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Physical inactivity and sedentary behaviors (SB) have promoted a dramatic increase in the incidence of a host of chronic disorders over the last century. The breaking up of sitting time (i.e., sitting to standing up transition) has been proposed as a promising solution in several epidemiological and clinical studies. In parallel to the large interest it initially created, there is a growing body of evidence indicating that breaking up prolonged sedentary time (i.e., > 7 h in sitting time) could reduce overall mortality risks by normalizing the inflammatory profile and cardiometabolic functions. Recent advances suggest that the latter health benefits, may be mediated through the immunomodulatory properties of extracellular vesicles. Primarily composed of miRNA, lipids, mRNA and proteins, these vesicles would influence metabolism and immune system functions by promoting M1 to M2 macrophage polarization (i.e., from a pro-inflammatory to anti-inflammatory phenotype) and improving endothelial function. The outcomes of interrupting prolonged sitting time may be attributed to molecular mechanisms induced by circulating angiogenic cells. Functionally, circulating angiogenic cells contribute to repair and remodel the vasculature. This effect is proposed to be mediated through the secretion of paracrine factors. The present review article intends to clarify the beneficial contributions of breaking up sitting time on extracellular vesicles formation and macrophage polarization (M1 and M2 phenotypes). Hence, it will highlight key mechanistic information regarding how breaking up sitting time protocols improves endothelial health by promoting antioxidant and anti-inflammatory responses in human organs and tissues.

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BACKGROUND: Fragmented QRS (fQRS) is defined as any QRS complex with duration of less than 120 ms (ms) and at least one notch in the R or S wave in two or more leads belonging to the same coronary territory. The fQRS represents a delay in ventricular conduction caused by a myocardial scar associated to arrhythmic events. METHODS: This is a descriptive, retrospective, cross-sectional study of a total of 123 patientsadmitted with ischemic heart disease. The aim was to correlate the presence of fQRS in a conventional 12-leads electrocardiogram (ECG) with myocardial regional motility disorders. RESULTS: A total of 62% of the patients were male, the mean age was 63 ± 12 SD. fQRS was observed in 44% (64% men and 36% women), the most frequent location being the inferior wall (61%), followed by the anteroseptal and lateral walls (14% for both). Of the 36 patients with fQRS, 30 had segmental disorders, while 6 did not. Of the 45 patients without fQRS, 28 had segmental disorders, but 17 did not, which gives us a sensitivity of 52% (moderate SnNout) and specificity of 74% (high SpPin), with a positive predictive value of 83%, a negative predictive value of 38% and a prevalence of 72%. CONCLUSION: The presence of fQRS in the ECG has high specificity and a high positive predictive value of the existence of segmental myocardial motility disorders in patients with documented coronary artery disease.

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ABSTRACT BACKGROUND: Knowing the epidemiological profile is relevant for improving healthcare practices. Movement disorders are neurological disorders characterized by the presence of involuntary movements. They have a negative impact on patients' quality of life. OBJECTIVES: To outline the frequencies of the different diagnoses seen among patients, along with their demographic characteristics, at a hospital in São Paulo (SP), Brazil, and to highlight the clinical aspects of those with Parkinson's disease. DESIGN AND SETTING: Retrospective descriptive epidemiological analysis at a specialized outpatient clinic in a state public hospital in São Paulo. METHODS: Patients treated at this clinic over a four-year period were analyzed. Diagnoses, demographic variables and associations with clinical aspects of Parkinson's disease were evaluated. RESULTS: Out of the 680 medical records analyzed, 58.4% related to females. Most patients were over 60 years of age, white, married and teachers. The most frequent diagnosis was Parkinson's disease, followed by essential tremor and dystonia. Parkinson's disease presented in the mixed clinical form; the most common initial symptom was tremor. The akinetic-rigid clinical form occurred in younger individuals and mostly presented with postural instability and freezing of gait in the early years of disease. CONCLUSIONS: Parkinson's disease, essential tremor and dystonia were the most frequent diagnoses. Characteristics like sex, frequency of other pathological conditions and the clinical and demographic aspects of Parkinson's disease were consistent with the data in the relevant literature.

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Stress-induced cardiomyopathy (SIC) results from a profound catecholaminergic surge during strong emotional or physical stress. SIC is characterized by acute left ventricular apex hypokinesia, in the absence of coronary arteries occlusion, and can lead to arrhythmias and acute heart failure. Although, most SIC patients recover, the process could be slow, and recurrence or death may occur. Despite that the SIC common denominator is a large catecholamine discharge, the pathophysiological mechanism is incompletely understood. It is thought that catecholamines have direct cytotoxicity on apical ventricular myocytes (VM), which have the highest ß-adrenergic receptors density, and whose overstimulation might cause acute Ca2+ overload and oxidative stress, causing death in some VM and stunning others. Rodents receiving acute isoproterenol (ISO) overdose (OV) mimic SIC development, however, they have not been used to simultaneously assess Ca2+ handling and contractility status in isolated VM, which might explain ventricular hypokinesia. Therefore, treating rats with a single ISO-OV (67 mg/kg body weight), we sought out to characterize, with confocal imaging, Ca2+ and shortening dynamics in Fluo-4-loaded VM, during the early (1-5 days) and late post-acute phases (15 days). We found that ISO-OV VM showed contractile dysfunction; blunted shortening with slower force development and relaxation. These correlated with Ca2+ mishandling; blunted Ca2+ transient, with slower time to peak and SR Ca2+ recovery. SR Ca2+ content was low, nevertheless, diastolic Ca2+ sparks were more frequent, and their duration increased. Contractility and Ca2+ dysfunction aggravated or remained altered over time, explaining slow recovery. We conclude that diminished VM contractility is the main determinant of ISO-OV hypokinesia and is mostly related to Ca2+ mishandling.

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Objetivo: Determinar las principales características epidemiológicas y clínicas de la enfermedad de Parkinson en el Hospital Nacional "Ramiro Prialé Priale" de Huancayo. Métodos: Estudio observacional, descriptivo tipo retrospectivo de una serie de casos. Se estudió 84 pacientes entre los años 2015 y 2017, atendidos en la consulta externa u hospitalización de Neurología y Medicina interna, para ello se revisó sus historias clínicas, el muestreo fue no probabilístico de tipo censal seleccionados por juicio del investigador. Resultados: El promedio de edad fue 72,93 años, predominó el género masculino (58,3%), el grado de instrucción universitario (50%) y la procedencia de Huancayo (77,4%). La hipertensión arterial descompensada fue el motivo de hospitalización (19,1%), el tiempo de enfermedad tuvo un rango de 1-7 años (57,1%) y el temblor de reposo y bradicinesia fue el síntoma motor más frecuente (23,8%). En los síntomas no motores, 38,1% tuvieron alteraciones del sueño, 21,4% antecedentes familiares de enfermedad de Parkinson y las comorbilidades más asociadas fueron: depresión (48,8%) e insomnio (41,7%). Conclusión: La enfermedad de Parkinson es una patología frecuente en adultos mayores y en el sexo masculino; el síntoma motor que predomina es el temblor de reposo y bradicinesia, y las comorbilidades neuropsiquiátricas asociadas son la depresión e insomnio.

Objective: To determine the main epidemiological and clinical characteristics of Parkinson's disease at the National Hospital "Ramiro Prialé Priale" in Huancayo. Methods: Observational, descriptive retrospective study of a serie of cases. 84 patients were studied between 2015 and 2017, treated in the outpatient clinic or hospitalization of Neurology and Internal Medicine, for which their medical records were reviewed, the sampling was non-probabilistic of the census type selected by the investigator's judgment. Results: The average age was 72.93 years, the male gender prevailed (58.3%), the degree of university education (50%) and the origin of Huancayo (77.4%). Decompensated arterial hypertension was the reason for hospitalization (19.1%), disease time ranged between 1-7 years (57.1%) and tremor at rest and bradykinesia was the most frequent motor symptom (23.8%) In non-motor symptoms, 38.1% had sleep disorders, 21.4% family history of Parkinson's disease and the most associated comorbidities were: depression (48.8%) and insomnia (41.7%). Conclusion: Parkinson's disease is a frequent pathology in older adults and males; The predominant motor symptom is resting tremor and bradykinesia, and the associated neuropsychiatric comorbidities are depression and insomnia.

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La enfermedad de Parkinson es un proceso degenerativo del sistema nervioso central de inicio insidioso progresivo y desarrollo lento, que es consecuencia de una lesión idiopática en el sistema extrapiramidal y cuyas manifestaciones clínicas son rigidez, temblor y bradicinesia. Se presenta en personas de edad avanzada, sin diferencias en cuanto a sexo, raza o clase socioeconómica, y su diagnóstico definitivo se determina por el método clínico. Al respecto, en este artículo se describe la conducta terapéutica que se debe seguir en los ancianos que padezcan la enfermedad, donde el tratamiento no farmacológico se debe enfocar a mejorar la situación física y psíquica del paciente y la familia, según el estadio evolutivo, y el farmacológico se basa en la levodopa como medicamento de elección, con la cual se logra elevar la calidad de vida de los ancianos afectados

Parkinson disease is a degenerative process of the central nervous system of progressive insidious beginning and slow development which is the consequence of an idiopathic lesion in the extrapiramidal system and which clinical manifestations are rigidity, tremor and bradykinesia. It is presented in people of advanced age, without differences as for sex, race or social-economic class, and its definitive diagnosis is determined through the clinical method. In this respect, the therapeutic approach that should be followed in the elderly that suffers the disease is described in this work, in which the non pharmacological treatment should be focused to improve the patient and family physical and psychical situation, according to the evolutive course, and the pharmacological treatment is based on levodopa as election drug, with which it is possible to elevate the life quality of the affected patients

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AIMS: This study analyzed the sensorial, structural and functional response of rats subjected to paw immobilization. MAIN METHODS: Animal pelvis, hip, knee and ankle were immobilized using waterproof tape during two weeks for assessment of sensorial response to thermal (hot plate test) and mechanical stimuli (Von Frey test), motor system structure (histology and radiography) and muscle function (soleus contractility). KEY FINDINGS: Disuse animals became more responsive to thermal stimuli (49%), although less responsive to mechanical challenge (58%). Disuse animals showed local injuries such as reduction in muscle fiber diameter (16.7% in gastrocnemius, 5.7% in soleus), contractile activity (55% of the control maximal tonic contraction) and tibia cortical thickness (9.3%), besides increased nitrite:protein ratio, suggestive of protein degradation. Disuse also evoked systemic adaptations that include increase in serum lactate dehydrogenase (36.1%) and alkaline phosphatase (400%), but reduction in calcium (8.4%) and total serum protein (5.5%), especially albumin (34.2%). SIGNIFICANCE: Two weeks of functional paw disuse leads to local and systemic harmful adaptive changes in sensorial and structural systems. This study brings new insights into nervous and motor system mechanism associated with therapeutic limb immobilization in muscle and skeletal pathological conditions.

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Object: Losses in functional capacity of upper limbs of elders confined to bed may be due to the fracture of the femur. Aims: To perform a systematic review of the literature regarding the Stasis Syndrome; to elaborate, according to a previous analysis, an intervention proposal involving multidisciplinary care, to alleviate the effects of the Stasis Syndrome; to verify the effect of this multidisciplinary protocol of intervention according to the biological variables of elders with Stasis Syndrome through the use of an instrument created for this purpose. Method: This is controlled clinical research, with a quantitative approach. It involves the use of quantification during and treatment of patients and the associated data collection, through statistical techniques and the use of specific software...

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A imobilização é um recurso frequentemente utilizado na prática clínica, sendo comum em patologias álgicas e nas fraturas. O objetivo deste estudo foi analisar a influência do processo de imobilização em músculo do sistema respiratório, o diafragma. O experimento foi efetuado com 12 ratos Wistar machos divididos em dois grupos, controle e imobilizado. O procedimento de imobilização foi realizado através de um método alternativo de imobilização por fita adesiva, sendo mantida por duas semanas. Analisou-se a morfometria das fibras do diafragma com coloração de hematoxilina e eosina. Ao compararmos o diâmetro médio das fibras musculares do diafragma dos animais imobilizados (47,15μm ± 0,329μm) em relação ao controle (54,67μm ± 0,396μm), encontramos diferença estatística entre os grupos (p < 0,0001). Considerando os dados encontrados, foi possível concluir que a imobilização de pata, no modelo utilizado, foi capaz de gerar hipotrofia da musculatura respiratória, assim como um quadro geral de redução de massa corporal do animal.

Immobilization is a frequently used procedure in clinical practice and common in pain diseases and fractures. This study examined the influence of immobilization in a muscle-related respiratory system, the diaphragm. This experiment was conducted with twelve male rats divided into two groups, control and immobilized with an alternative method of restraining by tape, kept for two weeks. We analyzed the morphometry of the diaphragm muscle fibers with hematoxylin/eosin staining. Statistical difference was found (p < 0.0001) when the average diameter of the diaphragm muscle fibers of immobilized animals (47.15μm ± 0.329μm) was compared to the ones in the control group (54.67μm ± 0.396μm). Considering the results, it can be concluded that the immobilization of the animal paw in the used model was able to produce hypotrophy of respiratory musculature, as well as a general framework for reducing the mass of the animal.

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