Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.158
Filtrar
1.
Emerg Med Clin North Am ; 38(4): 931-944, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981627

RESUMO

Emergency physicians must be prepared to rapidly diagnose and resuscitate patients with pulmonary embolism (PE). Certain aspects of PE resuscitation run counter to typical approaches. A specific understanding of the pathophysiology of PE is required to avoid cardiovascular collapse potentially associated with excessive intravenous fluids and positive pressure ventilation. Once PE is diagnosed, rapid risk stratification should be performed and treatment guided by patient risk class. Although anticoagulation remains the mainstay of PE treatment, emergency physicians also must understand the indications and contraindications for thrombolysis and should be aware of new therapies and models of care that may improve outcomes.


Assuntos
Embolia Pulmonar/terapia , Anticoagulantes/uso terapêutico , Biomarcadores/sangue , Angiografia por Tomografia Computadorizada , Estado Terminal , Ecocardiografia , Eletrocardiografia , Serviço Hospitalar de Emergência , Oxigenação por Membrana Extracorpórea , Hidratação , Humanos , Intubação Intratraqueal , Ácido Láctico/sangue , Trombólise Mecânica , Peptídeo Natriurético Encefálico/sangue , Óxido Nítrico/uso terapêutico , Oxigenoterapia , Fragmentos de Peptídeos/sangue , Sistemas Automatizados de Assistência Junto ao Leito , Respiração com Pressão Positiva , Embolia Pulmonar/classificação , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/fisiopatologia , Ressuscitação/métodos , Medição de Risco , Índice de Gravidade de Doença , Terapia Trombolítica , Troponina/sangue , Vasoconstritores/uso terapêutico
2.
PLoS One ; 15(8): e0237310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785289

RESUMO

This study aimed to investigate and compare the effects of preferred music on anaerobic threshold determination in an incremental running test, as well the physiological responses and perceived exertion at this intensity, in physically active men and women. Additionally, by using area under the curve (AUC) analysis of the parameters of interest during the graded test, we studied the effects of music at two physiological moments-before and after anaerobic threshold intensity (iAT)-in men and women. Twenty (men = 10; women = 10) healthy and active participants completed four visits to the laboratory. The first and second sessions were used for sample characterization. In the third and fourth sessions, participants performed an incremental running test (started at 7 km.h-1 with increments of 1 km.h-1 at each 3-minute stage) under preferred music and non-music conditions. Blood lactate ([Lac]), heart rate (HR), and perceived exertion were measured by two scales (RPEBorg and the estimation of time limit ‒ ETL) during all tests, and the total time of effort (TT) was considered as performance. Individual curves of the "intensity vs blood lactate" analyzed by the bissegmentation method provide the iAT and the AUC of [Lac], HR, RPEBorg, and ETL before and after the iAT attainment were calculated. The iAT for men (non-music: 11.5±0.9km.h-1 vs music: 11.6±1.1km.h-1) and women (non-music: 9.8±0.7km.h-1 vs music: 9.7±0.7km.h-1) was not affected by music, and for both sexes, there was no difference between non-music and music conditions in all variables obtained at iAT. The AUC of all variables were not affected by music before the iAT attainment. However, [Lac], HR, and RPEBorg presented higher values of AUC after iAT for the female group with preferred music. This may be due to the fact that 70% of women have increased TT under music conditions. Overall, preferred music did not affect the iAT determination in an incremental running test. However, some physiological responses and perceived exertion after iAT of female subjects seems to be influenced by preferred music.


Assuntos
Limiar Anaeróbio , Música , Corrida , Adulto , Feminino , Frequência Cardíaca , Humanos , Ácido Láctico/sangue , Masculino , Resistência Física , Esforço Físico , Adulto Jovem
3.
Ann Biol Clin (Paris) ; 78(4): 417-424, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32753366

RESUMO

We present the case of a four-year-old girl, who was hospitalized in intensive care unit for a coma resulting from metabolic acidosis with increased anion gap. The patient was treated for short bowel syndrome, following necrotising enterocolitis, which occurred 51 days after birth. In our initial evaluation of the patient's metabolic acidosis, we were unable to identify the cause of the increased anion gap. Urinary organic acids chromatography identified a large peak of lactate (quantified at 15 mmol/mol of creatiniuria), as well as its metabolites. The discrepancy between normal blood lactate concentration assayed by enzymatic assay, and the large amount of lactate found by gas-chromatography/mass spectrometry (GC/MS) in urine highlights the limit of the stereospecificity of enzymatic assays. Indeed, most lactates assay use enzymatic assays that are specific for L-lactate, whereas organic acids chromatography, whose column is mostly achiral, can detect both stereoisomers, D- and L-lactate. Organic acids in urine analysis, in addition to the clinical context, suggested a diagnosis of D-lactic acidosis. Following a review of the physiopathology and treatment of short bowel syndrome, we will discuss the mechanism and diagnosis of the D-lactic acidosis in our patient. This case highlights the need to perform an organic acid profile in urine in the presence of any unexplained increased anion gap to determine its cause.


Assuntos
Equilíbrio Ácido-Base/fisiologia , Acidose Láctica/diagnóstico , Acidose/diagnóstico , Coma/diagnóstico , Síndrome do Intestino Curto/diagnóstico , Acidose/etiologia , Acidose/metabolismo , Acidose Láctica/etiologia , Acidose Láctica/metabolismo , Acidose Láctica/urina , Análise Química do Sangue/métodos , Pré-Escolar , Coma/sangue , Coma/etiologia , Coma/urina , Diagnóstico Diferencial , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Ácido Láctico/sangue , Ácido Láctico/urina , Síndrome do Intestino Curto/complicações , Síndrome do Intestino Curto/metabolismo , Urinálise
4.
J Am Heart Assoc ; 9(15): e016706, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32600078

RESUMO

BACKGROUND The novel severe acute respiratory syndrome coronavirus 2 threatens human health, and the mortality rate is higher in patients who develop myocardial damage. However, the possible risk factors for myocardial damage in patients with coronavirus disease 2019 (COVID-19) are not fully known. METHODS AND RESULTS Critical type patients were selected randomly from 204 confirmed COVID-19 cases occurring in Renmin Hospital of Wuhan University from February 1, 2020 to February 24, 2020. Univariate analyses were used to compare the 2 groups: the myocardial damage group and the non-myocardial damage group. A total of 82 critical patients with COVID-19 were recruited: 34 with myocardial damage and 48 without myocardial damage. A total of 30 patients died in the myocardial damage group, and 20 died in the non-myocardial damage group. In univariate analysis, the proportion of elderly patients (>70 years old, 70.59% versus 37.50%; P=0.003) and patients with cardiovascular disease (41.18% versus 12.50%; P=0.003) was higher among myocardial damage patients than among non-myocardial damage patients. Multivariate analysis showed that age >70 years old (hazard ratio [HR], 2.44; 95% CI, 1.01-5.40), CRP (C-reactive protein) >100 mg/L (HR, 1.92; 95% CI, 0.94-3.92), lactate dehydrogenase >300 U/L (HR, 2.67; 95% CI, 1.03-6.90), and lactic acid >3 mmol/L (HR, 3.25; 95% CI, 1.57-6.75) were independent risk factors for myocardial damage in patients with COVID-19. CONCLUSIONS Old age (>70 years old), CRP >100 mg/L, lactate dehydrogenase >300 U/L, and lactic acid >3 mmol/L are high-risk factors related to myocardial damage in critical patients with COVID-19.


Assuntos
Cardiomiopatias/etiologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/análise , Cardiomiopatias/virologia , China/epidemiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , L-Lactato Desidrogenase/sangue , Ácido Láctico/sangue , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Risco
5.
Int J Sports Physiol Perform ; 15(6): 767-776, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32502972

RESUMO

CONTEXT: Combat sports are composed of high-intensity actions (eg, attacks, defensive actions, and counterattacks in both grappling and striking situations depending on the specific sport) interspersed with low-intensity actions (eg, displacement without contact, stepping) or pauses (eg, referee stoppages), characterizing an intermittent activity. Therefore, high-intensity interval training (HIIT) is at the essence of combat-sport-specific training and is used as complementary training, as well. HIIT prescription can be improved by using intensity parameters derived from combat-sport-specific tests. Specifically, the assessment of physiological indexes (intensity associated with the maximal blood lactate steady state, maximal oxygen consumption, and maximal sprint) or of time-motion variables (high-intensity actions, low-intensity actions, and effort:pause ratio) is a key element for a better HIIT prescription because these parameters provide an individualization of the training loads imposed on these athletes. PURPOSE: To present a proposal for HIIT prescription for combat-sport athletes, exemplifying with different HIIT protocols (HIIT short intervals, HIIT long intervals, repeated-sprint training, and sprint interval training) using combat-sport-specific actions and the parameters for the individualization of these protocols. CONCLUSIONS: The use of combat-sport-specific tests is likely to improve HIIT prescription, allowing coaches and strength and conditioning professionals to elaborate HIIT short intervals, HIIT long intervals, repeated-sprint training, and sprint interval training protocols using combat-sport actions, providing more specificity and individualization for the training sessions.


Assuntos
Desempenho Atlético/fisiologia , Comportamento Competitivo/fisiologia , Treinamento Intervalado de Alta Intensidade/métodos , Tomada de Decisões , Humanos , Ácido Láctico/sangue , Consumo de Oxigênio/fisiologia
6.
Medicine (Baltimore) ; 99(22): e20274, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481394

RESUMO

Sepsis is a life-threatening disease in the intensive care unit (ICU). The current diagnostic criteria for sequential organ failure assessment (SOFA) scores do not reflect the current understanding of sepsis. We developed a novel and convenient score to aid early prognosis.Retrospective multivariable regression analysis of 185 infected emergency ICU (EICU) patients was conducted to identify independent variables associated with death, to develop the new "STAPLAg" score; STAPLAg was then validated in an internal cohort (n = 106) and an external cohort (n = 78) and its predictive efficacy was compared with that of the initial SOFA score.Age, and initial serum albumin, sodium, PLR, troponin, and lactate tests in the emergency department were independent predictors of death in infected EICU patients, and were used to establish the STAPLAg score (area under the curve [AUC] 0.865). The initial SOFA score on admission was predictive of death (AUC 0.782). Applying the above categories to the derivation cohort yielded mortality risks of 7.7% for grade I, 56.3% for grade II, and 75.0% for grade III. Internal (AUC 0.884) and external (AUC 0.918) cohort validation indicated that the score had good predictive power.The STAPLAg score can be determined early in infected EICU patients, and exhibited better prognostic capacity than the initial SOFA score on admission in both internal and external cohorts. STAPLAg constitutes a new resource for use in the clinical diagnosis of sepsis and can also predict mortality in infected EICU patients. REGISTRATION NUMBER:: ChinCTR-PNC-16010288.


Assuntos
Escore de Alerta Precoce , Unidades de Terapia Intensiva , Escores de Disfunção Orgânica , Sepse/diagnóstico , Fatores Etários , Idoso , Feminino , Humanos , Ácido Láctico/sangue , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Estudos Retrospectivos , Sepse/sangue , Sepse/mortalidade , Albumina Sérica/análise , Sódio/sangue , Troponina/sangue
7.
Stud Health Technol Inform ; 270: 73-77, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570349

RESUMO

Blood lactate concentration is a reliable risk indicator of deterioration in critical care requiring frequent blood sampling. However, lactate measurement is an invasive procedure that can increase risk of infections. Yet there is no clinical consensus on the frequency of measurements. In response we investigate whether machine learning algorithms can be used to predict blood lactate concentration from ICU health records. We evaluate the performance of different prediction algorithms using a multi-centre critical care dataset containing 13,464 patients. Furthermore, we analyse impact of missing value handling methods in prediction performance for each algorithm. Our experimental analysis show promising results, establishing a baseline for further investigation into this problem.


Assuntos
Cuidados Críticos , Ácido Láctico , Aprendizado de Máquina , Algoritmos , Humanos , Ácido Láctico/sangue , Fatores de Risco
8.
Virol J ; 17(1): 80, 2020 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-32560646

RESUMO

BACKGROUND: Convalescent plasma (CP) transfusion was reported to be effective in treating critically ill patients with COVID-19, and hydroxychloroquine could potently inhibit SARS-CoV-2 in vitro. Herein, we reported a case receiving combination therapy with CP transfusion and hydroxychloroquine for the first time. CASE PRESENTATION: Laboratory findings showed high lactic acid level (2.1 mmol/L) and C-reactive protein (CRP, 48.8 mg/L), and low white blood cell count (1.96 × 109/L) in a 65-year-old Chinese man, who was diagnosed with severe COVID-19. CP was intravenously given twice, and hydroxychloroquine was orally administrated for a week (0.2 g, three times a day). The lactic acid and C-reactive protein levels remained high (2.1 mmol/L and 73.23 mg/L, respectively), while the arterial oxyhemoglobin saturation decreased to 86% with a low oxygenation index (OI, 76 mmHg) on day 4 after CP transfusion. His temperature returned to normal and the OI ascended above 300 on day 11. Moreover, the RNA test remained positive in throat swab, and computed tomography revealed severe pulmonary lesions on day 11 after admission. CONCLUSION: These findings suggested that the effectiveness of combination therapy with CP and hydroxychloroquine may be non-optimal, and specific therapy needs to be explored.


Assuntos
Transfusão de Componentes Sanguíneos/métodos , Infecções por Coronavirus/terapia , Hidroxicloroquina/administração & dosagem , Pneumonia Viral/terapia , Administração Oral , Idoso , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Antivirais/administração & dosagem , Betacoronavirus/isolamento & purificação , Proteína C-Reativa/metabolismo , Infecções por Coronavirus/sangue , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Humanos , Imunização Passiva/métodos , Ácido Láctico/sangue , Contagem de Leucócitos , Masculino , Oxiemoglobinas , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Carga Viral
9.
Gene ; 755: 144897, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32561323

RESUMO

The integrity of the intestinal barrier is critical for protecting the host against the intestinal lumen and pathogens. The roles of circRNAs in the intestinal barrier dysfunction in sepsis remained unclear. The present study aims to investigate the role of circ_0001105 in the intestinal mucosal permeability, oxidative damage and morphological changes during sepsis. We found that upregulation of circ_0001105 decreased the levels of serum D-lactic acid, diamine oxidase and fluorescence isothiocyanate dextran in septic rats. Upregulation of circ_0001105 also decreased the malondialdehyde content but enhanced superoxide dismutase activity in the intestinal tissues. Upregulation of circ_0001105 reduced the production of tumor necrosis factor α, interleukin (IL)-6, and IL-1ß and the expression of YAP1. Furthermore, upregulation of circ_0001105 improved the survival of rats with sepsis. In summary, our findings showed that circ_0001105 protects the intestinal barrier function of septic rats by inhibiting intestinal inflammation, oxidative damage and YAP1 expression. Our results provide a novel insight for developing sepsis treatment.


Assuntos
Proteínas Reguladoras de Apoptose/biossíntese , Mucosa Intestinal/metabolismo , RNA Circular/metabolismo , Sepse/metabolismo , Amina Oxidase (contendo Cobre)/sangue , Animais , Proteínas Reguladoras de Apoptose/genética , Proteínas Reguladoras de Apoptose/metabolismo , Regulação para Baixo , Inflamação/genética , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Perfuração Intestinal/metabolismo , Ácido Láctico/sangue , Masculino , Estresse Oxidativo/fisiologia , Permeabilidade , RNA Circular/biossíntese , RNA Circular/genética , Ratos , Ratos Sprague-Dawley , Sepse/genética , Fator de Necrose Tumoral alfa/metabolismo
10.
PLoS One ; 15(6): e0235195, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32589670

RESUMO

PURPOSE: Supporting post-exercise recovery requires choosing not only the right treatment but also the equipment, in which the impact is not always clear. The study aimed to determine the effect of foam rolling on the rate of lactate removal and DOMS prevention and whether the type of foam roller is effective in the context of post-exercise recovery. METHODS: This randomized trial enrolled 33 active healthy males divided into three groups of eleven individuals: foam rolling with a smooth (STH) or grid roller (GRID) or passive recovery (PAS). All the participants performed full squat jumps for one minute. Examination took place at rest (thermal imaging of skin temperature-[Tsk] and blood lactate-[LA]), immediately following exercise (Tsk & LA), immediately after recovery treatment (Tsk) and after 30 minutes of rest (Tsk & LA). Their pain levels were assessed using the Visual Analog Scale (VAS) 24, 48, 72, and 96 hours after exercise. RESULTS: The magnitude of lactate decrease depended on the type of recovery used. In the PAS group, the decrease in lactate concentration by 2.65 mmol/L following a half-hour rest was significantly lower than that in the other groups (STH vs. PAS p = 0.042 / GRID vs. PAS p = 0.025). For thermal responses, significant differences between both experimental groups were noted only 30 minutes after exercise. A significant decrease in pain in the STH group occurred between 48 and 96 hours, while the GRID group showed a systematic significant decrease in VAS values in subsequent measurements. Changes in VAS values in subsequent measurements in the PAS group were not statistically significant (p>0.05). CONCLUSIONS: Foam rolling seems to be effective for enhancing lactate clearance and counteracting DOMS, but the type of foam roller does not seem to influence the recovery rate.


Assuntos
Exercício Físico/fisiologia , Massagem/métodos , Músculo Esquelético , Mialgia/reabilitação , Adulto , Voluntários Saudáveis , Humanos , Ácido Láctico/sangue , Masculino , Músculo Esquelético/metabolismo , Músculo Esquelético/fisiologia , Adulto Jovem
11.
J Sports Med Phys Fitness ; 60(5): 713-719, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32438787

RESUMO

BACKGROUND: The importance of strength in Brazilian jiu-jitsu (BJJ) has inspired several recommendations of resistance training (RT) in BJJ athletes, yet little is known about their responses to different RT approaches. Thus, we aimed to investigate volume, efficiency, and fatigue responses in two popular RT protocols. METHODS: In a randomized crossover design, 12 male BJJ athletes (mean age: 24.5±3.1 years; height: 175±5 cm; body mass: 77.1±12.9 kg; body fat: 14.3±5.7%; BMI: 24.8±3.0) completed two separate RT protocols consisting of the same exercises performed either as straight sets (TRAD) or alternating sets (AST) for three sets to failure with a previously established 10-repetition maximum (10RM) load. Maximal number of repetitions (MNR), training duration, volume load (VL), and training efficiency (TE = VL/time), rating of perceived exertion (RPE), and blood lactate concentration (LAC) were assessed in each protocol. RESULTS: MNR decreased steadily from first to last sets for all exercises, with no difference between protocols (P>0.05), resulting in the same VL. The shorter duration of AST resulted in increased TE (P<0.001), which was accompanied by higher RPE (P<0.001) and LAC (P<0.05), as well as higher session perceived load (P<0.01). CONCLUSIONS: Given the role of VL as a driver of RT adaptations, both approaches may be suitable for improvements in strength and hypertrophy. The distinct differences in duration and metabolic response should be considered when implementing RT alongside regular sport training.


Assuntos
Artes Marciais/fisiologia , Músculo Esquelético/metabolismo , Treinamento de Resistência/métodos , Adulto , Estudos Cross-Over , Exercício Físico , Humanos , Ácido Láctico/sangue , Masculino , Fatores de Tempo , Adulto Jovem
12.
Tunis Med ; 98(2): 144-149, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32395804

RESUMO

BACKGROUND: Glaucoma is an optic neuropathy induced by many factors. Vascular dysfunction is involved in the mechanism underlying glaucoma. AIM: To determine the involvement of nitric oxide (NO), which is implicated in the regulation of ocular blood flow, in primary open angle glaucoma (POAG). Furthermore, lactate and uric acid (UA) levels were investigated. METHODS: Concentrations of NO, UA and lactate in plasma and aqueous humor (AH) were measured in 214 Tunisian patients (100 patients with POAG and 114 subjects with cataract as control group). NO metabolites, nitrate and nitrite (NOx) production were determined using the Griess reaction. UA and lactate concentrations were measured using enzymatic- colorimetric methods. RESULTS: NOx concentrations in patients with POAG were significantly lower compared to cataract group in plasma (5.23±1.55 µmol/L vs 18.35±6.87 µmol/L, p=0.01) and AH (20.54±7.41 µmol/L vs 45.25±10.92 µmol/L, p=0.02). Plasma and AH levels of lactate and UA were significantly higher in glaucoma patients than in control subjects. CONCLUSIONS: In the present study, decreased NO and increased UA and lactate levels were found in the AH and plasma of POAG patients compared to control subjects. These data suggest a possible involvement of these factors in glaucoma.


Assuntos
Glaucoma de Ângulo Aberto/metabolismo , Óxido Nítrico/metabolismo , Humor Aquoso/química , Humor Aquoso/metabolismo , Análise Química do Sangue , Estudos de Casos e Controles , Catarata/sangue , Catarata/metabolismo , Catarata/patologia , Feminino , Glaucoma de Ângulo Aberto/sangue , Glaucoma de Ângulo Aberto/patologia , Humanos , Ácido Láctico/análise , Ácido Láctico/sangue , Ácido Láctico/metabolismo , Masculino , Óxido Nítrico/análise , Óxido Nítrico/sangue , Tunísia , Ácido Úrico/análise , Ácido Úrico/sangue , Ácido Úrico/metabolismo
13.
Int J Sports Med ; 41(9): 574-581, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32353881

RESUMO

Over recent decades the association between metabolic and gas exchange parameters during exercise has become evident. Different "thresholds" (such as lactate thresholds, critical power, EMG thresholds) and intensity domains appear to be linked to an upper limit of oxygen uptake steady state (V̇O2SS). The aim of this study was to investigate whether MLSS is associated with the upper limit for a V̇O2SS. Forty-five subjects underwent one incremental test and 4-6 30-minute MLSS tests on a cycle ergometer. A three-component model was used to describe V̇O2 response at PMLSS and just above PMLSS+1. To evaluate the results, breath-by-breath V̇O2 and lactate (LA) values were analyzed using the intraclass correlation coefficient (ICC), increasing (k-) values and the Wilcoxon test. According to the calculated k-values of LA and VO2 at PMLSS and PMLSS+1, no significant increase of VO2 occurred during both intensities (PMLSS and PMLSS+1) from minute 10 to minute 30, confirming the existence of a V̇O2SS. Additionally, the ICC of 0.94 confirmed high accordance of the VO2 kinetics at both intensities (PMLSS and PMLSS+1). This study shows that power output at MLSS workload does not represent an accurate cut for an upper limit of V̇O2SS.


Assuntos
Limiar Anaeróbio/fisiologia , Exercício Físico/fisiologia , Ácido Láctico/sangue , Troca Gasosa Pulmonar/fisiologia , Adulto , Teste de Esforço , Feminino , Humanos , Masculino , Resistência Física/fisiologia , Adulto Jovem
14.
Int J Sports Med ; 41(9): 582-588, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32353882

RESUMO

Acute prolonged endurance running has been shown to alter muscle-specific circulating microRNA (miRNA) levels. Here, eighteen participants completed an 8 km run. We assessed the levels of hsa-miR-1-3p, -133a-3p, -133b, and -206 and their correlation with conventional biomarkers following exercise. Compared to before exercise (Pre), 8 km run significantly increased the lactate level immediately after exercise (0 h). Myoglobin (Mb) level increased at 0 h while creatine kinase (CK) level increased 24 h after exercise (24 h). The levels of creatine kinase MB isoenzyme (CK-MB) and cardiac troponin I (cTnI) were all elevated at 24 h and within the normal physiological range; The levels of hsa-miR-1-3p, -133a-3p, -133b significantly increased at 0 h but only hsa-miR-133a-3p still elevated at 24 h. Only hsa-miR-206 level decreased at 24 h; Additionally, the changes of hsa-miR-1-3p and hsa-miR-133a-3p were correlated with Mb at 24 h. These findings suggest that muscle-specific miRNA elevation in plasma is likely physiological and that these miRNA may be used as potential biomarkers for load monitoring in individuals.


Assuntos
MicroRNA Circulante/sangue , Músculo Esquelético/metabolismo , Resistência Física/fisiologia , Corrida/fisiologia , Adaptação Fisiológica , Biomarcadores/sangue , Frequência Cardíaca/fisiologia , Humanos , Ácido Láctico/sangue , Masculino , Músculo Esquelético/lesões , Consumo de Oxigênio/fisiologia , Condicionamento Físico Humano/fisiologia , Mecânica Respiratória/fisiologia , Corrida/lesões , Adulto Jovem
15.
J Dairy Sci ; 103(6): 5509-5513, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32307153

RESUMO

The objectives of this study were to describe the stability of bovine whole-blood electrolytes, glucose, and lactate in samples collected in lithium heparin tubes and stored in thermoconductive modules immersed in ice water. A total of 99 Jersey cows (40 first-parity, 18 second-parity, and 41 third-parity or greater cows) from a commercial dairy farm in West Texas were enrolled between June and July 2018. Blood was collected from the jugular vein using a 60-mL polypropylene syringe and equally distributed into 5 spray-dried evacuated lithium heparin tubes. Baseline samples were analyzed within 90 s of collection using a benchtop blood gas analyzer. The remaining 4 tubes were stored in a thermoconductive, passive-temperature-regulating module inside a cooler with ice water. At 30 min and 2, 4, and 8 h post-collection, samples were removed from the temperature-regulating module, gently inverted for 10 s, and analyzed. Repeated-measures models were built to evaluate the effect of time on the stability of ionized Ca (iCa), ionized Mg (iMg), Na, K, Cl, glucose, and lactate. Most of the analytes investigated remained stable up to 8 h under ice water storage conditions before analysis, including iCa, iMg, Cl, glucose, and lactate. However, Na and K were significantly affected by delayed analysis: Na remained stable up to 4 h post-collection, but K was not stable starting at 2 h post-collection. The results of this study are useful in helping future researchers and consultants to recognize acceptable time delays between whole blood collection and processing or analysis for electrolytes, glucose, and lactate.


Assuntos
Coleta de Amostras Sanguíneas/veterinária , Bovinos/sangue , Eletrólitos/sangue , Heparina/química , Animais , Gasometria/veterinária , Glicemia/análise , Cálcio/sangue , Cloretos/sangue , Feminino , Ácido Láctico/sangue , Lítio/química , Magnésio/sangue , Potássio/sangue , Refrigeração/veterinária , Sódio/sangue , Texas , Fatores de Tempo
16.
Am J Physiol Renal Physiol ; 318(6): F1418-F1429, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32308019

RESUMO

The use of high dialysate bicarbonate for hemodialysis in end-stage renal disease is associated with increased mortality, but potential physiological mediators are poorly understood. Alkalinization due to high dialysate bicarbonate may stimulate organic acid generation, which could lead to poor outcomes. Using measurements of ß-hydroxybutyrate (BHB) and lactate, we quantified organic anion (OA) balance in two single-arm studies comparing high and low bicarbonate prescriptions. In study 1 (n = 10), patients became alkalemic using 37 meq/L dialysate bicarbonate; in contrast, with the use of 27 meq/L dialysate, net bicarbonate loss occurred and blood bicarbonate decreased. Total OA losses were not higher with 37 meq/L dialysate bicarbonate (50.9 vs. 49.1 meq using 27 meq/L, P = 0.66); serum BHB increased in both treatments similarly (P = 0.27); and blood lactate was only slightly higher with the use of 37 meq/L dialysate (P = 0.048), differing by 0.2 meq/L at the end of hemodialysis. In study 2 (n = 7), patients achieved steady state on two bicarbonate prescriptions: they were significantly more acidemic when dialyzed against a 30 meq/L bicarbonate dialysate compared with 35 meq/L and, as in study 1, became alkalemic when dialyzed against the higher bicarbonate dialysate. OA losses were similar to those in study 1 and again did not differ between treatments (38.9 vs. 43.5 meq, P = 0.42). Finally, free fatty acid levels increased throughout hemodialysis and correlated with the change in serum BHB (r = 0.81, P < 0.001), implicating upregulation of lipolysis as the mechanism for increased ketone production. In conclusion, lowering dialysate bicarbonate does not meaningfully reduce organic acid generation during hemodialysis or modify organic anion losses into dialysate.


Assuntos
Ácido 3-Hidroxibutírico/sangue , Equilíbrio Ácido-Base , Alcalose/sangue , Bicarbonatos/administração & dosagem , Soluções para Hemodiálise/administração & dosagem , Falência Renal Crônica/terapia , Ácido Láctico/sangue , Diálise Renal , Adulto , Idoso , Idoso de 80 Anos ou mais , Alcalose/diagnóstico , Alcalose/etiologia , Alcalose/fisiopatologia , Bicarbonatos/efeitos adversos , Bicarbonatos/metabolismo , Biomarcadores/sangue , Ácidos Graxos não Esterificados/sangue , Feminino , Soluções para Hemodiálise/efeitos adversos , Soluções para Hemodiálise/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Falência Renal Crônica/sangue , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/fisiopatologia , Lipólise , Masculino , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
17.
Braz J Med Biol Res ; 53(4): e9200, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32267309

RESUMO

The consumption of alcoholic beverages influences carbohydrate and lipid metabolism, although it is not yet clear whether metabolism during physical exercise at different intensities is also affected. This was the objective of the present study. Eight young and healthy volunteers performed a treadmill test to identify the running speed corresponding to a lactate concentration of 4 mM (S4mM). At least 48 h later, they were subjected to two experimental trials (non-alcohol or alcohol) in which they performed two 1-km running sessions at the following intensities: 1) S4mM; 2) 15% above S4mM. In both trials, blood lactate, triglycerides, and glucose concentrations were measured before and after exercise. The acute alcohol intake increased triglycerides, but not lactate concentration under resting conditions. Interestingly, alcohol intake enhanced the exercise-induced increase in lactate concentration at the two intensities: S4mM (non-alcohol: 4.2±0.3 mM vs alcohol: 4.8±0.9 mM; P=0.003) and 15% above S4mM trial (P=0.004). When volunteers ingested alcohol, triglycerides concentration remained increased after treadmill running (e.g., at S4mM - at rest; non-alcohol: 0.2±0.5 mM vs alcohol: 1.3±1.3 mM; P=0.048). In contrast, glucose concentration was not modified by either alcohol intake, exercise, or their combination. We concluded that an acute alcohol intake changed lactate and lipid metabolism without affecting blood glucose concentration. In addition, the increase in lactate concentration caused by alcohol was specifically observed when individuals exercised, whereas augmented triglycerides concentration was already observed before exercise and was sustained thereafter.


Assuntos
Consumo de Bebidas Alcoólicas/sangue , Bebidas Alcoólicas/análise , Glicemia/metabolismo , Etanol/metabolismo , Ácido Láctico/sangue , Resistência Física/efeitos dos fármacos , Adulto , Desempenho Atlético/fisiologia , Glicemia/análise , Teste de Esforço , Humanos , Masculino , Resistência Física/fisiologia , Triglicerídeos/sangue , Adulto Jovem
18.
Anticancer Res ; 40(4): 1833-1841, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234871

RESUMO

BACKGROUND/AIM: Time-restricted feeding (TRF) during the dark phase of the day restores metabolic homeostasis in mice. MATERIALS AND METHODS: We performed untargeted metabolomic analysis on plasma from mice subjected to TRF that attenuates high-fat diet-enhanced spontaneous metastasis of Lewis lung carcinoma (LLC). RESULTS: Twenty-four of 152 identified metabolites differed among the four dietary groups (non-LLC-bearing mice fed the AIN93G diet and LLC-bearing mice fed the AIN93G, the high-fat diet (HFD), or TRF of the HFD). Component 1 of sparse partial least squares-discriminant analysis showed a clear separation between non-LLC-bearing and LLC-bearing mice. Major metabolites responsible for the changes were elevations in α-tocopherol, docosahexaenoic acid, cholesterol, dihydrocholestrol, isoleucine, leucine, and phenylalanine and decreases in lactic acid and pyruvic acid in LLC-bearing mice particularly those fed the HFD. Time-restricted feeding shifted the metabolic profile of LLC-bearing mice towards that of non-LLC-bearing controls. CONCLUSION: Time-restricted feeding improves metabolic profile of LLC-bearing mice.


Assuntos
Carcinoma Pulmonar de Lewis/sangue , Jejum/sangue , Metabolômica , Animais , Carcinoma Pulmonar de Lewis/dietoterapia , Colestanol/sangue , Colesterol/sangue , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Ácidos Docosa-Hexaenoicos/sangue , Jejum/fisiologia , Humanos , Insulina/sangue , Isoleucina/sangue , Ácido Láctico/sangue , Leucina/sangue , Camundongos , Metástase Neoplásica , Fenilalanina/sangue , Ácido Pirúvico/sangue , alfa-Tocoferol/sangue
19.
J Trauma Acute Care Surg ; 88(5): 671-676, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32317577

RESUMO

BACKGROUND: Acute mesenteric ischemia (AMI) is a highly morbid disease with a diverse etiology. The American Association for the Surgery of Trauma (AAST) proposed disease-specific grading scales intended to quantify severity based upon clinical, imaging, operative, and pathology findings. This grading scale has not been yet been validated for AMI. The goal of this study was to evaluate the correlation between the grading scale and complication severity. METHODS: Patients for this single center retrospective chart review were identified using diagnosis codes for AMI (ICD10-K55.0, ICD9-557.0). Inpatients >17 years old from the years 2008 to 2015 were included. The AAST grades (1-5) were assigned after review of clinical, imaging (computed tomography), operative and pathology findings. Two raters applied the scales independently after dialog with consensus on a learning set of cases. Mortality and Clavien-Dindo complication severity were recorded. RESULTS: A total of 221 patients were analyzed. Overall grade was only weakly correlated with Clavien-Dindo complication severity (rho = 0.27) and mortality (rho = 0.21). Computed tomography, pathology, and clinical grades did not correlate with mortality or outcome severity. There was poor interrater agreement between overall grade. A mortality prediction model of operative grade, use of vasopressors, preoperative serum creatinine and lactate levels showed excellent discrimination (c-index = 0.93). CONCLUSION: In contrast to early application of other AAST disease severity scales, the AMI grading scale as published is not well correlated with outcome severity. The AAST operative grade, in conjunction with vasopressor use, creatinine, and lactate were strong predictors of mortality. LEVEL OF EVIDENCE: Prognostic study, III.


Assuntos
Isquemia Mesentérica/diagnóstico , Índice de Gravidade de Doença , Idoso , Creatinina/sangue , Feminino , Custos Hospitalares/estatística & dados numéricos , Mortalidade Hospitalar , Humanos , Ácido Láctico/sangue , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Isquemia Mesentérica/sangue , Isquemia Mesentérica/economia , Isquemia Mesentérica/mortalidade , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Sociedades Médicas , Estados Unidos/epidemiologia
20.
Ann Thorac Surg ; 110(2): 434-440, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32224236

RESUMO

BACKGROUND: Elevated lactate levels may be caused by increased production suggestive of tissue ischemia; however, they may also occur without evidence of ischemia, by catecholamine activation of beta receptors. The purpose of this study was to determine the factors associated with increased lactate levels during and after lung transplantation and to evaluate whether lactate levels were associated with increased time to extubation and postoperative complications. METHODS: This was a retrospective study of patients who underwent lung transplantation between January 2015 and May 2017 at the University of Michigan, Ann Arbor, MI. Multivariable linear regression was used to determine the factors associated with peak lactate levels and to find the associations between lactate levels and outcomes of nitric oxide time, intubation time, length of stay, and creatinine level. Logistic regression was used to determine the associations between lactate levels and acute kidney injury and atrial fibrillation. RESULTS: A total of 86 patients underwent single-lung transplantation (n = 17; 20%) or double-lung transplantation (n = 69; 80%). All patients initially had normal lactate levels. On univariate analysis, lactate levels at several time points were correlated with subsequent acute kidney injury, increased time to extubation, and increased nitric oxide time. After adjustment, the study found that higher peak intensive care unit lactate levels (regression coefficient B = 0.046; interquartile range, 0.006, 0.086; P = .025) were associated with longer length of stay. CONCLUSIONS: Cardiopulmonary bypass time, total ischemic time, and catecholamine use were associated with higher lactate levels, whereas nitric oxide and higher pulmonary artery pressures were associated with lower levels. Increased lactate levels were independently associated with longer intubation times, postoperative acute kidney injury, and longer length of stay.


Assuntos
Acidose Láctica/epidemiologia , Extubação , Ácido Láctico/sangue , Transplante de Pulmão , Complicações Pós-Operatórias/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA