Lack of change in the respiratory quotient during oxygen supply dependence in endotoxemic shock: a subanalysis of an experimental controlled study / Ausência de alteração no quociente respiratório durante a dependência do suprimento de oxigênio no choque endotoxêmico: subanálise de um estudo experimental controlado

ABSTRACT Objective: To evaluate if the reductions in systemic and renal oxygen consumption are associated with the development of evidence of anaerobic metabolism. Methods: This is a subanalysis of a previously published study. In anesthetized and mechanically ventilated sheep, we measured the respiratory quotient by indirect calorimetry and its systemic, renal, and intestinal surrogates (the ratios of the venous-arterial carbon dioxide pressure and content difference to the arterial-venous oxygen content difference. The Endotoxemic Shock Group (n = 12) was measured at baseline, after 60 minutes of endotoxemic shock, and after 60 and 120 minutes of fluid and norepinephrine resuscitation, and the values were compared with those of a Control Group (n = 12) without interventions. Results: Endotoxemic shock decreased systemic and renal oxygen consumption (6.3 [5.6 - 6.6] versus 7.4 [6.3 - 8.5] mL/minute/kg and 3.7 [3.3 - 4.5] versus 5.4 [4.6 - 9.4] mL/minute/100g; p < 0.05 for both). After 120 minutes of resuscitation, systemic oxygen consumption was normalized, but renal oxygen consumption remained decreased (6.3 [5.9 - 8.2] versus 7.1 [6.1 - 8.6] mL/minute/100g; p = not significance and 3.8 [1.9 - 4.8] versus 5.7 [4.5 - 7.1]; p < 0.05). The respiratory quotient and the systemic, renal and intestinal ratios of the venous-arterial carbon dioxide pressure and content difference to the arterial-venous oxygen content difference did not change throughout the experiments. Conclusion: In this experimental model of septic shock, oxygen supply dependence was not associated with increases in the respiratory quotient or its surrogates. Putative explanations for these findings are the absence of anaerobic metabolism or the poor sensitivity of these variables in detecting this condition.

RESUMO Objetivo: Avaliar se as reduções do consumo de oxigênio sistêmico e renal estão associadas ao desenvolvimento de evidências de metabolismo anaeróbico. Métodos: Esta é uma subanálise de estudo já publicado. Em ovinos anestesiados e ventilados mecanicamente, medimos o quociente respiratório por calorimetria indireta e seus substitutos sistêmicos, renais e intestinais (as razões entre a diferença de pressão venoarterial do teor de dióxido de carbono e a diferença arteriovenosa do teor de oxigênio). O Grupo Choque Endotoxêmico (n = 12) foi medido inicialmente, após 60 minutos do choque endotoxêmico e após 60 e 120 minutos da ressuscitação com fluidos e norepinefrina, e os valores foram comparados com os do Grupo Controle (n = 12) sem intervenções. Resultados: O choque endotoxêmico diminuiu o consumo de oxigênio sistêmico e renal (6,3 [5,6 - 6,6] versus 7,4 [6,3 - 8,5] mL/minuto/kg e 3,7 [3,3 - 4,5] versus 5,4 [4,6 - 9,4] mL/minuto/100g; p < 0,05 para ambos). Após 120 minutos de ressuscitação, o consumo sistêmico de oxigênio foi normalizado, mas o consumo renal de oxigênio permaneceu reduzido (6,3 [5,9 - 8,2] versus 7,1 [6,1 - 8,6] mL/minuto/100g; p = NS e 3,8 [1,9 - 4,8] versus 5,7 [4,5 - 7,1]; p < 0,05). O quociente respiratório e as razões sistêmica, renal e intestinal entre a diferença na pressão venoarterial do teor de dióxido de carbono e a diferença arteriovenosa do teor de oxigênio não se alteraram ao longo dos experimentos. Conclusão: Nesse modelo experimental de choque séptico, a dependência do suprimento de oxigênio não foi associada a aumentos no quociente respiratório ou em seus substitutos. As explicações possíveis para esses achados são a ausência de metabolismo anaeróbico ou a baixa sensibilidade dessas variáveis na detecção dessa condição.

Role of Pv-aCO2 gradient and Pv-aCO2/Ca-vO2 ratio during cardiac surgery: a retrospective observational study

Abstract Introduction: Arterial lactate, mixed venous O2 saturation, venous minus arterial CO2 partial pressure (Pv-aCO2) and the ratio between this gradient and the arterial minus venous oxygen content (Pv-aCO2/Ca-vO2) were proposed as markers of tissue hypoperfusion and oxygenation. The main goals were to characterize the determinants of Pv-aCO2 and Pv-aCO2/Ca-vO2, and the interchangeability of the variables calculated from mixed and central venous samples. Methods: 35 cardiac surgery patients were included. Variables were measured or calculated: after anesthesia induction (T1), end of surgery (T2), and at 6-8 hours intervals after ICU admission (T3 and T4). Results: Macrohemodynamics was characterized by increased cardiac index and low systemic vascular resistances after surgery (p < 0.05). Hemoglobin, arterial-pH, lactate, and systemic O2 metabolism showed significant changes during the study (p < 0.05). Pv-aCO2 remained high and without changes, Pv-aCO2/Ca-vO2 was also high and decreased at T4 (p < 0.05). A significant correlation was observed globally and at each time interval, between Pv-aCO2 or Pv-aCO2/Ca-vO2 with factors that may affect the CO2 hemoglobin dissociation. A multilevel linear regression model with Pv-aCO2 and Pv-aCO2/Ca-vO2 as outcome variables showed a significant association for Pv-aCO2 with SvO2, and BE (p < 0.05), while Pv-aCO2/Ca-vO2 was significantly associated with Hb, SvO2, and BE (p < 0.05) but not with cardiac output. Measurements and calculations from mixed and central venous blood were not interchangeable. Conclusions: Pv-aCO2 and Pv-aCO2/Ca-vO2 could be influenced by different factors that affect the CO2 dissociation curve, these variables should be considered with caution in cardiac surgery patients. Finally, central venous and mixed values were not interchangeable.

Ventilatory Muscle Strength Six Months After Coronary Artery Bypass Grafting in Patients Submitted to Inspiratory Muscular Training Based on Anaerobioc Threshold: A Clinical Trial

Abstract Introduction Coronary artery bypass grafting (CABG) surgery is associated with a decline in ventilatory muscle strength and lung function. Inspiratory muscle training (IMT) based on anaerobic threshold (AT) has been used to minimize the impact of CABG on these parameters, but the long-term impact is unknown. Objective To test the hypothesis that AT-based IMT improves inspiratory muscle strength and lung function even six months after CABG. Methods This is a randomized controlled clinical trial. In the preoperative period, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), vital capacity (VC) and peak expiratory flow (PEF) rate were assessed. On the first postoperative day, patients were randomized into two groups: AT-based IMT (IMT-AT) (n=21) where the load was prescribed based on glycemic threshold and conventional IMT (IMT-C) (n=21), with load of 40% of MIP. Patients were trained during hospitalization until the day of discharge and were assessed at discharge and six months later. For within-group comparison, paired Student's t-test or Wilcoxon test was used, and independent Student's t-test or the Mann-Whitney test was used to analyze the different time points. A p<0.05 was considered significant. Results At six months after CABG surgery, statistical difference was found between the IMT-AT and the IMT-C groups in MIP (difference between the means of -5cmH2; 95% CI=- 8.21to-1.79) and VC (difference between the means of -2ml/kg;95%CI=-3.87to-0.13). No difference was found between groups in the other variables analyzed. Conclusion IMT-AT promoted greater recovery of inspiratory muscle strength and VC after six months of CABG when compared to conventional training.

Fitness training of athletes in freestyle skiing / Treinamento de aptidão física de atletas em esqui de estilo livre / Entrenamiento de aptitud física de atletas en esquí de estilo libre

ABSTRACT Introduction: Physical training is essential to physical fitness in freestyle skiers. The domain of stability in the technical movements is a determinant of the competition, always constantly improving. Objective: Develop a physical training program adapted to freestyle skiing. Methods: Twelve freestyle skiers were selected as volunteers for the experiment. This paper compares athletes' physical qualities and individual abilities before and after physical training. Through recent research, the athletes' physical condition was comprehensively evaluated to test the effectiveness of their physical training. results: Freestyle skiers showed good anaerobic fitness. A relationship was found between the maximum number of thrusts, the degree of spin in the air, the maximum power duration, and the power decay rate (P<0.05). In the body balance test, the lower limbs showed deficiencies in anteroposterior mobility, while bipodal balance showed no significantly statistical differences (P>0.05). Conclusion: This paper systematically studies body composition, the center of gravity strength, anaerobic capacity, and balance in freestyle skiers. The results provide a good assessment of the effect of fitness training on freestyle ski athletes. These results have particular guiding significance for formulating and implementing training programs focused on the sport. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O treinamento físico é parte essencial da aptidão física em esquiadores de estilo livre. O domínio da estabilidade nos movimentos técnicos é determinante sobre as competições, estando sempre em constante aprimoramento. Objetivo: Elaborar um programa de treinamento físico adaptado ao esporte do esqui de estilo livre. Métodos: Selecionou-se 12 esquiadores de estilo livre como voluntários ao experimento. Este artigo compara as qualidades físicas e habilidades individuais dos atletas antes e depois do treinamento físico. Através de pesquisas recentes, avaliou-se de forma abrangente a condição física dos atletas para testar a eficácia de seu treinamento físico. Resultados: Os esquiadores de estilo livre apresentaram uma boa praticabilidade anaeróbica. Foi encontrada uma relação particular entre o número máximo de propulsões e o grau de giro no ar, a duração máxima da potência e a taxa de decaimento da potência (P<0,05). No teste de equilíbrio corporal, os membros inferiores apresentaram deficiências de mobilidade anteroposterior, enquanto o equilíbrio bipodal não apresentou diferenças significativamente estatísticas (P>0,05). Conclusão: Este artigo fornece um estudo sistemático da composição corporal, força do centro gravitacional, capacidade anaeróbica e equilíbrio em esquiadores de estilo livre. Os resultados proporcionam uma boa avaliação do efeito de treinamento de aptidão física nos atletas de esqui de estilo livre. Estes resultados têm um significado orientador particular para a formulação e implementação de programas de treinamento focados na modalidade. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El entrenamiento físico es una parte esencial de la aptitud física en los esquiadores de estilo libre. El dominio de la estabilidad en los movimientos técnicos es determinante sobre las competiciones, estando siempre en constante mejora. Objetivo: Desarrollar un programa de entrenamiento físico adaptado al deporte del esquí de estilo libre. Métodos: Se seleccionaron doce esquiadores de estilo libre como voluntarios para el experimento. Este artículo compara las cualidades físicas y las capacidades individuales de los atletas antes y después del entrenamiento físico. Mediante una investigación reciente, se evaluó exhaustivamente la condición física de los atletas para comprobar la eficacia de su entrenamiento físico. Resultados: Los esquiadores de estilo libre mostraron una buena aptitud anaeróbica. Se encontró una relación particular entre el número máximo de empujes y el grado de giro en el aire, la duración de la potencia máxima y la tasa de disminución de la potencia (P<0,05). En la prueba de equilibrio corporal, los miembros inferiores mostraron deficiencias en la movilidad anteroposterior, mientras que el equilibrio bipodal no mostró diferencias estadísticas significativas (P>0,05). Conclusión: Este artículo proporciona un estudio sistemático de la composición corporal, la fuerza gravitatoria central, la capacidad anaeróbica y el equilibrio en esquiadores de estilo libre. Los resultados proporcionan una buena evaluación del efecto del entrenamiento físico en los atletas de esquí de estilo libre. Estos resultados tienen una especial importancia orientativa para la formulación y aplicación de programas de entrenamiento centrados en este deporte. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

El índice de anaerobiosis predice mortalidad en neumonía grave por SARS-CoV-2 / The anaerobiosis index predicts mortality in patients with severe pneumonia due to SARS-CoV-2 / O índice de anaerobiose prevê a mortalidade em pneumonia grave devido a SARS-CoV-2

Resumen: Introducción: Detectar y corregir el metabolismo anaerobio es indispensable en el paciente críticamente enfermo; desafortunadamente, no existe un estándar de oro. Los pacientes con neumonía grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) presentan hipoxemia severa, aumentando el metabolismo anaerobio. El lactato y la diferencia de presión venoarterial de dióxido de carbono/diferencia del contenido arteriovenoso de oxígeno (Δp(v-a)CO2/ΔC(a-v)O2) son útiles en este contexto. Material y métodos: Estudio de cohorte, prospectivo, descriptivo y analítico, que incluyó pacientes ingresados a la Unidad de Cuidados Intensivos (UCI) en el periodo comprendido entre el 18 de abril de 2020 al 18 de enero de 2021 con neumonía grave (definida por el inicio de ventilación mecánica invasiva) por SARS-CoV-2 confirmados. Resultados: En el periodo comprendido se incluyeron 91 pacientes que cumplieron con los criterios de inclusión. Del total, 39 pacientes se incluyeron en el grupo de supervivientes y 52 en el grupo de no supervivientes. Se puede observar que la Δp(v-a)CO2/ΔC(a-v)O2, o índice de anaerobiosis, tiene OR de 4.4, IC de 95% 1.51-13.04, p = 0.006 en el análisis multivariable. Conclusión: El incremento de la Δp(v-a)CO2/ΔC(a-v)O2, o índice de anaerobiosis, > 1.4 mmHg/mL está relacionado con 4.44 veces más riesgo de muerte en los pacientes con neumonía grave (intubados) por SARS-CoV-2.

Abstract: Introduction: Detecting and correcting anaerobic metabolism is essential in the critically ill patient, unfortunately, there is no gold standard. Patients with severe pneumonia due to SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) present severe hypoxemia, increasing anaerobic metabolism. Lactate and the venoarterial carbon dioxide pressure difference/arteriovenous oxygen content difference (Δp(v-a)CO2/ΔC(a-v)O2) are useful in this context. Material and methods: Prospective, descriptive and analytical cohort study that included patients admitted to the Intensive Care Unit (ICU) in the period from April 18, 2020 to January 18, 2021 with severe pneumonia (defined by the start of invasive mechanical ventilation) by SARS-CoV-2 confirmed. Results: In the period covered, 91 patients who met the inclusion criteria were included. Of the total, 39 patients were included in the survivors group and 52 in the non-survivors group. It can be seen that the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index has OR 4.4, 95% CI 1.51-13.04, p = 0.006 in the multivariate analysis. Conclusion: The increase in the Δp(v-a)CO2/ΔC(a-v)O2 also called anaerobiosis index > 1.4 mmHg/mL is associated with a 4.44 times higher risk of death in patients with severe pneumonia (intubated) due to SARS-CoV-2.

Resumo: Introdução: Detectar e corrigir o metabolismo anaeróbio é essencial no paciente crítico, infelizmente, não existe um «padrão ouro¼. Pacientes com pneumonia grave por SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) apresentam hipoxemia grave, aumentando o metabolismo anaeróbio. O lactato e a diferença de pressão venoarterial de dióxido de carbono/diferença do conteúdo arteriovenoso de oxigênio (Δp(v-a)CO2/ΔC(a-v)O2) são úteis neste cenário. Material e métodos: Estudo de coorte, prospectivo, descritivo e analítico que incluiu pacientes internados na Unidade de Terapia Intensiva (UTI) no período de 18 de abril de 2020 a 18 de janeiro de 2021 com pneumonia grave (definida pelo início da ventilação mecânica invasiva) por SARS-CoV-2 confirmados. Resultados: No período compreendido, foram incluídos 91 pacientes que atenderam aos critérios de inclusão. Do total, 39 pacientes foram incluídos no grupo sobrevivente e 52 no grupo não sobrevivente. Pode-se observar que o Δp(v-a)CO2/ΔC(a-v)O2 ou índice de anaerobiose tem OR 4.4, IC 95% 1.51-13.04, p = 0.006 na análise multivariada. Conclusão: Um aumento em Δp(v-a)CO2/ΔC(a-v)O2 ou índice de anaerobiose > 1.4 mmHg/mL está associado a um aumento de 4.44 vezes no risco de morte em pacientes com pneumonia grave (entubados) por SARS-CoV-2.

Rectal damage control: when to do and not to do / Control de daños de recto: que hacer y que no hacer

Abstract Rectal trauma is uncommon, but it is usually associated with injuries in adjacent pelvic or abdominal organs. Recent studies have changed the paradigm behind military rectal trauma management, showing better morbidity and mortality. However, damage control techniques in rectal trauma remain controversial. This article aims to present an algorithm for the treatment of rectal trauma in a patient with hemodynamic instability, according to damage control surgery principles. We propose to manage intraperitoneal rectal injuries in the same way as colon injuries. The treatment of extraperitoneal rectum injuries will depend on the percentage of the circumference involved. For injuries involving more than 25% of the circumference, a colostomy is indicated. While injuries involving less than 25% of the circumference can be managed through a conservative approach or primary repair. In rectal trauma, knowing when to do or not to do it makes the difference.

Resumen El trauma de recto es poco frecuente, pero generalmente se asocia a lesiones de órganos adyacentes en la región pélvica y abdominal. Estudios recientes han cambiado los paradigmas del manejo tradicional derivados del trauma militar, mostrando mejores resultados en la morbilidad y mortalidad. Sin embargo, las técnicas de control de daños en el trauma rectal aún son controvertidas. El objetivo de este articulo es proponer el algoritmo de manejo del paciente con trauma rectal e inestabilidad hemodinámica, según los principios de la cirugía de control de daños. Se propone que las lesiones del recto en su porción intraperitoneal sean manejadas de la misma manera que las lesiones del colon. Mientras que el manejo de las lesiones extraperitoneales del recto dependerá del compromiso de la circunferencia rectal. Si es mayor del 25% se recomienda realizar una colostomía. Si es menor, se propone optar por el manejo conservador o el reparo primario. Saber que hacer o que no hacer en el trauma de recto marca la diferencia.

Proporção entre pressão venosa central menos arterial de dióxido de carbono e conteúdo arterial menos venoso central de oxigênio como indicador de oxigenação tissular: uma revisão narrativa / Central venous minus arterial carbon dioxide pressure to arterial minus central venous oxygen content ratio as an indicator of tissue oxygenation: a narrative review

RESUMO A proporção entre pressão venosa central menos arterial de dióxido de carbono e conteúdo de oxigênio arterial menos venoso central (Pcv-aCO2/Ca-cvO2) foi proposta como marcador substituto para quociente respiratório e indicador de oxigenação tissular. Alguns pequenos estudos observacionais identificaram que Pcv-aCO2/Ca-cvO2 acima de 1,4 se associa com hiperlactatemia, dependência de suprimento de oxigênio e maior mortalidade. Mais ainda, a Pcv-aCO2/Ca-cvO2 foi incorporada a algoritmos para avaliação da oxigenação tissular e ressuscitação. Contudo, a evidência para estas recomendações é bastante limitada e de baixa qualidade. O objetivo desta revisão narrativa foi analisar as bases metodológicas, os fundamentos fisiopatológicos e a evidência experimental e clínica para dar suporte à utilização da Pcv-aCO2/Ca-cvO2 como marcador substituto para quociente respiratório. De um ponto de vista fisiopatológico, o aumento do quociente respiratório secundariamente a reduções críticas no transporte de oxigênio é um evento dramático e com risco à vida. Entretanto, este evento é facilmente observável e provavelmente não demandaria maiores monitoramentos. Visto que o início do metabolismo anaeróbico é indicado pelo aumento súbito do quociente respiratório e que a faixa normal do quociente respiratório é ampla, o uso do ponto de corte definido como 1,4 para Pcv-aCO2/Ca-cvO2 não faz sentido. Estudos experimentais demonstraram que a Pcv-aCO2/Ca-cvO2 é mais dependente de fatores que modificam a dissociação do dióxido de carbono da hemoglobina do que do quociente respiratório, e o quociente respiratório e Pcv-aCO2/Ca-cvO2 podem ter comportamentos distintos. Estudos conduzidos em pacientes críticos demonstraram resultados controvertidos com relação à capacidade da Pcv-aCO2/Ca-cvO2 para predizer o desfecho, hiperlactatemia, anomalias microvasculares e dependência de suprimento de oxigênio. Um estudo randomizado controlado também demonstrou que a Pcv-aCO2/Ca-cvO2 é inútil como alvo para ressuscitação. A Pcv-aCO2/Ca-cvO2 deve ser interpretada com cautela em pacientes críticos.

ABSTRACT The central venous minus arterial carbon dioxide pressure to arterial minus central venous oxygen content ratio (Pcv-aCO2/Ca-cvO2) has been proposed as a surrogate for respiratory quotient and an indicator of tissue oxygenation. Some small observational studies have found that a Pcv-aCO2/Ca-cvO2 > 1.4 was associated with hyperlactatemia, oxygen supply dependency, and increased mortality. Moreover, Pcv-aCO2/Ca-cvO2 has been incorporated into algorithms for tissue oxygenation evaluation and resuscitation. However, the evidence for these recommendations is quite limited and of low quality. The goal of this narrative review was to analyze the methodological bases, the pathophysiologic foundations, and the experimental and clinical evidence supporting the use of Pcv-aCO2/Ca-cvO2 as a surrogate for respiratory quotient. Physiologically, the increase in respiratory quotient secondary to critical reductions in oxygen transport is a life-threatening and dramatic event. Nevertheless, this event is easily noticeable and probably does not require further monitoring. Since the beginning of anaerobic metabolism is indicated by the sudden increase in respiratory quotient and the normal range of respiratory quotient is wide, the use of a defined cutoff of 1.4 for Pcv-aCO2/Ca-cvO2 is meaningless. Experimental studies have shown that Pcv-aCO2/Ca-cvO2 is more dependent on factors that modify the dissociation of carbon dioxide from hemoglobin than on respiratory quotient and that respiratory quotient and Pcv-aCO2/Ca-cvO2 may have distinct behaviors. Studies performed in critically ill patients have shown controversial results regarding the ability of Pcv-aCO2/Ca-cvO2 to predict outcome, hyperlactatemia, microvascular abnormalities, and oxygen supply dependency. A randomized controlled trial also showed that Pcv-aCO2/Ca-cvO2 is useless as a goal of resuscitation. Pcv-aCO2/Ca-cvO2 should be carefully interpreted in critically ill patients.

Evaluación del nivel de eficiencia física a estudiantes de Medicina / Evaluation of the level of physical efficiency in medical students

Introducción: La calidad del proceso enseñanza-aprendizaje en las clases de Educación Física, depende del desarrollo adecuado de habilidades y capacidades físicas, esto implica la búsqueda de vías más factibles para poder determinar con mayor acierto las deficiencias de nuestros estudiantes. Objetivo: Evaluar el nivel de eficiencia física a estudiantes de Medicina. Material y Métodos: Se realizó un estudio explicativo con diseño experimental, en la Filial de Ciencias Médicas Gabriela Arias del municipio de Cárdenas, en el curso escolar 2015-2016. El universo estuvo constituido por 54 estudiantes de Medicina de primer año quienes cumplieron con los criterios de inclusión; seleccionaron una muestra de 20, que se distribuyeron aleatoriamente en dos grupos, al grupo control se les aplicó las pruebas de aptitud físicas integradoras del programa de la signatura Educación Física y al grupo estudio las pruebas funcionales de terreno. Resultados: Las pruebas de aptitud físicas integradoras establecidas por el programa, no poseen ninguna prueba que determine la capacidad aeróbica y, por ende, los P1 no cuentan con la calidad científica requerida. Las pruebas funcionales de terreno permiten realizar una correcta planificación de las cargas de entrenamiento y lograr cumplir con los objetivos de la preparación, conociendo las características funcionales de los estudiantes y sus respuestas a las cargas de entrenamiento. Conclusiones: La aplicación de las pruebas funcionales de terreno permite una mayor integralidad en el proceso de evaluación de los diferentes sistemas energéticos, aeróbicos y anaeróbicos(AU)

Introduction: The quality of the teaching-learning process in Physical Education, depends on the appropriate development of abilities and physical capacities, which implies the search of more appropriate ways of determining the deficiencies of our students in a more successful way. Objective: To evaluate the level of physical efficiency in medical students. Material and Methods: An explanatory study with experiment design was conducted in the Subsidiary of Medical Sciences Gabriela Arias in Cárdenas municipality during the 2015-2016 academic year. The universe was composed of 54 first year medical students that fulfilled the inclusion criteria; a sample of 20 students was selected, who were randomly distributed in two groups. Tests of physical integrated behavior corresponding to the Physical Education syllabus were applied to the control group; and field tests of functional performance were applied to the experimental group. Results: The tests of physical integrated behavior conceived in the syllabus, do not demonstrate any evidence that determines the aerobic capacity; therefore, the lesson plans do not have the required scientific quality. The field tests of functional performance allow to carry out a correct planning of the training loads to be able to fulfill the objectives of the preparation, knowing the functional characteristics of the students and their responses to the training loads. Conclusions: The application of the field tests of functional performance provides a greater comprehensiveness in the evaluation process of the different energetic, aerobic, and anaerobic systems(AU)

Anaerobic digestion of wastewater from coffee and chemical analysis of biogas produced using gas chromatography: quantification of methane, and potential energy gas exchanger / Digestão anaeróbia de águas residuárias do café e análise química do biogás produzido por cromatografia gasosa: quantificação de metano e potencial de troca gasosa de energia

Methane is the main constituent of biogas, being responsible for its calorific value. This work objective was to present the analysis of methane concentration in the biogas originated from anaerobic treatment system of wastewater of coffee wet processing (CWP) at laboratory scale, using coffee coconut. The methane concentration were performed by gas-solid chromatography (GSC) analyses. The system was composed of a column Restek RT-Q-PLOT, with the stage sets, the divinyl-benzene, nitrogen as mobile phase and a flame ionization detector (FID). The results of the concentration of methane in the biogas ranged from 48.60 to 68.14%. The upper and lower calorific values were 25,654 and 23,777 kJ.m-3, respectively. For interchangeability, obtained a Wobbe number of 7,851 kcal.m-3, resulting in their interchangeability with piped gas (city gas).

O metano é o principal constituinte do biogás, sendo o responsável pelo seu poder calorífico. Neste trabalho, são apresentadas as análises da concentração de metano no biogás produzido a partir do tratamento das águas residuárias do processamento por via úmida do café (ARC) em sistema de tratamento anaeróbio em escala de laboratório, sendo utilizado o café coco para a produção destas ARC. As análises foram realizadas por cromatografia gás-sólido (CGS), sendo o sistema composto de uma coluna Restek RT-Q-PLOT, tendo como fase fixa, o divinil-benzeno; do nitrogênio como fase móvel e um detector de ionização de chama (DIC). Os resultados da concentração de metano no biogás variaram de 48,60 a 68,14 %, sendo estas variações obtidas em função dos parâmetros do processo de tratamento. Os poderes caloríficos superior e inferior foram de 25.654 e 23.777 kJ.m-3, respectivamente. Para a permutabilidade, obteve-se um número de Wobbe de 7.851 kcal.m-3, resultando na sua permutabilidade com o gás canalizado (gás da cidade).

Anaerobic culture on growth efficient bi-layered culture plate in a modified candle jar using a rapid and slow combustion system.

Success for maximum isolation of anaerobes depends on maintaining critically low oxygen levels throughout and growth in a reduced medium with exclusion of inhibitory substances. Hence a dual system was used equipped with candle combustion for instant exhaustion of major part of oxygen from a sealed jar, along with acidified steel wool for residual oxygen purging. For inhibitory substances removal, test anaerobes were grown on anaerobic medium layered on buffer charcoal agar bed. After 48 hours incubation average colony sizes were compared with that of growths in conventional Gas-Pak system. Better growths were noted in the innovative system.

Influence of lactic acid on seed germination of finger millet (Eleusine Coracana Gaertn.).

Lactic acid is regarded as a harmful product of anaerobic respiration occurring under waterlogged conditions in plant tissues. Effect of exogenous application of lactic acid on seed germination and activities of some important enzyme systems in seed of finger millet cultivar GPU28 was investigated. High concentration (0.5%) of lactic acid caused a marked reduction in germination percentage during initial phase (first 24 h) of seed germination. Lactic acid treatment caused suppression of seedling growth; radical growth being more sensitive than the coleoptiles growth. The analysis of enzyme activities at 24h germination stage revealed that lactic acid treatment caused decrease in the activities of enzyme amylase, acid phosphatase, ATPase, peroxidase, and catalase while there was elevation of alkaline phosphatase activity.

Stress response in pathogenic bacteria.

Bacterial pathogens survive under two entirely different conditions, namely, their natural environment and in their hosts. Response of these pathogens to stresses encountered during transition from the natural environment to human hosts has been described. The virulence determinants of pathogenic bacteria are under the control of transcriptional activators which respond to fluctuations in growth temperature, osmolarity, metal ion concentration and oxygen tension of the environment. The regulation of stress induced genes may occur at the level of transcription or translation or by post-translational modifications. Under certain stress conditions local changes in the superhelicity of DNA induce or repress genes. In addition to their role in survival of bacteria under stressful situations, the stress induced proteins are also implicated in the manifestation of pathogenicity of bacterial pathogens in vivo.