Effects of high intensity interval training on neuro-cardiovascular dynamic changes and mitochondrial dysfunction induced by high-fat diet in rats

This research was supported by the Brazilian National Council for Scientific and Technologic Development (CNPq) (Grant number: 474116/2008-5) and Carlos Chagas Filho Foundation for Research Support in the State of Rio de Janeiro (FAPERJ) (Grant number: E-26/ 111.732/2011), both received by Eliete Bouskela. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

α-Tocopherol Improves Microcirculatory Dysfunction on Fructose Fed Hamsters.

Fructose, an everyday component of western diet associated to chronic hyperglycemia and enhanced free radical production, impairs endothelial function and supplementation with antioxidants might improve it. In this study we investigated if vitamin E could reverse the microvascular damage elicited by fructose. Male Syrian golden hamsters drank either 10% fructose solution (F) or filtered water (C), combined with three concentrations of vitamin E in their chows [zero, normal (VE) or 5X (5XVE)] during 60 days. Microvascular reactivity in response to topical application of acetylcholine (Ach; endothelium-dependent vasodilator) or sodium nitroprusside (SNP; endothelium-independent vasodilator) and macromolecular permeability increase induced by either 30 min ischemia followed by reperfusion (I/R) or topical application of histamine (5 μM) were assessed using the cheek pouch preparation. Compared to controls (drinking filtered water), fructose-drinking animals showed decreased vasodilatation to acetylcholine in all concentrations tested (-56.2% for 10-9M, -53.9% for 10-7M and -43.7% for 10-5M). On the other hand, vitamin E supplementation resulted in increased responses for both water and fructose drinking groups (177.4% for F vs. F/5XVE and 241.6% for C vs. C/5XVE for 10-5M Ach). Endothelial-independent vasodilatation explored by topical application of SNP was restored and even enhanced with the supplementation of 5X vitamin E in both groups (80.1% for F vs. F/5XVE; 144.2% for C vs. C/5XVE; 3.4% of difference for C/5XVE vs. F/5XVE on 10-5M SNP). The number of leaky sites after I/R and histamine stimuli in vitamin E supplemented animals decreased (-25.1% and -15.3% for F vs. F/5XVE; and -21.7% and -16% of leaky sites comparing C vs. C/5XVE, respectively for I/R and histamine stimuli) pointing to tightening of the endothelial barrier for macromolecular permeability. Our results strongly suggest that vitamin E could improve the endothelial function and permeability barrier and also reverse impairments elicited by sugar overload

Mean arteriolar diameters after topical application of SNP–Endothelial- independent evaluation.

<p>Data are shown as changes of average diameter, expressed as mean ± SD and plotted in superimposed symbols. <b>(A)</b> Overall mean arteriolar diameters after topical application of three concentrations of sodium nitroprusside (10⁻⁹, 10⁻⁷ and 10⁻⁵ M) in the 2 treated groups. <b>(B)</b> Endothelial-independent responses of groups treated with filtered water, concomitantly associated with chows without vitamin E (C), with normal concentration of vitamin E (75U/kg–C/VE) and supplemented concentrations of vitamin E (375U/kg–C/5XVE). <b>(C)</b> Responses of groups that had the filtered water substituted by 10% fructose solution, concomitantly associated with chows without vitamin E (F), with normal concentration of vitamin E (75U/kg–F/VE) and supplemented concentrations of vitamin E (375U/kg–F/5XVE). ^<b>+</b><i>p</i><0.05 [10^-9M and 10^-7M] and <i>p</i><0.01 [10^-5M]. Significantly different from Control without vitamin E and ^<b>#</b>p<0.01 significantly different from fructose-drinking solution without vitamin E.</p

Experimental design and protocol.

<p>(1A) Eight weeks-old hamsters were treated during 8 weeks as described: animals were divided into two major groups, substitution of the drinking water by 10% fructose solution or kept drinking filtered water. Each major group had the formulated chow associated to three different concentrations of vitamin E: zero vitamin E (groups F and C), 75U/kg (normal concentration of vitamin E—groups F/VE and C/VE) and 375U/kg (5 times the normal concentration of vitamin E—groups F/5XVE and C/5XVE). After the 8^th week of treatment, the hamster cheek pouch microcirculation was evaluated by intravital microscopy and animals were euthanized for blood collection. (1B) Microcirculatory function was evaluated in two fronts: endothelial function by topical application of either acetylcholine or sodium nitroprusside, both in three different concentrations (10⁻⁹, 10⁻⁷ and 10^-5M), in a cumulative dose-response curve and macromolecular permeability increase induced by either ischemia/reperfusion (30 min local ischemia followed by reperfusion) or topical application of histamine (5 μM during 5 min).</p

Contents of the diet used on treated hamsters.

<p>*Vitamin Mix = Vitamin E content was altered in order to achieve three different concentrations [zero, (Normal) 75U/Kg and (5X times) 375U/Kg chow].</p><p>Contents of the diet used on treated hamsters.</p