IMPLICAÇÕES DO ISOLAMENTO SOCIAL DURANTE A PANDEMIA DO COVID-19 NA COMUNICAÇÃO DE CRIANÇAS

Introduction: With the COVID-19 pandemic, several countries adopted social distancing as a preventive measure, which caused the social isolation of families, consequently, children who were in the course of communication and language development had these processes delayed or not started. Objective: To analyze the impacts of social isolation during the COVID-19 pandemic on children's communication in São Luís - MA. Methods: A retrospective longitudinal observational study was adopted, evaluating the speech-language pathology records, on the communicative behavior, of 15 children treated at a speech-language pathology clinic, considering the last and the first assessment before and after social isolation, respectively. The answers were analyzed in percentage and for statistical analysis, a non- parametric chi-square test was used. Results: It is observed that there were significant differences (P < 0.05) in the results obtained by the evaluations of the medical records regarding the language aspects of the children assisted after social isolation, the children began not to obey orders and auditory and visual commands after isolation. , where an increase of 14% is observed and it differed significantly (P < 0.05) before social isolation. There was a significant change (P < 0.05) in the ratio of children who were sometimes able to communicate by forming sentences of 2 or 3 words correctly in order not to communicate after social isolation, with a   decrease from 36% to 14% of children who were able to communicate and an increase from 14% to 36% in the number of children who cannot. Conclusion: Social isolation during the COVID-19 pandemic negatively influenced the communication of children in São Luís - MA.Introdução: Com a pandemia da COVID-19 vários países adotaram o distanciamento social como medida preventiva, que ocasionou no isolamento social das famílias, consequentemente, as crianças que estavam em curso do desenvolvimento da comunicação e linguagem tiveram esses processos retardados ou não iniciados. Objetivo: analisar os impactos do isolamento social durante a pandemia da COVID-19 na comunicação de crianças em São Luís - MA. Métodos: Adotou-se estudo observacional do tipo longitudinal de caráter retrospectivo avaliando prontuários fonoaudiológicos, sobre o comportamento comunicativo, de 15 crianças atendidas numa clínica fonoaudiológica, considerando-se a última e a primeira avaliação antes e após o isolamento social, respectivamente. As respostas foram analisadas em porcentagem e para análise estatística adotou-se teste não paramétrico quadrado. Resultados: Observa-se que houve diferenças significativa (P < 0,05) nos resultados obtidos pelas avaliações dos prontuários quanto aos aspectos de linguagem das crianças atendidas depois do isolamento social, as crianças passaram a não obedecer a ordens e comandos auditivos e visuais depois do isolamento, onde se observa aumento de 14% e diferiu significativamente (P < 0,05) antes do isolamento social. Ocorreu mudança significativa (P < 0,05) na relação das crianças que conseguiam às vezes se comunicar formando frases de 2 ou 3 palavras corretamente para não se comunicar depois do isolamento social, com diminuição de 36% para 14% das crianças que conseguiam às vezes se comunicar e aumento de 14% para 36% no quantitativo de crianças que não conseguem. Conclusão: O isolamento social durante a pandemia do COVID-19 influenciou negativamente na comunicação de crianças em São Luís – MA

Noninvasive and invasive evaluation of cardiac dysfunction in experimental diabetes in rodents

BACKGROUND: Because cardiomyopathy is the leading cause of death in diabetic patients, the determination of myocardial function in diabetes mellitus is essential. In the present study, we provide an integrated approach, using noninvasive echocardiography and invasive hemodynamics to assess early changes in myocardial function of diabetic rats. METHODS: Diabetes was induced by streptozotocin injection (STZ, 50 mg/kg). After 30 days, echocardiography (noninvasive) at rest and invasive left ventricular (LV) cannulation at rest, during and after volume overload, were performed in diabetic (D, N = 7) and control rats (C, N = 7). The Student t test was performed to compare metabolic and echocardiographic differences between groups at 30 days. ANOVA was used to compare LV invasive measurements, followed by the Student-Newman-Keuls test. Differences were considered significant at P < 0.05 for all tests. RESULTS: Diabetes impaired LV systolic function expressed by reduced fractional shortening, ejection fraction, and velocity of circumferential fiber shortening compared with that in the control group. The diabetic LV diastolic dysfunction was evidenced by diminished E-waves and increased A-waves and isovolumic relaxation time. The myocardial performance index was greater in diabetic compared with control rats, indicating impairment in diastolic and systolic function. The LV systolic pressure was reduced and the LV end-diastolic pressure was increased at rest in diabetic rats. The volume overload increased LVEDP in both groups, while LVEDP remained increased after volume overload only in diabetic rats. CONCLUSION: These results suggest that STZ-diabetes induces systolic and diastolic dysfunction at rest, and reduces the capacity for cardiac adjustment to volume overload. In addition, it was also demonstrated that rodent echocardiography can be a useful, clinically relevant tool for the study of initial diabetic cardiomyopathy manifestations in asymptomatic patients

Moderate hyperhomocysteinemia provokes dysfunction of cardiovascular autonomic system and liver oxidative stress in rats

Hyperhomocysteinemia (HHcy) is associated with cardiovascular disease, atherosclerosis and reactive oxygen species generation. Thus, our aim was to investigate whether there was an association between HHcy, blood pressure, autonomic control and liver oxidative stress. Male Wistar rats were divided into 2 groups and treated for 8 weeks: one group (control, CO) received tap water, while the other group (methionine, ME) was given a 100 mg/kg of methionine in water by gavage. Two catheters were implanted into the femoral artery and vein to record arterial pressure (AP) and heart rate (HR) and drug administration. Signals were recorded by a data acquisition system. Baroreflex sensitivity was evaluated by HR responses to AP changes induced by vasoactive drugs. HR variability and AP variability were performed by spectral analysis in time and frequency domains to evaluate the contribution of the sympathetic and parasympathetic modulation. Lipid peroxidation and antioxidant enzyme activities were evaluated by measuring superoxide dismutase, catalase and glutathione peroxidase in liver homogenates. the ME group presented a significant increase in systolic arterial pressure (118 +/- 9 vs 135 +/- 6 mm Hg), diastolic arterial pressure (81 +/- 6 vs. 92 +/- 4) and mean arterial pressure (95 +/- 7 vs. 106 +/- 6). in addition, pulse interval variability presented a significant decrease (41%), while the low frequency component of AP was significantly increased (delta P = 6.24 mmHg(2)) in the ME group. We also found a positive association between lipid peroxidation and cardiac sympathetic modulation, sympathetic and vagal modulation ratio and systolic pressure variability. Collectively, these findings showed that HHcy induced dysfunction of cardiovascular autonomic system and liver oxidative stress. (C) 2013 Elsevier B.V. All rights reserved.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)FAPERGSUniv Fed Rio Grande do Sul, Inst Ciencias Basicas Saude, Dept Fisiol, Lab Fisiol Cardiovasc, BR-90046900 Porto Alegre, RS, BrazilUniv São Paulo, Inst Coracao, Unidade Hipertensao, BR-05508 São Paulo, BrazilUniv Fed Ciencias Saude Porto Alegre, BR-90050170 Porto Alegre, RS, BrazilUniversidade Federal de São Paulo, Dept Biociencias, São Paulo, BrazilUniv Fed Rio de Janeiro, Inst Nutr Josue Castro, BR-21941 Rio de Janeiro, BrazilUniv Santo Amaro, Programa Posgrad Ciencias Saude, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biociencias, São Paulo, BrazilWeb of Scienc

Resveratrol and grape juice differentially ameliorate cardiovascular autonomic modulation in L-NAME-treated rats

Polyphenols consumption detected in red wine and grape juice may prevent or help in the treatment of hypertension. However, cardiovascular autonomic effects of polyphenols were poorly studied. Therefore, we evaluated the effects of resveratrol and grape juice treatments in hemodynamics, baroreflex sensitivity, heart rate (HR) and blood pressure (BP) variability and cardiac redox parameters. Male Wistar rats were divided in 3 groups (n = 7/each) and treated for 30 days: only L-NAME-treated (60 mg/kg/day by oral gavage), L-NAME + resveratrol (L-NAME + R) and L-NAME + grape juice (L-NAME + G). BP signal was directly recorded and pulse interval (PI) and systolic arterial pressure (SAP) variability were analyzed in time and frequency domains. Baroreflex sensitivity (BRS) was determined by the alpha index. Oxidized and reduced glutathione concentrations were determined in cardiac tissue. L-NAME increased BP with no differences among groups (mean BP: L-NAME = 124 +/- 4, L-NAME + R = 126 +/- 3 and L-NAME + G = 125 +/- 4 mmHg). PI and SAP variability expressed by total variance were also similar among groups. However, normalized low frequency (LF) and high frequency (HF) components of PI variability were lower and higher, respectively, in both R and G-treated groups when compared to only L-NAME group. Interestingly, sympathetic modulation to the vessels (LF from SAP variability) and BRS were decreased and increased, respectively, only in L-NAME + R rats. Additionally, GSH/GSSG ratios were higher in L-NAME + R and L-NAME + G than in L-NAME group. Our results indicate that resveratrol and grape juice treatments can modulate autonomic function and promote cardiac redox benefits even when nitric oxide is decreased. Moreover, resveratrol influences not only cardiac but also vascular autonomic modulation. (C) 2013 Elsevier B.V. All rights reserved.Univ São Paulo, Escola Paulista Med, Inst Coracao InCor, Unidade Hipertensao, São Paulo, BrazilUniv Fed Ciencias Saude, Dept Ciencias Basicas Saude, Porto Alegre, RS, BrazilFundacao Univ Cardiol, Inst Cardiol, Unidade Pesquisa, Porto Alegre, RS, BrazilUniv Maranhao, UFMA, Hosp Univ Matemo Infantil, Sao Luis, BrazilUniv São Paulo, Escola Paulista Med, Inst Coracao InCor, Unidade Hipertensao, São Paulo, BrazilWeb of Scienc

Preventive role of exercise training in autonomic, hemodynamic, and metabolic parameters in rats under high risk of metabolic syndrome development

Preventive role of exercise training in autonomic, hemodynamic, and metabolic parameters in rats under high risk of metabolic syndrome development. J Appl Physiol 114: 786-791, 2013. First published January 17, 2013; doi:10.1152/japplphysiol.00586.2012.-High fructose consumption contributes to metabolic syndrome incidence, whereas exercise training promotes several beneficial adaptations. in this study, we demonstrated the preventive role of exercise training in the metabolic syndrome derangements in a rat model. Wistar rats receiving fructose overload in drinking water (100 g/l) were concomitantly trained on a treadmill (FT) or kept sedentary (F) for 10 wk. Control rats treated with normal water were also submitted to exercise training (CT) or sedentarism (C). Metabolic evaluations consisted of the Lee index and glycemia and insulin tolerance test (kITT). Blood pressure (BP) was directly measured, whereas heart rate (HR) and BP variabilities were evaluated in time and frequency domains. Renal sympathetic nerve activity was also recorded. F rats presented significant alterations compared with all the other groups in insulin resistance (in mg.dl(-1).min(-1): F: 3.4 +/- 0.2; C: 4.7 +/- 0.2; CT: 5.0 +/- 0.5 FT: 4.6 +/- 0.4), mean BP (in mmHG: F: 117 +/- 2; C: 100 +/- 2; CT: 98 +/- 2; FT: 105 +/- 2), and Lee index (in g/mm: F = 0.31 +/- 0.001; C = 0.29 +/- 0.001; CT = 0.27 +/- 0.002; FT = 0.28 +/- 0.002), confirming the metabolic syndrome diagnosis. Exercise training blunted all these derangements. Additionally, FS group presented autonomic dysfunction in relation to the others, as seen by an similar to 50% decrease in baroreflex sensitivity and 24% in HR variability, and increases in sympathovagal balance (140%) and in renal sympathetic nerve activity (45%). These impairments were not observed in FT group, as well as in C and CT. Correlation analysis showed that both Lee index and kITT were associated with vagal impairment caused by fructose. Therefore, exercise training plays a preventive role in both autonomic and hemodynamic alterations related to the excessive fructose consumption.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Sch Med, Heart Inst InCor, Hypertens Unit, BR-05403900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Nephrol, São Paulo, BrazilNove Julho Univ, São Paulo, BrazilUniv Prebiteriana Mackenzie, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Nephrol, São Paulo, BrazilWeb of Scienc

Blood Pressure, Metabolic and Autonomic Responses to Insulin and Intralipid (R) Infusion in Chagasic Patients

Background: Intralipid (R) and heparin infusion results in increased blood pressure and autonomic abnormalities in normal and hypertensive individuals. Objective: To evaluate insulin sensitivity and the impact of Intralipid (R) and heparin (ILH) infusion on hemodynamic, metabolic, and autonomic response in patients with the indeterminate form of Chagas' disease. Methods: Twelve patients with the indeterminate form of Chagas' disease and 12 healthy volunteers were evaluated. Results: Baseline blood pressure and heart rate were similar in both groups. Plasma noradrenaline levels were slightly increased in the Chagas' group. After insulin tolerance testing (ITT), a significant decline was noted in glucose in both groups. ILH infusion resulted in increased blood pressure in both groups, but there was no significant change in plasma noradrenaline. The low-frequency component (LF) was similar and similarly increased in both groups. The high-frequency component (HF) was lower in the Chagas' group. Conclusion: Patients with the indeterminate form of Chagas' disease had increased sympathetic activity at baseline and impaired response to insulin. They also had a lower high-frequency component and impaired baroreflex sensitivity at baseline and during Intralipid (R) and heparin infusion. (Arq Bras Cardiol 2012;98(3):225-233)FAPESPFAPES

Maximal exercise test is a useful method for physical capacity and oxygen consumption determination in streptozotocin-diabetic rats

BACKGROUND: The aim of the present study was to investigate the relationship between speed during maximum exercise test (ET) and oxygen consumption (VO(2)) in control and STZ-diabetic rats, in order to provide a useful method to determine exercise capacity and prescription in researches involving STZ-diabetic rats. METHODS: Male Wistar rats were divided into two groups: control (CG, n = 10) and diabetic (DG, n = 8). The animals were submitted to ET on treadmill with simultaneous gas analysis through open respirometry system. ET and VO(2 )were assessed 60 days after diabetes induction (STZ, 50 mg/Kg). RESULTS: VO(2 )maximum was reduced in STZ-diabetic rats (72.5 ± 1 mL/Kg/min(-1)) compared to CG rats (81.1 ± 1 mL/Kg/min(-1)). There were positive correlations between ET speed and VO(2 )(r = 0.87 for CG and r = 0.8 for DG), as well as between ET speed and VO(2 )reserve (r = 0.77 for CG and r = 0.7 for DG). Positive correlations were also obtained between measured VO(2 )and VO(2 )predicted values (r = 0.81 for CG and r = 0.75 for DG) by linear regression equations to CG (VO(2 )= 1.54 * ET speed + 52.34) and DG (VO(2 )= 1.16 * ET speed + 51.99). Moreover, we observed that 60% of ET speed corresponded to 72 and 75% of VO(2 )reserve for CG and DG, respectively. The maximum ET speed was also correlated with VO(2 )maximum for both groups (CG: r = 0.7 and DG: r = 0.7). CONCLUSION: These results suggest that: a) VO(2 )and VO(2 )reserve can be estimated using linear regression equations obtained from correlations with ET speed for each studied group; b) exercise training can be prescribed based on ET in control and diabetic-STZ rats; c) physical capacity can be determined by ET. Therefore, ET, which involves a relatively simple methodology and low cost, can be used as an indicator of cardio-respiratory capacity in future studies that investigate the physiological effect of acute or chronic exercise in control and STZ-diabetic male rats

The impact of metabolic syndrome on metabolic, pro-inflammatory and prothrombotic markers according to the presence of high blood pressure criterion

OBJECTIVES: We explored whether high blood pressure is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome. METHODS: We evaluated 135 consecutive overweight/obese patients. From this group, we selected 75 patients who were not under the regular use of medications for metabolic syndrome as defined by the current Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria. The patients were divided into metabolic syndrome with and without high blood pressure criteria (≥130/≥85 mmHg). RESULTS: Compared to the 45 metabolic syndrome patients without high blood pressure, the 30 patients with metabolic syndrome and high blood pressure had significantly higher glucose, insulin, homeostasis model assessment insulin resistance index, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, uric acid and creatinine values; in contrast, these patients had significantly lower high-density lipoprotein-cholesterol values. Metabolic syndrome patients with high blood pressure also had significantly higher levels of retinol-binding protein 4, plasminogen activator inhibitor 1, interleukin 6 and monocyte chemoattractant protein 1 and lower levels of adiponectin. Moreover, patients with metabolic syndrome and high blood pressure had increased surrogate markers of sympathetic activity and decreased baroreflex sensitivity. Logistic regression analysis showed that high-density lipoprotein, retinol-binding protein 4 and plasminogen activator inhibitor-1 levels were independently associated with metabolic syndrome patients with high blood pressure. There is a strong trend for an independent association between metabolic syndrome patients with high blood pressure and glucose levels. CONCLUSIONS: High blood pressure, which may be related to the autonomic dysfunction, is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome

ACE gene dosage determines additional autonomic dysfunction and increases renal angiotensin II levels in diabetic mice

OBJECTIVES: The present study aimed to investigate cardiovascular autonomic modulation and angiotensin II (Ang II) activity in diabetic mice that were genetically engineered to harbor two or three copies of the angiotensin-converting enzyme gene. METHODS: Diabetic and non-diabetic mice harboring 2 or 3 copies of the angiotensin-converting enzyme gene were used in the present study. Animals were divided into 4 groups: diabetic groups with two and three copies of the angiotensin-converting enzyme gene (2CD and 3CD) and the respective age-matched non-diabetic groups (2C and 3C). Hemodynamic, cardiovascular, and autonomic parameters as well as renal Ang II expression were evaluated. RESULTS: Heart rate was lower in diabetic animals than in non-diabetic animals. Autonomic modulation analysis indicated that the 3CD group showed increased sympathetic modulation and decreased vagal modulation of heart rate variability, eliciting increased cardiac sympathovagal balance, compared with all the other groups. Concurrent diabetes and either angiotensin-converting enzyme polymorphism resulted in a significant increase in Ang II expression in the renal cortex. CONCLUSION: Data indicates that a small increase in angiotensin-converting enzyme activity in diabetic animals leads to greater impairment of autonomic function, as demonstrated by increased sympathetic modulation and reduced cardiac vagal modulation along with increased renal expression of Ang II