Abstract-Knowing that exercise training reduces arterial pressure in hypertensive individuals and that pressure fall is accompanied by blockade of brain renin-angiotensin system, we sought to investigate whether training (T) affects central renin-angiotensin system. Spontaneously hypertensive rats (SHRs) and normotensive Wistar-Kyoto controls (WKY) were submitted to training or kept sedentary (S) for 3 months. After functional recordings, brain was removed and processed for autoradiography (brain stem sequential slices hybridized with 35 S-oligodeoxynucleotide probes for angiotensinogen [Aogen] and angiotensin II type 1 [AT 1A ] receptors). Resting arterial pressure and heart rate were higher in SHR S (177Ϯ2 mm Hg, 357Ϯ12 bpm versus 121Ϯ1 mm Hg, 320Ϯ9 bpm in WKY S ; PϽ0.05). Training was equally effective to enhance treadmill performance and to cause resting bradycardia (Ϫ10%) in both groups. Training-induced blood pressure fall (Ϫ6.3%) was observed only in SHR T . In SHR S (versus WKY S ) AT 1A and Aogen mRNA expression were significantly increased within the NTS and area postrema (average of ϩ67% and ϩ41% for AT 1A and Aogen, respectively; PϽ0.05) but unchanged in the gracilis nucleus. Training did not change AT 1A expression but reduced NTS and area postrema Aogen mRNA densities specifically in SHR T (PϽ0.05 versus SHR S , with values within the range of WKY groups). In SHRs, NTS Aogen mRNA expression was correlated with resting pressure (yϭ5.95x ϩ41; rϭ0.55; PϽ0.05), with no significant correlation in the WKY group. Concurrent training-induced reductions of both Aogen mRNA expression in brain stem cardiovascular-controlling areas and mean arterial pressure only in SHRs suggest that training is as efficient as the renin-angiotensin blockers to reduce brain renin-angiotensin system overactivity and to decrease arterial pressure. Key Words: angiotensin II Ⅲ angiotensin receptors Ⅲ blood pressure Ⅲ heart rate Ⅲ hypertension Ⅲ experimental Ⅲ rats T he renin-angiotensin system (RAS) is a widely distributed regulatory system with hormonal, paracrine, and intracrine functions in many tissues. 1-4 Brain RAS has been implicated in the pathogenesis (development/maintenance) of several forms of hypertension. 2,4 -6 All of the components of the RAS (precursor, enzymes, peptides, and receptors) are present in brain areas involved in cardiovascular control as the hypothalamic paraventricular nucleus and dorsal brain stem areas including the nucleus tractus solitarii (NTS), the dorsal motor nucleus of the vagus nerve, and the area postrema. 4,[7][8][9][10][11] It is important to notice that angiotensinogen (Aogen), angiotensin II (Ang II), and Ang II type 1 (AT 1A ) receptors are densely expressed within the NTS, indicating the importance of local RAS on cardiovascular control. 4,8,10 -14 In previous studies we showed both the close relationship between increased Aogen and Ang II AT 1A receptor mRNA expression in brain stem areas and elevated blood pressure 14 and the permissive role of Ang II to orchestrate, via AT 1 rec...

Lipopolysaccharides (LPS) can be used to induce experimental endotoxic shock, which is characterized by a significant decrease in mean arterial pressure (MAP) and a decreased vasoconstrictor response that have been attributed to excessive nitric oxide production. Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase), in addition to lowering serum cholesterol levels, exert many pleiotropic effects, including anti-inflammatory action. In the present study, we investigated the effect of simvastatin, an HMG-CoA reductase inhibitor, on the production of nitric oxide and the cardiovascular response to LPS. Male Wistar rats were pretreated with different doses of simvastatin (10, 20, 40, and 80 mg/kg, i.p.) or saline 20 min before i.v. injection of LPS (1.5 mg/kg) or saline (control). MAP was continuously recorded and nitrate plasma concentration was determined during the 6-h experimental session at 1-h intervals. The pressor response to phenylephrine (1 microg/kg) was evaluated before and 6 h after LPS administration. In the LPS-treated group, there was a time-dependent increase in nitrate plasma concentration (P<0.001), and this response was decreased in simvastatin pretreated rats (P<0.001). We also observed that LPS decreased the pressor response to phenylephrine (P<0.001), an effect that was reverted by simvastatin pretreatment (P<0.05). However, simvastatin did not modify the decrease of MAP induced by LPS. We concluded that simvastatin decreases nitrate plasma concentration in response to LPS and recovers vascular responsiveness during an experimental endotoxic shock. These data suggest the potential use of HMG-CoA reductase inhibitors as a coadjuvant in the treatment of septic shock.

in the trained SHR). Hypertension specifically reduced NTS OT receptor mRNA density (-46% versus sedentary WKY rats, P < 0.05); training did not change OT receptor density, but significantly increased OT mRNA expression (+2.5-fold in trained WKY rats and +15% in trained SHR). Concurrent hypertension-and training-induced plastic (peptide/receptor changes) and functional adjustments (HR changes) of oxytocinergic control support both the elevated basal HR in the SHR group and the slowing of the heart rate (rest and exercise) observed in trained WKY rats and SHR.

Descriptive, quantitative study carried out at a University Hospital in Curitiba-PR, Brazil. The objective was to analyze the caring actions performed at a semi-intensive care unit, from the perspective of the caring humanization, and also to evaluate the presence of comfort and communication measures in performing these actions. The data collection occurred under a systematic non-participant observation. The caring actions were grouped, according to its frequency, and presented in graphs. The comfort measures were present at 45% of the caring actions performed, and communication establishment was present at 40% of these actions. Even today, the comfort and communication measures, as reflected in the process of caring humanization, remain as an ideal speech. However, they are too far from reality of the health care system's users and workers.

The simulation affects students' perception of stressors and promotes their self-evaluation and critical thinking regarding the responsibility that comes with their learning.

The enzyme phosphatidylinositol 3-kinase (PI3-kinase) exerts an important role in the transduction of the anorexigenic and thermogenic signals delivered by insulin and leptin to first-order neurons of the arcuate nucleus in the hypothalamus. The termination of the intracellular signals generated by the activation of PI3-kinase depends on the coordinated activity of specific inositol phosphatases. Here we show that phosphoinositide-specific inositol polyphosphate 5-phosphatase IV (5ptase IV) is highly expressed in neurons of the arcuate and lateral nuclei of the hypothalamus. Upon intracerebroventricular (ICV) treatment with insulin, 5ptase IV undergoes a time-dependent tyrosine phosphorylation, which follows the same patterns of canonical insulin signaling through the insulin receptor, insulin receptor substrate-2, and PI3-kinase. To evaluate the participation of 5ptase IV in insulin action in hypothalamus, we used a phosphorthioate-modified antisense oligonucleotide specific for this enzyme. The treatment of rats with this oligonucleotide for 4 d reduced the hypothalamic expression of 5ptase IV by approximately 80%. This was accompanied by an approximately 70% reduction of insulin-induced tyrosine phosphorylation of 5ptase IV and an increase in basal accumulation of phosphorylated inositols in the hypothalamus. Finally, inhibition of hypothalamic 5ptase IV expression by the antisense approach resulted in reduced daily food intake and body weight loss. Thus, 5ptase IV is a powerful regulator of signaling through PI3-kinase in hypothalamus and may become an interesting target for therapeutics of obesity and related disorders.

O objetivo desta revisão sistemática é apresentar a simulação como estratégia de ensino para estudantes de graduação em enfermagem, conforme estudos brasileiros. A busca foi realizada nas bases de dados BDENF, Lilacs e Medline, utilizando-se as palavras-chave: ensino, educação, laboratório, simulação e enfermagem. Foram incluídos os artigos científicos sobre simulação como estratégia de ensino para estudantes de enfermagem publicados em português, de janeiro de 1999 a setembro de 2010. Para análise dos dados, os autores aplicaram a técnica de análise temática de conteúdo, descrita por Bardin. Nove artigos foram selecionados, sendo classificados em duas categorias: sete em "Simulação por Computador" e dois em "Laboratório de Enfermagem". Os resultados indicam que a simulação contribui para a aquisição de habilidades psicomotoras e autoconfiança. Não foram encontrados ensaios clínicos sobre a eficácia da simulação na prática dos estudantes de enfermagem. Há necessidade de mais pesquisas sobre o tema.

Qualitative, exploratory and interventionist case study at a teaching hospital of Paraná, with the objective of proposing a Tuberculosis Healthcare Management model focused on the hospital discharge, with a view to comprehensive care for patients with tuberculosis. Interviews were conducted with key informants (17 subjects), using the Theory of Nursing Praxis Intervention in Collective Health as the theoretical and methodological framework, with its three interdependent dimensions used as analytical categories. Weakness was revealed in the protocols for hospitalized patient care, insufficient integration between levels of care and the need for direct communication between the hospital and primary care nurses. In view of this result, a Healthcare Management Model, expressed as a flow of care with matrix support, nursing consultation and phone contact between nurses. The implementation of this model will lead to greater integration between the levels of care, permitting improvements in patient monitoring with greater probability of treatment compliance.