Melatonin and the cardiovascular system in animals: systematic review and meta-analysis

Melatonin, a hormone released by the pineal gland, demonstrates several effects on the cardiovascular system. Herein, we performed a systematic review and meta-analysis to verify the effects of melatonin in an experimental model of myocardial infarction. We performed a systematic review according to PRISMA recommendations and reviewed MEDLINE, Embase, and Cochrane databases. Only articles in English were considered. A systematic review of the literature published between November 2008 and June 2019 was performed. The meta-analysis was conducted using the RevMan 5.3 program provided by the Cochrane Collaboration. In total, 858 articles were identified, of which 13 were included in this review. The main results of this study revealed that melatonin benefits the cardiovascular system by reducing infarct size, improving cardiac function according to echocardiographic and hemodynamic analyses, affords antioxidant effects, improves the rate of apoptosis, decreases lactate dehydrogenase activity, enhances biometric analyses, and improves protein levels, as analyzed by western blotting and quantitative PCR. In the meta-analysis, we observed a statistically significant decrease in infarct size (mean difference [MD], -20.37 [-23.56, -17.18]), no statistical difference in systolic pressure (MD, -1.75 [-5.47, 1.97]), a statistically significant decrease in lactate dehydrogenase in animals in the melatonin group (MD, -4.61 [-6.83, -2.40]), and a statistically significant improvement in the cardiac ejection fraction (MD, -8.12 [-9.56, -6.69]). On analyzing potential bias, we observed that most studies presented a low risk of bias; two parameters were not included in the analysis, and one parameter had a high risk of bias. Melatonin exerts several effects on the cardiovascular system and could be a useful therapeutic target to combat various cardiovascular diseases

Cardiac implications after myocardial infarction in rats previously undergoing physical exercise

BACKGROUND: Few studies have analyzed the cardiac effects of exercise prior to coronary occlusion. OBJECTIVE: To evaluate the effects of myocardial infarction in rats undergoing physical exercise. METHODS: Female rats underwent swimming exercise or were kept sedentary for eight weeks and were randomized to coronary occlusion or sham surgery, in one of the following four groups: Sedentary (S), exercise (E), Sedentary myocardial infarction (SMI) and Exercise myocardial infarction (EMI). After six weeks, their biometrics, Doppler echocardiography, hemodynamics and myocardial mechanics were analyzed. RESULTS: No cardioprotection was observed in EMI animals and there was no difference in infarct size (%LV) between EMI (38.50 ± 4.60%) and SMI (36.58 ± 4.11%). Water content of the lung (%) of SMI (80 ± 0.59) and EMI (80 ± 0.57) was higher than that of S (78 ± 0.15) and E (78 ± 0.57) groups. Left ventricular systolic pressure (mmHg) (S: 130 ± 5, E: 118 ± 8; SMI: 91 ± 3; EMI: 98 ± 3) and the first positive time derivative (mmHg) positive pressure (S: 8216 ± 385; E: 8437 ± 572; SMI: 4674 ± 455; EMI: 5080 ± 412) of S and E were higher than those of SMI and EMI. The transverse fractional shortening (%) of SMI (27 ± 2) and EMI (25 ± 2) were similar and lower than that of E (65 ± 2) and S (69 ± 2). The E/A ratio was higher in SMI (5.14 ± 0.61) and EMI (4.73 ± 0.57) compared to S (2.96 ± 0.24) and E (2.83 ± 0 21). In studies of isolated papillary muscle, depression of the contractile capacity observed was similar to that of SMI and EMI, and there was no change in myocardial stiffness. CONCLUSION: Previous training by swimming did not attenuate cardiac implications due to myocardial infarction.FUNDAMENTO: Poucos estudos analisaram os efeitos cardíacos do exercício físico prévio à oclusão coronariana. OBJETIVO: Avaliar, em ratas submetidas a exercício físico, as repercussões do infarto do miocárdio. MÉTODOS: Ratas foram submetidas à natação ou permaneceram sedentárias por oito semanas e foram randomizadas para oclusão coronariana ou cirurgia simulada, compondo quatro grupos: Sedentário (S), Exercício (E), Sedentário infarto (SIM) e Exercício infarto (EIM). Após seis semanas, foram analisados biometria, ecodopplercardiograma, hemodinâmica e mecânica miocárdica. RESULTADOS: Não foram observados cardioproteção nos animais EIM e diferença no tamanho do infarto (%VE) entre EIM (38,50 ± 4,60%) e SIM (36,58 ± 4,11%). Os teores de água pulmonar (%) de SIM (80 ± 0,59) e EIM (80 ± 0,57) foram maiores do que em S (78 ± 0,15) e E (78 ± 0,57). A pressão sistólica (mmHg) do ventrículo esquerdo (S: 130 ± 5; E: 118 ± 8; SIM: 91 ± 3; EIM: 98 ± 3) e a primeira derivada temporal (mmHg/s) positiva da pressão (S: 8.216 ± 385; E: 8.437 ± 572; SIM: 4.674 ± 455; EIM: 5.080 ± 412) de S e E foram maiores do que em SIM e EIM. As frações de encurtamento da área transversa (%) de SIM (27 ± 2) e EIM (25 ± 2) foram similares e menores do que E (65 ± 2) e S (69 ± 2). A relação E/A foi maior em SIM (5,14 ± 0,61) e EIM (4,73 ± 0,57) em relação a S (2,96 ± 0,24) e E (2,83 ± 0,21). Em estudos de músculos papilares isolados foi verificada depressão da capacidade contrátil semelhante em SIM e EIM, e não houve alteração da rigidez miocárdica. CONCLUSÃO: O treinamento prévio por natação não atenuou as repercussões cardíacas em virtude do infarto do miocárdio.UNIFESP Departamento de MedicinaCentro Universitário Adventista de São PauloUNIFESP Departamento de FisiologiaInCor Departamento de PatologiaUniversidade Nove de Julho Departamento de Educação FísicaUNIFESP, Depto. de MedicinaUNIFESP, Depto. de FisiologiaSciEL

Adolescents’ knowledge of HPV and sexually transmitted infections at public high schools in São Paulo: A cross-sectional study

Purpose: To assess the knowledge of students from public high schools in poor communities about HPV and Sexually Transmitted Infections and their attitude towards and prevention of such diseases. Patients and methods: Cross-sectional study with adolescents from public schools of São Paulo – Brazil. Participants were selected for an interview by a randomization program. A questionnaire about knowledge, attitudes, and preventive practices regarding STIs, including HPV, according to sex was administered and answers were analyzed by the Poisson regression model with robust variance. Results: Median age of the 269 participants was 16 years. The majority was of African descent (68.8%, n = 185), most (74%, n = 199) were religious and the vast majority (90.7%, n = 244) lived with their parents. The Poisson regression revealed statistically significant sex-related differences regarding the following questions: “Do you know how it is prevented?” (PR = 1.12 [1.03‒1.23], p = 0.007); “Have you ever been concerned with HPV?” (PR = 1.10 [1.02‒1.19], p = 0.011); “Have you ever sought health care due to concerns about HPV?” (PR = 1.09 [1.04‒1.14], p < 0.001); “Do you know what a Pap Smear is?” (PR = 1.24 [1.13‒1.36], p < 0.001); “Do you know what the cervix is?” (PR = 1.23 [1.13‒1.34], p < 0.001); “Do you know what cervical cancer is?” (PR = 1.13 [1.04‒1.22], p = 0.004). Conclusions: The present results show that adolescents from public schools in poor communities in São Paulo City know little about HPV and cervical cancer. Male adolescents know less than female adolescents and are less concerned with health care

Prior exercise training and experimental myocardial infarction: A systematic review and meta-analysis

Exercising prior to experimental infarction may have beneficial effects on the heart. The objective of this study was to analyze studies on animals that had exercised prior to myocardial infarction and to examine any benefits through a systematic review and meta-analysis. The databases MEDLINE, Google Scholar, and Cochrane were consulted. We analyzed articles published between January 1978 and November 2018. From a total of 858 articles, 13 manuscripts were selected in this review. When animals exercised before experimental infarction, there was a reduction in mortality, a reduction in infarct size, improvements in cardiac function, and a better molecular balance between genes and proteins that exhibit cardiac protective effects. Analyzing heart weight/body weight, we observed the following results - Mean difference 95% CI - -0.02 [-0.61,0.57]. Metaanalysis of the infarct size (% of the left ventricle) revealed a statistically significant decrease in the size of the infarction in animals that exercised before myocardial infarction, in comparison with the sedentary animals -5.05 [-7.68, -2.40]. Analysis of the ejection fraction, measured by echo (%), revealed that animals that exercised before myocardial infarction exhibited higher and statistically significant measures, compared with sedentary animals 8.77 [3.87,13.66]. We conclude that exercise performed prior to experimental myocardial infarction confers cardiac benefits to animals

Terapias voltadas para o tratamento do transtorno dissociativo de identidade

O transtorno dissociativo de identidade compreende uma condição psicológica complexa provavelmente causada por inúmeros fatores, envolvendo trauma grave na primeira infância, como abuso sexual, físico ou emocional repetitivo e extremo e repetitivo. Este estudo teve como objetivo identificar as terapias voltadas para o tratamento do transtorno dissociativo de identidade. Para isso, foi realizada uma revisão integrativa de literatura, selecionando fontes a partir das bases de dados Medline e Lilacs. A partir da análise qualitativa de dados, concluiu-se que há vários tipos de terapias para o tratamento de pessoas transtorno dissociativo de identidade, devendo essas serem aplicadas conforme cada realidade. Nos estudos, foram identificados os modelos de tratamento psicanalítico relacional, fásico, psicoativo e psicotraumatológico. Em todos esses, foram registrados resultados satisfatórios, tais como a diminuição na dissociação e o aumento do funcionamento adaptativo do paciente, revelando a possibilidade de desconstruir crenças solidamente cultivadas e trazendo esperança aos pacientes no sentido de amenizar ou superar esse transtorno e garantir uma boa interação social

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

O exercício prévio melhora a sobrevida e atenua as repercussões miocárdicas da reperfusão tardia em ratas

Introduction: There is acceptable evidence that exercise benefits the heart function in diseases already established in the heart. The literature is less conclusive in respect to the beneficial effects of the previous exercise training in the evolution of transient and permanent coronary occlusion. Objective: This study aimed to evaluate the effects of previous swimming in structural, functional and molecular biology of rat hearts, evaluated four weeks after permanent coronary occlusion or one hour of ischemia followed by reperfusion. Methods: Rats were subjected to swimming protocol for eight weeks and randomized between four groups: 1) sedentary infarcted (SMI; n = 12); 2) exercised infarcted (EMI: n = 12), 3) sedentary ischemia/reperfusion (SIR; n= 9) and 4) exercised ischemia/reperfusion (EIR, n = 8). Thereafter, the rats remained four weeks under observation for spontaneous evolution of secondary pathophysiology of coronary occlusion. Results (x ± sem): The Kaplan Meyer curve indicated that sedentary rats had higher mortality than the exercised. Those suffering permanent occlusion and those reperfused had MI size (% LV) not differents (SMI: 44 ± 1; EMI: 47 ± 2; SIR: 46 ± 1; EIR: 49 ± 2). Sedentary groups denoted pulmonary congestion, in contrast to exercise animals, which has no pulmonary congestion. The cardiac masses of different groups did not differ in respect to LV and RV. The hemodynamic data included: a) higher heart rate in EMI group; b) LV systolic pressure reduced in SMI animals; c) attenuation of LV end diastolic pressure increase in EIR; d) first time derivatives of positive ventricular pressure reduction in infarcted groups. In Doppler echocardiogram, there were no differences between analyzed parameters: diastolic and systolic areas, transverse fractional shortening of areas and E/A ratio. In the analysis of the papillary muscles, the maximum forces developed by reperfused groups were higher than those of the infarcted and the same result was found for the positive derivative of force. The nuclear volume of the reminiscent cardiomyocytes of exercised groups was lower than those of the sedentary groups. Collagen content, apoptosis and caspase 3 in ischemia/reperfusion groups were lower than those subjected to permanent coronary occlusion. Quantification of phosphorylated AKT1 of SMI group was lower than that of other groups; the SERCA2a/GAPDH ratios were higher in the exercised animals, as well as phosphorylated phospholamban in the groups with isquemia/reperfusion. CaATPase of the SIM group was lower than all other groups. The values of the ryanodine receptor/GAPDH of EIM were lower than all other groups. Conclusion: Prior exercise training enhanced survival, structural, functional and molecular characteristics of rats submitted to late ischemia/reperfusion. In rats submitted to definitive coronary occlusion, previous exercise promoted: lesser nuclear volume, prolonged survival, normal systolic arterial and increased phosphorylated AKT1, SERCA2 of remanent myocardial.Introdução: Há evidências aceitáveis de que o exercício físico beneficia a função cardíaca em doenças já estabelecidas no coração. A documentação da literatura é menos conclusiva quanto aos efeitos benéficos da prática prévia do exercício físico na evolução da oclusão coronária transitória e definitiva. Objetivo: O presente trabalho visou avaliar os efeitos nas características estruturais, funcionais e de biologia molecular do exercício físico por natação, praticado durante oito semanas, no coração de ratas submetidas, posteriormente, à oclusão definitiva ou isquemia seguida de reperfusão tardia, após quatro semanas de cirurgia. Material e métodos: Ratas foram submetidas a protocolo de natação durante oito semanas e randomizadas entre quatro grupos: 1) sedentárias infartadas (SIM: n = 12); 2) exercitadas infartadas (EIM: n = 12); 3) sedentárias isquemia/reperfusão (SIR: n = 9) e 4) exercitadas isquemia/reperfusão (EIR: n = 8). Nos grupos SIR e EIR a reperfusão foi realizada 60 minutos após oclusão coronária. Após a aplicação deste protocolo, as ratas permaneceram quatro semanas em observação para evolução espontânea da fisiopatologia secundária à oclusão coronária. Resultados: As curvas de Kaplan Meyer indicaram que as ratas sedentárias tiveram maior mortalidade do que aquelas que se exercitaram. As que sofreram oclusão definitiva e aquelas que foram reperfundidas tiveram tamanho (% VE) do Infarto do Miocárdio (IM) que não diferiram (SIM: 44±1; EIM: 47±2; SIR: 46±1; EIR: 49±2). Os grupos sedentários denotaram congestão pulmonar, com teor de água do pulmão (%H2O) significantemente elevado SIR (80 ± 0,5), SIM (80 ± 0,4). O grupo EIR (78 ± 0,2) não apresentou congestão pulmonar, enquanto o grupo EIM (79 ± 0,1) não se diferenciou de nenhum dos grupos. Não houve diferenças nos pesos das massas cardíacas do VE e do VD entre os grupos. Ao ecodopplercardiograma não houve diferenças entre os parâmetros analisados: áreas diastólicas e sistólicas, fração de encurtamento das áreas transversas e razão E/A. Entre os dados hemodinâmicos destacaram-se: a) frequência cardíaca mais elevada no grupo EIM; b) pressão sistólica do VE reduzida nos animais de SIM; b) atenuação do aumento da pressão diastólica final do VE em EIR; c) diminuição dos valores máximos da primeira derivada temporal positiva das pressões ventriculares nos grupos infartados. Na análise dos músculos papilares, as forças máximas desenvolvidas pelos grupos reperfundidos foram mais elevadas do que as dos infartados e o mesmo resultado foi verificado para a primeira derivada positiva da força. O volume nuclear dos cardiomiócitos remanescentes dos grupos exercitados foi inferior aos dos grupos sedentários. O teor de colágeno e a apoptose dos grupos com isquemia e reperfusão foram inferiores aos submetidos à oclusão definitiva da coronária. A quantificação da AKT1 fosforilada do grupo SIM foi inferior à dos demais grupos, a caspase 3 clivada nos grupos SIR e EIR estava com valores inferiores aos grupos infartados e as relações SERCA2a/GAPDH foram superiores nos animais exercitados. Na quantificação da CaATPase não houve diferença entre os grupos. Na quantificação da fosfolambam fosforilada (PLP) em serina 16 e treonina 17 e a razão PLP 16-17/fosfolambam total os valores dos grupos SIR e EIR estavam significantemente menores nos grupos SIM e EIM. Os valores do receptor de rianodina/GAPDH de EIM foram menores do que os de todos os outros grupos. Conclusão: o exercício físico prévio melhorou a sobrevida, as características estruturais, funcionais e de biologia molecular das ratas submetidas à isquemia/reperfusão tardia. Nas ratas submetidas à oclusão definitiva da coronária, o exercício prévio também resultou em redução do volume nuclear e melhora da sobrevida, da pressão arterial, da expressão de AKT1 fosforilada, da SERCA2.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Serum cytokines in second trimester pregnancy and their relationship with spontaneous preterm births in the Ribeirão Preto and São Luiz cohorts

Abstract Objective To evaluate the association between second trimester plasma cytokine levels in asymptomatic pregnant women and preterm births (PTB) in an attempt to identify a possible predictor of preterm birth. Methods The study design was a nested case–control study including women with singleton a gestational age between 20–25(+ 6) weeks from two Brazilian cities. The patients were interviewed, Venous blood samples were collected. The participants were again evaluated at birth. A total of 197 women with PTB comprised the case group. The control group was selected among term births (426 patients). Forty-one cytokines were compared between groups. Results When only spontaneous PTB were analyzed, GRO, sCD40L and MCP-1 levels were lower in the case group (p < 0.05). Logarithmic transformation was performed for cytokines with discrepant results, which showed increased levels of IL-2 in the group of spontaneous PTB (p < 0.05). In both analyses, the incidence of maternal smoking and of a history of preterm delivery differed significantly between the case and control groups. In multivariate analysis, only serum GRO levels differed between the case and control groups. Conclusion Lower second trimester serum levels of GRO in asymptomatic women are associated with a larger number of PTB. This finding may reflect a deficient maternal inflammatory response