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

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

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

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

The role of serum lactate in post-cardiac arrest syndrome

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

Acute and chronic effects of cadmium on blood homeostasis of an estuarine crab, Chasmagnathus granulata, and the modifying effect of salinity

Whole body oxygen consumption and some hemolymph parameters such as pH, partial pressure of gases, level of ions and lactate were measured in the estuarine crab Chasmagnathus granulata after both acute (96 h) and chronic (2 weeks) exposure to cadmium at concentrations ranging from 0.4 to 6.3 mg/l. In all instances, the crabs developed hemolymph acidosis, but no respiratory (increased PCO2) or lactate increases were evident. Hemolymph levels of sodium and calcium were always increased by cadmium exposure. The chronic toxicity of cadmium was enhanced at 12 0/00 salinity, even causing a significantly higher mortality in comparison with the higher salinity (30 0/00) used. A general metabolic arrest took place at 12 0/00 salinity in the crabs chronically exposed to cadmium, as indicated by decreases of oxygen consumption and PCO2, an increase of PO2, along with no changes in lactate levels. These imbalances were associated with severe necrosis and telangiectasia in the respiratory gills, probably leading to respiratory impairment and finally histotoxic hypoxia and death of the animals

Efecto agudo de dobutamina y amrinona sobre la hemodinamia y perfusión esplácnica de pacientes en shock séptico / Acute effect of dobutamine and amrinone on hemodynamics and splanchnic perfusion in septic shock patients

Background: Vasoactive drugs used in the reanimation of septic patients, can modify splanchnic perfusion. Aim: To compare the effects of dobutamine and amrinone on gastric intramucosal pH (pHi), lactate levels and hemodynamics in surgical patients with compensated septic shock. Patients and methods: Fourteen postoperative patients with abdominal sepsis and compensated septic shock (pHi <7.32 or lactate >2.5 mmol/l) were studied in a prospective, randomized, unblinded study. Patients were randomized to receive (Group 1, n=7) dobutamine at 5 µg/Kg/min or (Group 2, n=7) amrinone at 5 µg/Kg/min. Hemodynamic data, arterial lactate and pHi were measured before and 30, 60 and 120 minutes after starting drug infusion. Results: Both drugs were associated with a decrease in lactate levels. Dobutamine infusion, but not amrinone, increased gastric pHi, as well as cardiac index and oxygen delivery. Conclusions: An improvement in gastric pHi associated with an increase in oxygen delivery, was observed with dobutamine. Amrinone showed no effect at the fixed, low dose used in the study

The metabolic effects of estriol in female rat liver

The effects of estriol on oxygen uptake, glucose release, lactate and pyruvate production, beta-hydroxybutyrate and acetoacetate production in perfused rat liver as well as, carbon uptake in rat liver and intracellular calcium in isolated Kupffer cells were investigated. Basal oxygen consumption of perfused liver increased significantly in estriol or ethanol-treated rats. But these increased effects were blocked by gadolinium chloride pretreatment. In a metabolic study, pretreatment with estriol resulted in a decrease in glucose production and in glycolysis while an increase in ketogenesis. A more oxidized redox state of the mitochondria was indicated by increased ratios of perfusate [lactate]/[pyruvate] and decreased ratios of perfusate [beta-hydroxybutyrate]/[acetoacetate]. Carbon uptake of Kupffer-cell increased significantly in estriol-treated rats. But these increased uptake were not shown in rats pre-treated by gadolinium chloride blocking phagocytosis. In isolated Kupffer cells from estriol-treated rats, intracellular calcium was more significantly increased after addition of lipopolysaccharide (LPS) than in controls. These findings suggest that the metabolic effects of estriol (two mg per 100 mg body wt) can be summarized to be highly toxic in rat liver, and these findings suggest that oral administration of estrogens may induce hepatic dysfunctions and play a role in the development of liver disease.

Clampeo aórtico experimental: comparación de las alteraciones metabólicas producidas por clampeo intermitente versus continuo / Experimental aortic clamping: comparisson of the metabolic alterations produced by intermittent versus continuous cross clamping

El clampeo aórtico es una técnica reconocida en el manejo de lesiones vasculares de la aorta toracoabdominal y en trauma. La complicación más temida es la paraplejía postoperatoria por compromiso de la irrigación medular, que puede presentarse hasta en un 38 por ciento de los pacientes. En un trabajo previo demostramos la disminución de paraplejía postclampeo mediante la utilización de un clampeo mediante la utilización de un clampeo de 30 minutos en forma intermitente versus continua, en un modelo experimental en conejos. Utilizando una modificación de dicho protocolo evaluamos las diferencias en el metabolismo ácido base producidos por clampeo aórtico intermitente vs continuo, tanto en el territorio distal como el proximal al clampeo, determinando los valores seriados de lactacidemia y gases en sangre, hasta 60 minutos después del clampeo. Se obtienen diferencias significativas (p <0,005) en los valores de lactacidemia, pH, HCO3 ST y BE en aquellos animales sometidos a clampeo aórtico intermitente y controles vs aquéllos sometidos a clampeo continuo. Se concluye que el clampeo aórtico intermitente presenta una alteración menor y estadísticamente significativa del metabolismo ácido base en este modelo de clampeo experimental

Role of calcium influx & energy metabolism in histamine release by filarial antigen in Mastomys natalensis experimentally infected with Brugia malayi.

The present work was undertaken to study the biochemical pathways involved in terms of role of calcium influx and status of energy metabolism in the activation of mast cells obtained from Mastomys natalensis infected with Brugia malayi when challenged in vitro with a potentially allergenic antigen (60 kDa) of Brugia malayi. It was observed that histamine release from sensitized lung and peritoneal mast cells was associated with intracellular influx of radioactive Ca2+, thus establishing the role of calcium in histamine release. The process of activation of mast cells by 60 kDA antigen was an energy requiring process as it utilized the energy phosphates in the form of ATP and the cells followed the aerobic respiratory pathway for the generation of energy molecules.

Proposta de referências para a prescriçäo de treinamento aeróbio e anaeróbio para corredores de média e longa duraçäo / Reference proposal for aerobic and anaerobic training for long and middle distance runners

O limiar anaeróbio é utilizado como referência para a prescriçao de esforços de capacidade aeróbia. Normalmente, o trabalho supra-limiar é identificado na curva [La] - intensidade, em velocidades correspondentes a valores fixos de [La]. Na prática, porém, esta abordagem mostrou-se pouco discriminatória, causada por diversas combinaçoes entre o aumento das [La] nestas intensidades e capacidade de treinamento intervalado e repetitório. Com o objetivo de atenuar este problema, passamos a identificar as velocidades médias de corrida de 3000 m (V3000) e 500 m (V500) como referências de potência aeróbia e capacidade lática, respectivamente. Preconiza-se, como encontrado na literatura, as intensidades relativas à velocidade de referência de máximo "steady-state" de lactato (velocidade de [La] de 3,5 ou 4 mmol x 1(-1) para a prescriçao do treinamento de capacidade aeróbia. O treinamento misto, aeróbio-anaeróbio compreende intensidades entre a V3,5/V4 e V3000 e o treino de capacidade lática entre a V3000 e V500. Em resultados de corredores de meio-fundo e fundo de alto nível, encontramos que V3,5 e V500 correspondem, respectivamente, a 89,2 por cento e 126,7 por cento de V3000. Estes valores estao de acordo com os que sao encontrados na literatura para a prescriçao de treinamento para atletas de elite, recomendando, portanto, a proposta apresentada.

Fisiopatología del trastorno de ansiedad / The physiopathologyof anxiety disorders

En los últimos años se ha estudiado el trastorno de ansiedad, desde muy diversos enfoques. En el siguiente artículo revisaremos las teorías fisiopatológicas propuestas por los diferentes grupos de investigación en esta área. Abordaremos tres enfoques teóricos: neurobiológico, psicoanalítico asi como del aprendizaje-conductual

Significance of ascitic fluid white blood cells, pH, lactate, and other chemistry in immediate diagnosis of spontaneous bacterial peritonitis.

From 1989 to 1991, 68 cirrhotic patients, 47 with uninfected ascites and 21 with SBP were studied for the significance of ascitic fluid pH, lactate, PMN count and other chemistry for immediate diagnosis of SBP. It was revealed that ascitic fluid PMN count if over 500 per mm3, the increased lactate, or decreased glucose level, strongly supported the diagnosis of SBP. In cases of suspecting SBP but with low PMN count the ascitic values of lactate, glucose and pH will guide the diagnosis. If the ascitic lactate plus glucose, or lactate plus pH are above the cut off levels (lactate > 25 mg/dl; glucose < 60 mg/dl and pH < 7.35) the diagnosis is strongly suggestive. The ascitic fluid pH and A-AF pH gradient were not of diagnostic value due to instability of pH after tapping. For other chemistry in the ascitic fluid, there was a slight increase in ADA level in SBP, but for glucose, protein and glutamine levels, there was no difference among the groups with and without SBP.

La acción de los diferentes isómeros del acido láctico en el colón de la rata / The action of different lactic acid isomers in the colon of rats

La presencia de ácido láctico en la luz colónica según su calidad y/o cantidad, puede asociarse con un daño metabólico del colonocito. En este trabajo se estudio la influencia de los diferentes isómeros del ácido lático y su recêmico en dos concentraciones extremas (20 y 100 mEq/l) en la luz colônica de la rata. Las modificaciones sobre el pH, el agua y los electrólitos se asociaron con la acción absortivo secretora de la pared colónica. Por otro lado se determinó la influencia del ácido láctico sobre el mucus colônico y la permeación de albúmina. Se efectuó el estudio histopatológico del ciego y del colon izquierdo. Se demuestra que existen diferencias en el comportamiento de la pared colónica frente a los distintos isómeros y al recémico del ácido láctico; (una) mayor absorción de agua, Na+ y Cl- para el isómero D(-) a baja concentración; comportándose en forma opuesta a altas concentraciones. El pH final es más alto con la forma D(-), no habiendo grandes variaciones en la permeación de albunina entre los diferentes isómeros. A altas concentraciones se frena la absorción de Cl-. Llama la atención el porcentaje alto de erosiones especialmente en el ciego dondo se halla el isómero (+) a alta concentración. Las presentes observaciones sugieren que la presencia de ácido láctico en la colitis ulcerosa merece mayor atención sobretudo en determinar la cantidad y calidad del mismo

Effects of hypotensive anesthesia with sodium nitroprusside or isoflurane on hemodynamic and metabolic changes

The hemodynamic and metabolic changes during induced hypotension with isoflurane (isoflurane group) or sodium nitroprusside (SNP group) were observed in twelve mongrel dogs. These hypotensive effects were evaluated at 30 and 60 minutes after the mean arterial blood pressure was lowered to 50% from the control. Hemodynamic changes were evaluated by measuring systemic arterial blood pressure, heart rate, central venous pressure, pulmonary capillary wedge pressure, cardiac output, systemic vascular resistance and pulmonary vascular resistance. Metabolic changes were evaluated by measuring serum lactate and pyruvate, arterio-venous oxygen content difference and oxygen extraction rate. We also compared the ventilatory effect of hypotensive anesthesia by blood gas analysis. The results were as follows: 1. Isoflurane inhalation 2-4% or SNP infusion 10-20 micrograms/kg/min was required to reduce the mean arterial pressure to 50% of the control. 2. Heart rate was decreased slightly in the isoflurane group but significantly decreased in the SNP group. 3. There were no significant changes in central venous pressure and pulmonary capillary wedge pressure in either group. 4. Cardiac output was reduced in both groups but was more severe in the isoflurane group. 5. Systemic vascular resistance was decreased by 36% in the isoflurane group and 47% in the SNP group. 6. Acidosis was apparent and did not recover to the control until 30 minutes after recovery in the SNP group. 7. Arterio-venous oxygen difference was increased during hypotension in the isoflurane group probably due to decreased cardiac output. 8. The lactate/pyruvate ratio increased slightly in the SNP group.

Bases fisiológicas en la evaluación médico deportiva: segunda parte; lactacidemia / Physiologic basis in the medical sportive appraisement: second part; lactacidemia

Dentro de las bases fisiológicas en la evaluación médico deportiva es indispensable el conocimiento de los pasos metabólicos del ácido láctico y su reflejo en la sangre, la lactacidemia. Así, intento describir parcialmente el metabolismo de los hidratos de carbono (glucógeno, glucosa) en su transformación en azucares más sencillos hasta la formación de ácido láctico con la producción de energía en forma de ATP, su entrada en el ciclo de Krebs y el importante papel que le cabe a las coenzimas portadoras de hidrógeno NAD y FAD en la captura de energía. Vemos los diferentes niveles de ácido láctico en sangre frente a distintos volúmenes, intensidades y pausas de trabajo. Esto permite afirmar que quién se dedica a la fisiología del deporte debe conocer que se puede acrecentar la velocidad de los pasos metabólicos con entrenamientos específicos que aumenten la actividad de las enzimas citoplásmicas que forman parte de este sistema formador de energia. De ahí la importancia de la determinación de la lactacidemia en el deporte, que nos indica si nos encontramos ante un ejercicio subaeróbico, hiperaeróbico, en el área funcional del VO. máximo o en el umbral aeróbico-anaeróbico, y nos da las pautas del tipo de entrenamiento que debemos diagramar para lograr un resultado metabólico que se ajuste a los requerimientos de la actividad física en cuestión

Lactate metabolism in chronic liver disease

The purpose of this study was to observe lactate metabolism in chronic liver disorders. Seventy four [74] cases were selected on the basis of history, clinical examination and laboratory aids. It was tried to correlate the arterial lactate levels with various hepatic functional reserves according to Child's criteria. It was revealed by this study that patients with chronic liver disorders have progressive hyperlactatemia according to decreasing hepatic functional reserve. Furthermore it is suggested that arterial lactate can be helpful in treating such patients when there are concomitant acid-base disturbances

The effect of hyperglycemia on lipid peroxidation in the global cerebral ischemia of the rat

To investigate the influence of hyperglycemia on ischemic brain damage, we measured brain ATP, lactate and malondialdehyde (MDA) levels in global cerebral ischemic models of Wistar rats. We induced global cerebral ischemia by the 4-vessel occlusion method. After 30 or 60 min of occlusion, and after 30 min of reperfusion, we measured brain ATP, lactate and MDA levels. During the ischemic period, brain ATP levels decreased to 30-70% of sham groups both in normoglycemic and hyperglycemic groups. But during the reperfusion period, the recovery rate of ATP levels was significantly lower in the hyperglycemic than in the normoglycemic groups (p less than 0.05). After 60 min of global ischemia, brain lactate increased much more in the hyperglycemic than in the normoglycemic group, and, during reperfusion, was washed out slowly in the hyperglycemic group. The MDA level, a parameter of lipid peroxidation, increased more in the hyperglycemic group than in the normoglycemic group during reperfusion periods (p less than 0.05). We conclude that hyperglycemia increases lactate accumulation, delays the recovery of energy metabolism, and enhances the lipid peroxidation in the transient global ischemia of rat brain. These findings may suggest the harmfulness of hyperglycemia in clinical cerebral ischemia.

Induction of L-asparaginase synthesis in Vibrio proteus.

Studies on L-asparaginase synthesis in V. proteus showed increased synthesis in cultures grown under conditions of moderate aeration (P less than 0.005) after oxygen had been used up from the medium. Addition of sodium lactate to the medium at a concentration of 80 mu mole/ml, stimulated L-asparaginase synthesis (2.2 times over control) in moderately-aerated cultures (P less than 0.001). The substrate L-asparagine induced enzyme synthesis when growth conditions were made anaerobic or lactate was incorporated into the medium (3.8 times increased enzyme synthesis over control).

Effect of thiabendazole & mebendazole on in vitro metabolism of Nippostrongylus brasiliensis adults.

Mebendazole and thiabendazole were found to inhibit glucose uptake and its metabolism in the adult rat hookworm (N. brasiliensis) in vitro. Rates of endogenous glycogen utilisation, and excretion of one of the end products of glycolysis viz., lactic acid, were found to be increased, when the intact N. brasiliensis adults were incubated for 60 min with mebendazole and thiabendazole, respectively.

Comparative study of phosphofructokinase from rat small intestine and liver. Control by fructose-2,6-bisphosphate and other effectors

As compared to the liver, intestinal mucosa shows a high rate of aerobic glycolysis. This difference has been attributed to the higher activity of the intestinal phosphofructokinase (PFK) isoenzyme. The regulatory properties of rat small intestine and liver PFK were investigated. At pH 8, where PFK activity can be evaluated free of allosteric influences, the specific activity of the liver isoenzyme was 25%higher that of the intestinal one, At pH 7, the mucosal PFK was activated to 80%of its maximal activity at pH 8, while the liver enzyme showed only a 40%activation. The apparent Kms for Fructose-6-P were 0.47 and 1.03 mM for the mucosal and hepatic isoenzymes, respectively. At 2 mM Fructose-6-P, the optimal ATP concentration for both isoenzymes was 1 mM Hogher ATP concentrations strongly anhibited both enzymes, but below 3 mM, PFK activity was larger in the mucosal homogenate. In addition, the intestinal PFK was more sensitive to activation by Fructose-2,6-bisphosphate and 6-phosphogluconate, particulary at low Fructose-6-p concentrations, and by AMP below 0.3 mM. These studies suggest that, under physiological conditions, the intestinal isoenzyme is more active than its liver counterpart. This may acccunt for the high rate of aerobic glycolysis observed in the intestinal mucosa

Aspectos positivos da participaçäo do lactato na atividade muscular / Positive contribution of the lactic acid metabolism during muscular exercise

Na situaçäo de repouso säo produzidos, diariamente, cerca de 120g de lactato dos quais apenas 1/3 säo provenientes dos tecidos de metabolismo virtualmente anaeróbico. Nestas condiçöes a maior parte do lactato circulante é removida pelo fígado (53%) que o utiliza na neoglicogênese e, em menor parte, para oxidaçäo ou na formaçäo de triglicerídeos. A neoglicogênese hepática do lactato tem importância na homeostase glicêmia (ciclo de Cori e no equilibrio ácido básico pois consome grande parte dos 1,29M de H+ gerados diariamente pelo ácido láctico. A outra via de utilizaçäo do lactato sangüíneo é a oxidaçäo completa para produçäo de energia. Este processo é ativo no fígado, córtex renal, pulmäo e fibras músculares oxidativas (tipo I e IIA). A produçäo ou utilizaçäo do lactato depende da concentraçäo intracelular do piruvato e no NADH ambos dependentes do sistema redoxi, ou seja, aerobiose citosólica. Durante o exercício físico o músuclo esquelético é o principal produtor de lactato. As respostas respiratórias e circulatórias näo säo instantâneas de modo que nos primeiros segundos o trabalho muscular é sustentado pela energia produzida anerobicamente. Nestas condiçöes, os estoques musculares de creatina fosfato (17uM/g) säo rapidamente depletados pela rápida demanda de ATP (3 uM/seg/g), o que faz com que o trabalho muscular, nesta fase, seja sustentado fundamentalmente, pela glicólise anaeróbica gerando grande quantidade de lactato. Além, de substrato neoglicogenético, o lactato, pela sua açäo vasodilatadora muscular e estimuladora da freqüência cardíaca e da ventilaçäo pulmonar, facilita a instalaçäo do trabalho muscular aeróbico...