Aerobic exercise prevents cardiomyocyte damage caused by oxidative stress in early cardiovascular disease by increasing vascularity while L-arginine supplementation prevents it by increasing activation of the enzyme nitric oxide synthase.

L-Arginine and chronic exercise reduce oxidative stress. However, it is unclear how they affect cardiomyocytes during cardiovascular disease (CVD) development. The aim of this research was to investigate the possible effects of L-arginine supplementation and aerobic training on systemic oxidative stress and their consequences on cardiomyocytes during cardiometabolic disease onset caused by excess fructose. Wistar rats were allocated into four groups: control (C), fructose (F, 10% fructose in water), fructose training (FT; moderate running, 50-70% of the maximal velocity), and fructose arginine (FA; 880 mg/kg/day). Fructose was given for two weeks and fructose plus treatments for the subsequent eight weeks. Body composition, blood glucose, insulin, lipid profile, lipid peroxidation, nitrite, metalloproteinase-2 (MMP-2) activity, left ventricle histological changes, microRNA-126, -195, and -146, eNOS, p-eNOS, and TNF-α expressions were analyzed. Higher abdominal fat mass, triacylglycerol level, and insulin level were observed in the F group, and both treatments reversed these alterations. Myocardial vascularization was impaired in fructose-fed groups, except in FT. Cardiomyocyte hypertrophy was observed in all fructose-fed groups. TNF-α levels were higher in fructose-fed groups than in the C group, and p-eNOS levels were higher in the FA than in the C and F groups. Lipid peroxidation was higher in the F group than in the FT and C groups. During CVD onset, moderate aerobic exercise reduced lipid peroxidation, and both training and L-arginine prevented metabolic changes caused by excessive fructose. Myocardial vascularization was impaired by fructose, and cardiomyocyte hypertrophy appeared to be influenced by pro-inflammatory and oxidative environments.

Aerobic exercise prevents cardiomyocyte damage caused by oxidative stress in early cardiovascular disease by increasing vascularity while L-arginine supplementation prevents it by increasing activation of the enzyme nitric oxide synthase

L-Arginine and chronic exercise reduce oxidative stress. However, it is unclear how they affect cardiomyocytes during cardiovascular disease (CVD) development. The aim of this research was to investigate the possible effects of L-arginine supplementation and aerobic training on systemic oxidative stress and their consequences on cardiomyocytes during cardiometabolic disease onset caused by excess fructose. Wistar rats were allocated into four groups: control (C), fructose (F, 10% fructose in water), fructose training (FT; moderate running, 50-70% of the maximal velocity), and fructose arginine (FA; 880 mg/kg/day). Fructose was given for two weeks and fructose plus treatments for the subsequent eight weeks. Body composition, blood glucose, insulin, lipid profile, lipid peroxidation, nitrite, metalloproteinase-2 (MMP-2) activity, left ventricle histological changes, microRNA-126, -195, and -146, eNOS, p-eNOS, and TNF-α expressions were analyzed. Higher abdominal fat mass, triacylglycerol level, and insulin level were observed in the F group, and both treatments reversed these alterations. Myocardial vascularization was impaired in fructose-fed groups, except in FT. Cardiomyocyte hypertrophy was observed in all fructose-fed groups. TNF-α levels were higher in fructose-fed groups than in the C group, and p-eNOS levels were higher in the FA than in the C and F groups. Lipid peroxidation was higher in the F group than in the FT and C groups. During CVD onset, moderate aerobic exercise reduced lipid peroxidation, and both training and L-arginine prevented metabolic changes caused by excessive fructose. Myocardial vascularization was impaired by fructose, and cardiomyocyte hypertrophy appeared to be influenced by pro-inflammatory and oxidative environments.

Histologic characterization of dilated cardiomyopathy in Estrela mountain dogs.

Dilated cardiomyopathy (DCM) is the second-most-important acquired cardiovascular disease in dogs (excluding heartworm disease in some geographic regions) and a major cause of morbidity and mortality in Estrela Mountain Dogs. The objective of this study is to describe the histologic features of DCM in Estrela Mountain Dogs, with special attention to the localization and quantification of attenuated wavy fibers (AWFs), fibrosis, and fatty infiltration. Myocardial samples from 10 areas were collected from the hearts of 10 dogs with DCM and 7 dogs without signs of cardiac disease-namely, the basal, middle, and apical portions of the free wall of both cardiac ventricles and the interventricular septum, as well as the left ventricular papillary muscle. In each sample, the presence or absence of AWFs was noted, and fatty infiltration and fibrosis were quantified. Fatty infiltration, fibrosis, and AWFs were observed in the myocardium of all dogs with DCM, in contrast to what has been described in other breeds. The left ventricular myocardium was the best tissue for diagnosis of DCM, based on these histologic features. The authors concluded that quantification of fibrosis and observation of AWFs in the left ventricular myocardium are useful in the histologic diagnosis of DCM in Estrela Mountain dogs.

Arthroscopic exposure of the patellar articular surface.

Patellofemoral cartilage degeneration is usually associated with a tight lateral retinaculum (lateral hyperpressure). The position of the patella on the femoral groove under hyperpressure makes reasonable access to the cartilage defects difficult for the arthroscopist. Frequently, the surgeon can barely see the cartilage, and the problem cannot be satisfactorily managed. By performing a lateral release and tilting the patella with a laterally drilled Kirschner wire, the articular surface of the patella can be completely exposed, allowing even perpendicular holes to be drilled whenever necessary.

[A methodology for the diagnosis and follow-up of the evolution of acute hepatitis in childhood. The Working Group of the Section of Pediatric Gastroenterology and Nutrition of the Portuguese Pediatrics Society]. / Metodologia de diagnóstico e controlo de evolução da hepatite aguda na criança. Grupo de Trabalho da Secção de Gastrenterologia e Nutrição Pediátrica de Sociedade Portuguesa de Pediatria.

The Working Group of the Section of Paediatric Gastroenterology and Nutrition of the Portuguese Society of Paediatrics established a protocol for the investigation of children with acute hepatitis. The main purpose of this proposal is to allow appropriate etiologic investigations and avoid unnecessary tests that are expensive and do not add relevant information for the correct follow-up of these patients.

Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report.

We present a surgical technique for the treatment of recurring dislocation of the patella. The procedure, based on Galleazzi's tenodesis of the semitendinosus, uses minimal dissection and small incisions to improve cosmetic results and speed recovery. A polyester ligament is passed through a bone tunnel at the midline of the patella and fixed at the medial condyle, thus creating a medial patellofemoral neoligament. We have reviewed the results of 30 knees in 30 patients with an average follow-up of 39 months. Twenty-five patients (83.3%) showed significant improvement of their initial complaints.

Anterior cruciate ligament reconstruction with a loop or double thickness of semitendinosus tendon.

This is a report on the use of a loop or double thickness of the semitendinosus tendon to reconstruct the anterior cruciate ligament in 26 patients. Through this method the tensile strength of the graft becomes greater than the tensile strength of the normal anterior cruciate ligament. The looped, free tendon is fixed tightly in holes in the femur and tibia by means of a bone plug obtained with the trephine used to cut these holes. The tight fit of the tendon in the femur and tibia creates a close relationship between graft and host and hence rapid revascularization of the tendon graft. As a measure of function, the pivot-shift test, Lachman's test, and anterior drawer sign were performed pre- and postoperatively. There was a good result in 23 and a fair result in 3 cases. The average follow-up period is 3 years.

Introducao a cirurgia artroscopica. / An introduction to arthroscopic surgery

A cirurgia astroscopica e apresentada e discutida atraves da analise de procedimentos basico. As indicacoes, vantagens e desvantagens da tecnica foram examinadas de forma a oferecer embasamento pratico-teorico aqueles que estao iniciando na astroscopia. Verificou-se, alem disso, que a cirurgia artroscopica proporcionou, aos pacientes, uma reabilitacao mais rapida do que a cirurgia convencional. Nao se pode, no entanto, afirmar que sua capacidade curativa seja maior do que a da cirurgia convencional, mas sim que se chegou ao mesmo objetivo por um caminho curto e menos arduo

Reconstrucao dos ligamentos cruzados do joelho com o tendao duplo do semitendinoso. / Reconstruction of the cruciate ligament with looped free tendon of the semitendinous muscle

A reconstrucao dos ligamentos cruzados do joelho com o tendao duplo do semitendinoso e apresentada e discutida com base nos resultados obtidos em 21 pacientes. Para a fixacao do tendao duplo na tibia e femur, utilizamos um tarugo de osso esponjoso. Esse tarugo foi obtido com a trefina que simultaneamente fez os tuneis de ancoragem na tibia e femur. Dezessete pacientes submeteram-se a reconstrucao do ligamento cruzado anterior e quatro do posterior. A manobra do ressalto lateral, o teste de Lachmann e gaveta posterior e anterior foram verificados no pre e pos-operatorio. Comparando estes achados, obtivemos 86,3% de bons resultados e 13,7% de regulares nas reconstrucoes do ligamento cruzado anterior. Quanto ao ligamento cruzado posterior, ficamos com 75% de bons e 25% de regulares.No entanto, nossa pequena casuistica com uma evolucao media de 13 meses ainda nao permite conclusoes definitivas