Effect of exercise training on plasma levels and functional properties of high-density lipoprotein cholesterol in the metabolic syndrome

Intense lifestyle modifications can change the high-density lipoprotein (HDL) cholesterol concentration. The aim of the present study was to analyze the early effects of short-term exercise training, without any specific diet, on the HDL cholesterol plasma levels and HDL functional characteristics in patients with the metabolic syndrome (MS). We studied 30 sedentary subjects, 20 with and 10 without the MS. The patients with the MS underwent moderate intensity exercise training for 3 months on bicycle ergometers. Blood was sampled before and after training for biochemical analysis, paraoxonase-1 activity, and HDL subfraction composition and antioxidative capacity. Lipid transfer to HDL was assayed in vitro using a labeled nanoemulsion as the lipid donor. At baseline, the MS group had greater triglyceride levels and a lower HDL cholesterol concentration and lower paraoxonase-1 activity than did the controls. Training decreased the plasma triglycerides but did not change the low-density lipoprotein or HDL cholesterol levels. Nonetheless, exercise training increased the HDL subfractions' antioxidative capacity and paraoxonase-1 activity. After training, the MS group had compositional changes in the smallest HDL subfractions associated with increased free cholesterol and cholesterol ester transfers to HDL, reaching normal values. In conclusion, the present investigation has added relevant information about the dissociation between the quantitative and qualitative aspects of HDL after short-term exercise training without any specific diet in those with the MS, highlighting the importance of evaluating the functional aspects of the lipoproteins, in addition to their plasma levels.     

In vitro study of a modified sagittal split osteotomy fixation technique of the mandible: a mechanical test

This study was performed to evaluate the compressive mechanical strength of rigid internal fixation (RIF) using 1.5-mm L-shaped plates fixed with monocortical screws in sagittal split osteotomy (SSO). Thirty synthetic hemimandibles, which had all undergone a 5-mm advancement, were divided into three groups: three 12-mm bicortical titanium screws were placed in an inverted L pattern in group A; one straight 2.0-mm system spaced titanium plate fixed with four 5-mm monocortical screws was used in group B; two 1.5-mm system L-shaped titanium plates, each fixed with four 5-mm monocortical screws, were used in group C. The models were subjected to compressive and progressive mechanical tests with forces applied in the area between the second premolar and first molar to verify resistance in Newtons (N). A displacement speed of 1 mm/min was applied, with a maximum 10 mm displacement of the distal segment or until disruption of the fixation. The deformity and/or eventual rupture of the plates were evaluated, and consequently their technical stability was determined. The results showed that the modified fixation technique tested in this study on synthetic mandibles resulted in adequate stability and superior mechanical behaviour compared to simulated osteosynthesis with the use of a straight 2.0-mm titanium plate.     

Major Cardiac–Psychiatric Drug–Drug Interactions: a Systematic Review of the Consistency of Drug Databases

Cardiovascular Drugs and Therapy - Major depressive disorder (MDD) and anxiety disorders (AD) are both highly prevalent among individuals with arrhythmia, ischemic heart disease, heart failure,...     

Rehabilitative management of swallowing and oral-motor movements in patients with tetanus of a public service in Brazil

When looking at developing countries, the prolonged intensive medical and nursing care required by many patients places extra demands on an already stretched healthcare budget. The purpose of this study was to verify the effectiveness of a systematic rehabilitative program for swallowing and oral-motor movements in intensive care unit patients with the diagnosis of tetanus. Forty-five patients who were clinically diagnosed with tetanus were included in the study. Participants were divided in two groups: GI - consisted of 18 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2002 to December 2005, prior to the existence of a systematic swallowing and oral-motor intervention; GII - consisted of 27 tetanus patients who were consecutively admitted to the infectious disease ICU from January 2006 to December 2009 and were submitted to a specific rehabilitative management of swallowing and of the oral-motor movements. Results indicate that the proposed rehabilitative program reduced by approximately 50% the time patients remained in the ICU. The significant improvement observed in patients with tetanus who were submitted to the rehabilitative program for swallowing and oral-motor movements occurred in conjunction with a reduction in the amount of time necessary to reintroduce oral feeding, to decannulate and to remove the feeding tubes. In conclusion, swallowing/muscle exercise, in patients with severe/very severe tetanus, seem to promote the remission of muscle tension and seem to maximize functional swallowing.     

Value of Electro‐Vectorcardiogram in Hypertrophic Cardiomyopathy

The electrocardiogram is an important tool for the initial diagnostic suspicion of hypertrophic cardiomyopathy in any of its forms, both in symptomatic and in asymptomatic patients because it is altered in more than 90 percent of the cases. Electrocardiographic anomalies are more common in patients carriers of manifest hypertrophic cardiomyopathy and the electrocardiogram alterations are earlier and more sensitive than the increase in left ventricular wall thickness detected by the echocardiogram. Nevertheless, despite being the leading cause of sudden death among young competitive athletes there is no consensus over the need to include the method in the pre‐participation screening. In apical hypertrophic cardiomyopathy the electrocardiographic hallmarks are the giant negative T waves in anterior precordial leads. In the vectorcardiogram, the QRS loop is located predominantly in the left anterior quadrant and T loop in the opposite right posterior quadrant, which justifies the deeply negative T waves recorded. The method allows estimating the left ventricular mass because it relates to the maximal spatial vector voltage of the left ventricle in the QRS loop. The recording on electrocardiogram or Holter monitoring of nonsustained monomorphic ventricular tachycardia in patients with syncope, recurrent syncope in young patient, hypotension induced by strain, bradyarrhythmia, or concealed conduction are markers of poor prognosis. The presence of rare sustained ventricular tachycardia is observed in mid‐septal obstructive HCM with apical aneurysm. The presence of complete right bundle branch block pattern is frequent after the percutaneous treatment and complete left bundle branch block is the rule after myectomy.     

Histological and Genotoxic Biomarkers in <Emphasis Type="Italic">Prochilodus lacustris</Emphasis> (Pisces,Prochilodontidae) for Environmental Assessment in a Protected Area in the Northeast of Brazil

The quality of aquatic environments all around the world is being altered by different human activities that represent direct threat to the ecological system and the aquatic biota. This study aimed to evaluate the occurrence of histological and genotoxic alterations in Prochilodus lacustris as indicators of anthropic impacts in a lacustrine environment in northeast Brazil. The histological alterations were evaluated using the histological alteration index, and the genotoxic alterations were detected using the micronuclei test, at three sampling stations (S1, S2 and S3). The gills presented lesions with three stages of severity, with mild lesions more frequent in the specimens collected at station S1. Mild hepatic tissue lesions were the most frequent type in both areas. Micronucleus analysis showed that station S3 was the most affected. The biological responses observed indicated that the fish are under influence of environmental changes. It is important to highlight that the organisms collected at station S3 had a more compromised health status.     

Assessment of the Maximal Range of Motion from Initial Sensation of Stretching to the Limits of Tolerance

The aim of this study was to determine whether the first sensation of stretching (ROM_FSS) may predict the maximum range of motion (ROM_MAX) in male (N = 37) and female (N = 32) volunteer subjects, and to assess the reliability of the ROM perceived by subjects in relation to a pre-determined ROM (ROM_50%). Subjects attempted three experimental sessions with 48 hours between sessions 1 and 2 and 28 days between sessions 1 and 3. Within each session, five trials were performed with isokinetic equipment to assess posterior thigh muscle flexibility. The results revealed a strong and significant correlation between ROM_MAX and ROM_FSS for both sexes, females (r = 0.96, p < 0.001, R² = 0.92) and males (r = 0.91, p < 0.001; R² = 0.82). The accuracy of the model verified by the standard error of estimate (SEE) was high in the equations proposed for both female (SEE = 4.53%) and male (SEE = 5.45%). Our results revealed that ROM_FSS may predict the ROM_MAX for both male and female subjects. The ROM_FSS may contribute to the development of evaluation methods that do not subject the individuals to conditions that may include unnecessary risk of injury and is well suited to monitor the training process of stretching exercises with submaximal loads.Key points

• An individual’s tolerance to stretching can be considered a continuum marked by the first sensation of stretching and the maximum range of motion as the continuum’s end-points.
• The first sensation of stretching and the point representing halfway between the first sensation and maximal range of motion are reliable measures in young men and women.
• The first sensation of stretching may be a safe and useful predictor of maximal range of motion.

Key words: Prediction equation, range of motion, onset of pain, muscle stretch intensity     

Proper microsurgical nerve suture may impede Wallerian degeneration of completely transected nerves. An electron microscopic study

Electron microscopic findings on the nerve of the biventer cervicis muscle of the chick, which was completely transected and immediately after submitted to an adequate microsurgical nerve suture, confirmed our previous statement that proper microsurgical nerve suture may impede the Wallerian degeneration that normally occurs in the distal segment of a completely transected nerve.