High-altitude exposure in patients with cardiovascular disease: risk assessment and practical recommendations.

Because of the development of modern transportation facilities, an ever rising number of individuals including many patients with preexisting diseases visit high-altitude locations (>2500 m). High-altitude exposure triggers a series of physiologic responses intended to maintain an adequate tissue oxygenation. Even in normal subjects, there is enormous interindividual variability in these responses that may be further amplified by environmental factors such as cold temperature, low humidity, exercise, and stress. These adaptive mechanisms, although generally tolerated by most healthy subjects, may induce major problems in patients with preexisting cardiovascular diseases in which the functional reserves are already limited. Preexposure assessment of patients helps to minimize risk and detect contraindications to high-altitude exposure. Moreover, the great variability and nonpredictability of the adaptive response should encourage physicians counseling such patients to adapt a cautionary approach. Here, we will briefly review how high-altitude adjustments may interfere with and aggravate/decompensate preexisting cardiovascular diseases. Moreover, we will provide practical recommendations on how to investigate and counsel patients with cardiovascular disease desiring to travel to high-altitude locations.

Do hematologic constituents really increase due to endurance exercise in horses?

The aim of this study was to evaluate the behavior of blood constituents in a group of horses that successfully completed long endurance rides in tropical conditions. Jugular vein puncture was done to collect blood before, during and after rides. Data were analyzed using a mathematic approach, based on the hematocrit and blood volume where the percentual change in plasma volume was used to correct the values of each variable analyzed. Significance was inferred when P<0.05. The proposed mathematical model to assess blood constituents concentrations allowed the observation of a different pattern of the variables behavior, pointing out that the approach followed by the authors could be more sensitive than ones that did not take this routine. In conclusion, the method used in this study enabled to monitor the physiological processes that actually occur during endurance effort in tropical conditions.

Do hematologic constituents really increase due to endurance exercise in horses?

Este estudo objetivou avaliar o comportamento dos componentes do sangue em cavalos que concluiram com êxito provas de enduro em condições tropicais. Punção da veia jugular foi realizada para coletar o sangue antes, durante e após o evento. Os dados foram analisados por meio de uma abordagem matemática, com base no hematócrito e volume de sangue onde a variação percentual no volume plasmático foi utilizada para corrigir os valores de cada variável analisada. O nível de significância adotado foi P<0,05. O modelo matemático proposto para avaliar as concentrações de componentes do sangue permitiu a observação de um padrão diferente no comportamento de várias variáveis plasmáticas, destacando que a abordagem seguida pelos autores é mais sensível do que aquelas que não seguiram este procedimento. em conclusão, o método utilizado neste estudo permitiu acompanhar os processos fisiológicos que realmente ocorrem durante o esforço de resistência em condições tropicais.

Influência da música no estado de ânimo e no desempenho em exercícios

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Iogurte de soja como coadjuvante no tratamento de câncer de mama

Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

Cardiopulmonary effects of butorphanol in sevoflurane-anesthetized guineafowl (Numida meleagris)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

High-altitude exposure in patients with cardiovascular disease: risk assessment and practical recommendations

Because of the development of modern transportation facilities, an ever rising number of individuals including many patients with preexisting diseases visit high-altitude locations (>2500 m). High-altitude exposure triggers a series of physiologic responses intended to maintain an adequate tissue oxygenation. Even in normal subjects, there is enormous interindividual variability in these responses that may be further amplified by environmental factors such as cold temperature, low humidity, exercise, and stress. These adaptive mechanisms, although generally tolerated by most healthy subjects, may induce major problems in patients with preexisting cardiovascular diseases in which the functional reserves are already limited. Preexposure assessment of patients helps to minimize risk and detect contraindications to high-altitude exposure. Moreover, the great variability and nonpredictability of the adaptive response should encourage physicians counseling such patients to adapt a cautionary approach. Here, we will briefly review how high-altitude adjustments may interfere with and aggravate/decompensate preexisting cardiovascular diseases. Moreover, we will provide practical recommendations on how to investigate and counsel patients with cardiovascular disease desiring to travel to high-altitude locations.

Disruption of estrogen signaling does not prevent progesterone action in the estrogen receptor α knockout mouse uterus

Estrogen is known to increase progesterone receptor (PR) levels in the wild-type mouse uterus, and this estrogen induction was thought to be important for progesterone action through the PR. The estrogen receptor α knockout (ERKO) mouse uterus was observed to express PR mRNA that cannot be induced by estrogen. Progesterone action was characterized to determine whether it was diminished in ERKO mice. The PR protein is present in the ERKO uterus at 60% of the level measured in a wild-type uterus. The PR-A and PR-B isoforms are both detected on Western blot, and the ratio of isoforms is the same in both genotypes. Although the level of PR is reduced in the ERKO uterus, the receptor level is sufficient to induce genomic responses, since both calcitonin and amphiregulin mRNAs were increased after progesterone treatment. Finally, the ERKO uterus can be induced to undergo a progesterone-dependent decidual response. Surprisingly, the decidual response is estrogen independent in the ERKO, although it remains estrogen dependent in a wild type. These results indicate that estrogen receptor α modulation of PR levels is not necessary for expression of the PR or genomic and physiologic responses to progesterone in the ERKO uterus.

Myocardial signaling defects and impaired cardiac function of a human beta 2-adrenergic receptor polymorphism expressed in transgenic mice.

A threonine to isoleucine polymorphism at amino acid 164 in the fourth transmembrane spanning domain of the beta 2-adrenergic receptor (beta 2AR) is known to occur in the human population. The functional consequences of this polymorphism to catecholamine signaling in relevant cells or to end-organ responsiveness, however, are not known. To explore potential differences between the two receptors, site-directed mutagenesis was carried out to mimic the polymorphism. Transgenic FVB/N mice were then created overexpressing wild-type (wt) beta 2AR or the mutant Ile-164 receptor in a targeted manner in the heart using a murine alpha myosin heavy chain promoter. The functional properties of the two receptors were then assessed at the level of in vitro cardiac myocyte signaling and in vivo cardiac responses in intact animals. The expression levels of these receptors in the two lines chosen for study were approximately 1200 fmol/mg protein in cardiac membranes, which represents a approximately 45-fold increase in expression over endogenous beta AR. Myocyte membrane adenylyl cyclase activity in the basal state was significantly lower in the Ile-164 mice (19.5 +/- 2.7 pmol/min/mg) compared with wt beta 2AR mice (35.0 +/- 4.1 pmol/min/mg), as was the maximal isoproterenol-stimulated activity (49.8 +/- 7.8 versus 77.1 +/ 7.3 pmol/min/mg). In intact animals, resting heart rate (441 +/- 21 versus 534 +/- 17 bpm) and dP/dtmax (10,923 +/- 730 versus 15,308 +/- 471 mmHg/sec) were less in the Ile-164 mice as compared with wt beta 2AR mice. Similarly, the physiologic responses to infused isoproterenol were notably less in the mutant expressing mice. Indeed, these values, as well as other contractile parameters, were indistinguishable between Ile-164 mice and nontransgenic littermates. Taken together, these results demonstrate that the Ile-164 polymorphism is substantially dysfunctional in a relevant target tissue, as indicated by depressed receptor coupling to adenylyl cyclase in myocardial membranes and impaired receptor mediated cardiac function in vivo. Under normal homeostatic conditions or in circumstances where sympathetic responses are compromised due to diseased states, such as heart failure, this impairment may have important pathophysiologic consequences.

The importance of physical fitness in the performance of adequate cardiopulmonary resuscitation

The aim of the present investigation was to evaluate the influence of the physical fitness of a cardiopulmonary resuscitation (CPR) provider on the performance of and physiologic response to CPR. To this end, comparisons were made of sedentary and physically active subjects in terms of CPR performance and physiologic variables. Two study groups were established: group P (n = 14), composed of sedentary, professional CPR rescuers (mean [± SD]; age, 34 ± 6 years; V̇O2max, 32.5 ± 5.5 mL/kg/min), and group Ex (n = 14), composed of physically active, nonexperienced subjects (age, 34 ± 6 years; V̇O2max, 44.5 ± 8.5 mL/kg/min). Each subject was required to perform an 18-min CPR session, which involved manual external cardiac compressions (ECCs) on an electronic teaching mannequin following accepted standard CPR guidelines. Subjects' gas exchange parameters and heart rates (HRs) were monitored throughout the trial. Variables indicating the adequacy of the ECCs (ECC depth and the percentage of incorrect compressions and hand placements) also were determined. Overall CPR performance was similar in both groups. The indicators of ECC adequacy fell within accepted limits (ie, an ECC depth between 38 and 51 mm). However, fatigue prevented four subjects from group P from completing the trial. In contrast, the physiologic responses to CPR differed between groups. The indicators of the intensity of effort during the trial, such as HR or percentage of maximum oxygen uptake (V̇O2max) were higher in group P subjects than group Ex subjects, respectively (HRs at the end of the trial, 139 ± 22 vs 115 ± 17 beats/min, p < 0.01; percentage of V̇O2max after 12 min of CPR, 46.7 ± 9.7% vs 37.2 ± 10.4%, p < 0,05). These results suggest that a certain level of physical fitness may be beneficial to CPR providers to ensure the adequacy of chest compressions performed during relatively long periods of cardiac arrest.

Positive and negative regulation of cellular immune responses in physiologic conditions and diseases.

The immune system has evolved to allow robust responses against pathogens while avoiding autoimmunity. This is notably enabled by stimulatory and inhibitory signals which contribute to the regulation of immune responses. In the presence of a pathogen, a specific and effective immune response must be induced and this leads to antigen-specific T-cell proliferation, cytokines production, and induction of T-cell differentiation toward an effector phenotype. After clearance or control of the pathogen, the effector immune response must be terminated in order to avoid tissue damage and chronic inflammation and this process involves coinhibitory molecules. When the immune system fails to eliminate or control the pathogen, continuous stimulation of T cells prevents the full contraction and leads to the functional exhaustion of effector T cells. Several evidences both in vitro and in vivo suggest that this anergic state can be reverted by blocking the interactions between coinhibitory molecules and their ligands. The potential to revert exhausted or inactivated T-cell responses following selective blocking of their function made these markers interesting targets for therapeutic interventions in patients with persistent viral infections or cancer.

Physiologic and productive responses of Holstein dairy cows with access to the constant or limited shade

The work: was carried out to evaluate the physiologic and productive responses of 16 Holstein breed cows, in different lactating stages and production levels, maintained in two free stall corral types, with or without plastic sheet covering, in the southeast-northwest of the covered area edges. The animals were confined in free stall system, during the months of the summer, with access to the constant or Limited shade. A complete randomized experimental design was: used. The physiological variables measured were respiratory frequency (morning an afternoon) and rectal temperature (morning and afternoon). The productive variables were milk production (morning, afternoon and daily), dry matter (DM) intake (% live weight) and efficiency of milk production (kg of milk/kg DM intake). The animals with access to the constant shade presented respiratory frequency (74.1 vs 81.0 breath/min.) and rectal temperature (39.5 vs 39.7 degrees C) lower and mirk production (22.6 vs 20.9 kg/day) and efficiency of milk production (1.3 vs 1.2 kg of milk/kg DM ingested) higher than the animals with access to the limited shade. There was no effect on the dry matter intake.

Effects of twenty-four hour transport or twenty-four hour feed and water deprivation on physiologic and performance responses of feeder cattle

The objective of this study was to compare the effects of 24-h road transport or 24-h feed and water deprivation on acute-phase and performance responses of feeder cattle. Angus x Hereford steers (n = 30) and heifers (n = 15) were ranked by gender and BW (217 +/- 3 kg initial BW; 185 +/- 2 d initial age) and randomly assigned to 15 pens on d -12 of the experiment (3 animals/pen; 2 steers and 1 heifer). Cattle were fed alfalfa-grass hay ad libitum and 2.3 kg/animal daily (DM basis) of a corn-based concentrate throughout the experiment (d -12 to 28). on d 0, pens were randomly assigned to 1 of 3 treatments: 1) transport for 24 h in a livestock trailer for 1,200 km (TRANS), 2) no transport but feed and water deprivation for 24 h (REST), or 3) no transport and full access to feed and water (CON). Treatments were concurrently applied from d 0 to d 1. Total DMI was evaluated daily from d -12 to d 28. Full BW was recorded before treatment application (d -1 and 0) and at the end of experiment (d 28 and 29). Blood samples were collected on d 0, 1, 4, 7, 10, 14, 21, and 28. Mean ADG was greater (P < 0.01) in CON vs. TRANS and REST cattle but similar (P = 0.46) between TRANS and REST cattle (1.27, 0.91, and 0.97 kg/d, respectively; SEM = 0.05). No treatment effects were detected for DMI (P >= 0.25), but CON had greater G: F vs. TRANS (P < 0.01) and REST cattle (P = 0.08) whereas G: F was similar (P = 0.21) between TRANS and REST cattle. Plasma cortisol concentrations were greater (P <= 0.05) in REST vs. CON and TRANS cattle on d 1, 7, 14, and 28 and also greater (P = 0.02) in TRANS vs. CON cattle on d 1. Serum NEFA concentrations were greater (P < 0.01) in REST and TRANS vs. CON cattle on d 1 and greater (P < 0.01) in REST vs. TRANS cattle on d 1. Plasma ceruloplasmin concentrations were greater (P = 0.04) in TRANS vs. CON cattle on d 1, greater (P = 0.05) in REST vs. CON on d 4, and greater (P <= 0.05) in REST vs. TRANS and CON on d 14. Plasma haptoglobin concentrations were greater (P < 0.01) in TRANS vs. CON and REST cattle on d 1 and greater (P <= 0.05) for REST vs. TRANS and CON cattle on d 7. In conclusion, 24-h transport and 24-h nutrient deprivation elicited acute-phase protein reactions and similarly reduced feedlot receiving performance of feeder cattle. These results suggest that feed and water deprivation are major contributors to the acute-phase response and reduced feedlot receiving performance detected in feeder cattle transported for long distances.