Perinatal exposure to Bisphenol A and developmental programming of the cardiovascular changes in the offspring

: Bisphenol A (BPA) is an industrial ubiquitous compound, frequently used to produce synthetic polymers and epoxy resins. BPA is a well-recognized endocrine disruptor and xenoestrogen compound. Evidence from epidemiological and experimental studies suggests that perinatal BPA exposure (gestation and/or lactation) increases the risk of developing various diseases, including the cardiovascular system. Developmental programming refers to environmental insults during the critical window of development that affect the structure and physiology of body systems, causing permanent changes in later stages. BPA influences the developmental programming of non-communicable diseases in the offspring. In the present review, we discuss the developmental programming of cardiovascular diseases related to perinatal exposure to BPA, supported by epidemiological and experimental evidence from published literature. The majority of the reported studies found a positive association between perinatal BPA exposure and adverse cardiovascular repercussions in the fetal, neonatal, and adulthood stages. The possible underlying mechanisms include epigenetic modifications of genes involved in cardiac muscle development, autonomic tone, collagenous and non-collagenous extracellular matrix, cardiac remodeling and calcium homeostasis, and mitochondrial energy metabolism. Epigenetics can modify the outcome of any disease. Hence, in the present review, we also discuss the role of epigenetics in preventing cardiovascular diseases following perinatal exposure to BPA. We also highlight how future treatment and drug delivery related to cardiovascular involvement could be based on epigenetic markers.

Evaluating the Effectiveness of Distance Learning Physical Education for Disabled Students

The article discusses the effectiveness of the application of the distance learning program at the level of the functional state and reserve capacities of the organism of students with disabilities: for 12 students of 17-19 years old with idiopathic structural scoliosis of II and III degrees of S-shaped type, engaged in a full-time program (stage I) and for the same students studying remotely (stage II), it was studied the functional indicators of the cardiovascular and autonomic nervous system, the function of external respiration, the tone of the paravertebral muscles of the back and neck, as well as indicators of strength and endurance. Then a comparison was made of the studied indicators of stages I and II. It is shown that distance learning has a negative impact on the health of students: hypertonicity of the muscles of the back and neck significantly increases almost twice (the most sensitive is the cervicothoracic region), there is a shift of autonomic tone by 10.73% towards sympathicotonia: heart rate blood pressure increased by 19.06% by 7.9%, respiratory rate by 7.92%, tidal and minute volumes by 17.8-20%, respectively. At the same time, strength endurance and the level of performance decrease by 11.7%. Such changes contribute to the tension of neurohumoral mechanisms of self-regulation, which leads to a decrease in the stock of functional reserves and significantly narrows the range of possible adaptive responses. It is shown that the informatization of the educational system in the edu cational process of students with disabilities should be of a mixed type, where the traditional form of classes remains the leading one.

Insomnia diagnosis and management: an osteopathic approach

Insomnia affects a large percentage of American adults and is among the most commonly treated medical conditions in the outpatient clinical setting. The psychological, medical and financial impact of insomnia is substantial. Research indicates that pharmacologic treatment is associated with significant risk, and clinicians should consider other modalities including cognitive behavioral therapy before prescribing medications for the treatment of insomnia. Other complementary treatments including yoga, stress management and traditional Chinese medical therapies are promising, but more research is needed. The osteopathic family physician plays an important role in diagnosis and management. An osteopathic approach to patient care is highly beneficial and includes a multifaceted evaluation when taking a patient history and osteopathic manipulative treatment (OMT) to balance autonomic tone and correct associated somatic dysfunction.

The application of vagus nerve stimulation in individuals with misophonia

Stimulating the Vagus nerve helps maintain the autonomic tone, indicating stabilising any hyperactivity in the nervous system. The vagus nerve stimulation is applied in individuals with seizures, depression, sepsis, pain, obesity, cardiovascular disease, lung disease, diabetes, stroke, and traumatic brain injury. Auditory neuroscience has been widely applied in individuals with tinnitus and has been demonstrated as a successful neuromodulation technique. Individuals with peripheral lesions of the hair cells induce a maladaptive change in the plasticity resulting in hyperactivity in the auditory and non-auditory structures. In order to reduce this hyperactivity, neuromodulation techniques such as; transcranial magnetic stimulation, transcranial direct current stimulation, transcranial alternating current stimulation, transcranial random noise stimulation, neurofeedback, epidural and subdural cortical and deep brain stimulation. The vagus nerve stimulation is also one form of neuromodulation technique considered to reduce the symptoms of tinnitus. It is believed that the ramus Auricularis Nervi vagi, an afferent sensory branch of the vagus nerve, innervates the afferent sensory branch of the vagus nerve, the ramus auricularis nervi vagi also innervate the outer ear canal and parts of the auricle. This auricular branch of the vagus nerve also called Arnold's nerve, which gives a projection to the nucleus of the solitary tract. The vagus nerve stimulation in individuals with tinnitus works to activate the auricular branch of the vagus nerve to reduce its symptoms. A similar principle of vagus nerve stimulation can be tried upon in individuals with misophonia. Literatures states that individuals with misophonia have hyperactivity in their non-classical auditory pathway that can be suppressed with the help of vagus nerve stimulation. The article discusses the possible effects of vagus nerve stimulation in individuals with misophonia.

Autonomic modulation of ventricular electrical activity: recent developments and clinical implications

Purpose This review aimed to provide a complete overview of the current stance and recent developments in antiarrhythmic neuromodulatory interventions, focusing on lifethreatening vetricular arrhythmias. Methods Both preclinical studies and clinical studies were assessed to highlight the gaps in knowledge that remain to be answered and the necessary steps required to properly translate these strategies to the clinical setting. Results Cardiac autonomic imbalance, characterized by chronic sympathoexcitation and parasympathetic withdrawal, destabilizes cardiac electrophysiology and promotes ventricular arrhythmogenesis. Therefore, neuromodulatory interventions that target the sympatho-vagal imbalance have emerged as promising antiarrhythmic strategies. These strategies are aimed at different parts of the cardiac neuraxis and directly or indirectly restore cardiac autonomic tone. These interventions include pharmacological blockade of sympathetic neurotransmitters and neuropeptides, cardiac sympathetic denervation, thoracic epidural anesthesia, and spinal cord and vagal nerve stimulation. Conclusion Neuromodulatory strategies have repeatedly been demonstrated to be highly effective and very promising anti-arrhythmic therapies. Nevertheless, there is still much room to gain in our understanding of neurocardiac physiology, refining the current neuromodulatory strategic options and elucidating the chronic effects of many of these strategic options.

Chronic Exposure to High Doses of Bisphenol A Exhibits Significant Atrial Proarrhythmic Effects in Healthy Adult Rats

Objectives: We aimed to evaluate the effects of chronic exposure to bisphenol A (BPA) on atrial fibrillation (AF) occurrence in rats. Methods: Twenty-two healthy female Wistar rats were randomized into three groups: Control (no BPA; n=7), BPA (exposed to usual BPA doses; 50 μg/kg/day, 9 weeks; n=7), and hBPA (exposed to high BPA doses; 25 mg/kg/day, 9 weeks; n=8). 24-h ECG monitoring was performed using radiotelemetry ECG devices prior to and after transesophageal atrial pacing. Spontaneous and pacing-induced atrial arrhythmias, autonomic tone, and in vivo an in vitro atrial arrhythmogenicity-related parameters were evaluated. Results: All studied parameters were similar between Control and BPA (all p>0.05). However, compared to Control, hBPA presented more atrial premature beats both at baseline (p=0.04) and after pacing (p=0.03), more AF episodes (p<0.001) and of longer duration (p=0.02) following transesophageal stimulation, and significantly higher vagal tone (all p<0.05). Conclusions: Chronic exposure to high, but not usual BPA doses induced significant atrial proarrhythmic effects in healthy rats, and this may be at least partially due to BPA-induced vagal hyperactivation. Exposure to high BPA doses, such as that occurring in plastics industry workers, could favor AF occurrence even in the absence of underlying cardiovascular disease.

Sex Differences in Molecular Mechanisms of Cardiovascular Aging

Cardiovascular disease (CVD) is still the leading cause of illness and death in the Western world. Cardiovascular aging is a progressive modification occurring in cardiac and vascular morphology and physiology where increased endothelial dysfunction and arterial stiffness are observed, generally accompanied by increased systolic blood pressure and augmented pulse pressure. The effects of biological sex on cardiovascular pathophysiology have long been known. The incidence of hypertension is higher in men, and it increases in postmenopausal women. Premenopausal women are protected from CVD compared with age-matched men and this protective effect is lost with menopause, suggesting that sex-hormones influence blood pressure regulation. In parallel, the heart progressively remodels over the course of life and the pattern of cardiac remodeling also differs between the sexes. Lower autonomic tone, reduced baroreceptor response, and greater vascular function are observed in premenopausal women than men of similar age. However, postmenopausal women have stiffer arteries than their male counterparts. The biological mechanisms responsible for sex-related differences observed in cardiovascular aging are being unraveled over the last several decades. This review focuses on molecular mechanisms underlying the sex-differences of CVD in aging.