Cardiac arrest patients admitted to intensive care unit after cardiopulmonary resuscitation: a retrospective cohort study to find predictors for mortality

Abstract Background In-hospital cardiac arrest is a common situation in hospital settings. Therefore, healthcare providers should understand the reasons that could affect the results of cardiopulmonary resuscitation. We aimed to determine the independent predictors for poor outcomes after the return of spontaneous circulation in in-hospital cardiac arrest patients, and also look for a relationship between patient's background parameters and the status at intensive care unit. Methods We did a retrospective cohort study using cardiac arrest patients admitted to the intensive care unit after successful cardiopulmonary resuscitation between 2011-2015. Patients' data were gathered from hospital database. Estimated probabilities of survival were computed using the Kaplan-Meier method. Cox proportional hazard models were used to determine associated risk factors for mortality. Results In total, 197 cardiac arrest patients were admitted to anesthesia intensive care unit after successful cardiopulmonary resuscitation in a 4-years period. Of 197 patients, 170 (86.3%) died in intensive care unit. Median of survival days was 4 days. Comorbidity (p= 0.01), higher duration of cardiopulmonary resuscitation (p= 0.02), lower Glasgow Coma Score (p= 0.00), abnormal lactate level (p= 0.00), and abnormal mean blood pressure (p= 0.01) were the main predictors for increased mortality in cardiac arrest patients after intensive care unit admission. Conclusion The consequent clinical status of the patients is affected by the physiological state after return of spontaneous circulation. Comorbidity, higher duration of cardiopulmonary resuscitation, lower arrival Glasgow Coma Score, abnormal lactate level, and abnormal mean blood pressure were the main predictors for increased mortality in patients admitted to the intensive care unit after successful cardiopulmonary resuscitation.

Lung ultrasonography as a tool to guide perioperative atelectasis treatment bundle in head and neck cancer patients undergoing free flap reconstructive surgeries: a preliminary observational study / Ultrassonografia pulmonar como ferramenta para orientar o tratamento perioperatório de atelectasia em pacientes com câncer de cabeça e pescoço submetidos a cirurgia reconstrutiva com retalho livre: um estudo observacional preliminar

Abstract Introduction: General anesthesia causes pulmonary atelectasis within few minutes of induction. This can have significant impact on postoperative outcome of cancer patients undergoing prolonged reconstructive surgeries. Objective: The purpose of this study was to evaluate the impact of sonographically detected perioperative atelectasis on the need for postoperative oxygen supplementation, bronchodilator therapy and assisted chest physiotherapy in patients undergoing free flap surgeries for head and neck carcinoma. Methods: Twenty eight head and neck cancer patients underwent bilateral pulmonary ultrasonographic assessments before and after lung surgery. Lung ultrasound scores, serum lactate, and PaO2/FiO2 ratio were measured both at the beginning and at end of the surgery. Patients were scanned in the supine position and the number of single and confluent B lines was noted. These values were correlated with the need for oxygen therapy, requirement of bronchodilators and total weaning time to predict the postoperative outcome. Other factors affecting weaning were also studied. Results: Among twenty eight patients, seven had mean lung ultrasound score of ≥10.5 which correlated with prolonged weaning time (144.56±33.5min vs. 66.7±15.7min; p = 0.005). The change in lung ultrasound score significantly correlated with change in PaO2/FiO2 ratio (r = −0.56, p = 0.03). Elevated total leukocyte count >8200 ΜL and serum lactate >2.1 mmoL/L also predicted prolonged postoperative mechanical ventilation. Conclusion: This preliminary study detected significant levels of perioperative atelectasis using point of care lung ultrasonography in head and neck cancer patients undergoing long duration surgical reconstructions. Higher lung ultrasound scores highlighted the need for frequent bronchodilator nebulizations as well as assisted chest physiotherapy and were associated with delayed weaning. We propose more frequent point of care lung ultrasonographic evaluations and use of recruitment maneuvers to reduce the impact of perioperative pulmonary atelectasis.

Resumo Introdução: A anestesia geral causa atelectasia pulmonar poucos minutos após sua indução. Isso pode ter um impacto significativo no resultado pós-operatório de pacientes com câncer submetidos a cirurgias reconstrutivas prolongadas. Objetivo: Avaliar o impacto das atelectasias perioperatórias detectadas por ultrassonografia na necessidade de suplementação pós-operatória de oxigênio, terapia broncodilatadora e fisioterapia respiratória assistida em pacientes com carcinoma de cabeça e pescoço submetidos a cirurgias com uso de retalho livre. Método: Foram submetidos a avaliações ultrassonográficas pulmonares bilaterais antes e após a cirurgia 28 pacientes com câncer de cabeça e pescoço. Os escores de ultrassonografia pulmonar, lactato sérico, razão PaO2/FiO2 foram medidos no início e no fim da cirurgia. Os pacientes foram avaliados na posição supina e o número de linhas B confluentes e únicas foi observado. Esses valores foram correlacionados com a necessidade de oxigenoterapia, necessidade de broncodilatadores e tempo total de desmame para predizer o resultado pós-operatório. Outros fatores que afetam o desmame também foram estudados. Resultados: Entre os 28 pacientes, sete apresentaram escore médio de ultrassonografia pulmonar ≥ 10,5, que se correlacionou com o tempo de desmame prolongado (144,56 ± 33,5 minutos vs. 66,7 ± 15,7 minutos; p = 0,005). A mudança no escore de ultrassonografia pulmonar correlacionou-se significantemente com a mudança na razão PaO2/FiO2 (r = −0,56, p = 0,03). A contagem total elevada de leucócitos > 8200 uLe o nível de lactato sérico >2,1 mmoL/L também previram ventilação mecânica pós-operatória prolongada. Conclusão: Este estudo preliminar detectou um nível significante de atelectasia perioperatória com ultrassonografia pulmonar no local de atendimento em pacientes com câncer de cabeça e pescoço submetidos a reconstruções cirúrgicas de longa duração. Escores mais altos de ultrassonografia pulmonar enfatizaram a necessidade de nebulizações broncodilatadoras frequentes e fisioterapia respiratória assistida e foram associados a desmame tardio. Propomos avaliações ultrassonográficas pulmonares mais frequentes no local de atendimento e o uso de manobras de recrutamento para reduzir o impacto das atelectasias pulmonares perioperatórias.

Predictive factors of prolonged ventilation following cardiac surgery with cardiopulmonary bypass

Abstract Introduction: In this trial, we initially aimed to investigate the major predictive factors for prolonged mechanical ventilation (PMV) following cardiac surgery with cardiopulmonary bypass (CPB) in our center and, secondarily, we tried to find out the effects of the independent factors on mortality. Methods: Between July 2017 and August 2018, 207 patients who underwent cardiac surgery with CPB were retrospectively investigated. The patients were randomly divided into two subgroups according to the duration of ventilator dependence (group 1 <24 hours, n=164, 79%; group 2 >24 hours, n=43, 21%). Results: 207 patients (mean age 59.47±10.56) who underwent cardiac surgery with CPB were enrolled in this study (n=145, 70% of male patients; n=62, 30% of female patients). Amid these patients, 43 (n=43, 20.77%) had prolonged intubation time. After multivariate logistic regression analysis among preoperative factors, female gender (OR=2.321, P=0.028), leukocytosis (OR=1.233, P=0.006), perioperative lactate level (OR=1.224, P=0.027), CPB time (OR=1.012, P=0.012) and postoperative revision for bleeding (OR=23.125, P=0.040) were significantly detected. The effect of predictive factors on mortality after cardiac surgery was determined and found that PMV did not affect hospital mortality (OR=1.979, P=0.420). Conclusion: In our report, we revealed, differently from previous studies, that intraoperative lactate levels which manifest organ perfusion and oxygenation were included and were significantly different in the early extubation group compared to the PMV group. Female gender, preoperative leukocytosis, intraoperative CPB time, lactate levels and postoperative revision for bleeding were the independent predictive factors for PMV. Moreover, PMV did not affect the early-term mortality during hospital stay.

O efeito agudo do fst-7 no desempenho, variáveis metabólicas e respostas perceptivas em homens bem treinados / Acute effect of fst-7 on performance, metabolic variables, and perceptual responses in well-trained men

O método Fascia Stretch Training 7 Sets (FST-7) ganhou popularidade nos últimos anos sendo disseminado por fisiculturistas norte-americanos. O objetivo do presente estudo foi comparar os efeitos do protocolo de treinamento do método FST-7 com ou sem alongamento passivo entre as séries nas variáveis metabólicas (lactato [LAC] e creatinofosfoquinase [CPK]), desempenho (volume total de treinamento ­ VTT) e percepção subjetiva de esforço (PSE) em homens bem treinados. Nove homens (23, 2 ± 1,7 anos; 174,2 ± 6,2 cm; 84,6 ± 9,8 kg, 3,4 ± 1,0 anos de experiência em treinamento de força) foram submetidos ao teste e re-teste de 10 repetições máximas (10RM) nos exercícios supino reto livre e crucifixo horizontal com halteres em dias distintos, respeitando 48 horas de intervalo entre a s sessões de teste e re-teste. Decorridas 72 horas do último dia de teste, os participantes realizaram os protocolos experimentais de forma randomizada com 72 horas de intervalo entre as sessões. As coletas sanguíneas foram realizadas 10 minutos antes e imediatamente após os protocolos de treinamento. O protocolo sem alongamento aumentou significativamente a concentração de LAC (p = 0,029). No entanto, o mesmo não ocorreu para a concentração de CPK (p = 0,302). O VTT foi maior para o protocolo sem alongamento (p < 0,001) e a PSE foi maior para o protocolo com alongamento entre as séries (p = 0,003). Concluímos que o método FST-7 com alongamento resultou em uma maior PSE, o que pode estar relacionado com o declínio do desempenho, traduzido pelo menor VTT em relação à condição sem alongamento. Adicionalmente, o menor VTT pode ter afetado o menor acúmulo de LAC observado no método FST-7 com o alongamento. (AU)

The Fascia Stretch Training 7 Sets (FST-7) method has gained popularity in the recent years being disseminated by American bodybuilders. The purpose of the study was to compare the effects of the Fascia Stretch Training 7 Sets (FST-7) method with or without passive stretching between sets on metabolic variables (lactate [LAC] and creatine kinase [CK]), performance (total training volume - TTV) and rating of perceived exertion (RPE) in trained men. For this, nine recreationally trained men (23.2 ± 1.7 years; 174.2 ± 6.2 cm; 84.6 ± 9.8 kg, 3.4 ± 1.0 years of experience in strength training) were submitted to the test and re-test of 10 repetition maximum (10RM) in the barbell bench press and fly with dumbbells on different days, respecting a 48-hour interval between the test and re-test sessions. After 72 hours of the last test day, participants performed the experimental protocols in randomized order with a 72-hour interval between sessions. Blood samples were taken 10 minutes before and immediately after the training protocols. The protocol without stretching was significantly increased LAC concentrations (p = 0.029). However, the same did not occur for the concentration of CK (p = 0.302). The TTV was higher for the protocol without stretching (p < 0.001), and the RPE was significantly higher for the protocol with stretching between sets (p = 0.003). We concluded that the FST-7 method with stretching resulted in higher RPE, which may be related to the decline in performance, translated by the lower TTV in relation to the condition without stretching. This lower TTV may have affected the lower LAC accumulation observed in the FST-7 method with stretching. (AU)

A ingestão do anti-inflamatório não esteroide naproxeno afeta parâmetros neuromusculares e metabólicos? / Does the ingestion of naproxen affect neuromuscular and metabolic parameters?

O naproxeno, assim como outros anti-inflamatórios não esteroides (AINEs), está entre os medicamentos mais prescritos no mundo. O objetivo do presente estudo é analisar o efeito da ingestão de naproxeno em parâmetros neuromusculares e determinar seu efeito no dano muscular por meio do uso do marcador lactato. Metodologicamente, foi conduzido um estudo cruzado randomizado, duplo-cego e controlado por placebo em 11 homens treinados em resistência, que realizaram uma sessão de treinamento de força após ingerir 500 mg de naproxeno e outra sessão de treinamento após ingerir um placebo. Os participantes realizaram três séries de supino horizontal com uma carga de 90% da repetição máxima (1RM) até a falha concêntrica. As variáveis de resultado incluíram número de repetições, carga de trabalho e lactato. Os resultados mostraram que há uma correlação positiva e moderada entre as variáveis somatório de repetições e carga total e entre as variáveis lactato e carga total, no grupo naproxeno. No grupo placebo, a correlação positiva e moderada deu-se entre somatório de repetições e carga total. Na análise magnitude baseada nas interferências, as variáveis se mostraram possíveis para uma probabilidade positiva ou trivial e improvável para uma probabilidade negativa. Concluiu-se no presente estudo que o uso do naproxeno como recurso ergogênico no treinamento de força reduz a percepção de fadiga, mas não tem efeito direto no dano muscular, analisado a partir do marcador lactato, logo não interfere de maneira significativa nos parâmetros neuromusculares analisados.

Naproxen, as other non-steroidal anti-inflammatory drugs (NSAIDs), features among the most widely prescribed drugs in the world. The aim of this study is to analyze the effect of naproxen intake on neuromuscular parameters and determine its effect on muscle damage through the use of the lactate marker. In terms of methodology, a randomized, double-blind, placebo-controlled crossover study was conducted on 11 resistance-trained men who underwent a strength training session after taking 500 mg of naproxen and another training session after taking a placebo. The participants performed three sets of horizontal bench presses with a load of 90% maximum repetition (1RM) until concentric failure. Result variables included number of repetitions, workload and lactate. The results showed that there is a positive and moderate correlation between the sum of repetition and total load variables and between lactate and total load variables in the naproxen group. In the placebo group, a positive and moderate correlation was observed between sum of repetitions and total load. In the magnitude analysis, based on the interferences, the variables were shown to be possible for a positive or trivial probability and unlikely for a negative probability. It was concluded that the use of naproxen as an ergogenic resource in strength training reduces the perception of fatigue but has no direct effect on muscle damage when analyzed from the lactate marker, therefore it does not significantly interfere in the analyzed neuromuscular parameters.

Salvianolic acid A alleviates the renal damage in rats with chronic renal failure

Abstract Purpose: To investigate the protective effects of salvianolic acid A (SAA) on renal damage in rats with chronic renal failure (CRF). Methods: The five-sixth nephrectomy model of CRF was successfully established in group CRF (10 rats) and group CRF+SAA (10 rats). Ten rats were selected as sham-operated group (group S), in which only the capsules of both kidneys were removed. The rats in group CRF+SAA were intragastrically administrated with 10 mg/kg SAA for 8 weeks. The blood urine nitrogen (BUN), urine creatinine (Ucr), creatinine clearance rate (Ccr), and serum uperoxide dismutase (SOD) and malondialdehyde (MDA) were tested. The expressions of transforming growth factor-β1 (TGF-β1), bone morphogenetic protein 7 (BMP-7) and Smad6 protein in renal tissue were determined. Results: After treatment, compared with group CRF, in group CRF+SAA the BUN, Scr, serum MDA and kidney/body weight ratio were decreased, the Ccr and serum SOD were increased, the TGF-β1 protein expression level in renal tissue was decreased, and the BMP-7 and Smad6 protein levels were increased (all P < 0.05). Conclusion: SAA can alleviate the renal damage in CRF rats through anti-oxidant stress, down-regulation of TGF-β1 signaling pathway and up-regulation of BMP-7/Smad6 signaling pathway.

Assessment of serum lactate levels, blood glucose values and blood gas values in sheep, newborn lambs and placenta / Avaliação da concentração de lactato sérico, glicemia e hemogasometria de ovelhas, cordeiros recém-nascidos e placenta

Newborn animals, in the fetal-to-neonatal transition, usually face several challenges in their first 24 hours, including issues with acid-base balance, glycemic levels and oxygenation. Difficulties to overcome such issues have caused several deaths among newborns. Therefore, studies have been carried out in order to evaluate them. The main purpose of this study is to evaluate the correlation between the serum lactate level in the mother, in the placenta and in the newborn. Moreover, the study measured the lactate level, blood glucose level and blood gas level in the first 24 hours. Tests were carried out right after birth, and at 4, 8, 12 and 24 hours after. Lactate levels were quite similar to the placental levels (p=0.991) which, in turn, were significantly different from the mother's (p=0.011). Results showed that, shortly after birth, the production of lactate in the placenta is part of the issue. Along the first 24 hours, the study observed a reduction of the levels of lactate in newborns; the levels were closer to the normal index levels for the species. Regarding the blood gas test results, we observed mild metabolic acidosis at birth; acid-base balance was completely stable at the end of the period.(AU)

Os principais desafios da transição fetal-neonatal são a estabilização do equilíbrio ácido-básico, glicemia e oxigenação ao longo das primeiras 24 horas de vida. Falhas nesse sistema são a maior causa de morte nesse período e os estudos de viabilidade neonatal tem se concentrado nas avaliações destas variáveis. O objetivo do presente estudo foi avaliar a comparação da lactatemia materna, placentária e neonatal ao nascimento e, ainda, observar o comportamento do lactato, glicemia e hemogasometria nas primeiras 24 horas de vida do neonato ovino. Para tanto, as avaliações foram realizadas ao nascimento, 4, 8, 12 e 24 horas após. A lactatemia neonatal se mostrou próxima à placentária (p=0,991) e significativamente diferente da materna (p=0,011), o que sugere uma influência da produção de lactato pela placenta na lactatemia neonatal ao nascimento. Ao longo das 24 horas de vida foi possível observar a depuração de lactato pelo organismo do neonato, aproximando assim dos valores de referência para a espécie. Na hemogasometria foi possível observar discreta acidose metabólica, com normalização já nas primeiras 4 horas e estabilização completa do equilíbrio ácido-básico ao final das 24 horas de vida.(AU)

Avaliação da lactatemia e das enzimas musculares de equinos Quarto de Milha submetidos à prova de laço em dupla com diferentes tipos de treinamento / Evaluation of lactatemia and muscle enzymes in Quarter Horses subjected to team ropping with different types of training

O objetivo do trabalho foi avaliar a influência de diferentes tipos de treinamento sobre o condicionamento físico de equinos por meio da determinação do lactato sanguíneo e da atividade sérica de creatina quinase, aspartato aminotransferase e lactato desidrogenase após exercício físico de alta intensidade e curta duração. Amostras de sangue venoso foram obtidas de 16 equinos da raça Quarto de Milha, divididos em dois grupos: grupo de treinamento regular (GTR) e grupo de treinamento esporádico (GTE), em sete diferentes momentos: 30 minutos antes do exercício (M0), imediatamente após (M1), 30 minutos (M2), uma (M3), duas (M4), seis (M5) e 24 (M6) horas após o exercício. Para a análise estatística, os dados foram testados quanto à normalidade e homogeneidade de variâncias. Para comparar os grupos e os momentos em cada grupo foram utilizados testes paramétricos (ANOVA) para a análise das atividades séricas das enzimas musculares e não paramétricos (Mann-Whitney e Friedmann) para a análise do lactato sanguíneo (P<0,05). Não houve diferença significativa entre os grupos para nenhuma variável. No entanto, dentro dos grupos experimentais foi possível observar diferenças significativas entre os momentos avaliados, em relação ao lactato e à LDH. No GTE, foram observadas diferenças significativas quanto ao lactato, entre o M0 e o M1, com valores respectivos de 0,90 mmol/L (mín. 0,8 - máx. 1,6) e 3,65mmo/L (mín. 1,0 - máx. 5,7) e quanto à LDH, onde os valores descritos no M6 diferiram significativamente de M0, M1, M2, M3 e M4. No GTR, diferenças significativas entre os momentos experimentais foram observadas em relação à LDH, sendo que os valores observados no M6 foram os menores e diferiram significativamente daqueles encontrados no M1, M2, M3 e M4. Em conclusão, não houve diferença entre o condicionamento físico dos animais treinados regularmente e aqueles treinados esporadicamente. A baixa magnitude das elevações das concentrações de CK, AST e LDH após o exercício e o rápido retorno aos valores basais, inclusive do lactato, observados em ambos os grupos, sugere que todos os animais avaliados estavam condicionados e aptos a realizar tal atividade física.(AU)

The aim of this study was to evaluate the influence of different types of training on physical fitness through the determination of blood lactate and serum creatinine kinase, aspartate aminotransferase, and lactate dehydrogenase activity after high intensity and short duration physical exercise. Venous blood samples were obtained from 16 Quarter Horses, divided into two groups: the regular training group (GTR) and sporadic training group (GTE), in seven different moments: 30 minutes before exercise (M0), immediately after the exercise (M1), 30 minutes (M2), one hour (M3), two hours (M4), six hours (M5) and 24 hours (M6) after the exercise. For statistical analysis, data was tested for normality and homogeneity of variances. To compare the groups and times in each group, parametric tests (ANOVA) were used for muscular enzymes activity and not parametric tests (Mann-Whitney and Friedmann) were used to analyze blood lactato (P<0.05). There was no significant difference between groups for any variable. However, within the experimental groups it was possible to observe significant differences between the evaluated moments, in relation to lactate and LDH. In the GTE, significant differences were observed for lactate between M0 and M1, with respective values ​​of 0.90 mmol/L (min. 0.8, max. 1.6) and 3.65 mmol/L (min. 1.0, max. 5,7) and for LDH, where the values ​​described in M6 differed significantly from M0, M1, M2, M3 and M4. In the GTR, significant differences between the experimental moments were observed in relation to LDH, and the values ​​observed in M6 were the lowest and differed significantly from those found in M1, M2, M3 and M4. In conclusion, there was no difference between the fitness of animals regularly trained and those trained sporadically. The low magnitude of elevations of serum CK, AST and LDH activity after exercise and the quick return to baseline values, including the blood lactate observed in both groups, suggest that all of evaluated animals were conditioned and able to perform such physical activity.(AU)

Effectiveness of a new non-hydrogen peroxide bleaching agent after single use - a double-blind placebo-controlled short-term study

Abstract Tooth whitening represents perhaps the most common aesthetic procedure in dentistry worldwide. The efficacy of bleaching depends on three aspects: bleaching agent, bleaching method, and tooth color. Objective: This in vivo study aimed to examine whitening effects on frontal teeth of the upper and lower jaws using an over-the-counter (OTC) non-hydrogen peroxide bleaching agent in comparison to a placebo after one single use. Material and methods: Forty subjects (25 female; 15 male) participated in this double-blind randomized placebo-controlled trial. The subjects were randomly allocated to two groups (n=20). The test group received the OTC product (iWhite Instant) and the placebo group received an identically composed product except for the active agents. Each subject was treated with a prefilled tray containing iWhite Instant or the placebo for 20 minutes. The tooth shade of the front teeth (upper and lower jaws) was assessed before (E_0), immediately after (E_1) and 24 h after treatment (E_2), using a shade guide (VITA classical). Statistical testing was accomplished using the Mann-Whitney U test (p<0.001). The dropout rate was 0%. Results: There were no significant differences at E_0 between placebo and test groups regarding the tooth color. Differences in tooth color changes immediately after (ΔE1_0) and 24 h after treatment (ΔE2_0) were calculated for both groups. The mean values (standard deviations) of tooth color changes for ΔE1_0 were 2.26 (0.92) in the test group and 0.01 (0.21) in the placebo group. The color changes for ΔE2_0 showed mean values of 2.15 (1.10) in the test group and 0.07 (0.35) in the placebo group. For ΔE1_0 and ΔE2_0 significant differences were found between the groups. Conclusion: In this short-term study, the results showed that a non-hydrogen peroxide bleaching agent has significant whitening effects immediately and 24 h after a single-use treatment.

Candidate genes for performance in horses, including monocarboxylate transporters / Genes candidatos para desempenho em equinos, incluindo transportadores de monocarboxilatos

Some horse breeds are highly selected for athletic activities. The athletic potential of each animal can be measured by its performance in sports. High athletic performance depends on the animal capacity to produce energy through aerobic and anaerobic metabolic pathways, among other factors. Transmembrane proteins called monocarboxylate transporters, mainly the isoform 1 (MCT1) and its ancillary protein CD147, can help the organism to adapt to physiological stress caused by physical exercise, transporting lactate and H+ ions. Horse breeds are selected for different purposes so we might expect differences in the amount of those proteins and in the genotypic frequencies for genes that play a significant role in the performance of the animals. The study of MCT1 and CD147 gene polymorphisms, which can affect the formation of the proteins and transport of lactate and H+, can provide enough information to be used for selection of athletic horses increasingly resistant to intense exercise. Two other candidate genes, the PDK4 and DMRT3, have been associated with athletic potential and indicated as possible markers for performance in horses. The oxidation of fatty acids is highly effective in generating ATP and is controlled by the expression of PDK4 (pyruvate dehydrogenase kinase, isozyme 4) in skeletal muscle during and after exercise. The doublesex and mab-3 related transcription factor 3 (DMRT3) gene encodes an important transcription factor in the setting of spinal cord circuits controlling movement in vertebrates and may be associated with gait performance in horses. This review describes how the monocarboxylate transporters work during physical exercise in athletic horses and the influence of polymorphisms in candidate genes for athletic performance in horses.(AU)

Algumas raças de equinos são altamente selecionadas para atividades desportivas. O potencial atlético de cada animal pode ser medido pelo seu desempenho nas competições equestres. Um alto potencial atlético depende, entre outros fatores, da capacidade do animal de produzir energia através dos metabolismos aeróbio e anaeróbio. As proteínas transmembrana chamadas transportadores de monoxarboxilato, principalmente a isoforma 1 (MCT1) e sua proteína auxiliar CD147, podem ajudam o organismo a se adaptar ao estresse fisiológico causado pelo exercício físico, transportando íons lactato e H+. Algumas raças de equinos são selecionadas para diferentes objetivos, portanto é provável que existam diferenças nas quantidades de transportadores monocarboxilatos e na frequência genotípica dos seus respectivos genes. O estudo de polimorfismos nos genes das proteínas MCT1 e CD147, afetando a sua formação e o transporte dos íons lactato e H+, podem fornecer informações suficientes para a seleção de equinos com capacidade de serem altamente treinados e resistentes a intensos exercícios. Dois outros genes candidatos que têm sido relacionados com potencial atlético e utilizados como possíveis marcadores para desempenho em equinos são o PDK4 e o DMRT3. A oxidação de ácidos graxos é altamente efetiva para produção de ATP e é controlada pela expressão do gene PDK4 (pyruvate dehydrogenase kinase, isozyme 4) no musculo esquelético durante e após do exercício físico. O gene DMRT3 (doublesex and mab-3 related transcription factor 3) codifica um importante fator de transcrição no controle dos movimentos em vertebrados e pode ser associado com a marcha em algumas raças de equinos. Esta revisão descreve como agem os transportadores de monocarboxilatos durante o exercício físico em equinos atletas e qual a influência de alguns polimorfismos em genes candidatos para o desempenho atlético em equinos.(AU)

Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Abstract The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA–DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler.

Valores de lactato sérico e sua correlação com parâmetros clínicos de cães saudáveis, mensurados durante atendimento ambulatorial veterinário / Serum lactate values and its correlation with clinical parameters evaluated at veterinary ambulatorial exam

A mensuração do lactato sérico é utilizada na rotina médica como marcador prognóstico de pacientes em estado de emergência. Sua interpretação não deve ser feita de forma isolada, mas conjunta aos demais parâmetros clínicos, pois seus valores podem sofrer interferência do estresse metabólico ou ambiental, contenção física e/ ou manipulação dos pacientes. Assim, buscou-se mensurar os valores do lactato sérico e parâmetros clínicos de cães saudáveis, bem como as suas correlações, durante o atendimento clínico ambulatorial veterinário. Para isso, foram avaliados 80 cães, machos ou fêmeas, com idade de um a oito anos, atendidos para revacinação anual polivalente. Foram considerados cães saudáveis os que não apresentaram intercorrências clínicas nos últimos 60 dias e alterações nos exames físicos e nos valores de hemograma e glicemia sérica. Foram mensurados inicialmente o peso corporal, a frequência cardíaca (FC) e respiratória (FR), tempo de preenchimento capilar (TPC), coloração de mucosas, temperatura retal (TR), periférica (TP) e a diferença entre TR e a TP, o Delta T°C. Por último, realizaram-se os exames de hemograma e glicemia sérica, juntamente com a mensuração do lactato sérico, utilizando para isso um lactímetro portátil, por meio da amostra sanguínea obtida da veia cefálica. Além disso, havendo a correlação dos valores do lactato séricos com o peso corporal os cães foram divididos conforme o cálculo do 33° e 66° percentil. Os cães avaliados evidenciaram valores médios de 18,3±12,1 kg de peso corporal e 3,0±1,9 anos de idade; FC de 126,6±29,1bpm, FR de 66±24mpm, TR de 38,9±0,4°C, TP de 31,5±1,0°C, Delta TºC de 7,3±1,0°C e lactato sérico de 3,2±0,4mmol/L; com este último, evidenciando intervalo de confiança a 95% de 3,1-3,3mmol/L e correlação significativa (p<0,05) dos seus valores com o peso corporal (r=0,6) e a frequência cardíaca (r=0,4). Os valores do lactato sérico obtidos foram comparados entre os grupos de cães conforme o peso corporal, evidenciando diferenças significativas (p<0,05) entre eles. Dessa forma, pode se concluir que os valores do lactato sérico em cães hígidos sob atendimento ambulatorial é de 3,2mmol/L, com o intervalo de confiança de 3,1-3,3mmol/L, ressaltando a influência que a FC e o peso corporal podem exercer nos seus valores.(AU)

The measurement of serum lactate is used in the medical routine as a prognosis marker of emergency patients. Its interpretation should not be done disconnectedly from the other clinical parameters once metabolical or environmental stress as well as restraint and/or manipulation of patients can interfere. Thus we tried to measure the levels of serum lactate and clinical parameters of healthy dogs, as their correlation during veterinarian outpatient clinical care. For that we evaluated 80 dogs, males and females, with age ranging from one to eight years, met for polyvalent annual revaccination. We considered to be healthy those dogs that had no clinical events in the last 60 days or alteration in physical exams, blood exam values and serum glycemia. We initially measured body weight, heart rate (HR) and respiratory (RR), capillary refill time, mucosa's coloring, rectal temperature (RT), peripheral temperature (PT) and the difference between RT and PT, Delta T°C. Finally we did the blood exam and the serum glycemia, as well as the serum lactate measurement. For that we used a portable lactimeter, using the blood sample taken from the cephalic vein. Furthermore, when there was correlation between the serum lactate values and the body weight, we divided the dogs according to the calculation of 33 and 66 percentile. Evaluated dogs showed average values of 18.3±12.1 kg of body weight and 3.0±1.9 of age; with HR of 126.6±29.1bpm, RR of 66±24mpm, RT of 38.9±0.4°C, PT of 31.5±1,0°C, Delta T°C of 7.3±1.0°C and serum lactate of 3.2±0.4mmol/L; with the latter showing range of 3.1-3.3mmol/L with 95% of reliability and significant correlation (p<0.05) between its values and the body weight (r=0.6) and the heart rate (r=0.4). The serum lactate values obtained were compared between the dogs' groups according to their body weight, showing distinguished differences between them. Thereby we concluded that the serum lactate values in dogs under outpatient care is 3.2mmol/L, with a trust gap of 3.1-3.3mmol/L, highlighting the influence that HR and body weight can have on its values.(AU)

Adaptation and validation of the Inventory of Family Protective Factors for the Portuguese culture / Adaptação e Validação do Instrumento Inventory of Family Protective Factors para a cultura portuguesa / Adaptación y Validación del Instrumento Inventory of Family Protective Factors para la cultura portuguesa

OBJECTIVES: to adapt and validate the Inventory of Family Protective Factors (IFPF) for the Portuguese culture. This instrument assesses protective factors that contribute to family resilience. Studies addressing resilience are embedded within the salutogenic paradigm, i.e. it addresses protective factors of individuals or groups without underestimating risk factors or vulnerability. METHOD: in order to assess the IFPF's linguistic and conceptual equivalence, the instrument was translated, retro-translated and the think-aloud protocol was used. We then verified the instrument's sensitiveness, reliability and validity of results to assess its psychometric characteristics. A factor analysis was performed of the principal components with varimax rotation of the scale's items and Cronbach's alpha coefficient was calculated for each dimension. A total of 85 families with disabled children, selected through simple random sampling, self-administered the instrument. RESULTS: the IFPF presents psychometric characteristics that are appropriate for the Portuguese population (Cronbach's alpha = .90). CONCLUSION: the IFPF was adapted and validated for the Portuguese culture and is an instrument to be used in studies intended to assess protective factors of family resilience. .

OBJETIVOS: adaptar e validar o Inventory of Family Protective Factors para a cultura portuguesa. Esse instrumento avalia os fatores protetores que contribuem para a resiliência familiar. Os estudos sobre resiliência inserem-se no paradigma salutogênico, abordando os fatores protetores dos indivíduos, ou grupos, sem subestimar os fatores de risco ou vulnerabilidade. MÉTODO: para avaliar a equivalência linguística e conceitual do Inventory of Family Protective Factors realizou-se a tradução, retroversão e reflexão falada; para aferir as características psicométricas do instrumento, verificou-se a sensibilidade, confiabilidade e a validade dos resultados. Foi realizada uma análise fatorial de componentes principais com rotação Varimax dos itens da escala e calculou-se o coeficiente alfa de Cronbach para cada dimensão. Através de uma amostragem aleatória simples, aplicou-se esse instrumento a 85 famílias de crianças com necessidades especiais que o autopreencheram. RESULTADOS: o Inventory of Family Protective Factors apresenta características psicométricas adequadas para a população portuguesa (alfa de Cronbach de .90). CONCLUSÃO: o Inventory of Family Protective Factors foi adaptado e validado para a cultura portuguesa. Considera-se que se trata de um instrumento útil para estudos nos quais há a proposta de avaliar os fatores protetores da resiliência familiar. .

OBJETIVOS: adaptar y validar el Inventory of Family Protective Factors (IFPF) para la cultura portuguesa. Este instrumento evalúa los factores protectores que contribuyen para la resiliencia familiar. Los estudios sobre resiliencia se insieren en el paradigma salutogénico, abordando los factores protectores de los individuos o grupos, sin subestimar los factores de riesgo o vulnerabilidad. MÉTODO: para evaluar la equivalencia lingüística y conceptual del IFPF realizamos la traducción, retrotraducción y reflexión hablada; para evaluar las características psicométricas del instrumento verificamos la sensibilidad, confiabilidad y la validez de los resultados. Realizamos un análisis factorial de los componentes principales con rotación varimax de los ítems de la escala y calculamos el coeficiente Alpha de Cronbach para cada dimensión. A través de un muestreo aleatorio simple, aplicamos este instrumento a 85 familias de niños con necesidades especiales que lo autollenaron. RESULTADOS: el IFPF presenta características psicométricas adecuadas para la población portuguesa (alfa de Cronbach de 0,90). CONCLUSIÓN: el IFPF fue adaptado y validado para la cultura portuguesa. Consideramos que se trata de un instrumento útil para estudios que se propongan evaluar los factores protectores de la resiliencia familiar. .

Increased lactate threshold after five weeks of treadmill aerobic training in rats / Aumento do limiar de lactato após cinco semanas de treinamento aeróbio em esteira em ratos

The aim of the present study was to analyse the lactate threshold (LT) changes in rats submitted to an aerobic treadmill-training programme. Twenty-five Wistar rats were divided into two groups: a sedentary control group (CG), and a trained group (TG) submitted to an aerobic training during 5 weeks. All the animals were submitted to an incremental treadmill exercise test in order to determine LT. There was an increase in the maximum running speed in the TG (from 32.25 ± 1.27 to 47.75 ± 3.13 m.min–1 – p = 0.001), and running speed at LT (from 26.21 ± 1.15 to 35.30 ± 2.24 m.min–1 – p = 0.004), a part from the reduction in blood lactate at LT. LT can be determined in rats, and aerobic training induced positive oxidative physiological adaptations in the animals.

O objetivo do presente estudo foi analisar as mudanças no limiar de lactato (LL) em ratos submetidos a um programa de treinamento aeróbio em esteira. Vinte e cinco ratos Wistar foram divididos em dois grupos: um grupo controle sedentário (CG), e um grupo treinado (GT) submetido a um treinamento aeróbio durante 5 semanas. Todos os animais foram submetidos a um teste de exercício incremental em esteira, a fim de determinar o LL. Houve um aumento na velocidade máxima de corrida no GT (de 32,25 ± 1,27 para 47,75 ± 3,13 m.min–1 - p = 0,001), e velocidade de corrida no LL (de 26,21 ± 1,15 para 35,30 ± 2,24 m.min–1 - p = 0,004), além da redução na concentração de lactato no LL. O LL pode ser determinado em ratos e o treinamento aeróbio induziu a adaptações fisiológicas oxidativas positivas nos animais.

The role of serum lactate in post-cardiac arrest syndrome

Cardiopulmonary arrest is a medical emergency with significant mortality. The success of resuscitation led to the emergence of post-cardiac arrest syndrome (PCAS), which originates from ischemia-reperfusion injury and its consequent increase in serum lactate. Despite the robust evidence correlating hyperlactatemia as a prognostic marker in critically ill patients, there is insufficient evidence about the role of serum lactate in the outcome of PCAS. Thus, the purpose of this review is to check the current evidence on the role of lactate in predicting mortality in PCAS.

Tissue response evaluation of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant

PURPOSE: To evaluate the tissue response of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant. METHODS: A total of 20 male guinea pigs were divided into 2 groups. After paracentesis in both ears, a biodegradable polymer of poly lactic-co-glycolic acid was implanted in only one middle ear. Histological analysis using neutrophil exudate and vascular neoformation (acute inflammation) and fibroblast proliferation and mononuclear inflammatory cells (chronic inflammation) as parameters was performed after 10 and 30 days of survival (groups 1 and 2, respectively). RESULTS: Four ears in group 1 and 7 in group 2 had an increase of neutrophil exudate. Vascular neoformation occurred in ears with or without the implant, in both groups. Fibroblast proliferation and mononuclear inflammatory cells (lymphocytes and macrophages) increased in ears with implant in group 2. CONCLUSION: The tissue response by histological analysis of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant, showed no statistically significant difference between ears with or without the implant. .

Concentração de lactato sérico em ovelhas e cordeiros mestiços (1/2 Suffolk) nascidos em eutocia / Lactate blood levels in sheep and newborn lambs (1/2 suffolk) in normal delivery

O objetivo do estudo foi avaliar a concentração de lactato sanguíneo venoso em ovelhas e em cordeiros neonatos imediatamente após o parto eutócico. Foram utilizadas 14 ovelhas, sendo nove da raça Suffolk e quatro mestiças e 20 cordeiros neonatos sadios (machos e fêmeas). O efeito do sexo, da raça e do número de cordeiros por parto foi investigado, bem como a possível correlação entre a concentração de lactato materno e neonatal. Não houve diferença entre machos e fêmeas, em relação à raça (Suffolk e mestiços), contudo a concentração de lactato foi mais elevada em cordeiros gêmeos ou trigêmeos quando comparado a cordeiros uníparos. Houve correlação positiva entre a concentração materna e a neonatal, sendo que quanto maior a concentração de lactato materno, maior a concentração no cordeiro imediatamente após o parto eutócico. Os resultados do presente estudo fornecem um subsídio por meio do qual se podem comparar os níveis de lactato sanguíneo em cordeiros em estado crítico.

The aim of this study was to evaluate the venous blood lactate concentration in sheep and newborn lambs immediately after normal delivery. We used 14 ewes, nine and four Suffolk crossbred lambs and 20 healthy newborns (males and females). The effect of gender, race and number of lambs per birth was investigated, as well as the possible correlation between the concentration of maternal and newborn lactate. There was no difference between males and females or in relation to race (and Suffolk crossbred); however the concentration of lactate was higher in twin or triplet lambs when compared to single lambs. There was a positive correlation between the maternal and newborn concentration and the higher the concentration of lactate, the greater the concentration in the lamb immediately after normal delivery. The results of this study provide a base from which to compare the blood lactate levels in lambs in critical condition.

Limiar anaeróbico (V4) e frequência cardíaca de cavalos Crioulos condicionados para prova funcional / Anaerobic threshold (V4) and heart rate of Crioulo horses conditioned for functional testing

Determinou-se o limiar anaeróbico (V4) de 23 cavalos Crioulos hígidos em treinamento. Os animais selecionados foram submetidos a testes de desempenho, composto por três etapas de velocidade progressiva de 6m/s, 8m/s e 10m/s, com duração de cinco minutos cada etapa, até que fosse atingida a concentração de 4mmol/dL de lactato sanguíneo. As concentrações de lactato sanguíneo elevaram-se a partir da velocidade de exercício de 6,0m/s, sendo que 20 animais (90%) atingiram 4mmol/L de lactato na velocidade entre 6 - 8m/s, com média de frequência cardíaca que variou de 121 a 140bpm. Concluiu-se que a V4 do cavalo Crioulo está entre as velocidades de 6 - 8m/s e a frequência cardíaca entre 121 - 140bpm.

The anaerobic threshold (V4) while running on a track is used in many breeds to evaluate physical conditioning and to establish a training regimen, but these data have not been obtained for the Crioulo breed. This study evaluated 23 healthy Crioulo horses to determine the anaerobic threshold (V4) during training. The selected animals were subjected to a performance test on a track. The test consisted of three five minute stages with increasing speeds of 6m/s, 8 m/s and 10m/s until the blood lactate concentration reached 4mmol/dL. Blood lactate concentrations began to increase at the exercise speed of 6m/s, and 90% (n=20) of the animals reached 4mmol/dL lactate between 6-8m/s, with an average heart rate ranging from 121 to 140bpm at these speeds. Our results demonstrate that the V4 of the Crioulo horse is between 6-8m/s at a heart rate between 121 and 140bpm.