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1.
Arq. ciências saúde UNIPAR ; 24(3): 139-144, set-dez. 2020.
Artigo em Português | LILACS | ID: biblio-1129451

RESUMO

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.


Assuntos
Humanos , Masculino , Adulto , Anti-Inflamatórios não Esteroides/farmacologia , Naproxeno/farmacologia , Fadiga Muscular/efeitos dos fármacos , Força Muscular/efeitos dos fármacos , Fármacos Neuromusculares/farmacologia , Supinação , Método Duplo-Cego , Treinamento de Resistência , Substâncias para Melhoria do Desempenho/farmacologia , Lactatos/sangue , Músculos/metabolismo
2.
Nat Commun ; 11(1): 5099, 2020 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-33037202

RESUMO

Mutations in the skeletal muscle Ca2+ release channel, the type 1 ryanodine receptor (RYR1), cause malignant hyperthermia susceptibility (MHS) and a life-threatening sensitivity to heat, which is most severe in children. Mice with an MHS-associated mutation in Ryr1 (Y524S, YS) display lethal muscle contractures in response to heat. Here we show that the heat response in the YS mice is exacerbated by brown fat adaptive thermogenesis. In addition, the YS mice have more brown adipose tissue thermogenic capacity than their littermate controls. Blood lactate levels are elevated in both heat-sensitive MHS patients with RYR1 mutations and YS mice due to Ca2+ driven increases in muscle metabolism. Lactate increases brown adipogenesis in both mouse and human brown preadipocytes. This study suggests that simple lifestyle modifications such as avoiding extreme temperatures and maintaining thermoneutrality could decrease the risk of life-threatening responses to heat and exercise in individuals with RYR1 pathogenic variants.


Assuntos
Hipertermia Maligna/genética , Mutação , Canal de Liberação de Cálcio do Receptor de Rianodina/genética , Termogênese/fisiologia , Tecido Adiposo Marrom/metabolismo , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Feminino , Resposta ao Choque Térmico/genética , Resposta ao Choque Térmico/fisiologia , Humanos , Lactente , Lactatos/sangue , Masculino , Hipertermia Maligna/etiologia , Hipertermia Maligna/mortalidade , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pessoa de Meia-Idade , Estudos Retrospectivos , Canal de Liberação de Cálcio do Receptor de Rianodina/metabolismo , Termogênese/genética , Proteína Desacopladora 1/genética , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-32645890

RESUMO

Background: Due to the importance of energy efficiency and economy in endurance performance, it is important to know the influence of different paddling cadences on these variables in the stand-up paddleboarding (SUP). The purpose of this study was to determine the effect of paddling at different cadences on the energy efficiency, economy, and physiological variables of international SUP race competitors. Methods: Ten male paddlers (age 28.8 ± 11.0 years; height 175.4 ± 5.1 m; body mass 74.2 ± 9.4 kg) participating in international tests carried out two test sessions. In the first one, an incremental exercise test was conducted to assess maximal oxygen uptake and peak power output (PPO). On the second day, they underwent 3 trials of 8 min each at 75% of PPO reached in the first test session. Three cadences were carried out in different trials randomly assigned between 45-55 and 65 strokes-min-1 (spm). Heart rate (HR), blood lactate, perceived sense of exertion (RPE), gross efficiency, economy, and oxygen uptake (VO2) were measured in the middle (4-min) and the end (8-min) of each trial. Results: Economy (45.3 ± 5.7 KJ·l-1 at 45 spm vs. 38.1 ± 5.3 KJ·l-1 at 65 spm; p = 0.010) and gross efficiency (13.4 ± 2.3% at 45 spm vs. 11.0 ± 1.6% at 65 spm; p = 0.012) was higher during de 45 spm condition than 65 spm in the 8-min. Respiratory exchange ratio (RER) presented a lower value at 4-min than at 8-min in 55 spm (4-min, 0.950 ± 0.065 vs. 8-min, 0.964 ± 0.053) and 65 spm cadences (4-min, 0.951 ± 0.030 vs. 8-min, 0.992 ± 0.047; p < 0.05). VO2, HR, lactate, and RPE were lower (p < 0.05) at 45 spm (VO2, 34.4 ± 6.0 mL·kg-1·min-1; HR, 161.2 ± 16.4 beats·min-1; lactate, 3.5 ± 1.0 mmol·l-1; RPE, 6.0 ± 2.1) than at 55 spm (VO2, 38.6 ± 5.2 mL·kg-1·min-1; HR, 168.1 ± 15.1 beats·min-1; lactate, 4.2 ± 1.2 mmol·l-1; RPE, 6.9 ± 1.4) and 65 spm (VO2, 38.7 ± 5.9 mL·kg-1·min-1; HR, 170.7 ± 13.0 beats·min-1; 5.3 ± 1.8 mmol·l-1; RPE, 7.6 ± 1.4) at 8-min. Moreover, lactate and RPE at 65 spm was greater than 55 spm (p < 0.05) at 8-min. Conclusion: International male SUP paddlers were most efficient and economical when paddling at 45 spm vs. 55 or 65 spm, confirmed by lower RPE values, which may likely translate to faster paddling speed and greater endurance.


Assuntos
Frequência Cardíaca/fisiologia , Consumo de Oxigênio/fisiologia , Oxigênio , Esforço Físico , Esportes Aquáticos , Adulto , Eficiência , Exercício Físico/fisiologia , Teste de Esforço , Humanos , Lactatos/sangue , Masculino , Pessoa de Meia-Idade , Respiração , Esportes Aquáticos/fisiologia
4.
J Card Surg ; 35(7): 1531-1538, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32598529

RESUMO

BACKGROUND: Surgical pulmonary embolectomy (SPE) has been around since the early days of cardiac surgery. But with the increase in thrombolytic and intervention options, indications of SPE have been limited. Literature suggests that risk stratification has been a key step in getting good results. We are analyzing serum lactate levels for risk stratification in massive and submassive pulmonary embolism (PE). METHODS: This study is a retrospective analysis of 82 cases that underwent SPE between January 1997 and January 2020. Patients were divided into two groups stratified by venous serum lactate levels on the first admission (Group I: normolactatemia <2 mmol/L, Group II: hyperlactatemia, >2 mmol/L). Primary endpoints were all-cause in-hospital mortality and secondary endpoints were cardiopulmonary bypass time, extracorporeal membrane oxygenator (ECMO) insertion, low cardiac output, blood product use, and right ventricular functions in the follow-up. RESULTS: Our study had an overall follow-up of 23 years with a median of 3.18 years. Overall, the in-hospital mortality rate was 8.54%. Group II had a higher mortality rate (P = .015) and morbidity incidences like cardiopulmonary bypass time (P = .008), ECMO insertion (P = .036), and open chest after surgery (P = .015). Although 5-year survival was better in group I a compared to group II (81%, 95% CI, 69%-93% vs 65%, 95% CI, 46%-84%), the log rank test showed no statistical survival difference among both groups on long-term follow-up. CONCLUSIONS: Long term survival after SPE is good and these results can further be improved by proper PE risk stratification. Alongside computed tomography and echocardiography, the importance of biomarkers like serum lactate can be explored in the PE management algorithm.


Assuntos
Embolectomia/métodos , Lactatos/sangue , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/cirurgia , Medição de Risco/métodos , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Ponte Cardiopulmonar , Embolectomia/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Embolia Pulmonar/mortalidade , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
5.
Medicine (Baltimore) ; 99(22): e20495, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481464

RESUMO

Biomarkers are valuable tools for the prediction of mortality in patients with sepsis. However, the use of a single biomarker to predict patient outcomes is challenging owing to the complexity and redundancy of the immune response to infections.We aimed to conduct a prospective observational analysis to investigate the prognostic value of pentraxin 3, interleukin 6, procalcitonin, and lactate combined in predicting the 28-day mortality rate in patients with sepsis or septic shock (n = 160; sepsis, 78; sepsis shock, 82). Two methods (the frequency sum of values above the cutoff, and the multivariate logistic regression model) were used to assess the prognostic value of the biomarker combination.In the receiver operating characteristic curve analyses, the combination of the 4 biomarkers was better than the Sequential Organ Failure Assessment (SOFA) score in predicting the 28-day mortality rate, regardless of whether the frequency sum of values above the cutoff or the multivariate logistic model was used for the analysis. The addition of the SOFA score to the biomarker combination did not result in a better performance for the prediction of mortality.The combined biomarker approach showed good performance in predicting 28-day all-cause mortality among patients diagnosed with either sepsis or septic shock according to the Sepsis-3 definitions. Furthermore, it was superior to the SOFA score in predicting mortality.


Assuntos
Biomarcadores/sangue , Escores de Disfunção Orgânica , Sepse/mortalidade , Choque Séptico/mortalidade , Idoso , Idoso de 80 Anos ou mais , Proteína C-Reativa/metabolismo , Feminino , Humanos , Interleucina-6/sangue , Lactatos/sangue , Masculino , Valor Preditivo dos Testes , Pró-Calcitonina/sangue , Prognóstico , Estudos Prospectivos , Componente Amiloide P Sérico/metabolismo
6.
Thorax ; 75(6): 510-512, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32217783

RESUMO

In this randomised, crossover trial, 22 patients with severe chronic obstructive pulmonary disease climbed six flights of stairs (108 steps) twice, under two test conditions: (1) energy conservation technique (ECT): participants were asked to rest for at least 5 seconds every three steps and (2) control condition: participants climbed the stairs at their own pace. Significant lower dyspnoea (primary outcome), leg discomfort, minute ventilation and capillary blood lactate under the ECT condition were found, with no change in total task time. CLINICAL TRIAL REGISTRATION: NCT03564028.


Assuntos
Dispneia/fisiopatologia , Esforço Físico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Descanso , Idoso , Estudos Cross-Over , Feminino , Humanos , Lactatos/sangue , Masculino , Pessoa de Meia-Idade , Ventilação Pulmonar
7.
BMC Surg ; 20(1): 25, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019557

RESUMO

BACKGROUND: This prospective randomized controlled study was designed to evaluate the effect of fluid restriction alone versus fluid restriction + low central venous pressure (CVP) on hepatic surgical field bleeding, intraoperative blood loss, and the serum lactate concentration in patients undergoing partial hepatectomy. METHODS: One hundred forty patients undergoing partial hepatectomy with intraoperative portal triad clamping were randomized into a fluid restriction group (Group F) or fluid restriction + low CVP group (Group L). Both groups received limited fluid infusion before the liver lesions were removed. Ephedrine was administered if the systolic blood pressure (SBP) decreased to <90 mmHg for 1 min. When the urine output was <20 ml/h or the SBP was <90 mmHg for 1 min more than three times, an additional 200 ml of crystalline solution was quickly infused within 10 min. In addition to fluid restriction, patients in Group L received continuous nitroglycerin and esmolol infusion to maintain a low CVP. The duration of portal triad clamping, frequency of additional fluid infusion, frequency of ephedrine administration, intraoperative blood loss, extent of liver resection, and bleeding score of the hepatic surgical field were recorded. Arterial blood gas analysis was performed before anesthesia (T1), after liver dissection and immediately before liver resection (T2), 10 min after removal of the liver lesion (T3), and before the patient was discharged from the postanesthesia care unit (T4). RESULTS: Being in the fluid restriction Group (Group F) (odds ratio = 5.04) and cirrhosis (odds ratio = 3.28) were risk factors for hepatic surgical field bleeding. Factors contributing to intraoperative blood loss were the operation time, duration of portal triad clamping, and extent of resection. No significant between-group difference was observed for blood loss or blood transfusion. The serum lactate concentration peaked at T3 in both groups. CONCLUSIONS: Maintaining a lower CVP during hepatectomy provides an optimal surgical field but has no significant effect on intraoperative blood loss. Moreover, lower CVP does not increase the serum lactate concentration. TRIAL REGISTRATION: "A comparative study of the effect fluid restriction and low CVP pressure on the oozing of blood in liver wounds and blood lactate in patients undergoing partial hepatectomy" was prospectively registered as a trial (registration number: ChiCTR-INR-17014172, date of registration: 27 December 2017).


Assuntos
Perda Sanguínea Cirúrgica , Pressão Venosa Central , Hepatectomia/métodos , Lactatos/sangue , Adulto , Idoso , Pressão Sanguínea , Transfusão de Sangue , Constrição , Feminino , Hidratação , Humanos , Cirrose Hepática/epidemiologia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Prospectivos
8.
J Zoo Wildl Med ; 50(4): 1026-1030, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926542

RESUMO

The Galápagos shearwater, Puffinus subalaris, is a seabird endemic to the Galápagos archipelago. Hematology, blood chemistry, and general health parameters have not been published for this species. Analyses were run on blood samples drawn from 20 clinically healthy Galápagos shearwaters captured by hand at their nests at Islote Pitt on San Cristóbal Island in July 2016. A portable blood analyzer (iSTAT) was used to obtain near immediate field results for pH, pO2, pCO2, TCO2, HCO3 -, hematocrit, hemoglobin, sodium, potassium, chloride, ionized calcium, creatinine, urea nitrogen, anion gap, and glucose. Blood lactate was measured using a portable Lactate Plus analyzer. The reported results provide baseline data that can be used for comparisons among populations and in detecting changes in health status among Galápagos shearwaters.


Assuntos
Bicarbonatos/sangue , Aves/sangue , Dióxido de Carbono/sangue , Hematócrito/veterinária , Oxigênio/sangue , Equilíbrio Ácido-Base , Animais , Glicemia , Cálcio/sangue , Cloretos/sangue , Creatinina/sangue , Hemoglobinas , Concentração de Íons de Hidrogênio , Lactatos/sangue , Potássio/sangue , Sódio/sangue
9.
Am J Physiol Renal Physiol ; 318(3): F689-F701, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31928224

RESUMO

Acute kidney injury (AKI) is a highly prevalent medical syndrome associated with high mortality and morbidity. Several types of cells, including epithelial cells, vascular endothelial cells, pericytes, and macrophages, participate in the development of AKI. Recently, renal fibroblasts were found to play an important role in the regulation of tubular injury, repair, and recovery after AKI. However, the mechanisms underlying fibroblast activation and proliferation during the progression of AKI remain unclear. In the present study, we found many activated myofibroblasts located in the renal interstitium with an abundance of extracellular matrix deposition following folic acid-induced AKI. The proliferative pattern of tubular epithelial cells and interstitial cells following acute injury was different, indicating that the proliferation of fibroblasts followed the proliferation of tubular epithelial cells. Furthermore, we observed that proliferative tubular epithelial cells preferred aerobic glycolysis as the dominating metabolic pathway in the progression of AKI. Lactate generated from injured tubules was taken up by interstitial fibroblasts in the later stages of AKI, which induced fibroblast activation and proliferation in vitro. Early inhibition of lactate production in tubules by glycolytic inhibitors suppressed fibroblast activation after folic acid-induced injury. Collectively, these results support the important role of fibroblasts in the development of AKI and suggest that lactate produced by glycolysis in tubular epithelial cells is a novel regulator of fibroblast activation and proliferation.


Assuntos
Lesão Renal Aguda/metabolismo , Fibroblastos/fisiologia , Túbulos Renais/metabolismo , Lactatos/metabolismo , Animais , Apoptose , Nitrogênio da Ureia Sanguínea , Linhagem Celular , Creatinina/sangue , Hepatócitos , Lactatos/sangue , Lipocalina-2/urina , Masculino , Camundongos
10.
Ulus Travma Acil Cerrahi Derg ; 26(1): 86-94, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31942740

RESUMO

BACKGROUND: Acute mesenteric ischemia (AMI) is a disease that causes an ischemia in the intestines due to the obstruction of the mesenteric vessels feeding the intestines, with a mortality rate reaching up to 80%. The overall incidence of AMI is 0.63 per 100,000 people. Early diagnosis and treatment are very important for survival. There is no ideal biomarker that can reflect different types and stages of AMI. This study investigated the predictive and prognostic value of L-lactate, D-dimer, leukocyte, C reactive protein (CRP) and neutrophil/lymphocyte ratio (NLR) in the preoperative period were investigated in patients operated for AMI. METHODS: A total of 44 patients operated for AMI between 2015 and 2019 were evaluated in this study. Demographic, clinical, radiological, laboratory and surgical findings of the patients included in this study were recorded. The patients were divided into groups according to the etiological type of AMI. L-lactate, D-dimer, CRP, leukocyte, and NLR levels of these patients were determined. Statistical analysis was performed according to AMI groups. RESULTS: The mean age of the 44 patients included in this study was 67.7 years and the female to male ratio was 0.76. According to tomography results, 31.8% (n=14) of the patients had mesenteric artery embolism, 29.5% (n=13) had mesenteric artery thrombus, 25% (n=11) had mesenteric vein thrombus and 13.6% (n=6) had non-occlusive mesenteric ischemia. When AMI types were compared, D-dimer and CRP levels were found to be significantly different from other markers. The total length of stay in the hospital was found to be significantly correlated with the L-lactate (p=0.047) and CRP (p=0.045) levels. In the analyses, CRP was determined to be the common biomarker that could be used in the diagnosis of mesenteric ischemia in all AMI types. CONCLUSION: Particularly, the CRP level can be used effectively in the preoperative period to diagnose AMI and to determine its subtype and clinical course. However, L-lactate, D-dimer, leukocyte and NLR are markers that have no predictive value in the diagnosis of all AMI subtypes.


Assuntos
Proteína C-Reativa/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Lactatos/sangue , Isquemia Mesentérica , Doença Aguda , Idoso , Feminino , Humanos , Linfócitos/citologia , Masculino , Isquemia Mesentérica/sangue , Isquemia Mesentérica/diagnóstico , Isquemia Mesentérica/epidemiologia , Neutrófilos/citologia , Valor Preditivo dos Testes , Prognóstico
11.
Sci Rep ; 10(1): 1133, 2020 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-31980694

RESUMO

Many hypotheses regarding the evolution of social play have been suggested, including the development of later-life assessment skills. However, the link between play fighting experience and information gathering during contests has yet to be examined. This paper explores the association between play fighting and contest assessment strategy in the domestic pig (Sus scrofa). Using an established framework, we provide evidence suggesting play fighting frequency may affect the extent to which individuals incorporate information regarding their own and their competitors' resource holding potential (RHP) in escalation decisions. Pigs were allocated as 'high play' or 'low play' based upon their relative play fighting frequency. To maximise variation in play, 12 litters underwent a socialisation treatment while the remaining 12 litters were kept isolated within their home pen (i.e. control treatment). At eight weeks of age contests were staged between pairs of unfamiliar pigs, using 19 'high play' dyads and 19 'low play' dyads. While 'high play' dyads were observed to rely on a pure self-assessment strategy, 'low play dyads' did not meet the predictions of either self- or mutual assessment, suggesting their contest behaviour may have been motivated by alternative factors. We suggest that early life play fighting may therefore allow individuals to develop an accurate estimate of their RHP.


Assuntos
Comportamento Agonístico , Jogos e Brinquedos/psicologia , Autoavaliação , Percepção Social , Suínos/psicologia , Animais , Glicemia/análise , Peso Corporal , Feminino , Lactatos/sangue , Masculino , Motivação , Análise de Componente Principal , Pele/lesões , Socialização , Suínos/sangue , Suínos/crescimento & desenvolvimento
12.
Vet Surg ; 49(3): 472-479, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31916608

RESUMO

OBJECTIVE: To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy. STUDY DESIGN: Prospective clinical study. ANIMALS: Forty adult horses in which large colon volvulus was diagnosed intraoperatively. METHODS: Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant. RESULTS: No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome. CONCLUSION: Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners. CLINICAL SIGNIFICANCE: Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.


Assuntos
Colo/patologia , Doenças dos Cavalos/sangue , Doenças dos Cavalos/diagnóstico , Volvo Intestinal/veterinária , Lactatos/sangue , Animais , Biópsia/veterinária , Gasometria/veterinária , Feminino , Hemorragia/patologia , Doenças dos Cavalos/terapia , Cavalos , Volvo Intestinal/sangue , Volvo Intestinal/diagnóstico , Volvo Intestinal/terapia , Masculino , Prognóstico , Estudos Prospectivos
13.
J Gastroenterol Hepatol ; 35(7): 1223-1228, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31749188

RESUMO

BACKGROUND: Hepatitis infection from non-hepatotropic viruses such as dengue virus (DENV) is increasing worldwide. There is increasing recognition of the changing epidemiology and atypical presentations of DENV infection including acute liver failure (ALF). There is paucity of data regarding incidence, disease characteristics, and markers of prognosis in patients who develop DENV-related ALF. METHODS: We aimed to study the incidence, clinical features, laboratory characteristics, and determinants of outcome in patients of DENV presenting with ALF. We reviewed all patients with DENV infection and focused on DENV-related ALF from 2014 to 2017. Diagnosis of DENV and ALF was confirmed by serological tests and standard criteria, respectively. RESULTS: Thirty-six patients (20 men, mean age 32.3) developed ALF among 10 108 patients with DENV infection (0.35%). Twenty-one patients died (58.3%). Although bilirubin, aspartate and alanine aminotransferase, and international normalized ratio were markedly elevated in all patients with DENV ALF, there was no statistically significant difference between survivors and non-survivors. Lactate levels, pH at admission, and model for end-stage liver disease (MELD) score were the only predictors of mortality. Lactate levels were significantly higher in non-survivors (11.5 ± 4.2 mmol/L) than survivors (6.3 ± 3.6 mmol/L) (P < 0.001). MELD score in non-survivors (26.7 ± 10.2) was significantly higher than in survivors (20 ± 7.2) (P = 0.039). Receiver operator characteristic curve showed lactate or pH to be a superior prognostic marker than MELD with an area under the curve of 0.80, 0.79, and 0.70, respectively. CONCLUSION: Dengue hepatitis progressed to ALF in 0.35%. Development of ALF was associated with a high mortality (> 50%). Lactate level, pH, and MELD score at admission were significant determinants of outcome.


Assuntos
Dengue/complicações , Dengue/diagnóstico , Hepatite Viral Humana/complicações , Hepatite Viral Humana/diagnóstico , Falência Hepática Aguda/etiologia , Adulto , Alanina Transaminase/sangue , Bilirrubina/sangue , Biomarcadores/sangue , Dengue/mortalidade , Feminino , Hepatite Viral Humana/mortalidade , Humanos , Concentração de Íons de Hidrogênio , Coeficiente Internacional Normatizado , Lactatos/sangue , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Testes Sorológicos , Taxa de Sobrevida
14.
J Sports Med Phys Fitness ; 60(3): 345-354, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31684705

RESUMO

BACKGROUND: Recovery from exercise is important in sports and rehabilitation for preventing exercise-induced injuries and recovery of performance. This study aimed to compare active recovery (AR), neuromuscular electrical stimulation (NMES), and foam rolling (FR) in terms of blood lactate (Bla) removal, reduction in delayed-onset muscle soreness (DOMS), and restoration of muscle strength, endurance, and flexibility in healthy young individuals. METHODS: Forty-five subjects aged 20-25 years were assigned to AR, FR, and NMES groups. The subjects performed a single bout of circuit-based high-intensity training (CBHIT) at 85% of the heart rate reserve (HRR). The subjects in the AR group walked at 40% of the HRR, whereas those in the FR group self-massaged the tight muscles. In the NMES group, electrical stimulation was applied to the hamstrings and quadriceps. All recovery methods took 15 minutes. The sit-and-reach performance, quadriceps and hamstring strength, and squat endurance of the subjects were measured prior to CBHIT and after recovery. Bla concentrations were measured before CBHIT and at 0, 5, and 20 minutes of recovery. The DOMS were evaluated for 3 days. RESULTS: After recovery, no significant differences were found between the groups in terms of quadriceps (right, P=0.82; left, P=0.772) and hamstring (right, P=0.41; left, P=0.30) strength, sit-and-reach performance (P=0.55), squat endurance (P=0.18), Bla concentration at each time point (P=0.94), and DOMS (P=0.31). CONCLUSIONS: This study showed that AR, NMES, and FR have similar effects on Bla removal, performance recovery, and DOMS reduction in healthy young individuals.


Assuntos
Lactatos/sangue , Músculo Esquelético/fisiopatologia , Mialgia/terapia , Adulto , Exercício Físico/fisiologia , Feminino , Músculos Isquiossurais/fisiopatologia , Humanos , Masculino , Força Muscular , Mialgia/fisiopatologia , Músculo Quadríceps/fisiopatologia , Recuperação de Função Fisiológica , Esportes , Adulto Jovem
15.
Sci Rep ; 9(1): 18817, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31827223

RESUMO

Elevated blood lactate after moderate exercise was reported in some of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We hypothesised that blood lactate could be also elevated in resting conditions. We aimed investigating the frequency of elevated lactate at rest in ME/CFS patients, and comparing characteristics of ME/CFS patients with and without elevated lactate. Patients fulfilling international consensus criteria for ME/CFS who attended the internal medicine department of University hospital Angers-France between October 2011 and December 2017 were included retrospectively. All patients were systematically hospitalised for an aetiological workup and overall assessment. We reviewed their medical records for data related to the assessment: clinical characteristics, comorbidities, fatigue features, post-exertional malaise (PEM) severity, and results of 8 lactate measurements at rest. Patients having ≥1 lactate measurement ≥2 mmol/L defined elevated lactate group. The study included 123 patients. Elevated (n = 55; 44.7%) and normal (n = 68; 55.3%) lactate groups were comparable except for PEM, which was more severe in the elevated lactate group after adjusting for age at disease onset, sex, and comorbidities (OR 2.47, 95% CI: 1.10-5.55). ME/CFS patients with elevated blood lactate at rest may be at higher risk for more severe PEM. This finding may be of interest in ME/CFS management.


Assuntos
Síndrome de Fadiga Crônica/sangue , Lactatos/sangue , Índice de Gravidade de Doença , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Biomed Res Int ; 2019: 3963780, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31828102

RESUMO

Background: Several studies have shown the utility of lactate level as a predictor of early outcomes in trauma patients. We conducted this study to evaluate the association of perioperative serum lactate levels with postoperative delirium (POD) in elderly trauma patients. Materials and Methods: This study included 466 elderly trauma patients with measurements of serum lactate levels on admission and 1 h after surgery. The associations of POD with serum lactate levels (on admission and 1 h after surgery) and lactate clearance were analyzed using Kendall's correlation. Perioperative serum lactate levels and lactate clearance as predictors of POD were evaluated using univariate and multivariable analyses. Results: The incidence of POD in the present study was 38.1%. Serum lactate levels on admission and at 1 h after surgery were significantly higher in major trauma than in minor trauma. In univariate analysis of perioperative serum lactate levels and lactate clearance as predictors of POD, the odds ratio (OR) for serum lactate level on admission was 4.19 (P < 0.01, 2.91 < 95% confidence interval (CI) < 6.02) and that 1 h after surgery was 3.83 (P < 0.01, 2.79 < 95% CI < 5.25); however, the OR for serum change of lactate level was 0.99 ((P < 0.09, 0.99 < 95% CI < 1.00). In multivariable analysis for predictors of POD, the OR for serum lactate level on admission was 2.40 (P < 0.09, 0.87 < 95% CI < 6.7), that for serum lactate 1 h after surgery was 2.83 (P=0.01, 1.28 < 95% CI < 6.24), that for ICU admission was 3.01 (P=0.01, 2.09 < 95% CI < 6.03), and that for ISS was 1.47 (P < 0.01, 1.27 < 95% CI < 3.70). Conclusions: Taking together the results of univariate and multivariable analyses, serum lactate level 1 h after surgery may be used as a prediction model of POD development in elderly trauma patients.


Assuntos
Delírio/sangue , Delírio/etiologia , Lactatos/sangue , Complicações Pós-Operatórias/sangue , Ferimentos e Lesões/sangue , Idoso , Feminino , Humanos , Incidência , Masculino , Razão de Chances , Estudos Retrospectivos , Fatores de Risco
17.
Arch Med Res ; 50(6): 325-332, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31677537

RESUMO

BACKGROUND: The timing of initiation of Norepinephrine (NEP) in septic shock is controversial. AIM OF THE STUDY: We evaluated the impact of early NEP simultaneously with fluids in those patients. METHODS: We randomized 101 patients admitted to the emergency department with septic shock to early NEP simultaneously with IV fluids (early group) or after failed fluids trial (late group). The primary outcome was the in-hospital survival while the secondary outcomes were the time to target mean arterial pressure (MAP) of 65 mmHg, lactate clearance and resuscitation volumes. RESULTS: There was no significant difference between the two groups regarding the baseline characteristics. NEP infusion started after 25 (20-30) and 120 (120-180) min in the early and late groups (p = 0.000). MAP of 65 mmHg was achieved faster in the early group (2 [1-3.5] h vs. 3 [2-4.75] h, p = 0.003). Serum lactate was decreased by 37.8 (24-49%) and 22.2 (3.3-38%) in both groups respectively (p = 0.005). Patients with early NEP were resuscitated by significantly lower volume of fluids (25 [18.8-28.7] mL/kg vs. 32.5 [24.4-34.6] mL/kg) in the early and late groups (p = 0.000). The early group had survival rate of 71.9% compared to 45.5% in the late group (p = 0.007). NEP started after 30 (20-120 min) in survivors vs. 120 (30-165 min) in non-survivors (p = 0.013). CONCLUSIONS: We concluded that early Norepinephrine in septic shock might cause earlier restoration of blood pressure, better lactate clearance and improve in-hospital survival.


Assuntos
Agonistas alfa-Adrenérgicos/uso terapêutico , Norepinefrina/uso terapêutico , Ressuscitação/métodos , Choque Séptico/tratamento farmacológico , Idoso , Pressão Sanguínea/fisiologia , Feminino , Humanos , Infusões Intravenosas/métodos , Lactatos/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
PLoS One ; 14(11): e0224801, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31710635

RESUMO

The objective of the present study was to verify the energy expenditure (EE), energy system contributions and autonomic control during and after an acute low-load or high-load resistance training (RT) protocol to momentary failure (MF) in young adults. Eleven young men (22 ± 3 yrs, 71.8 ± 7.7 kg; 1.75 ± 0.06 m) underwent a randomized crossover design of three knee extension acute protocols: a low-load RT [30% of their maximal strength (1RM); RT30] or a high-load RT (80% of 1RM; RT80) protocol, with all sets being performed to MF; or a control session (Control) without exercise. Participants were measured for EE, energy system contributions, and cardiac autonomic control before, during, and after each exercise session. Exercise EE was significantly higher for RT30 as compared to RT80. Furthermore, post measurements of blood lactate levels and the anaerobic lactic system contribution were significantly greater for RT30 as compared to RT80. In addition, parasympathetic restoration was lower for RT30 as compared to RT80. In conclusion, a low-load (30% 1RM) RT session produced higher EE during exercise than a high-load (80% 1RM) RT session to MF, and may be a good option for fitness professionals, exercise physiologists, and practitioners when choosing the optimal RT protocol that provides more EE, especially for those who want or need to lose weight.


Assuntos
Metabolismo Energético/fisiologia , Exercício Físico/fisiologia , Treinamento de Resistência , Frequência Cardíaca/fisiologia , Humanos , Lactatos/sangue , Masculino , Consumo de Oxigênio/fisiologia , Adulto Jovem
19.
Front Immunol ; 10: 2207, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31608052

RESUMO

Our previous studies of protective immunity and pathology against blood stage malaria parasites have shown that not only CD4+ T cells, but also CD8+ T cells and macrophages, are important for host defense against blood stage malaria infection. Furthermore, we found that Plasmodium yoelii 17XNL (PyNL) parasitizes erythroblasts, the red blood cell (RBC) precursor cells, which then express MHC class I molecules. In the present study, we analyzed spleen cytokine production. In CD8+ T cell-depleted mice, IL-10 production in early stage infection was increased over two-fold relative to infected control animals and IL-10+ CD3- cells were increased, whereas IFN-γ production in the late stage of infection was decreased. At day 16 after PyNL infection, CD8+ T cells produced more IFN-γ than CD4+ T cells. We evaluated the involvement of the immunoproteasome in induction of immune CD8+ T cells, and the role of Fas in protection against PyNL both of which are downstream of IFN-γ. In cell transfer experiments, at least the single molecules LMP7, LMP2, and PA28 are not essential for CD8+ T cell induction. The Fas mutant LPR mouse was weaker in resistance to PyNL infection than WT mice, and 20% of the animals died. LPR-derived parasitized erythroid cells exhibited less externalization of phosphatidylserine (PS), and phagocytosis by macrophages was impaired. Furthermore, we tried to identify the cause of death in malaria infection. Blood lactate concentration was increased in the CD8+ T cell-depleted PyNL-infected group at day 19 (around peak parasitemia) to similar levels as day 7 after infection with a lethal strain of Py. When we injected mice with lactate at day 4 and 6 of PyNL infection, all mice died at day 8 despite demonstrating low parasitemia, suggesting that hyperlactatemia is one of the causes of death in CD8+ T cell-depleted PyNL-infected mice. We conclude that CD8+ T cells might control cytokine production to some extent and regulate hyperparasitemia and hyperlactatemia in protection against blood stage malaria parasites.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Citocinas/imunologia , Lactatos/sangue , Malária/imunologia , Parasitemia/imunologia , Plasmodium yoelii , Baço/imunologia , Animais , Linfócitos T CD4-Positivos/imunologia , Eritrócitos , Feminino , Imunidade Celular , Macrófagos/imunologia , Malária/sangue , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Parasitemia/sangue
20.
J Appl Lab Med ; 3(4): 587-600, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-31639728

RESUMO

BACKGROUND: Sepsis is a leading cause of death for children in the US and worldwide. There is a lack of consensus how sepsis is clinically defined, and sepsis definitions and diagnostic guidelines for the pediatric population have remained unchanged for more than a decade now. Current pediatric definitions are largely based on adult guidelines and expert opinion rather than evidence based on outcomes in the pediatric populations. Without a clear definition of sepsis, it is challenging to evaluate the performance of new laboratory tests on the diagnosis and management of sepsis. CONTENT: This review provides an overview of common etiologies of sepsis in pediatric populations, challenges in defining and diagnosing pediatric sepsis, and current laboratory tests used to identify and monitor sepsis. Strengths and limitations of emerging diagnostic strategies will also be discussed. SUMMARY: Currently there is no single biomarker that can accurately diagnose or predict sepsis. Current biomarkers such as C-reactive protein and lactate are neither sensitive nor specific for diagnosing sepsis. New biomarkers and rapid pathogen identification assays are much needed. Procalcitonin, although having some limitations, has emerged as a biomarker with demonstrated utility in management of sepsis in adults. Parallel studies analyzing the utility of procalcitonin in pediatric populations are lagging but have shown potential to affect sepsis care in pediatric populations. Multibiomarker approaches and stepwise algorithms show promise in the management of pediatric sepsis. However, a major hurdle is the lack of validated clinical criteria for classification of pediatric sepsis, which is necessary for the development of well-designed studies that can assess the clinical impact of these emerging biomarkers.


Assuntos
Bactérias/isolamento & purificação , Análise Química do Sangue/normas , Hemocultura/normas , Consenso , Sepse/diagnóstico , Biomarcadores/sangue , Análise Química do Sangue/métodos , Hemocultura/métodos , Proteína C-Reativa/análise , Criança , Humanos , Lactatos/sangue , Pró-Calcitonina/sangue , Sepse/sangue , Sepse/microbiologia , Sepse/mortalidade
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