Muscle blood flow in heart failure : interaction between central and local factors

A intolerância ao exercício é uma característica marcante da insuficiência cardíaca. Diversos mecanismos, como anormalidades no metabolismo muscular, no consumo de oxigênio do músculo e principalmente no fluxo sangüíneo muscular, têm sido documentados em pacientes com insuficiência cardíaca. Contudo, a relação entre a tolerância ao exercício e perfusão muscular no exercício é ainda controversa neste estado. Diversos mecanismos têm sido propostos na participação da regulação da hiperemia relacionada ao exercício, incluindo os mecanismos neural, endotelial e a bomba muscular. O propósito desta revisão é apresentar as evidências experimentais e clínicas com relação ao controle da perfusão muscular no exercício na insuficiência cardíaca. Existe um consenso geral de que a insuficiência cardíaca crônica esteja associada à vasoconstrição periférica e à marcante elevação da atividade do sistema nervoso autônomo simpático. Evidências recentes sugerem, ainda, que a modulação inadequada da atividade vasoconstritora simpática, a disfunção endotelial e os mecanismos anormais de controle da bomba muscular podem ser responsáveis pela resposta vasodilatadora inadequada ao exercício nesses pacientes. Contudo, a interação entre os mecanismos de controle do fluxo sangüíneo muscular no exercício e, sobretudo, como esses mecanismos afetam a tolerância ao exercício na insuficiência cardíaca ainda precisam ser melhor investigados.Exercise intolerance is a hallmark of heart failure. Several mechanisms, such as abnormalities in muscle metabolism, muscle oxygen uptake and especially muscle blood flow have been documented in patients with heart failure. However, the relation between exercise tolerance and muscle perfusion during exercise is still controversial in this state. Several mechanisms have been proposed to be involved in the regulation of exercise hyperemia, including neural, endothelial and muscle pump mechanisms. The purpose of this review is to present experimental and clinical evidence regarding muscle perfusion control during exercise in heart failure. There is a general consensus that chronic heart failure is associated with peripheral vasoconstriction and marked elevation in sympathetic nervous system activity. Recent evidence also suggests that impaired modulation of sympathetic vasoconstriction, endothelial dysfunction and abnormal muscle pump mechanisms may be responsible for the blunted vasodilator responses to exercise in these patients. However, the interactions between muscle blood flow control mechanisms during exercise and especially how these factors affect exercise tolerance still need to be investigated in heart failure

Muscle blood flow in heart failure : interaction between central and local factors

A intolerância ao exercício é uma característica marcante da insuficiência cardíaca. Diversos mecanismos, como anormalidades no metabolismo muscular, no consumo de oxigênio do músculo e principalmente no fluxo sangüíneo muscular, têm sido documentados em pacientes com insuficiência cardíaca. Contudo, a relação entre a tolerância ao exercício e perfusão muscular no exercício é ainda controversa neste estado. Diversos mecanismos têm sido propostos na participação da regulação da hiperemia relacionada ao exercício, incluindo os mecanismos neural, endotelial e a bomba muscular. O propósito desta revisão é apresentar as evidências experimentais e clínicas com relação ao controle da perfusão muscular no exercício na insuficiência cardíaca. Existe um consenso geral de que a insuficiência cardíaca crônica esteja associada à vasoconstrição periférica e à marcante elevação da atividade do sistema nervoso autônomo simpático. Evidências recentes sugerem, ainda, que a modulação inadequada da atividade vasoconstritora simpática, a disfunção endotelial e os mecanismos anormais de controle da bomba muscular podem ser responsáveis pela resposta vasodilatadora inadequada ao exercício nesses pacientes. Contudo, a interação entre os mecanismos de controle do fluxo sangüíneo muscular no exercício e, sobretudo, como esses mecanismos afetam a tolerância ao exercício na insuficiência cardíaca ainda precisam ser melhor investigados.Exercise intolerance is a hallmark of heart failure. Several mechanisms, such as abnormalities in muscle metabolism, muscle oxygen uptake and especially muscle blood flow have been documented in patients with heart failure. However, the relation between exercise tolerance and muscle perfusion during exercise is still controversial in this state. Several mechanisms have been proposed to be involved in the regulation of exercise hyperemia, including neural, endothelial and muscle pump mechanisms. The purpose of this review is to present experimental and clinical evidence regarding muscle perfusion control during exercise in heart failure. There is a general consensus that chronic heart failure is associated with peripheral vasoconstriction and marked elevation in sympathetic nervous system activity. Recent evidence also suggests that impaired modulation of sympathetic vasoconstriction, endothelial dysfunction and abnormal muscle pump mechanisms may be responsible for the blunted vasodilator responses to exercise in these patients. However, the interactions between muscle blood flow control mechanisms during exercise and especially how these factors affect exercise tolerance still need to be investigated in heart failure

Comparative evaluation of safety and efficacy in reducing odors and improves genital hydration for hygiene products

Background and objective: It is important that women feel safe and protected against genital unpleasant odors. The aim of this study was to evaluate the safety and efficacy in reducing odors and improves genital hydration for hygiene products. Method: Study involving 230 female volunteers, age 18 to 45 years, distributed in five groups of 46 members. The volunteers used the investigational product for 30 days and the comparative for more 30 days. Between the administrations of the products, there was a wash-out period of 7 days. Each group used a different fragrance of the investigational product totaling 5 fragrances. The efficacy evaluation was subjective, through the questionnaires at the beginning and end of each treatment with product (investigational and control). Were assessed as variables, reduction of genital odour, genital moisturize, defoaming, facility of rinsing, final touch of the mucosa, final fragrance and cleaning sensation. At the end of study, a questionnaire was answered comparing directly the investigational product and control for two characteristics: odour reduction and cleaning sensation. Results: The investigational product demonstrated best ratings in all parameters, for the five fragrances, 30 days after use. With regard to product safety the volunteers had no adverse reaction. Conclusion: The care of the female genital region should be done properly promoting sense of protection and welfare of women. Hygiene should be done with products developed especially for the region intimately and with proven efficacy. © Copyright Moreira Jr. Editora.Todos os direitos reservados.Medcin Instituto da Pele Ltda Faculdade de Medicina Universidade de São Paulo (USP), São Paulo SPMedcin Instituto da Pele Ltda Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista (UNESP), Araraquara (SP)Medcin Instituto da Pele Ltda Faculdade de Farmácia e Bioquímica Universidade Nove de Julho (UNINOVE), São Paulo SPMedcin Instituto da Pele Ltda, Av. Dr. Carlos de Morais Barros, 304 Vila Campesina, CEP 06023-000 - Osasco - SPMedcin Instituto da Pele Ltda Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista (UNESP), Araraquara (SP

Comparative evaluation of safety and efficacy for hygiene products in menopausal women

Background and objective: The menopause is the last menstrual period. A milestone in the climacteric, when major changes occurs in women's lives. The aim of this study was to evaluate the safety and efficacy in moisturizing and recovery of genital mucosa for hygiene products in menopause women. Method: Study involving 70 female volunteers, age 45 to 65 years, distributed in two groups of 35 members. Each group received one fragrance of the investigational product for 15 days and then was added a moisturizing lotion to the investigational product for more 15 days. After 7 days of wash-out period the volunteers used the comparative product for more 30 days. Evaluation of efficacy was performed by instrumental measurements as Transepidermal Water Loss (TEWL) and Corneometry. Subjective evaluations were performed through the questionnaires at the beginning and end of each treatment with the products. At the end of study, a questionnaire was answered comparing directly the treatments. Results: The comparative product showed better results, statistically significant, than the investigational product fragrance Silver Frutal in sensation of elasticity and firmness of the mucosa. The addition of the moisturizing lotion in both investigational products fragrances Silver Frutal and Floral brought positive results to all parameters evaluated, except to viscosity. As for the safety, none of the volunteers had allergic reaction or other adverse event. Conclusion: The hygiene products for the female genital region should preserve the physiological condi. © Copyright Moreira Jr. Editora.Todos os direitos reservados.Medcin Instituto da Pele Ltda Faculdade de Medicina Universidade de São Paulo (USP), São Paulo SPMedcin Instituto da Pele Ltda Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista (UNESP), Araraquara (SP)Medcin Instituto da Pele Ltda Instituto de Química Universidade Estadual Paulista (UNESP), Araraquara (SP)Medcin Instituto da Pele Ltda Faculdade de Farmácia e Bioquímica Universidade Nove de Julho (UNINOVE), São Paulo SPMedcin Instituto da Pele Ltda, Av. Dr. Carlos de Morais Barros, 304 Vila Campesina, CEP 06023-000 - Osasco - SPMedcin Instituto da Pele Ltda Faculdade de Ciências Farmacêuticas Universidade Estadual Paulista (UNESP), Araraquara (SP)Medcin Instituto da Pele Ltda Instituto de Química Universidade Estadual Paulista (UNESP), Araraquara (SP