Consequences of General Anesthesia in Infancy on Behavior and Brain Structure.

BACKGROUND: One in 7 children will need general anesthesia (GA) before the age of 3. Brain toxicity of anesthetics is controversial. Our objective was to clarify whether exposure of GA to the developing brain could lead to lasting behavioral and structural brain changes. METHODS: A first study was performed in mice. The behaviors (fear conditioning, Y-maze, and actimetry) and brain anatomy (high-resolution magnetic resonance imaging) of 6- to 8-week-old Swiss mice exposed or not exposed to GA from 4 to 10 days old were evaluated. A second study was a complementary analysis from the preexisting APprentissages EXécutifs et cerveau chez les enfants d'âge scolaire (APEX) cohort to assess the replicability of our data in humans. The behaviors (behavior rating inventory of executive function, emotional control, and working memory score, Backward Digit Span, and Raven 36) and brain anatomy (high-resolution magnetic resonance imaging) were compared in 102 children 9 to 10 years of age exposed or not exposed to a single GA (surgery) during infancy. RESULTS: The animal study revealed chronic exacerbated fear behavior in the adult mice (95% confidence interval [CI], 4-80; P = .03) exposed to postnatal GA; this was associated with an 11% (95% CI, 7.5-14.5) reduction of the periaqueductal gray matter (P = .046). The study in humans suggested lower emotional control (95% CI, 0.33-9.10; P = .06) and a 6.1% (95% CI, 4.3-7.8) reduction in the posterior part of the right inferior frontal gyrus (P = .019) in the children who had been exposed to a single GA procedure. CONCLUSIONS: The preclinical and clinical findings of these independent studies suggest lasting effects of early life exposure to anesthetics on later emotional control behaviors and brain structures.

Risk Factors and Predictors of Hypothermia and Dropouts During Open-Water Swimming Competitions.

PURPOSE: To measure core temperature (Tcore) in open-water (OW) swimmers during a 25-km competition and identify the predictors of Tcore drop and hypothermia-related dropouts. METHODS: Twenty-four national- and international-level OW swimmers participated in the study. Participants completed a personal questionnaire and a body fat/muscle mass assessment before the race. The average speed was calculated on each lap over a 2500-m course. Tcore was continuously recorded via an ingestible temperature sensor (e-Celsius, BodyCap). Hypothermia-related dropouts (H group) were compared with finishers (nH group). RESULTS: Average prerace Tcore was 37.5°C (0.3°C) (N = 21). 7 participants dropped out due to hypothermia (H, n = 7) with a mean Tcore at dropout of 35.3°C (1.5°C). Multiple logistic regression analysis found that body fat percentage and initial Tcore were associated with hypothermia (G2 = 17.26, P < .001). Early Tcore drop ≤37.1°C at 2500 m was associated with a greater rate of hypothermia-related dropouts (71.4% vs 14.3%, P = .017). Multiple linear regression found that body fat percentage and previous participation were associated with Tcore drop (F = 4.95, P = .019). There was a positive correlation between the decrease in speed and Tcore drop (r = .462, P < .001). CONCLUSIONS: During an OW 25-km competition at 20°C to 21°C, lower initial Tcore and lower body fat, as well as premature Tcore drop, were associated with an increased risk of hypothermia-related dropout. Lower body fat and no previous participation, as well as decrease in swimming speed, were associated with Tcore drop.

Increasing levels of dietary crystalline methionine affect plasma methionine profiles, ammonia excretion, and the expression of genes related to the hepatic intermediary metabolism in rainbow trout (Oncorhynchus mykiss).

Strictly carnivorous fish with high requirements for dietary protein, such as rainbow trout (Oncorhynchus mykiss) are interesting models for studying the role of amino acids as key regulators of intermediary metabolism. Methionine is an essential amino acid for rainbow trout, and works as a signalling factor in different metabolic pathways. The study investigated the effect of increasing dietary methionine intake on the intermediary metabolism in the liver of juvenile rainbow trout. For this purpose, five diets were formulated with increasing methionine levels from 0.60 to 1.29% dry matter. The diets were fed in excess for six weeks before three sampling campaigns carried out successively to elucidate (i) the hepatic expression of selected genes involved in lipid, glucose and amino acid metabolism; (ii) the postprandial ammonia excretion; and (iii) the postprandial plasma methionine concentrations. The transcript levels of enzymes involved in lipid metabolism (fatty acid synthase, glucose 6 phosphate dehydrogenase and carnitine palmitoyl transferase 1 a), gluconeogenesis (fructose-1,6-biphosphatase) and amino acid catabolism (alanine amino transferase and glutamate dehydrogenase) were significantly affected by the increase in dietary methionine. Changes in gene expression reflected to some extent the decrease in ammonia excretion (P=0.022) and in the hepatosomatic index (HSI; P<0.001) when dietary methionine increased. Postprandial plasma methionine concentrations correlated positively with the dietary level (P<0.001) at the different sampling points. The study shows that the expression of several genes related to the hepatic intermediary metabolism in rainbow trout responded in a dose-dependent manner to increasing levels of dietary methionine.

Dietary methionine level affects growth performance and hepatic gene expression of GH-IGF system and protein turnover regulators in rainbow trout (Oncorhynchus mykiss) fed plant protein-based diets.

The effects of dietary level of methionine were investigated in juvenile rainbow trout (Oncorhynchus mykiss) fed five plant-based diets containing increasing content of crystalline methionine (Met), in a six week growth trial. Changes in the hepatic expression of genes related to i) the somatotropic axis: including the growth hormone receptor I (GHR-I), insulin-like growth hormones I and II (IGF-I and IGF-II, respectively), and insulin-like growth hormone binding protein-1b (IGFBP-1b); and ii) protein turnover: including the target of rapamycin protein (TOR), proteasome 20 delta (Prot 20D), cathepsin L, calpains 1 and 2 (Capn 1 and Capn 2, respectively), and calpastatin long and short isoforms (CAST-L and CAST-S, respectively) were measured for each dietary treatment. The transcript levels of GHR-I and IGF-I increased linearly with the increase of dietary Met content (P<0.01), reflecting overall growth performances. The apparent capacity for hepatic protein degradation (derived from the gene expression of TOR, Prot 20D, Capn 1, Capn 2, CAST-L and CAST-S) decreased with increasing dietary Met level in a relatively linear manner. Our results suggest that Met availability affects, directly or indirectly, the expression of genes involved in the GH/IGF axis response and protein turnover, which are centrally involved in the regulation of growth.