Comparação de marcadores plasmáticos de dano muscular após a realização de exercício de força com e sem oclusão vascular em homens fisicamente ativos e saudáveis

O objetivo principal do treinamento resistido com pesos é promover a quebra da homeostase do organismo. Desde que dentro dos limites fisiológicos, o organismo gera o fenômeno da supercompensação, alcançando um novo nível de aptidão física. Diversas técnicas são usadas para alcançar o condicionamento físico, e a oclusão vascular (kaatsu training) surge como uma opção permeada por benefícios para sedentários e portadores de patologias, mas ainda com poucas evidências para a população treinada. O objetivo desse trabalho foi comparar a magnitude de dano muscular no exercício resistido com e sem oclusão vascular em indivíduos treinados. Participaram 7 homens saudáveis e treinados. Foi utilizada a rosca bíceps no banco scotch, com 5 séries de repetições máximas com cargas de 40% de 1RM com a oclusão e 80% sem a oclusão. Foram coletadas amostras de sangue antes, imediatamente após, 24h e 48h após o exercício, com mensuração da CK, TGO e TGP. Não foram encontradas diferenças estatisticamente significativas na CK em nenhum dos momentos analisados, em ambas as técnicas. Com a TGO foram encontradas diferenças significaticas em ambas, imediatamente após, sem alterações nos demais momentos. A TGP teve o mesmo comportamento apenas no exercício sem oclusão. O nível de adaptação, o volume e o tipo de exercícios pode ser um fator de interferência quanto a comparação dos resultados. Conclui-se que em indivíduos treinados, exercícios de baixa itensidade com a oclusão vascular e de alta intensidade sem essa técica, causam magitude de dano muscular semelhante quando mensurado por meio de marcadores plasmáticos. ABSTRACTComparison of plasma markers of muscle damage after the exercise of strength with and without vascular occlusion in physically active and healthy menThe main goal of resistance training is to promote the breakdown of the body's homeostasis. Since within the physiological limits, the organism generates the phenomenon of supercompensation, reaching a new level of physical fitness. Several techniques are used to achieve physical conditioning, and vascular occlusion (kaatsu training) emerges as an option permeated by benefits for sedentary and pathological patients, but still with little evidence for the trained population. The objective of this study was to compare the magnitude of muscle damage in resistance exercise with and without vascular occlusion in trained individuals. 7 healthy and trained men participated. The biceps curl in the scotch bench was used, with 5 sets of maximal repetitions with loads of 40% of 1RM with occlusion and 80% without occlusion. Blood samples were collected before, immediately after, 24h and 48h after exercise, with measurement of CK, TGO and TGP. No statistically significant differences were found in CK in any of the analyzed moments, in both techniques. With the TGO, significant differences were found in both, immediately after, without changes in the other moments. TGP had the same behavior only in the non-occlusion exercise. The level of adaptation, the volume and the type of exercises can be an interference factor when comparing the results. It is concluded that in trained individuals, low intensity exercises with vascular occlusion and high intensity without this technique cause a similar magnitude of muscle damage when measured by plasmatic markers

High-intensity aerobic training lowers blood pressure and modulates the renal renin-angiotensin system in spontaneously hypertensive rats

Background: This study aimed to verify the effects of high-intensity aerobic training (HIAT) on BP control and renin-angiotensin system (RAS) components in renal tissue of SHR. Ten SHRs received HIAT or control for 8-weeks. At the end of the training, the SBP showed a reduction of ~ 30mmHg (p < .01) in HIAT and increased by ~ 15 mmHg in the  control group. HIAT resulted in a higher release of nitrite, IL-6, ACE2 and ATR2. These results indicated an association between BP, NO and renal RAS. Abbreviations: JAA: writing, carried out all experimental procedures, performed statistical analysis, original draft and revised manuscript DMS: data interpretation, formal analysis, writing, editing and revised manuscript BAP: carried all experimental procedures, revised manuscritpt CPCG: carried all experimental procedures, revised manuscritpt MEN: experimental procedures, revised manuscript and data interpretation RWP: drafted and revised manuscript RCA: writing, experimental procedures, revised manuscript JP: writing, data interpretation and revised manuscript OLF: writing, original draft and revised manuscript

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022