Therapeutic effectiveness of a single exercise session combined with WalkAide functional electrical stimulation in post-stroke patients:a crossover design study

A growing body of evidence has suggested that the imbalance of epigenetic markers and oxidative stress appears to be involved in the pathophysiology and progression of stroke.Thus,strategies that modulate these biomarkers might be considered targets for neuroprotection and novel therapeutic opportunities for these patients.Physical exercise has been reported to induce changes in these epigenetic markers and improve clinical outcomes in different populations.However,little is reported on this in post-stroke patients.The purpose of this study was to investigate the effect of a single exercise session with WalkAide functional electrical stimulation(FES)on cognitive performance,clinical functional parameters,oxidative stress and epigenetic modulation in post-stroke individuals.In this crossover design study,12 post-stroke individuals aged 54–72 years of either sexes were included and subjected to a single session of exercise(45 minutes)without WalkAide functional electrical stimulation(EXE alone group),followed by another single session of exercise(45 minutes)with WalkAide functional electrical stimulation(EXE+FES group).The clinical functional outcome measures,cognitive performance and blood collections for biomarker measurements were assessed pre-and post-intervention.After intervention,higher Berg Balance Scale scores were obtained in the EXE+FES group than in the EXE alone group.There was no significant difference in the Timed Up and Go test results post-intervention between EXE alone and EXE+FES groups.After intervention,a better cognitive performance was found in both groups compared with before the intervention.After intervention,the Timed Up and Go test scores were higher in the EXE+FES group than in the EXE alone group.In addition,the intervention induced lower levels of lipid peroxidation.After intervention,carbonyl level was lower,superoxide dismutase activity and superoxide dismutase/catalase activity ratio were higher in the EXE+FES group,compared with the EXE group alone.In each group,both histone deacetylase(HDAC2)and histone acetyltransferase activities were increased after intervention compared with before the intervention.These findings suggest that a single exercise session with WalkAide FES is more effective on balance ability and cognitive performance compared with conventional exercise alone in post-stroke patients.This is likely to be related to the regulation of oxidative stress markers.The present study was approved by the Research Ethics Committee of the Methodist University Center-IPA(approval No.2.423.376)on December 7,2017 and registered in the Brazilian Registry of Clinical Trials—ReBEC(RBR-9phj2q)on February 11,2019.

Effects of a multimodal exercise protocol on functional outcomes,epigenetic modulation and brain-derived neurotrophic factor levels in institutionalized older adults:a quasi-experimental pilot study

Epigenetic changes have been shown to be associated with both aging process and aging-related diseases.There is evidence regarding the benefits of physical activity on the functionality,cognition,and quality of life of institutionalized older adults,however,the molecular mechanisms involved are not elucidated.The purpose of this pilot study was to investigate the effects of a multimodal exercise intervention on functional outcomes,cognitive performance,quality of life(QOL),epigenetic markers and brain-derived neurotrophic factor(BDNF)levels among institutionalized older adult individuals.Participants(n=8)without dementia who were aged 73.38±11.28 years and predominantly female(87.5%)were included in this quasi-experimental pilot study.A multimodal exercise protocol(cardiovascular capacity,strength,balance/agility andflexibility,perception and cognition)consisted of twice weekly sessions(60 minutes each)over 8 weeks.Balance(Berg Scale),mobility(Timed Up and Go test),functional capacity(Six-Minute Walk test),cognitive function(Mini-Mental State Examination)and QOL(the World Health Organization Quality of Life-BREF Scale questionnaire)were evaluated before and after the intervention.Blood sample(15 mL)was also collected before and after intervention for analysis of biomarkers global histone H3 acetylation and brain-derived neurotrophic factor levels.Significant improvements were observed in cognitive function,balance,mobility,functional capacity and QOL after the intervention.In addition,a tendency toward an increase in global histone H3 acetylation levels was observed,while brain-derived neurotrophic factor level remained unchanged.This study provided evidence that an 8-week multimodal exercise protocol has a significant effect on ameliorating functional outcomes and QOL in institutionalized older adult individuals.In addition,it was also able to promote cognitive improvement,which seems to be partially related to histone hyperacetylation status.The Ethics Research Committee of Centro Universitário Metodista-IPA,Brazil approved the current study on June 6,2019(approval No.3.376.078).

Epigenetic marks are modulated by gender and time of the day in the hippocampi of adolescent rats:a preliminary study

Although the involvement of gender in epigenetic machinery in peripheral tissues during the neonatal period has been suggested, the gender-related epigenetic profile of brain areas during the adolescent period is rarely exploited. Furthermore, the influence of time of day on hippocampal acetylation marks has been demonstrated in young adult and aged rats; however, there are no studies reporting epigenetic changes in the adolescent period. Therefore, this study aimed to investigate the effects of gender on hippocampal DNA methyltransferase 1 content and histone deacetylase（HDAC） activity of adolescent rats at different time points, specifically early morning and afternoon. Both epigenetic markers increased significantly in the hippocampi of female rats compared to the male group, an indicator of reduced transcriptional activity. In addition, HDAC activity during the early morning was higher compared to afternoon groups in both male and female rats, while DNA methyltransferase 1 content was not altered by the time of day. Our findings demonstrate that hippocampal DNA methylation and histone acetylation status can be influenced by gender during the adolescent period, while the time of the day impacts HDAC activity.

Assessment of resting energy expenditure in patients with cirrhosis

BACKGROUND Malnutrition affects 20%to 50%of patients with cirrhosis.It may be associated with serious complications and has a direct impact on prognosis.Resting energy expenditure(REE)is an important parameter to guide the optimization of therapy and recovery of nutritional status in patients with cirrhosis.However,the REE of patients with cirrhosis is still unclear,casting doubt upon the optimal nutritional management approach.AIM To identify the best method that predicts the REE of cirrhotic patients,using indirect calorimetry(IC)as the gold standard.METHODS An observational study was performed on 90 patients with cirrhosis.REE was assessed by IC,bioelectrical impedance analysis(BIA),and predictive formulas,which were compared using Bland-Altman plots and the Student’s t-test.RESULTS REE values measured by IC(1607.72±257.4 kcal)differed significantly from those determined by all other methods(BIA:1790.48±352.1 kcal;Harris&Benedict equation:2373.54±254.9 kcal;IOM equation:1648.95±185.6 kcal;Cunningham equation:1764.29±246.2 kcal),except the Food and Agriculture Organization of the United Nations,World Health Organization,and United Nations University(FAO/WHO/UNU)(1616.07±214.6 kcal)and McArdle(1611.30±241.8 kcal)equations.We found no significant association when comparing IC and 24-h dietary recall among different Child-Pugh classes of cirrhosis.CONCLUSION The IOM and FAO/WHO/UNU equations have the best agreement with the CI.These results indicate a possibility of different tools for the clinical practice on cirrhotic patients.

Relationship between phase angle,steatosis,and liver fibrosis in patients coinfected with human immunodeficiency virus/hepatitis C virus

BACKGROUND Malnutrition,lipodystrophy,and dyslipidemia are prevalent characteristics in patients with human immunodeficiency virus(HIV)infection with or without previous treatment.Such a clinical condition can lead to the hypothesis of the presence of hepatic steatosis with possible progression to fibrosis and the risk of hepatocellular carcinoma.Notably,a low phase angle(PA),evaluated by bioelectrical impedance analysis(BIA),is an independent prognostic marker of clinical progression and survival in HIV-infected patients.AIM To evaluate the relationship between PA and body composition with steatosis and hepatic fibrosis in HIV/hepatitis C virus(HCV)-coinfected patients.METHODS A retrospective observational study by convenience sampling of coinfected HIV/HCV patients,in which all patients underwent transient elastography(Fibroscan)and BIA evaluation.Student’s t test was used for group comparisons,and Spearman’s or Pearson’s correlation test was used when appropriate.The significance level was set at 5%,and analyses were performed using SPSS version 21.0.RESULTS Forty-three patients who received antiretroviral therapy met the inclusion criteria,and 23(53.5%)were under treatment with protease inhibitors(PIs).There was no difference in PA between those who used PIs and those who did not(P=0.635).There was no correlation between fibrosis grade and PA(P=0.355)or lean mass(P=0.378).There was a significant inverse correlation between the controlled attenuation parameter(CAP)and lean mass(P=0.378),positive correlation between PA and lean mass(P=0.378),and negative correlation between PA and fatty mass(P=0.378),although the CAP and PA were not correlated.When evaluated by sex,no significant correlations were found.CONCLUSION PA determines the muscle function of HIV/HCV-coinfected patients,and the CAP values reinforce the association with lean mass,suggesting that patients require early nutritional interventions.

Purple Grape Juice,an Important Flavonoids Source,Influence in Biochemical Parameters in Offspring of Wistar Rats

Our objective was to evaluate the effect of chronic gestational treatment and post-breast feeding with purple grape juice on the biochemical parameters in offspring of dams. We used 40 male offspring from 14 Wistar rats which received purple grape juice or water by gavage daily for 42 days at a dose of 7 microliters/g. The offspring were divided into groups of water or juice. All received daily purple grape juice or water by gavage for 30 days after completion of their nursing period at a dose of 7 microliters/g. At the end of the treatment period, the offspring were euthanized by decapitation with its truncal blood collected and subsequently separated the serum from the blood. The measurements were performed by automation or by manual dosing. Considering the gestational factor, grape juice was able to reduce levels of total cholesterol, triglycerides, urea, alanine aminotransferase (ALT), and not alter the levels of creatinine and aspartate aminotransferase (AST) in serum of the offspring. When considering the post-breast feeding factor, grape juice resulted in an improvement in HDL-C. We concluded that purple grape juice was able to produce a beneficial effect on certain biochemical parameters in offspring.