Background: Ultrasonography has been used to identify structural, quantitative, and qualitative muscle changes. These changes have been assessed in different muscles during ICU stays; however, it is unclear if it can predict functioning after ICU discharge. Objective: To analyze the relationship between muscle changes assessed by ultrasonography and the strength and functioning of ICU survivors. Methods: A systematic review with a meta-analysis was performed according to the MOOSE guidelines and registered in PROSPERO. Searches of the following databases were performed by two of the authors: PubMed, Cinahl, Embase, Scopus, LILACS, Web of Science, and Science Direct. Qualitative analysis was performed using NOS and AHRQ scales. Meta-analysis was performed using the “R”, “metafor” package. Heterogeneity was assessed by I2 and Cochran’s Q test. Meta-regression analyses were performed to verify the moderators, and funnel plots and Egger’s regression intercept test were used to analyze the publication bias. Results: Sixteen articles were included in the qualitative assessment, and nine were used in the quantitative assessment. There is evidence of correlations between MT and muscle strength (r = 0.20 [0.11; 0.27]; p < 0.0001), and MT (r = 0.35 [0.19; 0.49]; p < 0.0001), CSA (r = 0.30 [0.10; 0.47]; p = 0.0038), EI (r = −0.29 [−0.53; −0.01]; p = 0.043) and mobility. In the subgroup analyses, some evidence of a correlation between specific muscles and strength and mobility were found. Conclusions: There is evidence for the correlation between muscle characteristics assessed by US and functioning outcomes.

OBJECTIVE:The pressure pain threshold is commonly employed to assess pain in various conditions. Despite its widespread use, the measurement of pressure pain thresholds is not consistently described across studies. Therefore, this review aimed to systematically examine the evidence regarding the assessment of pressure pain thresholds in patients with low back pain, including the protocols and body sites employed. METHODS:Six databases were systematically screened from their earliest records to May 2023 to identify studies utilizing pressure pain thresholds. Eligibility screening was conducted for the identified studies, and the included studies underwent appraisal using the appropriate tool corresponding to their study design. RESULTS:Upon categorizing based on the type of pain, we included 5 studies involving acute low back pain and 43 studies with chronic pain. The meta-analysis was conducted to compare subjects with and without pain, revealing no significant difference for the paraspinal region (SMD = -4.19, 95%CI = -11.7 to 3.32, z = -1.09, p = .27), piriformis (SMD = -1.24, 95%CI = -4.25 to 1.76, z = -0.81, p = .42) and quadratus lumborum musculature (SMD = -0.37, 95%CI = -1.35 to 0.60, z = -0.75, p = .45). CONCLUSION:The paraspinal and gluteal musculature are the most frequently evaluated. Concerning the protocols for assessment, no consensus was identified. However, studies that assessed chronic low back pain typically adhered to a similar approach regarding the number of measures and a constant increase in pressure.

Objetivo: realizar o monitoramento das internações no pronto-socorro de um Hospital Universitário utilizando o Sistema de Informação e Monitoramento das Internações no Pronto-Socorro (Simips) que foi criado com o objetivo de monitorar as internações no PS e gerar informações que auxiliem na prática assistencial e na gestão de leitos, da qualidade da assistência e de riscos assistenciais. Método: trata-se de estudo-piloto que monitorou as internações de pacientes adultos em PS, da admissão em regime de internação até a saída, utilizando o Simips. A amostra foi composta por prontuários de pacientes adultos admitidos em regime de internação no PS durante os meses de junho a agosto de 2019. Foram coletados dados socioepidemiológicos, escore de gravidade, escore de dependência dos cuidados de enfermagem, escore News, ocorrência de eventos adversos, tempos de permanência e os desfechos de saída. Resultados: foram analisados 158 prontuários de pacientes com mediana de 65 anos de idade. No grau de dependência dos cuidados de enfermagem, 89% foram classificados como cuidados mínimos no primeiro dia de internação hospitalar. A frequência de eventos adversos foi 39,2% e o atraso na terapêutica (administração) medicamentosa (12%) e a ausência de conciliação medicamentosa (8,9%) foram os mais prevalentes. Conclusão: o estudo mostrou um tempo de permanência no alto de pacientes em regime de internação no PS, com predominância de pacientes idosos e uma alta incidência de eventos adversos. desfecho, de forma clara, rápida e acessível, mostrou-se importante ao apontar situações que necessitam de intervenção imediata para melhorar a qualidade e segurança da assistência.

Objective: To explore the available knowledge on the application of biopsychosocial model (BPS) in patients with chronic low back pain (CLBP). Methods: A scoping review, including 32 papers that used a BPS to manage adult patients with CLBP, published in any language. Six different databases were searched. Results: According to the description of the protocols, most of them use BPS for assessment of the patients. In this first stage the most often evaluated were pain and disability, kinesiophobia and quality of life, and work-related factors. The intervention most used associate psychological and physical domains using pain education or cognitive functional therapy and active exercise. Even though was not the most common, in the social domain occupational, behavioral and family interventions were observed. Conclusion: BPS is more often used as combination of physical and psychological aspects, being the social domain restricted to work-related factors. Patien'ts perception of their health status is little explored, and it is suggested that the International Classification of Functioning, Disability and Health be used. Practice Implication: Patient perception as well as social factors in addition to occupational ones should be included in the clinical approach of the patient with CLBP and should be further explored in research.

ICU patients are exposed to several factors that can lead to muscle structural and functional changes, and ultrasonography can identify them. Although several studies have analyzed the reliability of muscle ultrasonography assessment, a protocol with more muscle assessments becomes a challenge. The aim of this study was to analyze the inter and intra-examiner reliability of peripheral and respiratory muscle ultrasonography assessment in critically ill patients. The sample size was 10 individuals aged ≥ 18 years who were admitted to the ICU. Practical training of four health professionals from different backgrounds was performed. After training, each examiner acquired three images to assess the thickness and echogenicity of the muscle groups: biceps brachii, forearm flexor group, quadriceps femoris, tibialis anterior and diaphragm. For the reliability analysis, an intraclass correlation coefficient was performed. Six hundred US images were analyzed for muscle thickness and 150 for echogenicity. Excellent intra-examiner reliability for echogenicity (ICC: 0.867–0.973) and inter-examiner reliability for thickness were found in all muscle groups (ICC: 0.778–0.942). For muscle thickness intra-examiner reliability, excellent results were found (ICC: 0.798–0.988), with a “good” correlation in one diaphragm assessment (ICC: 0.718). Excellent inter- and intra-examiner reliability of the thickness assessment and intra-examiner echogenicity of all muscles analyzed were found.

OBJECTIVE:To evaluate the effects of neuromuscular electrical stimulation on functional capacity of patients in the immediate postoperative period of cardiac surgery.DESIGN:A prospective, randomized controlled trial.SETTING:A cardiac surgery specialist hospital in Aracaju, Sergipe, Brazil. Subjects: Patients in the postoperative period of cardiac surgery.INTERVENTION:The control group received the conventional physiotherapy and the intervention group received neuromuscular electrical stimulation of the rectus femoris and gastrocnemius muscles bilaterally, applied for 60 min, twice a day for up to 10 sessions per patient, in the immediate postoperative period until postoperative day 5.MAIN MEASURES:The primary outcome was the distance walked, which was evaluated using the 6-min walk test on postoperative day 5. Secondary outcomes were gait speed, lactate levels, muscle strength, electromyographic activity of the rectus femoris and Functional Independence Measure, some of them evaluated on preoperative and postoperative period.RESULTS:Of 132 eligible patients, 88 patients were included and randomly allocated in two groups, and 45 patients were included in the analysis. No significant difference was found on the distance walked (p = 0.650) between patients allocated in intervention group (239.06 ± 88.55) and control group (254.43 ± 116.67) as well as gait speed (p = 0.363), lactate levels (p = 0.302), knee extensor strength (p = 0.117), handgrip strength (p = 0.882), global muscle strength (p = 0.104), electromyographic activity (p = 0.179) and Functional Independence Measure (p = 0.059).CONCLUSIONS:Although the effects are still uncertain, the use of neuromuscular electrical stimulation carried out in five days didn't present any benefit on functional capacity of patients in the immediate postoperative period of cardiac surgery.

D-limonene (D-LIM) is a monoterpene found mainly in the essential oil of citrus fruits. Cardiovascular effects of DLIM alone have been extensively demonstrated. Despite possessing important pharmacological effects, its chemical properties prevent its clinical application. This study aimed to produce and characterize hydroxypropyl-beta-cyclodextrin (HP-beta-CD) inclusion complex with D-LIM, and to assess its cardiovascular effects in animal model of arrhythmia. The inclusion complex was prepared by the slurry complexation, and characterized using HPLC, PXRD, DSC, and H-1 NMR. Molecular docking was performed to analyze the interactions between the complex. The antiarrhythmic effect was assessed in an animal model of arrhythmia induced by Bay K 8644. The physicochemical characterization showed that the D-LIM + HP-beta-CD complex formation had a complexation efficiency of 79.96 +/- 0.24%, which was corroborated with all analysis performed. Docking showed that D-LIM interacts with HP-beta-CD through hydrophobic and van der Waals bonds, with binding affinity of -4.2 kcal/mol. D-LIM + HP-beta-CD complex (10 mg/kg, i.v.) significantly reduced arrhythmias, reducing arrhythmia score (p < 0.01), duration of arrhythmias (p < 0.05) and prevented tachycardia (p < 0.05). Our results showed an efficient method of complexation of D-LIM + HP-beta-CD and improved its cardiovascular effects compared to D-LIM.

The dynamic balance of the lower limbs has shown great importance in accomplishing activities of daily living, especially for walking and maintenance in the orthostatic position. In this context, individuals with knee osteoarthritis have changes in their physical capacity, mainly due to joint changes and muscular wear. The instrument called OctoBalance® is one of the most used to evaluate this balance, which analyses four different executions of movement in the limbs. However, individuals with knee osteoarthritis cannot perform this evaluation due to the need for single limb support during movements. This study aimed to verify whether it is reproducible to perform the dynamic balance evaluation of lower limbs with a reduction of 10% of body weight through a suspension system. A cross-sectional study was carried out with 2 collections with a 48-hour interval between them, using the Lower Body Test performed with OctoBalance®. The dynamic balance test followed the protocol of 3 repetitions observing the learning factor and then 3 repetitions where the values were collected, with the suggested adaptation for all 4 diagonals in both limbs. The interclass correlation index (ICI), coefficient of variation (CV), estimative standard error (EEE) and minimum detectable difference (MDD) were calculated as indicators of reproducibility. Also, Bland-Altman Graphs were used for visual verification of the agreement between the means. Results: The reliability tests showed a very high interclass correlation through the ICI and low variation values for all the movements evaluated through the CV. The EEE and MDD calculations showed positive responses for greater reliability, and the Bland-Altman graphs showed an agreement between the means. Reproducibility was positive for the Lower Body Test with the Octobalance® platform for the evaluation of lower limb dynamic balance in women with knee osteoarthritis.

Introduction Osteoarthritis is a disease characterized by progressive wear and tear of the joint, with the knee being the most affected region. These patients have reduced mobility and mobility, among other symptoms. Thus, it is necessary to know the variables that influence the ability to walk. Objective To analyze how much the gait capacity, in the performance of the six-minute walk test, can be influenced by the maximum isometric strength of the quadriceps or by kinesiophobia in women with knee osteoarthritis. Materials and Methods This is a cross-sectional study with a sample of 49 women diagnosed with osteoarthritis. The evaluation was carried out in a single moment. Variables studied isometric quadriceps strength, level of fear of movement (kinesiophobia), and ability to walk. Simple linear regression analyzes were performed, with gait ability as the dependent variable and maximum isometric strength and kinesiophobia as independent. Data were presented with mean and standard deviation and were analyzed by the SPSS Statistic 22.0 software, considering p < 0.05 as significant. Results The maximum isometric strength presents a significant difference, directly interfering with the gait ability; as kinesiophobia does not show a statistically significant difference, it does not directly interfere with the ability to walk. Conclusion Maximal quadriceps isometric strength directly interferes with gait ability in women with knee osteoarthritis, thus suggesting the inclusion of this strategy in treatment programs for this population.

Objetivo: Analisar a percepção dos enfermeiros sobre a qualidade da assistência de enfermagem prestada aos pacientes em situação de internação no Pronto-socorro. Método: Trata-se de um estudo descritivo e transversal realizado com a aplicação de questionário estruturado, via on-line, com enfermeiros brasileiros que atuam em serviços de urgência e emergência, públicos ou privados, há pelo menos seis meses. O questionário, elaborado pelos pesquisadores contém 13 questões direcionadas à avaliação do Serviço de Urgência e Emergência e avaliação dos cuidados de enfermagem ofertado ao paciente em situação de internação no Pronto-socorro. As respostas foram classificadas em escala do tipo Likert de sete pontos: Nunca, Muito Raramente, Raramente, Ocasionalmente, Frequentemente, Muito frequentemente, Sempre. Resultados: 146 enfermeiros participaram da pesquisa. A maioria avaliou a superlotação como uma vivência frequente, relatou atraso e/ou dificuldades na regulação de pacientes para um leito de internação regular, evidenciou falhas no dimensionamento de enfermagem para o excedente de pacientes e que em horários de grande volume de admissões, frequentemente o cuidado de enfermagem fica comprometido. Conclusão: Na percepção dos enfermeiros, a qualidade do cuidado de enfermagem prestado ao paciente internado no pronto-socorro é prejudicada quando comparados aos cuidados recebidos em leito de internação regular.

Os acidentes de trânsito representam um importante problema de saúde pública mundial, em virtude do impacto morbimortalidade e qualidade de vida das vítimas, o presente artigo teve como objetivo avaliar os fatores preditores e a qualidade de vida das vítimas de trauma por acidentes de trânsito. Trata-se de um estudo observacional do tipo transversal com abordagem descritiva. A amostra foi não probabilística por conveniência, composta por 73 vítimas de trauma por acidentes de trânsito. A coleta de dados ocorreu em dois momentos: (1) durante a internação hospitalar; e (2) após 90 dias decorridos do evento traumático. Os instrumentos utilizados para o levantamento dos dados foi o de caracterização do perfil sociodemográfico e do acidente de trânsito, e o World Health Organization Quality of Life (WHOQOL) Bref. Os dados foram armazenados em planilhas eletrônicas do microsof excel 2013 e analisados com o programa BioEstat 5.0. Os fatores preditores que revelaram ter influência nos acidentes de trânsito, foram o sexo masculino (OR: 39.6), uso do álcool (OR: 31.7), ausência dos equipamentos de proteção individual (OR: 3.00) e uso de veículo automotor nos finais de semana (OR: 3,68). Na avaliação da qualidade de vida, os achados evidenciam que no trauma o domínio físico (35.1±14.8) foi o mais alterado quando comparado com os valores antes (80.5±11.2) e após 90 dias do trauma (54.0±14.5). Os acidentes de trânsito estavam associados ao sexo masculino na condução do veículo, com o consumo de álcool e o não uso dos equipamentos de proteção individual. Além disso, o trauma estar relacionado ao impacto negativo na qualidade de vida das vítimas.

Background: Strength training has beneficial effects on kidney disease, in addition to helping improve antioxidant defenses in healthy animals.Objective: To verify if strength training reduces oxidative damage to the heart and contralateral kidney caused by the renovascular hypertension induction surgery, as well as to evaluate alterations in the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) endogenous antioxidant enzymes.Methods: Eighteen male rats were divided into three groups (n =6/group): sham, hypertensive, and trained hypertensive. The animals were induced to renovascular hypertension through left renal artery ligation. Strength training was initiated four weeks after the induction of renovascular hypertension, continued for a 12-weeks period, and was performed at 70% of 1RM. After the training period, the animals were euthanized and the right kidney and heart were removed for quantitation of hydroperoxides, malondialdehyde and sulfhydryl groups, which are markers of oxidative damage. In addition, the activity of SOD, CAT, and GPx antioxidant enzymes was also measured. The adopted significance level was 5% (p < 0.05).Results: After strength training, a reduction in oxidative damage to lipids and proteins was observed, as could be seen by reducing hydroperoxides and total sulfhydryl levels, respectively. Furthermore, an increased activity of superoxide dismutase, catalase, and glutathione peroxidase antioxidant enzymes was observed.Conclusion: Strength training is able to potentially reduce oxidative damage by increasing the activity antioxidant enzymes.

The cardiovascular system provides enough blood flow to maintain metabolic needs of organs and tissues. To control the blood flow, vascular beds regulate the vascular resistance, altering its diameter and consequently the blood supply. It is well established that during Resistant training (RT) there is an increase in the muscle requirement for oxygen and other nutrients leading to vasodilatation in the exercised area. The increase in vascular nitric oxide (NO) bioavailability induced by shear stress and transmural pressure has played a fundamental role in this response. Positive effects are not restricted to the exercised vascular beds and important systemic effects can also be observed. Several variables can interfere on the effect of RT, therefore the understanding of these mechanisms is fundamental for a correct prescription of exercise aiming to maintain or improve the endothelial vascular function.

Doxorubicin (DOX) is an anticancer chemotherapy drug that is widely used in clinical practice. It is well documented that DOX impairs baroreflex responsiveness and left ventricular function and enhances sympathetic activity, cardiac sympathetic afferent reflexes and oxidative stress, which contribute to hemodynamic deterioration. Because resistance training (RT)-induced cardioprotection has been observed in other animal models, the objective of this study was to assess the effects of RT during DOX treatment on hemodynamics, arterial baroreflex, cardiac autonomic tone, left ventricular function and oxidative stress in rats with DOX-induced cardiotoxicity. Male Wistar rats were submitted to a RT protocol (3 sets of 10 repetitions, 40% of one-repetition maximum (1RM) of intensity, 3 times per week, for 8 weeks). The rats were separated into 3 groups: sedentary control, DOX sedentary (2.5 mg/kg of DOX intraperitoneal injection, once a week, for 6 weeks) and DOX + RT. After training or time control, the animals were anesthetized and 2 catheters were implanted for hemodynamic, arterial baroreflex and cardiac autonomic tone. Another group of animals was used to evaluate left ventricular function. We found that RT in DOX-treated rats decreased diastolic arterial pressure, heart rate, sympathetic tone and oxidative stress. In addition, RT increased arterial baroreflex sensitivity, vagal tone and left ventricular developed pressure in rats with DOX-induced cardiotoxicity. In summary, RT is a useful non-pharmacological strategy to attenuate DOX-induced cardiotoxicity.

ABSTRACT OBJECTIVE To develop and evaluate the usability of the admission monitoring system in an emergency room. METHODS This applied research intends to develop a software product and evaluate its usability. The development followed four stages: systematic review, structuring of the system framework, construction of system forms, and evaluation of the information generated. In the evaluation, the experts simulated the use of the system by inserting data from a fictitious medical record. We measured usability using the System Usability Scale (SUS). Scores and scores were calculated individually and globally. We propose these evaluation standards: worst case scenario, poor, average, good, excellent, and best-case scenario. RESULTS The Sistema de Informação e Monitoramento das Internações em Pronto-Socorro (SIMIPS - Information and Monitoring System for Emergency Room Admissions) monitors the epidemiological profile of admissions to the emergency room, time management, clinical deterioration, incidence of adverse events, and human resource management. The usability of SIMIPS, evaluated by 17 experts, reached the SUS Score 86.5 (best case scenario), and some suggestions for modifications were accepted. CONCLUSIONS We consider SIMIPS an easy-to-use tool, with real importance in the management of emergencies in view of overcrowding and congestion problems faced in Brazil.

Resumo Fundamento O treino de força tem efeitos benéficos em doenças renais, além de ajudar a melhorar a defesa antioxidante em animais saudáveis. Objetivo Verificar se o treino de força reduz o dano oxidativo ao coração e rim contralateral para cirurgia de indução de hipertensão renovascular, bem como avaliar as alterações na atividade das enzimas antioxidantes endógenas superóxido dismutase (SOD), catalase (CAT) e glutationa peroxidase (GPx). Métodos Dezoito ratos machos foram divididos em três grupos (n=6/grupo): placebo, hipertenso e hipertenso treinado. Os animais foram induzidos a hipertensão renovascular através da ligação da artéria renal esquerda. O treino de força foi iniciado quatro semanas após a indução da hipertensão renovascular, teve 12 semanas de duração e foi realizada a 70% de 1RM. Depois do período de treino, os animais foram submetidos a eutanásia e o rim esquerdo e o coração foram retirados para realizar a quantificação de peróxidos de hidrogênio, malondialdeído e grupos sulfidrílicos, que são marcadores de danos oxidativos. Além disso, foram medidas as atividades das enzimas antioxidantes superóxido dismutase, catalase e glutationa peroxidase. O nível de significância adotado foi de 5% (p < 0,05). Resultados Depois do treino de força, houve redução de danos oxidativos a lipídios e proteínas, como pode-se observar pela redução de peróxidos de hidrogênio e níveis sulfidrílicos totais, respectivamente. Além disso, houve um aumento nas atividades das enzimas antioxidantes superóxido dismutase, catalase e glutationa peroxidase. Conclusão O treino de força tem o potencial de reduzir danos oxidativos, aumentando a atividades de enzimas antioxidantes. (Arq Bras Cardiol. 2021; 116(1):4-11)

BACKGROUND:Overcrowding in emergency departments (EDs) is a worldwide challenge. As a result of the increased demand for EDs, slow internal patient flow, and unavailability of hospital beds, patients are kept in the corridors, causing a boarding effect. Studies have associated boarding in EDs with unfavorable clinical outcomes and adverse events. Thus, the purpose of this systematic review was to describe the effects of ED boarding on the occurrence of adverse events.DESIGN:We followed the Meta-Analysis of Observational Studies in Epidemiology checklist and registered this systematic review with PROSPERO (CRD42020117915).METHODS:Literature searches were performed using the databases PubMed, Scopus, Latin American and Caribbean Center on Health Sciences Information (LILACS), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane, as well as Google Scholar, OpenThesis, and the Brazilian Digital Library of Theses and Dissertations from September to November 2019. Cohort or case control studies that evaluated the occurrence of adverse events in patients who remained in an ED, waiting for a hospital bed, were included in the review.RESULTS:Seven studies met our eligibility criteria. Boarding in EDs may be related to a reduction in the quality of care, resulting in unfavorable clinical outcomes and adverse events.CONCLUSIONS:Boarding in EDs may be related to increases in adverse incidents and events.CLINICAL RELEVANCE:The evidence in this review suggests that ED boarding increases the occurrence of unfavorable outcomes and identifies important considerations for future research.

Aim: To investigate the hypothesis that the resistance exercise (RE) may be safer if the blood pressure (BP) is properly controlled through antihypertensive pharmacological treatment in hypertensive middle-aged women. Methods: The final sample was comprised of 19 hypertensive women, with an average age of 58±5 years and a body mass index of 29±5 Kg/m2. They were divided into three groups: controlled (n=6), uncompensated (n=8), and untreated (n=5). The subjects from all groups were submitted to a test of maximal strength on extensor chair and held a session of RE (knee extension, 3x12 to 60% 1RM) and the cardiovascular response (BP and heart rate) was monitored continuously by photoplethysmography during exercise and until five minutes after exercise (recovery). Results: Systolic BP (SBP) and diastolic BP (DBP) responses were lower in the controlled group compared to the other groups (p<0.05). The heart rate was not different between groups, while the double product was lower in the controlled group compared to the untreated group (p<0.05). The SBP and DBP peaks were lower in the controlled group compared to the other groups (p<0.05). Conclusion: The BP increases significantly during RE when the hypertension is not controlled. Pharmacological control was shown to be effective in preventing the increase of BP during the performance of the RE.

Several pathological conditions predict the use of glucocorticoids for the management of the inflammatory response; however, chronic or high dose glucocorticoid treatment is associated with hyperglycemia, hyperlipidemia, and insulin resistance and can be considered a risk factor for cardiovascular disease. Therefore, we investigated the mechanisms involved in the vascular responsiveness and inflammatory profile of mesenteric arteries of rats treated with high doses of glucocorticoids. Wistar rats were divided into a control (CO) group and a dexamethasone (DEX) group, that received dexamethasone for 7 days (2mg/kg/day, i.p.). Blood samples were used to assess the lipid profile and insulin tolerance. Vascular reactivity to Phenylephrine (Phe) and insulin, and O2•-production were evaluated. The intracellular insulin signaling pathway PI3K/AKT/eNOS and MAPK/ET-1 were investigated. Regarding the vascular inflammatory profile, TNF-α, IL-6, IL-1β and IL-18 were assessed. Dexamethasone-treated rats had decreased insulin tolerance test and endothelium-dependent vasodilation induced by insulin. eNOS inhibition caused vasoconstriction in the DEX group, which was abolished by the ET-A antagonist. Insulin-mediated relaxation in the DEX group was restored in the presence of the O2.- scavenger TIRON. Nevertheless, in the DEX group there was an increase in Phe-induced vasoconstriction. In addition, the intracellular insulin signaling pathway PI3K/AKT/eNOS was impaired, decreasing NO bioavailability. Regarding superoxide anion generation, there was an increase in the DEX group, and all measured proinflammatory cytokines were also augmented in the DEX group. In addition, the DEX-group presented an increase in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (TC) and reduced high-density lipoprotein cholesterol (HDL-c) levels. In summary, treatment with high doses of dexamethasone promoted changes in insulin-induced vasodilation, through the reduction of NO bioavailability and an increase in vasoconstriction via ET-1 associated with generation of O2•- and proinflammatory cytokines.

Abstract Aim: To evaluate the subacute effects of the number of Pilates exercise series (one and three) on the cardiovascular responses of medicated hypertensive women. Methods: Eight hypertensive and nine normotensive women underwent a Pilates session with low and high volume, and cardiovascular responses were measured. Aged sample of 50-65 years old underwent to anthropometrical measurements previously to the experimental procedures. The cardiovascular assessment was performed before and after every experimental session. The experimental procedures consisted of two familiarization sessions, load determination, and two experimental sessions (one or three series) for each group. Results: In the intragroup analysis, HR was found to be reduced in the normotensive group. In the hypertensive group, a reduction in the double product was observed after both Pilates sessions, and in the normotensive group only after the session with one series. The volume of exercises of the Pilates method did not interfere in the responses of systolic and diastolic BP after exercise. However, a more prominent area under the curve was seen in the systolic BP of hypertensive subjects who performed three series. Conclusion: The present study shows that performing one or three series of the Pilates exercise does not induce hypotension post-exercise and did not interfere in the cardiovascular responses of medicated hypertensive women.