Comparison of cardiac autonomic modulation of athletes and non-athletes individuals with spinal cord injury at rest and during a non-immersive virtual reality task.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To compare cardiac autonomic modulation of individuals with spinal cord injury (SCI) that practice different amounts of moderate to vigorous physical activity (PA) and able-bodied controls at rest and during a non-immersive Virtual Reality task. SETTING: Athletes with SCI of wheelchair basketball, wheelchair tennis, wheelchair handball, WCMX (wheelchair motocross), and para-swimming were assessed at the Faca na Cadeira Institute, ICEL and Clube Espéria in São Paulo, Brazil; non-athletes with SCI and able-bodied controls were assessed at the Acreditando Centro de Recuperação Neuromotora, São Paulo, Brazil. METHODS: One-hundred forty-five individuals were assessed: 36 athletes with traumatic SCI (41.1 ± 16.8 years old), 52 non-athletes with traumatic SCI (40.2 ± 14.1 years old), and 57 able-bodied individuals (39.4 ± 12.5 years old). Cardiac autonomic modulation was assessed through heart rate variability (HRV) measured in the sitting position at rest and during a VR game activity. RESULTS: We found significantly more favourable HRV for athletes with SCI when compared to non-athletes with SCI, but no differences between athletes with SCI and able-bodied controls. In addition, athletes and able-bodied controls showed adequate autonomic nervous system (ANS) adaptation (rest versus physical activity in VR), i.e., they experienced parasympathetic withdrawal during VR physical activity, which was not found in non-athletes with SCI. CONCLUSION: The practice of moderate to vigorous physical activity is associated with healthier cardiac autonomic modulation in adults with SCI, which may lead to more favourable health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04618003, retrospectively registered.

Human leukocyte antigen-G allele polymorphisms have evolved following three different evolutionary lineages based on intron sequences.

Human leukocyte antigen (HLA)-G alleles follow a different pattern of polymorphism generation from those of the HLA classical I alleles. These polymorphisms have been defined as a result of random permitted point mutations in exons. However, this polymorphism maintenance could have an evolutionary specific pathways based on noncoding regions as introns, 14-bp deletion/insertion (exon 8), or promoter regions. Therefore a systematic sequencing study of HLA-G alleles was done obtaining the complete genomic sequence of 16 different HLA-G alleles: nine alleles were intron and exon confirmatory sequences, four were exon confirmatory and new intron described sequences, and three were new alleles. A 14-bp deletion/insertion polymorphism was also sequenced in these alleles. These sequences, together with those previously published, were compared, and phylogenetic and molecular evolutionary analyses were performed. Results showed the presence of three major specific evolutionary patterns, tentatively named lineages, and the other four as minor lineages (only one allele). The relative age of the major lineages could also be established based on the number of lineage-specific positions and the number of alleles of each lineage. Two main mechanisms are clearly defined in the generation of the lineages (introns), gene conversion, and/or convergent evolution following specific patterns.

Relato de experiência de ações de humanização numa Unidade Neonatal / Experience report of humanization actions In a neonatal unit

O Hospital Geral de Itapecerica da Serra é um Centro de Referência Nacional do Ministério de Saúde para o Método Canguru (MC), com ações de humanização na assistência neonatal, sendo seus pilares: cuidados centrados na família, contato pele a pele, protocolo de dor, controle ambiental e estímulo/apoio à amamentação. Descrever as ações de humanização desenvolvidas no hospital baseadas na Metodologia Canguru. Foram elaboradas e implantadas rotinas, protocolos, procedimentos operacionais padrões, check list, treinamentos e palestras. Foi observada uma melhora no comportamento dos recém-nascidos (RN) que permaneceram mais estáveis, com episódios de repouso prolongado e uma maior participação dos pais e familiares que se mostraram mais tranquilos e confiantes nas condutas tomadas pelos profissionais. As mães manifestaram maior segurança e capacidade de amamentar e prestar os cuidados aos seus filhos, sendo que quase todas saíram com aleitamento exclusivo na alta. A alta aderência da equipe na prática diária valida as evidências científicas sugeridas sobre os benefícios da humanização ao RN, valorizando o papel da equipe multiprofissional e dos pais na recuperação e tratamento e garantindo qualidade de vida e dignidade nos atendimentos prestados.