The present study was carried out to evaluate the effect of statins associated with physical exercise (PE) in liver cells in dyslipidemic rats through cariometry. The animals were divided into six groups: animals subjected to a hypercholesterolemic diet (HD), simvastatin, with (G1) and without (G2) physical exercise (PE); HD submitted (G3) or not (G4) to PE, and commercial food diet (F) with (G5) and without (G6) PE. Histological analysis of the liver was performed by staining the slides with hematoxylin and eosin. The cariometric study included measuring the major and minor diameters of the hepatocytes nuclei. The Shapiro-Wilk test was also performed. To determine the differences among the groups, the Kruskal-Wallis Test with Dunn's post-test were conducted. The significance level was set at 5%. No difference was found in the hepatocytes nuclei between G5 and G6. When these groups were related with G3 and G4, reduced nuclei were observed. There was no difference between G1 and G6. The comparison between G6 and G2 showed that the nuclei in G2 were smaller. No difference was detected between G5 and G1. Changes were observed in the nuclei shape in G2 in comparison to G1. Considering G2 and G3, a decrease in the size of nuclei was observed in G3. On the other hand, G2 showed changes in shape in the comparative analysis with G4. The size and shape of G1 nuclei were larger than G3 as well as changes in shape were observed when compared to G4. G4 showed smaller nuclei than G3. Therefore, F, associated or not with the practice of PE, does not alter the size and shape of the hepatocytes nuclei; HD combined with sedentarism influences changes in the morphometric parameters of hepatocytes; and the association of simvastatin and PE seems to protect the hepatocytes nuclei with regard to HD.

INTRODUÇÃO: A doença renal crônica (DRC) é decorrente de uma lesão renal e perda progressiva e irreversível da função dos rins. A hemodiálise substitui parcialmente essa função, com o objetivo de corrigir as alterações metabólicas na DRC. Para acompanhar a adequação da diálise, é determinado o Kt/V - índice de depuração da ureia por sessão de hemodiálise. O exercício físico de moderada intensidade tem se mostrado de fundamental importância para melhorar os efeitos adversos ao tratamento dialítico. OBJETIVOS: Avaliar o Kt/V em indivíduos com DRC submetidos ao exercício físico isotônico de baixa intensidade durante a hemodiálise. MATERIAIS E MÉTODOS: Analisados dados de 15 voluntários de ambos os sexos, submetidos à hemodiálise três vezes por semana. Após duas horas do início da diálise, foi aplicado um protocolo de exercícios isotônicos de baixa intensidade de membros superiores e inferiores com duração de 30 minutos, por um período de três meses. Os valores do Kt/V foram comparados no período de três meses anteriores sem exercício e após três meses de exercício. RESULTADOS: A média dos valores do Kt/V nos três meses sem exercício foi de 1,13 ± 0,11 e após aplicação do programa de exercícios foi de 1,29 ± 0,12 (p < 0,05). CONCLUSÃO: O programa de exercício físico isotônico de baixa intensidade em pacientes com DRC, aplicados durante a sessão de diálise mostrou a melhora da eficiência dialítica.

INTRODUCTION: The chronic kidney disease (CKD) is due to a renal injury and progressive and irreversible loss of kidney function. Hemodialysis replace partially this function with the objective of correcting the metabolic changes in the DRC. To monitor the adequacy of dialysis is determined the Kt/V - rate of clearance of urea per session of dialysis. The exercise of moderate intensity has been of fundamental importance for improving the adverse effects of dialysis treatment. OBJECTIVES: To evaluate Kt/V in persons with CKD submitted the isotonic exercise of low intensity during hemodialysis. MATERIALS AND METHODS: It was analyzed data from 15 volunteers with CKD, both sexes, submitted to dialysis three times a week. After two hours of the start of dialysis, was applied a protocol of isotonic exercises with low intensity of upper and lower limbs lasting 30 minutes, for a period of three months. The values of Kt/V were compared in the period of three months without exercise and after three months (monthly average). The paired Student t test was used for statistical analysis (p < 0.05). RESULTS: The average values of Kt/V within three months without exercise was 1.13 ± 0.11 and after implementation of the program of exercises was 1.29 ± 0.12 (p < 0.05). CONCLUSION: The program of isotonic exercises of low intensity in patients with CKD applied during the session of dialysis improved the efficiency dialysis.

As estatinas são utilizadas no tratamento das dislipidemias, com grande tolerância; no entanto, vários efeitos colaterais podem surgir, destacando-se miopatia. A prática regular do exercício físico (EF) produz modificações favoráveis no perfil lipídico; entretanto, pode gerar lesões musculares. OBJETIVO: Avaliar o efeito da associação entre exercício físico e estatinas na função muscular, pela análise histológica, em modelo experimental animal com dislipidemia. MÉTODOS: Foram utilizados 80 ratos machos Wistar, distribuídos em oito grupos, incluindo animais submetidos à dieta hipercolesterolêmica (DH), sinvastatina com (G1) e sem (G2) EF; DH e fluvastatina, com (G3) e sem EF (G4); alimentados com ração comercial (RC) na presença (G5) e ausência de (G6) EF; DH submetidos (G7) ou não (G8) a EF. A DH foi administrada por 90 dias, as estatinas e prática de EF em esteira rolante por oito semanas. Os animais foram sacrificados, e o músculo sóleo retirado para análise histológica. Aplicaram-se os testes t de Student pareado e análise multivariada, com nível significante para p < 0,05. RESULTADOS: As principais alterações histológicas encontradas foram fibras de diferentes diâmetros, atróficas, em degeneração, splitting, edema, infiltrado inflamatório. Essas alterações foram observadas em 90% dos animais do grupo G1, 80% do G2, 70% do G3, 30% do G4, 40% do G5 e 30% do G7. Nos grupos G6 e G8 identificaram-se fibras musculares com morfologia preservada. CONCLUSÕES: Na avaliação histológica muscular, a associação entre fluvastatina, sinvastatina e exercício físico acarreta alterações morfológicas com predomínio no uso da sinvastatina, variando de grau leve a grave, no músculo sóleo de ratos, induzidos pelos inibidores da HMG-CoA redutase.

Statins are used in the treatment of dyslipidemias with great tolerance; however, several side effects can arise, mainly myopathies. Regular practice of physical exercises (PE) produces beneficial alteration in the lipid profile, but it can result in muscular lesions. OBJECTIVE: to evaluate the effect of the association between physical exercise and statins in the muscular function through histological analysis in an experimental animal model with dyslipidemia. METHODS: 80 male Wistar mice, distributed in 8 groups, namely: animals submitted to a hypercholesterolemic diet (HD), symvastatin with (G1) and without PE (G2) ; HD and fluvastatin with (G3) and without PE (G4); fed with commercial food (CR) in the presence (G5) and absence of PE (G6); HD submitted (G7) or not (G8) to PE were used. The HD was administered statins and PE practice on treadmill for 90 days for 8 weeks. The animals were sacrificed, and the soleus muscle was removed for histological analysis. Paired t-tests and multivariate analysis were applied with significance level of p<0.05. RESULTS: The most important histological alterations found were fibers with different diameters and atrophic, with degeneration, splitting, edema and inflammatory infiltrate. These alterations were observed in 90% of animals from G1; 80% from G2; 70% from G3; 30% from G4; 40% from G5 and 30% from G7. In the G6 and G8 groups muscular fibers with preserved morphology were identified. CONCLUSION: In the muscular histological evaluation, the association of fluvastatin, symvastatin and physical exercise results in morphological alterations with predominance with the use of simvastatin, varying from a light to a high level, in the soleus muscle of mice, induced by HMG-CoA reductase inhibitors.

Procedimentos cirúrgicos torácicos podem alterar a mecânica respiratória, repercutindo na função pulmonar. A presença de profissionais fisioterapeutas é fundamental no preparo e na reabilitação dos indivíduos que são submetidos à cirurgia cardíaca, visto que dispõem de um grande arsenal de técnicas. O objetivo foi verificar a efetividade de exercícios respiratórios, com e sem a utilização de dispositivos, e o treinamento muscular respiratório pré-cirurgia cardíaca na redução das complicações pulmonares pós-operatórias. Mesmo existindo controvérsias a respeito de qual técnica utilizar, estudos demonstram a eficácia da fisioterapia respiratória pré-cirúrgica na prevenção e na redução de complicações pulmonares pós-operatórias.

Cardiac surgical procedures change respiratory mechanics, defecting in lung dysfunction. The physical therapists play an important role in the preparation and rehabilitation of individuals who are undergoing cardiac surgery, as they have a large quantity of techniques. The objective was to evaluate the effectiveness of breathing exercises with and without the use of devices, and respiratory muscle training in preoperative period of cardiac surgery in reducing postoperative pulmonary complications. Although there are controversies as to which technique to use, studies show the effectiveness of preoperative physiotherapy in the prevention and reduction of postoperative pulmonary complications.

The chronic renal failure overall incidence is increasing every day. In Brazil, approximately 54.5 thousand people are on dialysis. Chronic kidney disease is a syndromic, progressive and irreversible renal function disease which results invariably in dialysis. Despite technological advances and benefits in increasing survival, hemodialysis causes complications and functional changes, affecting the quality of life of these subjects. This study aimed to evaluate and compare to controls the quality of life of patients submitted to physical therapy. We selected 60 chronic renal failure patients of both genders. The quality of life questionnaire Kidney Disease Quality of Life Short Form was applied to two groups: a control without physical therapy, and others who were submitted to a physical therapy treatment. The results showed impairment related to age, hemodialysis lengths and gender, in most of the dimensions analyzed in both groups. But when compared between groups, patients undergoing a physical therapy showed better quality of life indices. In conclusion the physical therapy contributes to a trend of improving the overall quality of life of patients with chronic renal failure undergoing hemodialysis.

La incidencia global de enfermedades renales crónicas está aumentando a cada día. En Brasil, aproximadamente 54.5 mil personas se encuentran en tratamiento dialítico. La enfermedad renal crónica, el síndrome progresivo e irreversible de la función renal, resulta siempre en terapia dialítica. A pesar de los avances tecnológicos y de los beneficios en la supervivencia cada vez mayor, las complicaciones causadas por la hemodiálisis y los cambios funcionales afectan a la calidad de vida de estos sujetos. Este estudio trata de evaluar y comparar la calidad de vida de los pacientes sometidos a la fisioterapia con controles. Se seleccionaron 60 enfermos con insuficiencia renal crónica de ambos géneros. Se aplicó un cuestionario de calidad de vida Kidney Disease Quality of Life Short Form para evaluar dos grupos de pacientes: un control, sin tratamiento fisioterapéutico, y uno que realizaba este tratamiento. Los resultados demostraron comprometimiento relacionado con la franja de edad, duración de la hemodiálisis y género en gran parte de las dimensiones analizadas en ambos grupos. Sin embargo, cuando se hizo el análisis entre los grupos, los pacientes sometidos a tratamiento obtuvieron mejores índices de calidad de vida. Se concluye que la fisioterapia contribuye a una tendencia de mejora general de la calidad de vida de los pacientes con insuficiencia renal crónica sometidos a la hemodiálisis.

A incidência global de doenças renais crônicas vem aumentando a cada dia. No Brasil, aproximadamente 54,5 mil pessoas se encontram em tratamento dialítico. A doença renal crônica, diagnóstico sindrômico, progressivo e irreversível da função renal, culmina invariavelmente na terapia dialítica. Apesar dos avanços tecnológicos e dos benefícios no incremento da sobrevida, a hemodiálise acarreta complicações e alterações funcionais que prejudicam a qualidade de vida desses sujeitos. O presente estudo buscou avaliar e comparar a qualidade de vida de pacientes submetidos à fisioterapia com controles. Foram selecionados sessenta doentes renais crônicos de ambos os gêneros. Aplicou-se o questionário de qualidade de vida Kidney Disease Quality of Life Short Form para avaliar dois grupos de pacientes: um controle, sem tratamento fisioterapêutico, e um que realizava o tratamento fisioterapêutico. Os resultados demonstraram comprometimento relacionado à faixa etária, tempo de hemodiálise e gênero em grande parte das dimensões analisadas em ambos os grupos; porém, quando se fez a análise entre os grupos, pacientes que realizaram fisioterapia obtiveram melhores índices de qualidade de vida. Concluiu-se que a fisioterapia contribui para uma tendência de melhora geral da qualidade de vida de pacientes renais crônicos submetidos à hemodiálise.

Physical exercise and statins, which are recommended for the treatment of dyslipidemia, are independently associated to the occurrence of muscle injury. The objective is analyze the effect of aerobic exercise associated to the use of simvastatin on the morphology of the gastrocnemius muscle. Thirty Wistar rats were divided into six groups, two of which received a standard diet (1 sedentary and 1 exercised) and four (1 sedentary with medication, 1 sedentary without medication, 1 exercised with medication, 1 exercised without medication) received a hypercholesterolemic diet (standard diet with the addition of cholesterol and coconut oil). Simvastatin (20 mg/Kg) was administered five days a week for eight weeks, together with aerobic training on a treadmill (9.75 m/min) for 60 minutes a day. The gastrocnemius muscle was removed, sliced, stained with Hematoxylin-Eosin and submitted to a histochemical reaction to determine mitochondrial activity. The data were analyzed using a paired t-test, analysis of variance and Scheffé's post hoc test (p<0.05). Greater histological alterations were found in the medicated and exercised animals, with a greater frequency of occurrence as well. The histochemical analysis revealed that the medicated groups had fibers with more intensive mitochondrial activity alongside fibers with an absence of reaction. The morphometric analysis revealed no significant differences between groups. It is suggested that simvastatin is a medication that leads to the occurrence of muscle injury and its administration in association with physical activity may exacerbate these injuries. This finding may be related to cellular respiration.

El ejercicio físico y las estatinas, son intervenciones recomendadas para el tratamiento de la dislipidemia y están independientemente asociadas con la ocurrencia de lesiones musculares. El objetivo fue analizar el efecto del ejercicio aeróbico asociado al uso de la sinvastatina en la morfología del músculo gastrocnemio. 30 ratas macho Wistar fueron divididos en 6 grupos, de los cuales 2 recibieron ración padrón, sedentarios, ejercitados y 4 recibieron dieta con alto nivel de colesterol, sedentarios con y sin medicamento, ejercitados con y sin medicamentos. La dieta fue elaborada a partir de una dieta padrón aumentada de colesterol y aceite de coco. La Sinvastatina (20 mg) fue administrada por 5 días por semana durante 8 semanas (20 mg/kg), junto al entrenamiento aeróbico en la estera (9,75 m/min) por 60 minutos por día. El músculo gastrocnemio colectado fue cortado y colorido por el método Hematoxilina-Eosina y sometido a una reacción histoquímica para verificar la actividad mitocondrial. Los datos fueron analizados utilizando el test t pareado, análisis de la variancia e Pos-Hoc de Scheffé, adoptándose p<0,05. Se verifico la presencia de alteraciones histológicas más significativas en los animales medicados y ejercitados, siendo también mayor la frecuencia de ocurrencia. El análisis histoquímica apunto que los grupos medicados presentaron fibras con actividad mitocondrial más intensa, al lado de fibras con pérdida de reacción. Los resultados de la morfometría no mostraron diferencias significativas entre los grupos estudiados. Se puede sugerir que la simvastatina es un medicamento que lleva a la ocurrencia de lesiones musculares e que su administración concomitante con la práctica de actividad física puede exacerbar estas lesiones, pudiendo tal hecho, estar relacionado con la respiración celular.

Physical exercise and statins, recommended interventions to dyslipidaemia treatment, are independently related to cardiomyocytes alterations, characterized by miocardic hypertrophy and apoptosis, respectively. Thus, the objective of the present study was to analyze the effects of statin and aerobic physical exercise association in the morphometric parameters of cardiac cell nucleus. 40 male rats adults were divided into four groups: exercised (DE); sedentary (DS), exercised and statin use (DES); sedentary and statin use (DSS). The animals received during the whole experimental period a hiperlipidic diet added 20% of coconut oil and 1.25% of cholesterol; after 30 days of its ingestión, a blood collection was made to verify the dyslipidaemia. Simvastatin (20 mg) was taken five days a week, during eight weeks. During this period, the animals exercised 60 minutes daily in the treadmill. After the last day of the protocol, the cardiac muscle was collected and maintained in liquid nitrogen (-180°C); the cuts were stained by Hematoxilin-Eosin method, and the cardiac fibers were submitted to the nuclear morphometric analyses. The data were analyzed using descriptive analyses, paired T test, Kruskal-Wallis test and Dunn post hoc test; for all analyses, it was adopted p<0.05. It was verified that the group receiving statin presented values statistically significant in comparison to the other groups, in the tridimensional and linear variables. The exercised and statin group, the values obtained in the morphometric analyses were similar to the control group. It is suggested that statins alone can cause alterations in the nucleus of cardiac cells that can be related to apoptosis occurrence and, when exercise is practiced associated to statin administration, the effects of statin can be reduced, what can be related to beneficial adaptations of cardiac mitochondrial in response to physical exercise, turning them more resistant to apoptotic stimuli.

El ejercicio físico y las estatinas, intervenciones recomendadas para tratamiento de la dislipidemia, están independientemente relacionadas con las alteraciones de los cardiomiocitos, que se caracterizan por hipertrofia miocárdica y apoptosis, respectivamente. El objetivo del presente estudio fue analizar los efectos de la asociación de estatinas y el ejercicio físico aeróbico en los parámetros morfométricos del núcleo de células cardíacas. 40 ratas macho adultas se dividieron en cuatro grupos: ejercitadas (DE); sedentarias (DS), ejercitadas y con uso de estatina (DES), sedentarias y con uso de estatina (DSS). Los animales recibieron durante todo el período experimental una dieta hiperlipidemica añadiendo 20% de aceite de coco y 1,25% de colesterol. Después de 30 días de su ingestión, se les extrajo sangre para verificar la dislipidemia. Los ejemplares ingirieron Simvastatina (20 mg) cinco días a la semana, durante ocho semanas. Durante este período, los animales ejercitaron 60 minutos diarios en la rueda de andar. Después del último día del protocolo,los animales fueron sacrificados y se les extrajo músculo cardiaco que fue mantenido en nitrógeno líquido (-180°C). De este material se obtuvieron cortes que fueron teñidos por el método de hematoxilina-eosina y las fibras cardiacas fueron sometidas a análisis morfométrico nuclear. Los datos fueron analizados mediante el análisis descriptivo, prueba de la t de Student, prueba de Kruskal-Wallis y Dunn test post hoc. Para todos los análisis fue aprobado p <0,05. Se comprobó que el grupo que recibió estatinas presentó valores estadísticamente significativos en comparación con los otros grupos, en las variables lineales y tridimensionales. En el grupo ejercitado y estatina, los valores obtenidos de los análisis morfométricos fueron similares a los del grupo control. Se sugiere que las estatinas, por sí solas, pueden causar alteraciones en el núcleo de las células cardiacas las cuales pueden estar relacionadas con la ocurrencia de apoptosis y, cuando se practica ejercicio asociado a la administración de estatina, los efectos de las estatinas pueden reducirse, pudiendo resultar beneficioso, en relación con las adaptaciones en la respuesta mitocondrial cardiaca al ejercicio físico, convirtiéndose en más resistentes a los estímulos de apoptosis.