Analysis of the biocompatibility of a biocelulose and a poly L- lactic acid membrane

The use of selective barriers as resorbable membranes has become a routine clinical procedure for guided bone regeneration. Therefore, the production of membranes with a low inflammatory potential during their resorption process has become the goal of a considerable number of researches. Aim: The purpose of the present study was to evaluate the biocompatibility of poly (L- lactic acid) (PLLA) and biocelulose membranes (BC) inserted in the subcutaneous tissue on the dorsum of rats. Methods: Fifteen animals underwent surgical procedures for the insertion of 4 types of membranes: COL (Collagen membrane) ­ Control Group; BC (Biocellulose membrane); BCAg (Biocellulose membrane impregnated with Silver); PLLA (Poly (L-lactic acid) membrane). All membrane types were inserted into each animal. Animals were euthanized after 3, 7, and 15 days of the surgical procedure. Descriptive histological analyses were carried out to investigate host tissue reaction to membrane presence by assessing the anti-inflammatory process composition associated with the membrane resorption and the presence of foreign-body reaction or encapsulation. Results: The BC membranes showed a higher degree of inflammation and poor pattern of integration with the surrounding tissues than the PLLA and COL membranes. Conclusion: The PLLA and COL membranes present better biocompatibility than the BC membranes

Hiperwarburgismo: la "hipoglucemia feliz" de los pacientes oncológicos: Revisión narrativa / Hyperwarburgism: the "Happy hypoglycemia" of cancer patients: Case report and review of literature

Introducción: La glucosa es el combustible energético cerebral, esta relación es establecida de manera integral en la inmensa mayoría de revisiones, debido al ávido consumo -y casi exclusivo - glucósico por parte del tejido neuronal. En esta esfera, la hipoglucemia se traduce por defecto en un conjunto de síntomas neurológicos, resultado del estado neuroglucopénico. Cuando la caída de estos niveles glicémicos es pronunciada desencadena alteraciones del estado sensorial, pudiendo llegar al coma con daños irreversibles de sostenerse en el tiempo. Propósito de la revisión: El objetivo de la revisión es presentar un caso de hipoglucemia severa sin sintomatología neuroglucopénica. Recientes hallazgos: Al ausencia de sintomatología neurológica se da debido al consumo del lactato ­ tradicionalmente producto anaerobiótico ­ como una vía metabólica energética alternativa al consumo de glucosa. La hipoglucemia puede ser compensada a nivel neurológico con sistemas lanzadores de lactato en el tejido neuronal, este puede sustituir a la glucosa como sustrato energético del cerebro. Conclusiones: La hipoglicemia sin síntomas adrenérgicos o neuroglucopénicos es un tema vinculado a pacientes oncológicos, y propone al lactato como combustible del tejido nervioso adicional a la glucosa. Por otra parte, la asociación lactato = hipoperfusión, es otra entidad que debe ser revisada y reanalizada por todo lo que implica el lactato dentro de la vía fisiopatológica metabólica corporal.

Introduction: Glucose is the cerebral energy fuel; this relationship is fully established in most re-views due to neuronal tissue's avid and almost exclusive glucose consumption. In this sphere, hypoglycemia is translated by default into a set of neurological symptoms resulting from the neuroglycopenic state. When the drop in these glycemic levels is pronounced, it triggers alterations in the sensory state, being able to reach a coma with irreversible damage if sustained over time. Purpose of the review: The objective is to present a case of severe hypoglycemia without neu-roglycopenic symptoms. Recent findings: The absence of neurological symptoms is due to the consumption of lactate ­ traditionally an anaerobic product ­ as an alternative energy metabolic pathway to glucosa consumption. Hypoglycemia can be compensated at the neurological level with lactate launching systems in neuronal tissue, replacing glucose as the brain's energy substrate. Conclusions: Hypoglycemia without adrenergic or neuroglycopenic symptoms is an issue linked to cancer patients, and lactate is proposed as fuel for nervous tissue in addition to glucose. On the other hand, the lactate-hypoperfusion association is another entity that must be reviewed and reanalyzed for everything that lactate implies within the body's metabolic pathophysiological pathway.

Medición de los niveles de lactato sérico y frecuencia cardiaca en caninos (Canis lupus familiaris) braquicefálicos, mesocefálicos y dolicocefálicos sometidos a prueba de esfuerzo en trotadora motorizada / Measurement of serum lactate levels and heart rate in canines (Canis lupus familiaris) Brachycephalic, Mesocephalic and Dolichocephalic submitted to a stress test on a motorized treadmill

RESUMEN Se analizaron los niveles de lactato sérico y de frecuencia cardiaca (FC) en 15 perros clinicamente sanos que fueron sometidos a pruebas de esfuerzo en trotadora motorizada, buscando verificar un grado de fatiga muscular frente a una prueba de esfuerzo intenso. Se consideraron pacientes con morfologia craneana de tipo braquicefálico, mesocefálico y dolicocefálico. Las mediciones séricas de lactato fueron conseguidas por medio de un medidor portátil, mientras que las frecuencias cardiacas se obtuvieron a través de un oximetro portátil a los tiempos 0, 10, 20 y 30 minutos, en los diferentes momentos de esfuerzo fisico en la trotadora motorizada, la cual fue adaptada en su inclinación en 15% y a un máximo de velocidad de 10 km/h. Las medias de los niveles séricos entre perros mesocefálicos y dolicocefálicos fueron significativas, a diferencia de los perros braquicefálicos los cuales resultaron no significativos. Las medias de las frecuencias cardiacas no tuvieron diferencia significativa bajo un 95% de confianza.

ABSTRACT Serum lactate and heart rate (HR) levels were analyzed in 15 clinically healthy dogs that were subjected to stress tests on a motorized treadmill, seeking to verify a degree of muscle fatigue compared to an intense exercise test. Patients with brachycephalic, mesocephalic and dolichocephalic type cranial morphology were considered. Serum lactate measurements were procured by means of a portable meter, while heart rates were obtained through a portable oximeter at the times 0, 10, 20, and 30 minutes at different moments of physical effort on the motorized treadmill, which was adapted in its inclination by 15% and at a maximum speed of 10 km/h. Mean serum levels between mesocephalic and dolichocephalic dogs were significant, unlike brachycephalic dogs, which were not significant. The mean heart rates did not have a significant difference under 95% confidence.

Blood lactate as a biomarker of depression: a comparative study between runners and sedentary people

Abstract Aim: The main objective of this work is to investigate whether recreational running, considered an aerobic exercise, would stimulate blood lactate production, reducing the risk of symptoms of depression. Methods: To accomplish this, we compared the depressive symptoms with the Beck Depression Inventory-II, the intensity of physical activity with the International Physical Activity Questionnaire, and blood samples of the D-lactate assay in two groups of participants who practiced and did not practice street running. Results: The results showed a negative correlation between blood lactate levels and the severity of symptoms of depression. In addition, running volunteers had significant blood lactate levels and low depression scores compared to non-running volunteers. Conclusion: This evidence suggests that street running may reduce symptoms of depression by stimulating blood lactate levels.

Low molecular weight heparin reduces arterial blood lactic acid content and increases estimated glomerular filtration rate in patients with moderate Covid-19 pneumonia / 中华医学杂志(英文版)

BACKGROUND@#Coronavirus disease 2019 (Covid-19) remains a serious health threat worldwide. We aimed to investigate whether low molecular weight heparin (LMWH) can promote organ function recovery in moderate Covid-19 pneumonia patients.@*METHODS@#We initiated an LMWH protocol in Covid-19 patients with increased D-dimer, body mass index >30 kg/m2 or a history of diabetes from January 18, 2020 at Shanghai Public Health Clinical Center. In this retrospective study, we assigned moderate Covid- 19 pneumonia patients admitted between January 18th and April 18, 2020 receiving the LMWH protocol to the LMWH group. Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching. General clinical information, indicators for renal function, arterial blood gas analyses, arterial blood lactic acid content (mmol/L), and coagulation indexes at 0 day, 3 days, 7 days, and 11 days after admission were recorded and compared between the two groups.@*RESULTS@#There were 41 patients in the LMWH group and 82 patients in the control group. General information in both groups were similar. Compared to the control group, the arterial blood lactic acid content (mmol/L) at day 11 (1.3 [1.1, 1.7] vs. 1.2 [0.9, 1.3], P = 0.016) was reduced in the LMWH group. The estimated glomerular filtration rate (eGFR) in the LMWH group was higher than that in the control group at day 7 (108.54 [89.11, 128.17] vs. 116.85 [103.39, 133.47], P = 0.039) and day 11 (113.74 [94.49, 126.34] vs. 128.31 [112.75, 144, 12], P  = 0.003). The serum creatinine levels (Scr) in the LMWH group were lower than that in the control group at day 7 (62.13 [51.47, 77.64] vs. 55.49 [49.50, 65.75], P = 0.038) and day 11 (63.35 [50.17, 75.73] vs. 51.62 [44.62, 61.24], P = 0.005).@*CONCLUSIONS@#LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients. Randomized controlled trials are warranted to further investigate this issue.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR2000034796.

Metabolomic Profile in Patients with Malignant Disturbances of the Prostate: An Experimental Approach / Perfil metabolómico en pacientes con alteraciones malignas de la próstata: Un enfoque experimental

Purpose To identify metabolites in humans that can be associated with the presence of malignant disturbances of the prostate. Methods In the present study, we selected male patients aged between 46 and 82 years who were considered at risk of prostate cancer due to elevated levels of prostate-specific antigen (PSA) or abnormal results on the digital rectal examination. All selected patients came from two university hospitals (Hospital Universitario del Valle and Clínica Rafael Uribe Uribe) and were divided into 2 groups: cancer (12 patients) and non-cancer (20 patients). Cancer was confirmed by histology, and none of the patients underwent any previous treatment. Standard protocols were applied to all the collected blood samples. The resulting plasma samples were kept at -80°C, and a profile of each one was acquired by nuclear magnetic resonance (NMR) using established experiments. Multivariate analyses were applied to this dataset, first to establish the quality of the data and identify outliers, and then, to model the data. Results We included 12 patients with cancer and 20 without it. Two patients were excluded due to contamination with ethanol. The remaining ones were used to build an Orthogonal Projections to Latent Structures Discriminant Analysis (OPLS-DA) model (including 15 non-cancer and 10 cancer patients), with acceptable discrimination (Q2 = 0.33). This model highlighted the role of lactate and lipids, with a positive association of these two metabolites and prostate cancer. Conclusions The primary discriminative metabolites between patients with and without prostate cancer were lactate and lipids. These might be the most reliable biomarkers to trace the development of cancer in the prostate.

Objetivo Identificar metabolitos en humanos que pueden estar asociados con la presencia de alteraciones malignas de la próstata. Métodos Se incluyeron muestras de pacientes masculinos entre 46 y 82 años y que se consideraron en riesgo de cáncer de próstata debido a la elevación del antígeno prostático específico (PSA) o el examen rectal anormal. Todos los pacientes seleccionados procedían de dos hospitales universitarios (Hospital Universitario del Valle y Clínica Rafael Uribe Uribe) y se dividieron en dos grupos: Oncológicos (12) vs no oncológicos (20). El cáncer fue confirmado por histología, y ninguno de ellos recibió tratamiento previo. Se aplicaron protocolos estándar a todas las muestras de sangre recolectadas. Las muestras de plasma resultantes se mantuvieron a −80°C y se adquirió un perfil de cada muestra mediante RMN. Se aplicaron análisis multivariantes a este conjunto de datos, primero para establecer la calidad de los datos e identificar valores atípicos, y para modelar los datos. Resultados Se incluyeron 12 pacientes con cáncer y 20 pacientes sin cáncer. Dos pacientes fueron excluidos por contaminación con etanol. Los restantes se utilizaron para construir un modelo OPLS-DA (15 pacientes no oncológicos y diez oncológicos), con una discriminación aceptable (Q2 = 0,33). Este modelo destacó el papel del lactato y los lípidos, encontrando una asociación positiva entre estos dos metabolitos y el cáncer de próstata. Conclusiones Los principales metabolitos discriminativos entre pacientes con cáncer de próstata versus no cáncer fueron el lactato y los lípidos. Estos podrían ser los biomarcadores más confiables para rastrear el desarrollo del cáncer en la próstata.

Efecto de la recuperación activa en la potencia pico y el lactato después de protocolos de sprints repetidos, realizados en cicloergómetros: una revisión sistemática / Active Recovery Effect in the Peak Power and the Lactate, after Repeated Sprints Pro- tocols, Executed in Cycloergometer: A Systemic Review / Efeito da recuperação ativa sobre a potência de pico e o lactato depois de repetidos protocolos de Sprints realizados em cicloergómetros: uma revisão sistemática

Introducción: La recuperación activa se ha utilizado en actividades físicas de alta demanda energética como los sprints repetidos en cicloergómetros. Objetivo: Analizar el efecto de la recuperación activa en la potencia pico y el lactato, después de protocolos de sprints repetidos, hechos en un cicloergómetro. Materiales: Las fuentes bibliográficas consultadas fueron las bases de datos electrónicas Pubmed y Web of Science. Método: Se evaluó la calidad de los nueve artículos incluidos para lectura completa, utilizando la escala PEDro. Resultados: La efectividad de la recuperación activa para los sprints repetidos (SR) con menor disminución de la potencia pico se presentó en tres estudios con tiempos de recuperación de 20 min, 4 min y 45 s, realizando 3 o 4 SR con porcentaje de cadencia de pedaleo de 40% y 28% VO2máx o entre 60 y 70 rpm. Los 9 estudios analizados no presentaron diferencias significativas (p > 0,05) en el comportamiento del lactato en cuanto a la recuperación activa con los protocolos que realizaron. No obstante, se presentan diferencias significativas (p = 0,001) entre la recuperación activa y otros métodos de recuperación. Conclusión: Se deben considerar las características de la población para los protocolos analizados con diferencias en los tiempos de recuperación activa y ejecución del sprint, así como la cantidad de SR realizados y los porcentajes de cadencia de pedaleo.

Introduction: active recovery has been used in physical activities from high energetic claim as repeated sprints on cycloergometer. Objectives: analyse the active recovery effect in peak power and the lactate after repeated sprints protocols, executed on cycloergometer. A systematized bibliography was developed. Material: The bibliography sources were looked up from electronic databases Pubmed and Web of Science. Methods: The quality from the nine articles includes was evaluated for a whole reading. Using PEDro the protocols analysed showed active recovery timing difference and sprint execution, thus as the repeated sprints quantity executed and the assigned pedalling cadence percentage. Results: The effectiveness of the active recovery for the repeated sprints (RS) with a less decrease from the peak power presented in three different trials with recovery times from 20 minutes, 4 minutes, 45 seconds. Execute 3 or 4 RS with pedalling cadence percentage of 40 and 28 VO2max or between 60 and 70 rpm. The nine analysed trials did not show significant differences (p > 0.05) in the lactate performance concerning to the active recovery with the executed protocols. However, it presented significant differences (p = 0.001) between the active recovery and other recovery techniques. Conclusions: It should consider the population characteristics for the analysed protocols with differences between the AR timing and sprint execution, like the quantity of RS executed and the pedalling cadence percentage.

Introdução: A recuperação ativa tem sido utilizada em atividades físicas exigentes em termos energéticos, tais como repetidos Sprints em cicloergómetros. Objetivo: Analisar o efeito da recuperação ativa sobre a potência de pico e o lactato depois de repetidos protocolos de Sprint realizados num cicloergómetro. Materiais: As fontes bibliográficas consultadas foram as bases de dados electrónicas Pubmed e Web of Science. Método: A qualidade dos nove artigos incluídos para leitura completa foi avaliada utilizando a escala PEDro. Resultados: A eficácia da recuperação ativa para Sprints repetidos (SR) com menor diminuição da potência de pico foi apresentada em três estudos com tempos de recuperação de 20 min, 4 min e 45 s, realizando 3 ou 4 SR com uma percentagem de cadência de pedalagem de 40 % e 28 % de VO2max ou entre 60 e 70 rpm. Os 9 estudos analisados não mostraram diferenças significativas (p > 0,05) no comportamento do lactato em termos de recuperação ativa com os protocolos que rea- lizaram. No entanto, houve diferenças significativas (p = 0,001) entre a recuperação ativa e outros métodos de recuperação. Conclusão: As características da população devem ser consideradas para os protocolos analisados com diferenças nos tempos de recuperação ativa e execução de Sprints, bem como o número de SR realizados e as percentagens de cadência de pedalagem.

Central venous oxygen saturation/lactate ratio and prediction of major adverse events after pediatric heart surgery

Abstract Introduction: Major adverse events (MAE) are unexpected but undesirably frequent after pediatric congenital heart surgery and contribute to poorer outcomes. The aim of this study was to test the predictive value of a ratio between central venous oxygen saturation and arterial lactate (ScvO2/lactate) for MAE after pediatric congenital heart surgery in a Brazilian university hospital. Methods: We conducted a retrospective observational study in a tertiary care university hospital, including 194 infants and children submitted to surgery for congenital heart disease. The predictive value of ScvO2, lactate, and ScvO2/lactate ratio were assessed by the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The incidence of MAE was 16% — cardiac arrest/death, unplanned reoperation, and low cardiac output syndrome were the most common events. Overall, ScvO2/lactate ratio discriminated patients with and without MAE very well (AUC 0.842), performing better than either variable alone, with sensitivity of 48%, specificity of 94%, PPV of 60%, and NPV of 91%. Conclusion: A ScvO2/lactate ratio > 5 can accurately identify patients at low risk of MAE after pediatric congenital heart surgery, with very good specificity and NPV, but poor sensitivity and PPV.

Marcadores hematológicos y bioquímicos para el diagnóstico precoz de bacteriemiascausadas por Enterobacteriaceae resistentes a los carbapenémicos / Haematological and biochemical markers for the early diagnosis of bacteremias caused bycarbapenem-resistant Enterobacteriaceae

INTRODUCCIÓN. Las bacteriemias causadas por Enterobacteriaceae resistentes a carbapenémicos se asocian con altas tasas de mortalidad a diferencia de las bacteriemias causadas por Enterobacteriaceae sensibles a carbapenémicos. Los hallazgos clínicos y de laboratorio son importantes para determinar los esquemas terapéuticos y su pronóstico; su diagnóstico precoz resulta esencial para un manejo adecuado. OBJETIVO. Relacionar valores de marcadores sanguíneos y bioquímicos en bacteriemias causadas por Enterobacteriaceae resistentes a carbapenémicos. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 427 y muestra de 224 datos de hemocultivos positivos para Enterobacteriaceae de pacientes atendidos en el Hospital de Especialidades Carlos Andrade Marín en el periodo mayo 2016 a julio 2018. Criterios de inclusión: i) al menos un hemocultivo positivo; ii) recuperación del aislado de CRE o CSE y iii) recolección simultanea de muestras de sangre y pruebas de laboratorio. Criterios de exclusión: i) bacteriemias polimicrobianas; ii) valores fuera de rango y iii) reportes sin valores numéricos. El análisis de datos se realizó mediante el programa estadístico International Business Machines Statistical Package for the Social Sciences versión 24.0. RESULTADOS. Se demostró que el recuento de leucocitos [OR 1,21 (95% IC: 1,03-1,43)], el recuento de plaquetas [OR 1,65 (95% IC: 1,37-1,98)] y el tiempo parcial de tromboplastina [OR 1,29 (95% IC: 1,04-1,60)] fueron buenas variables predictoras independientes, mediante análisis de regresión logística multivariante. CONCLUSIÓN. La trombocitopenia y el tiempo parcial de tromboplastina prolongado se asociaron con bacteremia causada por Enterobacteriaceae resistentes a carbapenémicos.

INTRODUCTION. Bacteremias caused by carbapenem-resistant Enterobacteriaceae are associated with high mortality rates in contrast to bacteremias caused by carbapenem-sensitive Enterobacteriaceae. Clinical and laboratory findings are important in determining therapeutic regimens and prognosis; early diagnosis is essential for appropriate management. OBJECTIVE. To relate blood and biochemical marker values in bacteremia caused by carbapenem-resistant Enterobacteriaceae. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 427 and sample of 224 blood culture data positive for Enterobacteriaceae from patients attended at the Carlos Andrade Marín Specialties Hospital in the period May 2016 to July 2018. Inclusion criteria: i) at least one positive blood culture; ii) recovery of CRE or CSE isolate and iii) simultaneous collection of blood samples and laboratory tests. Exclusion criteria: i) polymicrobial bacteremia; ii) out-of-range values and iii) reports without numerical values. Data analysis was performed using the statistical program International Business Machines Statistical Package for the Social Sciences version 24.0. RESULTS. Leukocyte count [OR 1.21 (95% CI: 1.03-1.43)], platelet count [OR 1.65 (95% CI: 1.37- 1.98)] and partial thromboplastin time [OR 1.29 (95% CI: 1.04-1.60)] were shown to be good independent predictor variables, by multivariate logistic regression analysis. CONCLUSION. Thrombocytopenia and prolonged partial thromboplastin time were associated with bacteremia caused by carbapenem-resistant Enterobacteriaceae.

Comparación de métodos de diagnóstico para el tratamiento hemodinámico en recién nacidos y prematuros utilizando la medición de la vena cava, lactato y criterios clínicos / Comparison of diagnostic methods for hemodynamic treatment in unborn and pre-term infants using the measurement of vena cava, lactate, and clinical criteria

Introducción: no existe un criterio único para evaluar el estado hemodinámico de los recién nacidos y prematuros y las diferentes variables en el grupo de recién nacidos, como la edad gestacional, el peso al nacer y los períodos de nacimiento. Métodos: Se trata de un estudio observacional descriptivo, transversal, epidemiológico con dos cohortes de pacientes. Los recién nacidos a término y Pretérmino, atendidos en la Unidad de Neonatal del Hospital Pablo Arturo Suárez, participan durante los meses comprendidos entre Noviembre de 2019 a enero de 2020. Resultados: la medición ecográfica del flujo de la vena cava inferior (FVCI) es útil para el tratamiento de manejo del paciente neonatal hemodinámicamente inestable. La muestra estuvo conformada por 110 recién nacidos atendidos en el servicio de neonatología del Hospital Pablo Arturo Suárez desde noviembre de 2019 a enero de 2020. Quito, Pichincha, Ecuador. Las variables bajo peso al nacer y prematuridad moderada tienen un valor estadística-mente significativo para el uso de inotrópicos. Las demás variables no presentan valor esta-dísticamente significativo. La frecuencia cardíaca, el gasto urinario, la presión arterial media, el ácido láctico, el llenado capilar, el flujo de la vena cava superior y el flujo de la vena cava inferior tienen valores estadísticamente significativos. Las comparaciones de FVCI y superior (FVCS) con frecuencia cardíaca, gasto urinario, presión arterial media, ácido láctico, llenado capilar tienen un valor estadísticamente significativo, excepto para el llenado capilar >3 segundos en FCVI. Se utilizó el análisis multivariado de Componentes Principales Categóricos (CATPCA) para caracterizar el estado hemodinámico e inotrópico, que resultaron significativos en el análisis bivariado. Dimensión, uno de los gráficos bidimensionales, discrimina el uso o no de inotrópicos y las categorías de parámetros hemodinámicos TAM <35 mmHg, ácido láctico, llenado capilar, FVCI y FVCS. La dimensión dos discrimina entre las categorías de gasto urinario y FC. Conclusión: En recién nacidos a término y prematuros con bajo peso y adecuado peso al nacer con inestabilidad hemodinámica en general, que fueron evaluados con ecografía para medir el flujo de la vena cava, la concordancia entre los criterios clínicos y la valoración ecográfica del flujo fue de 0.4 cm / seg en ambos métodos. Esta situación significa que la medición de los flujos cava venosos por ecografía es útil para evaluar el estado hemodinámico de los pacientes neonatales.

Introduction: There is no single criterion available to assess the hemodynamic state of new-born in-fants and preterm infants and the different variables in the group of newborns, such as gestational age, birth weight, and periods of birth. Methods: This is an epidemiological, cross-sectional, descriptive observational study with two patient cohorts. Newborn-to-term and preterm neonates assisted at the Neonatal Unit of the Pablo Arturo Suarez Hospital participated during the months between November 2019 to January 2020. Results: Ultrasound measurement of the vena cava (FVC) flow is useful for the management treatment of hemodynamically unstable neonatal patients. The sample was made up of 110 newborns treated in the Pablo Arturo Suarez Hospital's neonatology service from November 2019 to January 2020. Quito, Pichincha, Ecuador. The variables low birth weight and moder-ate prematurity have a statistically sig-nificant value for inotropic use.The other variables do not present statistically significant values. Heart rate, urinary output, mean blood pressure, lactic acid, capillary filling, upper vena cava flow, and lower vena cava flow had statistically significant values. FVCI and FVCS comparisons with heart rate, urinary output, mean blood pressure, lactic acid, and capillary filling had statistically significant values, except for capil-lary filling >3 sec in FCVI. Multivariate analysis of categorical main components (CATPCA) was used to characterize the hemodynamic state and inotropic state, which were significant in the bivariate analysis. Dimension, one of the two-dimensional graphs, discriminates the use or not of inotropics and the categories of hemodynamic parameters TAM <35 mmHg, lactic acid, capillary filling, FVCI, and FVCS. Dimension IIdiscriminates between the categories of urinary expenditure and HR. Conclusion: In term and preterm infants with low weight and adequate birth weight with hemody-namic instability in general, who were evaluated with ultrasonography to measure the flow of the vena cava, the agreement between the clinical criteria and the ultrasound assessment of the flow was 0.4 cm/sec in both methods. This situation means that the measurement of venous cava flows by echo sonography is useful for assessing neonatal patients' hemodynamic status.

Anafilaxia ao ácido poli-L-láctico / Poly-L-lactic acid anaphylaxis

Paciente feminina, 47 anos, previamente hígida, apresentou reação anafilática associada ao uso do ácido poli-L-láctico (PLLA). Imediatamente após a administração do bioestimulador, a paciente referiu edema de face que evoluiu para urticária generalizada, edema em membros inferiores e tremores. Posteriormente, apresentou edema de língua e dificuldade para falar. Teste de puntura com extratos de PLLA na concentração pura 1:1 e testes intradérmicos na diluição 1:10 e 1:100 mostrou-se positivo. Paciente negou cofatores no dia do procedimento e alergias prévias. O presente artigo descreve o primeiro caso da literatura de anafilaxia ao PLLA, onde se discute aspectos da reação anafilática e exames usados para o diagnóstico.

A previously healthy 47-year-old woman had an anaphylactic reaction caused by poly-L-lactic acid (PLLA). Immediately after the administration of the biostimulating agent, the patient reported facial edema, which progressed to generalized urticaria, lower extremity edema, and tremors. Then she had tongue edema and difficulties to talk. A prick test with pure PLLA extracts (1:1) and intradermic tests (1:10 and 1:100 dilutions) were positive. The patient denied cofactors on procedure day as well as previous allergies. This is the first case report of anaphylaxis due to PLLA and includes a discussion of aspects of the anaphylactic reaction and tests that were used to provide the diagnosis.

Aerobic and anaerobic exercise ability of athletes combined with balanced nutrition / Capacidade de exercício aeróbico e anaeróbio de atletas combinada com nutrição equilibrada / Efectos combinados de una nutrición equilibrada en la capacidad de los atletas para realizar actividades aeróbicas

ABSTRACT Balanced nutrition is very important for athletes' health and competition performance, and balanced nutrition has become a hot topic in the sports industry. In this study, 30s anaerobic work test and maximal oxygen uptake test were used to test anaerobic exercise ability and aerobic exercise ability, respectively. Four groups were set up in the two test methods, and the corresponding functional test indexes, heart rate recovery index and blood lactic acid recovery value were determined. The anaerobic capacity test showed that the maximum power of male athletes in the experimental group had significant statistical difference before and after dietary balance management, and the fatigue index of female athletes in the experimental group had a significant downward trend. Five minutes and nine minutes after exercise, the blood lactic acid value of males in the experimental group was lower than before balanced nutrition. The aerobic capacity test showed that the exhaustion time of male athletes in the experimental group was significantly different before and after balanced nutrition. After the balanced nutrition, the blood lactic acid value of male athletes in the experimental group was lower than before the management immediately and nine minutes after exercise, and the heart rate value of the male athletes in the experimental group was far lower than before the management.

RESUMO Uma alimentação balanceada é muito importante para a saúde e o desempenho dos atletas em competições, tendo se tornado um tema bastante debatido no setor esportivo. Neste estudo, foram utilizados testes anaeróbios de 30 segundos e o teste captação máxima de oxigênio para testar a capacidade de exercício anaeróbio e a capacidade de exercício aeróbio, respectivamente. Foram criados quatro grupos nos dois métodos de teste, e foram determinados os índices de teste funcional, o índice de recuperação da frequência cardíaca e o valor de recuperação do ácido láctico no sangue. O teste de capacidade anaeróbia mostrou que a potência máxima dos atletas masculinos do grupo experimental apresentava diferença estatística significativa antes e depois da administração de alimentação balanceada, e o índice de fadiga dos atletas do grupo experimental apresentava uma tendência descendente significativa Cinco minutos e nove minutos após o exercício, o valor do ácido láctico no sangue dos homens do grupo experimental mostrou-se inferior ao valor anterior à alimentação balanceada. O teste de capacidade aeróbica mostrou que o tempo de esgotamento dos atletas masculinos no grupo experimental mostrou-se significativamente diferente antes e depois da administração de alimentação balanceada. Após a administração de alimentação balanceada, o valor do ácido láctico no sangue dos atletas masculinos no grupo experimental foi menor do que aquele antes da administração de alimentação balanceada imediatamente e nove minutos após o exercício, e o valor da frequência cardíaca dos atletas masculinos no grupo experimental foi muito menor do que o valor anterior à administração de alimentação balanceada.

RESUMEN Una alimentación balanceada es muy importante para la salud y el desempeño de los atletas en competencias, habiéndose vuelto un tema bastante debatido en el sector deportivo. En este estudio, fueron utilizados tests anaeróbicos de 30 segundos y el test de captación máxima de oxígeno para verificar la capacidad de ejercicio anaeróbico y la capacidad de ejercicio aeróbico, respectivamente. Fueron creados cuatro grupos en los dos métodos de test, y fueron determinados los índices de test funcional, el índice de recuperación de la frecuencia cardíaca y el valor de recuperación del ácido láctico en la sangre. El test de capacidad anaeróbica mostró que la potencia máxima de los atletas masculinos del grupo experimental presentaba diferencia estadística significativa antes y después de la administración de alimentación balanceada, y el índice de fatiga de los atletas del grupo experimental presentaba una tendencia descendente significativa Cinco minutos y nueve minutos después del ejercicio, el valor del ácido láctico en la sangre de los hombres del grupo experimental se mostró inferior al valor anterior a la alimentación balanceada. El test de capacidad aeróbica mostró que el tiempo de agotamiento de los atletas masculinos en el grupo experimental se mostró significativamente diferente antes y después de la administración de alimentación balanceada. Después de la administración de alimentación balanceada, el valor del ácido láctico en la sangre de los atletas masculinos en el grupo experimental fue menor que aquel antes de la administración de alimentación balanceada inmediatamente y nueve minutos después del ejercicio, y el valor de la frecuencia cardíaca de los atletas masculinos en el grupo experimental fue mucho menor que el valor anterior a la administración de alimentación balanceada.

Using PacBio sequencing to investigate the effects of treatment with lactic acid bacteria or antibiotics on cow endometritis

BACKGROUND: Endometritis is the most common disease of dairy cows and traditionally treated with antibiotics. Lactic acid bacteria can inhibit the growth of pathogens and also have potential for treatment of endometritis. Using PacBio single-molecule real-time sequencing technology, we sequenced the fulllength l6S rRNA of the microbiota in uterine mucus samples from 31 cows with endometritis, treated with lactic acid bacteria (experimental [E] group) and antibiotics (control [C] group) separately. Microbiota profiles taken before and after treatment were compared. RESULTS: After both treatments, bacterial species richness was significantly higher than before, but there was no significant difference in bacterial diversity. Abundance of some bacteria increased after both lactic acid bacteria and antibiotic treatment: Lactobacillus helveticus, Lactococcus lactis, Lactococcus raffinolactis, Pseudomonas alcaligenes and Pseudomonas veronii. The bacterial species that significantly decreased in abundance varied depending on whether the cows had been treated with lactic acid bacteria or antibiotics. Abundance of Staphylococcus equorum and Treponema brennaborense increased after lactic acid bacteria treatment but decreased after antibiotic treatment. According to COG-based functional metagenomic predictions, 384 functional proteins were significantly differently expressed after treatment. E and C group protein expression pathways were significantly higher than before treatment (p < 0.05). CONCLUSIONS: In this study, we found that lactic acid bacteria could cure endometritis and restore a normal physiological state, while avoiding the disadvantages of antibiotic treatment, such as the reductions in abundance of beneficial microbiota. This suggests that lactic acid bacteria treatment has potential as an alternative to antibiotics in the treatment of endometritis in cattle.

Uso de los gases arteriales en trauma / Blood gas use in trauma

El trauma continúa siendo una de las primeras causas de muertes prevenibles en nuestro país. A pesar de la disminución del trauma militar, la incidencia que abarca todas las formas de trauma continúa siendo alta y congestiona los servicios de urgencias, por eso es fundamental el adecuado enfoque inicial para disminuir la mortalidad. Tradicionalmente, se han utilizado marcadores, como los signos vitales, para la identificación del choque hemorrágico, pero estudios observacionales de gran escala han demostrado cómo estos muchas veces no logran identificar a los pacientes con choque hemorrágico, haciendo necesario usar marcadores más objetivos, como los gases arteriales, con la medición del lactato y el déficit de base, que según literatura tienen mejor predicción de mortalidad, identificación temprana del choque y activación temprana de protocolos transfusionales

Trauma continues to be one of the lead causes of preventable deaths in our country. Even with the decrease of military trauma, the incidence of trauma remains high, dominating the emergency room. The initial approach is fundamental to decrease mortality. Traditionally, vital signs have been used as a marker of hemorrhage shock, but observational studies of high volumes of patients showed how those often can't identify patients with hemorrhage shock, which makes necessary more objective markers such as the blood gas with the measure of lactate and base deficit, which has proven useful in the prediction of mortality, early identification of shock and a faster activation of transfusion protocols

Lactate: a biological marker of physical activity in colombian weightlifting athletes / Lactato: um marcador biológico da atividade física em atletas colombianos de halterofilismo / Lactato: un marcador biológico de la actividad física en atletas colombianos de halterofilia

ABSTRACT Introduction Blood biomarkers are measurable metabolic products that allow objective monitoring of the training process, and their analysis provides an opportunity to improve athletic performance. Objective To evaluate blood lactate concentrations in a group of the Valle League weightlifting athletes as a tool to determine the effects of training and its direct relationship to performance during competition. Methods This is an observational cross-sectional study. Lactate levels of 32 weightlifting athletes belonging to the Valle Weightlifting League were evaluated. Blood samples were taken from the ear lobe to quantify the lactate concentration, using a Scout Lactate analyzer. Samples were taken before and after a high intensity training section consisting of four maximum repetition (MR) sports gestures, in which 5 series and 15 repetitions were performed for each sports gesture, with a rest period of 40 seconds between each exercise. The software program SPSS, version 25, was used to determine the lactate concentrations. Results An average lactate concentration 22.46 mg/dL was obtained for the athletes at rest, and an average of 98.30 mg/dL in the final lactate concentration, after high intensity exercise. Significant differences were found between the initial and final lactate concentrations. Conclusion Lactate concentration increases with physical activity; it varies from one individual to another; and it can be used as a biomarker of intensity of physical activity in the field of sports. Level of evidence; II type of study: Prognostic Studies Investigating the Effect of a Patient Characteristic on a disease outcome.

RESUMO Introdução Os biomarcadores sanguíneos são produtos metabólicos mensuráveis que permitem a monitorização objetiva do processo de treino, e sua análise é uma oportunidade para melhorar o desempenho atlético. Objetivos Avaliar as concentrações de lactato no sangue de um grupo de atletas de halterofilismo da Liga Valle como ferramenta para determinar os efeitos do treino e sua relação direta com o desempenho durante a competição. Métodos Este é um estudo transversal e observacional. Foram avaliados os níveis de lactato em 32 atletas da Liga de Halterofilismo Valle. A amostra de sangue foi retirada do lóbulo da orelha com o intuito de quantificar a concentração de lactato com o analisador Scout Lactate. As amostras foram colhidas antes e depois de uma seção de treino de alta intensidade, que consistiu em quatro gestos esportivos de repetição máxima (RM), nos quais foram realizadas 5 séries e 15 repetições para cada gesto esportivo, com um período de repouso de 40 segundos entre cada exercício. O software SPSS, versão 25 foi usado para determinar as concentrações de lactato. Resultados A concentração média de lactato nos atletas em repouso foi 22,46 mg/dl e a concentração média final foi de 98,30 mg/dl depois de exercício de alta intensidade. Foram encontradas diferenças significativas ao comparar a concentração inicial com a concentração final de lactato. Conclusões A concentração de lactato aumenta com a realização da atividade física, é variável de um indivíduo para outro e pode ser usada como biomarcador de intensidade da atividade física na área dos esportes. Nível de Evidência II; Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

RESUMEN Introducción Los biomarcadores sanguíneos son productos metabólicos mensurables que permiten la monitorización objetiva del proceso de entrenamiento, y su análisis es una oportunidad para mejorar el desempeño atlético. Objetivos Evaluar las concentraciones de lactato en la sangre de un grupo de atletas de halterofilia de la Liga Valle como herramienta para determinar los efectos del entrenamiento y su relación directa con el desempeño durante la competición. Métodos Este es un estudio transversal y observacional. Fueron evaluados los niveles de lactato en 32 atletas de la Liga de Halterofilia Valle. La muestra de sangre fue retirada del lóbulo de la oreja con el objetivo de cuantificar la concentración de lactato con el analizador Scout Lactate. Las muestras fueron tomadas antes y después de una sección de entrenamiento de alta intensidad, que consistió en cuatro gestos deportivos de repetición máxima (RM), en los que se realizaron 5 series y 15 repeticiones para cada gesto deportivo, con un período de descanso de 40 segundos entre cada ejercicio. El software SPSS versión 25 fue usado para determinar las concentraciones de lactato. Resultados La concentración promedio de lactato en los atletas en reposo fue 22,46 mg/dl y la concentración promedio final fue de 98,30 mg/dl después del ejercicio de alta intensidad. Fueron encontradas diferencias significativas al comparar la concentración inicial con la concentración final de lactato. Conclusiones La concentración de lactato aumenta con la realización de actividad física, es variable de un individuo para otro, y puede ser usada como biomarcador de intensidad de la actividad física en el área de los deportes. Nivel de evidencia II; Estudios pronósticos - Investigación del efecto de característica de un paciente sobre el resultado de la enfermedad

Effects of blood flow restriction in large and small muscle groups / Efeitos da restrição do fluxo sanguíneo em grupamentos musculares grandes e pequenos / Efectos de la restricción del flujo sanguíneo en grupos musculares grandes y pequeños

ABSTRACT Introduction It is known that strength training brings improvements in health and sports performance by causing muscle hypertrophy and increased strength, as well as modifying some hemodynamic and physiological factors. Several strength training methodologies have been developed, one of which is vascular occlusion. There are few studies with large muscle groups due to poor adherence to the training style and the fact that vascular occlusion of large muscle groups is more difficult. Objective To verify and compare the hemodynamic effects of exercise with and without vascular occlusion in different muscle groups. Methods Quantitative crossover study, with cross-sectional and field procedures. The sample consisted of 10 physically active healthy male and female subjects between 18 and 30 years of age. With the cross-over design, all the volunteers participated in 3 groups: intervention with vascular occlusion, intervention without vascular occlusion and the control group. Results Overall, lactate and cholesterol remained elevated after 15 minutes of recovery and blood glucose and blood pressure did not vary among the groups. Conclusion Vascular occlusion training is an effective method for manipulating hemodynamic variables. Evidence level II; Clinical study.

RESUMO Introdução Sabe-se que o treino de força traz melhorias para a saúde e o desempenho esportivo, por ocasionar hipertrofia muscular e aumento de força, além de modificar alguns fatores hemodinâmicos e fisiológicos. Foram desenvolvidos vários métodos de treinamento de força, entre eles, a oclusão vascular. Porém, existem poucos estudos com grandes grupamentos musculares, devido à pouca adesão ao estilo de treino e ao fato de a oclusão vascular de grandes grupos musculares ser mais difícil. Objetivo Verificar e comparar os efeitos hemodinâmicos do exercício com e sem oclusão vascular em diferentes grupamentos musculares. Métodos Estudo quantitativo, cruzado, com procedimentos transversais e de campo. A amostra foi composta por 10 indivíduos saudáveis e fisicamente ativos do sexo masculino e feminino, na faixa etária de 18 a 30 anos. Com o desenho cruzado, todos os voluntários participaram de 3 grupos: intervenção com oclusão vascular, intervenção sem oclusão vascular e grupo controle. Resultados De forma geral, entre grupos, o lactato e o colesterol se mantiveram elevados depois de 15 minutos de recuperação, a glicemia e as pressões arteriais não variaram. Conclusão O treinamento com oclusão vascular é um método eficaz para manipular as variáveis hemodinâmicas. Nível de evidência II; Estudo clínico.

RESUMEN Introducción Se sabe que el entrenamiento de fuerza trae mejoras para la salud y el desempeño deportivo, por causar hipertrofia muscular y aumento de fuerza, además de modificar algunos factores hemodinámicos y fisiológicos. Fueron desarrollados varios métodos de entrenamiento de fuerza, entre ellos, la oclusión vascular. Sin embargo, existen pocos estudios con grandes grupos musculares, debido a la poca adhesión al estilo de entrenamiento y al hecho de que la oclusión vascular de grandes grupos musculares grandes es más difícil. Objetivo Verificar y comparar los efectos hemodinámicos del ejercicio con y sin oclusión vascular en diferentes grupos musculares. Métodos Estudio cuantitativo, cruzado, con procedimientos transversales y de campo. La muestra fue compuesta por 10 individuos saludables y físicamente activos del sexo masculino y femenino, en el grupo de edad de 18 a 30 años. Con el diseño cruzado, todos los voluntarios participaron en 3 grupos: intervención con oclusión vascular, intervención sin oclusión vascular y grupo control. Resultados De forma general, entre los grupos, el lactato y el colesterol se mantuvieron elevados después de 15 minutos de recuperación, la glucemia y las presiones arteriales no variaron. Conclusión El entrenamiento de oclusión vascular es un método eficaz para manipular las variables hemodinámicas. Nivel de evidencia II; Estudio clínico.

Cardioprotective effect of eicosapentaenoic acid during ischemia and reperfusion / Efeito cardioprotetor do ácido eicosapentaenóico durante a isquemia e reperfusão

Objective: In this work, rats isolated hearts were infused EPA before the ischemia period and during reperfusion for available get well in parameter relatives to redox reactions. Methods: The effect of EPA was tested on isolated hearts induced to ischemia and reperfusion, treatment occurred at different times (ischemia or reperfusion). Antioxidant capacity against peroxyl radicals, glutathione cysteine ligase activity, glutathione concentration, lactate dehydrogenase, and creatine kinase concentration was analyzed. Results: Hearts treated with eicosapentaenoic acid had the minor generation of species reactive oxygen and lipid damage after reperfusion. The GSH concentration was higher when the hearts were treated with eicosapentaenoic acid in the period of reperfusion. Conclusion: In conclusion, this study demonstrates that the dose of EPA (20µM) used before ischemia can act as a cardioprotective antioxidant molecule, prevented damage heart from ischemic and reperfusion injury

Objetivo: Neste trabalho, corações isolados de ratos foram infundidos com EPA antes do período de isquemia e durante a reperfusão para obtenção de melhora em parâmetros relativos às reações redox. Métodos: O efeito do EPA foi testado em corações isolados induzidos a isquemia e reperfusão, o tratamento ocorreu em diferentes momentos (isquemia ou reperfusão). A capacidade antioxidante contra os radicais peroxil, atividade da glutationa cisteína ligase, concentração de glutationa, lactato desidrogenase e concentração de creatina quinase foi analisada. Resultados: Corações tratados com ácido eicosapentaenóico tiveram a menor geração de espécies reativas de oxigênio e danos lipídicos após a reperfusão. A concentração de GSH foi maior quando os corações foram tratados com ácido eicosapentaenóico no período de reperfusão. Conclusão: Em conclusão, este estudo demonstra que a dose de EPA (20µM) utilizada antes da isquemia pode atuar como uma molécula antioxidante cardioprotetora, prevenindo danos ao coração por isquemia e lesão de reperfusão.

Lactate can be a marker of metabolic syndrome in severe obesity? / Lactato pode ser marcador da síndrome metabólica na obesidade grave?

ABSTRACT Background: In the last decades, numerous studies have confirmed the importance of lactate - by-product to the nutrient signal of the intracellular redox state - to regulatory functions in energy metabolism. Aim: To evaluate changes in blood lactate in patients with severe obesity and its correlation with body composition and metabolic profile. Methods: Twenty-four people with severe obesity (BMI=40 kg/m2) were evaluated in a prospective case-control study before and six months after Roux-in-Y gastric bypass. The blood lactate, total cholesterol, and fractions, C-reactive protein and HOMA-IR were analyzed after 12 h fasting. Body mass composition was evaluated by bioelectrical impedance and respiratory quotient was measured by indirect calorimetry. Results: The initial lactate level was 2.5±1.1 mmol/l and returned to normal level (1.9±3.6 mmol/l, p=0.0018) after surgery. This reduction was positively correlated with a decrease in BMI (p=0.0001), % free fat mass (p=0,001), % fat mass (p=0.001) and HOMA-IR (p=0.01). There was normalization of lactatemia in 70% of patients. There was no correlation between lactatemia and C-reactive protein. Conclusions: There was a significant improvement of metabolic parameters, normalization of blood lactate, fat mass loss, although these individuals remained with a high BMI.

RESUMO Racional: Nas últimas décadas, inúmeros estudos confirmam a importância do lactato - subproduto ao sinal de nutrientes do estado redox intracelular - às funções reguladoras do metabolismo energético. Objetivo: Avaliar alterações no lactato sanguíneo em pacientes com obesidade grave e sua correlação com a composição corporal e o perfil metabólico. Métodos: Vinte e quatro pacientes com obesidade grave (IMC=40 kg/m2) foram avaliadas em um estudo prospectivo antes e após seis meses do bypass gástrico em Y-de-Roux. O lactato sanguíneo, colesterol total e frações, proteína C-reativa e HOMA-IR foram analisados após 12h de jejum. A composição corporal foi avaliada por bioimpedância elétrica e o quociente respiratório por calorimetria indireta. Resultados: O nível inicial de lactato foi de 2,5±1,1 mmol/l e retornou ao nível normal após a operação (1,9±3,6 mmol/l, p=0,0018). Essa redução foi correlacionada positivamente com a diminuição do IMC (p=0,0001), % de massa livre de gordura (p=0,001) e % de massa de gordura (p=0,001) e HOMA-IR (p=0,01). Houve normalização da lactatemia em 70% dos pacientes. Não houve correlação entre lactatemia e proteína C-reativa. Conclusões: Houve melhora significativa dos parâmetros metabólicos e normalização da lactatemia, perda de massa gorda, embora esses indivíduos permanecessem com IMC elevado.

Application of chronological lifespan in the construction of Escherichia coli cell factories / 生物工程学报

Microbial cell factories capable of producing valuable chemicals from renewable feedstocks provide a promising alternative towards sustainability. However, environmental stress remarkably affects the performance of microbial cell factories. By extending the chronological lifespan of microbial cells, the performance of microbial cell factories can be greatly improved. Firstly, an evaluation system for chronological lifespan and semi-chronological lifespan was established based on the changes in survival rates. Secondly, the addition of anti-aging drugs such as cysteine, carnosine, aminoguanidine and glucosamine increased the chronological lifespan of E. coli by 80%, 80%, 50% and 120%, respectively. Finally, we demonstrated that extending the chronological lifespan of E. coli increased the yield of metabolites produced by E. coli cell factories with endogenous (lactic acid and pyruvic acid) or exogenous (malic acid) metabolic pathway by 30.0%, 25.0%, and 27.0%, respectively. The strategy of extending chronological lifespan of E. coli provides a potential approach for enhancing the performance of microbial cell factories.