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Human T-lymphotropic virus type 1 (HTLV-1) is classically associated with the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), although the mechanisms of this neurological disorder remain unclear. In addition, some patients who develop "minor" neurological signs that do not meet diagnostic criteria for HAM/TSP are classified as asymptomatic carriers. This study aims to demonstrate the neurological symptoms of Brazilian patients living with HTLV-1 classified as not-HAM.TSP. This observational study evaluated patients treated in an HTLV reference center in Bahia, Brazil, between February 2022 and July 2023. The data were obtained through the analysis of medical records and neurological consultation. Those individuals classified as HAM/ TSP were excluded from this study. 74 patients were submitted to a careful neurological evaluation: 23 HAM/TSP, 22 were classified with intermediate syndrome (IS), and 29 were oligosymptomatic. Self-reported symptoms were significantly more common in the IS group, including urinary symptoms such as nocturia, urgency, incontinence, dysuria, weakness, paresthesia, lumbar pain, xerostomia, and xerophthalmia. Physical examination findings consistent with reduced vibratory and tactile sensitivity were more common in the IS group (p = 0.017 and p = 0.013). Alterations in the V and VIII cranial nerves were present in both groups. HTLV-1 can lead to the development of important neurological signs and symptoms in apparently asymptomatic individuals. This data highlights the need for more research into the neurological aspects of HTLV-1 infection and emphasizes the importance of early diagnosis, treatment, and support for individuals living with this virus.

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This study aimed to evaluate temperature variations on the thighs in an incremental cycling test in healthy recreational cyclists with two different fat percentages. Thirty-two male recreational cyclists were measured in height, body mass, thigh skinfold and body fat percentage, and from the body fat percentage were divided into two groups, Group 1: 16 cyclists who presented body fat percentage < 24% and Group 2: 16 cyclists who presented body fat percentage > 24%. Three thermographic photos were taken, before (Pre), just after (Post) and after 10 min (Post10) of the incremental cycling test to determine mean temperature of right and left Vastus Lateralis, Rectus Femoris and Biceps Femoris. Temperature variations were defined as the difference among the three moments: (i) var1 = Post-Pre, (ii) var2 = Post10- Pre and (iii) var3 = Post10-Post. Differences between groups and moments were calculated using magnitude-based inferences. Group 1 evidenced a very likely large increase in the cycling peak power output. Group 2 showed a likely and most likely moderate, large and very large increase in age, body mass and fat. Group 1 depicted a very likely to likely moderate temperature increase in the right and left Vastus Lateralis, Rectus Femoris and Biceps Femoris on Post10 compared to Post effort moment. Both groups depicted a very likely and most likely moderate and large temperature decrease of right and left Biceps Femoris on Pre compared to Post effort. Percentage of fat seems to discreetly influence skin temperature response, finding that might not be observed when we evaluate trained cyclists exhibiting different percentages of fat....(AU)

Este estudo objetivou a avaliar as variações de temperatura das coxas em um teste incremental de ciclismo em ciclistas recreacionais saudáveis com dois diferentes percentuais de gordura. Trinta e dois ciclistas recreacionais do sexo masculino foram avaliados em estatura, massa corporal, dobras cutâneas da coxa e percentual de gordura corporal, e, a partir do percentual de gordura corporal, foram divididos em dois grupos, Grupo 1: 16 ciclistas que apresentaram percentual de gordura corporal < 24% e Grupo 2: 16 ciclistas que apresentaram percentual de gordura corporal > 24%. Foram tiradas três fotos termográficas, antes (Pré), logo após (Pós) e após 10 min (Pós10) do teste de ciclismo para determinar a temperatura média do Vasto Lateral, Reto Femoral e Bíceps Femoral direito e esquerdo. As variações de temperatura foram definidas como a diferença entre os três momentos: (i) var1 = Pós-Pré, (ii) var2= Pós10-Pré e (iii) var3= Pós10-Pós. Diferenças entre grupos e momentos foram calculadas usando inferências baseadas em magnitude. Grupo 1 apresentou um provável a muito provável aumento moderado da temperatura para os Vastos Laterais direito e esquerdo, o Reto Femoral e o Bíceps Femoral no Pós10 em comparação com o momento pós-esforço. Grupo 2 mostrou aumentos provável e muito provável moderado, grande e muito grande na idade, massa corporal e gordura. Ambos os grupos descreveram uma muito provável e mais provável moderada e grande queda de temperatura do Bíceps Femoral direito e esquerdo no Pré comparado ao Pós-esforço. Percentagem de gordura parece influenciar discretamente a resposta da temperatura da pele, resultado que poderá não ser observado quando avaliados ciclistas treinados que apresentam diferentes percentagens de gordura....(AU)

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BACKGROUND: Volatile anesthetics modulate inflammation in acute respiratory distress syndrome (ARDS). However, it is unclear whether they act differently depending on ARDS etiology. We hypothesized that the in vivo and in vitro effects of sevoflurane and isoflurane on lung damage would not differ in pulmonary (p) and extrapulmonary (exp) ARDS. METHODS: Twenty-four Wistar rats were randomized to undergo general anesthesia (1-2 minutes) with sevoflurane and isoflurane. Animals were then further randomized to receive Escherichia coli lipopolysaccharide (LPS) intratracheally (ARDSp) or intraperitoneally (ARDSexp), and 24 hours after ARDS induction, they were subjected to 60 minutes of sevoflurane or isoflurane anesthesia at 1 minimal alveolar concentration. The primary outcome measure was interleukin (IL)-6 mRNA expression in lung tissue. Secondary outcomes included gas exchange, lung mechanics, histology, and mRNA expression of IL-10, nuclear factor erythroid 2-related factor-2 (Nrf2), surfactant protein (SP)-B, vascular cell adhesion molecule-1, epithelial amiloride-sensitive Na-channel subunits α and γ, and sodium-potassium-adenosine-triphosphatase pump subunits α1 (α1-Na,K-ATPase) and ß1 (ß1-Na,K-ATPase). Additional ARDSp and ARDSexp animals (n = 6 per group) were anesthetized with sodium thiopental but not mechanically ventilated (NV) to serve as controls. Separately, to identify how sevoflurane and isoflurane act on type II epithelial cells, A549 human lung epithelial cells were stimulated with LPS (20 µg/mL) for 24 hours, and SP-B expression was quantified after further exposure to sevoflurane or isoflurane (1 minimal alveolar concentration ) for 60 minutes. RESULTS: In ARDSp, sevoflurane reduced IL-6 expression to a greater degree than isoflurane (P = .04). Static lung elastance (P = .0049) and alveolar collapse (P = .033) were lower in sevoflurane than isoflurane, whereas Nrf2 (P = .036), SP-B (P = .042), and ß1-Na,K-ATPase (P = .038) expressions were higher in sevoflurane. In ARDSexp, no significant differences were observed in lung mechanics, alveolar collapse, or molecular parameters between sevoflurane and isoflurane. In vitro, SP-B expression was higher in sevoflurane than isoflurane (P = .026). CONCLUSIONS: Compared with isoflurane, sevoflurane did not affect lung inflammation in ARDSexp, but it did reduce lung inflammation in ARDSp.

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BACKGROUND: Administering anesthetics to the obese population requires caution because of a variety of reasons including possible interactions with the inflammatory process observed in obese patients. Propofol and dexmedetomidine have protective effects on pulmonary function and are widely used in short- and long-term sedation, particularly in intensive care unit settings in lean and obese subjects. However, the functional and biological effects of these drugs in obesity require further elucidation. In a model of diet-induced obesity, we compared the short-term effects of dexmedetomidine versus propofol on lung mechanics and histology, as well as biological markers of inflammation and oxidative stress modulation in obesity. METHODS: Wistar rats (n = 56) were randomly fed a standard diet (lean) or experimental diet (obese) for 12 weeks. After this period, obese animals received sodium thiopental intraperitoneally and were randomly allocated into 4 subgroups: (1) nonventilated (n = 4) for molecular biology analysis only (control); (2) sodium thiopental (n = 8); (3) propofol (n = 8); and (4) dexmedetomidine (n = 8), which received continuous IV administration of the corresponding agents and were mechanically ventilated (tidal volume = 6 mL/kg body weight, fraction of inspired oxygen = 0.4, positive end-expiratory pressure = 3 cm H2O) for 1 hour. RESULTS: Compared with lean animals, obese rats did not present increased body weight but had higher total body and trunk fat percentages, airway resistance, and interleukin-6 levels in the lung tissue (P = 0.02, P = 0.0027, and P = 0.01, respectively). In obese rats, propofol, but not dexmedetomidine, yielded increased airway resistance, bronchoconstriction index (P = 0.016, P = 0.02, respectively), tumor necrosis factor-α, and interleukin-6 levels, as well as lower levels of nuclear factor-erythroid 2-related factor-2 and glutathione peroxidase (P = 0.001, Bonferroni-corrected t test). CONCLUSIONS: In this model of diet-induced obesity, a 1-hour propofol infusion yielded increased airway resistance, atelectasis, and lung inflammation, with depletion of antioxidative enzymes. However, unlike sodium thiopental and propofol, short-term infusion of dexmedetomidine had no impact on lung morphofunctional and biological variables.

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We evaluated whether the short-term use of dexmedetomidine and propofol may attenuate inflammatory response and improve lung morphofunction in experimental acute lung injury (ALI). Thirty-six Wistar rats were randomly divided into five groups. Control (C) and ALI animals received sterile saline solution and Escherichia coli lipopolysaccharide by intraperitoneal injection respectively. After 24h, ALI animals were randomly treated with dexmedetomidine, propofol, or thiopental sodium for 1h. Propofol reduced static lung elastance and resistive pressure and was associated with less alveolar collapse compared to thiopental sodium and dexmedetomidine. Dexmedetomidine improved oxygenation, but did not modify lung mechanics or histology. Propofol was associated with lower IL (interleukin)-6 and IL-1ß expression, whereas dexmedetomidine led to reduced inducible nitric oxide (iNOS) and increased nuclear factor erythroid 2-related factor 2 (Nrf2) expression in lung tissue compared to thiopental sodium. In conclusion, in this model of mild ALI, short-term use of dexmedetomidine and propofol led to different functional effects and activation of biological markers associated with pulmonary inflammation.

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