. The rats were killed with excess anesthesia and cardiac muscle was removed, weighed, homogenized, centrifuged and stored at -20° C for analysis of protein expression of VEGF and COX-2 by Western blotting technique. Treatment with dexamethasone caused a weight loss of 18% in sedentary animals and 13% in trained as well as elevated levels of fasting glucose in sedentary (88%). The TF was unable to mitigate the loss in...

Preoperative therapy restores ventilatory parameters and reduces length of stay in patients undergoing myocardial revascularization

Introduction: The frequency of surgical procedures has increased steadily in recent decades, including the myocardial revascularization.Objectives: To demonstrate the importance of physiotherapy in the preoperative period of cardiac surgery in relation to the reduction of hospital stay, changes in lung volumes and respiratory muscle strength.Methods: We conducted a prospective study with patients undergoing myocardial revascularization, the Hospital das Clinicas da Universidade Estadual Paulista (UNESP)/Botucatu - SP. We evaluated 70 patients of both genders, aged between 40 and 75 years, subdivided into two groups: group I - 35 patients of both genders, who received a written protocol guidance, breathing exercises and respiratory muscle training in the preoperative period and group II - 35 patients of both genders, who received only orientation of the ward on the day of surgery. This study was approved by the Ethics Committee of UNESP /Botucatu - SP.Results: Maximal inspiratory pressure in third postoperative day and fifth postoperative day and significant difference between groups, being better for the intervention group. Expiratory pressure was significant in fifth postoperative day in the intervention group compared to controls. The difference of length of hospital stay in the postoperative was found between the groups with shorter hospital stay in the group receiving preoperative therapy.Conclusion: Physical therapy plays an important role in the preoperative period, so that individuals in the intervention group more readily restored the parameters evaluated before surgery, in addition, there was a decrease in the time of the postoperative hospital stay. Thus, it is thought the cost-effectiveness of a program of preoperative physiotherapy.

Efeito do treinamento aquático no perfil lipídico e na hipertrofia ventricular esquerda de camundongos hiperlipidêmicos

This study assessed the effects of Water training on the lipid profile and left ventricular structures in hyperlipidemic mice. Twenty-eight male LDLr-/- mice were randomly separated into 4 groups: sedentary, fed a standard diet (C); exercising, fed a standard diet (C+TRE); sedentary, fed a hyperlipidic diet (C+HL); and exercising, fed a hyperlipidic diet (E+HL). The exercising mice trained daily for 60 minutes during 60 days. After 48 hours of the end of the training period and 12 hours of rest fasting the animals were underwent euthanasia and the blood was collected for measuring the plasma levels of triglycerides, total cholesterol and its fractions (LDL, HDL, VLDL). The heart was removed and the left ventricle was weighed fresh to calculate the ratio left-ventricle weight (mg)/body weight (g). The results showed that the training was more effective in improving lipid plasma levels when combined with a balanced diet, thereby confirming that it is essential to associate physical exercise and diet. The training protocol resulted in eccentric left ventricular hypertrophy in the standard-diet group and decreased interstitial collagen deposition in the myocardium of the high-fat-diet animals, which may indicate an improved diastolic function with consequent improvement in the systolic function. It was concluded that regular moderate aerobic exercise induce beneficial and prophylactic adaptations to heart which promoted a better health condition and prevention to diseases.

Avaliação dos efeitos do carvedilol, ciclosporina A e citrato de sildenafil sobre a cardiotoxicidade induzida pela doxorrubicina em modelo experimental com coelhos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Doença cerebelar em cães e gatos

Diseases of the cerebellar system are common in small animals, and result in a clinical syndrome characterized by hypermetria, base-wide stance and intentional tremors of the head and body. All movements of the limbs are spastic and awkward. The neurological examination assists in the localization of lesions restricted to the cerebellum or in the detection of disorders relating to other parts of the nervous system, which characterizes a multifocal disease process. Neurological disorders in dogs and cats may suggest a very extensive list of differential diagnoses, since they may be caused by infectious, degenerative and traumatic processes, among others. The possible etiologies for cerebellar syndrome include: aplasia and hypoplasia, abiotrophy, cancer, vascular stroke and inflammatory disorders. The aim of this paper is to review the clinical signs that aid in the location of the cerebellar lesion and discuss the possible causes of this syndrome in dogs and cats.

Efeito da inibição da NADPH oxidase sobre o estresse oxidativo e o fenótipo muscular esquelético de ratos com insuficiência cardíaca crônica induzida por estenose aórtica

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Efeito da inibição da NADPH oxidase sobre o estresse oxidativo e o fenótipo muscular esquelético de ratos com insuficiência cardíaca crônica induzida por estenose aórtica

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Fatores de risco pré-operatórios para mediastinite após cirurgia cardíaca: análise de 2768 pacientes

INTRODUÇÃO: A esternotomia mediana longitudinal é a via de acesso mais utilizada no tratamento das doenças cardíacas. As infecções profundas da ferida operatória no pós-operatório das cirurgias cardiovasculares são uma complicação séria, com alto custo durante o tratamento. Diferentes estudos têm encontrado fatores de risco para o desenvolvimento de mediastinite e as variáveis pré-operatórias têm tido especial destaque. OBJETIVO: O objetivo deste estudo é identificar fatores de risco pré-operatórios para o desenvolvimento de mediastinite em pacientes submetidos a revascularização do miocárdio e a substituição valvar. MÉTODOS: Este estudo observacional representa uma coorte de 2768 pacientes operados consecutivamente. O período considerado para análise foi de maio de 2007 a maio de 2009 e não houve critérios de exclusão. Foi realizada análise univariada e multivariada pelo modelo de regressão logística das 38 variáveis pré-operatórias eleitas. RESULTADOS: Nesta série, 35 (1,3%) pacientes evoluíram com mediastinite e 19 (0,7%) com osteomielite associada. A idade média dos pacientes foi de 59,9 ± 13,5 anos e o EuroSCORE de 4,5 ± 3,6. A mortalidade hospitalar foi de 42,8%. Na análise multivariada, foram identificadas três variáveis como preditoras independentes de mediastinite: balão intra-aórtico (OR 5,41, 95% IC [1,83 -16,01], P=0,002), hemodiálise (OR 4,87, 95% IC [1,41 - 16,86], P=0,012) e intervenção vascular extracardíaca (OR 4,39, 95% IC [1,64 - 11,76], P=0,003). CONCLUSÃO: O presente estudo demonstrou que necessidade do suporte hemodinâmico pré-operatório com balão intra-aórtico, hemodiálise e intervenção vascular extracardíaca são fatores de risco para o desenvolvimento de mediastinite após cirurgia cardíaca.

Educational levels and the functional dependence of ischemic stroke survivors

We evaluated the functional dependence of stroke survivors from the Study of Stroke Mortality and Morbidity, using the Rankin Scale. Out of 355 ischemic stroke survivors (with a mean age of 67.9 years), 40% had some functional dependence at 28 days and 34.4% had some functional dependence at 6 months. Most predictors of physical dependence were identified at 28 days. These predictors were: low levels of education [illiterate vs. >= 8 years of education, multivariate odds ratio (OR) = 3.7; 95% confidence interval (95%CI): 1.60-8.54] and anatomical stroke location (total anterior circulation infarct, OR = 16.9; 95%CI: 2.93-97.49). Low levels of education and ischemic brain injury influenced functional dependence in these stroke survivors. Our findings reinforce the necessity of developing strategies for the rehabilitation of stroke patients, more especially in formulating specific strategies for care and treatment of stroke survivors with low socioeconomic status.

Deformação miocárdica pelo speckle tracking na cardiomiopatia dilatada grave

FUNDAMENTO: A alta e crescente prevalência de Cardiomiopatia Dilatada (CMD) representa sério problema de saúde pública. Novas tecnologias vêm sendo utilizadas objetivando diagnósticos mais sofisticados, que melhorem a abordagem terapêutica. Nesse cenário, o Speckle Tracking (STE) utiliza marcadores miocárdicos naturais para analisar a deformação sistólica do Ventrículo Esquerdo (VE). OBJETIVO: Mensurar o strain transmural longitudinal global (SG) do VE através do STE em pacientes com CMD grave, comparando os resultados com indivíduos normais e com parâmetros ecocardiográficos consagrados para análise da função sistólica do VE, validando o método nessa população. MÉTODOS: Foram estudados 71 pacientes com CMD grave, (53 ± 12a, 72% homens) e 20 controles (30 ± 8a, 45% homens). Foram obtidos os volumes e a FEVE pela ecocardiografia bi e tridimensional, parâmetros do Doppler, Doppler tecidual e o SG pelo STE. RESULTADOS: Comparados ao grupo controle, os volumes do VE foram maiores no grupo CMD; entretanto, a FEVE e velocidade de pico da onda E foram menores neste último. O índice de performance miocárdica foi maior entre os pacientes. As velocidades do miocárdio pelo Doppler tecidual (S', e', a') foram consideravelmente menores e a relação E/e' foi maior no grupo CMD. O SG apresentou-se diminuído no grupo CMD (-5,5% ± 2,3%), em relação aos controles (-14,0% ± 1,8%). CONCLUSÃO: No presente estudo, o SG foi significativamente menor nos pacientes com CMD grave, abrindo novas perspectivas para abordagens terapêuticas nessa população específica.

Sanguineous normothermic, intermittent cardioplegia, effects on hypertrophic myocardium: morphometric, metabolic and ultrastructural studies in rabbits hearts

OBJECTIVES: The present investigation aimed to study the protective effect of intermittent normothermic cardioplegia in rabbit's hypertrophic hearts. METHODS: The parameters chosen were 1) the ratio heart weight / body weight, 2) the myocardial glycogen levels, 3) ultrastructural changes of light and electron microscopy, and 4) mitochondrial respiration. RESULTS: 1) The experimental model, coarctation of the aorta induced left ventricular hypertrophy; 2) the temporal evolution of the glycogen levels in hypertrophic myocardium demonstrates that there is a significant decrease; 3) It was observed a time-dependent trend of higher oxygen consumption values in the hypertrophic group; 4) there was a significant time-dependent decrease in the respiratory coefficient rate in the hypertrophic group; 5) the stoichiometries values of the ADP: O2 revealed the downward trend of the values of the hypertrophic group; 6) It was possible to observe damaged mitochondria from hypertrophic myocardium emphasizing the large heterogeneity of data. CONCLUSION: The acquisition of biochemical data, especially the increase in speed of glycogen breakdown, when anatomical changes are not detected, represents an important result even when considering all the difficulties inherent in the process of translating experimental results into clinical practice. With regard to the adopted methods, it is clear that morphometric methods are less specific. Otherwise, the biochemical data allow detecting alterations of glycogen concentrations and mitochondria respiration before the morphometric alterations should be detected

Un estere misto degli acidi ialuronico, butirrico e retinoico è in grado di agire come rimodellante inverso della matrice cellulare sui fibroblasti cardiaci

Le cardiomiopatie che insorgono a seguito di infarto miocardico sono causa di elevata morbilità e mortalità dalle importanti ricadute cliniche, dovute alle patologie insorgenti a seguito dell’ischemia e della cicatrice post-infatuale. Il ventricolo sinistro danneggiato va incontro a un rimodellamento progressivo, con perdita di cardiomiociti e proliferazione dei fibroblasti, risultante in un’architettura e in una funzionalità dell’organo distorta. I fibroblasti cardiaci sono i principali responsabili della fibrosi, il processo di cicatrizzazione caratterizzato da un’eccessiva deposizione di matrice extracellulare (ECM). Negli ultimi anni gli sforzi del nostro laboratorio sono stati volti a cercare di risolvere questo problema, attraverso l’uso di una molecola da noi sintetizzata, un estere misto degli acidi butirrico, retinoico e ialuronico, HBR, capace di commissionare le cellule staminali in senso cardio-vascolare. Studi in vivo mostrano come l’iniezione diretta di HBR in cuori di animali sottoposti a infarto sperimentale, sia in grado, tra le atre cose, di diminuire la fibrosi cardiaca. Sulla base di questa evidenza abbiamo cercato di capire come e se HBR agisse direttamente sui fibroblasti, indagando i meccanismi coinvolti nella riduzione della fibrosi in vivo.. In questa tesi abbiamo dimostrato come HBR abbia un’azione diretta su fibroblasti, inibendone la proliferazione, senza effetti citotossici. Inoltre HBR induce una significativa riduzione della deposizione di collagene.. HBR agisce sull’espressione genica e sulla sintesi proteica, sopprimendo la trascrizione dei geni del collagene, così come dell’a-sma, inibendo la trasizione fibroblasti-miofibroblasti, e promuovendo la vasculogenesi (attraverso VEGF), la chemoattrazione di cellule staminali (attraverso SDF) e un’attività antifibrotica (inibendo CTGF). HBR sembra modulare l’espressione genica agendo direttamente sulle HDAC, probabilmente grazie alla subunità BU. L’abilità di HBR di ridurre la fibrosi post-infartuale, come dimostrato dai nostri studi in vivo ed in vitro, apre la strada a importanti prospettive terapeutiche.

Gestione dell'emergenza cardiocircolatoria: organizzazione dei soccorsi e tecnologie utilizzate

Descrizione dell'approccio al soccorso di patologie cardiovascolari con specifico riferimento alle patologie ischemiche, segnale ECG, suo utilizzo, vantaggi di un network di telecardiologia.

Genetic and environmental factors associated with cardiovascular diseases and acute myocardial infarction

Acute myocardial infarction (AMI) is a multifactorial disease with a complex pathogenesis where lifestyle, individual genetic background and environmental risk factors are involved. Altered inflammatory responses seems to be implicated in the pathogenesis of atherosclerosis. To understand which genes may predispose to increased risk of cardiovascular disease gene polymorphism of immune regulatory genes, and clinical events from the Offs of parents with an early AMI were investigated. Genetics data from Offs were compared with those obtained from healthy subjects and an independent cohort of patients with clinical sporadic AMI. Rates of clinical events during a 24 years follow up from Offs and from an independent Italian population survey were also evaluated. This study showed that a genetic signature consisting of the concomitant presence of the CC genotype of VEGF, the A allele of IL-10 and the A allele of IFN-γ was indeed present in the Offs population. During the 24-year follow-up, Offs with a positive familiarity in spite of a relatively young age showed an increased prevalence of diabetes, ischemic heart disease and stroke. In these patients with the genetic signature the EBV and HHV-6 herpes virus were also investigated and founded. These findings reinforce the notion that subjects with a familial history of AMI are at risk of an accelerated aging of cardiovascular system resulting in cardiovascular events. These data suggest that selected genes with immune regulatory functions and envoronmental factors are part of the complex genetic background contributing to familiarity for cardiovascular diseases.N