Medición y características del dolor después de la episiotomía y su relación con la limitación de actividades

This is a descriptive study, involving fifty women after vaginal delivery with episiotomy. The study aimed to measure and to characterize the perineal pain in primiparae who have had a natural childbirth with episiotomy and to verify the activities limited by the perineal pain. For evaluation of perineal pain, a Numeric Scale and the McGill Pain Questionnaire were used, as well as another questionnaire to analyze the activities limited. In the Numeric Scale, the median of perineal pain referred were five. The sensory and subjective evaluation categories were the most selected in the McGill questionnaire. The perineal pain was characterized as pulsing, pulling, hot, stinging, hurting, annoying, troublesome, tight and tense. The most limited activities were sitting, laying down (onto the bed), and walking. In conclusion, it was possible to verify the presence of perineal pain between women in the postpartum period caused by episiotomy and identify the activities of sitting, lying down and walking were limited for this symptom.Se realizo un estudio descriptivo de cincuenta mujeres después del parto vaginal con episiotomía. Objetivó-se medir y caracterizar el dolor perineal en primíparas sometidas al parto normal con episiotomía y verificar las actividades limitadas por el dolor perineal. Para la evaluación del dolor se utilizo la Escala Numérica, el Cuestionario de del Dolor de McGill y un cuestionario para analizar las actividades limitadas. En la Escala Numérica, la media de dolor fue cinco. Las categorías de evaluación sensorial y subjetiva fueron los más seleccionados en el cuestionario McGill. La dolor perineal se caracterizó como palpitante, de esfuerzo, que se calienta, quema, duele, aburrido, incómodo, y deja que mantiene estrechos. Sentado, tumbado y caminar son las actividades más limitados. Finalización: fue posible verificar la presencia de dolor perineal entre primíparas causada por la episiotomia e identificar las actividades de sentado, acostado y caminando se vieron limitados por en este síntoma.Trata-se de um estudo descritivo realizado com cinquenta mulheres em pós-parto vaginal com episiotomia. Objetivou-se mensurar e caracterizar a dor perineal em primíparas submetidas ao parto normal com episiotomia e verificar as atividades limitadas pela dor. Para avaliação da dor foi utilizada a Escala Numérica e o Questionário McGill, bem como um formulário para analisar as atividades que estavam limitadas. A média de dor perineal encontrada foi cinco. As categorias sensorial e avaliação subjetiva foram as mais selecionadas no Questionário McGill. A dor perineal foi caracterizada como latejante, que repuxa, que esquenta, ardida, dolorida, chata, incômoda, que prende e que deixa tensa. Sentar, deitar e deambular foram as atividades mais limitadas. Em conclusão, foi possível verificar a presença de dor perineal nas puérperas causada pela episiotomia e identificar que as atividades de sentar, deitar e deambular estavam limitadas por este sintoma.Universidade Federal de São Paulo (UNIFESP) Departamento de Ciências da Saúde Curso de FisioterapiaUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Biomecânica, Medicina Física e Reabilitação do Aparelho LocomotorUniversidade de São Paulo Escola de Enfermagem de Ribeirão Preto Programa de Pós-Graduação Enfermagem em Saúde PúblicaUNIFESP, Depto. de Ciências da Saúde Curso de FisioterapiaSciEL

Gestational exercise increases male offspring's maximal workload capacity early in life

Mothers' antenatal strategies to improve the intrauterine environment can positively decrease pregnancy-derived intercurrences. By challenging the mother-fetus unit, gestational exercise (GE) favorably modulates deleterious stimuli, such as high-fat, high-sucrose (HFHS) diet-induced adverse consequences for offspring. We aimed to analyze whether GE alters maternal HFHS-consumption effects on male offspring's maximal workload performance (MWP) and in some skeletal muscle (the soleus SOL and the tibialis anterior TA) biomarkers associated with mitochondrial biogenesis and oxidative fitness. Infant male Sprague-Dawley rats were divided into experimental groups according to mothers' dietary and/or exercise conditions: offspring of sedentary control diet-fed or HFHS-fed mothers (C-S or HFHS-S, respectively) and of exercised HFHS-fed mothers (HFHS-E). Although maternal HFHS did not significantly alter MWP, offspring from GE dams exhibited increased MWP. Lower SOL AMPk levels in HFHS-S were reverted by GE. SOL PGC-1α, OXPHOS C-I and C-IV subunits remained unaltered by maternal diet, although increased in HFHS-E offspring. Additionally, GE prevented maternal diet-related SOL miR-378a overexpression, while upregulated miR-34a expression. Decreased TA C-IV subunit expression in HFHS-S was reverted in HFHS-E, concomitantly with the downregulation of miR-338. In conclusion, GE in HFHS-fed dams increases the offspring's MWP, which seems to be associated with the intrauterine modulation of SM mitochondrial density and functional markers

Benefits on Hematological and Biochemical Parameters of a High-Intensity Interval Training Program for a Half-Marathon in Recreational Middle-Aged Women Runners

(1) Background: half-marathon races are popular among recreational runners, with increases in participation among middle-aged and women. We aimed to determine the effects of two half-marathon training programs on hematological and biochemical markers in middle-aged female recreational runners; (2) Methods: ten women (40 ± 7 years) followed moderate intensity continuous training (MICT), based on running volume below 80% VO2max, and another ten women followed high intensity interval training (HIIT) at 80-100% VO2max, with less volume, and combined with eccentric loading exercise. Hematology, plasma osmolality, and plasma markers of metabolic status, muscle damage, inflammatory, and oxidative stress were measured before (S1) and after (S2) training and 24 h after the half-marathon (S3); (3) Results: both training programs had similar moderate effects at S2. However, the acute response at S3 induced different alterations. There was a greater decrease in cholesterol and triglyceride levels in MICT and reductions in markers of damage and inflammation in HIIT. Greater variability in some plasma markers at S3 in MICT suggests that there is inter-individual variability in the response to training; (4) Conclusions: HIIT led to better adaptation to the competition maybe because of the repeated exposure to higher oxygen consumption and eccentric loading exercise

Self-paced free-running wheel mimics high-intensity interval training impact on rats´ functional, physiological, biochemical, and morphological features

Free-running wheel (FRW) is an animal exercise model that relies on high-intensity interval moments interspersed with low-intensity or pauses apparently similar to those performed in high-intensity interval training (HIIT). Therefore, this study, conducted over a 12-weeks period, aimed to compare functional, thermographic, biochemical and morphological skeletal and cardiac muscle adaptations induced by FRW and HIIT. Twenty-four male Wistar rats were assigned into three groups: sedentary rats (SED), rats that voluntarily exercise in free wheels (FRW) and rats submitted to a daily HIIT. Functional tests revealed that compared to SED both FRW and HIIT increased the ability to perform maximal workload tests (MWT-cm/s) (45 ± 1 vs. 55 ± 2 and vs. 65 ± 2). Regarding thermographic assays, FRW and HIIT increased the ability to lose heat through the tail during MWT. Histochemical analyzes performed in tibialis anterior (TA) and soleus (SOL) muscles showed a general adaptation toward a more oxidative phenotype in both FRW and HIIT. Exercise increased the percentage of fast oxidative glycolytic (FOG) in medial fields of TA (29.7 ± 2.3 vs. 44.9 ± 4.4 and vs. 45.2 ± 5.3) and slow oxidative (SO) in SOL (73.4 ± 5.7 vs. 99.5 ± 0.5 and vs. 96.4 ± 1.2). HITT decreased fiber cross-sectional area (FCSA-mm2) of SO (4350 ± 286.9 vs. 4893 ± 325 and vs. 3621 ± 237.3) in SOL. Fast glycolytic fibers were bigger across all the TA muscle in FRW and HIIT groups. The FCSA decrease in FOG fibers was accompanied by a circularity decrease of SO from SOL fibers (0.840 ± 0.005 vs. 0.783 ± 0.016 and vs. 0.788 ± 0.010), and a fiber and global field capillarization increase in both FRW and HIIT protocols. Moreover, FRW and HIIT animals exhibited increased cardiac mitochondrial respiratory control ratio with complex I-driven substrates (3.89 ± 0.14 vs. 5.20 ± 0.25 and vs. 5.42 ± 0.37). Data suggest that FRW induces significant functional, physiological, and biochemical adaptations similar to those obtained under an intermittent forced exercise regimen, such as HIIT

Admixture in Latin America: Geographic Structure, Phenotypic Diversity and Self-Perception of Ancestry Based on 7,342 Individuals

The current genetic makeup of Latin America has been shaped by a history of extensive admixture between Africans, Europeans and Native Americans, a process taking place within the context of extensive geographic and social stratification. We estimated individual ancestry proportions in a sample of 7,342 subjects ascertained in five countries (Brazil, Chile, Colombia, México and Perú). These individuals were also characterized for a range of physical appearance traits and for self-perception of ancestry. The geographic distribution of admixture proportions in this sample reveals extensive population structure, illustrating the continuing impact of demographic history on the genetic diversity of Latin America. Significant ancestry effects were detected for most phenotypes studied. However, ancestry generally explains only a modest proportion of total phenotypic variation. Genetically estimated and self-perceived ancestry correlate significantly, but certain physical attributes have a strong impact on self-perception and bias self-perception of ancestry relative to genetically estimated ancestry

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Gestational exercise and intergenerational inheritance. Metabolic and functional outcomes in rat liver and skeletal muscle

Programa de Doctorat en BiomedicinaMaternal environmental exposure during gestational period may affect offspring risk for chronic diseases. Accordingly, maternal metabolic disturbances induced by high-fat high-sucrose (HFHS) diets can have a negative impact on offspring liver and skeletal muscle (SM) tissue phenotypes. In contrast, gestational exercise (GE) seems to favorably modulate deleterious stimuli induced by HFHS- diet consumption, not only in mothers but also in their offspring. However, the mechanisms associated to intergenerational inheritance of favorable metabolic outcomes in the offspring are far to be understood, as well as the role of epigenetic regulation in the offspring program. In order to contribute to increase the scientific knowledge in this field, the present PhD thesis comprises two literature review publications and three animal-based experimental papers that were developed using a gestational diabetes mellitus (GDM) model. Therefore, the goal was to analyze the potential role of an exercised model that combines voluntary free-running wheel (FRW) with forced endurance exercise, against liver and SM offspring metabolic and functional impairments. Our data revealed that GE counteracted the negative impact of HFHS maternal diet and sedentarism in offspring liver and SM morphology. Moreover, offspring from HFHS exercised mothers exhibited an improvement in liver and SM parameters of mitochondrial biogenesis, oxidative phosphorylation subunits protein content and respiratory capacity, associated to improvements in maximal exercise performance. Additionally, improvements in biomarkers of mitochondrial performance seems to be regulated, at least in part, by the role of miRNAs through epigenetic modifications inhered by the offspring generation. Ultimately, these findings shed light on the importance of maternal lifestyle, specifically the relevance of GE, on the phenotypic programming of the offspring against GDM-associated metabolic impairments and ultimately to an enhanced functional performance. Hopefully, evidence from the present PhD thesis can contribute to encourage mothers to engage in an active lifestyle before and during pregnancy aiming positive outcomes in their offspring